bluuebunny/crossref_metadata_2025 huggingface dataset:
SAINT-Angle: self-attention augmented inception-inside-inception network and transfer learning improve protein backbone torsion angle prediction
Authors: Hasan A K M Mehedi , Ahmed Ajmain Yasar , Mahbub Sazan , Rahman M Saifur , Bayzid Md Shamsuzzoha
Published: April 2023

Motivation

Protein structure provides insight into how proteins interact with one another as well as their functions in living organisms. Protein backbone torsion angles (ϕ and ψ) prediction is a key sub-problem in predicting protein structures. However, reliable determination of backbone torsion angles using conventional experimental methods is slow and expensive. Therefore, considerable effort is being put into developing computational methods for predicting backbone angles.

Results

We present SAINT-Angle, a highly accurate method for predicting protein backbone torsion angles using a self-attention-based deep learning network called SAINT, which was previously developed for the protein secondary structure prediction. We extended and improved the existing SAINT architecture as well as used transfer learning to predict backbone angles. We compared the performance of SAINT-Angle with the state-of-the-art methods through an extensive evaluation study on a collection of benchmark datasets, namely, TEST2016, TEST2018, TEST2020-HQ, CAMEO and CASP. The experimental results suggest that our proposed self-attention-based network, together with transfer learning, has achieved notable improvements over the best alternate methods.

Availability and implementation

SAINT-Angle is freely available as an open-source project at https://github.com/bayzidlab/SAINT-Angle.

Supplementary information

Supplementary data are available at Bioinformatics Advances online.
Uptake of tumour necrosis factor-alpha inhibitor biosimilars for psoriasis: a drug utilization study from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR)
Authors: Phan Duc Binh , Bewley Anthony P , Smith Catherine H , Mackenzie Teena , Griffiths Christopher E M , Lunt Mark , Warren Richard B , Yiu Zenas Z N
Published: April 2023

Background

Tumour necrosis factor-alpha inhibitors (TNFi) have revolutionized the treatment of moderate-to-severe psoriasis. Following patent expiry of the originator biologics, TNFi biosimilars became available, presenting the opportunity for significant reductions in drug costs.

Objectives

To describe the uptake of TNFi biosimilars for psoriasis treatment in the UK and Ireland.

Methods

This observational cohort study utilizes data from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR), a national pharmacovigilance study register for patients with psoriasis on systemic treatments. We analysed biosimilar uptake trends over time in nine geographical regions of England along with Wales, Scotland, Northern Ireland and the Republic of Ireland. We assessed the incidence of switching to biosimilars in an originator-user cohort (switchers). Patients on originators infliximab, etanercept and adalimumab at the time originator patents expired, entered the cohort on 1 February 2015, August 2015 and October 2018, respectively, and were followed up until 31 October 2021. Trends in biosimilar initiations were assessed in an adalimumab-naïve cohort who started adalimumab between 1 October 2018 and 31 July 2019 (starters). We assessed the associations between patient factors and originator-to-biosimilar switching and biosimilar initiation using a multivariable Cox regression model and a multivariable logistic regression model, respectively.

Results

Included in the originator-user cohort were 4202 patients (209 on infliximab, 742 on etanercept and 3251 on adalimumab). For infliximab, etanercept and adalimumab, respectively, the cumulative incidence of originator-to-biosimilar switching increased with time to 14.8%, 23.6% and 66.6% after 3 years. Across geographical regions, 3-year switching rates varied from 0% to 43.7% for infliximab; from 0% to 40.4% for etanercept; and from 12.5% to 84.3% for adalimumab. Out of the 528 patients included in the adalimumab-naïve cohort, 67.8% started on biosimilars. Originator-to-biosimilar switching and biosimilar initiation were more common in men and in patients who had lower Psoriasis Area and Severity Index at cohort entry.

Conclusions

The uptake of biosimilars increased over time and varied considerably across the UK and Ireland; adalimumab had the highest biosimilar uptake rate compared with that of other TNFi drugs.
Reduced Serological Response to COVID-19 Booster Vaccine is Associated with Reduced B Cell Memory in Patients With Inflammatory Bowel Disease; VARIATION [VAriability in Response in IBD AgainsT SARS-COV-2 ImmunisatiON]
Authors: Doherty Jayne , O’Morain Neil , Stack Roisin , Tosetto Miriam , Inzitiari Rosanna , O’Reilly Sophie , Gu Lili , Sheridan Juliette , Cullen Garret , Mc Dermott Edel , Buckley Maire , Horgan Gareth , Mulcahy Hugh , Walshe Margaret , Ryan Elizabeth J , Gautier Virginie , Prostko John , Frias Edwin , Daghfal David , Doran Peter , O’Morain Colm , Doherty Glen A
Published: April 2023

Background and Aims

Patients with inflammatory bowel disease [IBD] have an attenuated response to initial COVID-19 vaccination. We sought to characterize the impact of IBD and its treatment on responses after the third vaccine against SARS-CoV-2.

Methods

This was a prospective multicentre observational study of patients with IBD [n = 202] and healthy controls [HC, n = 92]. Serological response to vaccination was assessed by quantification of anti-spike protein [SP] immunoglobulin [Ig]G levels [anti-SPIgG] and in vitro neutralization of binding to angiotensin-converting enzyme 2 [ACE2]. Peripheral blood B-cell phenotype populations were assessed by flow cytometry. SARS-CoV-2 antigen-specific B-cell responses were assessed in ex vivo culture.

Results

Median anti-SP IgG post-third vaccination in our IBD cohort was significantly lower than HCs [7862 vs 19 622 AU/mL, p < 0.001] as was ACE2 binding inhibition [p < 0.001]. IBD patients previously infected with COVID-19 [30%] had similar quantitative antibody response as HCs previously infected with COVID-19 [p = 0.12]. Lowest anti-SP IgG titres and neutralization were seen in IBD patients on anti-tumour necrosis factor [anti-TNF] agents, without prior COVID-19 infection, but all IBD patients show an attenuated vaccine response compared to HCs. Patients with IBD have reduced memory B-cell populations and attenuated B-cell responses to SARS-CoV-2 antigens if not previously infected with COVID-19 [p = 0.01]. Higher anti-TNF drug levels and zinc levels <65 ng/ml were associated with significantly lower serological responses.

Conclusions

Patients with IBD have an attenuated response to three doses of SARS-CoV-2 vaccine. Physicians should consider patients with higher anti-TNF drug levels and/or zinc deficiency as potentially at higher risk of attenuated response to vaccination.
Tree canopy cover and elevation affect the distribution of red harvester ant nests in a peri-urban setting
Authors: Elliott-Vidaurri Lilly V , Martinez Isabel , Pereira Engil , Penn Hannah J , Choudhury Robin A
Published: April 2023

With an increase in human population over the past 30 years, regional land use in south Texas has shifted from grassland and shrubland to a peri-urban matrix. Despite this shift from natural areas to more anthropogenically modified habitats, native red harvester ants (Pogonomyrmex barbatus) have maintained nest sites within parts of these matrices. To determine which habitat characteristics in a peri-urban landscape may play a role in red harvester ant nest site selection, we mapped the location of nests in 2020 and 2021. We then evaluated nest presence and absence relative to elevation, percentage of surrounding impervious surfaces, distance to roadways, and tree canopy cover (using NDVI). For a sub-sample of the study site, we also measured soil moisture and estimated the potential foraging area per colony with Voronoi tessellation. We found that nests were clustered together near high human-use areas such as athletic fields, lawns, sidewalks, and railroad tracks. Nests were more likely to be found in areas with higher elevation and lower tree canopy cover, with no impact from surrounding impervious surfaces or soil moisture. In fact, many nests were observed immediately adjacent to roadways and in paved parking lots. Red harvester ants are highly adept at nesting in disturbed, urbanized matrices, but still appear to be constrained by certain environmental factors like shading, potential flood risk (elevation), and access to food resources (foraging area).
Impact of body mass on P2Y12-inhibitor de-escalation in acute coronary syndromes—a substudy of the TROPICAL-ACS trial
Authors: Komócsi András , Merkely Béla , Hadamitzky Martin , Massberg Steffen , Rizas Konstantinos D , Hein-Rothweiler Ralph , Gross Lisa , Trenk Dietmar , Sibbing Dirk , Aradi Dániel
Published: April 2023

Aims

Clinical guidelines recommend de-escalation antiplatelet strategies to reduce bleeding risk in acute coronary syndrome (ACS) patients, albeit with a weak recommendation. This substudy of the TROPICAL-ACS trial aimed to determine the impact of body mass on the efficacy of a platelet function testing-guided de-escalation regimen in ACS patients after percutaneous coronary intervention.

Methods and results

Patients were randomized to prasugrel (control group) or a platelet function testing-guided regimen with clopidogrel or prasugrel defined after 1-week clopidogrel. The primary endpoint was the net clinical benefit [cardiovascular death, myocardial infarction, stroke, or Bleeding Academic Research Consortium (BARC) 2–5 bleeding] for 12 months. Overweight was defined as a body mass index >25 kg/m2.

Patients without overweight showed a significant net clinical benefit from the de-escalation strategy, while in overweight cases de-escalation was comparable to prasugrel treatment [hazard ratio (HR): 0.52; 95% confidence interval (CI): 0.31–0.88; P = 0.013 and HR: 0.95; 95% CI: 0.69–1.31, P = 0.717, P-non-inferiority = 0.03, respectively, P-interaction = 0.053]. The benefit of de-escalation in terms of the risk of bleeding or of the ischaemic events did not reach statistical significance. Bleeding events with de-escalation were less frequent in non-overweight patients but comparable in overweight patients (HR: 0.55; 95% CI: 0.30–1.03; P = 0.057 and HR: 0.95; 95% CI: 0.64–1.41, respectively, P-interaction = 0.147). Non-overweight patients had lower ischaemic event rates with de-escalation, while overweight cases had slightly less (HR: 0.47; 95% CI: 0.18–1.25; P = 0.128 and HR: 0.89; 95% CI: 0.53–1.50, respectively, P-interaction = 0.261).

Conclusion

The strategy of guided dual antiplatelet therapy de-escalation was associated with a significant net clinical benefit in non-overweight patients, while the two strategies were equivalent in overweight patients.
The Intergenerational Transmission of World War I on Female Labour
Authors: Gay Victor
Published: April 2023

Demographic shocks tied to World War I’s high death toll induced many women to enter the labour force in the immediate post-war period. I document a positive impact of these newly employed women on the labour force participation of subsequent generations of women until today. I also find that the war permanently altered attitudes toward the role of women in the labour force. I decompose this impact into three channels of intergenerational transmission: transmission from mothers to daughters, transmission from mothers-in-law to daughters-in-law via their sons and transmission through local social interactions.
Ruminococcus gnavus: friend or foe for human health
Authors: Crost Emmanuelle H , Coletto Erika , Bell Andrew , Juge Nathalie
Published: April 2023

Ruminococcus gnavus was first identified in 1974 as a strict anaerobe in the gut of healthy individuals, and for several decades, its study has been limited to specific enzymes or bacteriocins. With the advent of metagenomics, R. gnavus has been associated both positively and negatively with an increasing number of intestinal and extraintestinal diseases from inflammatory bowel diseases to neurological disorders. This prompted renewed interest in understanding the adaptation mechanisms of R. gnavus to the gut, and the molecular mediators affecting its association with health and disease. From ca. 250 publications citing R. gnavus since 1990, 94% were published in the last 10 years. In this review, we describe the biological characterization of R. gnavus, its occurrence in the infant and adult gut microbiota and the factors influencing its colonization of the gastrointestinal tract; we also discuss the current state of our knowledge on its role in host health and disease. We highlight gaps in knowledge and discuss the hypothesis that differential health outcomes associated with R. gnavus in the gut are strain and niche specific.
Nuclear genetic background influences the phenotype of the Drosophila tko25t mitochondrial protein-synthesis mutant
Authors: Jacobs Howard T , Tuomela Tea , Lillsunde Päivi
Published: April 2023

The Drosophila tko25t point mutation in the gene encoding mitoribosomal protein S12 produces a complex phenotype of multiple respiratory chain deficiency, developmental delay, bang-sensitivity, impaired hearing, sugar and antibiotic sensitivity, and impaired male courtship. Its phenotypic severity was previously shown to be alleviated by inbreeding and to vary with mitochondrial genetic background. Here, we show similarly profound effects conferred by nuclear genetic background. We backcrossed tko25t into each of 2 standard nuclear backgrounds, Oregon R and w1118, the latter used as recipient line in many transgenic applications requiring selection for the white minigene marker. In the w1118 background, tko25t flies showed a moderate developmental delay and modest bang-sensitivity. In the Oregon R background, males showed longer developmental delay and more severe bang-sensitivity, and we were initially unable to produce homozygous tko25t females in sufficient numbers to conduct a meaningful analysis. When maintained as a balanced stock over 2 years, tko25t flies in the Oregon R background showed clear phenotypic improvement though were still more severely affected than in the w1118 background. Phenotypic severity did not correlate with the expression level of the tko gene. Analysis of tko25t hybrids between the 2 backgrounds indicated that phenotypic severity was conferred by autosomal, X-chromosomal, and parent-of-origin-dependent determinants. Although some of these effects may be tko25t specific, we recommend that, in order to minimize genetic drift and confounding background effects, the genetic background of nonlethal mutants should be controlled by regular backcrossing, even if stocks are usually maintained over a balancer chromosome.
Quantifying Vulnerability to Poverty in the Drought-prone Lowlands of Ethiopia
Authors: Skoufias Emmanuel , Vinha Katja , Beyene Berhe Mekonnen
Published: April 2023

A forward-looking measure of ‘vulnerability to poverty’ is estimated and a concerted effort is made to understand the sources of vulnerability in the drought-prone lowlands of Ethiopia. Using the Household Consumption Expenditure Survey and the Welfare Monitoring Survey of 2015–16, which include additional zones in the Afar and Somali regions increasing the representativeness of the survey in pastoral areas, the analysis reveals that vulnerability is remarkably higher in the drought-prone lowlands than in the other ecological zones, even though differences in poverty rates are modest. The analysis also reveals important distinctions in the sources of vulnerability. In the drought-prone lowlands, (i) the prevalence of both poverty-induced and risk-induced vulnerability is the highest among all the ecological zones and (ii) the importance of vulnerability due to aggregate shocks, such as droughts, relative to vulnerability due to idiosyncratic shocks is higher than in the other ecological zones. These findings attest to the unique nature of the drought-prone lowlands in comparison to the other agroecological zones of Ethiopia and the need for adaptive social protection programmes targeting not only the chronically poor but also the vulnerable.
Broad- Versus Narrow-Spectrum Perioperative Antibiotics and Outcomes in Pediatric Congenital Heart Disease Surgery: Analysis of the Vizient Clinical Data Base
Authors: Cooch Peter B , Kim Mi-Ok , Swami Naveen , Tamma Pranita D , Tabbutt Sarah , Steurer Martina A , Wattier Rachel L
Published: April 2023

Background

Despite guidelines recommending narrow-spectrum perioperative antibiotics (NSPA) as prophylaxis for most children undergoing congenital heart disease (CHD) surgery, broad-spectrum perioperative antibiotics (BSPA) are variably used, and their impact on postoperative outcomes is poorly understood.

Methods

We used administrative data from U.S. hospitals participating in the Vizient Clinical Data Base. Admissions from 2011 to 2018 containing a qualifying CHD surgery in children 0–17 years old were evaluated for exposure to BSPA versus NSPA. Propensity score-adjusted models were used to compare postoperative length of hospital stay (PLOS) by exposure group, while adjusting for confounders. Secondary outcomes included subsequent antimicrobial treatment and in-hospital mortality.

Results

Among 18 088 eligible encounters from 24 U.S. hospitals, BSPA were given in 21.4% of CHD surgeries, with mean BSPA use varying from 1.7% to 96.1% between centers. PLOS was longer for BSPA-exposed cases (adjusted hazard ratio 0.79; 95% confidence interval [CI]: 0.71–0.89, P < .0001). BSPA was associated with higher adjusted odds of subsequent antimicrobial treatment (odds ratio [OR] 1.24; 95% CI: 1.06–1.48), and there was no significant difference in adjusted mortality between exposure groups (OR 2.06; 95% CI: 1.0–4.31; P = .05). Analyses of subgroups with the most BSPA exposure, including high-complexity procedures and delayed sternal closure, also did not find (but could not exclude) a measurable benefit from BSPA on PLOS.

Conclusions

BSPA use was common in high-risk populations, and varied substantially between centers. Standardizing perioperative antibiotic practices between centers may reduce unnecessary broad-spectrum antibiotic exposure and improve clinical outcomes.
Coping strategies, illness perceptions, and relationship dynamics contribute to female sexual function and sexual distress in Sjögren’s syndrome
Authors: McCready Jemma L , Deary Vincent , Collins Tracy L , Lendrem Dennis W , Hackett Katie L
Published: April 2023

Background

Sexual dysfunction and sexual distress are common complaints for women with the autoimmune rheumatic disease Sjögren’s syndrome (SS); however, the role of psychosocial and interpersonal factors has not previously been explored in SS.

Aim

This study investigated whether psychosocial variables, such as coping strategies, illness perceptions, and relationship dynamics, contributed to sexual function and sexual distress for women with SS.

Methods

Participants with SS completed an online cross-sectional survey that included prevalidated questionnaires assessing sexual function, sexual distress, disease-related symptom experiences, cognitive coping strategies, illness perceptions, relationship satisfaction, and partners’ behavioral responses. Multiple linear regression was used to identify factors significantly associated with sexual function (total Female Sexual Function Index [FSFI] score) and sexual distress (total Female Sexual Distress Scale score) for women with SS.

Outcomes

Study outcome measures were the FSFI, Female Sexual Distress Scale, EULAR Sjӧgren’s Syndrome Patient Reported Index, numeric rating scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort, Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (B-IPQ), West Haven–Yale Multidimensional Pain Inventory (WHYMPI), and Maudsley Marital Questionnaire.

Results

A total of 98 cisgender women with SS participated in the study (mean age = 48.13 years, SD = 13.26). Vaginal dryness was reported by 92.9% of participants, and clinical levels of sexual dysfunction (total FSFI score <26.55) were observed in 85.2% (n = 69/81) of cases. More vaginal dryness, lower CERQ positive reappraisal, and higher CERQ catastrophizing were significantly associated with poorer self-rated sexual function (R2 = 0.420, F3,72 = 17.394, P < .001). Higher CERQ rumination, lower CERQ perspective, lower WHYMPI distracting responses, and higher B-IPQ identity were significantly associated with higher sexual distress (R2 = 0.631, F5,83 = 28.376, P < .001).

Clinical Implications

This study suggests that interpersonal and psychosocial factors are important contributors to sexual function and distress in women with SS and that the development of psychosocial interventions for this population is warranted.

Strengths and Limitations

This study is one of the first to explore the impacts of coping strategies, illness perceptions, and relationship dynamics on sexual function and sexual distress for women with SS. Limitations of our study include its cross-sectional nature and narrow sample demographic, which limit the generalizability of our results to other population groups.

Conclusion

Women with SS who utilized adaptive coping strategies had better sexual function and lower levels of sexual distress than women who utilized maladaptive coping strategies.
Expansion and line-binned opacities of samarium ions for the analysis of early kilonova emission from neutron star mergers
Authors: Carvajal Gallego H , Deprince J , Palmeri P , Quinet P
Published: April 2023

Opacity calculations performed within the expansion and the line-binned formalisms are reported for Sm V–X ions in this paper. These were determined by means of new large-scale atomic structure and radiative rate computations carried out using the pseudo-relativistic Hartree-Fock (HFR) method from which energy levels, wavelengths, and oscillator strengths were deduced for more than 100 millions of spectral lines in the considered samarium ions. In the absence of any experimental data, the reliability of HFR results was roughly estimated by comparison with those obtained with an independent theoretical approach, namely the fully relativistic multiconfiguration Dirac-Hartree-Fock method, in Sm VI and Sm VII. The opacities were estimated for typical conditions corresponding to early phases of kilonovae following neutron star mergers, i.e. for a density ρ  = 10−10 g cm−3, a time after the merger t  = 0.1 day and temperatures ranging from 25 000 to 70 000 K. In addition, the atomic calculations allowed us to establish the ground level for each of the Sm ions considered (still unknown until now), as well as reliable partition functions that are crucial for the determination of the ionization balance by solving the Saha equation and for accurate opacity calculations.
A Randomized Clinical Trial of Transgender Women Switching to B/F/TAF: The (mo)BETTA Trial
Authors: Lake Jordan E , Hyatt Ana N , Feng Han , Debroy Paula , Kettelhut Aaren , Miao Hongyu , Peng Liming , Bhasin Shalender , Bell Susan , Rianon Nahid , Brown Todd T , Funderburg Nicholas T
Published: April 2023

Background

Cardiometabolic disease in transgender women (TW) is affected by gender-affirming hormonal therapies (GAHTs), HIV, and antiretroviral therapy (ART). We evaluated the 48-week safety/tolerability of switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) vs continued ART in TW on GAHT.

Methods

TW on GAHT and suppressive ART were randomized 1:1 to switch to B/F/TAF (Arm A) or continue current ART (Arm B). Cardiometabolic biomarkers, sex hormones, bone mineral density (BMD) and lean/fat mass by DXA scan, and hepatic fat (controlled continuation parameter [CAP]) were measured. Wilcoxon rank-sum/signed-rank and χ2 tests compared continuous and categorical variables.

Results

TW (Arm A n = 12, Arm B n = 9) had a median age of 45 years. Ninety-five percent were non-White; 70% were on elvitegravir or dolutegravir, 57% TAF, 24% abacavir, and 19% TDF; 29% had hypertension, 5% diabetes, and 62% dyslipidemia. There were no adverse events. Arm A/B had 91%/89% undetectable HIV-1 RNA at week 48 (w48). Baseline (BL) osteopenia (Arm A/B 42%/25%) and osteoporosis (17%/13%) were common, without significant changes. BL lean/fat mass were similar. At w48, Arm A had stable lean mass but increased limb (3 lbs) and trunk (3 lbs) fat (within-arm P < .05); fat in Arm B remained stable. No changes occurred in lipid or glucose profiles. Arm B had a greater w48 decrease (−25 vs −3 dB/m; P = .03) in CAP. BL and w48 concentrations of all biomarkers were similar.

Conclusions

In this cohort of TW, switch to B/F/TAF was safe and metabolically neutral, though greater fat gain occurred on B/F/TAF. Further study is needed to better understand cardiometabolic disease burden in TW with HIV.
The OPAQUE1/DISCORDIA2 myosin XI is required for phragmoplast guidance during asymmetric cell division in maize
Authors: Nan Qiong , Liang Hong , Mendoza Janette , Liu Le , Fulzele Amit , Wright Amanda , Bennett Eric J , Rasmussen Carolyn G , Facette Michelle R
Published: April 2023

Formative asymmetric divisions produce cells with different fates and are critical for development. We show the maize (Zea mays) myosin XI protein, OPAQUE1 (O1), is necessary for asymmetric divisions during maize stomatal development. We analyzed stomatal precursor cells before and during asymmetric division to determine why o1 mutants have abnormal division planes. Cell polarization and nuclear positioning occur normally in the o1 mutant, and the future site of division is correctly specified. The defect in o1 becomes apparent during late cytokinesis, when the phragmoplast forms the nascent cell plate. Initial phragmoplast guidance in o1 is normal; however, as phragmoplast expansion continues o1 phragmoplasts become misguided. To understand how O1 contributes to phragmoplast guidance, we identified O1-interacting proteins. Maize kinesins related to the Arabidopsis thaliana division site markers PHRAGMOPLAST ORIENTING KINESINs (POKs), which are also required for correct phragmoplast guidance, physically interact with O1. We propose that different myosins are important at multiple steps of phragmoplast expansion, and the O1 actin motor and POK-like microtubule motors work together to ensure correct late-stage phragmoplast guidance.
Knowing, Telling, Trusting
Authors: Holton Richard
Published: April 2023

This paper falls into three parts. The first looks at wh-constructions, focussing on the so-called factual whs, ‘X knows where… ’, ‘when’, ‘who’, ‘what’ etc. I suggest, drawing on both linguistic considerations and evidence from developmental psychology, that these constructions take things as their objects, not propositions; and that this may be why they are learned before those taking sentential complements. The second part moves to the case of telling-wh: to constructions such as telling someone who is at the door. This construction brings a very particular set of requirements, not just to tell the truth, but to tell all the relevant truths and nothing but. The third section, in a critical discussion of Katherine Hawley's work, argues that an account of trust and testimony focussing on the telling-wh construction brings better results than one focussed on the blander idea of assertion.
Physical Therapists Use Different Motivational Strategies for Stroke Rehabilitation Tailored to an Individual’s Condition: A Qualitative Study
Authors: Oyake Kazuaki , Sue Keita , Sumiya Motofumi , Tanaka Satoshi
Published: April 2023

Objective

Various strategies are used to motivate individuals with stroke during rehabilitation. However, how physical therapists select the motivational strategies that they use for each individual is yet to be established. Therefore, this study aimed to explore how physical therapists use different motivational strategies for individuals in stroke rehabilitation programs.

Methods

A criterion sample of 15 physical therapists who have worked in rehabilitation for over 10 years and were interested in an individual’s motivation participated in one-on-one semi-structured online interviews. The interviews explored their perspectives and experiences regarding the motivational strategies used depending on each individual’s condition. The collected data were analyzed with thematic analysis.

Results

A total of 9 themes emerged from the data upon thematic analysis and inductive coding. Participants used different strategies to encourage individuals’ active participation in physical therapy depending on (1) their mental health, (2) their physical difficulties, (3) their level of cognitive function, (4) their personality, (5) their activities and participation, (6) their age, (7) their human environment, and (8) the type of rehabilitation service where the individual underwent treatment. For example, in cases where an individual lost self-confidence, participants offered practice tasks that the individual could achieve with little effort to make them experience success. The interviews also revealed (9) motivational strategies used regardless of the individual’s condition. For instance, patient-centered communication was used to build rapport with individuals, irrespective of their condition.

Conclusion

This qualitative study suggests that physical therapists use different strategies depending on the individual’s mental health conditions, physical problems, level of cognitive function, personality, activities and participation, age, human environment, and the type of rehabilitation service where the individual undergoes treatment to motivate individuals with stroke during physical therapy.

Impact

The findings of this study can provide experience-based recommendations regarding the selection of motivational strategies for stroke rehabilitation.
Dendritic spine dynamics in associative memory: A comprehensive review
Authors: Guo Hongling , Ali Tahir , Que Jianyu , Zhou Yanmei , Bai Yang
Published: April 2023

Associative learning and memory are fundamental behavioral processes through which organisms adapt to complex environments. Associative memory involves long‐lasting changes in synaptic plasticity. Dendritic spines are tiny protrusions from the dendritic shaft of principal neurons, providing the structural basis for synaptic plasticity and brain networks in response to external stimuli. Mounting evidence indicates that dendritic spine dynamics are crucial in different associative memory phases, including acquisition, consolidation, and reconsolidation. Causally bridging dendritic spine dynamics and associative memory is still limited by the suitable tools to measure and control spine dynamics in vivo under behaviorally relevant conditions. Here, we review data providing evidence for the remodeling of dendritic spines during associative memory processing and outline open questions.
Relax to Heal? Perspectives of Patients with Diabetic Foot Ulcers and Health Professionals on Relaxation Sessions for Wound Healing
Authors: Ferreira Gabriela , Bernardo Ana Cristina , Carvalho André , Pereira M. Graça
Published: April 2023

OBJECTIVE

To explore patients’ and healthcare professionals’ (HPs’) perspectives on the suitability/acceptability of a relaxation intervention, its effects on patients’ well-being and diabetic foot ulcer (DFU) healing, and its incorporation into the multidisciplinary management of patients with diabetic foot.

METHODS

This qualitative study was nested within a three-arm pilot randomized controlled trial. Patients with a chronic DFU received four relaxation sessions. Investigators then interviewed patients, physicians, and nurses involved with diabetic foot consultations. Interviews were audio-recorded, transcribed, and analyzed using thematic content analysis.

RESULTS

Five themes emerged from patient’s interviews about the suitability/acceptability of the relaxation intervention: perceptions regarding the psychological intervention, distress, the relaxation technique, changes in the patient’s life, and changes in DFU/contribution to healing. Three themes emerged from interviews with HPs: perceptions regarding relaxation, changes in the patient, and changes in DFU/healing. Regarding the feasibility of the relaxation intervention, three themes emerged for both patients and HPs: suggested modifications, stressors/difficulties, and impact of COVID-19 pandemic. The utility theme emerged only in HP interviews, with subthemes of patients’ distress, psychological interventions, relaxation intervention, and integration of the psychologist in the team.

CONCLUSIONS

These findings provide evidence for the suitability/acceptability, feasibility, and utility of a relaxation intervention in diabetic foot consultations.
Pre-Existing Audiometric Hearing Loss is a Predictor of Significant Threshold Shift Following Injury During Combat Deployment
Authors: Joseph Antony R. , MacGregor Andrew J. , Dougherty Amber L.
Published: April 2023

Objectives:

Military personnel are exposed to multiple risk factors for hearing loss, particularly on the battlefield. The objective of this study was to determine whether pre-existing hearing loss predicted hearing threshold shift in male U.S. military personnel following injury during combat deployment.

Design:

This was a retrospective cohort study with 1573 male military personnel physically injured in Operations Enduring and Iraqi Freedom between 2004 and 2012. Audiograms before and after injury were analyzed and used to calculate significant threshold shift (STS), defined as a 30 dB or greater change in the sum of hearing thresholds at 2000, 3000, and 4000 Hz in either ear on the postinjury audiogram, relative to the same frequencies on the preinjury audiogram.

Results:

Twenty-five percent (n = 388) of the sample had preinjury hearing loss, which mostly occurred in the higher frequencies (i.e., 4000 and 6000 Hz). The prevalence of postinjury STS ranged from 11.7% to 33.3% as preinjury hearing level moved from better to worse. In multivariable logistic regression, preinjury hearing loss was a predictor of STS, and there was a dose-response relationship between severity of preinjury hearing threshold and postinjury STS, specifically for preinjury hearing levels of 40 to 45 dBHL (odds ratio [OR] = 1.99; 95% confidence interval [CI] = 1.03 to 3.88), 50 to 55 dBHL (OR = 2.33; 95% CI = 1.17 to 4.64), and >55 dBHL (OR = 3.77; 95% CI = 2.25 to 6.34).

Conclusions:

These findings suggest that better preinjury hearing provides increased resistance to threshold shift than impaired preinjury hearing. Although STS is calculated using 2000 to 4000 Hz, clinicians must closely attend to the pure-tone response at 6000 Hz and use this test frequency to identify service members at-risk for STS prior to combat deployment.
Percutaneous Posterior Pelvic Fixation of Spinopelvic Dissociation: A Multicenter Series of Displaced Patterns
Authors: Moo Young Justin P. , Savakus Jonathan C. , Obey Mitchel R. , Pereira Daniel E. , Hills Jeffrey M. , McKane Ava , Babcock Sharon N. , Miller Anna N. , Stephens Byron F. , Mitchell Phillip M.
Published: April 2023

Objective:

To characterize the success and complications of percutaneous posterior pelvic fixation in the treatment of displaced spinopelvic dissociation patterns.

Design:

Retrospective cohort study.

Setting:

Three Level I trauma centers.

Patients:

53 patients with displaced spinopelvic patterns were enrolled.

Intervention:

Percutaneous iliosacral screw fixation was used.

Main outcome measures:

Main outcome measures include incidence of union, fixation failure, and soft tissue complications.

Results:

All patients had displaced, unstable patterns with a mean preoperative kyphosis of 29.7 ± 15.4 degrees (range, 0–70). Most of the patients treated were neurologically intact (72%) or had an unknown examination at the time of fixation (15%). The median follow-up was 254 days (interquartile range, 141–531). The union rate was 98%. Radiographic and clinical follow-up demonstrated 1 case (2%) of nonunion. Two patients (4%) had radiographic evidence of screw loosening at the final follow-up, both of whom had fixation with a single sacroiliac-style screw placed bilaterally and went on to uneventful union. Neurologic recovery occurred at an average of 195 ± 114 days (range, 82–363 days). When present, long-term neurologic sequelae most commonly consisted of radicular pain and paresthesias at the final follow-up (n = 3, 6%).

Conclusions:

Percutaneous posterior pelvic fixation of select displaced spinopelvic dissociation seems to be safe with a low complication rate and reliable union. In a cohort of displaced fractures that were fixed in situ, we found a 2% rate of fixation failure/nonunion. Although rare, radicular pain and paresthesias were the most common long-term neurologic sequela.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Does a Modified Frailty Index Predict 30-day Complications After Long-Bone Nonunion or Malunion Surgery?
Authors: Chinta Sree , Fisher Nina D. , Tejwani Nirmal C.
Published: April 2023

Objective:

To assess the ability of a modified frailty index (mFI-5) score, which includes the presence of congestive heart failure, hypertension, chronic obstructive pulmonary disease, diabetes, and nonindependent functional status, and to identify patients at increased risk of complications after surgical treatment of long-bone nonunions/malunions.

Design:

Retrospective.

Setting:

Hospitals participating in the 2005–2018 American College of Surgeons National Surgical Quality Improvement Program.

Patients/Participants:

Patients in the American College of Surgeons National Surgical Quality Improvement Program database with upper extremity and lower extremity fractures were enrolled.

Intervention:

Surgical repair of nonunions/malunions of upper and lower extremity long bones.

Main Outcome Measure:

Postoperative complications after long-bone nonunion/malunion surgery.

Results:

Respective univariate analysis of the 2964 UE [1786 (60.3%) with mFI-5 of 0 and 386 (13.0%) with mFI-5 ≥2] and 3305 LE [1837 (55.6%) with mFI-5 of 0 and 498 (15.1%) with mFI-5 ≥2] showed that increasing mFI-5 score was associated with medical complications, extended longer length of stay, adverse discharge, and readmission. Binomial logistic regression showed that UE patients with mFI-5 ≥2 had increased risk of wound complications [odds ratio (OR) 2.512, 95% (confidence interval) CI: 1.037–6.086, P = 0.041), adverse discharge (OR 1.735, 95% CI: 1.204–2.499, P = 0.003), and unplanned readmission (OR 2.102, 95% CI: 1.038–4.255, P = 0.039), while LE patients with mFI-5 ≥2 had an increased risk of medical complications (OR 1.847, 95% CI: 1.307–2.610, P = 0.001), cumulative morbidity (OR 1.835, 95% CI: 1.342–2.510, P < 0.001), extended longer length of stay (OR 1.809, 95% CI: 1.233–2.654, P = 0.002), and adverse discharge (OR 1.841, 95% CI: 1.394–2.432, P < 0.001).

Conclusions:

mFI-5 score ≥2 is associated with significant increase in postoperative complications after surgical repair of long-bone nonunions/malunions.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Consensus Approach for Targeted Muscle Reinnervation in Amputees
Authors: Eberlin Kyle R. , Brown David A. , Gaston R. Glenn , Kleiber Grant M. , Ko Jason H. , Kovach Stephen J. , Loeffler Bryan J. , MacKay Brendan J. , Potter Benjamin K. , Roubaud Margaret S. , Souza Jason M. , Valerio Ian L. , Dumanian Gregory A.
Published: April 2023

Amputations have been performed with few modifications since the dawn of surgery. Blood vessels are ligated, bones are shortened, and nerves are cut. In a percentage of people, this can result in severe neuropathic, residual limb, and phantom limb pain. Targeted muscle reinnervation is a surgical procedure initially conceived to optimize function for myoelectric prostheses in amputees. Recently, it has been adopted more widely by surgeons for the prevention and treatment of neuropathic pain. Perhaps as a function of its relatively recent development, many authors perform this operation differently, and there has been no overall agreement regarding the principles, indications, technical specifics, and postoperative management guidelines. This article is written as a consensus statement by surgeons focused on the treatment of neuropathic pain and those with extensive experience performing targeted muscle reinnervation. It is designed to serve as a roadmap and template for extremity surgeons to consider when performing targeted muscle reinnervation.
Associations between hair cortisol and blood pressure: a systematic review and meta-analysis
Authors: Pageau Lauren M. , Ng Teresa J. , Ling Jiying , Given Barbara A. , Robbins Lorraine B. , Deka Pallav , Schlegel Emma C.
Published: April 2023

Objective:

Stress is widely considered to be a risk factor for high blood pressure (BP), but evidence on the associations between biomarkers of chronic stress and BP is inconsistent. This systematic review and meta-analysis assessed the current state of the science on relationships between measures of cortisol concentration reflecting chronic stress exposure [hair cortisol concentration (HCC), nail cortisol concentration)] and BP.

Methods:

PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane Library, and Embase were searched. Random effects models were used to assess the pooled effect size. Exploratory moderation analysis was performed.

Results:

Out of 32 465 identified, 16 articles met eligibility criteria and were included in the review, while 14 were included in the meta-analysis. No articles were reported on the association between nail cortisol concentration and BP. Small, positive associations were observed between HCC and SBP [r = 0.19 (95% confidence interval (CI): 0.08–0.29)] and HCC and DBP [r = 0.13 (95% CI: 0.04–0.22)]. Cortisol analysis method was identified as a significant moderator of the association between HCC and DBP. HCC was largely, positively associated with hypertension status [odds ratio = 3.23 (95% CI: 2.55–4.09), P < 0.001].

Conclusions:

Current evidence suggests that higher HCC may be associated with elevated BP and a potential risk factor for hypertension. However, results should be interpreted with caution because HCC can be affected by hair color, hair care products, and analytic methods. Given the limitations of studies included in this review, further research is needed.
Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi
Authors: Gotti Manuel , Sciarra Roberta , Pulsoni Alessandro , Merli Francesco , Luminari Stefano , Zerbi Caterina , Trentin Livio , Re Alessandro , Rusconi Chiara , Viviani Simonetta , Rossi Andrea , Cocito Federica , Botto Barbara , Meli Erika , Pinto Antonello , Dogliotti Irene , Gini Guido , Puccini Benedetta , Ricci Francesca , Nassi Luca , Fabbri Alberto , Liberati Anna Marina , Merli Michele , Filippi Andrea Riccardo , Bonfichi Maurizio , Zoboli Valentina , Tartaglia Germana , Annechini Giorgia , D’Elia Gianna Maria , Del Giudice Ilaria , Alvarez Isabel , Visentin Andrea , Pravato Stefano , Dalceggio Daniela , Pagani Chiara , Ferrari Silvia , Cristinelli Caterina , Lazic Tanja , Ferretti Virginia Valeria , Ricardi Umberto , Arcaini Luca
Published: April 2023

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5–12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss >10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II–III–IV NLPHL.
Proof of Concept: Trans-atrial AngioVac Aspiration of Mitral Valve Thrombosis in a COVID-19 Patient
Authors: Gerosa Gino , Ponzoni Matteo , Evangelista Giuseppe , Tessari Chiara , Tiberio Ivo , Molè Angelo , Zanella Fabio , Pittarello Demetrio , Tarzia Vincenzo
Published: April 2023

In patients with a prohibitive surgical risk, the AngioVac cannula can be used to remove left-sided cardiac masses, as an off-label adaptation of the device. We herein describe a novel micro-invasive approach to gain access to the left atrium for the aspiration of a mitral valve mass in a patient affected by severe coronavirus disease 2019. Through a right anterior mini-thoracotomy, the right superior pulmonary vein was accessed and used to insert the aspiration cannula. A parallel venous-arterial extracorporeal membrane oxygenation (ECMO)-like circuit provided circulatory and respiratory support to ensure proper intra- and postoperative hemodynamic stabilization.
Agreement Between Viscoelastic Coagulation Monitor (VCM), TEG 5000, and Coagulation Tests in Critically Ill Patients: A Multicenter Study
Authors: Panigada Mauro , Meli Andrea , Forastieri Molinari Andrea , Grazioli Lorenzo , Giani Marco , Ceriani Daniele , Bianchi Cecilia , Passarelli Maria Teresa , Consonni Dario , Grasselli Giacomo
Published: April 2023

The performance of viscoelastic coagulation monitor (VCM) compared with TEG 5000 (TEG) is unknown. In this multicenter study, the authors evaluated the agreement among VCM/TEG parameters and their relationship with standard coagulation tests in critically ill patients. Viscoelastic coagulation monitor, TEG, and laboratory samples were analyzed simultaneously. Viscoelastic coagulation monitor/TEG agreement was computed by Bland and Altman’s plots, association with laboratory parameters was studied with Spearman’s correlation coefficient and random-intercept linear models. One-hundred and twenty-seven patients enrolled, 320 paired observations: 210 (65.6%) under unfractioned heparin (UFH), 94 (29.4%) under low molecular weight heparin (LMWH), 16 (5.0%) no heparin. Under UFH prolonged clot formation times and reduced the amplitude of viscoelastic tracings on both devices, especially on TEG. The type of heparin affected the agreement between VCM/TEG homolog parameters. Reaction time (TEG-R) resulted 23.1 min longer than the homolog clotting time (VCM-CT) under UFH; maximum amplitude (TEG-MA) resulted 29.5 mm higher than maximum clot firmness (VCM-MCF) under LMWH. Weak correlation was observed between VCM-CT/TEG-R and activated partial thromboplastin time (aPTT)/anti-Xa; no correlation was found between VCM-alpha/TEG-angle and fibrinogen concentration. Viscoelastic coagulation monitor-MCF showed strong (LWMH) to moderate (UFH) correlation with platelet count, while TEG-MA only showed lower correlation. Viscoelastic coagulation monitor and TEG are differently affected by heparin. The platelet count is well represented by VCM-MCF even during UFH administration.