bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal mental health and economic autonomy in lowland rural Nepal
Authors: Marphatia Akanksha A , Busert-Sebela Laura K , Gram Lu , Cortina-Borja Mario , Reid Alice M , Manandhar Dharma S , Wells Jonathan C K , Saville Naomi M
Published: July 2023

Background and objectives

In patrilocal societies, married women typically co-reside with their parents-in-law, who may act in their son’s reproductive interests. These relationships may shape maternal mental health and autonomy. Few studies have examined these dynamics from an evolutionary perspective. Theoretically, marital kin may increase their fitness by increasing maternal investment or by reducing paternity uncertainty. We explored how co-residence with parents-in-law and husband is associated with maternal outcomes to evaluate whether marital kin provide support or constraint.

Methodology

We analysed data from 444 households in rural lowland Nepal. Maternal mental health was assessed by General Health Questionnaire. Logistic regression models investigated whether, relative to mothers living with both husband and parents-in-law, those co-resident with other combinations of relatives had poorer mental health and lower household economic autonomy (decision-making, bargaining power), adjusting for socio-economic confounders.

Results

Co-residence with husband only, or neither husband nor parents-in-law, was associated with higher odds of mothers reporting feeling worthless and losing sleep but also earning income and making household expenditure decisions. Husband co-residence was associated with overall maternal distress but also with less unpaid care work and greater decision-making responsibility. There were no differences in maternal outcomes for mothers living with parents-in-law only, relative to those living with both husbands and parents-in-law.

Conclusions and implications

Co-residence of parents-in-law and husbands was associated with contrasting patterns of maternal mental health and economic autonomy. We suggest that different marital kin place different economic demands on mothers, while restricting their autonomy in different ways as forms of ‘mate-guarding’.
Normalization of ascending aorta dimension for body size influences pathophysiologic correlation in hypertensive patients: the Campania Salute Network
Authors: Mancusi Costantino , Manzi Maria Virginia , Lembo Maria , Fucile Ilaria , Basile Christian , Bardi Luca , Morisco Carmine , De Luca Nicola , Bossone Eduardo , Trimarco Bruno , Izzo Raffaele , de Simone Giovanni , Esposito Giovanni
Published: July 2023

Aims

In the present study, we assessed correlates and their consistency of ascending aorta (AscAo) measurement in treated hypertensive patients.

Methods and results

A total of 1634 patients ≥ 18 years old with available AscAo ultrasound were included. Ascending aorta was measured at end-diastole with leading edge to leading edge method, perpendicular to the long axis of the aorta in parasternal long-axis view at its maximal identifiable dimension. Correlations of AscAo and AscAo normalized for height (AscAo/HT) or body surface area (AscAo/BSA) with demographics and metabolic profile were explored. Multi-variable regression was also used to identify potential confounders influencing univariate correlations. Sensitivity analysis was performed using cardiovascular (CV) outcome. Correlations with age, estimated glomerular filtration rate, systolic blood pressure (BP), and heart rate (HR) were similar among the three aortic measures. Women exhibited smaller AscAo but larger AscAo/BSA than men with AscAo/HT offsetting the sex difference. Obesity and diabetes were associated with greater AscAo and AscAo/HT but with smaller AscAo/BSA (all P < 0.001). In multi-variable regression model, all aortic measure confirmed the sign of their relations with sex and metabolic profile independently of age, BP, and HR. In Kaplan–Mayer analysis, only dilated AscAo and AscAo/HT were significantly associated with increased risk of CV events (both P < 0.008).

Conclusions

Among patients with long-standing controlled systemic hypertension, magnitude of aortic remodelling is influenced by the type of the measure adopted, with physiological consistency only for AscAo and AscAo/HT, but not for AscAo/BSA.
Genetic control of the error-prone repair of a chromosomal double-strand break with 5′ overhangs in yeast
Authors: Shaltz Samantha , Jinks-Robertson Sue
Published: July 2023

A targeted double-strand break introduced into the genome of Saccharomyces cerevisiae is repaired by the relatively error-prone nonhomologous end joining (NHEJ) pathway when homologous recombination is not an option. A zinc finger nuclease cleavage site was inserted out-of-frame into the LYS2 locus of a haploid yeast strain to study the genetic control of NHEJ when the ends contain 5′ overhangs. Repair events that destroyed the cleavage site were identified either as Lys+ colonies on selective medium or as surviving colonies on rich medium. Junction sequences in Lys+ events solely reflected NHEJ and were influenced by the nuclease activity of Mre11 as well as by the presence/absence of the NHEJ-specific polymerase Pol4 and the translesion-synthesis DNA polymerases Pol ζ and Pol η. Although most NHEJ events were dependent on Pol4, a 29-bp deletion with endpoints in 3-bp repeats was an exception. The Pol4-independent deletion required translesion synthesis polymerases as well as the exonuclease activity of the replicative Pol δ DNA polymerase. Survivors were equally split between NHEJ events and 1.2 or 11.7 kb deletions that reflected microhomology-mediated end joining (MMEJ). MMEJ events required the processive resection activity of Exo1/Sgs1, but there unexpectedly was no dependence on the Rad1–Rad10 endonuclease for the removal of presumptive 3′ tails. Finally, NHEJ was more efficient in nongrowing than in growing cells and was most efficient in G0 cells. These studies provide novel insights into the flexibility and complexity of error-prone DSB repair in yeast.
Telehealth Use Among Older Adults With Sensory, Cognitive, and Physical Impairments: A Substitute or Supplement to Traditional Care?
Authors: Choi Shinae L , Carr Deborah , Namkung Eun Ha
Published: July 2023

Objectives

Telehealth use flourished during the COVID-19 pandemic, as older patients faced obstacles to seeking in-person care. Heavy reliance on telehealth may continue postpandemic, due to increased Medicare investments in its use. However, it is unclear if older adults with disabilities face obstacles to effective telehealth use. We evaluate (a) how sensory, physical, and cognitive impairments affect older adults’ use of telehealth only, traditional in-person care only, neither, or both (i.e., combined care); and (b) whether these patterns differ on the basis of socioeconomic and social resources that may facilitate telehealth use.

Method

Data are from the Self-Administered Questionnaire in the 2020 wave of the Health and Retirement Study (n = 4,453). We estimated multinomial logistic regression models to evaluate associations between impairments and health care service use and tested 2-way interaction terms to evaluate moderation effects.

Results

Persons without impairments were most likely to use combined care, considered the optimal form of care. Persons with vision or cognitive impairment were more likely to use telehealth or traditional care only, whereas persons with 3 or more physical limitations were least likely to use telehealth alone, relative to combined care. Patterns did not differ significantly on the basis of any of the potential moderators.

Discussion

We discuss implications for health care policy and practice, in light of reimbursement changes proposed by the Centers for Medicare and Medicaid Services for telehealth services. These proposals include the elimination of voice-only services which may be particularly beneficial to vision-impaired older adults.
PnMYB4 negatively modulates saponin biosynthesis in Panax notoginseng through interplay with PnMYB1
Authors: Man Jinhui , Shi Yue , Huang Yuying , Zhang Xiaoqin , Wang Xin , Liu Shanhu , He Gaojie , An Kelu , Han Dongran , Wang Xiaohui , Wei Shengli
Published: July 2023

Saponins are the main triterpenoid ingredients from Panax notoginseng, a well-known Chinese medicine, and are important sources for producing drugs to prevent and treat cerebrovascular and cardiovascular diseases. However, the transcriptional regulatory network of saponin biosynthesis in P. notoginseng is largely unknown. In the present study we demonstrated that one R2R3-MYB transcription factor, designated PnMYB4, acts as a repressor of saponin accumulation. Suppression of PnMYB4 in P. notoginseng calli significantly increased the saponin content and the expression level of saponin biosynthetic genes. PnMYB4 directly bound to the promoters of key saponin biosynthetic genes, including PnSS, PnSE, and PnDS, to repress saponin accumulation. PnMYB4 and the activator PnMYB1 could interacted with PnbHLH, which is a positive regulator of saponin biosynthesis, to modulate the biosynthesis of saponin. PnMYB4 competed with PnMYB1 for binding to PnbHLH, repressing activation of the promoters of saponin structural genes induced by the PnMYB1-PnbHLH complex. Our study reveals that a complex regulatory module of saponin biosynthesis is associated with positive and negative MYB transcriptional regulators and provides a theoretical basis for improving the content of saponins and efficacy of P. notoginseng.
Dynamic ranking and translation synchronization
Authors: Araya Ernesto , Karlé Eglantine , Tyagi Hemant
Published: July 2023

In many applications, such as sport tournaments or recommendation systems, we have at our disposal data consisting of pairwise comparisons between a set of $n$ items (or players). The objective is to use these data to infer the latent strength of each item and/or their ranking. Existing results for this problem predominantly focus on the setting consisting of a single comparison graph $G$. However, there exist scenarios (e.g. sports tournaments) where the pairwise comparison data evolve with time. Theoretical results for this dynamic setting are relatively limited, and are the focus of this paper. We study an extension of the translation synchronization problem, to the dynamic setting. In this set-up, we are given a sequence of comparison graphs $(G_t)_{t\in{{\mathscr{T}}}}$, where $ {{\mathscr{T}}} \subset [0,1]$ is a grid representing the time domain, and for each item $i$ and time $t\in{{\mathscr{T}}}$ there is an associated unknown strength parameter $z^*_{t,i}\in{{\mathbb{R}}}$. We aim to recover, for $t\in{{\mathscr{T}}}$, the strength vector $z^*_t=(z^*_{t,1},\dots ,z^*_{t,n})$ from noisy measurements of $z^*_{t,i}-z^*_{t,j}$, where $\left \{{i,j}\right \}$ is an edge in $G_t$. Assuming that $z^*_t$ evolves smoothly in $t$, we propose two estimators—one based on a smoothness-penalized least squares approach and the other based on projection onto the low-frequency eigenspace of a suitable smoothness operator. For both estimators, we provide finite sample bounds for the $\ell _2$ estimation error under the assumption that $G_t$ is connected for all $t\in{{\mathscr{T}}}$, thus proving the consistency of the proposed methods in terms of the grid size $|\mathscr{T}|$. We complement our theoretical findings with experiments on synthetic and real data.
Microencapsulation protected Lactobacillus viability and its activity in modulating the intestinal microbiota in newly weaned piglets
Authors: Li Linyan , Yin Fugui , Wang Xiaoyin , Yang Chongwu , Yu Hai , Lepp Dion , Wang Qi , Lessard Martin , Lo Verso Luca , Mondor Martin , Yang Chengbo , Nie Shaoping , Gong Joshua
Published: July 2023

Lactobacilli are sensitive to heat, which limits their application as probiotics in livestock production. Lactobacillus rhamnosus LB1 was previously shown to reduce enterotoxigenic Escherichia coli (ETEC) and Salmonella infections in pigs. To investigate its potential in the application, the bacterium was microencapsulated and examined for its survival from feed pelleting and long-term storage as well as its function in modulating pig intestinal microbiota. The in vitro studies showed that freshly microencapsulated Lactobacillus rhamnosus LB1 had viable counts of 9.03 ± 0.049 log10 colony-forming units/g, of which only 0.06 and 0.87 Log of viable counts were reduced after storage at 4 and 22 °C for 427 d. The viable counts of encapsulated Lactobacillus rhamnosus LB1 were 1.06 and 1.54 Log higher in the pelleted and mash feed, respectively, than the non-encapsulated form stored at 22 °C for 30 d. In the in vivo studies, 80 piglets (weaned at 21 d of age) were allocated to five dietary treatments for a 10-d growth trial. The dietary treatments were the basal diet (CTL) and basal diet combined with either non-encapsulated LB1 (NEP), encapsulated LB1 (EP), bovine colostrum (BC), or a combination of encapsulated LB1 and bovine colostrum (EP-BC). The results demonstrated that weaning depressed feed intake and reduced growth rates in pigs of all the treatments during 21 to 25 d of age; however, the body weight gain was improved during 25 to 31 d of age in all groups with the numerically highest increase in the EP-BC-fed pigs during 21 to 31 d of age. Dietary treatments with EP, particularly in combination with BC, modulated pig intestinal microbiota, including an increase in Lactobacillus relative abundance. These results suggest that microencapsulation can protect Lactobacillus rhamnosus LB1 against cell damage from a high temperature during processing and storage and there are possible complementary effects between EP and BC.
Bees and thrips carry virus-positive pollen in peach orchards in South Carolina, United States
Authors: Tayal Mandeep , Wilson Christopher , Cieniewicz Elizabeth
Published: July 2023

Prunus necrotic ringspot virus (PNRSV) and prune dwarf virus (PDV) are pollen-borne viruses of important stone fruit crops, including peaches, which can cause substantial yield loss. Although both horizontal and vertical (i.e., seed) transmission of both viruses occurs through pollen, the role of flower-visiting insects in their transmission is not well understood. Bees and thrips reportedly spread PNRSV and PDV in orchards and greenhouse studies; however, the field spread of PNRSV and PDV in peach orchards in the southeastern United States is not explored. We hypothesized that bees and thrips may facilitate virus spread by carrying virus-positive pollen. Our 2-yr survey results show that 75% of captured bees are carrying virus-positive pollen and moving across the orchard while a subsample of thrips were also found virus positive. Based on morphology, Bombus, Apis, Andrena, Eucera, and Habropoda are the predominant bee genera that were captured in peach orchards. Understanding the role of bees and thrips in the spread of PNRSV and PDV will enhance our understanding of pollen-borne virus ecology.
Protein availability on Qinghai–Tibetan Plateau meadows determines density and life-history characteristics of plateau pikas (Ochotona curzoniae)
Authors: Wu Xueqin , Shang Guozhen , Chen Huiqing , Wu Yan , Hou Chu , Yang Yuangang , Zhang Lu , Cao Yifan , Bian Jianghui
Published: July 2023

Plateau pikas (Ochotona curzoniae) play a keystone role in the alpine meadow ecosystem on the Qinghai–Tibetan Plateau (QTP). For decades, alpine meadows on the QTP have suffered from severe degradation, predominantly due to livestock grazing and frequent dramatic increases in plateau pikas. The cause has long been thought to be that livestock grazing provides open habitats for pikas. However, open habitats with low food nutrient quality are insufficient to maintain high-density populations. Feeding facilitation is a process or action undertaken by one species whose activity benefits another species. However, the facilitative effects on population consequences remain unclear. Here, we examined the impact of feeding facilitation on the population dynamics of plateau pikas. We hypothesize that the high protein amount provided by meadows that have been overgrazed would be an important factor leading to dramatic increases in plateau pikas. We found that plateau pikas preferred high-protein foods, and relatively abundant high-protein food resources were found in meadows following high levels of livestock grazing. Body mass and amount of protein in stomach digesta of pikas were higher in moderately and heavily grazed meadows than in lightly grazed meadow. Thus, pika population density was associated with high-protein food resources. A supplemental protein experiment confirmed that high-protein foods led to higher pika population density by increasing reproductive performance. Livestock grazing increased the abundance of plateau pikas by shifting plant nutrient contents toward higher protein conditions favorable to them. Feeding facilitation is an important factor that causes a dramatic increase in plateau pikas.
Institutions That Influence Cross-Boundary Forest Management: Four Cases of Shared Stewardship in Practice
Authors: Aldworth Tyler , Schultz Courtney
Published: July 2023

The USDA Forest Service’s 2018 Shared Stewardship Strategy emphasizes the need to coordinate work with actors across boundaries to increase the pace and scale of land management, particularly as it relates to forest restoration and wildfire mitigation. We researched how the Strategy was being implemented at the project level by conducting forty-four interviews with individuals closely involved with four large-scale cross-boundary hazardous fuels reduction projects. Our objectives were to identify institutions that facilitated and challenged cross-boundary work under the Strategy and document how actors innovated to overcome challenges they encountered. We found that Shared Stewardship had the greatest opportunity to shift the larger forest management paradigm within states that created new institutions specifically to support the Strategy and its objectives. However, numerous institutional challenges such as yearly funding levels and complex bureaucratic requirements, frustrated efforts to increase the pace and scale of management actions under the Strategy.

Study Implications: We conducted research on cross-boundary projects that met the intent of the USDA Forest Service’s Shared Stewardship Strategy. We found that the cross-boundary tenets of the Strategy were best supported when states worked together with the federal government to create new institutions that facilitate multijurisdictional work. Our interviewees said that various bureaucratic hurdles remain difficult to navigate, and that they believe annual funding appropriations are not currently enough to support significant increases in the pace and scale of management. Our interviewees said Shared Stewardship supported cross-boundary actions, but more remains to be done to best support multijurisdictional work.
Fisetin alleviates chronic urticaria by inhibiting mast cell activation via MRGPRX2
Authors: Zhang Yonghui , Huang Yihan , Dang Baowen , Hu Shiting , Zhao Chenrui , Wang Yuejin , Yuan Yujuan , Liu Rui
Published: July 2023

Objectives

The activation of mast cell (MC) plays an important part in the pathogenesis of chronic urticaria (CU), and the expression of MRGPRX2 (Mas-related G-protein coupled receptor X2) and the circulating levels of SP (substance P) in skin MC of CU patients increased. Fisetin is a natural flavonoid with anti-inflammatory and antiallergic pharmacological effects. This study aimed to investigate the inhibitory effect of fisetin on CU via MRGPRX2 and its possible molecular mechanisms.

Methods

OVA/SP co-stimulated and SP-stimulated CU like murine models were used to evaluate the effect of fisetin on CU. MRGPRX2/HEK293 cells and LAD2 cells were used to perform the antagonism effect of fisetin on MC via MRGPRX2.

Key findings

The results indicated that fisetin prevented urticaria-like symptoms in murine CU models, and inhibited MCs activation by suppressing calcium mobilization and degranulation of cytokines and chemokines via binding to MRGPRX2. The bioinformatics analysis showed that fisetin might have an interaction relationship with Akt in CU. The western blotting experiments showed that fisetin downregulated the phosphorylation levels of Akt, P38, NF-κB, and PLCγ in C48/80 activated LAD2 cells.

Conclusions

Fisetin alleviates CU progression by inhibiting mast cell activation via MRGPRX2, which may be a novel therapeutic candidate for CU.
Incidental aortocaval fistula in the setting of an unruptured abdominal aortic aneurysm
Authors: Sohail Amir H , Cohen Koral , Ho Kimberly , Cimaroli Sawyer , Brathwaite Collin E M , Shin Patrick
Published: July 2023

An aortocaval fistula, a rare abnormal vascular communication between the aorta and inferior vena cava, is most commonly associated with abdominal aortic aneurysms (AAAs). Other factors leading to aortocaval fistula formation include atherosclerosis, collagen vascular diseases, vasculitis, hematogenous infections, prior spinal surgery, malignancy and radiation exposure. In rare instances, aortocaval fistulas may be discovered incidentally on abdominal imaging. We report an unusual case of an incidental aortocaval fistula in a 93-year-old male patient with an unruptured AAA, presenting with shortness of breath, malaise and lethargy. The patient had no other obvious risk factors for aortocaval fistula formation. Multidetector computed tomography angiography helped identify the fistula, and the patient was eventually transferred to hospice for comfort measures. This case highlights the importance of detailed imaging and preoperative planning in managing aortocaval fistulas and associated AAAs.
Vietnam’s energy transition to 2050: is importing liquefied natural gas a good solution?
Authors: Minh Thong Le , Van Hiep Tran
Published: July 2023

Energy and the environment are among the biggest challenges facing humanity in the 21st century. The issue of the energy transition has become increasingly important as countries around the world seek to shift towards cleaner, more sustainable forms of energy. For a rapidly developing economy like Vietnam, the energy challenge becomes even more urgent. A reasonable energy transition strategy will be an important prerequisite for sustainable economic development, national security, environmental improvement and climate change mitigation. One potential solution that has been proposed is to increase imports of liquefied natural gas (LNG) to help meet Vietnam’s energy needs while reducing its reliance on coal. In this article, the author analyses the potential for Vietnam to import LNG in the future.
Partial stellar tidal disruption events and their rates
Authors: Bortolas Elisa , Ryu Taeho , Broggi Luca , Sesana Alberto
Published: July 2023

Tidal disruption events (TDEs) of stars operated by massive black holes (MBHs) will be detected in thousands by upcoming facilities such as the Vera Rubin Observatory. In this work, we assess the rates of standard total TDEs, destroying the entire star, and partial TDEs, in which a stellar remnant survives the interaction, by solving 1D Fokker–Planck equations. Our rate estimates are based on a novel definition of the loss cone whose size is commensurate with the largest radius at which partial disruptions can occur, as motivated by relativistic hydrodynamical simulations. Our novel approach unveils two important results. First, partial TDEs can be more abundant than total disruptions by a factor of a few to a few tens. Second, the rates of complete stellar disruptions can be overestimated by a factor of a few to a few tens if one neglects partial TDEs, as we find that many of the events classified as total disruptions in the standard framework are in fact partial TDEs. Accounting for partial TDEs is particularly relevant for galaxies harbouring a nuclear stellar cluster featuring many events coming from the empty loss cone. Based on these findings, we stress that partial disruptions should be considered when constraining the luminosity function of TDE flares; accounting for this may reconcile the theoretically estimated TDE rates with the observed ones.
Structural basis for specific DNA sequence motif recognition by the TFAP2 transcription factors
Authors: Liu Ke , Xiao Yuqing , Gan Linyao , Li Weifang , Zhang Jin , Min Jinrong
Published: July 2023

The TFAP2 family regulates gene expression during differentiation, development, and organogenesis, and includes five homologs in humans. They all possess a highly conserved DNA binding domain (DBD) followed by a helix-span-helix (HSH) domain. The DBD-HSH tandem domain specifically binds to a GCC(N3)GGC consensus sequence, but the precise recognition mechanisms remain unclear. Here, we found that TFAP2 preferred binding to the GCC(N3)GGC sequence, and the pseudo-palindromic GCC and GGC motifs and the length of the central spacer between the two motifs determined their binding specificity. Structural studies revealed that the two flat amphipathic α-helical HSH domains of TFAP2A stacked with each other to form a dimer via hydrophobic interactions, while the stabilized loops from both DBD domains inserted into two neighboring major grooves of the DNA duplex to form base-specific interactions. This specific DNA binding mechanism controlled the length of the central spacer and determined the DNA sequence specificity of TFAP2. Mutations of the TFAP2 proteins are implicated in various diseases. We illustrated that reduction or disruption of the DNA binding ability of the TFAP2 proteins is the primary cause of TFAP2 mutation-associated diseases. Thus, our findings also offer valuable insights into the pathogenesis of disease-associated mutations in TFAP2 proteins.
Neurotoxicity and management of primary and secondary central nervous system lymphoma after adoptive immunotherapy with CD19-directed chimeric antigen receptor T-cells
Authors: Karschnia Philipp , Arrillaga-Romany Isabel C , Eichler April , Forst Deborah A , Gerstner Elizabeth , Jordan Justin T , Ly Ina , Plotkin Scott R , Wang Nancy , Martinez-Lage Maria , Winter Sebastian F , Tonn Joerg-Christian , Rejeski Kai , von Baumgarten Louisa , Cahill Daniel P , Nahed Brian V , Shankar Ganesh M , Abramson Jeremy S , Barnes Jeffrey A , El-Jawahri Areej , Hochberg Ephraim P , Johnson P Connor , Soumerai Jacob D , Takvorian Ronald W , Chen Yi-Bin , Frigault Matthew J , Dietrich Jorg
Published: July 2023

Background

Chimeric antigen receptor (CAR) T-cells targeting CD19 have been established as a leading engineered T-cell therapy for B-cell lymphomas; however, data for patients with central nervous system (CNS) involvement are limited.

Methods

We retrospectively report on CNS-specific toxicities, management, and CNS response of 45 consecutive CAR T-cell transfusions for patients with active CNS lymphoma at the Massachusetts General Hospital over a 5-year period.

Results

Our cohort includes 17 patients with primary CNS lymphoma (PCNSL; 1 patient with 2 CAR T-cell transfusions) and 27 patients with secondary CNS lymphoma (SCNSL). Mild ICANS (grade 1–2) was observed after 19/45 transfusions (42.2%) and severe immune effector cell-associated neurotoxicity syndrome (ICANS) (grade 3–4) after 7/45 transfusions (15.6%). A larger increase in C-reactive protein (CRP) levels and higher rates of ICANS were detected in SCNSL. Early fever and baseline C-reactive protein levels were associated with ICANS occurrence. CNS response was seen in 31 cases (68.9%), including a complete response of CNS disease in 18 cases (40.0%) which lasted for a median of 11.4 ± 4.5 months. Dexamethasone dose at time of lymphodepletion (but not at or after CAR T-cell transfusion) was associated with an increased risk for CNS progression (hazard ratios [HR] per mg/d: 1.16, P = .031). If bridging therapy was warranted, the use of ibrutinib translated into favorable CNS-progression-free survival (5 vs. 1 month, HR 0.28, CI 0.1–0.7; P = .010).

Conclusions

CAR T-cells exhibit promising antitumor effects and a favorable safety profile in CNS lymphoma. Further evaluation of the role of bridging regimens and corticosteroids is warranted.
Forces on and in the cell walls of living plants
Authors: Jarvis Michael C
Published: July 2023

Environmental influences and differential growth subject plants to mechanical forces. Forces on the whole plant resolve into tensile forces on its primary cell walls and both tensile and compression forces on the secondary cell wall layers of woody tissues. Forces on cell walls are further resolved into forces on cellulose microfibrils and the noncellulosic polymers between them. Many external forces on plants oscillate, with time constants that vary from seconds to milliseconds. Sound waves are a high-frequency example. Forces on the cell wall lead to responses that direct the oriented deposition of cellulose microfibrils and the patterned expansion of the cell wall, leading to complex cell and tissue morphology.

Recent experiments have established many of the details of which cell wall polymers associate with one another in both primary and secondary cell walls, but questions remain about which of the interconnections are load bearing, especially in primary cell walls. Direct cellulose–cellulose interactions appear to have a more important mechanical role than was previously thought, and some of the noncellulosic polymers may have a role in keeping microfibrils apart rather than cross-linking them as formerly envisaged.
(g− 2)e, μ and decayseb→eaγ in a SU(4)L⊗U(1)Xmodel with inverse seesaw neutrinos
Authors: Thao N H , Binh D T , Hong T T , Hue L T , Khoi D P
Published: July 2023

We will show that the 3-4-1 model with heavy right-handed neutrinos can explain the recent experimental data of (g − 2)e, μ anomalies of charged leptons and neutrino oscillations through the inverse seesaw mechanism. In addition, the model can predict large lepton flavor violating decay rates μ → eγ and τ → μγ, eγ with accuracy equal to recent experimental sensitivities.
Significant Clinical Improvement Was Predicted in a Cohort of Patients With Low Back Pain Early in the Care Process
Authors: Brennan Gerard P , Snow Greg , Minick Kate I , Stevans Joel M
Published: July 2023

Objective

The purpose of this study was to determine the proportion of patients with low back pain who achieved clinical improvement in disability within 3 or 6 physical therapy visits, identify factors that predicted improvement, and predict the probability of improvement by the third and sixth visits.

Methods

This retrospective, observational study looked at patients (N = 6523) who completed a numeric pain scale and Modified Low Back Disability Questionnaire (MDQ) at every visit. Four prediction models were developed: 30% improvement by visit 3 and by visit 6 and 50% improvement by visit 3 and by visit 6. A logistic regression model was fit to predict patients’ improvement in disability using the MDQ. Predictive models used age, disability scores, sex, symptom duration, and payer type as factors. Receiver operating characteristic curves and area under the curve were computed for the models. Nomograms illustrate the relative impacts of the predictor variables.

Results

Disability improved 30% in 42.7% of patients by visit 3 and 49% by visit 6. Disability improved 50% in 26% of patients by visit 3 and 32.9% by visit 6. First visit score (MDQ1) was strongest factor to predict 30% improvement by visit 3. The visit 3 score (MDQ3) was strongest factor to predict a 30% or 50% improvement by visit 6. The combination of MDQ1 and MDQ3 scores was strongest overall predictive factor for visit 6. The area under the curve values for models using only the MDQ1 and MDQ3 scores to predict 30% or 50% improvement by the sixth visit were 0.84 and 0.85, respectively, representing excellent overall diagnostic accuracy of the prediction models.

Conclusion

Excellent discrimination to predict patients’ significant clinical improvement by visit 6 using 2 outcome scores was demonstrated. Gathering outcomes routinely enhances assessment of prognosis and clinical decision making.

Impact

Understanding prognosis of clinical improvement supports physical therapists’ contribution to value-based care.
The Role of Movement in Physical Therapist Clinical Reasoning
Authors: Christensen Nicole , Black Lisa , Gilliland Sarah , Huhn Karen , Wainwright Susan
Published: July 2023

Objective

The purpose of this study was to explore how physical therapists use movement as a component of their clinical reasoning. Additionally, this research explored whether movement as a component of clinical reasoning aligns with the proposed signature pedagogy for physical therapist education, human body as teacher.

Methods

The study utilized qualitative, descriptive methods in a multiple case studies design (each practice setting represented a different case for analysis purposes) with cross-case comparisons. Researchers conducted 8 focus groups across practice settings including acute care, inpatient neurological, outpatient orthopedics, and pediatrics. Each focus group had 4 to 6 participants. Through an iterative, interactive process of coding and discussion among all researchers, a final coding scheme was developed.

Results

Through exploration of the research aims, 3 themes emerged from the data. These primary themes are: (1) movement drives clinical reasoning to optimize function; (2) reasoning about movement is multisensory and embodied; and (3) reasoning about movement relies on communication.

Conclusions

This research supports a description of movement as the lens used by physical therapists in clinical reasoning and the integral role of movement in clinical reasoning and in learning from and through movement of the human body while learning from clinical reasoning experiences in practice.

Impact

As the understanding of the ways physical therapists use and learn from movement in clinical reasoning and practice continues to emerge, it is important to continue exploring ways to best make this expanded, embodied conception of clinical reasoning explicit in the education of future generations of physical therapists.
Mesenchymal Stem/Stromal Cells Therapy for Metabolic Syndrome: Potential Clinical Application?
Authors: Huang Xiuyi , Liu Yunchong , Li Zilun , Lerman Lilach O
Published: July 2023

Mesenchymal stem/stromal cells (MSCs), a class of cells with proliferative, immunomodulatory, and reparative functions, have shown therapeutic potential in a variety of systemic diseases, including metabolic syndrome (MetS). The cluster of morbidities that constitute MetS might be particularly amenable for the application of MSCs, which employ an arsenal of reparative actions to target multiple pathogenic pathways simultaneously. Preclinical studies have shown that MSCs can reverse pathological changes in MetS mainly by inhibiting inflammation, improving insulin resistance, regulating glycolipid metabolism, and protecting organ function. However, several challenges remain to overcome before MSCs can be applied for treating MetS. For example, the merits of autologous versus allogeneic MSCs sources remain unclear, particularly with autologous MSCs obtained from the noxious MetS milieu. The distinct characteristics and relative efficacy of MSCs harvested from different tissue sources also require clarification. Moreover, to improve the therapeutic efficacy of MSCs, investigators have explored several approaches that improved therapeutic efficacy but may involve potential safety concerns. This review summarized the potentially useful MSCs strategy for treating MetS, as well as some hurdles that remain to be overcome. In particular, larger-scale studies are needed to determine the therapeutic efficacy and safety of MSCs for clinical application.
Community organization guides standardization, adaptability, and innovation: lessons from peer support in the Shanghai Integration Model
Authors: Evans Megan , Liu Yuexing , Wu Xiaoyu , Cai Chun , Tang Patrick Y , Maggy Coufal Muchieh , Qian Yiqing , Fisher Edwin B , Jia Weiping
Published: July 2023

Although there is broad evidence for the value of peer support (PS) in preventing and managing diabetes and other chronic diseases, identifying approaches to stage, scale, and adapt PS interventions is a challenge. Community organization may provide a process for such adaptation of standardized PS and diabetes management to individual communities. This community organization approach was used to develop PS in 12 communities in Shanghai, China. Through a convergent mixed methods design, project records, semi-structured interviews, and an implementation assessment characterized processes of adaptation of standardized materials, examined the extent to which the program was implemented, and identified key success factors and challenges. Findings from both interviews and the implementation assessment indicated that communities adapted standardized intervention components to meet the needs of their communities and assumed responsibility for implementation of different components of the program based on their community’s available capacity. Additionally, community innovations occurring as part of the project were reported and standardized for dissemination in future iterations of the program. Key success factors identified included cooperation and collaboration among varied partners within and across communities. Two challenges illustrate the resilience of the community organization model in response to COVID-19 and the need for further adaptation in rural communities. Community organization provided a useful approach to standardization, adaptation, innovation, and reporting of PS interventions for diabetes management.
RNF167‐mediated ubiquitination of Tollip inhibits TNF‐α‐triggered NF‐κB and MAPK activation
Authors: Yan Zhenzhen , Dai Jingwei , Wang Jiayue , Feng Qianxi , Wang Yaguang , Han Tongye , Wu Chen
Published: July 2023

Toll‐interacting protein (Tollip) is a multifunctional regulator in cellular activities. However, whether its functions are subjected to post‐translational modifications remains elusive. Here, we identified ubiquitination as a post‐translational modification on Tollip. We found that Tollip interacted with ring finger protein 167 (RNF167) through its C‐terminal coupling of ubiquitin to ER degradation (CUE) domain, and RNF167 functioned as the potential E3 ligase to attach K33‐linked poly‐ubiquitin chains to the Lys235 (K235) site of Tollip. Furthermore, we discovered Tollip could inhibit TNF‐α‐induced nuclear factor‐kappa B (NF‐κB) and mitogen‐activated protein kinase (MAPK) activation, and substitution of Lys235 on Tollip to arginine failed to suppress TNF‐α‐NF‐κB/MAPK (JNK) cascades, revealing the role of Tollip and its ubiquitination in NF‐κB/MAPK pathways. Thus, our study reveals the novel biological function of Tollip and RNF167‐dependent ubiquitination of Tollip in TNF‐α signaling.
Study of spermatogenic and Sertoli cells in the Hu sheep testes at different developmental stages
Authors: Su Jie , Yang Yanyan , Zhao Feifei , Zhang Yue , Su Hong , Wang Daqing , Li Kuo , Song Yongli , Cao Guifang
Published: July 2023

Spermatogenesis is a highly organized process by which undifferentiated spermatogonia self‐renew and differentiate into spermatocytes and spermatids. The entire developmental process from spermatogonia to sperm occurs within the seminiferous tubules. Spermatogenesis is supported by the close interaction of germ cells with Sertoli cells. In this study, testicular tissues were collected from Hu sheep at 8 timepoints after birth: 0, 30, 90, 180, 270, 360, 540, and 720 days. Immunofluorescence staining and histological analysis were used to explore the development of male germ cells and Sertoli cells in the Hu sheep testes at these timepoints. The changes in seminiferous tubule diameter and male germ cells in the Hu sheep testes at these different developmental stages were analyzed. Then, specific molecular markers were used to study the proliferation and differentiation of spermatogonia, the timepoint of spermatocyte appearance, and the maturation and proliferation of Sertoli cells in the seminiferous tubules. Finally, the formation of the blood–testes barrier was studied using antibodies against the main components of the blood–testes barrier, β‐catenin, and ZO‐1. These findings not only increased the understanding of the development of the Hu sheep testes, but also laid a solid theoretical foundation for Hu sheep breeding.
Bioflavonoid luteolin prevents sFlt‐1 release via HIF‐1α inhibition in cultured human placenta
Authors: Eddy Adrian C. , Chiang Chun Yi , Rajakumar Augustine , Spradley Frank T. , Dauer Patricia , Granger Joey P. , Rana Sarosh
Published: July 2023

Preeclampsia (PE) is a serious hypertensive complication of pregnancy and is a leading cause of maternal death and major contributor to maternal and perinatal morbidity, including establishment of long‐term complications. The continued prevalence of PE stresses the need for identification of novel treatments which can target prohypertensive factors implicated in the disease pathophysiology, such as soluble fms‐like tyrosine kinase 1 (sFlt‐1). We set out to identify novel compounds to reduce placental sFlt‐1 and determine whether this occurs via hypoxia‐inducible factor (HIF)‐1α inhibition. We utilized a commercially available library of natural compounds to assess their ability to reduce sFlt‐1 release from primary human placental cytotrophoblast cells (CTBs). Human placental explants from normotensive (NT) and preeclamptic (PE) pregnancies were treated with varying concentrations of luteolin. Protein and mRNA expression of sFlt‐1 and upstream mediators were evaluated using ELISA, western blot, and real‐time PCR. Of the natural compounds examined, luteolin showed the most potent inhibition of sFlt‐1 release, with >95% reduction compared to vehicle‐treated. Luteolin significantly inhibited sFlt‐1 in cultured placental explants compared to vehicle‐treated in a dose‐ and time‐dependent manner. Additionally, significant decreases in HIF‐1α expression were observed in luteolin‐treated explants, suggesting a mechanism for sFlt‐1 downregulation. The ability of luteolin to inhibit HIF‐1α may be mediated through the Akt pathway, as inhibitors to Akt and its upstream regulator phosphatidylinositol‐3 kinase (PI3K) resulted in significant HIF‐1α reduction. Luteolin reduces anti‐angiogenic sFlt‐1 through inhibition of HIF‐1α, making it a novel candidate for the treatment of PE.
Ready. Set. Game: Using Nursing Knowledge to Escape the Virtual Room in the Didactic Setting
Authors: Scott Georgianna , Bowers Teresa , Gibbs Shelli P. , Creed Joan M. , Pate Leigh B.
Published: July 2023

Most virtual escape rooms are built using Google documents that ask a series of questions; our faculty team wanted to provide a more interactive experience in a large classroom and created a virtual escape room that mimicked the Next Generation NCLEX testing platform. Each room contained a case study with multiple-choice questions. Seventy-three of 98 possible students completed the escape room survey. All recommended this activity to other students, and 91 percent said they preferred the game format more than the lecture format. Virtual escape rooms are interactive, engaging, and can be used successfully to bridge theory to practice.
Do insurance and socioeconomic status affect outcomes for children who undergo surgery for medial epicondyle fractures?
Authors: Ziegman Jacqueline M. , Duncan Molly , Balch Samora Julie
Published: July 2023

Background:

Low socioeconomic status (SES) and Medicaid insurance have been associated with poorer outcomes. The purpose of this study is to compare outcomes among children with Medicaid vs private insurance, and children with low vs high SES who undergo surgery for medial epicondyle fractures.

Methods:

This is a retrospective review of patients who underwent surgery for medial epicondyle fractures at a large pediatric hospital between 2015 and 2020. SES was measured using the Opportunity Atlas and the United States Small-Area Life Expectancy Estimate Project. A subset of patients were prospectively administered the PROMIS Pediatric Pain Intensity Numeric Rating Scale and PROMIS Pediatric Upper Extremity Short Form to gather additional information on outcomes as they relate to SES.

Results:

Of 117 patients, 59 (50.4%) were females, 90 (76.9%) were Caucasian, and average age was 11.1. The average household income was $44,889 (SD=$11,417) and most patients (72.6%) were privately insured. Higher household income was associated with increased number of follow-up appointments (β=0.29, 95% CI=0.08, 0.50) and increased likelihood of using physical therapy (OR=1.67, 95% CI=1.15, 2.42). Patients with private insurance returned to activity 20.5 days sooner than those with public insurance (β=−20.52, 95% CI=−39.5, −1.53). Private insurance tended to be related to less likelihood of complications and more likelihood of use of physical therapy.

Conclusions:

Insurance and SES may play a role in shaping healthcare outcomes for pediatric patients receiving surgery for medial epicondyle fractures.

Level of Evidence:

Prognostic Level III.
Use of ketamine for severe asthma exacerbation in a pregnant patient with persistent bronchospasm: a case report
Authors: Johnson Melanie , Abbas Malak , Abdo Jaber , Mansour Mansour , Jones Jessica
Published: July 2023

Background

Estimated 4%–8% of pregnancies are complicated by asthma. Adequate management in this population is critical to minimize complications. Patients presenting with asthma exacerbation are typically managed with standard bronchodilators and systemic corticosteroids. However, additional agents may be used in patients with refractory asthma exacerbation. Ketamine has been used in refractory bronchospasm, although its efficacy in published literature is heterogeneous.

Case Presentation

We present a case of a pregnant patient with severe asthma exacerbation refractory to standard and salvage treatment who achieved termination of bronchospasm with ketamine infusion.

Conclusion

After receiving ketamine infusion for several days, the patient had improved air flow and achieved successful extubation, without experiencing rebound bronchospasm. Although this individual clinical case alone cannot change guidelines or directives to use in refractory asthma exacerbations, it offers a possible treatment option to patients and providers in unusually severe cases with extenuating risk factors.
Angiotensin Receptor-neprilysin Inhibitor Versus Renin-angiotensin System Inhibitor for Dementia Risk in Patients With Heart Failure
Authors: Hu Wei-Syun , Lin Cheng-Li
Published: July 2023

The authors report the impact of angiotensin receptor-neprilysin inhibitor (ARNI) versus renin-angiotensin system inhibitor (RASI) on the management and outcomes in dementia among heart failure (HF) patients as obtained from the real-life nationwide registry. In this study, HF patients between January 1, 2017 and December 31, 2019 were divided into 2 groups, including subjects receiving RASI and ARNI. The incidence rate of dementia was calculated with the unit of 1000 person-years. Cox proportional hazard model was applied for the examination of the hazard ratio, and also presented with 95% confidence interval. Between 2017 and 2019, RASI and ARNI cohorts contain 18,154 subjects. After adjusting with age, sex, comorbidities, and medications, ARNI cohort had a lower risk of dementia (adjusted hazard ratio = 0.83; 95% confidence interval = 0.72, 0.95) than RASI cohort. The authors concluded that use of ARNI was associated with a lower risk of new-onset dementia in patients with HF.
First Dorsal Metacarpal Artery Flap for Thumb Reconstruction Postresection of Subungual Squamous Cell Carcinoma
Authors: Alkabbaa Saud , Alkhotani Mona , Almehaid Faisal , Alammar Alwaleed , Abdelrazek Sameh , Akkour Mousa
Published: July 2023

Subungual squamous cell carcinoma refers to rare tumors that arise from the digits, most commonly in the thumb and big toe. These tumors are frequently diagnosed late due to them presenting as chronic wounds or wart infections. They are low-grade tumors that rarely have nodal involvement, and their treatment options include surgical resection with or without amputation, and radiotherapy for patients who cannot tolerate surgery. We present a case of a patient who underwent tumor excision and immediate reconstruction of the digit.