bluuebunny/crossref_metadata_2025 huggingface dataset:
Home mechanical ventilation for children with severe neurological impairment: Parents' perspectives on clinician counselling
Authors: Bogetz Jori F. , Munjapara Vasu , Henderson Carrie M. , Raisanen Jessica C. , Jabre Nicholas A. , Shipman Kelly J. , Wilfond Benjamin S. , Boss Renee D.
Published: January 2022

Aim

To retrospectively explore the perspectives of parents of children with severe neurological impairment (SNI), such as those with severe cerebral palsy, epilepsy syndromes, and structural brain differences, on clinician counseling regarding home mechanical ventilation (HMV).

Method

Inductive thematic analysis was performed on data from telephone interviews with parents who chose for and against HMV for their child with SNI at three academic children’s hospitals across the USA.

Results

Twenty‐six parents/legal guardians of 24 children were interviewed. Fourteen children had static encephalopathy, 11 received HMV, and 20 were alive at the time of parent interviews. Themes included how HMV related to the child’s prognosis, risk of death, and integration with goals of care. Although clinicians voiced uncertainty about how HMV would impact their child, parents felt this was coupled with prescriptive/intimidating examples about the child’s end of life and judgments about the child’s quality of life.

Interpretation

While prognositc uncertainty exists, this study suggests that parents of children with SNI seek clinician counseling about HMV that considers their goals of care and views on their child’s quality of life.
Clinical practice guidelines for management of hyperglycaemia in adults with diabetic kidney disease
Authors: Karalliedde Janaka , Winocour Peter , Chowdhury Tahseen A. , De Parijat , Frankel Andrew H. , Montero Rosa M. , Pokrajac Ana , Banerjee Debasish , Dasgupta Indranil , Fogarty Damian , Sharif Adnan , Wahba Mona , Mark Patrick B. , Zac‐Varghese Sagen , Patel Dipesh C. , Bain Stephen C.
Published: January 2022

A significant percentage of people with diabetes develop chronic kidney disease and diabetes is also a leading cause of end‐stage kidney disease (ESKD). The term diabetic kidney disease (DKD) includes both diabetic nephropathy (DN) and diabetes mellitus and chronic kidney disease (DM CKD). DKD is associated with high morbidity and mortality, which are predominantly related to cardiovascular disease.

Hyperglycaemia is a modifiable risk factor for cardiovascular complications and progression of DKD. Recent clinical trials of people with DKD have demonstrated improvement in clinical outcomes with sodium glucose co‐transporter‐2 (SGLT‐2) inhibitors. SGLT‐2 inhibitors have significantly reduced progression of DKD and onset of ESKD and these reno‐protective effects are independent of glucose lowering. At the time of this update Canagliflozin and Dapagliflozin have been approved for delaying the progression of DKD.

The Association of British Clinical Diabetologists (ABCD) and UK Kidney Association (UKKA) Diabetic Kidney Disease Clinical Speciality Group have undertaken a literature review and critical appraisal of the available evidence to inform clinical practice guidelines for management of hyperglycaemia in adults with DKD. This 2021 guidance is for the variety of clinicians who treat people with DKD, including GPs and specialists in diabetes, cardiology and nephrology.
Imaging of equine septic discospondylitis using MRI, CT and post‐mortem radiographs
Authors: Geller Morgan , Slater Robert , Graham‐Williams Elizabeth , Wolf Tatiana , Spriet Mathieu , Berryhill Emily , Skipper Lauren , Aleman Monica
Published: January 2022

This report describes a case of septic discospondylitis in an 11‐year‐old American Miniature stallion. Key imaging features are described here and include Fast Spin Echo T2/STIR hyperintensity on MRI of the intervertebral disc space and surrounding soft tissues as well as vertebral endplate destruction. Spinal cord deformation was seen concurrently and is considered likely secondary to either associated inflammatory granulation tissue or disc herniation. These findings most likely explain the apparent cervical pain and spinal ataxia grade 2/5 due to cervical spinal cord disease in this case.
SLDCNet: Skin lesion detection and classification using full resolution convolutional network‐based deep learning CNN with transfer learning
Authors: Varma P. Bharat Siva , Paturu Siddartha , Mishra Suman , Rao B. Srinivasa , Kumar Pala Mahesh , Krishna Namani Vamshi
Published: January 2022

Background

Skin cancer is one of the life threating diseases in the world. So, millions of lives can be saved by early detection of skin cancer. In addition, automating the computer‐aided system of skin lesion detection and classification (SLDC) will assist the medical practitioners to ensure more efficacious treatment of skin lesion disease.

Material and Method

In this article, a hybrid preprocessing‐based transfer learning model for SLDC is proposed, which is named as SLDCNet. Initially, the hybrid Gaussian filter (HGF) with connected component label (CCL) based fast march inpainting procedure is used for hair removal and denoising of skin lesions. Next, full resolution convolutional networks (FrCN) based segmentation method is adapted for detecting the cancer region. Then, feature extraction is performed using deep residual learning and finally, transfer learning mechanism is applied for classification of eight skin lesions.

Results

The extensive simulation results shows that proposed SLDCNet resulted in a classification accuracy of 99.92%, sensitivity of 99%, and specificity of 99.36%, respectively.

Conclusion

From the obtained results, it is proven that proposed SLDCNet provides better performance as compared to state‐of‐art SLDC approaches, and even the standard ISIC‐2019 public challenge.
PP1A prevents ROS‐induced pyroptosis by inhibiting MAPK/caspase‐3 in mouse adipose tissue
Authors: Chen Yizhe , Che Meng , Li Chaowei , Li Yizhou , Zhang Tiantian , Li Xinjian , Sun Chao
Published: January 2022

Pyroptosis is a type of programmed cell death triggered by a variety of exogenous stimuli, playing important roles in the development of cells. Recent studies have shown that pyroptosis also occurs in human and mouse adipocytes. The serine/threonine protein phosphatase 1 catalytic subunit α (PP1A) is located in the nucleus and functions in the regulation of cell development, glucose metabolism and protein synthesis. PP1A can also target important proteins in the process of apoptosis. However, it is still unclear whether PP1A participates in the regulation of pyroptosis in mouse adipocytes. In the present study, we investigated the function of PP1A in reactive oxygen species‐induced pyroptosis and the related mechanism in mouse adipose tissue. Our results demonstrated that PP1A suppressed pyroptosis in adipocytes by inhibiting the reactive oxygen species/mitogen‐activated protein kinase/caspase‐3 signaling pathway and promoting M2 macrophage polarization. This experiment provides a theoretical basis for understanding the regulatory function and mechanism of PP1A in pyroptosis caused by oxidative stress in adipocytes.
Association of early bevacizumab interruption with efficacy of atezolizumab plus bevacizumab for advanced hepatocellular carcinoma: A landmark analysis
Authors: Hatanaka Takeshi , Hiraoka Atsushi , Tada Toshifumi , Hirooka Masashi , Kariyama Kazuya , Tani Joji , Atsukawa Masanori , Takaguchi Koichi , Itobayashi Ei , Fukunishi Shinya , Tsuji Kunihiko , Ishikawa Toru , Tajiri Kazuto , Ochi Hironori , Yasuda Satoshi , Toyoda Hidenori , Ogawa Chikara , Nishimura Takashi , Kakizaki Satoru , Shimada Noritomo , Kawata Kazuhito , Tanaka Takaaki , Ohama Hideko , Nouso Kazuhiro , Morishita Asahiro , Tsutsui Akemi , Nagano Takuya , Itokawa Norio , Okubo Tomomi , Arai Taeang , Imai Michitaka , Naganuma Atsushi , Koizumi Yohei , Nakamura Shinichiro , Joko Kouji , Iijima Hiroko , Hiasa Yoichi , Kumada Takashi ,   Real‐life Practice Experts for HCC (RELPEC) Study Group,   HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
Published: January 2022

Aim

The present study focused on the association of early bevacizumab (Bev) interruption with the clinical outcome of atezolizumab plus bevacizumab.

Methods

This retrospective study included 239 patients with advanced hepatocellular carcinoma receiving atezolizumab/Bev from September 2020 to June 2021 at 16 different institutions in Japan. We conducted a 9‐week landmark analysis to investigate the association of Bev interruption due to adverse events with the therapeutic efficacy.

Results

The median age was 73.0 (68.0–80.0) years old, with 195 (81.6%) men. The objective response rate was significantly higher in patients without Bev interruption than in those with it (34.5% vs. 17.3%, p = 0.038). The median progression‐free survival (PFS) was 6.5 months (95% confidence interval [CI] 4.5–9.7) and 9.0 months (95% CI 7.1–not applicable) in patients with and without Bev interruption, respectively, with statistical significance (p = 0.021). The 12‐month overall survival (OS) rates in patients with and without Bev interruption were 49.4% (CI 27.7%–67.9%) and 82.2% (95% CI 70.3%–89.6%), respectively, showing a significant difference (p = 0.004). The presence of Bev interruption was a significant factor associated with the PFS (p = 0.021) and OS (p = 0.008). A multivariate analysis showed that modified albumin–bilirubin 2b (p < 0.001) and later‐line treatment (p = 0.018) were unfavorable factors associated with Bev interruption. Liver injury, appetite loss, protein urea, and ascites or hepatic edema were more frequently found in patients with Bev interruption than in those without it.

Conclusions

Early Bev interruption was an unfavorable factor associated with the PFS and OS. Good liver function and treatment settings may be associated with maintaining Bev treatment.
Socio‐economic inequality in reported dental self‐care behaviour among Iranian households: A national pooled study
Authors: Kazemi‐Karyani Ali , Yahyavi Dizaj Jafar , Khoramrooz Maryam , Soltani Shahin , Soofi Moslem , Irandoust Kamran , Ramezani‐Doroh Vajihe
Published: January 2022

Background

Setting out effective prevention strategies in dental diseases needs recognition related factors of the prevention behaviours and targeting the most disadvantaged groups in the term of dental hygiene. This study aimed to investigate socio‐economic inequality in the dental self‐care status (DSS) of Iranian households and decompose the measured inequality into its contributors.

Method

In this cross‐sectional study, pooled data were extracted from Households Income and Expenditure Surveys (HIESs) conducted in Iran from 2012 to 2017. The index of socio‐economic status (SES) for each household was constructed using principal components analysis (PCA). We used Wagstaff normalized concentration index as a measure of socio‐economic inequality in dental self‐care. Decomposition analysis was applied to determine the main factors contributed to the measured inequality.

Results

The prevalence of dental self‐care in the whole population was 40.56%. The total concentration index was 0.271 (CI: 0.266, 0.275). The results of decomposition analysis for the measured inequality showed that SES, was the highest positive contributors (90.19%) followed by sex of household's head (12.15%), place of residence (11.79%) and education level of household‘s head (11.71%). Furthermore, the province of residence had the highest negative contribution (−11.37) to the inequality.

Conclusion

The findings of this study showed that a huge portion of the observed inequality was explained by SES that might give us a policy recommendation: There is room for improving dental health and reducing inequality in dental self‐care by paying more attention to SES‐disadvantaged households.
Present status and future directions—Vital pulp treatment and pulp preservation strategies
Authors: Duncan Henry F.
Published: January 2022

Therapeutic strategies focussed on the pulp preservation, are important when managing vital teeth with deep caries and an exposed pulp. These vital pulp treatments (VPTs); however, are not new, with indirect and direct pulp capping procedures being described as a therapy for carious teeth for over a century. As a result of unpredictable outcomes, the traditional indications for VPT particularly when the pulp was exposed were limited to the treatment of immature teeth with incomplete root formation. Over the last 20 years, the advent of regenerative endodontics and the promotion of biologically based therapies aimed at reducing intervention have reinvigorated VPT with new waves of basic science and clinical research indicating a role for VPT not only in mature cariously affected teeth, but also in teeth with signs and symptoms indicative of irreversible pulpitis. Driven by new materials such as hydraulic calcium silicate cements, a better understanding of pulpal immunity and biology as well and improved tissue handling, VPT has been at the forefront of treatment recommendations made by global Cariology and Endodontic organizations. Care must be exercised, however, as key gaps in scientific knowledge remain alongside severe limitations in educational dissemination amongst dentists. Although research has highlighted that carious injury to the dentine–pulp complex stimulates a wide range of responses and that the interaction between infection, inflammation and repair will eventually impact on the outcome of pulpitis, our ability to accurately and objectively diagnose the true inflammatory state of the pulp remains poor. An overreliance on symptoms leaves clinicians with subjective, crude diagnostic tools by which to inform treatment planning and decision‐making, which results in large variations in the treatments offered to patients. Not only is there an urgent need to develop preoperative and intraoperative diagnostic tools, but there is also a paucity of the high‐quality comparative evidence required to answer the most important questions and justify treatment options. The aim of this review was to consider the current status of VPT and to discuss the principle problems that are hindering clinical acceptance of these techniques. Potential solutions and opportunities are offered to suggest ways that VPT may become a more consistently prescribed evidenced‐based treatment in dental practice.
Advances in dermatology in sub‐Saharan Africa in the past 20 years from workshops to the birth of the African Society of Dermatology and Venereology
Authors: Verschoore Michèle , Dlova Ncoza
Published: January 2022

Background

Highly pigmented African skin and hair have distinct characteristics because of their unique physiology and structure. Twenty years ago, despite an increasing number of dermatology specialists in some African countries, there remained a paucity of collaborative research and workshops on African hair and skin, and there was a need for an inclusive African society to represent dermatologists from all English and French‐speaking countries in sub‐Saharan Africa.

Methods

We documented significant research advances between 2000 and 2021 on African hair and skin physiology, as well as clinical dermatology, in sub‐Saharan Africa.

Results

The main advances documented include the launch of annual African hair and skin workshops in 2004, the introduction of African research grants and the Africaderm web platform in 2013, and the registration of the African Society of Dermatology and Venereology (ASDV) in 2015, which led to the inaugural scientific meeting of ASDV in 2016.

Conclusion

There have been significant research advances in African hair and skin over the past 20 years. As skin physiology and skin conditions are similar across sub‐Saharan Africa, scientific and clinical partnerships between companies, academia, and public health care sectors have played a key role in translating new scientific findings on African hair and skin to ensure knowledge is shared. This information has helped educate African specialists, health care workers, and consumers, with a particular focus on the preventable nature of certain dermatoses like skin bleaching‐related complications and traction alopecia.
Efficacy and safety of avanafil as compared with sildenafil in the treatment of erectile dysfunction: A randomized, double blind, multicenter clinical trial
Authors: Kumar Manish , Pathade Amey D , Gupta S VijayaBhaskara , Goyal Sanjay , Rath Debadarshi , Thakre Manish , Sanmukhani Jayesh , Mittal Ravindra
Published: January 2022

Objective

To compare the efficacy and safety of avanafil as compared with sildenafil in the management of patients with erectile dysfunction.

Methods

It was a prospective, randomized, double‐blind, two‐arm, active‐controlled, parallel, multicenter, non‐inferiority clinical study carried out in patients with erectile dysfunction for at least 3 months and International Index of Erectile Function – Erectile Function domain score of <26 at enrolment.

Results

A total of 220 patients were randomized to receive either avanafil tablets 100 mg or sildenafil tablets 50 mg in 1:1 ratio. After 4 weeks of treatment, 40.0% of patients in the avanafil group and 45.6% of patients in the sildenafil group required dose escalation to a high dose (avanafil 200 mg/sildenafil 100 mg). The difference in the mean change of International Index of Erectile Function – Erectile Function score from baseline in the two groups increased from week 4 (1.1, 95% confidence interval −0.2 to 2.5) to week 8 (1.4, 95% confidence interval 0.1–2.7) and week 12 (2.1, 95% confidence interval 0.8–3.5), showing non‐inferiority at week 4, and superiority at week 8 and week 12. Avanafil showed a faster onset of action as shown by a significantly better response to modified Sexual Encounter Profile 1 in the avanafil group (84.8%) as compared with that in the sildenafil group (28.2%; P < 0.001). Both avanafil and sildenafil were well tolerated by all the patients in the study; the most common adverse event reported during the study was headache in both the groups.

Conclusion

Avanafil is superior to sildenafil in improving the International Index of Erectile Function – Erectile Function domain score at the end of 12 weeks of treatment with the added advantage of faster onset of action.
Multi‐centre prospective randomised controlled clinical trial to evaluate a bioactive split thickness skin allograft vs standard of care in the treatment of diabetic foot ulcers
Authors: Armstrong David G. , Galiano Robert D. , Orgill Dennis P. , Glat Paul M. , Carter Marissa J. , Di Domenico Lawrence A. , Reyzelman Alexander M. , Zelen Charles M.
Published: January 2022

Diabetic foot ulcers (DFUs) pose a significant risk for infection and limb loss. Advanced wound therapies including human skin allografts have shown promise in resolving these challenging wounds. The primary objective of this randomised, prospective study was to compare the response of 100 subjects with non‐healing DFUs of which 50 were treated with a cryopreserved bioactive split thickness skin allograft (BSA) (TheraSkin; Misonix,Inc., Farmingdale, NY) compared with 50 subjects treated with standard of care (SOC, collagen alginate dressing) at 12 weeks. Both groups received standardised care that included glucose monitoring, weekly debridement's as appropriate, and an offloading device. The primary endpoint was proportion of full‐thickness wounds healed at 12 weeks, with secondary endpoints including differences in percent area reduction (PAR) at 12 weeks, changes in Semmes‐Weinstein monofilament score, VAS pain, and w‐QoL. The result illustrated in the intent‐to‐treat analysis at 12 weeks showed that 76% (38/50) of the BSA‐treated DFUs healed compared with 36% (18/50) treated with SOC alone (adjusted P = .00056). Mean PAR at 12 weeks was 77.8% in the BSA group compared with 49.6% in the SOC group (adjusted P = .0019). In conclusion, adding BSA to SOC appeared to significantly improve wound healing with a lower incidence of adverse events related to treatment compared with SOC alone.
The association between estimated glomerular filtration rate and prognosis in patients with diabetic foot osteomyelitis
Authors: Zhang Jinghang , Chen Dong , Li Xuemei , Ding Min , Xu Jun , Wang Meijun , Chang Bai
Published: January 2022

We aimed to explore the association between estimated glomerular filtration rate (eGFR) and prognosis in patients with diabetic foot osteomyelitis (DFO). Three hundred twenty‐one DFO inpatients were enrolled and classified into four groups according to the eGFRs as follows: normal (≥90), mildly reduced (60‐89), moderately reduced (30‐59) and severely reduced (<30). These patients were followed‐up for 6 months to observe the outcomes, including ulcer healing and amputation. The associations between eGFR and the outcomes were analysed by univariate and multivariate logistic regression models. Compared with patients with normal eGFR, patients with severely reduced eGFR group had higher risk of healing failure (OR = 4.72, 95% CI: 1.44‐15.48), total amputation (OR = 4.50, 95% CI: 1.18‐17.13) and minor amputation (OR = 4.05, 95% CI: (1.04‐15.87). Severely reduced eGFR in patients with DFO was an independent predictor for amputation and healing failure.
Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity
Authors: Yanari Shingo , Sasaki Akira , Umemura Akira , Ishigaki Yasushi , Nikai Haruka , Nishijima Tsuguo , Sakurai Shigeru
Published: January 2022

Aims/Introduction

Obstructive sleep apnea (OSA) is among the most important obesity‐related diseases, and offers the potential for accelerated the early onset and progression of type 2 diabetes. The aim of the present study was to clarify the therapeutic effect of laparoscopic sleeve gastrectomy on OSA in severely obese Japanese patients, and to find correlations between OSA improvements and β‐cell function (BCF).

Materials and Methods

Between September 2013 and December 2019, 61 patients who underwent laparoscopic sleeve gastrectomy were enrolled. The apnea–hypopnea index (AHI) was used to diagnose OSA. The tongue area, uvula area and other parameters were measured using cone‐beam computed tomography. Regarding BCF parameters, the homeostasis model assessment of β‐cell function, insulinogenic, Matsuda and disposition indexes were used to evaluate the improvement in BCF. Improvement of OSA was defined as AHI <15.

Results

The improvement rate of OSA was 51.8% (29/56). The change in AHI was significantly correlated with the excess weight loss percentage (ρ = 0.501), changes in tongue area (ρ = 0.350) and uvula area (ρ = 0.341). Multivariate analysis showed that preoperative AHI and postoperative hemoglobin A1c were independent prognostic factors of OSA non‐improvement. The homeostasis model assessment of β‐cell function (P < 0.001), the insulinogenic index (P < 0.001) and the disposition index (P = 0.019) of patients with AHI of <15 were significantly higher than those in patients with AHI of ≥15.

Conclusions

Laparoscopic sleeve gastrectomy is a promising procedure for severely obese patients with OSA. BCF recovery was found to be significantly higher in patients with OSA improvement.
Paediatric mycosis fungoides – characteristics, management and outcomes with particular focus on the folliculotropic variant
Authors: Reiter O. , Amitay‐Laish I. , Oren‐Shabtai M. , Feinmesser M. , Ben‐Amitai D. , Hodak E.
Published: January 2022

Background

The literature on paediatric mycosis fungoides (MF) and especially its folliculotropic variant (FMF) is sparse.

Objectives

To describe the clinical manifestations, treatments, outcomes and long‐term course of paediatric MF, including FMF.

Methods

A retrospective analysis was conducted of all consecutive MF patients diagnosed at ≤18 years attending two medical centres in 1995–2015.

Results

The cohort included 71 patients, all but two of whom had early‐stage disease: hypopigmented (55%), folliculotropic (42%) and classical MF (39%), alone or in combination. The head and neck area were involved in 43% of patients with early‐stage FMF compared to 12% of the non‐FMF group (P = 0.004). There was no difference in the involvement of other body areas between the groups. Pruritus, although mild, was more often recorded among patients with early‐stage FMF compared to non‐FMF (58% vs. 29%, respectively, P = 0.02). Complete response (CR) was achieved in 60 of the 69 patients with early‐stage MF (87%) after an average of 1.8 treatment modalities. NBUVB was the most administered treatment to non‐FMF patients with CR rates of 63% vs. 29% of FMF patients (P = 0.04). Systemic/bath PUVA and UVA+NBUVB were the most administered treatments to FMF patients with CR rates of 60% vs. 81% for non‐FMF patients (P = 0.17). During a mean follow‐up of 9.2 years (range 1–24), stage progression was observed in four (6%) of the patients with early‐stage disease, two of whom (all FMF) to advanced stage.

Conclusions

Paediatric MF presents as an early‐stage disease with over‐representation of hypopigmented and FMF variants. NBUVB and UVA‐based therapies yield good response rates in non‐FMF and FMF patients, respectively. Disease course is indolent, and even on relatively long follow‐up, it has a very low progression rate from early to advanced‐stage disease, occurring in patients with FMF. We propose a treatment algorithm for paediatric MF.
Questions and health outcomes prioritization for the development of a COVID‐19 dental clinical practice guideline: A case study
Authors: Zaror Carlos , Deana Naira Figueiredo , Espinoza‐Espinoza Gerardo , Aravena‐Rivas Yanela , Muñoz‐Millán Patricia , Pineda Patricia , Burdiles Pamela , Nahuelhual Paula , Canelo‐Aybar Carlos , Alonso‐Coello Pablo
Published: January 2022

Rationale, Aims and Objectives

In the context of a pandemic, the rapid development of clinical practice guidelines (CPGs) is critical. The guideline development process includes prioritization of the guideline topic, questions and health outcomes. This case study describes the application of a new methodology to prioritize questions and rate the importance of health outcomes for a COVID‐19 dental guideline.

Methods

Panel members rated the topic and the questions' overall importance, using a 9‐point scale (1 = least important; 9 = most important). In addition, they rated six criteria if multiple questions received the same overall importance rating: common in practice, uncertainty in practice, variation in practice, new evidence available, cost consequences, not previously addressed. Panellists also rated the importance of each outcome, defined with health outcome descriptors, using a 9‐point scale and the utility of health outcomes on a visual analogue scale. The correlation between each criterion and overall question importance was tested by Spearman correlation coefficient.

Results

Of seven topics, four were rated as high priority and three were rated as important, but not of high priority. Thirty‐six percent of the questions (18/50) were rated as high priority to address in the guideline and 64% (32/50) were rated as an important question but not of high priority. Of the 11 outcomes, 72.7% were rated as critical for decision making. The mean utility rating was 0.57 (SD 0.32), with a minimum mean rating of 0.16 and a maximum of 0.76 (SD 0.23).

Conclusion

This case study demonstrated that this approach provides a rigorous and transparent methodology to conduct the prioritizations of guideline topics, questions and health outcomes.
Malaysian Society of Gastroenterology and Hepatology consensus statement on metabolic dysfunction‐associated fatty liver disease
Authors: Chan Wah‐Kheong , Tan Soek‐Siam , Chan Siew‐Pheng , Lee Yeong‐Yeh , Tee Hoi‐Poh , Mahadeva Sanjiv , Goh Khean‐Lee , Ramli Anis Safura , Mustapha Feisul , Kosai Nik Ritza , Raja Ali Raja Affendi
Published: January 2022

The Malaysian Society of Gastroenterology and Hepatology saw the need for a consensus statement on metabolic dysfunction‐associated fatty liver disease (MAFLD). The consensus panel consisted of experts in the field of gastroenterology/hepatology, endocrinology, bariatric surgery, family medicine, and public health. A modified Delphi process was used to prepare the consensus statements. The panel recognized the high and increasing prevalence of the disease and the consequent anticipated increase in liver‐related complications and mortality. Cardiovascular disease is the leading cause of mortality in MAFLD patients; therefore, cardiovascular disease risk assessment and management is important. A simple and clear liver assessment and referral pathway was agreed upon, so that patients with more severe MAFLD can be linked to gastroenterology/hepatology care, while patients with less severe MAFLD can remain in primary care or endocrinology, where they are best managed. Lifestyle intervention is the cornerstone in the management of MAFLD. The panel provided a consensus on the use of statin, angiotensin‐converting enzyme inhibitor or angiotensin receptor blocker, sodium–glucose cotransporter‐2 inhibitor, glucagon‐like peptide‐1 agonist, pioglitazone, vitamin E, and metformin, as well as recommendations on bariatric surgery, screening for gastroesophageal varices and hepatocellular carcinoma, and liver transplantation in MAFLD patients. Increasing the awareness and knowledge of the various stakeholders on MAFLD and incorporating MAFLD into existing noncommunicable disease‐related programs and activities are important steps to tackle the disease. These consensus statements will serve as a guide on MAFLD for clinicians and other stakeholders.
Updating the landmark literature for the practice of geriatrics: Notable articles from 2012–2019
Authors: Solberg Laurence M. , Sehgal Mandi , Patel Pragnesh , Akers Katherine G. , Pomputius Ariel , Schwartz Andrea Wershof , Scheiner Shellina R. , Small Alexander , Hidlebaugh Elizabeth , Johnson Theodore M. , Vaughan Camille P.
Published: January 2022

Background

Remaining current on the latest advances in the peer‐reviewed literature is a basic tenant of medical education and evidence‐based practice. We updated an important prior publication (Vaughan, et al.) identifying landmark articles in geriatric medicine by considering the influence of altmetrics and updating the list with notable articles published between 2012 and 2019.

Methods

Articles were identified by searching Web of Science and Scopus for highly cited articles clinically relevant to geriatrics or gerontology and by searching the Altmetric Explorer database for relevant articles with high altmetric scores. The results of the literature search were screened and evaluated using a bibliometric score consisting of an adjusted journal impact factor, citation count, and altmetric score.

Results

The top 12 notable articles in geriatrics were selected by a consensus panel and ranked using an expert opinion survey. This process reinforces the concept of combining subjective and objective measures to identify notable articles to be used for the education of healthcare professionals in geriatrics principles of care for older adults.

Conclusions

While our update was performed approximately 9 years after the initial identification of landmark articles, we propose that future updates are conducted at an interval of every 5 years by the governance of a national professional society.
Scutellarin potentiates the skin regenerative function of self growth colony, an optimized platelet‐rich plasma extract, in cultured keratinocytes through VEGF receptor and MAPK signaling
Authors: Guo Maggie Suisui , Gao Xiong , Hu Weihui , Wang Xiaoyang , Dong Tina Tingxia , Tsim Karl Wah Keung
Published: January 2022

Background

Migration of keratinocyte plays an essential role in wound healing. The proprietary platelet‐rich plasma from human blood, named as self‐growth colony (SGC), functions in stimulating migration of wounded keratinocytes. In addition, the growth factors, including VEGF, being enriched in SGC could account for this function. Scutellarin, an active phytochemical from root of Scutellaria barbata D. Don, has been proposed to have various pharmacological functions; however, the activity in epidermal skin cells is yet to be explored. Here, the role of scutellarin in potentiating the functionality of SGC to promote the regeneration of wounded keratinocyte was probed.

Methods

Molecular docking and ultrafiltration‐based LC‐MS were performed to verify the binding between scutellarin and VEGF, which potentiated the VEGF‐mediated functions. Scratch assay, performed on cultured keratinocytes, was to analyze the treatments of SGC and scutellarin in the process of wound healing. Western blot analysis was to confirm the involvement of signaling cascades in observed effects.

Results

We have identified the binding of scutellarin with VEGF. The binding accounted for the potentiation role of scutellarin in skin regeneration, as triggered by SGC. The co‐treatment of scutellarin and SGC onto scratched keratinocyte cultures was able to enhance the process of wound healing, that is, scutellarin showed a potentiating effect to SGC. In addition, the potentiation of scutellarin was shown to be mediated by phosphorylation of VEGF receptor‐2 (VEGFR2) and mitogen‐activated protein kinase (MAPK) signaling.

Conclusion

These findings support the application of scutellarin as an enhancing agent in potentiating the SGC‐mediated wound healing.
Experiences of Online Bullying and Offline Violence‐Related Behaviors Among a Nationally Representative Sample of US Adolescents, 2011 to 2019
Authors: Kreski Noah T. , Chen Qixuan , Olfson Mark , Cerdá Magdalena , Martins Silvia S. , Mauro Pia M. , Branas Charles C. , Rajan Sonali , Keyes Katherine M.
Published: January 2022

BACKGROUND

Being bullied online is associated with being bullied in school. However, links between online bullying and violence‐related experiences are minimally understood. We evaluated potential disparities in these associations to illuminate opportunities to reduce school‐based violence.

METHODS

We used five cohorts of Youth Risk Behavior Survey national cross‐sectional data (2011‐2019, Ntotal = 73 074). We used survey‐weighted logistic and multinomial models to examine links between online bullying and five school‐based violence‐related experiences: offline bullying, weapon carrying, avoiding school due to feeling unsafe, being threatened/injured with a weapon, and physical fighting. We examined interactions by sex, race/ethnicity, and sexual identity.

RESULTS

Being bullied online was positively associated with all offline violence‐related behaviors. Groups with stronger associations between online bullying and physical fighting, including boys, adolescents whose sexual identity was gay/lesbian or unsure, and many adolescents of color (Black, Hispanic/Latino, and Asian/Pacific Islander adolescents), had stronger associations between online bullying and either weapon carrying or avoiding school.

CONCLUSIONS

Online bullying is not an isolated harmful experience; many marginalized adolescents who experience online bullying are more likely to be targeted in school, feel unsafe, get in fights, and carry weapons. Reduction of online bullying should be prioritized as part of a comprehensive school‐based violence prevention strategy.
Efficacy and safety of alfosbuvir plus daclatasvir in Chinese patients with hepatitis C virus genotypes 1, 2, 3, and 6 infection: An open‐label, phase 2 study
Authors: Hua Rui , Kong Fei , Wen Xiaofeng , Xiong Qingfang , Chen Jiayu , Meng Chenxin , Ma Hong , Tan Youwen , Huang Yan , Jiang Yongfang , Guan Yujuan , Mao Xiaorong , Wang Jiefei , Xin Yongning , Gao Hainv , Xu Bin , Li Cheng , Wu Qiong , Zhang Xian , Wang Zhiqiang , Zhao Liwen , Zhang Yuexin , Li Guangming , Niu Junqi
Published: January 2022

Alfosbuvir is a novel potent HCV NS5B polymerase inhibitor in development for the treatment of chronic HCV infection. Our previous studies indicated that alfosbuvir monotherapy was well‐tolerated and druggable in healthy subjects and HCV‐infected patients. Here, we evaluate the efficacy and safety of alfosbuvir in combination with daclatasvir in Chinese patients with HCV genotype 1, 2, 3 or 6. In this open‐label study, patients with chronic HCV infection were randomly assigned with a 1:1:1 ratio to receive 12 weeks of daclatasvir 60 mg plus alfosbuvir at a dose of 400, 600 or 800 mg (Cohort A, B or C) daily. Randomization was stratified by HCV genotype and the presence or absence of cirrhosis at screening. The primary endpoint was a sustained virologic response 12 weeks after the end of treatment (SVR12). A total of 124 patients were enrolled in the study, all of whom were available for post‐treatment week 12 assessments. SVR12 was achieved in 92.7% (38/41), 95.2% (40/42) and 100% (41/41) of patients in Cohort A, B and C respectively. The most common adverse events were hepatic steatosis, upper respiratory tract infection, hypercholesterolaemia, hypertriglyceridaemia, blood bilirubin increased, and total bile acids increased. There were no discontinuations due to adverse events, and no treatment‐related serious adverse events were reported. Once‐daily oral administration of alfosbuvir plus daclatasvir were highly effective and safe in Chinese patients infected with HCV genotype 1, 2, 3 or 6, suggesting this regimen could be a promising drug candidate for HCV treatment irrespective of genotype.

(ClinicalTrials.gov number, NCT04070235).
Freeflow: The novel portable uroflowmeter can help to realize practical urinary conditions at home
Authors: Kato Shinobu , Watanabe Hajime , Yamasue Kotaro
Published: January 2022

Objectives

To evaluate the effectiveness of a novel portable urine flowmeter, Freeflow, for examining the actual state of urination at home.

Methods

Forty‐three patients with benign prostatic hyperplasia used the Freeflow uroflowmeter in the hospital and at home without accumulating urine. We created a nomogram for each patient's urine volume and maximal urinary flow rate (Qmax). Furthermore, we investigated the actual state of each patient's urination. We also investigated the differences in the micturition status between daytime and nighttime.

Results

Of the 43 patients, 40 were able to provide the necessary data in the hospital, and all patients provided data measured at home. The trial period of the home assessment was 2‐7 days. Regarding the average urine volume, no significant difference was observed between in‐hospital and at‐home patients; however, Qmax and mean flow rate (Qave) were significantly higher at home. The average coefficient of variation was very large. The relationship between daytime and nighttime was observed in 30 patients; urine volume increased significantly at nighttime; however, no significant difference was observed in Qmax and Qave. The nomogram for several days and a completed urinary diary helped to display daytime and nighttime urination characteristics.

Conclusions

Freeflow, the newly developed uroflowmeter, enabled us to determine the fluctuations in the measurements recorded at home and the differences between daytime and nighttime. Thus, creating a nomogram for objectively examining nighttime urination status and utilizing a urination diary was found to be effective for providing correct diagnosis and treatment of lower urinary tract symptoms.
Arthropod moulting hormones (ecdysteroids) are present in the blood of insectivorous bats
Authors: Hornok Sándor , Berkecz Róbert , Sós Endre , Sándor Attila D. , Körmöczi Tímea , Solymosi Norbert , Kontschán Jenő , Hunyadi Attila
Published: January 2022

Ecdysteroids are steroid hormones involved in moulting and development of arthropods. Blood samples of 32 individual bats of eight insectivorous species were analysed for the presence of ecdysteroids, using liquid chromatography and mass spectrometry. Nine ecdysteroids were detected. The spectrum of these ecdysteroids was similar in bat species which take their preferred food items from the same insect order. The spectrum of blood‐borne ecdysteroids was broader in the autumn than in the summer, and higher concentrations of 20‐hydroxyecdysone (the most common ecdysteroid) occurred in samples from large bat species than from small ones. Ecdysteroids may have anabolic effects on insectivorous bats and may also affect their blood‐feeding arthropod parasites.
Effect of lemon essential oil on halitosis
Authors: Ma Li , Pang Chenyu , Yan Changqing , Chen Jing , Wang Xiaoyu , Hui Jin , Zhou Li , Zhang Xiangyu
Published: January 2022

Objectives

To evaluate the effect of lemon essential oil (LEO) on salivary bacteria and volatile sulfur compound (VSC) production of patients with halitosis.

Materials and Methods

Saliva of five patients with halitosis was collected, after adding different concentrations (0.563–9 mg/ml) of LEO, detecting the growth of salivary bacteria, the formation of biofilm, and VSC production, and compare the difference of different concentrations of LEO on bacterial growth and VSC production. 48 volunteers were randomly divided into 4 groups. After gargling with LEO, cetylpyridinium chloride (CPC), chlorhexidine (CHX), and hydrogen peroxide (H2O2) separately measure changes of VSC production and pH values at 30, 45, 60, 90, and 120 min and then compare the differences at different time points within group.

Results

Compared with the negative control group, under subinhibitory concentrations of LEO (0.563–2.25 mg/ml), the biofilm formation and VSC production of salivary bacteria in LEO group were significantly inhibited (p < 0.05). Compared with the baseline, the VSC production of subjects decreased after rinsing with the LEO in 60 min (p < 0.05). After gargling with LEO, the pH value rose significantly in 30 min and reverted to the baseline level at 120 min (p < 0.05).

Conclusions

Lemon essential oil can inhibit the growth of salivary bacteria and reduce VSC production of patients with halitosis.
Machine learning: A modern approach to pediatric asthma
Authors: Cilluffo Giovanna , Fasola Salvatore , Ferrante Giuliana , Licari Amelia , Marseglia Giuseppe Roberto , Albarelli Andrea , Marseglia Gian Luigi , La Grutta Stefania
Published: January 2022

Among modern methods of statistical and computational analysis, the application of machine learning (ML) to healthcare data has been gaining recognition in helping us understand the heterogeneity of asthma and predicting its progression. In pediatric research, ML approaches may provide rapid advances in uncovering asthma phenotypes with potential translational impact in clinical practice. Also, several accurate models to predict asthma and its progression have been developed using ML. Here, we provide a brief overview of ML approaches recently proposed to characterize pediatric asthma.
Role of air pollutants mediated oxidative stress in respiratory diseases
Authors: Traina Giovanni , Bolzacchini Ezio , Bonini Maira , Contini Daniele , Mantecca Paride , Caimmi Silvia Maria Elena , Licari Amelia
Published: January 2022

Airborne particulate (PM) components from fossil fuel combustion can induce oxidative stress initiated by reactive oxygen species (ROS) that are strongly correlated with airway inflammation and asthma. A valid biomarker of airway inflammation is fractionated exhaled nitric oxide (FENO). The oxidative potential of PM2.5 can be evaluated with the dithiothreitol (DTT) dosage, which represents both ROS chemically produced and intracellular ROS of macrophages. This correlates with quality indicators of the internal environment and ventilation strategies such as dilution and removal of airborne contaminants.
Approximate or accurate? Efficacy of daily use of weather and air quality mobile applications for pollen allergy sufferers?
Authors: Travaglini Alessandro , Brighetti Maria Antonia , Della Giustina Auro , Pattini Stefano , Sfika Ifigenia , Malizia Velia , Tripodi Salvatore , Di Menno di Bucchianico Alessandro
Published: January 2022

Nowadays, technology permeates every aspect of human activity, from the professional to the recreational side, and the recent pandemic crisis has only amplified a clearly defined trend.

Through portable devices, people play, work, and get information. The immediacy of information and of many aspects of our life is a condition that, once acquired, is difficult to give up. However, immediate information must also be correct, and not all issues can easily be simplified to the point of being understandable in the absence of basic theoretical notions to a large audience. This aspect is particularly relevant when dealing with issues related to human health and the communication problems encountered in recent months concerning the spread of SARS‐CoV‐2, and the vaccination campaign is there to prove it. With the intent of clarifying the advantages and disadvantages of fast and accessible information, in this article, some of the most widespread applications for mobile devices, dedicated to pollen allergens, air quality, parks, gardens, and green areas, were examined.

A widespread lack of clarity on the sources of the data and on the criteria used to formulate synthetic judgments—that often confuse the final users—was noted.
Hypersensitivity reactions to vaccines in children: from measles to SARS‐CoV‐2
Authors: Caffarelli Carlo , Liotti Lucia , Bianchi Annamaria , Bottau Paolo , Caimmi Silvia , Crisafulli Giuseppe , Franceschini Fabrizio , Paglialunga Claudia , Saretta Francesca , Mori Francesca
Published: January 2022

Allergic individuals at risk for hypersensitivity reactions to measles vaccine marketed for a long time are well established. On the other hand, risk factors for hypersensitivity reactions to the new mRNA COVID‐19 vaccines currently include a history of allergy, allergy to excipient of the vaccine, or hypersensitivity reactions to the first dose of COVID‐19 vaccine. In the last two cases, the recipient should be assessed by an allergist before vaccination to share a decision on the choice of vaccination. Studies on skin testing accuracy and desensitization protocols to the COVID‐19 vaccines and the efficacy of potential alternatives in patients with confirmed hypersensitivity reactions to the first COVID‐19 vaccine are necessary to improve the safety of COVID‐19 vaccines.
Congenital and acquired defects of immunity: An ever‐evolving story
Authors: Castagnoli Riccardo , Delmonte Ottavia M. , Notarangelo Luigi D.
Published: January 2022

Inborn errors of immunity (IEI), also referred to as primary immunodeficiencies (PID), are disorders that, for the most part, result from mutations in genes involved in immune host defense and immune regulation. With the increased availability of high‐throughput DNA sequencing and improved genomic data interpretation, the number of newly identified genes associated with IEI has exponentially increased over the last decade. Here, we focus on the newly described IEI associated with severe COVID‐19 and SASH3 deficiency, the most recently reported IEI with impaired T‐cell receptor (TCR) signaling.