bluuebunny/crossref_metadata_2025 huggingface dataset:
Anomalous connection of the circumflex coronary artery to the pulmonary trunk in a patient with Taussig–Bing anomaly: a case report
Authors: Van den Eynde Jef , Rammeloo Lukas A J , Jongbloed Monique R M , Hazekamp Mark G , van der Palen Roel L F
Published: October 2022

Background

Coronary anomalies are present in one-third of all patients with transposition of the great arteries (TGA) and have been associated with increased risk of adverse outcomes after the arterial switch operation. Therefore, knowledge about coronary anatomy remains key.

Case summary

A 5-day-old girl with prenatal diagnosis of Taussig–Bing anomaly (double outlet right ventricle with TGA and large subpulmonary ventricular septal defect) along with aortic arch hypoplasia and coarctation of the aorta underwent the arterial switch operation with closure of the ventricular septal defect and aortic arch repair. On preoperative echocardiography, the right (R) and left coronary artery (LCx) connected both to aortic sinus 1, suggesting 1RLCx coronary anatomy according to the Leiden Convention coronary coding system. However, intraoperative inspection led to a reclassification of the coronary anatomy: the right coronary artery and left anterior descending coronary artery connected to aortic sinus 1 (1RL) as had been observed on echocardiography, but—remarkably—the circumflex coronary artery (Cx) connected to the posterior sinus of the pulmonary trunk. As a consequence, cardioplegia was administered into both the aortic and pulmonary roots, and the circumflex coronary artery could stay in its native position without having to be transferred during the arterial switch operation.

Discussion

Various disruptions during embryological development can lead to unusual coronary anatomy in TGA patients. While anomalous connection of a coronary artery to the pulmonary trunk remains exceedingly rare, care should be taken to identify this pattern when present as failure to do so may result in adverse outcomes.
Ventricular fibrillation in acute myocardial infarction: 20-year trends in the FAST-MI study
Authors: Garcia Rodrigue , Marijon Eloi , Karam Nicole , Narayanan Kumar , Anselme Frédéric , Césari Olivier , Champ-Rigot Laure , Manenti Vladimir , Martins Raphael , Puymirat Etienne , Ferrières Jean , Schiele François , Simon Tabassome , Danchin Nicolas
Published: October 2022

Aims

Sudden cardiac arrest remains a major complication of acute myocardial infarction (AMI) and is frequently related to ventricular fibrillation (VF). Incidence and impact of VF among patients hospitalized for AMI were evaluated.

Methods and results

Data from the FAST-MI programme consisting of 5 French nationwide prospective cohort studies between 1995 and 2015 were analysed, totally including 14 423 patients with AMI (66 ± 14 years, 72% males, 59% ST-elevation myocardial infarction). Overall, proportion of patients presenting in-hospital VF decreased from 3.9% in 1995 to 1.8% in 2015 (P < 0.001). One-year mortality decreased from 60.7% to 24.6% (P < 0.001). However, compared with patients who did not develop VF, the over-risk of 1-year mortality associated with VF was stable over time [hazard ratio (HR) 6.78, 95% confidence interval (CI) 5.03–9.14 in 1995 and HR 6.64, 95% CI 4.20–10.49 in 2015, P = 0.52]. This increased mortality in the VF group was mainly related to fatal events occurring prior to hospital discharge, representing 86.2% of 1-year mortality, despite the very low rate of implantable cardioverter defibrillator in the VF group (2.6%).

Conclusion

This study demonstrates that in-hospital VF incidence and mortality in the setting of AMI have significantly decreased over the past 20 years. Nevertheless, VF remained steadily associated with approximately a 10-fold increased relative risk of in-hospital mortality, without an impact on post-discharge mortality. Beyond long-term cardiac defibrillation strategy, these results emphasize the need to identify in-hospital interventions to further reduce mortality in VF patients.

Study registration

ClinicalTrials.gov Identifier: NCT00673036, NCT01237418, NCT02566200
Detection of skin defects on loquat using hyperspectral imaging combining both band radio and improved three-phase level set segmentation method
Authors: Han Zhaoyang , Li Bin , Wang Qiu , Sun Zhaoxiang , Liu Yande
Published: October 2022

Background and objectives

Skin defects are one of the primary problems that occur in post-harvest grading and processing of loquats. Skin defects lead to the loquat being easily destroyed during transportation and storage, which causes the risk of other loquats being infected, affecting the selling price.

Materials and Methods

In this paper, a method combining band radio image with an improved three-phase level set segmentation algorithm (ITPLSSM) is proposed to achieve high accuracy, rapid, and non-destructive detection of skin defects of loquats. Principal component analysis (PCA) was used to find the characteristic wavelength and PC images to distinguish four types of skin defects. The best band ratio image based on characteristic wavelength was determined.

Results

The band ratio image (Q782/944) based on PC2 image is the best segmented image. Based on pseudo-color image enhancement, morphological processing, and local clustering criteria, the band ratio image (Q782/944) has better contrast between defective and normal areas in loquat. Finally, the ITPLSSM was used to segment the processing band ratio image (Q782/944), with an accuracy of 95.28%.

Conclusions

The proposed ITPLSSM method is effective in distinguishing four types of skin defects. Meanwhile, it also effectively segments images with intensity inhomogeneities.
Risk Analysis for Quality Control Part 1: The Impact of Transition Assumptions in the Parvin Model
Authors: Schmidt Robert L , Moore Ryleigh A , Walker Brandon S , Rudolf Joseph W
Published: October 2022

Background

Setting quality control (QC) limits involves balancing the risk of false-positive results and false-negative results. Recent approaches to QC have focused on the assessment of false-negative results. The Parvin model is the most-used model for risk analysis. The Parvin model assumes that the system makes a transition from an in-control to an out-of-control (OOC) state but makes no further transitions after moving to the OOC state. The implications of this assumption are unclear.

Methods

We used simulation experiments to compare the performance of QC systems based on no OOC transitions allowed (NOOCTA) vs systems where OOC transitions were allowed (OOCTA).

Results

The NOOCTA assumption leads to paradoxical tradeoff curves between false-positive results and false-negative results. Predictions of a false-negative result based on NOOCTA were about 10 times lower than models based on OOCTA.

Conclusions

The most common models for QC risk analysis underestimate false-negative results. There is a need to develop better risk-based methods for QC analysis.
A framework for a consistent and reproducible evaluation of manual review for patient matching algorithms
Authors: Gupta Agrayan K , Kasthurirathne Suranga N , Xu Huiping , Li Xiaochun , Ruppert Matthew M , Harle Christopher A , Grannis Shaun J
Published: October 2022

Healthcare systems are hampered by incomplete and fragmented patient health records. Record linkage is widely accepted as a solution to improve the quality and completeness of patient records. However, there does not exist a systematic approach for manually reviewing patient records to create gold standard record linkage data sets. We propose a robust framework for creating and evaluating manually reviewed gold standard data sets for measuring the performance of patient matching algorithms. Our 8-point approach covers data preprocessing, blocking, record adjudication, linkage evaluation, and reviewer characteristics. This framework can help record linkage method developers provide necessary transparency when creating and validating gold standard reference matching data sets. In turn, this transparency will support both the internal and external validity of recording linkage studies and improve the robustness of new record linkage strategies.
Persistently High Rates of Abdominal Computed Tomography Imaging Among Patients With Inflammatory Bowel Disease Who Present to the Emergency Department
Authors: Kandel Rana , Merlano, Maria , Tan Pearl , Brar Gurmun , Mallick Ranjeeta , Macdonald Blair , Dubé Catherine , Murthy Sanjay , Stiell Ian , McCurdy Jeffery D
Published: October 2022

Background

Recent guidelines recommended judicious use of abdominal computed tomography (CT) in the emergency department (ED) for inflammatory bowel disease. Trends in CT utilization over the last decade, including since the implementation of these guidelines, remain unknown.

Methods

We performed a single-centre, retrospective study between 2009 and 2018 to assess trends in CT utilization within 72 h of an ED encounter. Changes in the annual rates of CT imaging among adults with IBD were estimated by Poisson regression and CT findings by Cochran-Armitage or Cochran-Mantel Haenszel tests.

Results

A total of 3000 abdominal CT studies were performed among 14,783 ED encounters. CT utilization increased annually by 2.7% in Crohn’s disease (CD) (95% confidence interval [CI], 1.2 to 4.3; P = 0.0004), 4.2% in ulcerative colitis (UC) (95% CI, 1.7 to 6.7; P = 0.0009) and 6.3% in IBD unclassifiable (95% CI, 2.5 to 10.0; P = 0.0011). Among encounters with gastrointestinal symptoms, 60% with CD and 33% with UC underwent CT imaging in the final year of the study. Urgent CT findings (obstruction, phlegmon, abscess or perforation) and urgent penetrating findings alone (phlegmon, abscess or perforation) comprised 34% and 11% of CD findings, and 25% and 6% of UC findings, respectively. The CT findings remained stable overtime for both CD (P = 0.13) and UC (P = 0.17).

Conclusion

Our study demonstrated persistently high rates of CT utilization among patients with IBD who presented to the ED over the last decade. Approximately one third of scans demonstrated urgent findings, with a minority demonstrating urgent penetrating findings. Future studies should aim to identify patients in whom CT imaging is most appropriate.
From ‘Capture to Courtroom’
Authors: Koenig Alexa
Published: October 2022

The past decade has witnessed a profound shift in the documentation of war crimes and other serious international crimes. Whereas evidence collection has traditionally been conducted by legally mandated investigators, and focused on interviewing witnesses as well as gathering and preserving physical and documentary evidence, conventional forms of fact-gathering are now being supplemented by abundant digital documentation gathered by a dispersed network of individuals and organizations that represent a broad array of disciplines. This shift has been facilitated by two important developments: first, a transition in modes of information sharing from analogue to digital sources, including from older generation technologies like the telephone and fax to online platforms like TikTok and Telegram. Secondly, an increased understanding that digital documentation requires both a collaborative and multidisciplinary approach to data collection, storage, processing, analysis and presentation. In this comment, I outline the many investigative stages in which cross-organizational and multi-disciplinary collaboration are taking place, both informally and formally; briefly discuss some of the weaknesses and strengths of such collaborations; and explore what these changes mean for international criminal justice more generally.
The Phonology of the Judaeo-Arabic Dialect of Gabes (Southern Tunisia)
Authors: Gʁbski Wiktor
Published: October 2022

This paper presents a phonological analysis of a hitherto unexamined endangered Arabic dialect, that of the Jews of Gabes in Southern Tunisia, combining a comparative examination of various phonological phenomena in selected Arabic dialects of the region. The primary aim of the study is to establish the features distinguishing Jewish Gabes from other Jewish North-African dialects, and, since no south- Tunisian Jewish dialect has been studied to date, to produce a thorough analysis of the sound system of this variety. Special attention was paid to the alternations of sibilants in the region, which distinguish North-African Arabic from the dialects spoken East of Egypt. Moreover, this article constitutes the very first attempt at acoustic analysis of the emphatics and vowels in North-African Arabic. Based on the data obtained by means of the Praat software, it has been shown that the emphatic consonants in Jewish Gabes have different levels of spreadability.
ChemFOnt: the chemical functional ontology resource
Authors: Wishart David S , Girod Sagan , Peters Harrison , Oler Eponine , Jovel Juan , Budinski Zachary , Milford Ralph , Lui Vicki W , Sayeeda Zinat , Mah Robert , Wei William , Badran Hasan , Lo Elvis , Yamamoto Mai , Djoumbou-Feunang Yannick , Karu Naama , Gautam Vasuk
Published: October 2022

The Chemical Functional Ontology (ChemFOnt), located at https://www.chemfont.ca, is a hierarchical, OWL-compatible ontology describing the functions and actions of >341 000 biologically important chemicals. These include primary metabolites, secondary metabolites, natural products, food chemicals, synthetic food additives, drugs, herbicides, pesticides and environmental chemicals. ChemFOnt is a FAIR-compliant resource intended to bring the same rigor, standardization and formal structure to the terms and terminology used in biochemistry, food chemistry and environmental chemistry as the gene ontology (GO) has brought to molecular biology. ChemFOnt is available as both a freely accessible, web-enabled database and a downloadable Web Ontology Language (OWL) file. Users may download and deploy ChemFOnt within their own chemical databases or integrate ChemFOnt into their own analytical software to generate machine readable relationships that can be used to make new inferences, enrich their omics data sets or make new, non-obvious connections between chemicals and their direct or indirect effects. The web version of the ChemFOnt database has been designed to be easy to search, browse and navigate. Currently ChemFOnt contains data on 341 627 chemicals, including 515 332 terms or definitions. The functional hierarchy for ChemFOnt consists of four functional ‘aspects’, 12 functional super-categories and a total of 173 705 functional terms. In addition, each of the chemicals are classified into 4825 structure-based chemical classes. ChemFOnt currently contains 3.9 million protein-chemical relationships and ∼10.3 million chemical-functional relationships. The long-term goal for ChemFOnt is for it to be adopted by databases and software tools used by the general chemistry community as well as the metabolomics, exposomics, metagenomics, genomics and proteomics communities.
Structure and mechanism of the type I-G CRISPR effector
Authors: Shangguan Qilin , Graham Shirley , Sundaramoorthy Ramasubramanian , White Malcolm F
Published: October 2022

Type I CRISPR systems are the most common CRISPR type found in bacteria. They use a multisubunit effector, guided by crRNA, to detect and bind dsDNA targets, forming an R-loop and recruiting the Cas3 enzyme to facilitate target DNA destruction, thus providing immunity against mobile genetic elements. Subtypes have been classified into families A-G, with type I-G being the least well understood. Here, we report the composition, structure and function of the type I-G Cascade CRISPR effector from Thioalkalivibrio sulfidiphilus, revealing key new molecular details. The unique Csb2 subunit processes pre-crRNA, remaining bound to the 3′ end of the mature crRNA, and seven Cas7 subunits form the backbone of the effector. Cas3 associates stably with the effector complex via the Cas8g subunit and is important for target DNA recognition. Structural analysis by cryo-Electron Microscopy reveals a strikingly curved backbone conformation with Cas8g spanning the belly of the structure. These biochemical and structural insights shed new light on the diversity of type I systems and open the way to applications in genome engineering.
Lineage Landscape: a comprehensive database that records lineage commitment across species
Authors: Yan Haoteng , Wang Ronghao , Ma Shuai , Huang Daoran , Wang Si , Ren Jie , Lu Changfa , Chen Xin , Lu Xiaoyong , Zheng Zikai , Zhang Weiqi , Qu Jing , Zhou Yuanchun , Liu Guang-Hui
Published: October 2022

Commitment to specific cell lineages is critical for mammalian embryonic development. Lineage determination, differentiation, maintenance, and organogenesis result in diverse life forms composed of multiple cell types. To understand the formation and maintenance of living individuals, including human beings, a comprehensive database that integrates multi-omic information underlying lineage differentiation across multiple species is urgently needed. Here, we construct Lineage Landscape, a database that compiles, analyzes and visualizes transcriptomic and epigenomic information related to lineage development in a collection of species. This landscape draws together datasets that capture the ongoing changes in cell lineages from classic model organisms to human beings throughout embryonic, fetal, adult, and aged stages, providing comprehensive, open-access information that is useful to researchers of a broad spectrum of life science disciplines. Lineage Landscape contains single-cell gene expression and bulk transcriptomic, DNA methylation, histone modifications, and chromatin accessibility profiles. Using this database, users can explore genes of interest that exhibit dynamic expression patterns at the transcriptional or epigenetic levels at different stages of lineage development. Lineage Landscape currently includes over 6.6 million cells, 15 million differentially expressed genes and 36 million data entries across 10 species and 34 organs. Lineage Landscape is free to access, browse, search, and download at http://data.iscr.ac.cn/lineage/#/home.
A guard protein mediated quality control mechanism monitors 5’-capping of pre-mRNAs
Authors: Klama Sandra , Hirsch Anna G , Schneider Ulla M , Zander Gesa , Seel Anika , Krebber Heike
Published: October 2022

Efficient gene expression requires properly matured mRNAs for functional transcript translation. Several factors including the guard proteins monitor maturation and act as nuclear retention factors for unprocessed pre-mRNAs. Here we show that the guard protein Npl3 monitors 5’-capping. In its absence, uncapped transcripts resist degradation, because the Rat1–Rai1 5’-end degradation factors are not efficiently recruited to these faulty transcripts. Importantly, in npl3Δ, these improperly capped transcripts escape this quality control checkpoint and leak into the cytoplasm. Our data suggest a model in which Npl3 associates with the Rai1 bound pre-mRNAs. In case the transcript was properly capped and is thus CBC (cap binding complex) bound, Rai1 dissociates from Npl3 allowing the export factor Mex67 to interact with this guard protein and support nuclear export. In case Npl3 does not detect proper capping through CBC attachment, Rai1 binding persists and Rat1 can join this 5’-complex to degrade the faulty transcript.
A year of COVID: the evolution of labour market and financial inequalities through the crisis
Authors: Crossley Thomas F , Fisher Paul , Low Hamish , Levell Peter
Published: October 2022

We use high-quality UK panel data to document the extent that pre-existing labour market and financial inequalities were exacerbated by the pandemic between April 2020 and September 2021. Some inequalities worsened, others did not, and in some cases, initial widening of labour market inequalities was subsequently reversed. We find no evidence of an overall divergence in labour market outcomes by gender. Initial changes for ethnic minorities and the young were largely reversed by March 2021. Those in the top third of the long-run income distribution experienced income falls, but also increased saving. Net wealth increased not for only the affluent, but also for middle deciles of the long-run income distribution. These deciles were most protected by the furlough scheme. Those at the bottom of the income distribution were more likely to report a decline in net wealth over the year.
Insight into the control of nodule immunity and senescence during Medicago truncatula symbiosis
Authors: Berrabah Fathi , Bernal Gautier , Elhosseyn Ait-Salem , El Kassis Cyrille , L’Horset Roxane , Benaceur Farouk , Wen Jiangqi , Mysore Kirankumar S , Garmier Marie , Gourion Benjamin , Ratet Pascal , Gruber Véronique
Published: October 2022

Medicago (Medicago truncatula) establishes a symbiosis with the rhizobia Sinorhizobium sp, resulting in the formation of nodules where the bacteria fix atmospheric nitrogen. The loss of immunity repression or early senescence activation compromises symbiont survival and leads to the formation of nonfunctional nodules (fix−). Despite many studies exploring an overlap between immunity and senescence responses outside the nodule context, the relationship between these processes in the nodule remains poorly understood. To investigate this phenomenon, we selected and characterized three Medicago mutants developing fix− nodules and showing senescence responses. Analysis of specific defense (PATHOGENESIS-RELATED PROTEIN) or senescence (CYSTEINE PROTEASE) marker expression demonstrated that senescence and immunity seem to be antagonistic in fix− nodules. The growth of senescence mutants on non-sterile (sand/perlite) substrate instead of sterile in vitro conditions decreased nodule senescence and enhanced defense, indicating that environment can affect the immunity/senescence balance. The application of wounding stress on wild-type (WT) fix+ nodules led to the death of intracellular rhizobia and associated with co-stimulation of defense and senescence markers, indicating that in fix+ nodules the relationship between the two processes switches from opposite to synergistic to control symbiont survival during response to the stress. Our data show that the immune response in stressed WT nodules is linked to the repression of DEFECTIVE IN NITROGEN FIXATION 2 (DNF2), Symbiotic CYSTEINE-RICH RECEPTOR-LIKE KINASE (SymCRK), and REGULATOR OF SYMBIOSOME DIFFERENTIATION (RSD), key genes involved in symbiotic immunity suppression. This study provides insight to understand the links between senescence and immunity in Medicago nodules.
Development of tropoelastin-functionalized anisotropic PCL scaffolds for musculoskeletal tissue engineering
Authors: Zhang Miao , Wang Ziyu , Zhang Anyu , Liu Linyang , Mithieux Suzanne M , Bilek Marcela M M , Weiss Anthony S
Published: October 2022

The highly organized extracellular matrix (ECM) of musculoskeletal tissues, encompassing tendons, ligaments and muscles, is structurally anisotropic, hierarchical and multi-compartmental. These features collectively contribute to their unique function. Previous studies have investigated the effect of tissue-engineered scaffold anisotropy on cell morphology and organization for musculoskeletal tissue repair and regeneration, but the hierarchical arrangement of ECM and compartmentalization are not typically replicated. Here, we present a method for multi-compartmental scaffold design that allows for physical mimicry of the spatial architecture of musculoskeletal tissue in regenerative medicine. This design is based on an ECM-inspired macromolecule scaffold. Polycaprolactone (PCL) scaffolds were fabricated with aligned fibers by electrospinning and mechanical stretching, and then surface-functionalized with the cell-supporting ECM protein molecule, tropoelastin (TE). TE was attached using two alternative methods that allowed for either physisorption or covalent attachment, where the latter was achieved by plasma ion immersion implantation (PIII). Aligned fibers stimulated cell elongation and improved cell alignment, in contrast to randomly oriented fibers. TE coatings bound by physisorption or covalently following 200 s PIII treatment promoted fibroblast proliferation. This represents the first cytocompatibility assessment of novel PIII-treated TE-coated PCL scaffolds. To demonstrate their versatility, these 2D anisotropic PCL scaffolds were assembled into 3D hierarchical constructs with an internally compartmentalized structure to mimic the structure of musculoskeletal tissue.
Deep stratification by transcriptome molecular characters for precision treatment of patients with systemic lupus erythematosus
Authors: Qiao Jun , Zhang Sheng-Xiao , Chang Min-Jing , Zhao Rong , Song Shan , Hao Jia-Wei , Wang Can , Hu Jing-Xi , Gao Chong , Wang Cai-Hong , Li Xiao-Feng
Published: October 2022

Objectives

To leverage the high clinical heterogeneity of systemic lupus erythematosus (SLE), we developed and validated a new stratification scheme by integrating genome-scale transcriptomic profiles to identify patient subtypes sharing similar transcriptomic markers and drug targets.

Methods

A normalized compendium of transcription profiles was created from peripheral blood mononuclear cells (PBMCs) of 1046 SLE patients and 86 healthy controls (HCs), covering an intersection of 13 689 genes from six microarray datasets. Upregulated differentially expressed genes were subjected to functional and network analysis in which samples were grouped using unsupervised clustering to identify patient subtypes. Then, clustering stability was evaluated by the stratification of six integrated RNA-sequencing datasets using the same method. Finally, the Xgboost classifier was applied to the independent datasets to identify factors associated with treatment outcomes.

Results

Based on 278 upregulated DEGs of the transcript profiles, SLE patients were classified into three subtypes (subtype A–C) each with distinct molecular and cellular signatures. Neutrophil activation-related pathways were markedly activated in subtype A (named NE-driving), whereas lymphocyte and IFN-related pathways were more enriched in subtype B (IFN-driving). As the most severe subtype, subtype C [NE-IFN-dual-driving (Dual-driving)] shared functional mechanisms with both NE-driving and IFN-driving, which was closely associated with clinical features and could be used to predict the responses of treatment.

Conclusion

We developed the largest cohesive SLE transcriptomic compendium for deep stratification using the most comprehensive microarray and RNA sequencing datasets to date. This result could guide future design of molecular diagnosis and the development of stratified therapy for SLE patients.
Dementia Caregiver Insights on Use of Assistive Technologies
Authors: Mikula Cynthia M , Perry Casey , Boone Anna E , Benge Jared F , Scullin Michael K , Kiselica Andrew M
Published: October 2022

Concerns about developing memory problems and losing independence constitute a significant source of stress for the aging population. Impairments in cognitive and functional abilities are the hallmark symptoms of dementia, a common age-related condition. The responsibility of caring for older adults with dementia falls disproportionately on family and friends. Technologies, such as smartphone applications, wearable devices, and smart speakers, offer an array of features to support dementia care. However, there is limited information on the current use of technology in caregiving. Thus, we conducted semi-structured interviews with a U.S. sample of 21 caregivers (76.19% female, age 54.76 ± 15.65) to older adults with dementia on the ways they currently use technology for caregiving, as well as concerns about and facilitators of the use of assistive technologies. Participants reported using assistive technologies for a variety of caregiving responsibilities, including facilitating social connectedness, tracking rest and sleep, promoting leisure/activity, managing instrumental activities of daily living, accessing health care, and ensuring patient safety. Several concerns about technology use in caregiving were also identified, including cost, ease of use, and safety and privacy concerns. In addition, caregivers reported that they could be supported in using technology by relying on knowledgeable friends/family members, using simple forms of technology, and receiving assistance for implementing new technology, and helping the person with dementia to use the technology. Results suggest that while technology has the potential to improve many aspects of caregiving and reduce associated caregiver strain, efforts to make these techniques less costly and more familiar are needed.
Pyruvate prevents the onset of the cachectic features and metabolic alterations in myotubes downregulating STAT3 signaling
Authors: Mannelli Michele , Gamberi Tania , Garella Rachele , Magherini Francesca , Squecco Roberta , Fiaschi Tania
Published: October 2022

Cachexia is a systemic disease associated with several pathologies, including cancer, that leads to excessive weight loss due to enhanced protein degradation. Previously, we showed that cachectic features in myotubes are provoked by a metabolic shift toward lactic fermentation. Our previous results led us to hyphotesise that increasing pyruvate concentration could impede the metabolic modifications responsible for induction of cachexia in myotubes. Here, we demonstrated that the addition of sodium pyruvate in conditioned media from CT26 colon cancer cells (CM CT26) prevents the onset of either phenotypic and metabolic cachectic features. Myotubes treated with CM CT26 containing sodium pyruvate show a phenotype similar to the healthy counterpart and display lactate production, oxygen consumption, and pyruvate dehydrogenase activity as control myotubes. The use of the Mitochondrial Pyruvate Carrier inhibitor UK5099, highlights the importance of mitochondrial pyruvate amount in the prevention of cachexia. Indeed, UK5099‐treated myotubes show cachectic features as those observed in myotubes treated with CM CT26. Finally, we found that sodium pyruvate is able to decrease STAT3 phosphorylation level, a signaling pathway involved in the induction of cachexia in myotubes. Collectively, our results show that cachexia in myotubes could be prevented by the utilization of sodium pyruvate which impedes the metabolic modifications responsible for the acquisition of the cachectic features.
Accelerating to Practice: Defining a Competency-Based Curriculum Framework for Nursing Education Part 1
Authors: Forneris Susan Gross , Tagliareni M. Elaine , Allen Buffy
Published: October 2022

AIM

This study aims to address the transition-to-practice dilemma for novice nurse, define gaps, and lay a foundation for a curriculum framework.

BACKGROUND

The National League for Nursing has challenged and supported nurse educators in developing teaching methodologies that prepare novice nurses for professional practice. Over a decade ago, compelling research fueled a debate that continues today, with nursing education and practice research reporting lack of readiness for practice by novice nurses and the goal of identifying gaps and potential strategies for solutions.

METHOD

The Utstein-style meeting strategy consensus approach was used to refine the data gaps reported in the literature.

RESULTS

The findings from this work generated a strong foundation for a transition-to-practice curriculum framework.

CONCLUSION

The Utstein-style meeting provided for a diverse conversation across multiple perspectives. Participants worked collaboratively in real time to further illuminate and refine the data gaps and inform nursing curricula.
Exploring the Experiences of Doctor of Nursing Practice Students’ Use of Flipgrid to Create a Community of Inquiry in a Predominantly Online Program
Authors: Sebach Aaron M.
Published: October 2022

The purpose of this qualitative descriptive study was to explore the experiences of Doctor of Nursing Practice (DNP) students utilizing Flipgrid, a free, asynchronous online video discussion forum, as an alternative to written journals and discussion boards in a predominately online program. Results suggest greater student engagement, efficiency, and public speaking skills with Flipgrid than with conventional journals and discussion boards. Flipgrid can serve as an active learning strategy to promote a community of inquiry among online DNP students.
Ready, Set, Start: Mentoring Graduating Nursing Students During a Pandemic
Authors: Beauvais Audrey Marie , Vittner Dorothy , Phillips Kathyrn E. , Burrows Karen , Corcoran Karen , Saracino Katherine H. , Kazer Meredith
Published: October 2022

Nurses are graduating from educational programs and entering health care systems at a time of great turmoil because of the COVID-19 pandemic. To support the transition to practice, nursing faculty implemented a postgraduation mentorship program (START). This exploratory study sought to describe the faculty mentor and new graduate mentee experience. Related variables (NCLEX pass rates, perceived stress, and professional quality of life) are provided to contextualize the results. The research is significant given the burden the pandemic places on the health care system, which may limit the resources available to new graduate nurses.
Examining the Impact of Structured, Reflective Prebriefing on Student Performance During Simulation
Authors: Watts Sarah O. , Curtis Amy , Ware Katilya S. , Chidume Tiffani , Jones Meghan C.
Published: October 2022

Little is known about the impact of prebriefing on students’ experiences of learning with simulation. This mixed-methods study evaluated the impact of prebriefing activities on nursing students’ satisfaction, confidence, and performance of nursing skills during a simulation. Findings revealed students who experienced a structured, more robust prebriefing had improved performance during the simulation and reported higher levels of confidence and satisfaction in learning compared to a group that experienced a standard prebriefing. Findings are significant to the profession, they support the incorporation of structured, reflective prebriefing activities in simulation-based experiences.
Health State Utility Values Associated with Cochlear Implants in Adults: A Systematic Review and Network Meta-Analysis
Authors: Dixon Peter R. , Shapiro Justin , Tomlinson George , Cottrell Justin , Lui Justin T. , Falk Lindsey , Chen Joseph M.
Published: October 2022

Objectives:

The cost-effectiveness of bilateral cochlear implants in adults remains uncertain despite established clinical benefits. In cost-effectiveness studies, benefit is often measured by change in health state utility value (HSUV), a single number summary of health-related quality of life anchored at 0 (state of being dead) and 1 (perfect health). Small differences in bilateral cochlear implant HSUV change conclusions of published models, and invalid estimates can therefore mislead policy and funding decisions. As such, we aimed to review and synthesize published HSUV estimates associated with cochlear implants.

Design:

We included observational or experimental studies reporting HSUV for adult patients (age ≥18 years) with at least moderate-profound sensorineural hearing loss in both ears who received unilateral or bilateral cochlear implants. We searched MEDLINE, EMBASE, PsycINFO, and Cochrane Library databases up to May 1, 2021. Study and participant characteristics and HSUV outcomes were extracted. Narrative synthesis is reported for all studies. A Bayesian network meta-analysis was conducted to generate pooled estimates for the mean difference in HSUV for three comparisons: (1) unilateral cochlear implant versus preimplant, (2) bilateral cochlear implants versus preimplant, (3) bilateral versus unilateral cochlear implants. Our principal measure was pooled mean difference in HSUV.

Results:

Thirty-six studies reporting unique patient cohorts were identified. Health Utilities Index, 3 (HUI-3) was the most common HSUV elicitation method. HSUV from 19 preimplant mean estimates (1402 patients), 19 unilateral cochlear implant mean estimates (1701 patients), and 5 bilateral cochlear implants mean estimates (83 patients) were pooled to estimate mean differences in HUI-3 HSUV by network meta-analysis. Compared with preimplant, a unilateral cochlear implant was associated with a mean change in HSUV of +0.17 (95% credible interval [CrI] +0.12 to +0.23) and bilateral cochlear implants were associated with a mean change of +0.25 (95% CrI +0.12 to +0.37). No significant difference in HSUV was detected for bilateral compared with unilateral cochlear implants (+0.08 [95% CrI −0.06 to +0.21]). Overall study quality was moderate.

Conclusions:

The findings of this review and network meta-analysis comprise the best-available resource for parameterization of cost-utility models of cochlear implantation in adults and highlight the need to critically evaluate the validity of available HSUV instruments for bilateral cochlear implant populations.

Protocol registration: PROSPERO (CRD42018091838)
Antihyperlipidemic Treatment Options in Statin Resistance and Intolerance
Authors: Danilov Alexandrina , Frishman William H. , Aronow Wilbert S.
Published: October 2022

Cardiovascular disease is the global leading cause of death and hypercholesterolemia is implicated as one of its top contributors. Moreover, there is growing recognition that lower low-density lipoprotein cholesterol levels offer greater protection against cardiovascular disease. Statins are the first-line lipid-lowering agents for both primary and secondary prevention of cardiovascular disease in patients with hypercholesterolemia. However, statin resistance and intolerance lead to undertreatment in patients who would likely derive the most benefit from antihyperlipidemic drugs. Several non-statin therapies are increasingly prescribed to such patients, most commonly ezetimibe and the PCSK9 monoclonal antibodies, but numerous other options have been developed in recent years and investigations into new therapies are ongoing. The use of these non-statin therapies requires the clinician to take a highly personalized approach to cholesterol reduction in complex patients. In this review, we describe current non-statin options for statin-resistant and statin-intolerant patients in addition to areas of active research.
Review of Autologous Fat Grafting in Postmastectomy Reconstruction Patients: Nonroutine Diagnostics and Oncologic Safety
Authors: Sayyed Adaah A. , Perez-Alvarez Idanis M. , Singh Tanvee , King Caroline A. , Welschmeyer Alexandra F. , Bartholomew Alexander J. , Sher Sarah , Tousimis Eleni A. , Song David H. , Fan Kenneth L.
Published: October 2022

Background:

Autologous fat grafting (FG) is increasingly used as an adjunctive reconstruction technique to augment volume, achieve symmetry, and improve contour deformities. This study aims to characterize the oncologic and surgical safety of FG in women undergoing autologous breast reconstruction (ABR) or implant-based reconstruction (IBR).

Methods:

A retrospective chart review was performed for all patients undergoing FG at a multi-site single health system between 2015 to 2018. A total of 228 eligible breasts from 155 patients were identified using Current Procedural Terminology codes. Patients were divided by reconstructive technique. Bivariate analyses compared baseline characteristics and post-FG outcomes.

Results:

Mean age for patients undergoing ABR (129 breasts) was 52.8 years compared to 48.6 years for those undergoing IBR (99 breasts; P = 0.002). A heavier volume of fat was grafted per ABR breast (143.8mL) than per IBR breast (102.2mL; P = 0.002). Forty-seven (20.6%) breasts required FG revision, more frequently in ABR breasts (31.0%) than IBR breasts (7.1%; P < 0.001). Following FG, 17.5% of patients experienced a palpable mass, and 18.9% of breasts underwent nonroutine diagnostics or procedures, with no difference between ABR and IBR groups. Most biopsies noted benign findings such as fat necrosis (2.2%) or a benign mass (0.9%), with recurrence only noted in two patients (0.9%). Mean follow-up was 20.4 months.

Conclusion:

FG is a safe, surgically simple procedure more commonly performed in ABR breasts. FG use in ABR and IBR breasts is oncologically safe, with no impairment in breast surveillance and low rates of locoregional recurrence, but possibly increased incidence of nonroutine imaging and biopsies.
High Median Nerve Paralysis: Is the Hand of Benediction or Preacher’s Hand A Correct Sign?
Authors: Duraku Liron S. , Schreuders Ton A.R. , Power Dominic M. , Rajaratnam Vaikunthan , Chaudhry Tahseen , Hundepool Caroline A. , Zuidam Jelle M.
Published: October 2022

Background:

High median nerve injuries are commonly presented in textbooks as adopting the typical posture of hand of benediction or preacher’s hand. This study aimed to show that the hand of benediction or preacher’s hand is incorrectly associated with a high median nerve paralysis.

Methods:

A retrospective review of four cases with a high median nerve injury is presented. Diagnosis of a high median nerve injury was performed by means of intraoperative findings, electrodiagnostic studies, or ultrasound imaging. None of the patients presented in this study had a hand of benediction on physical examination despite the presence of a high median nerve lesion.

Results:

All four patients with high median nerve injuries showed a similar hand posture when attempting to make a fist. Firstly, the index finger still flexed at the metacarpophalangeal joint because of the ulnar innervated interossei muscles. Secondly the thumb is completely abducted at the carpometocarpal joint and extended at the interphalangeal joint. Lastly, middle finger flexion is possible due to dual innervation of its flexor digitorum profundus by the ulnar nerve as well as due to the quadriga phenomenon.

Conclusions:

The clinical appearance of a high median nerve palsy is different from the classical hand of benediction or preacher’s hand posture pointing finger. We have shown that this incorrect association can result in delayed referral of patients with high median nerve injuries.
Efficacy of Müller’s Muscle-conjunctival Resection With or Without Suturing for the Correction of Ptosis
Authors: van Philips Iris O. R. , van Minderhout Helena M. , Stefanovic Maja , van Philips Lucien A. M.
Published: October 2022

Purpose:

The purpose of this study was to compare the efficacy of Müller muscle-conjunctival resection (MMCR) with or without suturing for the correction of ptosis.

Methods:

A retrospective chart review was performed of 30 patients (56 eyelids) undergoing sutureless (sMMCR) (34 eyelids) or conventional MMCR (cMMCR) (22 eyelids). Primary outcome measures were the change in MRD1 and vertical eyelid height (VLH). Secondary outcome measures were the amount of resection of MMCR (rMMCR) and postoperative symmetry of 1 mm or less.

Results:

In total, 49 eyelids (87.5%) had involutional ptosis and 7 (12.5%) had contactlens induced ptosis. The age and follow up between the sMMCR and cMMCR groups was, respectively, 65.1 ± 11.0 versus 65.5 ± 11.0 years and 4.0 ± 2.5 versus 6.5 ± 2.1 months. Preoperatively there were no significant differences noted between the sMMCR and cMMCR groups. Postoperatively there was a statistically significant difference in change of MRD1 between the sMMCR and cMMCR groups, 2.74 ± 0.20 mm and 2.02 ± 0.25 mm (p = 0.026). The difference in change of VLH and rMMCR was not significant between the sMMCR and cMMCR groups, 2.28 ± 0.13 mm and 2.14 ± 0.15 mm (p = 0.49) and 9.29 ± 2.14 versus 9.46 ± 1.97 mm (p = 0.83). There were no significant differences in postoperative symmetry.

Conclusion:

The sMMCR and cMMCR techniques demonstrated equal effectiveness for the correction of ptosis. The rapid sMMCR could become the procedure of choice for the correction of involutional and contact lens induced ptosis.
Phlegmasia Cerulea Dolens
Authors: Placencia Mitzy , Wong Eugene
Published: October 2022

Phlegmasia cerulea dolens is a condition that results from severe venous obstruction of either the upper or, more commonly seen, lower extremities. This rare and life-threatening condition translates to “blue painful inflammation,” which highlights its most prominent presenting symptoms. A case of this condition is described here.
Dataset for the Reporting of Carcinoma of the Cervix: Recommendations From the International Collaboration on Cancer Reporting (ICCR)
Authors: Park Kay J. , Selinger Christina I. , Alvarado-Cabrero Isabel , Duggan Máire A. , Kiyokawa Takako , Mills Anne M. , Ordi Jaume , Otis Christopher N. , Plante Marie , Stolnicu Simona , Talia Karen L. , Wiredu Edwin K. , Lax Sigurd F. , McCluggage W. Glenn
Published: October 2022

Cervical carcinoma remains one of the most common cancers affecting women worldwide, despite effective screening programs being implemented in many countries for several decades. The International Collaboration on Cancer Reporting (ICCR) dataset for cervical carcinoma was first developed in 2017 with the aim of developing evidence-based standardized, consistent and comprehensive surgical pathology reports for resection specimens. This 4th edition update to the ICCR dataset on cervical cancer was undertaken to incorporate major changes based upon the updated International Federation of Obstetricians and Gynecologists (FIGO) staging for carcinoma of the cervix published in 2018 and the 5th Edition World Health Organization (WHO) Classification of Female Genital Tumors published in 2020 and other significant developments in pathologic aspects of cervical cancer. This updated dataset was developed by a panel of expert gynecological pathologists and an expert gynecological oncologist, with a period of open consultation. The revised dataset includes “core” and “noncore” elements to be reported; these are accompanied by detailed explanatory notes and references providing the rationale for the updates. Standardized reporting using datasets such as this helps facilitate consistency and accuracy, data collection across different sites and comparison of epidemiological and pathologic parameters for quality and research purposes.
Molecular Evidence for Epithelial Origin of Mixed Ovarian Epithelial-Germ Cell Neoplasms: Report of 2 Cases and Review of Literature
Authors: Hall Katie C. , Post Miriam D. , Alldredge Jill , Aisner Dara L. , Berning Amber
Published: October 2022

Ovarian germ cell tumors (GCT) account for 2% to 3% of malignant ovarian neoplasms in Western countries and typically occur within the first 2 decades. When presenting later in life, GCTs may be associated with epithelial malignancies. In these circumstances, it has been theorized that these tumors may originate from a somatic, rather than germ cell origin, especially in the postmenopausal setting; however, the true derivation is not fully understood. Our database was searched for primary ovarian GCTs associated with a malignant epithelial component in patients above 35 yr of age, from 2006 to 2021. Two cases were identified and in each case, slides were reviewed and targeted next-generation sequencing was utilized to identify and compare gene mutation variants in morphologically distinct components. Patient A is a 58-yr-old, with choriocarcinoma and minor component of mucinous adenocarcinoma, and patient B is a 43-yr-old, with yolk sac tumor and minor component of endometrioid adenocarcinoma. The morphologically distinct areas in each case showed disparate staining patterns; however, next-generation sequencing demonstrated identical mutation variants within both the germ cell and epithelial components. Variants in CDKN2A, PIK3CA, PIK3R1, and TP53 were present in patient A’s tumor, while patient B’s tumor showed CTNNB1, PIK3R1, and 2 PTEN variants. These mutational patterns are similar to those seen in pure epithelial counterparts, suggesting somatic derivation of the germ cell component. These rare tumors portend a poor prognosis and understanding their origin has clinical and therapeutic implications.