bluuebunny/crossref_metadata_2025 huggingface dataset:
From Statistical Physics to Data-Driven Modelling
Authors: Cocco Simona , Monasson Rémi , Zamponi Francesco
Published: November 2022

Today’s science is characterised by an ever-increasing amount of data, due to instrumental and experimental progress in monitoring and manipulating complex systems made of many microscopic constituents. How can we make sense of such data, and use them to enhance our understanding of biological, physical, chemical, … systems? The primary objective of this textbook is to introduce the concepts and methods, at the crossroad between probability theory, statistics, optimisation, statistical physics, inference and machine learning, necessary to answer this question. The second objective of this book is to provide practical applications for these methods, which will allow students to really assimilate the underlying ideas and techniques. Most of the applications we propose here are related to biology, as they were part of a course to Master of Science students specialised in biophysics. The book's companion web site contains all the data sets necessary for the tutorials presented in the book, as well as other applications. The material presented here is accessible to MSc students in physics, in applied maths and computational biology. Readers will need basic knowledge in programming (Python or some equivalent language) for the applications. Emphasis is not put on mathematical rigour, but on the development of intuition and the deep connections with statistical physics. Our major goal is that students will be able to understand the mathematics behind the methods, and not act as mere consumers of statistical packages!
Asymptotic inference and information
Authors: Cocco Simona , Monasson Rémi , Zamponi Francesco
Published: November 2022

In this chapter we will treat the case of asymptotic inference, in which a large number of data is available and a comparatively small number of parameters have to be inferred. In this regime, there exists a deep connection between inference and information theory, whose description will require us to introduce the notions of entropy, cross entropy, Fisher information, Shannon information. Last of all, we will see how the maximum entropy principle is, in practice, related to Bayesian inference.
An Early Fragment on Evil
Authors: Stewart M. A.
Published: November 2022

Presents and discusses a fragmentary early manuscript in Hume’s handwriting on an aspect of the problem of evil—namely the attempt to weigh the relative happiness and misery in human life. Suggests that the fragment might once have formed part of a projected or excised fifth (or fourth) part of Book One of the Treatise, applying Hume’s scepticism to religious questions. Contrasts the lucid and direct style of the argument of the fragment with the diffuseness of the same argument presented by Philo in Part X of the Dialogues.
Hume’s Reception in Ireland
Authors: Stewart M. A.
Published: November 2022

Begins with some of the very earliest responses to Hume, on the part of the Irish anti-deists Philip Skelton, Robert Clayton, and John Leland. Then turns to the Irish reaction to the History of England, and, especially, to Catholic objections to Hume’s account of the 1641 rebellion. Goes on to consider how Hume featured in the proceedings of the Royal Irish Academy (established in 1785) and in courses of lectures given in the early nineteenth century at Trinity College and the Belfast Academical Institution (now Queen’s University). Takes the story of Hume’s reception in Ireland to the end of the nineteenth century, showing how Hume’s views came to be seen as stereotypical in contemporary critiques of religion, and also how Hume was taken more seriously by those sympathetic to Kant and idealism.
The translation of leadership discourse to public services
Authors: Wallace Mike , Reed Michael , O’Reilly Dermot , Tomlinson Michael , Morris Jonathan , Deem Rosemary
Published: November 2022

An explanation is developed of why Labour government politicians chose a leader-centric conception of leadership for their focus in seeking to develop individual senior staff from public service organizations as leaders through the suite of national leadership development interventions. Leadership is analysed as a metaphorical concept, drawing attention to some parts of a target phenomenon while downplaying others. The history of discourse in the United States (US) and the United Kingdom (UK) is traced, which frames the process of organizing public services, beginning with administration and portraying its partial replacement by management and then leadership, following the innovatory articulation of visionary conceptions in the USA. The chapter documents the emergence of leader-centric visionary leadership discourse within the Labour Party in the early 1990s prior to forming the Labour government, and the influences on this choice as the focus for developing senior staff in public service organizations as leaders committed to implementing government-driven reforms.
Elite orchestration and mediation of national leadership development provision
Authors: Wallace Mike , Reed Michael , O’Reilly Dermot , Tomlinson Michael , Morris Jonathan , Deem Rosemary
Published: November 2022

Research findings are reported explaining why and how senior officials responsible for each intervention, construed as intermediate-level elites, responded to their remit in developing provision within parameters variably set and monitored by government elites. The interventions catered for individuals at different career stages, with a mixed focus on improving present practice as leaders and preparing for possible promotion to a more senior post. The government linkage with leading reforms was diluted. Most representative bodies for senior staff in the three service sectors supported interventions as means of professionalizing their members through specialist training as leaders. A government initiative to rationalize provision across the suite of interventions was resisted by emphasizing the context-sensitivity of provision for each service sector. An abductive explanation is advanced of the generative mechanisms at play, centring on the moderate subversion of acculturation and its delimitation by government arrangements directly or indirectly regulating the interventions.
Microcirculation dynamics in systemic vasculitis: evidence of impaired microvascular response regardless of cardiovascular risk factors
Authors: Dolgyras Panagiotis , Lazaridis Antonios , Anyfanti Panagiota , Gavriilaki Eleni , Koletsos Nikolaos , Triantafyllou Areti , Nikolaidou Barbara , Galanapoulou Vasiliki , Douma Stella , Gkaliagkousi Eugenia
Published: November 2022

Objectives

Systemic vasculitides (SVs) are a highly inflammatory group of diseases characterized by significant cardiovascular (CV) mortality. Microvascular damage closely linked with accelerated atherosclerosis and thrombosis represents a core pathophysiological mechanism contributing to the excess CV risk of patients with SVs. Skin represents an easily accessible tissue facilitating non-invasive microvascular study. In this study we aimed to investigate microcirculation dynamics and associate them with disease-related factors in patients with SVs.

Methods

We assessed skin microcirculation using laser speckle contrast imaging (LSCI) and vascular reactivity by the post-occlusive reactive hyperaemia (PORH) protocol in a meticulously selected group of patients with SVs without CV disease and compared them to controls, matched for age, sex, BMI and smoking status.

Results

Sixty individuals were included in the study, 30 patients and 30 controls. Patients with SVs presented a lower peak magnitude during reperfusion phase (median [interquartile range] 207 [60.1] vs 143.7 [41.0] laser speckle perfusion units, P < 0.001) and lower percentage cutaneous vascular conductance increase (mean (s.d.) 190.0 [49.6]% vs 149.6 [48.9]%, P = 0.002) as compared with controls. Importantly, microvascular damage was correlated with disease duration (P < 0.001, r = −0.563 and P < 0.001, r = 0.442, respectively).

Conclusion

For the first time we have shown that patients with SVs exhibit impaired microvascular function and blunted reactivity after occlusion, as this was demonstrated by the LSCI technique. Therefore, skin microcirculation may be a useful, non-invasive method in patients with SVs for the early detection of microvascular dysfunction, which is closely related to the high CV risk that these patients bear.
Forever Grateful
Authors: Treston Carole
Published: November 2022

A nurse remembers Dr. Fauci's impact during the early days of the AIDS crisis.
Drug Receives New Indication for Pediatric Graft-Versus-Host Disease
Authors: Aschenbrenner Diane S.
Published: November 2022

Ibrutinib (Imbruvica) has received a new indication for the treatment of graft-versus-host disease in pediatric patients at least one year of age when one or more systemic therapies have failed.

The product's labeling warns of the risk of hemorrhage, infections, cardiac arrythmias, cardiac failure and sudden death, hypertension, cytopenia, secondary primary malignancies, tumor lysis syndrome, and embryo–fetal toxicity.

The most common adverse effects include laboratory abnormalities, musculoskeletal pain, pyrexia, pneumonia, abdominal pain, stomatitis, diarrhea, and headache. Nurses should carefully assess for these adverse effects and provide appropriate education regarding their prevention.
Dietary Supplement Labels May Be Inaccurate and Misleading
Authors: Rosenberg Karen
Published: November 2022

According to this study:

The labeling on dietary supplements marketed to support or boost the immune system is often inaccurate and inconsistent with Food and Drug Administration requirements.

Quality control measures appear to be insufficient for most of these products.
Multidisciplinary Care Pathway Improves Outcomes in Geriatric Trauma Patients
Authors: Rosenberg Karen
Published: November 2022

According to this study:

Implementation of a multidisciplinary geriatric clinical pathway for people who have traumatic injury led to substantial improvement in delirium and other clinical outcomes.
Better Outcomes with Home-Based Cardiac Rehabilitation
Authors: Rosenberg Karen
Published: November 2022

According to this study:

In a demographically diverse population, including higher risk, medically complex patients, participation in home-based cardiac rehabilitation was associated with fewer hospitalizations at 12 months compared with center-based cardiac rehabilitation.
A Nurse Innovator Paves the Way for Other Nurses
Authors: Giuliano Karen K. , Landsman Kelly
Published: November 2022

This is the third article in a series on nurse innovators, which focuses whenever possible on nurse–engineer partnerships and outlines working, replicable models of collaboration between the two disciplines. In this installment, we profile Brian Mohika, BSN, RN, creator of CathWear—a wearable medical device that supports patients with catheter drainage leg bags. His nine-year journey of successes and challenges highlights the value of early, real-time collaboration with an interdisciplinary team, and underscores the need for nurses to see themselves as innovators.
Shift Change: From ICU Nurse to ICU Patient
Authors: Cusmano Alison
Published: November 2022

A post-childbirth emergency and a new understanding of the comforting presence of nurses.
Comparison of Regular Versus After Hours Admissions to a 24-hour Opioid Treatment Program
Authors: Sherrick Robert C.
Published: November 2022

Objectives

October of 2017 marked the opening of the first US Opioid Treatment Program (OTP) that was staffed 24 hours a day, 7 days a week, with admissions on demand, both during normal OTP working hours and outside the hours when most OTPs are able to accept new patients. This article compares demographic and treatment outcomes for those patients admitted during normal working hours with those admitted after hours or on weekends.

Methods

All admissions to the 24-hour OTP between January 2018 and December 2020 who were new to treatment at this OTP and started on methadone were included. An internal database of patient demographics and dosing events was collected during the normal treatment process. These data were examined regarding initial demographics, dosing, and treatment outcomes, comparing patients admitted during normal working hours with those admitted when most OTPs would be closed and unable to admit new patients.

Results

A total of 7,334 admissions were included, 2,631 during normal working hours, and 4,703 after hours or on weekends. After-hours patients were comparable in age but were more likely to be male (56.0% vs. 52.5%, P < 0.01), employed (24.1% vs. 22.1%, P < 0.05), and White versus non-White (56.2% vs. 51.5%, P < 0.001) compared with working-hour admissions. Outcomes of first-day dose, 30th-day dose, and 30-day treatment attendance did not differ between the 2 groups.

Conclusions

In this situation where patients could be admitted at any time, the majority presented after hours. Patients who were admitted after-hours did not have worse treatment outcomes than those who were admitted during working hours. These findings suggest that offering OTP admission after-hours and on weekends will not result in attracting patients with low motivation and poorer outcomes than those who are admitted during working hours. Extending OTP admission hours has the potential to improve medication for opioid use disorder access and treatment outcomes.
Cardiovagal baroreflex sensitivity, blood pressure and blood pressure variability – the Maastricht study
Authors: Zhou Tan Lai , Reulen Jos P.H. , Van Der Staaij Hilde , Stehouwer Coen D.A. , Van Greevenbroek Marleen , Henry Ronald M.A. , Kroon Abraham A.
Published: November 2022

Objective:

Low baroreflex sensitivity (BRS) has been hypothesized to underlie high blood pressure (BP) and greater BP variability on the longer term, but evidence is scarce. In addition, these associations may differ by sex and (pre)diabetes. Therefore, we investigated whether cardiovagal BRS is associated with short- to mid-term mean BP and BP variability, and differs according to sex and (pre)diabetes.

Methods:

Cross-sectional data from the population-based Maastricht study (age 60 ± 8 years, 52% men), where office (n = 2846), 24-h (n = 2404) and 7-day BP measurements (n = 2006) were performed. Spontaneous BRS was assessed by cross-correlating systolic BP and instantaneous heart rate. We used linear regression with adjustments for age, sex, BP or BP variability, and cardiovascular risk factors.

Results:

With regard to BP, 1-SD (standard deviation) lower BRS (−5.75 ms/mmHg) was associated with higher office, 24-h and 7-day systolic BP (2.22 mmHg [95% confidence interval [CI]: 1.59; 2.80], 0.95 mmHg [0.54; 1.36], and 1.48 mmHg [0.99; 1.97], respectively) and diastolic BP (1.31 mmHg [0.97; 1.66], 0.57 mmHg [0.30; 0.84], and 0.86 mmHg [0.54; 1.17], respectively). Per 1-SD lower BRS, these associations were stronger in women (0.5–1.5 mmHg higher compared to men), and weaker in those with type 2 diabetes (1–1.5 mmHg lower compared to normal glucose metabolism). With regard to BP variability, BRS was not consistently associated with lower BP variability.

Conclusions:

Lower cardiovagal BRS is associated with higher mean BP from the short- to mid-term range, and not consistently with BP variability. The associations with mean BP are stronger in women and weaker in those with type 2 diabetes.
Antihypertensive medication classes and the risk of dementia over a decade of follow-up
Authors: Schroevers Jakob L. , Eggink Esmé , Hoevenaar-Blom Marieke P. , Van Dalen Jan Willem , Van Middelaar Tessa , Van Gool Willem A. , Richard Edo , Moll Van Charante Eric P.
Published: November 2022

Introduction:

Use of angiotensin II (ATII)-stimulating antihypertensive medication (AHM), including angiotensin receptor blockers (ARBs) and dihydropyridine calcium channel blockers (CCBs), has been associated with lower dementia risk. Previous studies had relatively short follow-up periods. The aim of this study is to investigate if these effects are sustained over longer periods.

Methods:

This post hoc observational analysis was based on data from a dementia prevention trial (preDIVA and its observational extension), among Dutch community-dwelling older adults without prior diagnosis of dementia. Differential associations between AHM classes and incident dementia were studied after 7.0 and 10.4 years, based on the median follow-up durations of dementia cases and all participants.

Results:

After 7 years, use of ATII-stimulating antihypertensives [hazard ratio = 0.68, 95% confidence interval (CI) = 0.47–1.00], ARBs (hazard ratio = 0.54, 95% CI = 0.31–0.94) and dihydropyridine CCBs (hazard ratio = 0.52, 95% CI = 0.30–0.91) was associated with lower dementia risk. After 10.4 years, associations for ATII-stimulating antihypertensives, ARBs and dihydropyridine CCBs attenuated (hazard ratio = 0.80, 95% CI = 0.61–1.04; hazard ratio = 0.75, 95% CI = 0.53–1.07; hazard ratio = 0.73, 95% CI = 0.51–1.04 respectively), but still suggested lower dementia risk when compared with use of other AHM classes. Results could not be explained by competing risk of mortality.

Conclusion:

Our results suggest that use of ARBs, dihydropyridine CCBs and ATII-stimulating antihypertensives is associated with lower dementia risk over a decade, although associations attenuate over time. Apart from methodological aspects, differential effects of antihypertensive medication classes on incident dementia may in part be temporary, or decrease with ageing.
EFFICACY OF COMBINED SYSTEMIC CORTICOSTEROID AND EARLY IMMUNOMODULATORY THERAPY WITHIN THREE MONTHS OF ONSET IN VOGT–KOYANAGI–HARADA DISEASE
Authors: Park Hyo Song , Park Hyun Young , Lee Christopher Seungkyu , Lee Sung Chul , Lee Ji Hwan
Published: November 2022

Purpose:

To evaluate the clinical outcomes of combined systemic corticosteroid and early immunomodulatory therapy (IMT) within 3 months of onset in Vogt–Koyanagi–Harada (VKH) disease compared with conventional therapy.

Methods:

This retrospective observational case series included 73 eyes of 38 patients with VKH, categorized into the conventional (n = 41) and the early IMT (n = 32) groups. Clinical information was gathered from patients' medical records. Primary outcome measures were visual acuity, subfoveal choroidal thickness, and uveitis outcome including occurrence of sunset glow fundus.

Results:

The logarithm of minimal angle of resolution visual acuity of both groups improved, with statistically significant difference at the last follow-up (P < 0.01, Mann–Whitney U test). Their mean subfoveal choroidal thickness decreased, with no statistically significant difference at the last follow-up (P = 0.21, T-test). In the conventional and early IMT groups, 27 (65.9%) and 15 (46.9%) eyes, respectively, had chronic or chronic recurrent VKH and sunset glow fundus was observed in 33 (80.5%) and 16 (50.0%) eyes, respectively.

Conclusion:

Combined systemic corticosteroid and early IMT within 3 months of onset was superior to conventional therapy in the final visual and uveitis outcome of patients with VKH disease. Therefore, IMT may be added early in cases of VKH disease, even when under control with high-dose corticosteroid.
Associations Between Thyroid Eye Disease and Glaucoma Among Those Enrolled in the National Institutes of Health All of Us Research Program
Authors: Delavar Arash , Radha Saseendrakumar Bharanidharan , Lee Tonya C. , Topilow Nicole J. , Ting Michelle A. , Liu Catherine Y. , Korn Bobby S. , Weinreb Robert N. , Kikkawa Don O. , Baxter Sally L.
Published: November 2022

Purpose:

To assess the association between thyroid eye disease (TED) and glaucoma.

Methods:

Patients 18 years of age and over enrolled in the NIH All of Us Research Program, a nationwide cohort, were extracted. Those with conditions relating to TED were identified and compared with 2020 US Census-matched controls without a diagnosis of TED in a 1:4 ratio. The authors used Pearson’s χ2 tests to study demographics by TED status, and logistic regression to generate odds ratios and 95% confidence intervals to evaluate the association between TED and glaucoma (any type, including glaucoma suspect), using those without TED as the reference group. Multivariable models were adjusted for age, gender, race/ethnicity, eye doctor visits, and smoking status.

Results:

A total of 393 cases of TED were identified, and 1,572 US Census-matched controls. The median age of the cohort was 63 years (interquartile range: 48–73 years). Age, gender, and race/ethnicity varied by TED status (p < 0.001). Overall, 114 (29.0%) of TED cases had a diagnosis of glaucoma, compared with 94 (6.0%) of non-TED controls. On bivariate logistic regression models, those diagnosed with TED were significantly more likely to be diagnosed with glaucoma compared with controls (odds ratio: 6.42; 95% confidence interval: 4.76–8.70; p < 0.001). This trend persisted on multivariable logistic regression controlling for confounding factors (odds ratio: 3.37; 95% confidence interval: 1.85–6.20 p < 0.001).

Conclusions:

Individuals with TED were significantly more likely to be diagnosed with glaucoma. Clinicians caring for patients with TED should be aware of this elevated risk and arrange glaucoma evaluation, accordingly.
Addressing Metabolic Comorbidity in Individuals With Intellectual and Developmental Disability on Antipsychotics
Authors: Stogios Nicolette , Hahn Margaret K. , Lunsky Yona , Desarkar Pushpal , Agarwal Sri Mahavir
Published: November 2022

Purpose/Background

Individuals with intellectual and developmental disabilities (IDDs) are at increased risk for serious metabolic comorbidities, which is further exacerbated by the high rate of antipsychotic use in this population. There is currently a lack of literature on effective treatment options for antipsychotic-induced weight gain and metabolic abnormalities in IDD. This case series reports on the clinical use of metformin in patients with IDD on antipsychotics.

Methods/Procedures

We conducted a retrospective review of patients in a novel clinical service at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada for adults with IDD experiencing antipsychotic-related weight gain and other metabolic aberrations. Charts were reviewed for weight and other metabolic outcome measures before and after commencing metformin treatment.

Findings/Results

In 11 patients referred to this clinic, the mean weight loss while on metformin treatment was 11.1 kg, with over 50% of the sample achieving clinically meaningful weight loss of >7%. Additional adaptive changes were observed for fasting glucose, glycated hemoglobin, triglyceride, and high-density lipoprotein cholesterol levels.

Implications/Conclusions

In line with its use in severe mental illness, metformin may be a safe, effective, and accessible treatment option for patients with IDD experiencing metabolic adverse effects of antipsychotic medication. Further research and randomized controlled trials are needed to examine the efficacy of metformin in this population.
Tinea Gladiatorum Detection With a Dermatophyte Test Strip
Authors: Berg Mark A. , Martin Casey
Published: November 2022

Objective:

Determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and concordance of diafactory hs-TP (DTS) to detect tinea gladiatorum using direct potassium hydroxide (KOH) microscopy as the reference standard.

Design:

Prospective, comparative study.

Setting:

Seventeen Minnesota high schools during the winter wrestling season.

Patients:

Seventy-one consecutive high school wrestlers identified with a suspicious rash during skin inspection.

Interventions:

Samples were obtained from each rash for both DTS and direct KOH microscopy.

Main Outcome Measures:

Readings were recorded as positive or negative.

Results:

Direct KOH microscopy identified tinea gladiatorum in 35 of the 71 samples (46%). DTS sensitivity was 80% (95% confidence interval 63%-92%), and specificity was 82% (66%-92%). PPV was 85% (68%-95%), and NPV was 86% (72 %-91%). The DTS result was 83% concordant (72%-91%) with direct KOH microscopy.

Conclusions:

Similar to rapid Covid antigen tests, DTS required brief, basic training to perform and gave onsite results in 5 to 30 minutes. Although DTS is not approved for use in the United States by the FDA, concordance compared with direct KOH microscopy in diagnosing tinea gladiatorum was similar to results reported for DTS-TU in tinea unguium and tinea pedis. Further study comparing DTS to a reference standard using PCR plus direct microscopy is warranted.
A systematic review of epidemiology and outcomes of Crohn’s disease-related enterocutaneous fistulas
Authors: Iglay Kristy , Bennett Dimitri , Kappelman Michael D. , Reynolds Kamika , Aldridge Molly , Karki Chitra , Cook Suzanne F.
Published: November 2022

Background:

Enterocutaneous fistulas (ECF) are rare sequelae of Crohn’s disease (CD) that occur either postoperatively or spontaneously. ECFs are associated with high morbidity and mortality. This systematic literature review assesses the disease burden of CD-related ECF and identifies knowledge gaps around incidence/prevalence, treatment patterns, clinical outcomes, healthcare resource utilization (HCRU), and patient-reported outcomes (PROs).

Methods:

English language articles published in PubMed and Embase in the past 10 years that provided data and insight into the disease burden of CD-related ECF (PROSPERO Registration number: CRD42020177732) were identified. Prespecified search and eligibility criteria guided the identification of studies by two reviewers who also assessed risk of bias.

Results:

In total, 582 records were identified; 316 full-text articles were assessed. Of those, eight studies met a priori eligibility criteria and underwent synthesis for this review. Limited epidemiologic data estimated a prevalence of 3265 persons with ECF in the USA in 2017. Clinical response to interventions varied, with closure of ECF achieved in 10% to 62.5% of patients and recurrence reported in 0% to 50% of patients. Very little information on HCRU is available, and no studies of PROs in this specific population were identified.

Conclusion:

The frequency, natural history, and outcomes of ECF are poorly described in the literature. The limited number of studies included in this review suggest a high treatment burden and risk of substantial complications. More robust, population-based research is needed to better understand the epidemiology, natural history, and overall disease burden of this rare and debilitating complication of CD.
Application value of coaxial puncture needle (technique) in ultrasound-guided puncture biopsy of peripheral pulmonary masses
Authors: Zhang Mei Wu , Zhang Yan , Lv Shu Yi , Fan Xiao Xiang , Zhu Jia Zhen , Zhang Bai Song , Yang Zhen Hua
Published: November 2022

This study aims to investigate the effect of ultrasound (US)-guided coaxial puncture needle in puncture biopsy of peripheral pulmonary masses. In this retrospective analysis, 157 patients who underwent US-guided percutaneous lung biopsy in our hospital were divided into a coaxial biopsy group and a conventional biopsy group (the control group) according to the puncture tools involved, with 73 and 84 patients, respectively. The average puncture time, number of sampling, sampling satisfaction rate, puncture success rate and complication rate between the 2 groups were compared and discussed in detail. One hundred fifty-seven patients underwent puncture biopsy, and 145 patients finally obtained definitive pathological results. The overall puncture success rate was 92.4% ([145/157]; with a puncture success rate of 97.3% [71/73] from the coaxial biopsy group and a puncture success rate of 88.1% [74/84] from the conventional biopsy group (P < .05). For peripheral pulmonary masses ≤3 cm, the average puncture time in the coaxial biopsy group was shorter than that in the conventional biopsy group, and the number of sampling, sampling satisfaction rate and puncture success rate were significantly higher than those in the conventional biopsy group (P < .05). There was no significant difference in the complication rate between the 2 groups (P > .05). For peripheral pulmonary masses >3 cm, the average puncture time in the coaxial biopsy group was still shorter than that in the conventional biopsy group (P < .05). The differences between the 2 groups in the number of sampling, satisfaction rate of the sampling, the success rate of puncture and the incidence of complications were not significant (P > .05). US guided coaxial puncture biopsy could save puncture time, increase the number of sampling, and improve the satisfaction rate of sampling and the success rate of puncture (especially for small lesions) by establishing a biopsy channel on the basis of the coaxial needle sheath. It provided reliable information for the diagnosis, differential diagnosis and individualized accurate treatment of lesions as well.
Bone demineralization in a cohort of Egyptian pediatric liver transplant recipients: Single center pilot study
Authors: Kotb Magd A. , Fawaz Lubna A. , Zeitoun Rania A. , Shaalan Yomna M. , Aly Nazira , Abd El Kader Hesham , El Tagy Gamal , Esmat Haytham , Hamza Alaa F. , Abd El Baky Hend
Published: November 2022

Liver transplantation (LT) is the definitive treatment of end-stage liver disease. The long-term survival following LT spurred more interest in improving the quality of life of patients. This was a cohort study that included 23 pediatric liver transplant recipients who underwent LT due to hereditary or metabolic liver diseases. Bone health assessment was performed at their last follow up clinically (anthropometric measures), biochemically and radiologically (Dual Energy X-ray Absorptiometry [DEXA] scans). Poor bone health was defined as z-score <−1. Mean age at LT was 5.77 years (standard deviation [SD] 3.64) and 43% were males. Biliary atresia was the most common cause of end stage liver disease (35%). Mean age at follow up was 14 years (SD 5.48) and mean follow up was 8 years (SD 4.12 years). Eleven patients (48%) had poor bone health (osteopenia 22% and osteoporosis 26%). On univariate analysis, being on steroids at last follow up (odds ratio [OR] 13.2, 95% confidence interval [CI] 1.23–140.67, P = .03), weight at last follow up (OR 0.45, 95% CI 0.20–0.99, P = .04), platelets at last follow up (OR 0.98, 95% CI 0.96–s0.99, P = .02), hemoglobin at last follow up (OR 0.33, 95% CI 0.12–0.89, P = .03) were significantly associated with poor bone health. None of the variables were significant on multivariate analysis. At most recent follow up, 48% of patients demonstrated poor bone health by DEXA scans. More studies are required to evaluate predictors of poor bone health after LT in children.
Thoracic endovascular aortic repair and optimal medical treatment for acute type B penetrating aortic ulcer associated with intramural hematoma
Authors: Xu Xiuchun , Lu Feng , Li Li
Published: November 2022

To compare the safety and efficacy of thoracic endovascular aortic repair (TEVAR) and optimal medical treatment (OMT) for type B penetrating aortic ulcer (PAU) associated with intramural hematoma (IMH). From January 2015 to December 2018, 68 consecutive patients with acute type B PAU associated with IMH were enrolled in the study. TEVAR was performed following initially OMT in 30 patients (group A), and OMT was performed in 38 patients (group B). Primary outcome was aortic-related mortality. Secondary outcomes included all-cause mortality, aortic-related adverse events, and complete aortic remodeling. There was no significant difference in the baseline characteristics of patients among the 2 groups except for the depth of PAU and the thickness of IMH. Patients in group B had a significant higher risk of aortic-related mortality (13.3% vs 0%, P = .045), as the same to aortic-related adverse events during follow-up. Compared to OMT, TEVAR contributed to the favorable aortic remodeling more significantly during the mid-term follow-up (85.7% vs 18.2%, P < .001). Comparing with optimal medical repair, TEVAR for patients with PAU associated with IMH could promote the favorable aortic remolding more significantly and result in lower aortic-related mortality during mid-term follow-up. It should be considered as the first-line therapeutic option when intervention is required.
Specificity of estimating femoral anteversion using linea aspera version for total hip arthroplasty: A three-dimensional computed tomography study
Authors: Mohamed Thajudeen Mohamed Zaim , Mahmood Merican Azhar , Hashim Muhammad Sufian , Nordin Abid
Published: November 2022

Femoral anteversion is an important parameter that can prevent complication following total hip arthroplasty (THA) caused by improper positioning of the implant. However, assessing femoral anteversion can be challenging in situation with significant defect of the femoral neck. In this study, linea aspera version was nominated as alternative parameter to femoral anteversion. So, the main objective of this study is to determine whether femoral anteversion correlates with linea aspera version. Cross-sectional study. Three-dimensional images of 100 femora were generated and their femoral anteversion and linea aspera version was measured. Correlation between the parameters was calculated. The mean linea aspera version was 7.27° ± 12.17° (mean ± standard deviation) while the mean femoral anteversion was 11.84° ± 10.06°. The linea aspera version was inversely correlated with the femoral anteversion with a correlation coefficient of –0.85. Linea aspera should be considered as an additional bony landmark to assess proper implant positioning in THA.
Patellofemoral osteoarthritis does not influence clinical outcomes of fixed-bearing unicompartmental knee arthroplasty
Authors: Ji Xiaohui , Li Hua , Yang Shan , Zhao Ming , Liu Ning , Cheng Yanxin , Huang Xiaodan
Published: November 2022

Unicompartmental knee arthroplasty (UKA) is an ideal surgical approach in treatment of end-stage knee osteoarthritis (KOA), however, indications of UKA have been controversial, and the radiographic and symptomatic patellofemoral osteoarthritis (PFOA) are often considered as a contraindication of medial UKA. 337 fixed bearing UKAs were retrospectively recruited in our joint center between January 1, 2011 and June 30, 2020. There were 105 patients accompanied by PFOA and 232 patients have normal PF joint. International Cartilage Repair Society (ICRS) system was introduced to quantify the degeneration degree of PF joint. Oxford Knee Score (OKS), Forgotten Joint Score (FJS), Kellgren-Lawrence (K-L) classifying system and visual analogue scale (VAS) were adopted to evaluate outcomes between with and without PFOA. There was no significant difference of age, BMI, gender, OKS, FJS and other variables between PFOA and Non-PFOA group. After more than 5 years follow-up, UKA patients with or without PFOA could all achieve a satisfactory improvement of OKS, VAS and FJS score. ROM of the replaced knee increased from preoperative 110° to 130°. 74.3% (78/105) and 75.0% (174/232) patients have no change of K-L grade in PFOA and Non-PFOA group, OKS, FJS, VAS score and ROM were also comparable in all patients and no significant outcomes difference were found between two group. The presence of patellofemoral joint osteoarthritis and anterior knee pain should not be considered to be contraindications to medial fixed-bearing UKA.
Inpatients with shoulder osteoarthritis who received integrative Korean medicine treatment: Long-term follow-up of an observation study
Authors: Choi Yun-Young , Lee Jee Young , Yang Su-Hyun , Lee Tae-Geol , Oh Da-Yoon , Kim Dong Woo , Lee Soo-Jin , Lee Yoon Jae , Ha In-Hyuk
Published: November 2022

This study aimed to investigate the long-term clinical efficacy of and satisfaction with integrative Korean medicine (KM) treatment in patients with shoulder osteoarthritis (SOA). We conducted a prospective observational study of patients with SOA. Patients aged 19 years and older who underwent inpatient treatment for more than 1 week were eligible for enrollment in the study. The primary evaluation index was the numeric rating scale for shoulder pain. Sub-evaluation indices included the Shoulder Pain and Disability Index for shoulder function, EuroQol-5-dimension score for overall quality of life, and Patient Global Impression of Change. Outcome measures were assessed at admission, discharge, and follow-up. For the follow-up questionnaire survey, the following information was collected: current status, surgery after discharge, reasons for finding integrative KM treatment satisfactory/unsatisfactory, and quality of life after discharge. In total, 186 patients were enrolled in the primary analysis, and 103 patients completed the follow-up survey. The mean number of days of follow-up was 1019 ± 439. Compared with the baseline, the mean differences in the numeric rating scale and Shoulder Pain and Disability Index were 3.05 ± 0.34 and 36.06 ± 5.53, respectively. Regarding the Patient Global Impression of Change, 89 out of 103 (86.4%) patients chose “minimally improved” or better. Furthermore, the EuroQol-5-dimension score also increased, showing an improvement of health-related quality of life after treatment. Integrative KM treatment is a potential option for reducing pain severity and improving function and health-related quality of life in patients with SOA. Prospective randomized studies would support this finding for the next step.
The expression of Ets-1 and Fli-1 is associated with interferon-inducible genes in peripheral blood mononuclear cells from Japanese patients with systemic lupus erythematosus
Authors: Suzuki Eiji , Zhang Xian K. , Yashiro-Furuya Makiko , Asano Tomoyuki , Kanno Takashi , Kobayashi Hiroko , Migita Kiyoshi , Ohira Hiromasa
Published: November 2022

Transcription factors E26 transformation-specific-1 (Ets-1) and Friend leukemia insertion site-1 (Fli-1) and type I interferon (IFN) have been implicated in systemic lupus erythematosus (SLE). We examined the expression of these genes in peripheral blood mononuclear cells (PBMCs) from Japanese patients with SLE and analyzed their association with SLE. We enrolled 53 Japanese patients with SLE, 42 patients with rheumatoid arthritis (RA), and 30 healthy donors (HDs) (as controls) in this study. PBMCs were collected from all participants, and the expressions of Ets-1, Fli-1, and three interferon-inducible genes (IFIGs) (interferon-inducible protein with tetratricopeptide 1 [IFIT1], interferon-inducible protein 44 [IFI44], and eukaryotic translation initiation factor 2 alpha kinase 2 [EIF2AK2]) were measured using real-time polymerase chain reaction (PCR). The relationships of each molecule with clinical symptoms, laboratory data, and treatments were analyzed. The expression of Ets-1 and Fli-1 was significantly lower in the PBMCs from patients with SLE than that in the PBMCs from patients with RA and HDs. The expression of the three IFIGs was significantly higher in the PBMCs from patients with SLE than that in the PBMCs from patients with RA and HDs. For patients with SLE, significantly positive correlations were found between Ets-1 and three IFIGs; a similar trend was observed between Fli-1 and IFIGs. IFIG expression in the PBMCs was significantly higher in patients with SLE than that in other participants, and the expression of Ets-1 and Fli-1 was positively associated with IFN expression. Therefore, it was suggested that Ets-1 and Fli-1 were associated with the pathophysiology of SLE by regulating the type I IFN pathway.
Gout as a risk factor for osteoporosis: A Korean population-based study
Authors: Kim Ji Hyoun , Kim So Rae , Kang Gilwon , Choi In Ah
Published: November 2022

Uric acid acts as both an antioxidant and a pre-oxidant that induces oxidative stress; thus, it plays a paradoxical role in inflammation. However, the effect of gout, a hallmark of hyperuricemia, on osteoporosis remains unclear. Therefore, this study aimed to investigate the association between gout and osteoporosis. This retrospective cohort study used data from the Korean National Health Insurance Service Database. In total, 628,565 participants who were diagnosed with gout and prescribed medications for gout for at least 90 days were selected. The control cohort included patients with no history of gout or use of gout medication. Age and sex 1:1 propensity score matching and Cox proportional hazards models were used to investigate risk factors for osteoporosis. In total, 305,810 patients with gout met the inclusion criteria. Compared with the control group, both men and women with gout showed an increased incidence rate ratio of osteoporosis. In the stratified analysis by age, patients with gout showed an increased incidence rate ratio for osteoporosis in all age groups, except for those over 80 years of age (P < .001). Gout showed an increased hazard ratio of 1.48 (95% CI: 1.45–1.51, P < .001). The female sex has also been identified as a risk factor for osteoporosis. Patients in their 70s had the highest HR. Gout is significantly associated with the risk of osteoporosis. In particular, the results of this study showed that the incidence of osteoporosis increased up to four times in male patients in their 20s with gout compared to without gout.
Disseminated fusarium infection after allogeneic hematopoietic stem cell transplantation after CART: A case report
Authors: Fei Hairong , Liu Xiaodan , Sun Lingjie , Shi Xue , Wang Wei , Zhao Hongguo , Zhao Chunting
Published: November 2022

Background:

Fusarium is a conditional pathogen that can cause invasive infection in patients with hematological diseases under immune function.

Methods:

A case of recurrent and refractory Philadelphia chromosome-positive acute lymphoblastic leukemia was treated with allogeneic hematopoietic stem cell transplantation after chimeric antigen receptor-modified T cells treatment.

Results:

During transplantation, disseminated Fusarium infection occurred, involving the skin, liver, spleen and central nervous system, and the patient eventually died.

Conclusions:

Early identification of Fusarium infection based on the characteristic rash and timely antifungal treatment can improve the cure rate.
Clinical application of free inguinal flaps with retrograde blood supply anastomotic to repair soft tissue defects of extremities
Authors: Han Zhongbing , Zhang Kuankuan , Liu Haizhou , Liu Yangyang , Zhang Changchun
Published: November 2022

To observe the clinical efficacy of free inguinal flaps with retrograde blood supply anastomosis to repair skin and soft tissue defects in the limbs. A total of 25 patients with soft tissue defects of the limbs treated from January 2019 to December 2021 were selected and repaired with free inguinal flaps anastomotic with retrograde blood supply. All 25 skin flaps survived; 1 patient had skin flap infection and the wound healed gradually after symptomatic treatment, and 1 patient had venous embolism and the skin flap survived after re-anastomosis. The patients were followed up for 6 to 18 months after the operation. After healing, the patient recovered satisfactorily, and the flap had a good appearance, texture, and flexibility; a reoperation was not required. The patient was satisfied with the effect of the treatment. Retrograde vascular anastomosis with the anterolateral femoral perforator flap is safe and reliable for repairing the soft tissue defects of the limbs. It is convenient for micromanipulation and can achieve satisfactory clinical results, and thus is an ideal repair method.
Cytogenetical and hematological analysis of chronic myelogenous leukemia patients with a novel case 52XX, t (1;9;22) (q23.3; q34; q11.2), +6, +8, i(9) (q10;q10), +18,+19,+21+der22 t(9;22)(q34;q11)
Authors: Asif Muhammad , Hussain Abrar , Ali Irfan , Baloch Zarak , Rasool Mahmood , Achakzai Niaz M.
Published: November 2022

(9;22) (q34; q11) translocation is appear in above ninety percent of chronic myelogenous leukemia patients while variant/complex translocations were observed in almost 5% to 8% chronic myelogenous leukemia (CML) positive cases. Gleevec (Imatinib Mesylate) is the first choice breakpoint cluster region (BCR)/ABL targeted oral therapy that produced a complete response almost in 71% to 80% of patients affected with CML. A complete blood count (CBC) of 37 patients was done during diagnosis, however only 21 showed abnormal CBC values which were selected for the study. Karyotyping study using bone marrow samples was performed on 21 CML patients for the conformation of 9;22, however, fluorescence in situ hybridisation was performed for the detection of the BCR–ABL fusion gene of 15 patients. Out of 21, 17 patients showed Ph-positive (9;22) (q34; q11) translocation. Sixteen CML patients showed standard translocation however only CML patients showed a three-way variant/complex translocation with six additional chromosomes, 52XX, t(1;9;22) (q23.3;q34;q11),+6,+8, i(9)(q10;q10), +18,+19,+21 + der22 t(9;22)(q34;q11)). Here we report we report a novel case of six additional chromosomes with the three-way translocation of 52XX, t(1;9;22) (q23.3;q34;q11),+6,+8, i(9)(q10;q10), +18,+19,+21 + der22 t(9;22)(q34;q11) in blast phase.
Relationship of muscle power and bone mineral density with the α-actinin-3 R577X polymorphism in Japanese female athletes from different sport types: An observational study
Authors: Kobayashi Tetsuro , Seki Shotaro , Hwang Inkwan
Published: November 2022

The aim of this study was to clarify the relationships between muscle power and bone mineral density (BMD) and the α-actinin-3 (ACTN3) R577X polymorphism in Japanese female collegiate athletes participating in sports with various mechanical-load characteristics. This study included 260 female collegiate athletes involved in 10 competitive sports and 26 controls (mean ages, 19.2 ± 1.2 and 19.7 ± 1.3 years, respectively). The sports were classified into 3 categories (low-impact, multidirectional, and high-impact) based on the exercise load characteristics. Data on sports participation and competition experience were obtained through a questionnaire-type survey. The maximum anaerobic power (MAnP) test was performed to measure muscle power. The total body BMD was measured using dual-energy X-ray absorptiometry. The ACTN3 R577X polymorphism (rs1815739) was analyzed using a TaqMan® assay. The multidirectional sports participants with the RR genotype of the ACTN3 R577X polymorphism had a higher BMD than those with the RX and RX + XX genotypes (P = .018 and P = .003, respectively). The RR genotype was also associated with a higher MAnP than those with the RX + XX genotypes (P = .035). No other variables related to BMD and MAnP were significantly different. Our results suggests that the RR genotype may confer high trainability for BMD and muscle power in Japanese female collegiate athletes participating in multidirectional sport types. However, these associations were not found in the athletes participating in the low- and high-impact sport types.