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Low dose oral isotretinoin for the treatment of adult patients with mild-to-moderate acne vulgaris: Systematic review and meta-analysis

Dermatol Ther. 2022 Jan 9:e15311. doi: 10.1111/dth.15311. Online ahead of print.

ABSTRACT

Acne vulgaris is one of the most common dermatologic complaints. Recently, isotretinoin has been used as an off-label indication for the treatment of mild-to-moderate grades of acne not responding to conventional treatment. Its conventional recommended dose is 0.5-1.0 mg/kg per day to the cumulative dose of 120-150 mg/kg.

OBJECTIVES: To qualify the state of evidence and analyze the efficacy of the low daily dose and the pulsed doses of isotretinoin in treating mild-to-moderate acne patients with regards to response and relapse rates.

METHOD: Systematic review and meta-analysis using an electronic literature search were performed. 320 potentially relevant articles were included and reviewed.

RESULTS: The level of evidence is moderate to low as conducted by the GRADE quality of evidence assessment. The pooled statistical estimate for response to treatment in the group comparing low daily doses with conventional dose showed an overall benefit for conventional dose. On the other hand, pooled data from the group comparing the low daily dose with the pulsed doses yielded an overall beneficial effect from using the low daily dose compared with the pulsed doses on achieving the response.

CONCLUSIONS: Given all of the available studies, the quality of evidence is low. It appears that conventional dose isotretinoin improves the odds of prolonged remission in adults with mild-to-moderate acne vulgaris compared to the low doses.

PMID:35000295 | DOI:10.1111/dth.15311

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Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Neurospine. 2021 Dec;18(4):667-680. doi: 10.14245/ns.2142206.253. Epub 2021 Dec 31.

ABSTRACT

To formulate the specific guidelines for the recommendation of thoracolumbar fracture regarding surgical techniques and nonfusion surgery. WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meeting. For nonfusion surgery and thoracolumbar fracture, a systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020. The search was further refined by excluding the articles which were duplicate, not in English or were based on animal or cadaveric subjects. After thorough shortlisting, only 50 articles were selected for full review in this consensus meeting. To generate a consensus, the levels of agreement or disagreement on each item were voted independently in a blind fashion through a Likert-type scale from 1 to 5. The consensus was achieved when the sum for disagreement or agreement was ≥ 66%. Each consensus point was clearly defined with evidence strength, recommendation grade, and consensus level provided. A magnitude of prospective papers were analyzed to formulate consensus on various surgical techniques that can be employed to address different types of thoracolumbar fractures. Surgical treatment of thoracolumbar fractures can be a better option over the nonoperative approach, especially for those who cannot tolerate months in an orthosis or cast, such as those with multiple extremity injuries, skin lesions, obesity, and so forth. It generally allows early mobilization, less hospital stay, reduced pulmonary complications, and better correction of sagittal balance. Current available literature fails to demonstrate any statistically significant benefit of fusion surgery over nonfusion in thoracolumbar fractures.

PMID:35000320 | DOI:10.14245/ns.2142206.253

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Identification of Pulsatilla chinensis (Bge.) Regel and look-alike species by ultra-performance liquid chromatography/time-of-flight mass spectrometry using multivariate statistical analysis

J Sep Sci. 2022 Jan 9. doi: 10.1002/jssc.202100732. Online ahead of print.

ABSTRACT

Pulsatillae Radix, the root of Pulsatilla chinensis (Bge.) Regel, is recorded in the Pharmacopoeia of the People’s Republic of China and has been widely used for its pharmacological activities, such as anti-inflammatory, antioxidant, antibacterial, antitumor, and cardiovascular benefits. However, there are several look-alike species that can be marketed as Pulsatillae Radix. To distinguish Pulsatilla chinensis (Bge.) Regel from its look-alikes, viz. Pulsatilla cernua (Thunb.) Bercht et Opiz., Pulsatilla dahurica (Fisch.) Spreng., Anemone tomeutosa (Maxim.) Pei., and Rhaponticum uniflorum (L.) DC, we used ultra-performance liquid chromatography/time-of-flight mass spectrometry combined with principal component analysis to compare their chemical compositions. Four ions, a (RT 8.98 min, m/z 1381.6671), b (RT 10.64 min, m/z 1219.6143), c (RT 11.52 min, m/z 1217.5978), and d (RT 13.6 min, m/z 749.4463) from Pulsatillae chinensis (Bge.) Regel were identified as potential chemical markers to distinguish it from look-alike species using an unsupervised statistical model combined with orthogonal partial least-squares discriminant analysis. The results of this study provide an effective method for identifying and distinguishing Pulsatilla chinensis (Bge.) Regel from similar plants. This article is protected by copyright. All rights reserved.

PMID:35000282 | DOI:10.1002/jssc.202100732

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In vivo genome-editing screen identifies tumor suppressor genes that cooperate with Trp53 loss during mammary tumorigenesis

Mol Oncol. 2022 Jan 9. doi: 10.1002/1878-0261.13179. Online ahead of print.

ABSTRACT

Breast cancer is a heterogeneous disease that comprises multiple histological and molecular subtypes. To gain insight into mutations that drive breast tumorigenesis, we describe a pipeline for the identification and validation of tumor suppressor genes. Based on an in vivo genome-wide CRISPR/Cas9-screen in Trp53+/- heterozygous mice, we identified tumor suppressor genes that include the scaffold protein Axin1, the protein kinase A regulatory subunit gene Prkar1a, as well as the proof-of-concept genes Pten, Nf1 and Trp53 itself. Ex vivo editing of primary mammary epithelial organoids was performed to further interrogate the roles of Axin1 and Prkar1a. Increased proliferation and profound changes in mammary organoid morphology were observed for Axin1/Trp53 and Prkar1a/Trp53 double mutants compared to Pten/Trp53 double mutants. Furthermore, direct in vivo genome editing via intraductal injection of lentiviruses engineered to express dual short-guide RNAs revealed that mutagenesis of Trp53 and either Prkar1a, Axin1 or Pten markedly accelerated tumor development compared to Trp53-only mutants. This proof-of-principle study highlights the application of in vivo CRISPR/Cas9-editing for uncovering cooperativity between defects in tumor suppressor genes that elicit mammary tumorigenesis.

PMID:35000262 | DOI:10.1002/1878-0261.13179

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Sub-micro scale cell segmentation using deep learning

Cytometry A. 2022 Jan 9. doi: 10.1002/cyto.a.24533. Online ahead of print.

ABSTRACT

Automated cell segmentation is key for rapid and accurate investigation of cell responses. As instrumentation resolving power increases, clear delineation of newly revealed cellular features at the sub-micron through nanoscale becomes important. Reliance on manual investigation of myriad small features retards investigation; however, use of deep learning methods has great potential to reveal cell features both at high accuracy and high speed, which may lead to new discoveries in the near term. In this study, semantic cell segmentation systems were investigated by implementing fully convolutional neural networks called U-nets for segmentation of astrocytes cultured on Poly-L-lysine-functionalized planar glass. The network hyperparameters were determined by changing the number of network layers, loss functions, and input image modalities. Atomic force microscopy (AFM) images were selected for investigation as these are inherently nanoscale and are also dimensional. AFM height, deflection, and friction images were used as inputs separately and together, and the segmentation performances were investigated on five-fold cross-validation data. Transfer learning methods, including VGG16, VGG19, and Xception, were used to improve cell segmentation performance. We find that AFM height images inherit more discriminative features than AFM deflection and AFM friction images for cell segmentation. When transfer learning methods are applied, statistically significant segmentation performance improvements are observed. Segmentation performance was compared to classical image processing algorithms and other algorithms in use by considering both AFM and electron microscopy segmentation. An accuracy of 0.9849, Matthews correlation coefficient of 0.9218, and Dice’s similarity coefficient of 0.9306 were obtained on the AFM test images. Performance evaluations show that the proposed system can be successfully used for AFM cell segmentation with high precision. This article is protected by copyright. All rights reserved.

PMID:35000269 | DOI:10.1002/cyto.a.24533

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Effect of horticultural therapy on mental health: a meta-analysis of randomized controlled trials

J Psychiatr Ment Health Nurs. 2022 Jan 9. doi: 10.1111/jpm.12818. Online ahead of print.

ABSTRACT

INTRODUCTION: HT has been widely used to promote mental health. However, heterogeneity and sample size issues of randomised-controlled trials made it challenging to illustrate effect sizes across the evidence.

AIM: The purpose of this meta-analysis was to explore the effect of HT on mental health.

METHODS: We used the PRISMA framework. A keyword search of Web of Science, PubMed, ProQuest, and Cochrane was performed. The inclusion criteria were HT with RCTs and mental health assessments. A random-effects model was used to perform the meta-analysis.

RESULTS: A total of 1,056 records were searched, and 18 eligible studies extracted. The included RCTs had no statistical heterogeneity and publication bias. The meta-analysis showed that the HT experimental groups had a significant and positive impact on mental health compared to the control groups (effect size = 0.55).

DISCUSSION: HT should be considered for enhancing mental health. The included studies had no negative outcomes and the most common HT intervention was at least eight sessions. Therefore, HT should be considered to enhance mental health. However, the concealed allocation and blinding processes should be improved in future studies.

IMPLICATIONS FOR PRACTICE: This study recommends that HT should be integrated into healthcare settings to improve mental health.

PMID:35000249 | DOI:10.1111/jpm.12818

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Successional adaptive strategies revealed by correlating arbuscular mycorrhizal fungal abundance with host plant gene expression

Mol Ecol. 2022 Jan 9. doi: 10.1111/mec.16343. Online ahead of print.

ABSTRACT

The shifts in adaptive strategies revealed by ecological succession and the mechanisms that facilitate these shifts are fundamental to ecology. These adaptive strategies could be particularly important in communities of arbuscular mycorrhizal fungi (AMF) mutualistic with sorghum where strong AMF succession replaces initially ruderal species with competitive ones and where the strongest plant response to drought is to manage these AMF. Although most studies of agriculturally important fungi focus on parasites, the mutualistic symbionts, AMF, constitute a research system of human-associated fungi whose relative simplicity and synchrony are conducive to experimental ecology. First, we hypothesize that, when irrigation is stopped to mimic drought, competitive AMF species should be replaced by AMF species tolerant to drought stress. We then, for the first time, correlate AMF abundance and host plant transcription to test two novel hypotheses about the mechanisms behind the shift from ruderal to competitive AMF. Surprisingly, despite imposing drought stress, we found no stress tolerant AMF, likely due to our agricultural system having been irrigated for nearly six decades. Remarkably, we found strong and differential correlation between the successional shift from ruderal to competitive AMF and sorghum genes whose products (i) produce and release strigolactone signals, (ii) perceive mycorrhizal-lipochitinoligosaccharide (Myc-LCO) signals, (iii) provide plant lipid and sugar to AMF and, (iv) import minerals and water provided by AMF. These novel insights frame new hypotheses about AMF adaptive evolution and suggest a rationale for selecting AMF to reduce inputs and maximize yields in commercial agriculture.

PMID:35000239 | DOI:10.1111/mec.16343

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Oral Health-Related Quality of Life in Patients with Parkinson’s Disease

J Oral Rehabil. 2022 Jan 9. doi: 10.1111/joor.13304. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a neurodegenerative condition affecting quality of life. Due to a worsening of oral health in PD patients with the progression of the disease, oral health-related quality of life (OHRQoL) could be impaired as well.

OBJECTIVES: To assess whether PD patients in The Netherlands experience worse OHRQoL than historical controls, and to investigate which factors are associated with OHRQoL in PD patients.

MATERIAL & METHODS: In total, 341 PD patients (65.5 ± 8.4 years) and 411 historical controls (62.6 ± 5.3 years) participated. Both groups completed a questionnaire. The PD patients were asked questions regarding demographics, PD, oral health, and OHRQoL. The historical controls filled in demographic information and questions regarding OHRQoL. The latter construct was assessed using the Dutch 14-item version of the Oral Health Impact Profile (OHIP-14). Data were analysed using independent samples t-tests and univariate and multivariate linear regression analysis.

RESULTS: The mean OHIP-14 score was higher in PD patients (19.1 ± 6.7) than in historical controls (16.5 ± 4.4) (t(239)=6.5; p<0.001). OHRQoL in PD patients was statistically significant associated with motor aspects of experiences of daily living (B=0.31; t(315)=7.03p<0.001), worsening of the oral environment during disease course (B=3.39; t(315)=4.21p<0.001), being dentate (B= -5.60; t(315)=-4.5; p<0.001), tooth wear (B=2.25; t(315)=3.29; p=0.001), and possible burning mouth syndrome (B=5.87; t(315)=2.87; p=0.004).

CONCLUSION: PD patients had a lower OHRQoL than historical controls. Besides, PD-related variables and oral health-related variables were associated with OHRQoL.

PMID:35000220 | DOI:10.1111/joor.13304

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Intralesional bone marrow and superior check desmotomy is superior to conservative treatment of equine superficial digital flexor tendonitis

Equine Vet J. 2022 Jan 9. doi: 10.1111/evj.13553. Online ahead of print.

ABSTRACT

BACKGROUND: Superficial digital flexor tendon (SDFT) injury is common in racehorses and a significant cause of lost training days and wastage in the industry.

OBJECTIVES: To compare the post-injury performance of Thoroughbred and Standardbred racehorses diagnosed with SDFT tendonitis treated with intralesional bone marrow and superior check desmotomy or managed conservatively and further, to compare this performance with that of uninjured racehorses.

STUDY DESIGN: Retrospective and case controlled.

METHODS: Medical and race records of racehorses treated surgically or managed conservatively for SDFT tendonitis were collated. Signalment, lesion severity and treatment were identified and performance post-injury compared. Performance of the treatment groups was further assessed by comparison with uninjured racehorses matched for age, sex, number of starts pre-injury and randomly selected from the cases’ last races.

RESULTS: The study population comprised 114 racehorses divided into surgical (39/114), conservative (38/114) and control groups (37/114). Horses that had surgery were more likely to return to racing than those managed conservatively [OR 4.7 95%CI (1.6-14.3), p= 0.006]. Standardbreds were more likely to return to race compared to Thoroughbreds [OR 4.0 95%CI 1.2-13.3), p=0.03)]. There was no statistical significant difference in average number of placings, average number of wins and post-injury earnings between the surgically treated and conservatively managed groups (p=0.9, p=0.9 and p=0.7 respectively). The average number of lifetime starts post-injury/post-selection between surgery, conservative and control groups were not statistically significantly different (p=0.2). Surgically treated horses had a statistically significantly shorter time to start post-injury compared to the conservative group (p=0.04).

MAIN LIMITATIONS: The retrospective nature of the study precludes an actual fit as a non-randomised clinical trial and the non-randomised nature of the allocation of the treatment groups is biased.

CONCLUSIONS: Surgical intervention of superficial digital flexor tendonitis in racehorses suffering flexor tendon injury showed a higher likelihood of return to racing than conservative treatment.

PMID:35000213 | DOI:10.1111/evj.13553

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Profiling of Widely Targeted Metabolomics for the Identification of chemical composition in epidermis, xylem and pith of Gleditsiae spina

Biomed Chromatogr. 2022 Jan 9:e5331. doi: 10.1002/bmc.5331. Online ahead of print.

ABSTRACT

Gleditsiae spina, the thorn of Gleditsia sinensis Lam., has a long history of being used as a traditional medicine in East Asian countries. However, only a few biologically active substances have been identified from Gleditsiae spina. In this study, the epidermis, xylem and pith of Gleditsiae spina, respectively, namely Gs-E, Gs-X and Gs-P, were studied. We used a widely targeted metabolomics method to investigate the chemical composition in Gs-E, Gs-X and Gs-P. A total of 728 putative metabolites were identified from Gleditsiae spina, including 211 primary metabolites and 517 secondary metabolites. These primary and secondary metabolites could be categorized into more than 10 different classes. Flavonoids, phenolic acids, lipids, and amino acids and derivatives, and organic acids constituted the main metabolite groups. Multivariate statistical analysis showed that the Gs-E, Gs-X and Gs-P samples could be clearly separated. Differential accumulated metabolite (DAM) analysis revealed that more than half of the DAMs exhibited the highest relative concentrations in Gs-E, and most of the DAMs showed the lowest relative concentrations in Gs-X. Moreover, 11 common differential primary metabolites and 79 common differential secondary metabolites were detected in all comparison groups. These results further our understanding of chemical composition and metabolite accumulation of Gleditsiae spina.

PMID:35000209 | DOI:10.1002/bmc.5331