bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreased bone resorption in Ezh2 myeloid cell conditional knockout mouse model
Authors: Caviness Perry C. , Gai Dongzheng , Lazarenko Oxana P. , Blackburn Michael L. , Zhan Fenghuang , Chen Jin‐Ran
Published: June 2023

Osteoclasts derived from hematopoietic stem cells control bone resorption. Identifying novel molecules that can epigenetically regulate osteoclastogenesis is important for developing novel treatments for osteoporosis and other disorders associated with bone deterioration and promoting healthy bone formation. The polycomb group (PcG) protein enhancer of zeste homolog 2 (Ezh2), a histone lysine methyltransferase, is associated with epigenetic regulation of numerous cellular processes, but its involvement in bone cell development and homeostasis is not yet clear. Here, LysM‐Cre mice were crossed with Ezh2flox/flox mice to delete Ezh2 in myeloid cell lineage mature macrophages. Conditional knockout of Ezh2 (CKO) in myeloid cell line resulted in significant increases in postnatal bone growth in the first 6 months of life for both male and female mice. For female mice, optimal bone mass was seen for mice with Ezh2 deleted in both chromosomes in a pair (f/f Cre+; CKO). For male mice, optimal bone mass was found after deletion of Ezh2 from just one chromosome (f/− Cre+) with no difference in bone phenotype between f/− Cre+ and CKO male mice. In addition to the gender‐specific difference in bone phenotype, Ezh2 CKO mice had significantly less macrophages (CD11b+) present in the bone marrow compared with control mice as well as significantly more mature osteoblasts and bone formation biomarkers present (P1NP, osteocalcin). Inflammatory array for protein lysed from bone tissue revealed deletion of Ezh2 decreased inflammatory milieu in both male and female mice compared with controls. Unexpectedly, myeloid cell deletion of Ezh2 also increased the number of mature osteoblast present in the bone. Deletion of Ezh2 also led to an increase in gene expression of osteoclast‐suppressive genes IRF8, MafB, and Arg1 due to a decrease in the presence of the suppressive H3K27me3 epigenetic mark. These findings suggest that manipulation of Ezh2 expression may be a viable strategy to combat bone resorptive disorders such as osteoporosis or arthritis.
Complex chemical signals dictate Ah receptor activation through the gut–lung axis
Authors: Dong Fangcong , Murray Iain A. , Annalora Andrew , Coslo Denise M. , Desai Dhimant , Gowda Krishne , Yang Jian , Wang Dingbowen , Koo Imhoi , Hao Fuhua , Amin Shantu G. , Patterson Andrew D. , Marcus Craig , Perdew Gary H.
Published: June 2023

The aryl hydrocarbon receptor (AHR) mediates intestinal barrier homeostasis. Many AHR ligands are also CYP1A1/1B1 substrates, which can result in rapid clearance within the intestinal tract, limiting systemic exposure and subsequent AHR activation. This led us to the hypothesis that there are dietary substrates of CYP1A1/1B1 that functionally increase the half‐life of potent AHR ligands. We examined the potential of urolithin A (UroA), a gut bacterial metabolite of ellagitannins, as a CYP1A1/1B1 substrate to enhance AHR activity in vivo. UroA is a competitive substrate for CYP1A1/1B1 in an in vitro competition assay. A broccoli‐containing diet promotes the gastric formation of the potent hydrophobic AHR ligand and CYP1A1/1B1 substrate, 5,11‐dihydroindolo[3,2‐b]carbazole (ICZ). In mice, dietary exposure to UroA in a 10% broccoli diet led to a coordinated increase in duodenal, cardiac, and pulmonary AHR activity, but no increase in activity in the liver. Thus, CYP1A1 dietary competitive substrates can lead to enhanced systemic AHR ligand distribution from the gut, likely through the lymphatic system, increasing AHR activation in key barrier tissues. Finally, this report will lead to a reassessment of the dynamics of distribution of other hydrophobic chemicals present in the diet.
Designing a Road Map for Action to Address Bias and Racism Within a Large Academic Medical Center
Authors: Butts Gary C. , Abner Pamela , Hess Leona , Palermo Ann-Gel S. , Cotilletta Ben , Gianelli Arthur , Richardson Lynne D.
Published: June 2023

The convergence of the COVID-19 pandemic, the Black Lives Matter Movement, and the public anguish and outrage resulting from the murder of George Floyd in 2020 intensified the commitment of many health care institutions to pursue racial and social justice and achieve health equity. The authors describe the Road Map for Action to Address Racism, which was developed to unify and systematize antiracism efforts across the Mount Sinai Health System. A 51-member Task Force to Address Racism, comprising faculty, staff, students, alumni, health system leaders, and trustees, developed recommendations to achieve the goal of becoming an antiracist and equitable health care and learning institution by intentionally addressing all forms of racism and promoting greater diversity, inclusion, and equity for its workforce and community. Grounded in the principles of Collective Impact, the Task Force developed a set of 11 key strategies to effect systemwide change. The strategies affected all aspects of the organization: business systems and financial operations, delivery of care, workforce development and training, leadership development, medical education, and community engagement. The authors describe Road Map implementation, currently in process, including the appointment of strategy leaders, evolution of a governance structure integrating stakeholders from across the health system, development of an evaluation framework, communication and engagement efforts, and process measures and progress to date. Lessons learned include the importance of recognizing the work of dismantling racism as integral to, not apart from, the institution’s day-to-day work, and the need for specialized expertise and a significant investment of time to coordinate Road Map implementation. Going forward, rigorous assessment of quantitative and qualitative outcomes and a commitment to sharing successes and challenges will be critical to eradicating systems that have perpetuated inequities in the biomedical sciences and medicine and in the delivery of health care.
High Cell Saver Autotransfusion is Associated With Perioperative Medical Complications in Adult Spinal Deformity Patients
Authors: Mohanty Sarthak , Sardar Zeeshan M. , Hassan Fthimnir M. , Reyes Justin , Coury Josephine R. , Lombardi Joseph M. , Lehman Ronald A. , Lenke Lawrence G.
Published: June 2023

Study Design.

A retrospective, propensity-matched observational study.

Objective.

To assess the impact of cell saver (CS) homologous transfusion on perioperative medical complications in adult patients undergoing spinal deformity surgery.

Summary of Background Data.

Despite many endorsing its use, many analyses still refute the efficacy of CS on decreasing total perioperative allogenic red blood cell transfusions, cost efficiency, and its effect on perioperative complications.

Methods.

Adult patients who underwent spinal deformity surgery at a single center between 2015 and 2021 were retrospectively reviewed. Patient-specific, operative, radiographic, and 30-day complications/readmission data were collected for further analysis. Two methods were utilized to test our hypothesis: (1) absolute threshold model: two cohorts created among patients who received ≥550 mL of CS intraoperatively and those who received less; (2) adjusted ratio model: two cohorts created dependent on the ratio of CS to estimated blood loss (EBL). Propensity-score matching and various statistical tests were utilized to test the association between CS and perioperative medical complications.

Results.

Two hundred seventy-eight patients were included in this analysis with a mean age of 61.3±15.7yrs and 67.6% being female. Using the first method, 73 patients received ≥550 mL of CS, and 205 received less. Propensity-score matching resulted in 28 pairs of patients. 39.3% of patients with ≥550 mL CS required readmission within 30 days compared with 3.57% of patients in the <550 mL cohort (P=0.016), despite a nearly identical proportion of patients requiring intraoperative blood transfusions (P>0.9999). Using the second method, 155 patients had CS/EBL<0.33 and 123 with CS/EBL ≥0.33. 5.16% and 21.9% among patients with CS/EBL<0.33 and CS/EBL≥0.33, respectively, were readmitted by the 30-day marker (P<0.0001).

Conclusions.

Our findings indicate that greater CS volumes transfused are associated with higher rates of 30-day readmissions. Thus, surgeons should consider limiting CS volume intraoperatively to 550 mL and when greater volumes are required or preferred, ensuring that the ratio of CS:EBL remains under 0.33.
Techniques for Continuous Catheter Irrigation of a Septic Metacarpophalangeal Joint
Authors: Wang Qiao , McGrouther Duncan A.
Published: June 2023

Septic arthritis of the metacarpophalangeal joint (MCPJ) compromises 9% of hand infections in Singapore. Common surgical treatment is open arthrotomy and joint washout. The wound is often left open for drainage postoperatively. Repeated debridement and secondary closure are frequently needed after the index surgery. We describe a method of continuous catheter irrigation of septic MCPJ joint using an infant feeding catheter. This method provides great infection clearance to avoid repeated debridement and allows primary closure of the wound to avoid secondary closure. This method also significantly reduces postoperative pain so that to facilitate early mobilization of the joint, which is crucial for functional recovery. We illustrate the techniques of this procedure and key points of postoperative management in the ward with case examples to demonstrate its simplicity, safety, and efficacy in treating MCPJ septic arthritis.
Developing Faculty Developers: An Underexplored Realm in Professional Development
Authors: Kolomitro Klodiana , Soleas Eleftherios , Steinert Yvonne
Published: June 2023

As faculty developers enter the field and grow in their roles, how do they keep up with ongoing changes and ensure that their knowledge remains relevant and up-to-date? In contrast to most of the studies which focused on the needs of faculty members, we focus on the needs of those who fulfill the needs of others. We highlight the knowledge gap and lack of adaptation of the field to consider the issue of professional development of faculty developers more broadly by studying how they identify their knowledge gaps and what approaches they use to address those gaps. The discussion of this problem sheds light on the professional development of faculty developers and offers several implications for practice and research. Our own piece of the solution indicates that faculty developers follow a multimodal approach to the development of their knowledge, including formal and informal approaches to addressing perceived gaps. Within this multimodal approach, our results suggest that the professional growth and learning of faculty developers is best characterized as a social practice. Based on our research, it would seem worthwhile for those in the field to become more intentional about the professional development of faculty developers and harness aspects of social learning in that process to better reflect faculty developers' learning habits. We also recommend applying these aspects more broadly to, in turn, enhance the development of educational knowledge and educational practices for the faculty members these educators support.
Investigating the relationship between breast and gynecological cancers and infertility and its treatments: a case-control study
Authors: Naghizadeh Somayyeh , Faroughi Farnaz , Mirghafourvand Mojgan
Published: June 2023

Objective

Due to the high prevalence of breast and gynecological cancers among women, it is crucial to identify the risk factors of these cancers. Thus, the present study aimed to evaluate the relationship between breast and gynecological cancers and infertility and its treatments in women suffering from these cancers.

Methods

This case–control study was conducted with the participation of 400 people (200 women with breast and gynecological cancers and 200 healthy women without a history of cancer) in hospitals and health centers in Tabriz, Iran, in 2022. Data were collected using a four-part researcher-made questionnaire including sociodemographic characteristics, obstetric characteristics, information related to cancer, and information related to infertility and its treatments.

Result

s Based on the multivariable logistic regression model and by controlling sociodemographic and obstetric characteristics as possible confounding variables, women with cancer had an infertility history almost four times more than women who did not have a history of cancer (OR = 3.56; 95% CI: 1.36–9.33; P = 0.010). Women with breast cancer had an infertility history five times more than women without a history of breast cancer (OR = 5.11; 95% CI: 1.68–15.50; P = 0.004). The infertility history of women with gynecological cancer was more than three times that of the control group. However, there was no statistically significant difference between the two groups (OR = 3.36; 95% CI: 0.99–11.47; P = 0.053).

Conclusion

Infertility and its treatments may be involved in increasing the risk of breast and gynecological cancers.
Exploring the Documentation of Delirium in Patients After Cardiac Surgery
Authors: Poikajärvi Satu , Peltonen Laura-Maria , Siirala Eriikka , Heimonen Juho , Moen Hans , Salanterä Sanna , Junttila Kristiina
Published: June 2023

Delirium is a common disorder for patients after cardiac surgery. Its manifestation and care can be examined through EHRs. The aim of this retrospective, comparative, and descriptive patient record study was to describe the documentation of delirium symptoms in the EHRs of patients who have undergone cardiac surgery and to explore how the documentation evolved between two periods (2005-2009 and 2015-2020). Randomly selected care episodes were annotated with a template, including delirium symptoms, treatment methods, and adverse events. The patients were then manually classified into two groups: nondelirious (n = 257) and possibly delirious (n = 172). The data were analyzed quantitatively and descriptively. According to the data, the documentation of symptoms such as disorientation, memory problems, motoric behavior, and disorganized thinking improved between periods. Yet, the key symptoms of delirium, inattention, and awareness were seldom documented. The professionals did not systematically document the possibility of delirium. Particularly, the way nurses recorded structural information did not facilitate an overall understanding of a patient's condition with respect to delirium. Information about delirium or proposed care was seldom documented in the discharge summaries. Advanced machine learning techniques can augment instruments that facilitate early detection, care planning, and transferring information to follow-up care.
Comparative Study Among CO2 Laser, Intralesional Vitamin D3, and Combined Intralesional Vitamin D3 and CO2 Laser in Treatment of Palmoplantar Warts
Authors: El Sharkawy Dina Ahmed , Nada Hanan Rabea , Radman Al-Kubati Sahar
Published: June 2023

BACKGROUND

Many therapeutic modalities are used for palmoplantar warts; whether destructive, such as chemical cautery, electrocautery, cryocautery, surgical removal, and laser ablation, or immunotherapeutic, stimulating the immune system against the virus such as intralesional vitamin D3 injection.

OBJECTIVE

To compare the efficacy of intralesional vitamin D injection combined with CO2 laser to the efficacy of either modality alone.

PATIENT AND METHODS

Eighty age- and sex-matched patients with palmoplantar warts were divided into 4 groups: Group A received intralesional vitamin D3 injections, group B received ablative CO2 laser, group C received CO2 laser and intralesional vitamin D3 injection, and group D (control group) were injected intralesionally with normal saline. Assessment was performed clinically, photographically, and dermoscopically before and after treatment to evaluate the response, and then, another assessment was performed after 3 months to detect any recurrence.

RESULTS

Complete clearance was seen in 90% of cases in group C, in 80% in group A, and in 75% in group B with no statistically significant difference.

CONCLUSION

Intralesional vitamin D, CO2 laser, and the combination show comparable efficacy and recurrence rates. Intralesional vitamin D maybe a better option for people with a relative contraindication to CO2 laser.
Electrodesiccation and Curettage for Squamous Cell Carcinoma in Situ: The Effect of Anatomic Location on Local Recurrence
Authors: Veverka Kevin K. , Stratman Erik J.
Published: June 2023

BACKGROUND

Electrodesiccation and curettage (EDC) is a common, minimally invasive treatment of cutaneous squamous cell carcinoma in situ (SCCIS).

OBJECTIVE

Determine the 5-year recurrence rate of EDC for SCCIS and to determine if this differs by anatomic location.

METHOD AND MATERIALS

A retrospective, single-center, cohort study of patients treated between January 1, 2000, and January 1, 2017, with at least 5 years of follow-up. The overall 5-year recurrence rate of EDC for SCCIS was calculated and compared across low-risk (L), moderate-risk (M), and high-risk (H) anatomic zones.

RESULTS

Five hundred ten tumors were randomly identified from 367 unique patients. The 5-year recurrence rate of the entire cohort was 5.3%. There was no significant difference in recurrence by clinical size or immunosuppressed status. One hundred thirty-four tumors in the L zone were matched 1:1:1 to tumors in the M and H zones. The 5-year recurrence rate of M zone tumors (8.2%) and H zone tumors (6.0%) were higher than the recurrence rate of a L zone tumors (3.0%), but this was not statistically significant (p = .075 and p = .247, respectively).

CONCLUSION

Electrodesiccation and curettage allows for a high 5-year cure rate across a broad range of anatomic sites. However, overall cure rate should be individualized by anatomic location when counseling patients.
Vasomotor and other menopause symptoms and the prevalence of ideal cardiovascular health metrics among premenopausal stage women
Authors: Choi Hye Rin , Chang Yoosoo , Kim Yejin , Cho Yoosun , Kwon Min-Jung , Kang Jeonggyu , Kwon Ria , Lim Ga-Young , Kim Kye-Hyun , Kim Hoon , Hong Yun Soo , Park Jihwan , Zhao Di , Cho Juhee , Guallar Eliseo , Park Hyun-Young , Ryu Seungho
Published: June 2023

Objective

We examined the association between menopause symptoms and the prevalence of ideal cardiovascular health (CVH) metrics among premenopausal women.

Methods

This cross-sectional study comprised 4,611 premenopausal women aged 42 to 52 years. Data for CVH metrics were collected during health screening examinations. Menopause symptoms were measured using the Korean version of the Menopause-Specific Quality of Life questionnaire. For vasomotor, psychosocial, physical, and sexual symptoms, participants were divided into absent or symptomatic groups, further divided into tertiles (range, 0-7; 7 being the most bothersome). Ideal CVH metrics were defined according to the American Heart Association Life Simple 7 metrics, except dietary component. Cardiovascular health metrics were scored from 0 (unhealthy) to 6 (healthy) and classified as poor (0-2), intermediate (3-4), and ideal (5-6). Multinomial logistic regression models were used to estimate the prevalence ratios for intermediate and poor CVH metrics using ideal CVH as the reference.

Results

The overall and 4 menopause-specific quality of life domain scores were significantly associated with poorer CVH metrics scores in a dose-response manner (P < 0.05). After adjusting for age, parity, education level, anti-Mullerian hormone levels, and alcohol intake, women with the most bothersome degree for vasomotor, psychosocial, physical, and sexual symptoms had significantly higher prevalence of poor CVH metrics, with corresponding prevalence ratios (95% confidence interval) of 2.90 (1.95-4.31), 2.07 (1.36-3.15), 3.01 (1.19-7.65), and 1.66 (1.15-2.39), respectively, compared with those without each vasomotor, psychosocial, physical, and sexual symptom.

Conclusions

Premenopausal stage women with either vasomotor or nonvasomotor menopausal symptoms have significantly higher prevalence of poor CVH metrics, compared with those without any menopausal symptoms.
The prevalence of osteoporosis in postmenopausal women in urban Tianjin, China and its related factors
Authors: Liu Jie , Xia Rong-Lin , Li Chen , Song Qian , Cui Xiu-Li , Chao Ai-Jun
Published: June 2023

Objectives

The aims of the study are to understand the prevalence of osteoporosis in postmenopausal women in urban Tianjin, China and its related factors through a questionnaire and to assess the correlation between individual characteristics, physical mobility, psychological and emotional well-being, and prevalence, as well as people's awareness of osteoporosis.

Methods

We selected 240 postmenopausal women from 12 randomly selected streets in 6 administrative districts of Tianjin for bone mineral density measurement and a face-to-face questionnaire survey to obtain the relevant data. Female residents who had lived in the communities under the jurisdiction of the incorporated streets for more than 10 years and had been in menopause for 2 years were included. The women were made aware of the study, there were no communication barriers, and they were willing to undergo dual-energy absorptiometry and cooperate in completing the questionnaire. We used one-way analysis of variance, Fisher exact test, and Pearson correlation analysis for the statistical analysis.

Results

The overall prevalence of osteoporosis in postmenopausal women in the six districts of Tianjin was found to be 52.08%, and the χ2 test for trend showed a clear trend of increasing with age (P = 0.035). Body mass index was found to be the most significant personal characteristic affecting the prevalence of osteoporosis; the mean values of the nonosteoporosis and osteoporosis group were (25.45 ± 3.09) and (23.85 ± 3.16), respectively (P < 0.001); previous fractures were closely associated with the prevalence of osteoporosis. Awareness about osteoporosis had not disseminated among the population, and 9.17% of the participants had never heard of the disease. While 75.42% and 72.92% of the participants, respectively, believe that the harm of osteoporosis cannot be compared with heart disease and cerebral infarction, 56.67% had never had an examination for osteoporosis and paid little to no attention to this disease. People still had major misconceptions about the hazards of osteoporosis and common-sense precautions that needed to be followed.

Conclusions

Although osteoporosis is prevalent among postmenopausal women in urban Tianjin and is strongly linked to both history of fracture and body mass index, most women are only familiar with the disease's name and lack an understanding of the dangers it poses as well as the importance of early diagnosis and treatment. To ensure the prevention and control of osteoporosis, it is crucial to focus on increasing the examination and treatment rates and spreading awareness of the three-level diagnosis and treatment pattern among the public.
A Mobile Health Behavior Change Intervention for Women With Coronary Heart Disease
Authors: Beckie Theresa M. , Sengupta Avijit , Dey Arup Kanti , Dutta Kaushik , Ji Ming , Chellappan Sriram
Published: June 2023

Purpose:

The aim of this study was to evaluate the effects of a mobile health (mHealth) intervention, HerBeat, compared with educational usual care (E-UC) for improving exercise capacity (EC) and other patient-reported outcomes at 3 mo among women with coronary heart disease.

Methods:

Women were randomized to the HerBeat group (n = 23), a behavior change mHealth intervention with a smartphone, smartwatch, and health coach or to the E-UC group (n = 24) who received a standardized cardiac rehabilitation workbook. The primary endpoint was EC measured with the 6-min walk test (6MWT). Secondary outcomes included cardiovascular disease risk factors and psychosocial well-being.

Results:

A total of 47 women (age 61.2 ± 9.1 yr) underwent randomization. The HerBeat group significantly improved on the 6MWT from baseline to 3 mo (P = .016, d = .558) while the E-UC group did not (P = .894, d =−0.030). The between-group difference of 38 m at 3 mo was not statistically significant. From baseline to 3 mo, the HerBeat group improved in anxiety (P = .021), eating habits confidence (P = .028), self-efficacy for managing chronic disease (P = .001), diastolic blood pressure (P = .03), general health perceptions (P = .047), perceived bodily pain (P = .02), and waist circumference (P = .008) while the E-UC group showed no improvement on any outcomes.

Conclusions:

The mHealth intervention led to improvements in EC and several secondary outcomes from baseline to 3 mo while the E-UC intervention did not. A larger study is required to detect small differences between groups. The implementation and outcomes evaluation of the HerBeat intervention was feasible and acceptable with minimal attrition.
Drug-Facilitated Sexual Assault With Tetrahydrozoline (Visine)
Authors: Edwards Carrie Nelms , Tilley Donna Scott , Ayala Francisco
Published: June 2023

This is a case presentation of an 18-year-old male victim who experienced a drug-facilitated sexual assault (DFSA). The drug used to incapacitate him was tetrahydrozoline (Visine) given rectally. Tetrahydrozoline, intended for ophthalmic administration, is in the class of drugs known as imidazoline receptor agonists and has been used as an agent for DFSA since the 1940s. DFSA is increasing, particularly among young men. Care of victims of DFSA is discussed with particular attention to mental health sequelae in this patient population.
A Multi-stage Dynamic Incentive Model for Construction Project Managers From the Perspective of Work-Family Conflict
Authors: Lin Lingna , Sun Yien
Published: June 2023

Objective

This study aims to design incentives for organizations to improve the work engagement of construction project managers (CPMs) when they experience work-family conflict.

Methods

Based on principal-agent theory, a multistage dynamic incentive model for CPMs’ work engagement under the perspective of work-family conflict is constructed by integrating contract and reputation effect incentive mechanisms. Then MATLAB software was used to simulate the theoretical model for the arithmetic example. Finally, 182 valid questionnaires were tested for the conclusions of the model.

Results

In the two stages of the incentive model, work resources significantly positively influence CPMs’ work engagement, and work-family conflict harms CPMs’ work engagement. Including a reputation mechanism has two effects on the first stage of the incentive model. First, reputation has an incentive effect on CPMs’ work engagement. Second, it reduces the negative impact of work-family conflict on work engagement. The combination of contract- and reputation-based incentives will improve CPMs’ work engagement.

Conclusions

The results suggest that incentives targeted at increasing the work engagement of CPMs may be necessary.
The Relationship Between Stress and Sleep Sufficiency in the Context of Varied Workplace Social Support
Authors: Kunz James J. , Fisher Gwenith G. , Ganster Daniel C. , Gibbons Alyssa M. , Graham Daniel J. , Schwatka Natalie V. , Dally Miranda J. , Shore Erin , Brown Carol E. , Tenney Liliana , Newman Lee S.
Published: June 2023

Objective

Sufficient sleep is essential for well-being. We examined the relationship between work-related social support, work stress, and sleep sufficiency, predicting that workers with higher social support would report higher sleep sufficiency across varying levels of work stress.

Methods

The data set analyzed in the present study included 2213 workers from approximately 200 small (<500 employees) businesses in high, medium, and low hazard industries across Colorado.

Results

Perceived social support variables moderated the relationship between work stress and sleep sufficiency such that employees reporting higher levels of social support reported higher sleep sufficiency when work stress was low or moderate but not high.

Conclusions

Although preventing work stress is optimal, in cases where employers cannot apply primary interventions to prevent stress (eg, eliminating/reducing night shifts), employers should attempt to increase social support or other more relevant resources for employees.
Audiogram Configuration, Molecular Etiology, and Outcome of Cochlear Implantation in Postlingual Auditory Neuropathy Spectrum Disorder
Authors: Kim Yehree , Han Jae Joon , Oh Jayoung , Han Jin Hee , Kim Min Young , Jung Jinsei , Choi Jae Young , Choi Byung Yoon
Published: June 2023

Objective

To explore the diverse molecular etiologies of postlingual auditory neuropathy spectrum disorder (ANSD) and report on the electrically evoked compound action potential (ECAP) thresholds and the outcome of cochlear implantation (CI).

Methods

Patients with late-onset, progressive hearing loss who went through molecular genetic testing were enrolled. Type of sensorineural hearing loss (SNHL) was classified as flat, reverse-slope, midfrequency, downsloping, or ski slope. We identified postlingual ANSD subjects through diagnostic tracts applied differently depending on the degree of SNHL. For CI recipients, individual ECAP thresholds, postoperative speech perception abilities, and the genetic cause were analyzed.

Results

The detection rate of ANSD among patients with postlingual SNHL was 5.1% (15/293 probands). Diverse genetic etiologies were identified in 7 (46.6%) of the 15 postlingual ANSD subjects, the genetic cause being found exclusively in subjects with reverse-slope SNHL. The pattern of intraoperative ECAP responses was also diverse and showed some correlation with the genetic etiology. Despite the diverse molecular etiology and ECAP responses, CI in postlingual ANSD patients, including those with features involving the postsynaptic component, yielded significant improvements in speech understanding.

Conclusions

This study proposes a differentiated diagnostic approach that focuses on both poor speech discrimination and reverse-slope hearing loss for the diagnosis of ANSD. Based on the improvement of speech understanding from all cochlear implantees with ANSD as well as the correlation between the genetic etiology and ECAP thresholds, we suggest that CI can significantly benefit ANSD subjects even those with unknown etiologies unless there is overt peripheral neuropathy.
Infection With Saprochaete Clavata in Children After Hematopoietic Cell Transplantation
Authors: Styczynski Tomasz , Sadlok Jagoda , Richert-Przygonska Monika , Debski Robert , Zalas-Wiecek Patrycja , Czyzewski Krzysztof , Styczynski Jan
Published: June 2023

Septic shock is a very rare manifestation of invasive fungal disease (IFD) in children after allogeneic hematopoietic cell transplantation (allo-HCT). The objective of this paper is analysis of two cases of pediatric patients with IFD caused bySaprochaete clavataafter allo-HCT. Literature data on this infection in children and its outcome were also summarized. Infection withSaprochaete clavatepresenting with symptoms of septic shock was being reported in 4 children, and 2 of them survived the infection. In conclusion, with quick diagnosis and quick treatment, the outcome of therapy of infection withSaprochaete clavatawas successful.
Fatal Rapunzel Syndrome
Authors: Zyla Alexandra A. , Jacques Rebekah
Published: June 2023

We report a rare case of a young child, younger than10 years, who died of complications related to trichophagia and multiple gastrointestinal trichobezoars. One year before death, the child's clinical history yielded a diagnosis of iron deficiency anemia, believed to be related to poor diet, and alopecia areata, the etiology of which was unknown. Two weeks before death, the child presented with complaints of intermittent “flu-like” symptoms and vomiting. The child reported abdominal pain, anorexia, and fatigue on the night before death. The next morning, the child ate breakfast and was subsequently discovered unresponsive.

On external examination, there were areas of thinning head hair. Postmortem computed tomography, magnetic resonance imaging, and internal examination revealed 3 distinct trichobezoars, occupying the stomach, jejunum, and ileum. This was complicated by small bowel obstructions and perforations due to the trichobezoars. The cause of death was peritonitis secondary to small bowel perforations due to small bowel obstruction with multiple trichobezoars. This is the first case report to demonstrate the utility of postmortem computed tomography and magnetic resonance imaging in characterizing the nature and extent of trichobezoars in a fatal case of Rapunzel syndrome.
Prognostic Implications of CD24, SOX2, and Nanog Expression in Invasive Urothelial Carcinoma
Authors: Abdelbary Abeer M. , Atwa Hanaa A. , Elfarargy Ola M. , Qasem Ebtisam R. , Elaidy Noha F.
Published: June 2023

Background:

Urinary bladder cancer (BC) is the seventh most common cancer worldwide with the highest incidence rates in Western Europe, North America, and Australia. The most common type of BC is urothelial carcinoma (UC), which represents a significant cause of morbidity and mortality.

Objective:

The aim of the study was to evaluate the prognostic value of CD24, SOX2, and Nanog in UC cases and the correlation with recurrence and survival.

Materials and Methods:

In this study, the authors investigated the expression of CD24, SOX2, and Nanog in 80 patients with urinary BC. The clinical significance of the markers was evaluated by assessing the correlation with the clinicopathologic parameters and prognosis.

Results:

The CD24 expression was positive in 62.5% of the BC patients, there was a significant association between CD24 expression and high grade and stage and lymphovascular invasion (LVI), P (0.002, 0.0010, and 0.001). SOX2 was expressed in 60 patients (75%), the expression was significantly associated with age, stage, grade, LVI, lymph node, and smoking, P (0.016, 0.01, <0.001, 0.003, 0.036, and 0.002), respectively. Nanog expression was positive in 60% of the BC patients. There was a significant association between Nanog expression and age, high grade, high stage, and LVI (P=0.016, <0.001, and 0.003), respectively.

Conclusions:

A significant relation between CD24, SOX2, and Nanog with the invasive potential of UC. This increase in expression of the 3 markers with the grades and stages of UC suggests that they can play a role in the development of UC, so they can be used in targeted therapy in the future.
Application of Neuronavigation in Microvascular Decompression: Optimizing Craniotomy and 3D Reconstruction of Neurovascular Compression
Authors: Wang Jing , Zhang Wei , Wang Xin , Luo Tian , Wang Xuelian , Qu Yan
Published: June 2023

Object:

Microvascular decompression (MVD) is the best curative treatment for trigeminal neuralgia and hemifacial spasm. We used the neuronavigation to reconstruct the 3D image of cranial nerve and blood vessel to identify the neurovascular compression, and to reconstruct the venous sinus and skull to optimize craniotomy.

Patients and Methods:

A total of 11 trigeminal neuralgia and 12 hemifacial spasm cases were selected. All patients had preoperative MRI which included 3D Time of Flight (3D-TOF), Magnetic Resonance Venography (MRV) and computer tomography (CT) for navigation. Imaging sequences were fused and reconstructed by navigation system before operation. The 3D-TOF images were used to delineate cranial nerve and vessel. The CT and MRV images were used to mark transverse sinus and the sigmoid sinus for craniotomy. All patients underwent MVD and have the preoperative view compared with intraoperative findings.

Results:

Approaching to the cerebellopontine angle right after opening the dura and got no cerebellar retracion or petrosal vein rupture during craniotomy. Ten of 11 trigeminal neuralgia and all 12 hemifacial spasm patients got excellent preoperative 3D reconstruction fusion images, which were also confirmed by intraoperative findings. All 11 trigeminal neuralgia patients and 10 of 12 hemifacial spasm patients were symptom free without any neurological complications just after the surgery. Other 2 hemifacial spasm patients got delayed resolution in 2 months after surgery.

Conclusions:

Through the neuronavigation guided craniotomy and the 3D neurovascular reconstruction, surgeons can better identify the compression of nerve and blood vessel, and reduce complications.
Toxoplasmic Lymphadenitis of the Head and Neck Region
Authors: Lee Dong Eun , Lee Dong Hoon , Lim Sang Chul
Published: June 2023

Objective:

We analyzed the clinical characteristics and treatment results in patients with a final diagnosis of toxoplasmic lymphadenitis after surgery.

Methods:

A total of 23 patients with a final diagnosis of toxoplasmic lymphadenitis of the head and neck region after surgery from January 2010 to August 2022 were enrolled.

Results:

All patients with toxoplasmic lymphadenitis presented with a neck mass and a mean age of over 40. The most common location of toxoplasma lymphadenitis in the head and neck was neck level II in 9 patients, followed by level I, level V, level III, the parotid gland, and level IV. Three patients had masses in multiple regions of the neck. Preoperative diagnosis (based on imaging tests, physical examination, and fine-needle aspiration cytology results) was benign lymph node enlargement in 11 cases, malignant lymphoma in 8 cases, metastatic carcinoma in 2 cases, and parotid tumors in 2 cases. All patients underwent surgical resection and were diagnosed with toxoplasma lymphadenitis based on the final biopsy. There were no major complications after surgery. A total of 10 patients (43.5%) received additional antibiotics after surgery. There was no recurrence of toxoplasmic lymphadenitis during the follow-up period.

Conclusions:

It is challenging to assess the diagnostic accuracy of preoperative examination in toxoplasma lymphadenitis; hence, surgical resection is necessary to differentiate it from other diseases.
Upper beak depression instead of elevation dominates cranial kinesis in woodpeckers
Authors: Lyons S. , Baeckens S. , Van Wassenbergh S.
Published: June 2023

The value of birds’ ability to move the upper beak relative to the braincase has been shown in vital tasks like feeding and singing. In woodpeckers, such cranial kinesis has been thought to hinder pecking as delivering forceful blows calls for a head functioning as a rigid unit. Here, we tested whether cranial kinesis is constrained in woodpeckers by comparing upper beak rotation during their daily activities such as food handling, calling and gaping with those from closely related species that also have a largely insectivorous diet but do not peck at wood. Both woodpeckers and non-woodpecker insectivores displayed upper beak rotations of up to 8 degrees. However, the direction of upper beak rotation differed significantly between the two groups, with woodpeckers displaying primarily depressions and non-woodpeckers displaying elevations. The divergent upper beak rotation of woodpeckers may be caused either by anatomical modifications to the craniofacial hinge that reduce elevation, by the caudal orientation of the mandible depressor muscle forcing beak depressions, or by both. Our results suggest that pecking does not result in plain rigidification at the upper beak's basis of woodpeckers, but it nevertheless significantly influences the way cranial kinesis is manifested.
Temporal dynamics of trauma memory persistence
Authors: Bonsall Michael B. , Holmes Emily A.
Published: June 2023

Traumatic events lead to distressing memories, but such memories are made all the worse when they intrude to mind unbidden and recurrently. Intrusive memories and flashbacks after trauma are prominent in several mental disorders, including post-traumatic stress disorder and can persist for years. Critically, the reduction of intrusive memories provides a treatment target. While cognitive and descriptive models for psychological trauma exist, these lack formal quantitative structure and robust empirical validation. Here, using techniques from stochastic process theory, we develop a mechanistically driven, quantitative framework to extend understanding of the temporal dynamic processes of trauma memory. Our approach is to develop a probabilistic description of memory mechanisms to link to the broader goals of trauma treatment. We show how the marginal gains of treatments for intrusive memories can be enhanced as key properties (intervention strength and reminder strength) of the intervention and memory consolidation (probability memories are labile) vary. Parametrizing the framework with empirical data highlights that while emerging interventions to reduce occurrence of intrusive memories can be effective, counterintuitively,
weakening
multiple reactivation cues may help reduce intrusive memories more than would stronger cues. More broadly, the approach provides a quantitative framework for associating neural mechanisms of memory with broader cognitive processes.
Systematic enhancement of protein crystallization efficiency by bulk lysine-to-arginine (KR) substitution
Authors: Banayan Nooriel E. , Loughlin Blaine J. , Singh Shikha , Forouhar Farhad , Lu Guanqi , Wong Kam-Ho , Neky Matthew , Hunt Henry S. , Bateman Larry B. , Tamez Angel , Handelman Samuel K. , Nicholson Price W. , Hunt John F.
Published: June 2023

Structural genomics consortia established that protein crystallization is the primary obstacle to structure determination using x-ray crystallography. We previously demonstrated that crystallization propensity is systematically related to primary sequence, and we subsequently performed computational analyses showing that arginine is the most overrepresented amino acid in crystal-packing interfaces in the Protein Data Bank. Given the similar physicochemical characteristics of arginine and lysine, we hypothesized that multiple lysine-to-arginine (KR) substitutions should improve crystallization. To test this hypothesis, we developed software that ranks lysine sites in a target protein based on the redundancy-corrected KR substitution frequency in homologs. We demonstrate that three unrelated single-domain proteins can tolerate 5-11 KR substitutions with at most minor destabilization and that these substitutions consistently enhance crystallization propensity. This approach rapidly produced a 1.9 Å crystal structure of a human protein domain refractory to crystallization with its native sequence. Structures from bulk-KR-substituted domains show the engineered arginine residues frequently make high-quality hydrogen-bonds across crystal-packing interfaces. We thus demonstrate that bulk KR substitution represents a rational and efficient method for probabilistic engineering of protein surface properties to improve protein crystallization.
Getting More by Asking for Less: Linking Species Interactions to Species Co-Distributions in Metacommunities
Authors: Barbier Matthieu , Bunin Guy , Leibold Mathew A.
Published: June 2023

One of the more difficult challenges in community ecology is inferring species interactions on the basis of patterns in the spatial distribution of organisms. At its core, the problem is that distributional patterns reflect the ‘realized niche’, the net result of a complex interplay of processes involving dispersal, environmental, and interaction effects. Disentangling these effects can be difficult on at least two distinct levels. From a statistical point of view, splitting a population’s variation into contributions from its interaction partners, abiotic environment and spatial proximity requires ‘natural experiments’ where all three factors somehow vary independently from each other. On a more conceptual level, it is not even clear how to meaningfully separate these processes: for instance, species interactions could depend on the state of the abiotic and biotic environment, and these two processes may combine in highly non-additive ways. Here we show that the latter issue arises almost inescapably, even in a simple theoretical setting designed to minimize it. Using a model of competitive metacommunity dynamics where direct species interactions are assumed to be context-independent, we show that inferring these interactions accurately from cross-species correlations is a major challenge under all but the most restrictive assumptions. However, we also find that it is possible to estimate the statistical moments (mean value and variance) of the species interactions distribution much more robustly, even if the precise values cannot be inferred. Consequently, we argue that study of multi-species spatial patterns can still be informative for theoretical approaches that build on statistical distributions of species parameters to predict macroscopic outcomes of community assembly.
sAMP-VGG16: Drude polarizable force-field assisted image-based deep neural network prediction model for short antimicrobial peptides
Authors: Pandey Poonam , Srivastava Anand
Published: June 2023

During the last three decades, antimicrobial peptides (AMPs) have emerged as a promising therapeutic alternative to antibiotics. The approaches for designing AMPs span from experimental trial-and-error methods to synthetic hybrid peptide libraries. To overcome the exceedingly expensive and time-consuming process of designing effective AMPs, many computational and machine-learning tools for AMP prediction have been recently developed. In general, to encode the peptide sequences, featurization in these rely on approaches based on (a) amino acid composition, (b) physicochemical properties, (c) sequence similarity, and (d) structural properties. In this work, we present an image-based deep neural network model to predict AMPs, where we are using feature encoding based on Drude polarizable force-field atom types, which can capture the peptide properties more efficiently compared to conventional feature vectors. The proposed prediction model identifies AMPs with promising accuracy and efficiency and can be used as a next-generation screening method for predicting new AMPs. The source code is publicly available at the Figshare server
sAMP-VGG16.