bluuebunny/crossref_metadata_2025 huggingface dataset:
(228) Would the Cylinders Lenght be Shorter in Men with Erectile Dysfunction After Prostatectomy or Peyronie's disease?
Authors: Cavalcanti Filho M T , Lemos C , Mauad Lacerda D A , Fernandes G R , Monteiro L
Published: March 2024

Introduction

Inflatable penile prosthesis (IPP) is indicated to treatment for Erectile Dysfunction (ED). The men with erectile dysfunction, after prostatectomy and/or peyronie’s disease can affect penile atrophy. The three-volume IPP consists of a reservoir, pump, and cylinders. Penile atrophy could increase the difficulty of cylinders insertion or space. Would the cylinders length be shorter in men with erectile dysfunction after prostatectomy or Peyronie's disease?

Objective

We aimed to compare the cylinders length of IPP in three groups: patients with erectile dysfunction after prostatectomy, ED with Peyronie's disease AND ED only.

Methods

Retrospective study, single-center, included men with erectile dysfunction submitted to inflatable penile prosthesis. Divided into group 1 ED after prostatectomy, group 2 ED with Peyronie's and group 3 ED only. We performed a Kruskal-Wallis test to determine whether there were significant differences between three independent groups. To determine which groups have significant differences, we performed multiple comparisons using Dunn's test with Bonferroni correction for p-values.

Results

136 patients were included in this analysis, Group 1 ED after prostatectomy (n=25), Group 2 ED with Peyronie's (n=29) and group 3 ED only (n=82). Age of patients were 64,08, 52,65 and 54,11, respectively. The minimum cylinders length used was 17.5cm and the maximum was 26cm. The Kruskal-Wallis test result was significant (p < 0.001), indicating that at least one is different from the others. Dunn's test results showed that the group 3 has a significantly higher median than the 1 and 2 groups (p < 0.001), while there was no significant difference between the groups 1 and 2 (p = 0.891).

Conclusions

Men with erectile dysfunction after prostatectomy and men with Peyronie's disease have a shorter total cylinder length when comparing erectile dysfunction only. These findings are important to guide patients regarding the expected results in the postoperative.

Disclosure

No.
(234) The Effect of Cigarette Smoking Cessation on Semen Quality
Authors: Ragheb A , Abdelbary A , Massoud A , Mohamed M , Elmarakby A
Published: March 2024

Introduction

Extensive research efforts have always focused on the deleterious effects of smoking on male reproduction by comparing fertility in smokers versus nonsmokers. Nevertheless, studies on the effect of smoking cessation on male fertility remain scarce.

Objective

Our primary aim was to investigate the reversibility of the negative impact of smoking on male fertility. Secondarily, we studied the effect of both time after smoking cessation as well as the smoking index on semen quality improvement.

Methods

Our study included 60 participants who applied to a smoking cessation program. The volunteers started by completing a fertility background questionnaire. Two semen specimens, provided 2 weeks apart, were analyzed according to the WHO guidelines for each candidate on three different occasions. The first was right before smoking cessation followed by the 2nd and 3rd at 3 and 6 months after stopping smoking, respectively. Semen quality was compared between the 3 occasions. The degree of change was correlated with the level of smoking. The nicotine level in urine was used for smoking cessation compliance monitoring during the study.

Results

Comparing semen quality on the 3 different occasions respectively, we detected a significant improvement in semen volume (3.33 ml ± 1.07 vs. 3.88 ml ± 0.80 vs. 4.34 ml ± 0.67, P < 0.001), sperm concentration (14.77 million /ml ± 6.49 vs. 17.71 million/ml ± 6.41 vs. 19.27 million/ml ± 6.46, P < 0.001), total sperm count (49.33 million ± 25.31 vs. 70.16 million ± 30.85 vs. 84.01 million ± 31.00, P < 0.001), progressive motility (20.7% vs. 35.3% vs. 42.28%, P < 0.001), total motility (41.48% vs. 60.33% vs. 67.67%, P < 0.001) and abnormal morphology (69.32% Vs. 50.88% vs. 40.82%, P < 0.001). Improvement in all parameters was positively correlated to time after cessation. Higher smoking indices were related to higher levels of improvement in semen volume, sperm concentration, and total count (areas under the curve of 0.867, 0.852, and 0.863 respectively, P < 0.001 for each).

Conclusions

The negative effect of smoking on semen quality is reversible. Smoking cessation has a time-dependent positive effect on main semen parameters, hence, positive potential for fecundity improvement in men.

Disclosure

No.
(261) Asian Men’s Health Report 2
Authors: Ho C , Tan H M
Published: March 2024

Introduction

The Asian Men’s Health Report 2 is a follow up to the first Asian Men’s Health Report in 2013 with updated data and new aspects delved into.

Objective

To report on the state of men’s health in Asia

Methods

Key databases that contained information on the health status of men from Asian countries were used. When limited data were available, findings from independent studies were sought to supplement the data.

Results

A general trend towards a more aging Asian population can be seen from the population pyramid for Asia in 1950, 2015 and 2050. Men have a lower life expectancy at birth than women in all Asian countries. Men have lower healthy life expectancy compared to women in all Asian countries except Kuwait and Qatar. Ischemic heart disease, stroke and chronic obstructive pulmonary disease are the top three causes of death and DALY among both Asian men and women. More women die due to communicable diseases compared to men. Death due to road traffic injuries are more common in men than women

Conclusions

There are rooms for improvement for men’s health in Asia. Health care practitioners and policy makers should take up the lead.

Disclosure

No.
(273) Influences of Oral Dehydroepiandrosterone (DHEA) Administration on Hormonal Profile, Menopausal Clinical Symptoms and Sexual Function in Early Postmenopausal Symptomatic Women
Authors: Andguladze M , Tevdorashvili G , Tevdorashvili M , Tevdorashvili D
Published: March 2024

Introduction

Dehydroepiandrosterone (DHEA) and its sulfate (DHEAs) are steroid hormones secreted by the adrenal glands. The aging process is associated with decreased levels of DHEA and DHEAs, which are the initial causes of many age-related changes.

Objective

We aimed to evaluate the effects of oral administration of DHEA (50mg/day) on hormonal profile, menopausal clinical symptoms and sexual function in early postmenopausal symptomatic Caucasian women at baseline and after 2, 4 and 6 months of treatment.

Methods

For our prospective clinical trial, 42 symptomatic early postmenopausal women (50–55±3.5 years) were selected. Participants were divided into two groups. The study group (n-22) received oral DHEA 50mg/day for 6 months and the control group (n-20) received placebo. Serum levels of DHEA, DHEAs, androstenedione (A4), allopregnanolone (3α,5α- THP), progesterone (P4), 17OH progesterone (17OHP), cortisol, testosterone (T), dihydrotestosterone (DHT), estrone (E1), estradiol (E2), SHBG, LH, FSH and β-Endorphin were determined at baseline and after 2, 4 and 6 months of treatment. The results of the Menopause Rating Scale (MRS) and the McCoy Female Sexuality Questionnaire (MFSQ) were evaluated before and after the treatment.

Results

During the treatment period in the study group, a progressive increase in serum levels of DHEA, DHEAs, A4, T, DHT, E2, E1, 3α,5α-THP and β-Endorphin were observed. P4 and 17OHP levels showed only a slight increase. By the 4th month of treatment and final data, a decrease in cortisol levels was observed. LH and FSH levels gradually decreased. SHBG levels remained constant. After 6 months of treatment, assessing the results of the MRS in the DHEA group showed a progressive improvement of menopausal symptoms. The results of the McCoy questionnaire were also improved in the study group.

Conclusions

DHEA administration had a significant effect on certain endocrine parameters in early postmenopausal symptomatic Caucasian women, was associated with improvements of menopausal physical symptoms, sexual function and psycho-emotional parameters. Our findings support the hypothesis that administration of DHEA in symptomatic postmenopausal women restores both androgenic and estrogenic milieu and reduces most of the clinical symptoms caused by the changes of these environments during postmenopausal period. On this basis we can assume, that DHEA may be considered as a potentially effective medication for MHT. However, conducting further, more specific clinical trials are needed.

Disclosure

No.
Exploring the relationship between X-ray binaries and compact star clusters (I): NGC 4490 and NGC 4214
Authors: Akyuz A , Akkaya Oralhan I , Allak S , Acar S , Doner O , Aksaker N
Published: March 2024

We conducted a study to investigate the relationship between X-ray binaries (XRBs) and compact star clusters in the nearby star-forming galaxies NGC 4490 and NGC 4214. By analysing archival data from Chandra, we identified a total of 32 XRBs with X-ray luminosities Lx > 1036 erg s−1 in both galaxies. Utilizing data from HST/WFC3/UVIS, we presented a new catalogue of 715 compact star clusters in NGC 4490 and identified 312 such clusters in NGC 4214. In the case of NGC 4490, 14 of the 17 XRBs are associated with clusters, whereas in NGC 4214 all 15 XRBs are connected to clusters within a radius of <200 pc. Furthermore, among the XRBs in NGC 4490, 12 out of the 17 have optical counterparts. Similarly, in NGC4214, 11 out of the 15 XRBs exhibit optical counterparts. We have evidence for a substantial population of high-mass X-ray binaries (HMXBs) associated with clusters, accounting for ∼70  per cent and 40  per cent of the detected XRBs in NGC 4490 and NGC 4214, respectively. HMXBs are often found near young, less massive clusters, while low-mass X-ray binaries (LMXBs) are associated with older, more massive clusters in these galaxies. Intermediate-mass XRBs in NGC 4214, on the other hand, tend to be close to young clusters, suggesting that their formation mechanism is more similar to HMXBs than to LMXBs.
lncRNA OIP5-AS1 promotes mitophagy to alleviate osteoarthritis by upregulating PPAR-γ to activate the AMPK/Akt/mTOR pathway
Authors: Sun Zhilu , Tang Jie , You Ting , Zhang Bihong , Liu Yu , Liu Jing
Published: March 2024

Objectives

Osteoarthritis (OA) is the most common chronic joint degenerative disease. Herein, we investigated long non-coding RNA Opa-interacting protein 5-antisense transcript 1’s (OIP5-AS1) in regulating mitophagy during OA.

Methods

RNA immunoprecipitation and RNA pull-down verified the relationship between molecules. Cell counting kit-8 detected cell viability. Enzyme-linked immunosorbent assay evaluated inflammatory cytokines secretion. Flow cytometry measured the contents of reactive oxygen species (ROS) and calcium. Immunofluorescence staining analysed TOMM20 and LC3B levels. JC-1 staining was adopted to measure mitochondrial membrane potential. The changes of mitophagy were analysed by transmission electron microscopy.

Results

Lipopolysaccharide (LPS) treatment contributed to the decrease of chondrocyte viability, and calcium level and inhibited mitochondrial membrane potential, while elevating the secretion of inflammatory factors, ROS, and TOMM20 expression. OIP5-AS1 overexpression inhibited LPS-induced chondrocyte injury and activated mitophagy. OIP5-AS1 upregulated the peroxisome proliferator–activated receptor-γ (PPAR-γ) mRNA level to regulate adenosine monophosphate–activated protein kinase (AMPK)/v-akt murine thymoma viral oncogene homolog (Akt)/mammalian target of rapamycin (mTOR) signalling by interacting with FUS. PPAR-γ overexpression alleviated LPS-induced chondrocyte injury by activating AMPK/Akt/mTOR signalling. PPAR-γ knockdown reversed the promotion of OIP5-AS1 upregulation on mitophagy.

Conclusions

OIP5-AS1 promotes PPAR-γ expression to activate the AMPK/Akt/mTOR signalling, thereby enhancing mitophagy and alleviating OA progression.
Inflammation and gut barrier function-related genes and colorectal cancer risk in western European populations
Authors: Mandle Hannah B , Jenab Mazda , Gunter Marc J , Tjønneland Anne , Olsen Anja , Dahm Christina C , Zhang Jie , Sugier Pierre-Emmanuel , Rothwell Joseph , Severi Gianluca , Kaaks Rudolf , Katzke Verena A , Schulze Matthias B , Masala Giovanna , Sieri Sabina , Panico Salvatore , Sacerdote Carlotta , Bonet Catalina , Sánchez Maria-Jose , Amiano Pilar , Huerta José María , Guevara Marcela , Palmqvist Richard , Löwenmark Thyra , Perez-Cornago Aurora , Weiderpass Elisabete , Heath Alicia K , Cross Amanda J , Vineis Paolo , Hughes David J , Fedirko Veronika
Published: March 2024

Gut barrier dysfunction and related inflammation are known to be associated with the development and progression of colorectal cancer (CRC). We investigated associations of 292 single-nucleotide polymorphisms (SNPs) from 27 genes related to endotoxins/lipopolysaccharide (LPS) sensing and tolerance, mucin synthesis, inflammation, and Crohn’s disease with colon and rectal cancer risks. Incident CRC cases (N = 1374; colon = 871, rectum = 503) were matched 1:1 to controls nested within the European Prospective Investigation into Cancer and Nutrition cohort. Previously measured serum concentrations of gut barrier function and inflammation biomarkers (flagellin/LPS-specific immunoglobulins and C-reactive protein [CRP]) were available for a sub-set of participants (Ncases = 1001; Ncontrols = 667). Forty-two unique SNPs from 19 different genes were associated with serum biomarkers at Punadjusted ≤ 0.05 among controls. Among SNPs associated with a gut permeability score, 24 SNPs were in genes related to LPS sensing and mucin synthesis. Nine out of 12 SNPs associated with CRP were in genes related to inflammation or Crohn’s disease. TLR4 was associated with colon cancer at the SNP level (nine SNPs, all Punadjusted ≤ 0.04) and at the gene level (Punadjusted ≤ 0.01). TLR4 rs10759934 was associated with rectal cancer but not colon cancer. Similarly, IL10 was associated with rectal cancer risk at an SNP and gene level (both Punadjusted ≤ 0.01), but not colon cancer. Genes and SNPs were selected a priori; therefore, we present unadjusted P-values. However, no association was statistically significant after multiple testing correction. This large and comprehensive study has identified gut barrier function and inflammation-related genes possibly contributing to CRC risk in European populations and is consistent with potential etiological links between host genetic background, gut barrier permeability, microbial endotoxemia, and CRC development.
Set2 regulates Ccp1 and Swc2 to ensure centromeric stability by retargeting CENP-A
Authors: Lim Kim Kiat , Lam Ulysses Tsz Fung , Li Ying , Zeng Yi Bing , Yang Henry , Chen Ee Sin
Published: March 2024

Precise positioning of the histone-H3 variant, CENP-A, ensures centromere stability and faithful chromosomal segregation. Mislocalization of CENP-A to extra-centromeric loci results in aneuploidy and compromised cell viability associated with formation of ectopic kinetochores. The mechanism that retargets mislocalized CENP-A back to the centromere is unclarified. We show here that the downregulation of the histone H3 lysine 36 (H3K36) methyltransferase Set2 can preserve centromere localization of a temperature-sensitive mutant cnp1-1 Schizosaccharomyces pombe CENP-A (SpCENP-A) protein and reverse aneuploidy by redirecting mislocalized SpCENP-A back to centromere from ribosomal DNA (rDNA) loci, which serves as a sink for the delocalized SpCENP-A. Downregulation of set2 augments Swc2 (SWR1 complex DNA-binding module) expression and releases histone chaperone Ccp1 from the centromeric reservoir. Swc2 and Ccp1 are directed to the rDNA locus to excavate the SpCENP-Acnp1-1, which is relocalized to the centromere in a manner dependent on canonical SpCENP-A loaders, including Mis16, Mis17 and Mis18, thereby conferring cell survival and safeguarding chromosome segregation fidelity. Chromosome missegregation is a severe genetic instability event that compromises cell viability. This mechanism thus promotes CENP-A presence at the centromere to maintain genomic stability.
EpiDiverse Toolkit: a pipeline suite for the analysis of bisulfite sequencing data in ecological plant epigenetics
Authors: Nunn Adam , Can Sultan Nilay , Otto Christian , Fasold Mario , Díez Rodríguez Bárbara , Fernández-Pozo Noé , Rensing Stefan A , Stadler Peter F , Langenberger David
Published: March 2024

The expanding scope and scale of next generation sequencing experiments in ecological plant epigenetics brings new challenges for computational analysis. Existing tools built for model data may not address the needs of users looking to apply these techniques to non-model species, particularly on a population or community level. Here we present a toolkit suitable for plant ecologists working with whole genome bisulfite sequencing; it includes pipelines for mapping, the calling of methylation values and differential methylation between groups, epigenome-wide association studies, and a novel implementation for both variant calling and discriminating between genetic and epigenetic variation.
Light Wavelength as a Contributory Factor of Environmental Fitness in the Cyanobacterial Circadian Clock
Authors: Kawamoto Naohiro , Nakanishi Shuji , Shimakawa Ginga
Published: March 2024

A circadian clock is an essential system that drives the 24-h expression rhythms for adaptation to day–night cycles. The molecular mechanism of the circadian clock has been extensively studied in cyanobacteria harboring the KaiC-based timing system. Nevertheless, our understanding of the physiological significance of the cyanobacterial circadian clock is still limited. In this study, we cultured wild-type Synechococcus elongatus PCC 7942 and circadian clock mutants in day–night cycles at different light qualities and found that the growth of the circadian clock mutants was specifically impaired during 12-h blue light/12-h dark (BD) cycles for the first time. The arrhythmic mutant kaiCAA was further analyzed by photosynthetic measurements. Compared with the wild type, the mutant exhibited decreases in the chlorophyll content, the ratio of photosystem I to II, net O2 evolution rate and efficiency of photosystem II photochemistry during BD cycles. These results indicate that the circadian clock is necessary for the growth and the maintenance of the optimum function of the photosynthetic apparatus in cyanobacteria under blue photoperiodic conditions.
Protective effects of Azilsartan against cyclophosphamide-induced ovarian toxicity in rats model
Authors: Mahmood Naza Mohammed Ali
Published: March 2024

Background

Cyclophosphamide (CP) is an effective alkylating anticancer agent that is widely used in cancer chemotherapy, and it can cause ototoxicity and infertility in women.

Objectives

So, this study aimed to evaluate the protective effects of Azilsartan (AZ) as an antioxidant and anti-inflammatory agent in a rat model of CP-induced ovarian toxicity.

Materials and Methods

After receiving the 28 female Wister rats, they were acclimatized in proper environmental conditions for a week and then randomly divided into four groups based on the study protocol. After 15 days of the experiment, they were sacrificed, and organs were collected for biomarker detection (Using the ELISA technique) and histopathological analysis.

Results

The level of IL-10 was significantly (P < 0.05) decreased in all treated groups compared to control hostile groups, while the TNF-α level was significantly (P < 0.05) increased in AZ (220.67 ± 7.88 ng/mL) and AZ + CP groups (221.78 ± 9.11 ng/mL) compared to control negative/CP groups. Regarding the oxidative biomarker level, a significant increase was only found in the AZ + CP group (176.02 ± 6.71 nmol/mL) compared to the control negative group. On the other hand, histopathological findings revealed that ovarian sections in animals that received a single dose of CP had severe ovarian atrophy with significant follicular regression and deterioration, as well as depletion of stromal supportive tissues.

Conclusions

Azilsartan drastically reduced CP-induced ovarian toxicity in vivo by enhancing oxidative stress and inhibiting inflammatory effects in ovarian cells.
Diverse RNA viruses in the venom-related microenvironment of different animal phyla
Authors: Ji Jingkai , Li Cixiu , Hu Tao , Tian Zhongshuai , Li Juan , Xu Lin , Zhou Hong , Holmes Edward C , Shi Weifeng
Published: March 2024

Venom is known as the source of natural antimicrobial products. Previous studies have largely focused on the expression of venom-related genes and the biochemical components of venom. With the advent of metagenomic sequencing, many more microorganisms, especially viruses, have been identified in highly diverse environments. Herein, we investigated the RNA virome in the venom-related microenvironment through analysis of a large volume of venom-related RNA-sequencing data mined from public databases. From this, we identified viral sequences belonging to thirty-six different viruses, of which twenty-two were classified as ‘novel’ as they exhibited less than 90 per cent amino acid identity to known viruses in the RNA-dependent RNA polymerase. Most of these novel viruses possessed genome structures similar to their closest relatives, with specific alterations in some cases. Phylogenetic analyses revealed that these viruses belonged to at least twenty-two viral families or unclassified groups, some of which were highly divergent from known taxa. Although further analysis failed to find venom-specific viruses, some viruses seemingly had much higher abundance in the venom-related microenvironment than in other tissues. In sum, our study provides insights into the RNA virome of the venom-related microenvironment from diverse animal phyla.
Prevalence of Kratom Use Disorder Among Kratom Consumers
Authors: Hill Katherine , Grundmann Oliver , Smith Kirsten E. , Stanciu Corneliu N.
Published: March 2024

Objectives

Kratom leaf products are increasingly consumed in the United States, with many consumers reporting they experience beneficial effects from kratom use. However, there is a growing concern for kratom’s potential to result in dependence when used regularly. As such, we sought to assess, using Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), diagnostic criteria for substance use disorder, the prevalence of “kratom use disorder” (KUD) among kratom consumers.

Methods

Our cross-sectional study used an online, anonymous survey between February and May 2023. Through nonprobability sampling, we recruited people older than 18 years who currently consume kratom. Participants were asked about their kratom consumption patterns, adverse effects perceived to stem from kratom consumption, comorbid diagnoses, and components for a DSM-5, substance use disorder, adapted for kratom.

Results

Among the total sample (N = 2061), KUD criteria were met by 25.5% of participants (n = 525); the most commonly reported symptoms were tolerance (n = 427, 81.3%) and withdrawal (n = 357, 68.0%). After adjusting for age, gender, daily frequency of kratom consumption, and history of either a substance use disorder or a mental health condition, those with a concurrent diagnosis of another substance use disorder had 2.83 times higher odds of meeting KUD criteria (95% CI, 2.19–3.67) compared with those without one.

Conclusions

In this large cross-sectional study, most participants who met the criteria for a KUD diagnosis were categorized as having a mild or moderate KUD. Individual characteristics associated with KUD were related to being male, young, consuming kratom frequently, and having psychiatric and substance use disorder comorbidities.
Twelve-month progression-free survival with sotorasib and panitumumab in KRAS G12C mutant metastatic colorectal cancer
Authors: Kavgaci Gozde , Dizdar Omer , Yalcin Suayib
Published: March 2024

Colorectal cancer (CRC) ranks third in global cancer prevalence, with 40% presenting as metastatic colorectal cancer (mCRC). KRAS mutations in mCRC patients confer resistance to anti-EGFR treatments. Promising inhibitors such as sotorasib and adagrasib targeting KRASG12C mutations have demonstrated efficacy. Herein, we present a heavily pretreated mCRC case with a progression-free survival of 12 months with sotorasib and panitumumab. In 2017, a 27-year-old male presented with abdominal pain and received a diagnosis of stage IIIC KRAS G12C mutant CRC. Following surgery and adjuvant chemotherapy, he developed metastases in the liver and lungs in 2020. Treatment with FOLFIRINOX and bevacizumab, and later FOLFIRI and bevacizumab, with surgeries and local interventions resulted in partial responses. Upon disease progression, sotorasib and panitumumab were initiated, achieving a complete metabolic response. After 12 months of progression-free survival, oligoprogressive liver lesions were surgically resected. This case highlights the remarkable outcome of a heavily treated KRAS G12C mutant mCRC patient. The combination of sotorasib and panitumumab, along with multidisciplinary approaches including surgery and local interventions, played an important role in our patient’s survival.
State of the Art: Pouch Surgery in the 21st Century
Authors: Maspero Marianna , Hull Tracy L.
Published: March 2024

BACKGROUND:

An ileoanal pouch with ileal pouch-anal anastomosis is the preferred method to restore intestinal continuity in patients who require a total proctocolectomy. Pouch surgery has evolved during the past decades thanks to increased experience and research, changes in the medical management of patients who require an ileal pouch, and technological innovations.

OBJECTIVE:

To review the main changes in pouch surgery during the last two decades, with focus on staging, minimally invasive and transanal approaches, pouch design, and anastomotic configuration.

RESULTS:

The decision on the number of stages depends on the patient’s conditions, their indication for surgery, and the risk of anastomotic leak. A minimally invasive approach should be performed whenever feasible, but open surgery still has a role in this technically demanding operation. Transanal IPAA may be performed in experienced centers and may reduce conversion to open in the hostile pelvis. The J pouch is the easiest, fastest, and most commonly performed design, but other designs may be used when a J-pouch is not feasible. A stapled anastomosis without mucosectomy can be safely performed in the majority of cases, with low incidence of rectal cuff neoplasia and better functional outcomes than handsewn. Finally, Crohn’s disease is not an absolute contraindication to an ileoanal pouch, but pouch failure may be higher compared to other indications.

CONCLUSIONS:

Many technical nuances contribute to the success of an ileoanal pouch. The current standard of care is a laparoscopic J pouch with double-stapled anastomosis, but this should not be seen as a dogma, and the optimal approach and design should be tailored to each individual patient. See video from symposium.
Navigating menopause at work: a preliminary study about challenges and support systems
Authors: Alzueta Elisabet , Menghini Luca , Volpe Laila , Baker Fiona C. , Garnier Ann , Sarrel Philip M. , de Zambotti Massimiliano
Published: March 2024

Objective

Women's increasing workforce participation necessitates understanding unique life phases like menopause for enhanced workplace inclusivity. This research investigates the challenges and needs of peri-menopausal women in work settings, using the Job Demands–Resources model as a foundation.

Methods

A cross-sectional survey was administered to 351 working women aged 40 to 65 years in the United States. Hierarchical multiple regression models were employed to assess the relationship between the severity of menopausal symptoms, emotional exhaustion, work engagement, and turnover intentions.

Results

Most of the respondents reported moderate (38.46%) to severe (35.9%) menopausal symptoms. Notably, 54% of the women were caregivers for children or adults. About 77.7% of participants reported work-related challenges due to menopause, with a perceived reduction in productivity (56.8%) being the most common issue. The severity of menopausal symptoms was found to significantly predict more emotional exhaustion (P < 0.001), less work engagement (P < 0.001), and greater turnover intentions (P = 0.03). Concerns about being perceived as less capable in the workplace due to menopausal symptoms were reported by 51.2% of respondents. A striking gap exists between the workplace measures desired by women, such as formal menopause policies and managerial training (65.4%-68%), and their actual implementation (2%-6.3%).

Conclusions

This study reveals an exigent need for increased awareness and structural changes to support working women going through menopause. The findings have far-reaching implications for not just promoting gender equity and well-being but are also pivotal for maintaining a diversified, engaged, and effective workforce.
Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis: A randomized controlled trial
Authors: Kumar Manoj , Venishetty Shantan , Jindal Ankur , Bihari Chhagan , Maiwall Rakhi , Vijayaraghavan Rajan , Saggere Muralikrishna Shasthry , Arora Vinod , Kumar Guresh , Sarin Shiv K.
Published: March 2024

Background and Aims:

Patients with Child-Turcotte-Pugh class B and C cirrhosis with upper gastrointestinal bleeding (UGIB) have systemic as well as localized (in the mucosa of the esophagus and stomach) fibrinolysis. The aim of this study was to evaluate the efficacy and safety of tranexamic acid in the treatment of acute UGIB in patients with cirrhosis.

Approach and Results:

A total of 600 patients with advanced liver cirrhosis (Child-Turcotte-Pugh class B or C) presenting with UGIB were randomly allocated to either the tranexamic acid (n=300) or the placebo group (n=300). The primary outcome measure was the proportion of patients developing 5-day treatment failure. Failure to control bleeding by day 5 was seen in 19/300 (6.3%) patients in the tranexamic acid group and 40/300 (13.3%) patients in the placebo group (p=0.006). Esophageal endoscopic variceal ligation (EVL) site as a source of failure to control bleeding by day 5 among patients undergoing first-time esophageal EVL (excluding patients with a previous post-EVL ulcer as a source of bleed) was seen in 11/222 (4.9%) patients in the tranexamic acid group and 27/225 (1212.0%) patients in the placebo group (p=0.005). However, 5-day and 6-week mortality was similar in the tranexamic acid and placebo groups.

Conclusions:

Tranexamic acid significantly reduces the failure to control bleeding by day 5 and failure to prevent rebleeding after day 5 to 6 weeks in patients with advanced liver cirrhosis (Child-Turcotte-Pugh class B or C) presenting with UGIB, by preventing bleeding from the EVL site.
Tympanic Perforations in Children: When to Propose Surgical Closure?
Authors: Del Puppo Marine , Farinetti Anne , Roman Stéphane , Rossi Marie-Eva , Le Treut Claire , Nicollas Richard , Moreddu Eric
Published: March 2024

Objective

This study aims to analyze the impact of age and other prognostic factors on the success of myringoplasty.

Study design

A retrospective case series.

Settings

Pediatric ENT department of a tertiary academic center.

Patients

Two hundred forty-one children (318 ears) aged 3 to 17 years with tympanic perforation.

Intervention

Myringoplasty performed between 2009 and 2019.

Main outcomes measures

The rate of tympanic closure, perforation recurrence, revision surgery, and audiometric gain were collected. The impact of age and anatomical and surgical factors was analyzed for each procedure.

Results

With a mean follow-up time of 1 year, the tympanic closure rate was 87.7%, the perforation recurrence rate was 18.6%, and 16.7% of ears required reoperation. The mean air–bone gap decreased from 21 dB preoperatively to 12 dB postoperatively (p < 0.0001). We did not find different anatomical and audiometric results for our three groups of patients classified according to age. Audiometric results were associated with the location of the perforation, intraoperative inflammation of the middle ear mucosa, and the surgical technique performed.

Conclusion

Myringoplasty in children is associated with excellent anatomical and functional results, even in the youngest patients. It can be proposed whatever the child's age if the patients are well selected before giving the indication.
Autoimmune and inflammatory neurological disorders in the intensive care unit
Authors: Legouy Camille , Cervantes Anna , Sonneville Romain , Thakur Kiran T.
Published: March 2024

Purpose of review

The present review summarizes the diagnostic approach to autoimmune encephalitis (AE) in the intensive care unit (ICU) and provides practical guidance on therapeutic management.

Recent findings

Autoimmune encephalitis represents a group of immune-mediated brain diseases associated with antibodies that are pathogenic against central nervous system proteins. Recent findings suggests that the diagnosis of AE requires a multidisciplinary approach including appropriate recognition of common clinical syndromes, brain imaging and electroencephalography to confirm focal pathology, and cerebrospinal fluid and serum tests to rule out common brain infections, and to detect autoantibodies. ICU admission may be necessary at AE onset because of altered mental status, refractory seizures, and/or dysautonomia. Early management in ICU includes prompt initiation of immunotherapy, detection and treatment of seizures, and supportive care with neuromonitoring. In parallel, screening for neoplasm should be systematically performed. Despite severe presentation, epidemiological studies suggest that functional recovery is likely under appropriate therapy, even after prolonged ICU stays.

Conclusion

AE and related disorders are increasingly recognized in the ICU population. Critical care physicians should be aware of these conditions and consider them early in the differential diagnosis of patients presenting with unexplained encephalopathy. A multidisciplinary approach is mandatory for diagnosis, ICU management, specific therapy, and prognostication.
An Illustrated Review of the Recent 2019 World Health Organization Classification of Neuroendocrine Neoplasms: A Radiologic and Pathologic Correlation
Authors: Ursprung Stephan , Zhang M. Lisa , Asmundo Luigi , Hesami Mina , Najmi Zahra , Cañamaque Lina Garcia , Shenoy-Bhangle Anuradha S. , Pierce Theodore T. , Mojtahed Amirkasra , Blake Michael A. , Cochran Rory , Nikolau Konstantin , Harisinghani Mukesh G. , Catalano Onofrio A.
Published: March 2024

Recent advances in molecular pathology and an improved understanding of the etiology of neuroendocrine neoplasms (NENs) have given rise to an updated World Health Organization classification. Since gastroenteropancreatic NENs (GEP-NENs) are the most common forms of NENs and their incidence has been increasing constantly, they will be the focus of our attention. Here, we review the findings at the foundation of the new classification system, discuss how it impacts imaging research and radiological practice, and illustrate typical and atypical imaging and pathological findings. Gastroenteropancreatic NENs have a highly variable clinical course, which existing classification schemes based on proliferation rate were unable to fully capture. While well- and poorly differentiated NENs both express neuroendocrine markers, they are fundamentally different diseases, which may show similar proliferation rates. Genetic alterations specific to well-differentiated neuroendocrine tumors graded 1 to 3 and poorly differentiated neuroendocrine cancers of small cell and large-cell subtype have been identified. The new tumor classification places new demands and creates opportunities for radiologists to continue providing the clinically most relevant report and on researchers to design projects, which continue to be clinically applicable.
Comparison of ultrasound-guided erector spinal muscle plane block and quadratus block for laparoscopic renal cancer resection:A single-center,double-blind, randomized controlled trial
Authors: Zhang Meng , Zhao Shuchuan , Li Mingfang , Liu Yue , Li Hu , Su Peng , Xu Guangmin
Published: March 2024

Objective

This study investigated the effects of ultrasound-guided erector spinal muscle plane block (ESPB) and quadratus muscle block (QLB) on the quality of analgesia and recovery after laparoscopic nephrectomy.

Design

randomized, controlled, double-blind study.

Setting

A single tertiary care academic medical center,include anesthesia preparation room, operating room, anesthesia recovery room and ward.

Patients

Aged 18-70years,ASA grades I-III,elective laparoscopic partial nephrectomy or radical nephrectomy and 54 patients were included in the statistical analysis.

Interventions

All included patients were randomassigned to the erector spinal muscle plane block or the quadratus block,and all patients underwent morphine pump controlled analgesia.

Results

The study found that ultrasound-guided ESPB had a higher incidence of hypotension than QLB at the T1 time point, but it did not significantly increase the intraoperative dose of the vasoactive drug used. Patients in the ESPB group showed significant improvement in resting NRS pain scores at 0.5h,number of morphine pumps at 6h and 24h, cumulative morphine equivalent consumed 6h after surgery, and QOR-15 score at 24 h after surgery, and shortened hospital stay.

Conclusions

Compared with QLB,ESPB has certain advantages in analgesia and recovery quality after laparoscopic nephrectomy, and shows opioid frugality effect at individual postoperative time points.

Trial registration

The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry on 15/08/2023 (ChiCTR2300074743).

Key point

Although regional anaesthsia is beneficial for laparoscopic renal cancer resection, it is still controversial which type of regional anaesthsia is most appropriate.

A good regional anaesthsia not only has a long postoperative analgesia time, but also has better anesthesia recovery quality.

The primary outcome measure was the cumulative consumption of morphine equivalent within 6h after surgery.

ESPB is a good regional anaesthsia that can be used for laparoscopic renal cancer resection.

In this randomised controlled trial of patients undergoing laparoscopic renal cancer resection, compared with QLB, ESPB has certain advantages in analgesia and recovery quality after laparoscopic nephrectomy.
Real-time control of a hearing instrument with EEG-based attention decoding
Authors: Hjortkjær Jens , Wong Daniel D.E. , Catania Alessandro , Märcher-Rørsted Jonatan , Ceolini Enea , Fuglsang Søren A. , Kiselev Ilya , Di Liberto Giovanni , Liu Shih-Chii , Dau Torsten , Slaney Malcolm , de Cheveigné Alain
Published: March 2024

Enhancing speech perception in everyday noisy acoustic environments remains an outstanding challenge for hearing aids. Speech separation technology is improving rapidly, but hearing devices cannot fully exploit this advance without knowing which sound sources the user wants to hear. Even with high-quality source separation, the hearing aid must know which speech streams to enhance and which to suppress. Advances in EEG-based decoding of auditory attention raise the potential of neurosteering, in which a hearing instrument selectively enhances the sound sources that a hearing-impaired listener is focusing their attention on. Here, we present and discuss a real-time brain-computer interface (BCI) system that combines a stimulus-response model based on canonical correlation analysis (CCA) for real-time EEG attention decoding, coupled with a multi-microphone hardware platform enabling low-latency real-time speech separation through spatial beamforming. We provide an overview of the system and its various components, discuss prospects and limitations of the technology, and illustrate its application with case studies of listeners steering acoustic feedback of competing speech streams via real-time attention decoding. A software implementation code of the system is publicly available for further research and explorations.
The TCRs of pathogenic Th17 cells in arthritogenic mice are shifted toward a Treg-like repertoire
Authors: Llamas-Covarrubias Mara A. , Tanaka Atsushi , Loza Martin , Diez Diego , Xu Zichang , Lim Ee Lyn , Teraguchi Shunsuke , Sakaguchi Shimon , Standley Daron M.
Published: March 2024

Mutations in the ZAP-70 gene that cause moderate attenuation of T cell receptor (TCR) signaling in mice can result in autoimmune manifestations. One explanation for this pathology is a shift in the regulatory-conventional (Treg-Tconv) T cell repertoire composition. To test this hypothesis, we characterized the single-cell gene expression profiles and TCR repertoires of Tconv and Treg CD4+ T cells of arthritic (ZAC), poised (SKG) ZAP-70 mutant, and wild-type (WT) mice. We identified a group of Th17 cells which exhibited a pathogenic signature and occurred exclusively in inflamed joints of ZAC mice. Such pathogenic signature was uniquely detected in CD4+ T cells obtained from inflamed joints of RA patients. Overall, the Tconv repertoires of ZAP-70 mutant mice were increasingly similar to the repertoires of WT Tregs, and this effect was most notable in the subset of pathogenic Th17 cells. Our results support a model where, upon moderate ZAP-70-mediated signal weakening, T cells that would normally develop into Tregs, instead develop into self-reactive Tconvs, resulting in a breakdown in self-tolerance and susceptibility to autoimmune arthritis.
Something old, something new: the origins of an unusual renal cell underpinning a beetle water-conserving mechanism
Authors: Beaven Robin , Koyama Takashi , Naseem Muhammad T. , Halberg Kenneth V. , Denholm Barry
Published: March 2024

Tenebrionid beetles have been highly successful in colonising environments where water is scarce, underpinned by their unique osmoregulatory adaptations. These include a cryptonephridial arrangement of their organs, in which part of their renal/Malpighian tubules are bound to the surface of the rectum. This allows them to generate a steep osmotic gradient to draw water from within the rectum and return it to the body. Within the cryptonephridial tubules a seemingly novel cell type, the leptophragmata, is considered to play a key role in transporting potassium chloride to generate this osmotic gradient. Nothing was known about the developmental mechanisms or evolution of these unusual renal cells. Here we investigate the mechanisms underpinning development of the leptophragmata in the red flour beetle,Tribolium castaneum. We find that leptophragmata express and require ateashirt/tiptoptranscription factor gene, as do the secondary renal cells ofDrosophila melanogasterwhich lack a cryptonephridial arrangement. We also find an additional transcription factor, Dachshund, is required to establish leptophragmata identity and to distinguish them from the secondary cells inTribolium’snon-cryptonephridial region of renal tubule. Dachshund is also expressed in a sub-population of secondary cells inDrosophila. So leptophragmata, which are unique to the beetle lineage, appear to have originated from a specific renal cell type present ancestrally, and specified by a conserved repertoire of transcription factors.

Significance

Beetles are a highly successful insect group and represent a quarter of all known animal species. Their digestive/renal systems have undergone major evolutionary change compared to other insects, likely contributing to their success. A dramatic example is the cryptonephridial complex, an evolutionary innovation of the gut and renal system which integrate as a powerful water-conservation system; an adaptation for survival in arid conditions. An unusual renal cell type—the leptophragmata—underpin the functions of the complex, but their developmental and evolutionary origins are unknown. Here we reveal the developmental mechanism that establish leptophragmata identity and, by studying a species lacking a cryptonephridial complex, shed light on their evolutionary origin. More broadly, the work illuminates the evolution of novel cell types.
Astrocytic thrombospondins 1 and 2 are required for cortical synapse development controlling instrumental performance
Authors: Lawal Oluwadamilola O. , Ulloa Severino Francesco Paolo , Wang Shiyi , Bindu Dhanesh Sivadasan , Sakers Kristina , Johnson Sarah Anne , Yin Henry H. , Eroglu Cagla
Published: March 2024

During development, controlled synaptogenesis is required to form functioning neural circuits that underlie cognition and behavior. Astrocytes, a major glial-cell type in the central nervous system (CNS), promote synapse formation by secreting synaptogenic proteins. Thrombospondins 1 and 2 (TSP1/2), which act through their neuronal receptor α2δ-1, are required for proper intracortical excitatory synaptogenesis. In the adult brain, the loss of α2δ-1 impairs training-induced excitatory synaptogenesis in the anterior cingulate cortex (ACC), and this impairment leads to increased effort-exertion during high-effort tasks. Here, we tested whether TSP1 and TSP2 are required for controlling effort during operant conditioning by using a lever press for food reward training in mice. Surprisingly, we found that constitutive loss of TSP1/2 significantly reduced lever pressing performance when the effort required for a food reward was increased, a phenotype opposite of α2δ-1 loss. Loss of TSP1/2 reduced excitatory synapse number significantly in adult brains. However, in the ACC of TSP1/2 knockout mice, there was still training-induced excitatory synaptogenesis, likely through the upregulation of TSP4, a TSP isoform that is also synaptogenic. Unexpectedly, we also found a significant increase in inhibitory synapse number and function in the ACC of TSP1/2 knockout mice, which was eliminated after training. Finally, we found that astrocyte-specific ablation of TSP1/2 in developing but not adult astrocytes is sufficient to reduce performance during high-effort tasks. Taken together, our study highlights the importance of developmental astrocyte-derived synaptogenic cues TSP1 and 2 in establishing excitatory and inhibitory circuits that control effort during operant conditioning in adults.