bluuebunny/crossref_metadata_2025 huggingface dataset:
The landscape of L-functions: degree 3 and conductor 1
Authors: Farmer David , Koutsoliotas Sally , Lemurell Stefan , Roberts David
Published: February 2024

We extend previous lists by numerically computing approximations to many L-functions of degree

d
=
3

d=3

, conductor

N
=
1

N=1

, and small spectral parameters. We sketch how previous arguments extend to show that for very small spectral parameters there are no such L-functions. Using the case

(
d
,
N
)
=
(
3
,
1
)

(d,N) = (3,1)

as a guide, we explain how the set of all L-functions with any fixed invariants

(
d
,
N
)

(d,N)

can be viewed as a landscape of points in a

(
d
−
1
)

(d-1)

-dimensional Euclidean space. We use Plancherel measure to identify the expected density of points for large spectral parameters for general

(
d
,
N
)

(d,N)

. The points from our data are close to the origin and we find that they have smaller density.
DP2LM: leveraging deep learning approach for estimation and hypothesis testing on mediation effects with high-dimensional mediators and complex confounders
Authors: Wang Shuoyang , Huang Yuan
Published: February 2024

Traditional linear mediation analysis has inherent limitations when it comes to handling high-dimensional mediators. Particularly, accurately estimating and rigorously inferring mediation effects is challenging, primarily due to the intertwined nature of the mediator selection issue. Despite recent developments, the existing methods are inadequate for addressing the complex relationships introduced by confounders. To tackle these challenges, we propose a novel approach called DP2LM (Deep neural network-based Penalized Partially Linear Mediation). This approach incorporates deep neural network techniques to account for nonlinear effects in confounders and utilizes the penalized partially linear model to accommodate high dimensionality. Unlike most existing works that concentrate on mediator selection, our method prioritizes estimation and inference on mediation effects. Specifically, we develop test procedures for testing the direct and indirect mediation effects. Theoretical analysis shows that the tests maintain the Type-I error rate. In simulation studies, DP2LM demonstrates its superior performance as a modeling tool for complex data, outperforming existing approaches in a wide range of settings and providing reliable estimation and inference in scenarios involving a considerable number of mediators. Further, we apply DP2LM to investigate the mediation effect of DNA methylation on cortisol stress reactivity in individuals who experienced childhood trauma, uncovering new insights through a comprehensive analysis.
Systematic Bibliographic Database Searching for an Overview of Reviews: A Practical Guide Using Children’s Participation as a Case Study
Authors: McCafferty Paul , Mercado Garcia Esther
Published: February 2024

Systematic literature reviews are crucial in research. Identifying relevant research is the first stage in a systematic review, yet challenges exist hindering their efficacy. Through a case study search strategy addressing the question ‘What do we know about children’s participation in child welfare decision-making?’, this article seeks to promote efficiency in searching by building on existing conceptual and practical guidelines for conducting systematic literature searches and appraisal of database performance in social work research. Thirteen databases were utilised in this study. The total citations, unique hits, sensitivity and precision for each database were calculated to gauge database performance before conducting a cross-study comparison with five previously published social work systematic reviews to begin recognising emergent themes. Social Science Citation and PsycINFO are effective high-performing databases in social work. Social Services Abstracts, Applied Social Science Index and Abstracts are also recommended. The article emphasises the pitfalls of relying on a single database, highlighting the importance of comprehensive searches to avoid bias and increase relevance. The findings underscore the need for social work professionals to develop effective database searching skills, leveraging the information age to inform and enhance practice, promoting efficiency and addressing the challenges faced in this critical stage of research.
Tracking Cryptococcal Meningitis to Monitor HIV Program Success During the Treat All Era: An Analysis of National Data in Botswana
Authors: Milburn James , Ntwayagae Ookeditse , Suresh Rachita , Ngoni Kebatshabile , Northcott Cassie , Penney James , Kinsella Matthew , Mechie Imogen , Ensor Samuel , Thamae Goitseone , Leeme Tshepo , Lawrence David S , Chebani Tony , Grint Daniel , Tenforde Mark W , Avalos Ava , Ramaabya Dinah , Ogando Justus , Mokomane Margaret , Mine Madisa , Jarvis Joseph N
Published: February 2024

Background

Cryptococcal meningitis (CM) causes substantial mortality in African countries with a high prevalence of human immunodeficiency virus (HIV), despite advances in disease management and increasing antiretroviral therapy (ART) coverage. Reliable diagnosis of CM is cheap and more accessible than other indicators of advanced HIV disease burden such as CD4 testing or investigation for disseminated tuberculosis; therefore, monitoring CM incidence has the potential to serve as a valuable metric of HIV programmatic success.

Methods

Botswana national meningitis surveillance data from 2015 to 2022 were obtained from electronic health records. All electronic laboratory records from cerebrospinal fluid samples analyzed within government healthcare facilities in Botswana were extracted from a central online repository. Adjustments for missing data were made through triangulation with prospective cohort study datasets. CM case frequency was enumerated using a case definition and incidence calculated using national census data.

Results

A total of 1744 episodes of CM were identified; incidence declined from 15.0 (95% confidence interval [CI], 13.4–16.7) cases/100 000 person-years in 2015 to 7.4 (95% CI, 6.4–8.6) cases/100 000 person-years in 2022. However, the rate of decline slowed following the introduction of universal treatment in 2016. The highest incidence was observed in men and individuals aged 40–44 years. The proportion of cases diagnosed through cryptococcal antigen testing increased from 35.5% to 86.3%.

Conclusions

CM incidence has decreased in Botswana following expansion of ART coverage but persists at a stubbornly high incidence. Most cases are now diagnosed through the cheap and easy-to-use cryptococcal antigen test, highlighting the potential of using CM as key metric of program success in the Treat All era.
The effect of retrieval practice on vocabulary learning for DHH children
Authors: Reimer Casey K , Grantham Heather , Butler Andrew C
Published: February 2024

On average, deaf and hard-of-hearing (DHH) children have difficulty developing expressive spoken vocabulary comparable to hearing peers. Yet, there are no evidence-based practices to guide classroom instruction for teachers of the deaf. Retrieval practice—a robust learning strategy—has been shown to improve children’s retention of vocabulary, but it has not been investigated with DHH children who use listening and spoken language. The present study examined whether DHH children benefit from using retrieval practice to learn new vocabulary. Sixteen DHH children (in the age range of 5.0–8.11 years) were taught a set of new vocabulary words using retrieval practice or repeated exposure. A recall test was administered two days later. Results showed that DHH children were twice as likely to recall a word taught through retrieval practice than exposure (OR = 2.01, p = .02). Presence of an additional diagnosis and number of practice trials were also significant predicting factors of vocabulary learning.
The Births, Lives and Deaths of Corporations in Late Imperial Russia
Authors: Gregg Amanda , Nafziger Steven
Published: February 2024

Enterprise creation, destruction and evolution support the transition to modern economic growth, yet these processes are poorly understood in industrialising contexts. We investigate Imperial Russia's industrial development at the firm level by examining entry, exit and persistence of corporations. Relying on newly developed balance sheet panel data from every non-financial Russian corporation (more than 2,500 of them) between 1899 and 1914, we examine the characteristics of entering and exiting corporations, how new entrants evolved and the impact of founder identity on subsequent outcomes. Russian corporations evolved within a market environment, conditional on overcoming distortionary institutional barriers to entry that slowed the emergence of these leading firms in the Imperial economy.
Effects of orthopedic treatment (distraction splint) on dentofacial deformities in patients with juvenile idiopathic arthritis
Authors: Vassis Stratos , Sabljic Sanja , Noeldeke Beatrice , Sefidroodi Mohammedreza , Küseler Annelise , Klit Pedersen Thomas , Stoustrup Peter
Published: February 2024

Background

Juvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joint (TMJ), which can alter mandibular growth and development and result in dentofacial deformities.

Objective

To assess the outcomes of orthopedic treatment with distraction splint (DS) in patients with JIA-related dentofacial deformity.

Methods

The retrospective study involved 30 patients with JIA and unilateral TMJ involvement, another study group of 20 patients with JIA and bilateral TMJ involvement, and a control group of 18 non-JIA orthodontic patients with Class II and III malocclusions. The inclusion criteria were DS treatment and cone-beam computed tomography (CBCT) scans before (T0) and 2 years after treatment (T1). Dentofacial morphology and deformity were evaluated based on a validated three-dimensional CBCT-based morphometric analysis. Intergroup differences in outcome measures were compared at T0 and T1, and intragroup changes between T0 and T1 were assessed using the Kruskal–Wallis test.

Results

Initial evaluations at T0 revealed significant differences between the unilateral and bilateral JIA groups and the control group for three out of eight dentofacial deformity variables: inter-side difference in total posterior mandibular height, mandibular axial angle, and posterior/anterior face height (ratio). At follow-up (T1), significant inter-group differences were only observed in total posterior mandibular height indicating that intergroup differences were less pronounced after splint treatment. Assessing inter-group changes between T0 and T1 showed that all parameters remained constant except posterior/anterior face height ratio, which significantly decreased between T0 and T1.

Conclusions

The findings demonstrate the potential of DS treatment for patients with JIA and unilateral or bilateral TMJ involvement to generally support normal dentofacial growth or at least limit further deterioration of dentofacial deformities.
Transglobal spread of an ecologically relevant sea urchin parasite
Authors: Ritchie Isabella T , Vilanova-Cuevas Brayan , Altera Ashley , Cornfield Kaileigh , Evans Ceri , Evans James S , Hopson-Fernandes Maria , Kellogg Christina A , Looker Elayne , Taylor Oliver , Hewson Ian , Breitbart Mya
Published: February 2024

Mass mortality of the dominant coral reef herbivore Diadema antillarum in the Caribbean in the early 1980s contributed to a persistent phase shift from coral- to algal-dominated reefs. In 2022, a scuticociliate most closely related to Philaster apodigitiformis caused further mass mortality of D. antillarum across the Caribbean, leading to >95% mortality at affected sites. Mortality was also reported in the related species Diadema setosum in the Mediterranean in 2022, though the causative agent of the Mediterranean outbreak has not yet been determined. In April 2023, mass mortality of Diadema setosum occurred along the Sultanate of Oman's coastline. Urchins displayed signs compatible with scuticociliatosis including abnormal behavior, drooping and loss of spines, followed by tissue necrosis and death. Here we report the detection of an 18S rRNA gene sequence in abnormal urchins from Muscat, Oman, that is identical to the Philaster strain responsible for D. antillarum mass mortality in the Caribbean. We also show that scuticociliatosis signs can be elicited in Diadema setosum by experimental challenge with the cultivated Philaster strain associated with Caribbean scuticociliatosis. These results demonstrate the Philaster sp. associated with D. antillarum mass mortality has rapidly spread to geographically distant coral reefs, compelling global-scale awareness and monitoring for this devastating condition through field surveys, microscopy, and molecular microbiological approaches, and prompting investigation of long-range transmission mechanisms.
Unravelling novel and pleiotropic genes for cannon bone circumference and bone mineral density in Yorkshire pigs
Authors: Qiu Zijian , Cai Wenwu , Liu Qian , Liu Kaiyue , Liu Chenxi , Yang Huilong , Huang Ruihua , Li Pinghua , Zhao Qingbo
Published: February 2024

Leg weakness is a prevalent health condition in pig farms. The augmentation of cannon bone circumference and bone mineral density can effectively improve limb strength in pigs and alleviate leg weakness. This study measured forelimb cannon bone circumference (fCBC) and rear limb cannon bone circumference (rCBC) using an inelastic tapeline and rear limb metatarsal area bone mineral density (raBMD) using a dual-energy X-ray absorptiometry bone density scanner. The samples of Yorkshire castrated boars were genotyped using a 50K single-nucleotide polymorphism (SNP) array. The SNP-chip data were imputed to the level of whole-genome sequencing data (iWGS). This study used iWGS data to perform genome-wide association studies and identified novel significant SNPs associated with fCBC on SSC6, SSC12, and SSC13, rCBC on SSC12 and SSC14, and raBMD on SSC7. Based on the high phenotypic and genetic correlations between CBC and raBMD, multi-trait meta-analysis was performed to identify pleiotropic SNPs. A significant potential pleiotropic quantitative trait locus (QTL) regulating both CBC and raBMD was identified on SSC15. Bayes fine mapping was used to establish the confidence intervals for these novel QTLs with the most refined confidence interval narrowed down to 56 kb (15.11 to 15.17 Mb on SSC12 for fCBC). Furthermore, the confidence interval for the potential pleiotropic QTL on SSC15 in the meta-analysis was narrowed down to 7.45 kb (137.55 to137.56 Mb on SSC15). Based on the biological functions of genes, the following genes were identified as novel regulatory candidates for different phenotypes: DDX42, MYSM1, FTSJ3, and MECOM for fCBC; SMURF2, and STC1 for rCBC; RGMA for raBMD. Additionally, RAMP1, which was determined to be located 23.68 kb upstream of the confidence interval of the QTL on SSC15 in the meta-analysis, was identified as a potential pleiotropic candidate gene regulating both CBC and raBMD. These findings offered valuable insights for identifying pathogenic genes and elucidating the genetic mechanisms underlying CBC and BMD.
MHY1485 potentiates immunogenic cell death induction and anti-cancer immunity following irradiation
Authors: Sun Lue , Morikawa Kumi , Sogo Yu , Sugiura Yuki
Published: February 2024

Recent in vitro experiments showed that combined treatment with MHY1485, a low-molecular-weight compound, and X-ray irradiation significantly increased apoptosis and senescence in tumor cells, which was associated with oxidative stress, endoplasmic reticulum (ER) stress and p21 stabilization, compared to radiation treatment alone. However, evidence for MHY1485 treatment-mediated suppression of tumor growth in animals is still lacking. Furthermore, it has been shown that ER stress enhances immunogenic cell death (ICD) in tumor cells, as it can exert a favorable influence on the anti-cancer immune system. In the present study, we examined whether co-treatment of MHY1485 and X-ray irradiation induces ICD and in vivo tumor growth suppression using the CT26 and Lewis lung carcinoma murine tumor cell lines. We found that MHY1485 + X-ray treatment promotes ICD more effectively than X-ray treatment alone. MHY1485 suppresses tumor growth in vivo under co-treatment with X-rays and increases INF-γ, tumor necrosis factor, interleukin-2 and interleukin-12 levels in the spleen as well as the presence of CD8+ cells in the tumor. The results suggest that MHY1485 treatment leads to the conversion of irradiated tumors into effective vaccines. Thus, MHY1485 is a promising lead compound for use in combination with radiotherapy.
Noninvasive biomarkers for lupus nephritis
Authors: Liu Ting , Yang Yun-long , Zhou Yan , Jiang Yong-mei
Published: February 2024

Lupus nephritis (LN) is one of the most severe clinical manifestations of systemic lupus erythematosus (SLE). Notably, the clinical manifestations of LN are not always consistent with the histopathological findings. Therefore, the diagnosis and activity monitoring of this disease are challenging and largely depend on invasive renal biopsy. Renal biopsy has side effects and is associated with the risk of bleeding and infection. There is a growing interest in the development of novel noninvasive biomarkers for LN. In this review, we summarize most of the LN biomarkers discovered so far by correlating current knowledge with future perspectives. These biomarkers fundamentally reflect the biological processes of kidney damage and repair during disease. Furthermore, this review highlights the role of urinary cell phenotype detection in the diagnosis, monitoring, and treatment of LN and summarizes the limitations and countermeasures of this test.
Post-traumatic stress disorder in hospital doctors after the COVID-19 pandemic
Authors: Rollin L , Guerin O , Petit A , Bourdon L , Guillemette S , Gislard A , Clin B , Bachelet L , Rouget Mejjad I , Rouger F , Benichou J , Gehanno J F , Commune A
Published: February 2024

Background

Prior studies showed that during the coronavirus disease 2019 (COVID-19) pandemic healthcare workers had a higher risk of developing post-traumatic stress disorder (PTSD) symptoms. However, studies conducted among doctors several years after the beginning of the COVID-19 pandemic are scarce.

Aims

To evaluate the prevalence of PTSD among hospital doctors and to describe potential explanatory factors.

METHODS

The Protec-Cov study was an observational, cross-sectional, multicentre study, which used an anonymous online questionnaire to evaluate PTSD in doctors from six hospitals in France between December 2021 and March 2022. The presence of PTSD was assessed using the Post-traumatic Stress Disorder Checklist Scale (PCLS) questionnaire with a cut-off of 44.

RESULTS

Among the 307 doctors included, 18% presented a PCLS ≥44. The multivariate analysis showed that factors associated with a PCLS ≥44 were having a higher workload than before the COVID-19 pandemic (odds ratio [OR] = 4.75; 95% confidence interval [CI] 1.68–13.38), not feeling recognized within the professional environment (OR = 2.83; 95% CI 1.26–6.33), and feeling isolated because of the lockdown (OR = 4.2; 95% CI 1.97–8.95). Approximately 30% of hospital doctors (n = 91) felt a need for psychological support but only 31% of them (n = 28) received support.

Conclusions

Based on our findings, a high prevalence of PTSD was observed among hospital doctors 2 years after the beginning of the COVID-19 pandemic. This study supports an early diagnosis of PTSD in this category of healthcare workers and warrants further study.
Two different viral proteins suppress NUCLEAR FACTOR-YC-mediated antiviral immunity during infection in rice
Authors: Tan Xiaoxiang , Wang Guoda , Cao Chen , Yang Zihang , Zhang Hehong , Li Yanjun , Wei Zhongyan , Chen Jianping , Sun Zongtao
Published: February 2024

Plant viruses have multiple strategies to counter and evade the host’s antiviral immune response. However, limited research has been conducted on the antiviral defense mechanisms commonly targeted by distinct types of plant viruses. In this study, we discovered that NUCLEAR FACTOR-YC (NF-YC) and NUCLEAR FACTOR-YA (NF-YA), 2 essential components of the NF-Y complex, were commonly targeted by viral proteins encoded by 2 different rice (Oryza sativa L.) viruses, rice stripe virus (RSV, Tenuivirus) and southern rice black streaked dwarf virus (SRBSDV, Fijivirus). In vitro and in vivo experiments showed that OsNF-YCs associate with OsNF-YAs and inhibit their transcriptional activation activity, resulting in the suppression of OsNF-YA-mediated plant susceptibility to rice viruses. Different viral proteins RSV P2 and SRBSDV SP8 directly disrupted the association of OsNF-YCs with OsNF-YAs, thereby suppressing the antiviral defense mediated by OsNF-YCs. These findings suggest an approach for conferring broad-spectrum disease resistance in rice and reveal a common mechanism employed by viral proteins to evade the host’s antiviral defense by hindering the antiviral capabilities of OsNF-YCs.
Evidence-based medicine or statistically manipulated medicine? Are we slaves to the P-value?
Authors: Goel Harsh , Raheja Divisha , Nadar Sunil K
Published: February 2024

First popularized almost a century ago in epidemiologic research by Ronald Fisher and Jerzy Neyman, the P-value has become perhaps the most misunderstood and even misused statistical value or descriptor. Indeed, modern clinical research has now come to be centered around and guided by an arbitrary P-value of <0.05 as a magical threshold for significance, so much so that experimental design, reporting of experimental findings, and interpretation and adoption of such findings have become largely dependent on this “significant” P-value. This has given rise to multiple biases in the overall body of biomedical literature that threatens the very validity of clinical research. Ultimately, a drive toward reporting a “significant” P-value (by various statistical manipulations) risks creating a falsely positive body of science, leading to (i) wasted resources in pursuing fruitless research and (ii) futile or even harmful policies/therapeutic recommendations. This article reviews the history of the P-value, the conceptual basis of P-value in the context of hypothesis testing and challenges in critically appraising clinical evidence vis-à-vis the P-value. This review is aimed at raising awareness of the pitfalls of this rigid observation of the threshold of statistical significance when evaluating clinical trials and to generate discussion regarding whether the scientific body needs a rethink about how we decide clinical significance.
Daily light exposure profiles and the association with objective sleep quality in patients with Parkinson’s disease: The PHASE study
Authors: Obayashi Kenji , Saeki Keigo , Tai Yoshiaki , Yamagami Yuki , Esaki Yuichi , Yoshikawa Tadanobu , Sugie Kazuma , Kataoka Hiroshi
Published: February 2024

Study Objectives

Light information crucially influences sleep initiation and continuity. The purpose of this study was to compare daily light exposure between patients with Parkinson’s disease (PD) and non-PD older adults and evaluate the association of daily light exposure with objective sleep measures in patients with PD.

Methods

In this cross-sectional study of 189 outpatients with PD and 1101 community-dwelling older adults (controls), daily light exposure was measured using wrist light meters during the daytime and light meters set in the bedrooms during the nighttime, and objective sleep quality was measured by wrist actigraphy.

Results

The median duration of exposure to ≥ 1000 lux light was significantly shorter in patients with PD than in controls. The median nighttime light intensity was higher in patients with PD than in controls. Among patients with PD, multivariable analysis suggested that the highest quartile of exposure to ≥ 1000 lux light during the daytime was linked to significantly higher sleep efficiency (SE) by 8.0% and shorter wake after sleep onset (WASO) by 36.9 minutes than the lowest quartile. During the nighttime, the highest quartile of mean light intensity had significantly lower SE by 6.8%, longer WASO by 24.1 minutes, longer sleep onset latency, and higher fragmentation index, than the lowest quartile. Importantly, daytime and nighttime light levels were independently associated with objective sleep measures.

Conclusions

The present study illustrated that greater daytime light exposure and lower nighttime light exposure are significantly associated with better objective sleep measures in patients with PD.
A primer on the restorative therapies for erectile dysfunction: a narrative review
Authors: Narasimman Manish , Sandler Max , Bernstein Ari , Loloi Justin , Saltzman Russell G , Bernie Helen , Ramasamy Ranjith
Published: February 2024

Introduction

Erectile dysfunction (ED) is a common condition that affects millions worldwide. Patients and urologists alike are seeking alternative therapies that can provide long-lasting results in the treatment of ED. This review provides a comprehensive overview of restorative treatments available for ED, such as platelet-rich plasma, stem cell therapy, and shockwave therapy.

Objective

The aim of this narrative review is to provide a primer for urologists and general practitioners on the basics of implementing ED restorative therapies in their practice.

Methods

The PubMed, MEDLINE, and Google Scholar databases were searched for articles in the English language through August 31, 2023, that included key terms such as “erectile dysfunction,” “restorative therapy,” “shockwave therapy,” “platelet-rich plasma,” “stem cell therapy,” and “stromal vascular fraction.” Reference lists of selected studies were manually reviewed to find articles not identified by the initial database search.

Results

Shockwave therapy has demonstrated effectiveness in treating ED, with devices like the Medispec ED1000 and Storz Duolith showing statistically significant improvements in patient scores for International Index of Erectile Function (IIEF)–Erectile Function scores in clinical trials. In reported studies of platelet-rich plasma injections, a substantial percentage of patients reached a minimal clinically important difference in the IIEF–Erectile Function scale after treatment. Studies of ED treatment with stem cell therapy, while limited and with small sample sizes, have demonstrated encouraging improvements in patient scores for the abridged 5-item version of the IIEF after treatment.

Conclusion

Shockwave, platelet-rich plasma, and stem cell therapies are important, novel, noninvasive restorative treatments for ED that can provide relief for patients wishing to avoid a more invasive approach. While these therapies have shown promising results in clinical trials, more research is required to establish them as standardized and efficacious options in the management of ED.
Dynamics of Puccinia striiformis f. sp. tritici Urediniospores and Its Relationship with Meteorological Factors in Mianyang, China
Authors: Hu Xuemin , Lin Jiahao , Li Yuxiang , Zhang Hua , Xu Xiangming , Hu Xiaoping
Published: February 2024

Stripe rust, caused by Puccinia striiformis f. sp. tritici ( Pst), is one of the main diseases of wheat worldwide. Mianyang of Sichuan province in Southwest China is one of main regions for winter Pst inoculum production and spring epidemic and provides urediniospores for infecting wheat in the surrounding regions. Understanding the urediniospore dynamics is important to predict and manage stripe rust. In this study, spore trapping coupled with a TaqMan real-time quantitative PCR method was used to monitor airborne Pst urediniospores from December 2019 to December 2022 in Mianyang. Weather conditions (temperature, relative humidity, daily sunshine duration, and precipitation) were collected for the same period. These data were used to study the relationship of airborne urediniospore density with climatic conditions. The results showed that Pst urediniospores were captured all year round, and the annual peak of urediniospore densities occurred in the period from March to April in which the urediniospores accounted for the largest proportion of the annual total urediniospores. The density of urediniospores in the period of March to April was linearly related to the average sunshine duration of 20 days and average temperature of 15 days prior to the final day of a 7-day trapping period. This relationship needs to be tested in other regions where Pst can sporulate during the winter before it can be integrated with Pst infection conditions to predict rust development.
Novel Uses of Methadone Under the “72-Hour Rule” to Facilitate Transitions of Care and Low-Dose Buprenorphine Induction in an Outpatient Bridge Clinic
Authors: Shahlapour Minaliza , Singh Sabetta , Christine Paul J. , Laks Jordana , Evans James , Farrell Natalija M. , Khan G. Karim , Taylor Jessica L. , Rozansky Hallie
Published: February 2024

Background

Federal regulations restrict methadone for opioid use disorder (OUD) treatment to licensed opioid treatment programs (OTPs). However, providers in other settings can administer methadone for opioid withdrawal under the “72-hour rule” while linking to further care. Prior work has demonstrated that methadone initiation in a low-barrier bridge clinic is associated with high OTP linkage and 1-month retention rates. We describe 2 other novel applications of the 72-hour rule in which methadone withdrawal management facilitated linkage to inpatient hospitalization and outpatient buprenorphine induction.

Case Presentations

Patient 1 was a 46-year-old woman with OUD complicated by serious injection-related infections. Severe opioid withdrawal limited her ability to tolerate emergency department wait times and receive inpatient care. We administered methadone for opioid withdrawal in an outpatient bridge clinic immediately before emergency department referral; this enabled hospital admission for intravenous antibiotics and anticoagulation. Patient 2 was a 36-year-old man with OUD desiring buprenorphine treatment. He had been unable to complete traditional buprenorphine induction without experiencing precipitated withdrawal. Thus, we recommended a low-dose buprenorphine induction overlapping with a full opioid agonist. Given the patient's preference to stop using fentanyl immediately, he received 72 hours of methadone for withdrawal treatment during the induction phase and successfully transitioned to buprenorphine without significant concomitant fentanyl use.

Conclusion

In addition to facilitating OTP linkage, on-demand 72-hour methadone administration for opioid withdrawal can reduce barriers to acute medical care and buprenorphine treatment.
Traditional Versus Water-resistant Short Leg Casting: A Randomized Controlled Pilot Study
Authors: Carveth Stephen L. , Bomar James D. , Scott MaryLou , Rickert Kathleen D. , Upasani Vidyadhar V.
Published: February 2024

Introduction:

We conducted a randomized controlled trial comparing fiberglass short leg casts with traditional cast padding to similar casts with water-resistant cast padding and recorded the opinion of the patient/caregiver and Orthopaedic Technicians (Ortho Techs) that applied and removed the casts.

Methods:

Subjects with an injury that would be treated with a short leg cast were enrolled and randomized into a traditional cast or a water-resistant cast. Following cast application, the Ortho Tech that applied the cast completed a questionnaire asking their opinion on ease of application, moldability, padding level, and time taken for application. Following the removal of the study cast, the Ortho Tech that removed the cast completed a questionnaire that included an assessment of skin condition and evidence of the patient poking items inside the cast, as well as their opinion of ease of padding removal, padding durability and longevity, and an overall quality assessment of the cast padding. Following cast removal, the patient (or caregiver) also completed a questionnaire asking for their assessment of comfort, the weight of the cast, itchiness, heat/sweat, smell, and satisfaction. Patients who were treated with an expanded polytetrafluoroethylene cast were also asked about their happiness with the cast’s water resistance and asked how long the cast took to dry.

Results:

Sixty patients were included in this study, thirty in each group. The water-resistant casts took longer to apply than the traditional casts (12.4±4.0 vs. 8.2±3.2 min, P<0.001). The Ortho Techs favored the traditional cast when it came to ease of application (P<0.001), moldability (P=0.003), ease of padding removal (P<0.001), padding durability (P=0.006), padding longevity (P=0.005), and their overall impression (P=0.014). The patients/caregivers responded similarly among the 2 groups for each survey question.

Conclusions:

Patients randomized into each cast type tolerated their cast similarly; however, the Ortho Techs involved in this study preferred the traditional cast.
Hypoxic transcriptomes predict survival and tumor-infiltrating immune cell composition in cutaneous melanoma
Authors: Diaz Michael J. , Quach Jessica , Song Joanna , Milanovic Silvija , Tran Jasmine T. , Ladehoff Lauren C. , Batchu Sai , Whitman Patrick , Kaffenberger Benajmin H. , Montanez-Wiscovich Marjorie E.
Published: February 2024

Hypoxia has established associations with aggressive tumor phenotypes in many cancers. However, it is not currently understood whether tumor hypoxia levels map to distinct immune infiltrates in cutaneous melanoma, potentially unveiling novel therapeutic targets. To this end, we leveraged a previously identified seven-gene hypoxia signature to grade hypoxia levels of 460 cutaneous melanomas obtained from the Broad Institute GDAC Firehose portal. CIBERSORTx (https://cibersortx.stanford.edu/) was employed to calculate the relative abundance of 22 mature human hematopoietic populations. Clinical outcomes and immune cell associations were assessed by computational means. Results indicated that patients with high-hypoxia tumors reported significantly worse overall survival and correlated with greater Breslow depth, validating the in-silico methodology. High-hypoxia tumors demonstrated increased infiltration of activated and resting dendritic cells, resting mast cells, neutrophils, and resting NK cells, but lower infiltration of gamma-delta T cells. These data suggest that high tumor hypoxia correlates with lower survival probability and distinct population differences of several tumor-infiltrating leukocytes in cutaneous melanomas.
Silicone Migration from Intact Saline Breast Implants
Authors: Azahaf Siham , Spit Karlinde A. , de Blok Christel J.M. , Bult Peter , Nanayakkara Prabath W.B.
Published: February 2024

Breast augmentation is a widely performed surgical procedure worldwide, predominantly using silicone gel-filled implants. Concerns have primarily revolved around ruptures and the potential health risks associated with leaked silicone from silicone gel-filled implants. Cases of silicone migration from the shell of saline breast implants remain scarce. This case report introduces a unique case of a 66-year-old patient with silicone migration from intact saline breast implants. The patient presented with a range of symptoms consistent with breast implant illness. Radiological findings suggested the presence of silicone in the axillary lymph nodes, despite the integrity of the implants, thereby confirming silicone migration. Histopathological evaluation revealed a foreign body reaction and the presence of silicone in the axillary lymph nodes. Given the saline filling, the source is likely the polydimethylsiloxane shell. The rarity of documented silicone migration from intact saline breast implants, especially in patients with breast implant illness, underscores the need for more research into the health implications of leaked silicone particles from breast implants.
Remote programming in stage I sacral neuromodulation: a Multi-Center prospective feasibility study
Authors: Jing Jibo , Meng Lingfeng , Zhang Yaoguang , Wang Xinhao , Zhu Wen , Wang Qingwei , Lu Li , Song Wei , Zhang Yifei , Li Yan , Ning Jiaxing , Wang Haoran
Published: February 2024

Objective:

Sacral neuromodulation (SNM) has emerged as an effective therapy for refractory lower urinary tract dysfunction (LUTD). Remote programming holds promise in addressing the time and economic burdens associated with outpatient programming, especially for patients in the observation period following Stage I implant surgery (where the lead is implanted first without the pulse generator). The study aimed to explore the effectiveness and patient satisfaction of remote programming for Stage I SNM patients, and analyze the benefits patients gain from remote programming.

Methods:

This prospective study was conducted at multiple high-level clinical SNM centers in China. Patients requiring SNM implantation were enrolled and divided into two groups based on patient preference: remote programming (RP) group and outpatient control (OC) group. Patient attitudes toward RP were assessed through questionnaires, and the degree of symptom improvement was compared between the two groups to explore the usability of RP.

Results:

A total of 63 participants from 6 centers were included in the study, with 32 belonging to the RP group. The remote programming system presents a high level of usability (98%) and willingness (satisfaction rate: 96.83%) in result of questionnaire. RP showed a significant advantage in improving patients’ score of ICSI/ICPI (medianΔICSI/ICPI RP vs OC= -13.50 vs -2, P=0.015). And slightly ameliorate urinary symptoms such as pain (medianΔVAS RP vs OC= -1 vs 0, P= 0.164 ) and urgency ( medianΔOBASS -2.5 vs -1, P= 0,229), but the difference was not statistically significant. RP did not significantly impact the quality of life of patients (P=0.113), so do the rate of phase-two conversion (P= 0.926) or programming parameters.

Conclusion:

To the best of our knowledge, the presented study is the first multicenter research focusing on the remote programming of Stage I SNM patients. Through the clinical implementation and patient feedback, we demonstrate that remote programming is not inferior to in-person programming in terms of success rate, effectiveness, safety, and patient satisfaction.
Watch-and-Wait strategy vs. resection in patients with radiologic complete response after conversion therapy for initially unresectable hepatocellular carcinoma：a propensity score-matching comparative study
Authors: Li Binkui , Wang Chenwei , He Wei , Qiu Jiliang , Zheng Yun , Zou Ruhai , Lin Zhu , Shi Yunxing , Yuan Yichuan , Zhang Rong , Zhang Chao , Chen Minshan , Lau Wan Yee , Yuan Yunfei
Published: February 2024

Background:

The optimal subsequent management for patients with initially unresectable hepatocellular carcinoma (uHCC) who have achieved complete response (CR) following conversion therapy remains unclear. This study aims to evaluate the feasibility and outcomes of the watch-and-wait (W-W) strategy versus surgical resection (SR) for these patients.

Materials and Methods:

This retrospective study reviewed patients with initially uHCC who underwent conversion therapy employing transarterial therapies combined with or without systemic therapies. Radiologic CR (rCR), clinical CR (cCR), and pathologic CR (pCR) were evaluated. Overall survival (OS) and progression-free survival (PFS) were compared between the W-W and SR groups.

Results:

Among 1880 patients with uHCC who underwent conversion therapy, 207 (11.0%) achieved rCR. Finally, we enrolled 149 patients meeting the inclusion criteria, including 74 receiving W-W strategy and 75 undergoing SR. Among the 149 patients with rCR, the W-W group demonstrated comparable 3-year OS rates to the SR group (80.9% vs 83.1%, P=0.77), but demonstrated inferior PFS rates (14.4% vs 46.5%, P=0.002). These results remained consistent after propensity score matching. For the 57 patients who achieved cCR, the W-W group exhibited comparable 3-year OS (88.1% vs 87.9%, P=0.89) and PFS rates (27.8% vs 40.8%, P=0.34) compared to SR group. Among the 75 patients in the SR group, 31 (41.3%) achieved pCR and 44 (58.7%) reached non-pCR. When compared with patients with pCR, those who achieved rCR in the W-W group showed comparable OS but inferior PFS rates. Moreover, patients who achieved rCR in the W-W group displayed both comparable OS and PFS rates to those with non-pCR.

Conclusion:

The W-W strategy offered comparable survival outcomes to surgical resection in patients with initially uHCC who achieved rCR or cCR after conversion therapy. For these patients, the W-W strategy could be offered as an alternative treatment option.
Ultrasound Biofeedback Increases Abdominal Muscle Activation in Golfers With a History of Low Back Pain
Authors: Skibski Andrew , Stout Jeffrey R. , Ingersoll Christopher D. , Mangum L. Colby
Published: February 2024

Objectives:

To compare activation ratios of the transverse abdominis (TrA) during an abdominal draw-in maneuver (ADIM) and abdominal obliques during a golf swing, with and without ultrasound biofeedback, and to determine intrarater reliability of these ultrasound thickness measures.

Design:

Single-session crossover study.

Setting:

Laboratory.

Participants:

Sixteen adult golfers with 2 or more episodes of low back pain (LBP) in the past year.

Interventions:

Verbal cueing alone and verbal cueing with ultrasound biofeedback.

Main Outcome Measures:

Bilateral TrA activation ratios were calculated during an ADIM with and without ultrasound biofeedback. Activation ratios of the abdominal obliques were calculated bilaterally during golf swings with and without ultrasound biofeedback. Intraclass correlation coefficients (ICCs) were calculated for average thickness across all muscles and conditions for the nonbiofeedback trials.

Results:

Transverse abdominis activation ratios were significantly higher when ultrasound biofeedback was provided bilaterally (P < 0.001). Abdominal oblique activation ratios during the golf swing were also significantly higher with ultrasound biofeedback for the lead (P = 0.014) and trail (P < 0.001) sides. Intraclass correlation coefficient values ranged from 0.92 to 0.97 (P < 0.001).

Conclusions:

Ultrasound biofeedback can increase activation ratios of the TrA during a supine ADIM in adult golfers with a history of LBP. Postswing ultrasound biofeedback increases activation of the abdominal obliques during a golf swing in golfers with a history of LBP. Ultrasound thickness measures of the TrA and obliques have excellent intrarater reliability.
Chorea as the only presenting clinical feature of rheumatic fever: a case report
Authors: Thapa Santosh , Raut Ujwal , Shrestha Garima , Shah Sandesh , Helmu Mangal Bahadur
Published: February 2024

Introduction and importance:

Sydenham’s chorea (SC), a major neurological manifestation of acute rheumatic fever (ARF), is commonly seen in young children and adolescents. It is characterized by rapid, unpredictable, involuntary, and nonpatterned contractions affecting mostly distal limbs. It can also be associated with clinical or subclinical carditis. SC has been reported as a major manifestation in only 3.87% cases of acute rheumatic fever in Nepal.

Case presentation:

The authors report a case of a 12-year-old boy with abnormal movement of his right hand and unsteady gait for 12 days. On examination, he had an abnormal hand grip with difficulty maintaining a tetanic contraction (Milkmaid’s grip). Laboratory investigations revealed increased anti-Streptolysin O titre and erythrocyte sedimentation rate. Echocardiography revealed subclinical carditis. After thorough clinical examination and pertinent investigations, the final diagnosis of ARF with SC was made.

Clinical discussion:

SC is a major clinical feature of rheumatic fever according to the revised Jones criteria. It is related to a previous Group A β-haemolytic Streptococcus pyogenes (GABHS) infection. Approximately 50–65% of the patients with rheumatic fever later develop clinically detectable carditis. Although a self-limiting condition, it might need treatment with antiepileptics, neuroleptics, and phenothiazines.

Conclusion:

Any child presenting with a movement disorder should also be considered for SC, necessitating additional testing, including a cardiovascular assessment. It needs to be distinguished from other causes of movement disorders as well as psychiatric conditions. Treatment is necessary for moderate to severe chorea that interfere with daily activities. Compliance with subsequent antibiotic prophylaxis is essential for avoiding future cardiac complications.
Limited significance of bicarbonate therapy in the treatment of diabetic ketoacidosis: a rare case report in the periphery of Nepal
Authors: Shrestha Pran , Gautam Ajaya Raj , Malla Sibika , Parajuli Susmita , K.C. Rupak
Published: February 2024

Introduction and importance:

An uncontrolled hyperglycaemia accompanied by metabolic acidosis and an increase in total body ketone, if left untreated, has the potential to develop into complications, including diabetes ketoacidosis (DKA). Management of this complication with IV hydration, IV Insulin, and potassium (KCL) maintenance is a comprehensive approach. On the contrary, bicarbonate therapy is generally not regarded as a standard treatment due to its unfavourable outcome.

Case presentation:

The authors present a case of a 21-year-old female who was brought in a semiconscious state to the emergency department with complaints of pain in the abdomen, headache, and vomiting. DKA was diagnosed following the patient’s symptoms and arterial blood gas analysis report. She was managed with IV fluids, IV insulin, and KCL.

Clinical discussion:

Generally, pH less than 6.8 has a poor patient survival outcome. Here, the patient presented with pH less than 6.6, where she was managed with the standard regimen without the need to administer bicarbonate therapy.

Conclusion:

DKA is a life-threatening condition that can be precipitated by non-adherence to medications and infections with IV insulin and hydration playing a pivotal role in its management while bicarbonate offers no beneficial effect.
Mycobacterium interjectum causing submandibular lymphadenitis in a child
Authors: Lin Sallie , Trieu Connie
Published: February 2024

Nontuberculous mycobacteria (NTM) commonly manifest as cervical lymphadenitis in immunocompetent children. Only a few species, such as Mycobacterium avium complex (MAC), cause infection in children. With recent advances in gene sequencing,

Mycobacterium interjectum

has been identified as a rare cause of adenitis in children, with at least ten cases reported since 1993. Curative treatment for NTM lymphadenitis, particularly when caused by MAC, usually involves complete surgical excision of the affected lymph nodes. This case report highlights successful treatment of submandibular lymphadenitis caused by

M. interjectum

in a paediatric patient, despite multi-drug resistance in vitro.