bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric morbidity across the life course and provoked vulvodynia: is it dependent upon the presence of non–stress-related immune dysfunction?
Authors: Harlow Bernard L , Mühlrad Hanna , Yan Jane , Linnros Evelina , Lu Donghao , Fox Matthew P , Bohm-Starke Nina
Published: July 2024

Background

Vulvodynia impacts up to 8% of women by age 40, and these women may have a more compromised immune system than women with no vulvar pain history.

Aim

Given that psychiatric morbidity is associated with vulvodynia and is known to activate immune inflammatory pathways in the brain and systemically, we sought to determine whether the association between psychiatric morbidity and vulvar pain was independent of or dependent upon the presence of immune-related conditions.

Methods

Women born in Sweden between 1973 and 1996 with localized provoked vulvodynia (N76.3) and/or vaginismus (N94.2 or F52.5) diagnosed between 2001 and 2018 were matched to two women from the same birth year with no vulvar pain. International Statistical Classification of Diseases and Related Health Problems (ICD-9 or -10 codes) were used to identify women with a history of depression, anxiety, attempted suicide, neurotic disorders, stress-related disorders, behavioral syndromes, personality disorders, psychotic disorders, or chemical dependencies, as well as a spectrum of immune-related conditions. The Swedish National Prescribed Drug Register was used to identify women with filled prescriptions of antidepressants or anxiolytics.

Outcomes

Vulvodynia, vaginismus, or both were outcomes assessed in relation to psychiatric morbidity.

Results

Women with vulvodynia, vaginismus, or both, relative to those without vulvar pain, had adjusted odds ratios between 1.4 and 2.3, with CIs highly compatible with harmful effects. When we assessed women with and those without a lifetime history of immune-related conditions separately, we also observed elevated odds ratios in both groups for mood, anxiety, and neurotic and stress disorders.

Clinical implications

Documenting psychiatric impairment as a cause or consequence of vulvodynia is critical in clinical practice because psychiatric conditions may impact treatment efficacy.

Strengths and Limitations

Strengths of this study include a data source that represents the entire population of women in Sweden that is known to be highly accurate because Sweden provides universal healthcare. Limitations include difficulty in making an accurate assessment of temporality between psychiatric morbidity and the first onset of vulvar pain. In addition, because Swedish registry data have limited information on lifestyle, behavioral, and anthropomorphic factors such as smoking, diet, physical activity, and obesity, these conditions could not be assessed as confounders of psychiatric morbidity and vulvar pain.

Conclusions

Immune pathways by which women with psychiatric conditions increase their risk of vulvar pain could be independent from other immune pathways.
Pathways to sustainable development: an overview of the progress and obstacles of hydroelectric power production in Angola
Authors: Joaquim Francisco Domingos , Lacerda Cordeiro Mikael Jhordan , de Abreu Pereira Uhr Daniel , Gallego Ziero Uhr Júlia
Published: July 2024

This article offers an in-depth examination of the historical trajectory of Angola’s hydroelectric energy sector, contextualizing its evolution within the country’s political and economic landscape. It begins by tracing the origins of hydroelectric development. Subsequently, it delves into the post-independence era marked by political turmoil and civil conflict, elucidating the challenges faced by the energy infrastructure amidst the ravages of war. Moreover, the article scrutinizes Angola’s post-conflict reconstruction efforts, particularly in revitalizing hydroelectric facilities and formulating strategic energy policies. It assesses the regulatory framework governing the energy sector, identifying deficiencies and proposing avenues for enhancement to ensure transparency and efficiency. This study explores the prospects and challenges associated with the Baynes Binational Hydroelectric Project on the Angola–Namibia border, highlighting its potential to foster regional cooperation and bolster energy security. The article underscores institutional reforms and strategic investments to propel Angola towards a more resilient and inclusive energy future.
Our Growing Volume Electron Microscopy Community
Authors: Czymmek Kirk J , Darrow Michele C , Verkade Paul , Ortega-Sandoval Mario E , Wacker Kate
Published: July 2024

Volume electron microscopy (vEM) represents a powerful group of electron microscopy workflows that enable collection of large three-dimensional volumes at ultrastructural resolution to interrogate cells and tissues across length scales. Due to the breadth of approaches, users are challenged with numerous specialized and nuanced workflows and the requirements for handling, segmenting, visualizing, and quantifying large and complex datasets. As such, a vEM community of core facilities, early adopters, and commercial vendors of vEM solutions have come together to reduce the barriers for successful adoption of vEM. Supported by the Chan Zuckerberg Initiative, the rapidly expanding community has built a broad coalition sharing knowledge and working together to accelerate improvements in results, speed, and automation in vEM workflows. Here we provide an overview of the vEM concept, our growing resources, and an open invitation to join our community and upcoming vEM Technology Forum with technical talks, discussions, hands-on demonstrations, and networking.
Insights Into the Role of Porosity in Lithium-Ion Battery Electrode Performance Using the TESCAN Unitom HR Micro-CT
Authors: Boone Marijn
Published: July 2024

Use of lithium-ion batteries is extensive with many applications. One of the most common analyses performed in quality control for battery production is the characterization of porosity after calendaring. In this study we report the use of micro-CT to evaluate porosity at the micron scale to enable geometrical quantification of the copper anode current collector. Micro-CT resolution permitted analysis of particle disintegration and delamination from the current collector, which provided a starting point for porosity characterization. Segmentation analysis revealed an average porosity below 30% with a wide range of pore sizes from 1.2 µm to 9.6 µm. This information is critical for the optimization of electrical resistance and may improve the economy of production by reducing the time for battery cell soaking with electrolyte.
Structural basis for a highly conserved RNA-mediated enteroviral genome replication
Authors: Das Naba Krishna , Vogt Jeff , Patel Alisha , Banna Hasan Al , Koirala Deepak
Published: July 2024

Enteroviruses contain conserved RNA structures at the extreme 5′ end of their genomes that recruit essential proteins 3CD and PCBP2 to promote genome replication. However, the high-resolution structures and mechanisms of these replication-linked RNAs (REPLRs) are limited. Here, we determined the crystal structures of the coxsackievirus B3 and rhinoviruses B14 and C15 REPLRs at 1.54, 2.2 and 2.54 Å resolution, revealing a highly conserved H-type four-way junction fold with co-axially stacked sA-sD and sB-sC helices that are stabilized by a long-range A•C•U base-triple. Such conserved features observed in the crystal structures also allowed us to predict the models of several other enteroviral REPLRs using homology modeling, which generated models almost identical to the experimentally determined structures. Moreover, our structure-guided binding studies with recombinantly purified full-length human PCBP2 showed that two previously proposed binding sites, the sB-loop and 3′ spacer, reside proximally and bind a single PCBP2. Additionally, the DNA oligos complementary to the 3′ spacer, the high-affinity PCBP2 binding site, abrogated its interactions with enteroviral REPLRs, suggesting the critical roles of this single-stranded region in recruiting PCBP2 for enteroviral genome replication and illuminating the promising prospects of developing therapeutics against enteroviral infections targeting this replication platform.
The human mitochondrial translation factor TACO1 alleviates mitoribosome stalling at polyproline stretches
Authors: Brischigliaro Michele , Krüger Annika , Moran J Conor , Antonicka Hana , Ahn Ahram , Shoubridge Eric A , Rorbach Joanna , Barrientos Antoni
Published: July 2024

The prokaryotic translation elongation factor P (EF-P) and the eukaryotic/archaeal counterparts eIF5A/aIF5A are proteins that serve a crucial role in mitigating ribosomal stalling during the translation of specific sequences, notably those containing consecutive proline residues (1,2). Although mitochondrial DNA-encoded proteins synthesized by mitochondrial ribosomes also contain polyproline stretches, an EF-P/eIF5A mitochondrial counterpart remains unidentified. Here, we show that the missing factor is TACO1, a protein causative of a juvenile form of neurodegenerative Leigh's syndrome associated with cytochrome c oxidase deficiency, until now believed to be a translational activator of COX1 mRNA. By using a combination of metabolic labeling, puromycin release and mitoribosome profiling experiments, we show that TACO1 is required for the rapid synthesis of the polyproline-rich COX1 and COX3 cytochrome c oxidase subunits, while its requirement is negligible for other mitochondrial DNA-encoded proteins. In agreement with a role in translation efficiency regulation, we show that TACO1 cooperates with the N-terminal extension of the large ribosomal subunit bL27m to provide stability to the peptidyl-transferase center during elongation. This study illuminates the translation elongation dynamics within human mitochondria, a TACO1-mediated biological mechanism in place to mitigate mitoribosome stalling at polyproline stretches during protein synthesis, and the pathological implications of its malfunction.
Transfer of Respiratory Syncytial Virus Prefusion F Protein Antibody in Low Birthweight Infants
Authors: Kachikis Alisa B , Rumfelt Kalee , Pike Mindy , Sosa Monica , Stolarczuk Jennifer E , Cho Hye , Eckert Linda O , Martin Emily T , Englund Janet A
Published: July 2024

Background

Respiratory syncytial virus (RSV)–associated lower respiratory tract infection contributes significantly to morbidity/mortality worldwide in low birthweight (LBW) infants (<2500 g). Studies have demonstrated decreased maternal immunoglobulin G (IgG) transfer of various antibodies to LBW infants. We aimed to evaluate naturally acquired RSV anti–prefusion F protein (anti-preF) antibody transfer in pregnancies with LBW versus normal birthweight (NBW) infants.

Methods

In this cohort study conducted among pregnant individuals and their infants, we tested paired maternal and singleton infant cord samples for RSV anti-preF IgG via an electrochemiluminescence immunoassay, using linear regression to evaluate associations between LBW and anti-preF IgG. Covariates included seasonality, insurance, small-for-gestational-age birthweight, and gestational age at delivery.

Results

We tested maternal/cord RSV anti-preF IgG from 54 and 110 pregnancies with LBW and NBW infants, respectively. Of LBW infants, 22 (40.7%) were born both preterm and with small-for-gestational-age birthweight. The median (interquartile range) gestational age at delivery and birthweight were 34.0 (31.7–37.1) weeks and 1902 (1393–2276) g for LBW infants versus 39.1 (38.3–39.9) weeks and 3323 (3109–3565) g for NBW infants (both P < .001). In unadjusted comparisons, preterm infants had significantly lower cord anti-preF IgG levels and cord-maternal IgG ratios compared with full-term infants, while LBW infants had significantly lower cord-maternal IgG ratios than NBW infants (all P < .01). After adjustment for covariates, there was no difference in cord-maternal IgG ratios (β =−0.29 [95% confidence interval, −.63 to .05]) between LBW and NBW infants.

Conclusions

We documented robust transfer of maternal RSV anti-preF IgG in pregnancies with both LBW and NBW infants. Further studies are needed to assess immune protection in at-risk infants.
Epidemiology, Clinical Manifestations, Treatment, and Outcome of Mucormycosis: A Review of 77 Cases From a Single Center in France
Authors: Denis Blandine , Resche-Rigon Matthieu , Raffoux Emmanuel , Ronchetti Anne-Marie , Dudoignon Emmanuel , Verillaud Benjamin , Valade Sandrine , Lorillon Gwenaël , Rabian Florence , Xhaard Aliénor , Touratier Sophie , Hamane Samia , Alanio Alexandre , De Castro Nathalie
Published: July 2024

Background

The aim of this study was to assess the epidemiology, clinical manifestations, and outcome of mucormycosis over 15 years in a single center in France.

Methods

We conducted a retrospective analysis of all mucormycosis cases in our institution from 1 January 2006 to 31 December 2020 and analyzed patients’ medical records, laboratory results, and treatment to describe the epidemiology, clinical manifestations, diagnosis, treatment, and outcome. Mucorales quantitative polymerase chain reaction (qPCR) for the diagnosis was implemented in 2015.

Results

Seventy-seven mucormycosis cases were analyzed in 77 patients, with a median age of 54 years (60% male). Identified risk factors were hematological diseases (46 cases [60%]), solid malignancies (2 cases), solid organ transplants (3), burns (18), diabetes only (7), and trauma (1). Sites of infection were lungs (42%), sinus (36%), skin (31%), central nervous system (9%), liver (8%), others (6%), and disseminated (12%). Diagnosis remained difficult and qPCR contributed to mucormycosis diagnosis in 30% of cases. Among hematology patients, serum qPCR was the only positive test in 15% of cases. A mixed mold infection was diagnosed in 24 of 77 (31%) patients. Surgical treatment was undertaken in 43 (56%) cases. Most patients received liposomal amphotericin B (89%), with a combination therapy in 18 of 77 cases (23%). Three-month survival rate was 40% (95% confidence interval [CI], .30–.53]). As for treatment, adjunction of surgery (hazard ratio, 0.47 [95%CI, .25–.91); P = 0.02) was associated with lower mortality.

Conclusions

Mucormycosis remained associated with high mortality, especially in the hematological and burn populations. Surgery in combination with antifungal treatment was associated with improved survival.
PARP inhibitor therapy in patients with IDH1 mutated cholangiocarcinoma
Authors: Mohan Arathi , Quingalahua Elit , Gunchick Valerie , Paul Simi , Kumar-Sinha Chandan , Crysler Oxana , Zalupski Mark M , Sahai Vaibhav
Published: July 2024

Background

Isocitrate dehydrogenase 1 (IDH1) missense mutations occur at a frequency of 10%-15% in intrahepatic cholangiocarcinoma (iCCA). IDH1 mutations result in accumulation of (R)-2-hydroxyglutarate, an oncometabolite that leads to DNA hypermethylation and impairment of homologous recombination (HR). Impairment of HR results in a “BRCAness” phenotype which may confer sensitivity to poly(ADP ribose) polymerase (PARP) inhibition.

Methods

We conducted a retrospective cohort review to identify patients with advanced, IDH1 mutated iCCA treated with a PARP inhibitor (PARPi) at the University of Michigan between 2018 and 2023. Patients are described with respect to prior lines of therapy, response to platinum-based chemotherapy, and progression-free survival (PFS) and overall survival (OS) from the time of PARPi initiation.

Results

Between 2018 and 2023 we identified 40 patients with IDH1 mutated iCCA of which 6 patients were treated with a PARPi as monotherapy or in combination with an ATR inhibitor or anti-PD-1 immune checkpoint inhibitor. Majority of patients (n = 5) carried an IDH1 R132C mutation per tissue-based next generation sequencing. All patients had previously received at least one line of cisplatin-based systemic therapy for advanced disease prior to treatment with PARPi. PFS and OS from time of PARPi initiation ranged from 1.4 to 18.5 months and 2.8 to 42.4 months, respectively. Best response on PARPi therapy included 2 partial responses.

Conclusion

This is the first case series to describe PARPi treatment in IDH1 mutated iCCA. Results underscore the limitation of PARPi monotherapy, potentially support combined PARPi therapies, and highlight a need for effective treatment options for patients with IDH1 mutated iCCA.
Spatial immunophenotyping using multiplexed imaging of immune follicles in secondary lymphoid tissues
Authors: Allam Mayar , Hu Thomas , Fang Zhou , Pi Michelle , Singh Ankur , Coskun Ahmet F
Published: July 2024

Secondary lymphoid organs (SLOs), including tonsils (TS), lymph nodes (LN), and Peyer's Patches, exhibit complementary immune functions. However, little is known about the spatial organization of immune cells and extracellular matrix (ECM) in the SLOs. Traditional imaging is limited to a few markers, confining our understanding of the differences between the SLOs. Herein, imaging mass cytometry addressed this gap by simultaneously profiling 25-plex proteins in SLO tissues at subcellular resolution. The antibody panel targeted immune, stromal, chemokine, epigenetic, and functional markers. For robust cell identification, a computational workflow SpatialVizPheno was developed to spatially phenotype 999,970 cells using two approaches, including manual gating and semi-supervised gating, iterative clustering, and annotation. LN exhibited the highest density of B cells while the intestinal tissues contained the highest proportion of regulatory and follicular helper T cells. SpatialVizPheno identified the most prevalent interaction between follicular dendritic cells and stromal cells (SCs), plasmablasts/plasma cells, and the SCs across the lymphoid tissues. Collagen-enriched regions were associated with the spatial orientation of B cell follicles in both TS and LN tissues, but not in intestinal lymphoid tissues. Such spatial differences of immunophenotypes and ECM in different SLO tissues can be used to quantify the relationship between cellular organization and ultimate immune responses.
Measuring the Extent to Which Voter Fraud Beliefs Link Election Reforms to Voter Confidence in the United States
Authors: Coll Joseph A
Published: July 2024

Proponents of restrictive voting policies argue that they are necessary to reduce fraud beliefs and instill confidence in elections. However, recent scholarship examining this dynamic in the United States finds that the effects of voting restrictions on fraud beliefs and voter confidence differ by party, suggesting the extent to which fraud beliefs undergird this relationship may also differ by party. Whether voter fraud beliefs tie voter restrictions to voter confidence is inherently important given the assumed role of voter fraud beliefs and voter restrictions in increasing voter confidence, an issue well highlighted in the 2020 election. This study contributes to this literature by measuring the extent to which voter fraud beliefs undergird the relationship between restrictive election policies and voter confidence among Republicans and Democrats. Findings suggest that voter fraud beliefs play a significant and substantive mediating role for Republicans but not Democrats, in line with prominent theories arguing that partisan elite signaling colors electoral reform perceptions.
An Introduction to the Human Connectome Project for Early Psychosis
Authors: Jacobs Grace R , Coleman Michael J , Lewandowski Kathryn E , Pasternak Ofer , Cetin-Karayumak Suheyla , Mesholam-Gately Raquelle I , Wojcik Joanne , Kennedy Leda , Knyazhanskaya Evdokiya , Reid Benjamin , Swago Sophia , Lyons Monica G , Rizzoni Elizabeth , John Omar , Carrington Holly , Kim Nicholas , Kotler Elana , Veale Simone , Haidar Anastasia , Prunier Nicholas , Haaf Moritz , Levitt James J , Seitz-Holland Johanna , Rathi Yogesh , Kubicki Marek , Keshavan Matcheri S , Holt Daphne J , Seidman Larry J , Öngür Dost , Breier Alan , Bouix Sylvain , Shenton Martha E
Published: July 2024

Background

The time following a recent onset of psychosis is a critical period during which intervention may be maximally effective. Studying individuals in this period also offers an opportunity to investigate putative brain biomarkers of illness prior to the long-term effects of chronicity and medication. The Human Connectome Project for Early Psychosis (HCP-EP) was funded by the National Institutes of Mental Health (NIMH) as an extension of the original Human Connectome Project’s approach to understanding the human brain and its structural and functional connections.

Design

The HCP-EP data were collected at 3 sites in Massachusetts (Beth Israel Deaconess Medical Center, McLean Hospital, and Massachusetts General Hospital), and one site in Indiana (Indiana University). Brigham and Women’s Hospital served as the data coordination center and as an imaging site.

Results

The HCP-EP dataset includes high-quality clinical, cognitive, functional, neuroimaging, and blood specimen data acquired from 303 individuals between the ages of 16–35 years old with affective psychosis (n = 75), non-affective psychosis (n = 148), and healthy controls (n = 80). Participants with early psychosis were within 5 years of illness onset (mean duration = 1.9 years, standard deviation = 1.4 years). All data and novel or modified analytic tools developed as part of the study are publicly available to the research community through the NIMH Data Archive (NDA) or GitHub (https://github.com/pnlbwh).

Conclusions

This paper provides an overview of the specific HCP-EP procedures, assessments, and protocols, as well as a brief characterization of the study participants to make it easier for researchers to use this rich dataset. Although we focus here on discussing and comparing affective and non-affective psychosis groups, the HCP-EP dataset also provides sufficient information for investigators to group participants differently.
Exploring nicotinamide adenine dinucleotide precursors across biosynthesis pathways: Unraveling their role in the ovary
Authors: Ren Caifang , Zhang Shuang , Chen Yanyan , Deng Kaiping , Kuang Meiqian , Gong Zihao , Zhang Ke , Wang Panqi , Huang Pan , Zhou Zhengrong , Gong Aihua
Published: July 2024

Natural Nicotinamide Adenine Dinucleotide (NAD+) precursors have attracted much attention due to their positive effects in promoting ovarian health. However, their target tissue, synthesis efficiency, advantages, and disadvantages are still unclear. This review summarizes the distribution of NAD+ at the tissue, cellular and subcellular levels, discusses its biosynthetic pathways and the latest findings in ovary, include: (1) NAD+ plays distinct roles both intracellularly and extracellularly, adapting its distribution in response to requirements. (2) Different precursors differs in target tissues, synthetic efficiency, biological utilization, and adverse effects. Importantly: tryptophan is primarily utilized in the liver and kidneys, posing metabolic risks in excess; nicotinamide (NAM) is indispensable for maintaining NAD+ levels; nicotinic acid (NA) constructs a crucial bridge between intestinal microbiota and the host with diverse functions; nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) increase NAD+ systemically and can be influenced by delivery route, tissue specificity, and transport efficiency. (3) The biosynthetic pathways of NAD+ are intricately intertwined. They provide multiple sources and techniques for NAD+ synthesis, thereby reducing the dependence on a single molecule to maintain cellular NAD+ levels. However, an excess of a specific precursor potentially influencing other pathways. In addition, Protein expression analysis suggest that ovarian tissues may preferentially utilize NAM and NMN. These findings summarize the specific roles and potential of NAD+ precursors in enhancing ovarian health. Future research should delve into the molecular mechanisms and intervention strategies of different precursors, aiming to achieve personalized prevention or treatment of ovarian diseases, and reveal their clinical application value.
Predicting prolonged hospital stay following hip dysplasia surgery in the pediatric population
Authors: Dance Sarah , Quan Theodore , Parel Philip M. , Ranson Rachel , Tabaie Sean A.
Published: July 2024

Previous studies have shown that minimizing the length of hospital stay (LOS) following surgical procedures reduces costs and can improve the patients’ quality of life and satisfaction. However, this relationship has not been defined following operative treatment for developmental dysplasia of the hip (DDH). Therefore, the purpose of this study was to determine the most important nonmodifiable and modifiable factors that can predispose patients to require a prolonged LOS following hip dysplasia surgery. From 2012 to 2019, a national pediatric database was used to identify pediatric patients who underwent surgery for hip dysplasia. Demographic, clinical, and comorbidity variables were analyzed in a patient cohort who had a normal LOS versus one with an extended LOS using chi-square tests and analysis of variance. Statistically significant variables (P value <0.05) were inputted into an artificial neural network model to determine the level of importance. Out of 10,816 patients, 594 (5.5%) had a prolonged LOS following DDH surgery. The five most important variables to predict extended LOS following hip dysplasia surgery were increased operative time (importance = 0.223), decreased BMI (importance = 0.158), older age (importance = 0.101), increased preoperative international normalized ratio (importance = 0.096), and presence of cardiac comorbidities (importance = 0.077). Operative time, BMI, age, preoperative international normalized ratio, and cardiac comorbidities had the greatest effect on predicting prolonged LOS postoperatively. Evaluating factors that impact patients’ LOS can help optimize costs and patient outcomes.
Shoulder Motion Overestimated by Mallet Scores
Authors: Lovette Madison , Chafetz Ross S. , Russo Stephanie A. , Kozin Scott H. , Zlotolow Dan A.
Published: July 2024

Background:

Brachial plexus birth injuries (BPBI) occur in up 0.4 to 4.6 per 1000 live births. Weakness about the shoulder and development of glenohumeral joint contractures are common sequalae of BPBI. Shoulder function in children with BPBI is frequently assessed using the modified Mallet classification to evaluate upper extremity motion deficits. The purpose of this study was to assess the accuracy of the abduction, external rotation, and hand-to-mouth Mallet classification scores in children with BPBI using motion capture.

Methods:

A retrospective study of 107 children with BPBI who underwent motion capture assessment and Mallet scores on the same date were reviewed. Motion capture measurements were used to calculate humerothoracic elevation and external rotation joint angles in the abduction/hand-to-mouth and external rotation positions, respectively. The humerothoracic joint angles were converted to the corresponding Mallet scores. Discrepancies between the Mallet scores determined by clinicians and those determined by motion capture were assessed.

Results:

For abduction, 24.3% of Mallet scores were misclassified during clinical examination. Of the misclassified scores, 22 were overestimated by 1 point and 4 were underestimated by 1 point compared with motion capture. For external rotation, 72.9% of Mallet scores were misclassified during clinical examination. Only 5 patients had an HT elevation that was less than 40 degrees, with 4 of them (80%) having a Mallet hand-to-mouth score of 4. There were no differences in proportion of patients with HT elevation less than 40 degrees who had a Mallet score of 4 or a Mallet score less than 4.

Conclusions:

There was better agreement in global abduction Mallet scores compared with external rotation and hand-to-mouth Mallet scores. This difference was likely due to the complex compensatory strategies that patients employ while performing external rotation and hand-to-mouth positions. The inaccuracy of the clinically determined Mallet scores is alarming given that they are frequently utilized to assist with surgical indications and are commonly used as outcome measures.

Level of Evidence:

Level IV Case series
Recovery Trajectories of Patient-reported Outcomes After Surgery for Degenerative Cervical Myelopathy
Authors: Banerjee Anjishnu , Yang Yushan , Wang Marjorie C. , Vedantam Aditya
Published: July 2024

Study Design:

Retrospective study.

Objective:

The aim of this study was to identify recovery trajectory clusters after surgery for degenerative cervical myelopathy (DCM), as well as to determine clinical and imaging characteristics associated with functional recovery trajectories.

Background:

Accurate prediction of postsurgical neurological recovery for the individual patient with DCM is challenging due to varying patterns of functional recovery. Latent class Bayesian models can model individual patient patterns and identify groups of patients with similar phenotypes for personalized prognostication.

Methods:

A prospective single-center study of 70 consecutive patients with DCM undergoing elective cervical spine decompression for DCM between 2010 and 2017 was performed. Outcomes were recorded using the modified Japanese Orthopedic Association (mJOA), Neck Disability Index (NDI), and the Short Form–36 Physical Component Score (SF-36 PCS) at 3, 6, 12, and 24 months. Recovery trajectories were constructed based on unsupervised Bayesian latent class modeling. Clinical and imaging predictors of recovery trajectories were also determined.

Results:

Recovery after surgery for DCM showed 3 distinct recovery trajectory clusters for each outcome. The commonest recovery trajectory was sustained improvement for the mJOA (41.1%), stagnation for the NDI (60.3%), and stability for the SF-36 PCS (46.6%). Age, duration of symptoms, and baseline disability were the strongest predictors of each recovery trajectory. Degree of cord compression, neck pain, and intramedullary T2-hyperintensity were predictive of NDI and SF-36 PCS but not mJOA recovery trajectory. Sex was associated with the NDI recovery trajectory but not SF-36 PCS and mJOA recovery trajectories.

Conclusion:

Using prospective data and a data-driven approach, we identified 3 distinct recovery trajectory clusters and associated factors for mJOA, NDI, and SF-36 PCS in the first 24 months after surgery for DCM. Our results can enhance personalized clinical prognostication and guide patient expectations at different time points after surgery for DCM.
The Fragility Index
Authors: Meade Matthew H. , Buchan Levi , Michael Mark , Woods Barrett
Published: July 2024

With the vast increase in spinal surgery research and accessibility, critical evaluation of studies is paramount. Historically, P values and confidence intervals have been the gold standard, but more recently, the inclusion of the Fragility Index has brought a more holistic approach. The Fragility Index aims to communicate the robustness of a trial and how tenuous statistical significance may be. It can be used in conjunction with more traditional methods for evaluating research.
Calcaneo-Achilles Allograft Shoulder Interposition Arthroplasty, Novel Technique for Superior Escape Post Hemiarthroplasty for Failed rTSA: A Case Report
Authors: Swenson Riley , Brahme Indraneel S. , Weatherby David J. , Cole Peter A.
Published: July 2024

Background:

Reverse total shoulder arthroplasties have become common in orthopaedics to treat osteoarthritis in patients with rotator cuff deficiency. Complications of revision hemiarthroplasty from reverse total shoulder arthroplasty include anterosuperior escape, which is defined as a deficiency of the coracoacromial arch that allows the humeral head to migrate proximally. A 58-year-old woman, with superior escape and massive destruction of the shoulder suspensory complex after hemiarthroplasty conversion from a reverse total shoulder arthroplasty (rTSA), presented to our clinic with chronic, disabling shoulder pain.

Materials and Methods:

The patient underwent a novel salvage procedure with a calcaneo-achilles allograft fixed to the remaining glenoid through the proximal humeral shaft. The goal of this procedure was to preserve as much function in the patient’s arm as possible and reduce her chronic shoulder pain.

Results:

The patient continued to follow up in our clinic for 1 year postoperatively. She noted complete relief of pain by 6 weeks postoperatively. She also denied any neurologic symptoms in her operative extremity. Her patient-reported outcomes indicated major improvement in her preoperative symptoms.

Conclusion:

A calcaneal-achilles bone tendon allograft interposition arthroplasty may be a viable solution for failed conversion of rTSA to hemiarthroplasty or problems of end-stage arthritis with superior escape and destruction of the shoulder girdle.
Exacerbation of Kaposi sarcoma following BRAF/MEK inhibitor therapy in a melanoma patient: a case report and mechanistic insight
Authors: Tsimpidakis Antonios , Koumprentziotis Ioannis-Alexios , Mastoraki Evanthia , Plaka Michaella , Gogas Helen , Stratigos Alexander , Nikolaou Vasiliki
Published: July 2024

We present a case of a 75-year-old male patient who experienced a severe exacerbation of his Kaposi sarcoma lesions, which have remained clinically stable for a year, following treatment with BRAF/mitogen-activated protein kinase inhibitors for his coexisting melanoma. In this case, we present the possibility that BRAF/MEK inhibition may be mechanistically associated with the progression of Kaposi sarcoma and briefly discuss the potential mechanisms behind this phenomenon.
Hemophagocytic lymphohistiocytosis induced by dabrafenib-trametinib in a patient with metastatic melanoma: a case report and pharmacovigilance analysis
Authors: Elmes Joseph B. , Davis Jessica M. , Musselwhite Laura W. , Chiad Zane , Moore Donald C. , Amin Asim
Published: July 2024

Hemophagocytic lymphohistiocytosis (HLH) has been reported rarely with BRAF/MEK inhibitor combinations, including dabrafenib/trametinib. Postmarketing pharmacovigilance analyses evaluating outcomes associated with dabrafenib/trametinib-induced HLH are also lacking. Herein, we report a case of dabrafenib/trametinib-induced HLH in a patient with metastatic melanoma. Recovery of HLH-related symptoms was observed following drug discontinuation, supportive care, and corticosteroids. We also conducted a pharmacovigilance analysis of the USA Food and Drug Administration Adverse Event Reporting System (FAERS) to describe postmarketing cases of HLH with dabrafenib/trametinib exposure. There were 50 reports of HLH with dabrafenib/trametinib in FAERS. Most cases occurred in the setting of melanoma (n = 39; 78%) and most were reported in Europe (n = 39; 74%). Hospitalization was the most common outcome (n = 39; 78%) of this adverse event per FAERS. HLH is a rare complication of dabrafenib/trametinib, and clinicians should be aware and monitor for signs of this potentially serious and life-threatening adverse event.
Binge drinking at time of bariatric surgery is associated with liver disease, suicides, and increases long-term mortality
Authors: Alvarado-Tapias Edilmar , Martí-Aguado David , Gómez-Medina Concepción , Ferrero-Gregori Andreu , Szafranska Justyna , Brujats Anna , Osuna-Gómez Rubén , Guinart-Cuadra Albert , Alfaro-Cervelló Clara , Pose Elisa , Ventura-Cots Meritxell , Clemente Ana , Fernández-Carrillo Carlos , Contreras Cynthia , Cabezas Joaquin , López-Pelayo Hugo , Arab Juan Pablo , Argemi Josepmaria , Bataller Ramon
Published: July 2024

Background and Aims:

Alcohol use disorder has been reported in patients undergoing bariatric procedures, but the pattern of alcohol consumption has not been evaluated. We investigated the prevalence, risk factors, and impact of binge drinking (BD) at the time of surgery and during follow-up.

Methods:

A prospective, longitudinal study of subjects undergoing bariatric surgery was included in the LABS-2 registry between 2006 and 2009. Participants with AUDIT questionnaire at the time of surgery and a minimum of 12 months follow-up were included. BD was defined as consuming ≥5 drinks on at least 1 occasion in the previous month. Liver biopsies were obtained during bariatric procedures in not all cases. Survival analysis was performed with the adjusted Cox regression model and competing risk.

Results:

A total of 2257 subjects were included, with a median follow-up of 79 months. The prevalence of BD at time of surgery was 12%, and it raised up to 23% during follow-up. Patients with BD predominantly had a binge eating disorder (OR=1.35 [95% CI: 1.04–1.76]), regularly consumed fast food [OR=1.4 (95% CI: 1.07–1.85)] and used other drugs (OR=2.65 [95% CI: 1.74–4.04]). Within liver biopsies evaluation, BD showed higher hepatic iron deposits (OR=3.00 [95% CI: 1.25–7.21]). BD at the time of surgery was associated with a higher risk of BD during follow-up (OR=10.49 [95% CI: 7.86–14.00]) and long-term mortality (HR: 3.21 [95% CI: 1.67–6.18]). Specific causes of death in these patients with BD were liver disease (p=0.020), suicide (p=0.015), neoplasms (p=0.034), and respiratory (p=0.025).

Conclusions:

The prevalence of BD in patients undergoing bariatric surgery is high and increases the risk of postoperative liver disease, suicides, and long-term mortality.
Summary of the Centers for Disease Control and Prevention’s Self-reported Traumatic Brain Injury Survey Efforts
Authors: Daugherty Jill , Peterson Alexis , Black Lindsey , Waltzman Dana
Published: July 2024

Objective: Surveillance of traumatic brain injury (TBI), including concussion, in the United States has historically relied on healthcare administrative datasets, but these methods likely underestimate the true burden of TBI. The Centers for Disease Control and Prevention (CDC) has recently added TBI prevalence questions to several national surveys. The objective of this article is to summarize their recent efforts and report TBI prevalence estimates. Setting: Surveys. Participants: Adult and youth respondents to a series of national surveys. Design: Recent nationally representative surveys with either 12-month or lifetime TBI prevalence questions were identified. Main Measures: For each data source, survey methodology, TBI definition, question wording, and prevalence estimates were examined. Results: TBI prevalence varied depending on the question wording and data source. Overall 12-month prevalence of concussion/TBI among adults ranged from 2% to 12% while overall lifetime prevalence of concussion or TBI ranged from 19% to 29%. Overall 12-month prevalence of concussion/TBI among children and adolescents was 10% while 12-month prevalence of sports- and recreation-related concussion for youth ranged from 7% to 15%. Overall lifetime prevalence of TBI among youth ranged from 6% to 14%. Conclusion: Survey data based on self-reported concussions and TBIs resulted in larger prevalence estimates than would be expected based on traditional surveillance methods. Analyses of the various surveys shows that how the questions are asked and what terminology is used can notably affect the estimates observed. Efforts can be made to optimize and standardize data collection approaches to ensure consistent measurement across settings and populations.
Functional connectivity associations with menstrual pain characteristics in adolescents: an investigation of the triple network model
Authors: Payne Laura A. , Seidman Laura C. , Napadow Vitaly , Nickerson Lisa D. , Kumar Poornima
Published: July 2024

Menstrual pain is associated with deficits in central pain processing, yet neuroimaging studies to date have all been limited by focusing on group comparisons of adult women with vs without menstrual pain. This study aimed to investigate the role of the triple network model (TNM) of brain networks in adolescent girls with varied menstrual pain severity ratings. One hundred participants (ages 13-19 years) completed a 6-min resting state functional magnetic resonance imaging (fMRI) scan and rated menstrual pain severity, menstrual pain interference, and cumulative menstrual pain exposure. Imaging analyses included age and gynecological age (years since menarche) as covariates. Menstrual pain severity was positively associated with functional connectivity between the cingulo-opercular salience network (cSN) and the sensory processing regions, limbic regions, and insula, and was also positively associated with connectivity between the left central executive network (CEN) and posterior regions. Menstrual pain interference was positively associated with connectivity between the cSN and widespread brain areas. In addition, menstrual pain interference was positively associated with connectivity within the left CEN, whereas connectivity both within the right CEN and between the right CEN and cortical areas outside the network (including the insula) were negatively associated with menstrual pain interference. Cumulative menstrual pain exposure shared a strong negative association with connectivity between the default mode network and other widespread regions associated with large-scale brain networks. These findings support a key role for the involvement of TNM brain networks in menstrual pain characteristics and suggest that alterations in pain processing exist in adolescents with varying levels of menstrual pain.
Association between perception of harm and valence of shoulder movement images with disability levels related to chronic shoulder pain
Authors: Tozzo Marcela Camargo , Reis Felipe J.J. , Alaiti Rafael Krasic , Hotta Gisele Harumi , Oliveira Anamaria Siriani de
Published: July 2024

Recent studies highlight an interplay between pain perception and emotional responses. This necessitates a thorough investigation into how beliefs and motivational influences respond to visual stimuli of movements. Such an analysis is crucial for understanding the extent to which these factors contribute to disability levels associated with shoulder pain. We aimed to investigate the relationship between the perception of harm and the valence in images depicting shoulder movements and determine how these perceptions are linked to disability levels associated with shoulder pain. This cross-sectional study recruited 42 individuals with chronic shoulder pain. Participants were presented with 58 shoulder movements images. Each participant evaluated these images for emotional valence and arousal using the self-assessment manikin. For every image, they provided their level of avoidance, fear, and perception of harm in a numerical scale. We measured disability levels and pain catastrophizing using the Shoulder Pain and Disability Index and the Pain Catastrophizing Scale. A direct acyclic graph was used. Multiple linear regression analysis was conducted with shoulder disability as the dependent variable and perception of harm and valence as independent variables, adjusted for the confounders catastrophizing and arousal. This analysis resulted in a significant model (F
4,37 = 11.44; adjusted R
2 = 0.547; P < 0.01). The perception of harm to shoulder movement (β = 0.11; P < 0.001; 95% confidence interval = 5.6-11.8) was significantly associated with the level of shoulder disability, whereas valence did not show a significant association (β = 0.26; P = 0.15; 95% confidence interval = 1.7-10.8). The perception of harm associated with shoulder movements images during daily activities was associated with disability. Individuals who believe that shoulder movements are harmful have greater disability.
Perceived Social Isolation Among Patients With Multiple Sclerosis Suffering From Disease-Induced Pain and Disability
Authors: KHATOONI Marzieh , DEHGHANKAR Leila , BAHRAMI Mahdie , PANAHI Rahman , HAJNASIRI Hamideh
Published: July 2024

Background

Patients with multiple sclerosis (MS) face a wide range of symptoms, including physical disability, imbalance, motor disorders, and acute and chronic pain. The psychosocial consequences of these symptoms may limit social well-being and quality of life in these patients.

Purpose

The aim of the study was to assess self-perceived social isolation among patients with MS and its relationship with pain intensity and disability status.

Methods

This cross-sectional study was conducted on 200 patients with MS referred to neurology wards and clinics, the MS Association, and rehabilitation centers. Data collection tools used included a demographic information form, Numeric Pain Rating Scale, Expanded Disability Status Scale, and Social Isolation Questionnaire.

Results

The mean scores of 4.66 (SD = 1.15) for disability and 4.18 (SD = 2.22) for pain intensity both indicated moderate levels of both. Of the sample, 21.5% (43 patients) reported no pain, 22.5% (n = 45) reported mild pain, 35% (n = 70) reported moderate pain, and 21% (n = 42) reported intense pain. The average social isolation score was 63.52 (SD = 3.32), which is higher than the theoretical average. Of the sample, 44.5% reported low social isolation, whereas 55.5% indicated high social isolation. Gender, duration of MS, economic status, disability status, and pain intensity were all found to be significantly associated with social isolation in patients with MS (all ps < .05).

Conclusions

Based on the findings, comprehensive support plans are necessary to improve psychosocial well-being, social life, and quality of life in patients with MS.
Outcomes of clinical decision support systems in real-world perioperative care: a systematic review and meta-analysis
Authors: Cai Jianwen , Li Peiyi , Li Weimin , Zhu Tao
Published: July 2024

Background:

Although clinical decision support systems (CDSS) have been developed to enhance the quality and efficiency of surgeries, little is known regarding the practical effects in real-world perioperative care.

Objective:

To systematically review and meta-analyze the current impact of CDSS on various aspects of perioperative care, providing evidence support for future research on CDSS development and clinical implementation.

Methods:

This systematic review and meta-analysis followed the Cochrane Handbook and PRISMA statement guidelines, searching databases up to 2 February 2024, including MEDLINE, PubMed, Embase, Cochrane, and Web of Science. It included studies on the effectiveness of CDSS in assisting perioperative decision-making, involving anesthesiologists, doctors, or surgical patients, and reporting at least one outcome such as complications, mortality, length of stay, compliance, or cost.

Results:

Forty studies met inclusion criteria, analyzing outcomes from 408 357 participants, predominantly in developed countries. Most perioperative CDSS use was associated with improved guideline adherence, decreased medication errors, and some improvements in patient safety measures such as reduced postoperative nausea and vomiting and myocardial injury. However, reported results varied widely, and no significant improvement in postoperative mortality was observed.

Conclusion:

The preliminary findings of this review offer an overview of the potential use of CDSS in real-world perioperative situations to enhance patient and anesthesiologist outcomes, but further researches with broader outcome dimensions, involving more stakeholders, and with longer follow-up periods are warranted for the critical evaluation of CDSS and then in better facilitate clinical adoption.