bluuebunny/crossref_metadata_2025_split huggingface dataset:
Airborne anaphylaxis: highlighting an invisible enemy
Authors: Ridolo Erminia , Incorvaia Cristoforo , Schroeder Jan Walter 
Published: August 2022

Purpose of review
Airborne anaphylaxis is a rare disorder defined by the occurrence of anaphylactic reactions to inhaled allergens, which may arise not only in occupational exposure but also in common settings. Foods are the most common cause of airborne anaphylaxis, even organic mixtures scents. The other important cause is represented by drugs, while in the wide range of other causes, there are often reports on unique cases. This review aims to make an overview about the potential causes of airborne anaphylaxis, by analysing what is described in literature on this topic.

Recent findings
Concerning epidemiology, no data on specific prevalence of airborne allergy in adults are available. To date, only one study evaluated the specific prevalence of airborne allergy with anaphylaxis to foods in children, resulting in 5.9% of reactions due to exposure to aerosolized foods, compared with 78% of reactions caused by food ingestion. In addition to anaphylaxis, airborne-related reactions may also present with symptoms such as rhino-conjunctivitis, wheezing, dyspnoea and asthma.

Summary
A detailed anamnesis facilitates a correct diagnosis, which allows appropriate therapeutic and preventive interventions, but, similarly to rare diseases in general, only specialized doctors are able to implement it. The assumption of the approach used in emergency medicine for other causes of anaphylaxis, that is referring the patient at discharge to an allergist who will teach the basic notions to recognize symptoms and access the appropriate therapy, would allow the patient to avoid situations of serious danger.
Hereditary alpha-tryptasemia
Authors: Bonadonna Patrizia , Nalin Francesca , Olivieri Francesco 
Published: August 2022

Purpose of review
To discuss our evolving knowledge about the genetic variations in human tryptase and recent advances in associated clinical phenotypes.

Recent findings
Hereditary alpha-tryptasemia (HAT) is an autosomal dominant genetic trait and a common cause of elevated basal serum tryptase (BST) in Western populations. It is a risk factor for severe anaphylaxis and an established modifier of mast cell mediator–associated symptoms among patients with systemic mastocytosis (SM).

Summary
The unique properties of naturally occurring alpha/beta-tryptase heterotetramers may explain certain elements of phenotypes associated with HAT. Understanding the physiology of tryptases and how this may relate to the clinical features associated with HAT is the first step in identifying optimal medical management and targets for novel therapeutics.
Treatment of Stage I-III Hip Joint Tuberculosis With Open Surgical Debridement and Hip Spica in Children: A Retrospective Study
Authors: Yang Lei , Zuo Jingjing , Li Lang , Wang Daoxi , Yang Xiaodong , Tang Xueyang 
Published: August 2022

Background:
This study aimed to evaluate the outcome of surgical debridement combined with postoperative hip spica immobilization in the treatment of hip joint tuberculosis in children.

Methods:
This retrospective study enrolled 87 children with stage I to III hip joint tuberculosis treated surgically at our hospital from January 2010 to January 2016. All patients considering hip tuberculosis routinely received a 4-week conservative treatment first, including rest, protected weight-bearing, and 4-drugs antitubercular chemotherapy. Surgical debridement was indicated when there was no relief after this conservative protocol. Patients were divided into 2 groups according to the duration of hip spica immobilization after operation: group A (hip spica for 4 wk, 39 patients) and group B (hip spica for 6 wk, 48 patients). All patients were recommended partial weight-bearing for 7 days and then followed the same hip joint exercises program when spica was removed. Postoperative radiographs, hip dislocation or subluxation, and modified Harris hip score (MHHS) were assessed. All patients were followed up at least 5 years.

Results:
There were 87 patients enrolled in our study, including 34 females and 53 males, with a mean age of 7.2±2.8 years old (range: 2 to 14 y). No significant difference was observed between these 2 groups in baseline data. In group A, the mean MHHS improved from 52.1±14.7 before surgery to 87.8±8.3 at the final follow-up (P<0.000). In group B, there was also a significant difference between the preoperative MHHS (52.7±9.4) and the final MHHS (88.6±6.5) (P<0.000). Although there was no significant difference between these 2 groups in the final MHHS (P=0.593), there were also no significant differences between these 2 groups in wound healing delay (3 in group A and 6 in group B, P=0.705) and pathologic subluxation (3 in group A and 1 in group B, P=0.467). The only difference between group A (79.2±8.5) and group B (75.5±7.5) was the early functional outcome assessed by using MHHS after 1 month of hip joint exercises (P=0.032).

Conclusions:
Surgical debridement combined with antitubercular chemotherapy is an effective treatment for stage I to III hip tuberculosis in children when there is no improvement after conservative treatment. Prolonged hip spica immobilization may not reduce the risk of hip subluxation after open surgical debridement but could lead to a delay in early functional recovery. Time of spica immobilization should be individualized and based on the surgeon’s evaluation and the patient’s condition.
Mechanisms of microRNA action in rectal cancer radiotherapy
Authors: Zhu Lili , Wang Mojin , Chen Na , Zhang Yujie , Xu Tao , Zhuang Wen , Xiao Shuomeng , Dai Lei 
Published: August 2022

Abstract
Preoperative neoadjuvant chemoradiotherapy, combined with total mesorectal excision, has become the standard treatment for advanced localized rectal cancer (RC). However, the biological complexity and heterogeneity of tumors may contribute to cancer recurrence and metastasis in patients with radiotherapy-resistant RC. The identification of factors leading to radioresistance and markers of radiosensitivity is critical to identify responsive patients and improve radiotherapy outcomes. MicroRNAs (miRNAs) are small, endogenous, and noncoding RNAs that affect various cellular and molecular targets. miRNAs have been shown to play important roles in multiple biological processes associated with RC. In this review, we summarized the signaling pathways of miRNAs, including apoptosis, autophagy, the cell cycle, DNA damage repair, proliferation, and metastasis during radiotherapy in patients with RC. Also, we evaluated the potential role of miRNAs as radiotherapeutic biomarkers for RC.
Percentage of Age-Predicted Cardiorespiratory Fitness May Be a Stronger Risk Indicator for Incident Type 2 Diabetes Than Absolute Levels of Cardiorespiratory Fitness
Authors: Kunutsor Setor K. , Khan Hassan , Seidu Samuel , Laukkanen Jari A. 
Published: August 2022

Purpose:
There are inverse and independent associations between cardiorespiratory fitness (CRF) and several adverse cardiometabolic outcomes. The percentage of age-predicted CRF (%age-predicted CRF) is comparable to absolute CRF as a risk indicator for some of these outcomes, but the association between %age-predicted CRF and risk of type 2 diabetes (T2D) has not been previously investigated. We aimed to assess the association between %age-predicted CRF and T2D in a prospective cohort study.

Methods:
Cardiorespiratory fitness, as measured directly by peak oxygen uptake, was assessed in 1901 men aged 42-60 yr who underwent cardiopulmonary exercise testing. The age-predicted CRF estimated from a regression equation for age was converted to %age-predicted CRF using (achieved CRF/age-predicted CRF) × 100. Hazard ratios (95% CI) were estimated for T2D.

Results:
During a median follow-up of 26.8 yr, 227 T2D cases were recorded. The risk of T2D decreased continuously with increasing %age-predicted CRF (P value for nonlinearity = .30). A 1-SD increase in %age-predicted CRF was associated with a decreased risk of T2D in analysis adjusted for established risk factors (HR = 0.68: 95% CI, 0.59-0.79). The corresponding adjusted risk was (HR = 0.51: 95% CI, 0.35-0.75) comparing extreme tertiles of %age-predicted CRF. The respective estimates for the association between absolute CRF and T2D were—HR (95% CI)—0.71 (0.60-0.83) and 0.64 (0.44-0.95).

Conclusions:
Percentage of age-predicted CRF is linearly, inversely, and independently associated with the risk of incident T2D and may be a stronger risk indicator for T2D compared to absolute CRF in a general population of middle-aged and older men.
Medical Accuracy of Patient Discussions in Oculoplastic Surgery on Social Media
Authors: Schmuter Gabriella , North Victoria S. , Kazim Michael , Tran Ann Q. 
Published: August 2022

Purpose:
The aim of this study was to characterize major topics of discussion in oculoplastic surgery on a social media forum and to evaluate the medical accuracy of the content discussed on these platforms.

Methods:
A cross-sectional analysis of oculoplastics key search terms was performed on 2 active forums (r/PlasticSurgery and r/CosmeticSurgery) on Reddit. The content analysis involved the top posts in Reddit’s history from 2008 to 2022. Medical accuracy was determined by actively practicing, board-certified, and fellowship-trained oculoplastic surgeons.

Results:
The most common topics of patient discussions involved inquiring for advice regarding a procedure (44%) and sharing before-and-after photos (34%). The most common topics of patient discussions included providing support, encouragement, or sympathy for a patient (80%) and the cost of a procedure (62%). Misunderstanding of the medical pathophysiology of the patient’s condition was seen in 68% of discussions on this social media platform. Medically inaccurate information was seen in 31% of all analyzed statements. When the type of physician performing a given procedure was disclosed, half reported an oculoplastic surgeon performed the surgery.

Conclusions:
The social media platform, Reddit, is a popular source of advice and information for current and prospective oculoplastic surgery patients. Such social media forums should be used as a sort of psychosocial and psychological support rather than as a primary source of medical information.
The Association Between Computerized Tomography Findings and Ocular Trauma Score in Open Globe Injury: The Prognostic Value of Imaging
Authors: Ameli Kambiz , Arabi Amir , Shahraki Toktam , Markatia Zahra , Mashouf Parham , Shahraki Tamkin , Yazdanjou Farangis , Baradaran-rafii Alireza , Bayaraa Enkhmandakh , Lee Wendy 
Published: August 2022

Purpose:
The aim of this study was to evaluate the association between CT findings and Ocular Trauma Score (OTS) in open globe injury.

Methods:
In 182 eyes with open globe injury, CT findings were categorized into 5 major types: scleral irregularity with decreased globe volume, dislocation of the crystalline lens, abnormal vitreous density, thickening of the chorioretinal layer, and intraocular foreign body/air. Association between different types and number of CT findings with OTS stages were evaluated through a multivariate analysis.

Results:
Mean age of the patients was 38 ± 8.5 years. The most common CT findings were severe scleral irregularity or globe collapse (71.9%) and abnormal vitreous density (56%). The most common OTS stages were II (44.5%) and I (30.7%). In multivariate analysis, abnormal vitreous density (odds ratio [OR] = 2.11, p < 0.001), chorioretinal thickening (OR = 1.89, p < 0.001), and intraocular foreign body/air (OR = 1.58, p = 0.001) were associated with more advanced OTS stages (I or II). Mean OTS in eyes with 1, 2, and 3 CT findings were 66 (stage III), 47 (stage II), and 37 (stage I), respectively (p value = 0.008). Presence of 2 (OR = 2.46, p < 0.001) and 3 (OR = 2.92, p < 0.001) CT findings were associated with more advanced OTS stages (I or II).

Conclusions:
The type and number of CT findings may help to predict the OTS stage and visual prognosis in eyes with open globe injury.
Expert Opinions on Thermal Discomfort Related to Idiopathic Scoliosis Orthoses
Authors: Purdie Jaime , Jang Sun Hae 
Published: August 2022

ABSTRACT

Introduction
The purpose of this study was to investigate expert opinions regarding the current status of and mitigation solutions for thermal discomfort associated with the use of thoracic-lumbar-sacral orthoses (TLSOs) in treating patients with idiopathic scoliosis (IS).

Materials and Methods
Qualitative data were gathered via interviews with experts in a variety of fields. Three primary categories of discussion were established: current status of thermal discomfort experienced by patients with IS treated with TLSOs, current mitigation strategies, and obstacles to implementation of a hypothetical novel TLSO. Data were analyzed utilizing Pell Institute's six-step method for qualitative data analysis.

Results
Six experts participated in this study: three spinal orthotics experts, who are orthotists currently treating IS with TLSOs; one thermal discomfort expert, who has been studying thermal discomfort for prosthetic devices; and two mechanical engineering experts, who conduct college courses on thermodynamics. Primary signs and symptoms of thermal discomfort identified by experts were heat rash, verbal complaint, and excessive sweating. Factors identified by experts as related to the occurrence of thermal discomfort fell into three categories: orthotic design, surrounding environment, and patient conditions. Experts also identified possible strategies used to mitigate thermal discomfort, which involved orthotic fabrication options, orthotic modification options, and patient behavioral changes.

Conclusions
Anecdotally, thermal discomfort experienced by TLSO users exists to varying degrees. The orthotic design, the environment, and the patient may impact the occurrence. Factors correlating to thermal discomfort may be skin temperature, friction, and moisture. Minimizing the quantity of skin surface area covered by the orthosis may be a primary thermal discomfort mitigation strategy. However, further investigation into the relationship between skin surface area coverage and thermal discomfort is required.

Clinical Relevance
This study introduces concepts and strategies that may be used by clinicians to reduce thermal discomfort experienced by patients with IS treated with a TLSO.
Health literacy, illness perception, depression, and self-management among African Americans with type 2 diabetes
Authors: Ajuwon Abidemi M. , Insel Kathleen 
Published: August 2022

ABSTRACT

Background:
Type 2 diabetes mellitus (T2DM) causes significant morbidity and mortality. Compared with non-Hispanic Whites, African Americans are more likely to suffer and die from T2DM.

Purpose:
This study examines the associations between health literacy, illness perception, depression, working memory, executive function, and self-management among African Americans (18–65 years) with T2DM.

Methodology:
A descriptive cross-sectional design was used. Data were collected through Research Electronic Data Capture and transferred to the Statistical Package for the Social Sciences software version 26 for statistical analysis. Fifty-three participants met study eligibility criteria.

Results:
Health literacy was associated with depression (r = −0.433, p = .003), more concerns about illness (r = −0.357, p = .02), and better medication adherence (r = 0.487, p = .001). Higher levels of depression were inversely associated with medication adherence (r = −0.449, p = .002; r = 0.449, p = .003). Higher concern about illness was associated with lower medication adherence (r = −0.414, p = .005).

Conclusions:
Lower health literacy coupled with illness perception and depression is associated with lower self-management behaviors among African Americans which can lead to complications of T2DM. More studies are needed to examine the association of cognitive factors with self-management activities among African Americans with T2DM.

Implications:
Limited health literacy is associated with lower medication adherence among African Americans with T2DM. Illness perception is a significant factor that influences self-management of T2DM among African Americans. Using screening tools that assess health literacy and illness perception may address underlying concerns regarding adherence to T2DM treatment regimens in African Americans.
Predicting Extent of Microsurgical Resection of Sporadic Vestibular Schwannoma
Authors: Macielak Robert J. , Lohse Christine M. , Wallerius Katherine P. , Lawlor Skye K. , Neff Brian A. , Van Gompel Jamie J. , Driscoll Colin L.W. , Link Michael J. , Carlson Matthew L. 
Published: August 2022

Objective
Develop a predictive model for incomplete microsurgical resection of sporadic vestibular schwannoma (VS).

Study Design
Historical cohort.

Setting
Tertiary referral center.

Patients
Patients with sporadic VS.

Interventions
Microsurgery with preoperative intent of gross total resection.

Main Outcome Measures
Patient and tumor characteristics that influence extent of resection.

Results
Among 603 patients, 101 (17%) had intracanalicular tumors and 502 (83%) had tumors with cerebellopontine angle (CPA) extension. For patients with CPA tumors, 331 (66%) underwent gross total resection and 171 (34%) underwent near-total or subtotal resection (NTR-STR). Multivariable modeling identified older age at surgery, larger linear tumor size, and absence of a fundal fluid cap as predictive of NTR-STR (p < 0.001). From this model, one can estimate that a 20-year-old with a tumor that has less than 10 mm of CPA extension and a present fundal fluid cap has a predicted probability of NTR-STR of 0.01 (or 1%), whereas a 70-year-old with a tumor that has 30 mm or greater CPA extension and absence of a fundal fluid cap has a predicted probability of NTR-STR of 0.91 (or 91%). Among the 171 patients who underwent NTR-STR, 24 required secondary treatment at the time of last follow-up.

Conclusion
The primary predictors of incomplete microsurgical resection of VS include older age at surgery, larger linear tumor size, and absence of a fundal fluid cap. These factors can be used to estimate the likelihood of NTR-STR, aiding in preoperative discussions regarding future surveillance and potential need of secondary treatment, as well as shared clinical decision making.
Early Translabyrinthine Surgery for Small- and Medium-Sized Vestibular Schwannomas: Consecutive Cohort Analysis of Outcomes
Authors: Zanoletti Elisabetta , Mazzoni Antonio , Chiumenti Francesca Angela , d’Avella Domenico , Cazzador Diego 
Published: August 2022

Objective
Reappraisal of the role of translabyrinthine (TLAB) surgery in small- and medium-sized vestibular schwannomas (VSs).

Study Design
Retrospective study.

Setting
Tertiary referral center.

Patients
A total of 330 consecutive patients diagnosed between 1973 and 2019 with small- and medium-sized VS up to 20 mm in the extrameatal portion submitted to surgical treatment.

Interventions
VS removal through microscopic TLAB approach.

Main Outcome Measures
Facial nerve function according to the House-Brackmann scale at 12-month follow-up, postoperative complications and entity of tumor resection assessed with postoperative MRI. A comparative analysis of outcomes between two groups of patients was further conducted, according to tumor size: Group A, small-sized (intrameatal or ≤10 mm extrameatal tumors) and Group B, medium-sized VSs (extrameatal between 11 and 20 mm).

Results
Complete tumor removal was achieved in all cases. The overall complication rate was 5.5%, being cerebrospinal fluid leak the most frequent. Patients with small-sized VS (n = 121) presented a significantly better facial nerve function than patients with medium-sized tumors (n = 209), showing House-Brackmann Grades I to II in 92.6% versus 73.6% of cases, respectively (p < 0.001). A nearly 4.5-fold higher risk of poor facial nerve function at 12 months affects patients with medium-sized tumors (odds ratio, 4.473; 95% confidence interval, 2.122–9.430; p < 0.001).

Conclusion
In the current scenario of multioptional VS management, when hearing preservation is not feasible, early TLAB approach as first-line treatment for small-sized VSs showed favorable results. Factors supporting such proactive surgical treatment include long-term definitive cure, no major complications, good facial nerve outcomes, and the possibility of simultaneous hearing rehabilitation with a cochlear implant.
Acute myocardial infarction in young adults with chronic kidney disease
Authors: Gyurjian Karo , Schweis Franz , Patel Sej , Hammershaimb Bryant , Chiu Sarah , Nadadur Malini , Chen Aiyu , Wu Yi-Lin , Lee Ming-Sum 
Published: August 2022

Objective
The goal of this study was to evaluate the prevalence of chronic kidney disease (CKD) in young patients with acute myocardial infarction (AMI) and to report their characteristics and clinical outcomes.

Background
Underlying renal dysfunction is a risk factor for poor cardiovascular outcomes in older patients. The implication of CKD in young patients with AMI is not well studied.

Methods
This is a retrospective population-based cohort study of patients aged 18–50 who presented with AMI between 2006 and 2016. Medical records were reviewed to confirm diagnosis and to identify treatment and long-term outcomes. Cox regression models were used to evaluate the association of CKD with mortality.

Results
Among 1753 young patients with type 1 AMI (median age 45 years, 85.3% male), CKD was present in 112 (6.8%) patients. A higher proportion of CKD patients had concomitant hypertension, hyperlipidemia, diabetes, and obesity. Use of statin and P2Y12 inhibitors post-AMI was lower in CKD patients. Over a median follow-up of 7.2 years, CKD was associated with higher all-cause mortality [hazard ratio (HR), 9.3; 95% CI, 6.3–13.8]. This association persisted after adjusting for demographics, comorbidities, and treatment (adjusted HR, 3.6; 95% CI, 2.2–6.0).

Conclusion
Presence of CKD was associated with 3.6-fold higher mortality over a median follow-up of 7.2 years. A lower proportion of CKD patients were treated with statin therapy and P2Y12 inhibitors. These findings highlight the need for intensive risk factor modification and optimal use of guideline-directed medical therapies in this high-risk population.
Subphenotypes of acute kidney injury in adults
Authors: Vaara Suvi T. , Forni Lui G. , Joannidis Michael 
Published: August 2022

Purpose of review
Acute kidney injury is a heterogeneous syndrome and as such is associated with multiple predisposing conditions and causes all of which affect outcomes. Such heterogeneity may conceal the potential benefit of therapies when generally applied to patients with acute kidney injury (AKI). The discovery of pathophysiology-based subphenotypes could be of benefit in allocating current and future therapies to specific groups.

Recent findings
Clinical subphenotypes group patients into categories according to predisposing factors, disease severity, and trajectory. These may be helpful in assessing patient outcomes. Analyses of existing databases have revealed biological subphenotypes that are characterized by levels of biomarkers indicative of hyperinflammation and endothelial injury. Patients with increased levels of these biomarkers display higher mortality rates compared with those with lower levels and there is potential that this group might respond differently to therapies. However, challenges remain in the validation, generalizability, and application of these subphenotypes.

Summary
Subphenotyping may help reduce heterogeneity under the umbrella term of acute kidney injury. Despite challenges remain, the identification of AKI subphenotypes has opened the potential of AKI research focused on better targeted therapies.