bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Metabolic Stress Induces Lymphatic Dysfunction Through KATP Channel Activation
Authors: Kim Hae Jin , Norton Charles E , Zawieja Scott D , Castorena-Gonzalez Jorge A , Davis Michael J
Published: July 2024

Lymphatic dysfunction is an underlying component of multiple metabolic diseases, including diabetes, obesity, and metabolic syndrome. We investigated the roles of KATP channels in lymphatic contractile dysfunction in response to acute metabolic stress induced by inhibition of the mitochondrial electron transport chain. Ex vivo popliteal lymphatic vessels from mice were exposed to the electron transport chain inhibitors antimycin A and rotenone, or the oxidative phosphorylation inhibitor/protonophore, CCCP. Each inhibitor led to a significant reduction in the frequency of spontaneous lymphatic contractions and calculated pump flow, without a significant change in contraction amplitude. Contraction frequency was restored by the KATP channel inhibitor, glibenclamide. Lymphatic vessels from mice with global Kir6.1 deficiency or expressing a smooth muscle-specific dominant negative Kir6.1 channel were resistant to inhibition. Antimycin A inhibited the spontaneous action potentials generated in lymphatic muscle and this effect was reversed by glibenclamide, confirming the role of KATP channels. Antimycin A, but not rotenone or CCCP, increased dihydrorhodamine fluorescence in lymphatic muscle, indicating ROS production. Pretreatment with tiron or catalase prevented the effect of antimycin A on wild-type lymphatic vessels, consistent with its action being mediated by ROS. Our results support the conclusion that KATP channels in lymphatic muscle can be directly activated by reduced mitochondrial ATP production or ROS generation, consequent to acute metabolic stress, leading to contractile dysfunction through inhibition of the ionic pacemaker controlling spontaneous lymphatic contractions. We propose that a similar activation of KATP channels contributes to lymphatic dysfunction in metabolic disease.
Association Between Falls and Social Frailty in Community-Dwelling Older Japanese Adults
Authors: Sawa Ryuichi , Doi Takehiko , Tsutsumimoto Kota , Nakakubo Sho , Sakimoto Fumio , Matsuda Soichiro , Shimada Hiroyuki
Published: July 2024

Objectives

This study aimed to investigate the association between falls and social frailty and its components among older Japanese adults.

Methods

This is a cross-sectional study. Participants were categorized into 3 groups based on the number of falls in the past year: no fall (none), a single fall (occasional), and more than one fall (recurrent). The participants who met 2 or more of the following criteria were defined as socially frail: living alone, going out less frequently compared with the previous year, rarely visiting friends, feeling unhelpful to friends or family, and not talking with someone daily.

Results

A total of 4,495 older Japanese adults living in a community analyzed in this study (51.0% women). Of the participants in this study, 3,851 (85.7%) were categorized as none, 443 (9.9%) as occasional, and 201 (4.5%) as recurrent. The proportion of participants considered socially frail was 11.5% in this study. Recurrent falls were associated with social frailty, even after adjusting for covariates (odds ratio [OR]: 1.49; 95% confidence interval [CI]: 1.01–2.19). The experience of recurrent falls was associated with the following components: “feeling unhelpful to friends and family” (OR: 1.62; 95% CI: 1.14–2.31) and “going outside less frequently compared with last year” (OR: 1.57; 95% CI: 1.06–2.31).

Discussion

Among older Japanese adults, recurrent falls were associated with social frailty and with 2 of its components in particular: social roles and social participation. Future longitudinal studies should be conducted to gain insight into any causal relationships between these variables.
Light stress elicits soilborne disease suppression mediated by root-secreted flavonoids in Panax notoginseng
Authors: Fang Haiyan , Guo Cunwu , Mei Xinyue , Hao Minwen , Zhang Jiayin , Luo Lifen , Liu Haijiao , Liu Yixiang , Huang Huichuan , He Xiahong , Zhu Youyong , Yang Min , Zhu Shusheng
Published: July 2024

Developing disease-suppressive soils is an effective approach for managing soilborne diseases, which can be achieved through crop metabolism and root secretion modification to recruit beneficial soil microbiota. Many factors, such as light, can elicit and modify plant metabolomic activities, resulting in disease suppression. To investigate the impact of light, Panax notoginseng was planted in a greenhouse and forest, conditioned with three levels of light intensities, including the optimal (15% light transmittance of full light), suboptimal low (5% light transmittance of full light) and suboptimal high (30% light transmittance of full light) intensities. We assessed the rhizosphere microbiota of P. notoginseng and root rot disease caused by soilborne pathogen Ilyonectria destructans, and elucidated the mechanism. Results showed that suboptimal light conditions alleviated root rot disease of P. notoginseng by enriching beneficial microbiota in the rhizosphere. Both low and high light stresses enhanced the secondary metabolism profile in favor of plant defense, particularly the flavonoid pathway. Notably, high light stress demonstrated a robust ability to promote flavonoid metabolism and secretion, resulting in the enrichment of more beneficial microorganisms that suppressed the soilborne pathogen I. destructans. These findings highlight the potential for adjusting canopy light intensities to improve soil health and promote sustainable agriculture.
Comparative phylogeography and genetic diversity of two co-occurring anti-tropical krill species Hansarsia megalops and Thysanoessa gregaria in the Atlantic Ocean
Authors: Kulagin Dmirty N , Simakova Ulyana V , Lunina Anastasiia A , Vereshchaka Alexander L
Published: July 2024

Hansarsia megalops and Thysanoessa gregaria are two abundant krill species in the warm-temperate belts in the North and South Atlantic. This pattern of disjunct distribution, often referred to as anti-tropical (or bipolar), is a regular phenomenon among marine organisms that can appear at different taxonomic levels. Analysis of spatial genetic diversity based on variation of the mitochondrial cytochrome oxidase I (COI) gene was carried out to understand whether these broadly sympatric krill species have similar patterns in population structure and demographic history. The results suggested that the anti-tropical distribution of both species was driven by trans-equatorial migrations during different historical periods. We observed contrasting differences in genetic diversity between species coupled with similar patterns of genetic diversity and structure in disjunct populations on both sides of the equator. We also found additional genetically distinctive populations of T. gregaria in the South Atlantic in Subantarctic waters and showed that the Southern Subtropical Frontal Zone acts as a strong boundary between two genetically distinctive populations of T. gregaria. The results suggest that both species-specific habitat preferences and interactions between closely related species (congeners) may shape differences in population genetic diversity and structure among species.
KPP transition fronts in a one-dimensional two-patch habitat
Authors: Hamel François , Zhang Mingmin
Published: July 2024

This paper is concerned with the existence of transition fronts for a one-dimensional two-patch model with KPP reaction terms. Density and flux conditions are imposed at the interface between the two patches. We first construct a pair of suitable super- and subsolutions by making full use of information of the leading edges of two KPP fronts and gluing them through the interface conditions. Then, an entire solution obtained thanks to a limiting argument is shown to be a transition front moving from one patch to the other one. This propagating solution admits asymptotic past and future speeds, and it connects two different fronts, each associated with one of the two patches. The paper thus provides the first example of a transition front for a KPP-type two-patch model with interface conditions. To Professor James D. Murray in admiration and recognition of his great achievements in mathematical biology
Accelerating onchocerciasis elimination in humanitarian settings: lessons from South Sudan
Authors: Siewe Fodjo J N , Jada S R , Rovarini J , Bol Y Y , Carter J Y , Hadermann A , Lakwo T , Colebunders R
Published: July 2024

There is persistent meso- and hyperendemicity of onchocerciasis (river blindness) in South Sudan, a country that has endured armed conflict for many years. In 2018, Amref Health Africa, in collaboration with local communities, the South Sudan Ministry of Health and other stakeholders, initiated some interventions, among which was Innovative Approaches to Reduce the Burden of Disease Caused by Onchocerciasis (IARDO) project. This project implemented several strategies, including identifying areas where onchocerciasis elimination programs need strengthening, switching from annual to biannual community-directed treatment with ivermectin (CDTI), additional ivermectin administration to postpartum women and school children and a community-based ‘slash and clear’ vector control strategy. These measures resulted in increased CDTI coverage, fewer bites from blackfly vectors and decreased onchocerciasis-related morbidity. The feasibility of these interventions, low cost, national government support and community ownership suggest their long-term sustainability.
GuidingBand: Evaluating Speed, Precision and Accuracy of a Vibrotactile Hand Guidance System
Authors: Poncibi B , Waghwase Atish , Joshi Anirudha
Published: July 2024

Computerized tactile guidance systems can potentially help in human visual perception tasks such as identifying a desired object in a collection of similar objects. We designed a wrist-wearable tactile guidance system called GuidingBand that provides vibrational cues to help the user pick visual targets out of an array. We conducted three studies to systematically investigate the interplay of machine-led tactile guidance and human visual perception. The studies involve presenting visual targets to users on a screen and giving them visual search tasks. In Study 1, we identified the error rate of our guidance system. We presented participants (N=20) with arrays of identical, square targets to pick from, progressively reduced the target sizes and evaluated error rates for each size. Notably, we observed a 4% error rate at a target size of 10 mm. In Study 2, we compared the error rate of the guidance system with and without the help of human visual perception in a visual search task. We constructed a task that involved showing users an array of distractor rectangles (set sizes 2 to 10) varying only in length and asked them to identify the correct target that was previously shown to them. Participants (N=13) had fewer errors when they tried to identify targets with tactile guidance alone, followed by guidance and perception combined and perception alone. In Study 3, we had the same task as Study 2 but the distractor set sizes were larger (varying from 4 to 28), we had more participants (N=30) and measured errors and task time. While perception alone was the fastest, it was also the most error prone. The combined mode was faster and less error prone than guidance only mode, as expected, indicating that human–computer collaboration yielded the best performance.
The circadian rhythm as therapeutic target in inflammatory bowel disease
Authors: Post Zoë , Zilberstein Netanel F , Keshavarzian Ali
Published: July 2024

The primary objectives of the management of patients with inflammatory bowel disease (IBD) are to prevent IBD flares, prevent/delay disease progression and improve patients’ quality of life. To this end, one needs to identify risk factor(s) associated with flare-ups and disease progression. We posit that disruption of circadian rhythms is one of the key factors that is associated with risk of flare-up and disease progression. This hypothesis is based on published studies that show: (1) The circadian rhythm regulates many biological processes including multiple IBD-relevant biological processes that are critical in inflammatory/immune processes such as environment/microbe interaction, microbe/host interaction, intestinal barrier integrity and mucosal immunity—all central in the pathogenesis of IBD, and (2) Circadian machinery is the primary tool for the host to interact with the environment. Circadian misalignment results in a loss of preparedness of the host to respond and adjust to the environmental changes that could make the host more vulnerable to IBD flare-ups. In this review, we first provide an overview of circadian rhythms and its role in healthy and disease states. Then we present data to support our hypothesis that: (1) IBD patients have disrupted circadian rhythms (“social jet lag”) and (2) circadian misalignment and associated disrupted sleep decreases the resiliency of IBD patients resulting in microbiota dysbiosis, more disrupted intestinal barrier integrity and a more aggressive disease phenotype. We also show that circadian-directed interventions have a potential to mitigate the deleterious impact of disrupted circadian and improve IBD disease course.
Putting Freedom of Contract in its Place
Authors: Stone Rebecca
Published: July 2024

I develop a novel, rights-based conception of contract—the “democratic conception”—that can deliver a justification for granting a sphere of freedom to contracting parties while setting principled limits on that grant. It justifies doctrines—including the penalty doctrine, the doctrine of substantial performance, a robust doctrine of changed circumstances, and a robust doctrine of unconscionability—that an influential group of contract theorists argue set unprincipled limits on the parties’ equal procedural freedom. My account shows how these doctrines can be rendered compatible with a robust principle of freedom of contract that is grounded in the parties’ rights.
The Role of the Army Medical Corps (MC) in the Caribbean Campaign of the Spanish American War
Authors: Nieves J Edwin , Stack Kathleen M , Pace April A
Published: July 2024

The 5th Army Medical Corps Caribbean campaigns provided valuable lessons on the noncombat hazards to troops and the challenges to the provision of care in a tropical theater of operations. The Army quickly adapted the lessons learnt for the invasion in Puerto Rico and future overseas expeditions.
The effect of AGN feedback on the Lyman-α forest signature of galaxy protoclusters at z∼ 2.3
Authors: Dong Chenze , Lee Khee-Gan , Cui Weiguang , Davé Romeel , Sorini Daniele
Published: July 2024

The intergalactic medium in the vicinity of galaxy protoclusters are interesting testbeds to study complex baryonic effects such as gravitational shocks and feedback. Here, we utilize hydrodynamical simulations from the SIMBA and The Three Hundred suites to study the mechanisms influencing large-scale Lyman-$\alpha$ transmission in $2\lt z\lt 2.5$ protoclusters. We focus on the matter overdensity-Lyman-$\alpha$ transmission relation $(\delta _m-\delta _F)$ on Megaparsec-scales in these protoclusters, which is hypothesized to be sensitive to the feedback implementations. The lower density regions represented by the SIMBA-100 cosmological volume trace the power-law $\delta _m-\delta _F$ relationship often known as the fluctuating Gunn–Peterson approximation. This trend is continued into higher density regions covered by simulations that implement stellar feedback only. Simulations with active galactic nucleus (AGN) thermal and AGN jet feedback, however, exhibit progressively more Lyman-$\alpha$ transmission at fixed matter overdensity. Compared with the seven protoclusters observed in the COSMOS field, only two display the excess absorption expected from protoclusters. The others exhibit deviations: four show some increased transparency suggested by AGN X-ray thermal feedback models while the highly transparent COSTCO-I protocluster appears to reflect intense jet feedback. Discrepancies with the stellar-feedback-only model suggests processes at play beyond gravitational heating and/or stellar feedback as the cause of the protocluster transparencies. Some form of AGN feedback is likely at play in the observed protoclusters, and possibly long-ranged AGN jets in the case of COSTCO-I. While more detailed and resolved simulations are required to move forward, our findings open new avenues for probing AGN feedback at Cosmic Noon.
Combating air pollution significantly reduced air mercury concentrations in China
Authors: Feng Xinbin , Fu Xuewu , Zhang Hui , Wang Xun , Jia Longyu , Zhang Leiming , Lin Che-Jen , Huang Jen-How , Liu Kaiyun , Wang Shuxiao
Published: July 2024

In the past decade, China has motivated proactive emission control measures that have successfully reduced emissions of many air pollutants. For atmospheric mercury, which is a globally transported neurotoxin, much less is known about the long-term changes in its concentrations and anthropogenic emissions in China. In this study, over a decade of continuous observations at four Chinese sites show that gaseous elemental mercury (GEM) concentrations continuously increased until the early 2010s, followed by significant declines at rates of 1.8%–6.1% yr−1 until 2022. The GEM decline from 2013 to 2022 (by 38.6% ± 12.7%) coincided with the decreasing concentrations of criteria air pollutants in China and were larger than those observed elsewhere in the northern hemisphere (5.7%–14.2%). The co-benefits of emission control measures contributed to the reduced anthropogenic Hg emissions and led to the GEM decline in China. We estimated that anthropogenic GEM emissions in China were reduced by 38%–50% (116–151 tons) from 2013 to 2022 using the machine-learning and relationship models.
CHCHD2 P14L, found in amyotrophic lateral sclerosis, exhibits cytoplasmic mislocalization and alters Ca2+ homeostasis
Authors: Ikeda Aya , Meng Hongrui , Taniguchi Daisuke , Mio Muneyo , Funayama Manabu , Nishioka Kenya , Yoshida Mari , Li Yuanzhe , Yoshino Hiroyo , Inoshita Tsuyoshi , Shiba-Fukushima Kahori , Okubo Yohei , Sakurai Takashi , Amo Taku , Aiba Ikuko , Saito Yufuko , Saito Yuko , Murayama Shigeo , Atsuta Naoki , Nakamura Ryoichi , Tohnai Genki , Izumi Yuishin , Morita Mitsuya , Tamura Asako , Kano Osamu , Oda Masaya , Kuwabara Satoshi , Yamashita Toru , Sone Jun , Kaji Ryuji , Sobue Gen , Imai Yuzuru , Hattori Nobutaka
Published: July 2024

CHCHD2 and CHCHD10, linked to Parkinson's disease and amyotrophic lateral sclerosis-frontotemporal dementia (ALS), respectively, are mitochondrial intermembrane proteins that form a heterodimer. This study aimed to investigate the impact of the CHCHD2 P14L variant, implicated in ALS, on mitochondrial function and its subsequent effects on cellular homeostasis. The missense variant of CHCHD2, P14L, found in a cohort of patients with ALS, mislocalized CHCHD2 to the cytoplasm, leaving CHCHD10 in the mitochondria. Drosophila lacking the CHCHD2 ortholog exhibited mitochondrial degeneration. In contrast, human CHCHD2 P14L, but not wild-type human CHCHD2, failed to suppress this degeneration, suggesting that P14L is a pathogenic variant. The mitochondrial Ca2+ buffering capacity was reduced in Drosophila neurons expressing human CHCHD2 P14L. The altered Ca2+-buffering phenotype was also observed in cultured human neuroblastoma SH-SY5Y cells expressing CHCHD2 P14L. In these cells, transient elevation of cytoplasmic Ca2+ facilitated the activation of calpain and caspase-3, accompanied by the processing and insolubilization of TDP-43. These observations suggest that CHCHD2 P14L causes abnormal Ca2+ dynamics and TDP-43 aggregation, reflecting the pathophysiology of ALS.
Supersymmetric Expansion Algorithm and Complete Analytical Solution for the Hulthén and Anharmonic Potentials
Authors: Napsuciale M , Rodríguez S , Kirchbach M
Published: July 2024

An algorithm for providing analytical solutions to Schrödinger’s equation with nonexactly solvable potentials is elaborated. It represents a symbiosis between the logarithmic expansion method and the techniques of supersymmetric quantum mechanics as extended toward non-shape-invariant potentials. The complete solution to a given Hamiltonian $H_{0}$ is obtained from the nodeless states of the Hamiltonian $H_{0}$ and of a set of supersymmetric partners $H_{1}, H_{2},..., H_{r}$. The nodeless states (dubbed “edge” states) are unique and in general can be ground or excited states. They are solved using the logarithmic expansion which yields an infinite system of coupled first-order hierarchical differential equations, converted later into algebraic equations with recurrence relations which can be solved order by order. We formulate the aforementioned scheme, termed the “Supersymmetric Expansion Algorithm,” step by step and apply it to obtain for the first time the complete analytical solutions of the 3D Hulthén, and the 1D anharmonic, oscillator potentials.
Three-dimensional cultured human umbilical cord mesenchymal stem cells attenuate pulmonary fibrosis by improving the balance of mitochondrial fusion and fission
Authors: Zhai Huifang , Jiang Mengqi , Zhao Yaqin , Wang Yujie , Zhang Haitong , Ji Yunxia , Song Xiaodong , Zhang Jinjin , Lv Changjun , Li Minge
Published: July 2024

Pulmonary fibrosis is a kind of fibrotic interstitial pneumonia with poor prognosis. Aging, environmental pollution, and coronavirus disease 2019 are considered as independent risk factors for pulmonary fibrogenesis. Consequently, the morbidity and mortality striking continues to rise in recent years. However, the clinical therapeutic efficacy is very limited and unsatisfactory. So it is necessary to develop a new effective therapeutic approach for pulmonary fibrosis. Human umbilical cord mesenchymal stem cells (hucMSCs) are considered as a promising treatment for various diseases because of their multiple differentiation and immunomodulatory function. The key bottleneck in the clinical application of hucMSCs therapy is the high-quality and large-scale production. This study used FloTrix miniSpin bioreactor, a three-dimensional (3D) cell culture system, for large-scale expansion of hucMSCs in vitro, and proved 3D cultured hucMSCs inhibited the differentiation of fibroblasts into myofibroblasts and myofibroblasts proliferation and migration, leading to slow down the development of pulmonary fibrosis. Further mechanistic studies clarified that hucMSCs reduced the amount of binding between circELP2 and miR-630, resulting in blocking YAP/TAZ translocation from cytoplasm to nucleus. This condition inhibited mitochondrial fusion and promoted mitochondrial fission, and ultimately improved fusion/fission balance and cellular homeostasis. To sum up, this work clarified the anti-fibrosis and mechanism of hucMSCs cultured from the 3D FloTrix miniSpin bioreactor. We hope to provide new ideas and new methods for the clinical transformation and industrialization of hucMSCs therapy.
A detailed survey of the murine limbus, its stem cell distribution, and its boundaries with the cornea and conjunctiva
Authors: Nureen Lamia , Biazik Joanna , Carnell Michael , Di Girolamo Nick
Published: July 2024

The narrow intersection between the cornea and conjunctiva, otherwise known as the limbus, is purported to harbor stem cells (SCs) that replenish the ocular surface epithelium throughout life. Damage to this site or depletion of its SCs can have dire consequences for eye health and vision. To date, various SC and keratin proteins have been used to identify the limbus, however, none could definitively mark its boundaries. Herein, we use the mouse as a model system to investigate whether structural and phenotypic features can be used to define the limbus and its boundaries with adjacent tissues. We demonstrate that differentially aligned blood and lymphatic vessels, intraepithelial nerves, and basal epithelial cellular and nuclei dimensions can be used as structural landmarks of the limbus. Identification of these features enabled approximation of the limbal expanse, which varied across distinct ocular surface quadrants, with the superior nasal and inferior temporal limbus being the widest and narrowest, respectively. Moreover, label-retaining SCs were unevenly distributed across the ocular circumference, with increased numbers in the superior temporal and inferior temporal moieties. These findings will heighten our current understanding of the SC niche, be beneficial for accurately predicting SC distribution to improve their isolation and devising efficacious cell therapies, and importantly, aid the ongoing search for novel SC markers.
Establishment and Effect of a Protist Consortium on the Maize Rhizosphere
Authors: Taerum Stephen J. , Patel Ravikumar R. , Micciulla Jamie , Steven Blaire , Gage Daniel , Triplett Lindsay R.
Published: July 2024

Protists are abundant in the rhizosphere, and protist inoculation onto plants has revealed protists’ roles in plant growth and development, disease suppression, and relationships with plant-beneficial bacteria. In this study, we evaluated the establishment of an 18-member defined protist consortium after inoculation onto germinated maize seedlings, along with the effects on the bacterial populations in the rhizosphere. Inoculated protists established a community that could be detected in the rhizosphere 3 weeks after inoculation. Plants inoculated with the protist consortium developed a bacterial community structure similar to that of plants inoculated with protist-free rhizosphere bacteria but different from that of uninoculated plants. This indicates that the protist cultures introduced rhizosphere-competent bacteria to the seedling. We also observed a plant growth phenotype, as inoculation with rhizosphere bacteria suppressed plant growth in the absence, but not the presence, of protists. Maize inoculated with an antibiotic-treated protist had lower biomass than plants inoculated with an untreated protist, indicating that growth promotion by protists depended on bacteria in the protist culture microbiome. This study shows that inoculation of germinated seeds establishes protist and bacterial communities on maize roots and that plant-detrimental effects of rhizosphere bacteria can be mitigated by the presence of protists.
Beyond the appearances: exploring complexities in anaphylaxis differential diagnosis
Authors: Nicola Stefania , Lo Sardo Luca , Borrelli Richard , Quinternetto Anna , Rashidy Nicolò , Brussino Luisa
Published: July 2024

Purpose of review

Anaphylaxis is a severe, and potentially life-threatening hypersensitivity reaction whose diagnosis is based on clinical signs and symptoms and their prompt recognition. The presence of mimics and unusual presentations necessitate a careful evaluation and expertise in the field, due to potential diagnostic errors and hence a delay in the treatment.

The aim of this review is to analyze and make an overview of the potential differential diagnosis of anaphylaxis, focusing on the clinical challenges of recognizing these conditions effectively among similar others.

Recent findings

The presence of mimics and unusual presentations of anaphylaxis necessitate a careful evaluation, emphasizing the importance of a comprehensive diagnostic approach.

Tryptase is well known marker of mast cells activation, and a useful tool assisting the diagnosis of anaphylaxis, helping to differentiate it from atypical mimickers.

The differential diagnosis of anaphylaxis comprises a very wide setting, and a systematic approach assessing different categories of cardiovascular, skin, respiratory airway, neuropsychiatric, and hematologic systems, can facilitate recognition of the correct diagnosis of this complex and life-threatening condition.
Chronic urticaria: not only after COVID-19 vaccination
Authors: Yacoub Mona-Rita , Ferlito Arianna , Nettis Eustachio
Published: July 2024

Purpose of review

To resume the current literature about vaccination and the onset of chronic urticaria.

Recent findings

The recent large-scale vaccination against SARS-CoV-2 targeting elderly, adult and children, has highlighted how vaccines can trigger onset or exacerbation of chronic urticaria.

COVID-19 vaccines may act as triggers in the development of chronic spontaneous urticaria. More data regarding the other vaccines are necessary to evaluate a similar potential role. Proper education of patients with vaccine-induced chronic urticaria is essential to avoid vaccination hesitancy.
Healthcare Worker Attitudes to Living Donation Prior to Planned Withdrawal of Care
Authors: Rath Smruti , Luo Claire , Washburn Laura , Price Matthew Brent , Goss Matthew , Moolchandani Priyanka , Parsons Sandra , Rana Abbas , Goss John , Galván Nhu Thao Nguyen
Published: July 2024

Background and Aims:

This study assesses the attitudes of healthcare practitioners toward Living Donation Prior to Planned Withdrawal of Care (LD-PPW): the recovery of a living donor organ before withdrawal of life-sustaining measures in a patient who does not meet criteria for brain death, but for whom medical care toward meaningful recovery is deemed futile.

Methods:

An electronic survey was administered to 1735 members of the American Society of Transplant Surgeons mailing list with 187 responses (10.8%).

Results:

Data from this study revealed that 70% of responding practitioners agreed with LD-PPW due to principles of beneficence and autonomy. Also, 65% of participants felt confident in their ability to declare the futility of care and 70% felt that LD-PPW should be added as an option when registering to become an organ donor.

Conclusion:

Currently, nearly half of all donation after circulatory determination of death do not proceed to donation. LD-PPW has been proposed as an alternative procedure targeted at increasing the quality and quantity of transplantable organs while respecting the donor’s right to donate, though its implementation has been hindered by concerns over public and provider perception. This study revealed support for LD-PPW among healthcare practitioners as an alternative procedure to increase the quality and quantity of transplantable organs while respecting the donor’s right to donate.
A Retrospective Study of Ballistic Pelvic Fractures With Focus on Short-Term Clinical Outcomes
Authors: Benson Dillon , Goldberg Ellen , Christiano Anthony , Erdman Mary-Kate , Lee Adam , Strelzow Jason
Published: July 2024

OBJECTIVES:

To evaluate the orthopaedic management, associated injuries, and outcomes in patients treated for low-velocity ballistic pelvic fractures.

METHODS:

Design:

Retrospective chart review.

Setting:

Single, urban, Level I trauma center.

Patient Selection Criteria:

Patients 15 years or older treated for low-velocity ballistic pelvic (OTA/AO 61 and 62) fractures from May 2018 to August 2021.

Outcome Measures and Comparisons:

Primary study measures included pelvic fracture location, concomitant associated injuries, surgical interventions, and antibiotic treatment. Postinjury sequelae evaluated include infection, neurologic deficit, and need for orthopaedic removal of foreign body. Risk factors of postinjury sequelae were investigated.

RESULTS:

A total of 156 patients with ballistic pelvic fractures were included. The cohort consisted of 135 (86.5%) male patients with a mean age of 29.8 years. One hundred ten (70.5%) patients sustained 2 or more gunshot wounds. Ninety-eight (62.8%) patients underwent an exploratory laparotomy with 79 (50.6%) having a confirmed concomitant intestinal injury. Additional associated injuries included nerve injury (13.5%), vascular injury requiring repair or embolization (10.9%), and bladder injury (10.3%). Nine (5.7%) patients underwent orthopaedic operative management—five (3.2%) patients for operative fixation and 4 (2.5%) patients for removal of intra-articular foreign bodies. Diabetes (odds ratio [OR]: 33.1, P = 0.025), neurologic deficit on presentation (OR: 525.2, P < 0.001), vascular injury requiring repair or embolization (OR: 8.7, P = 0.033), and orthopaedic pelvic fixation (OR: 163.5, P = 0.004) were positively associated with the defined postinjury sequelae at 30 and 90 days of follow-up. There was not a statistically significant association between infection and retained foreign body (OR: 3.95 [95% CI 0.3–58.7, P = 0.318]) or bowel contamination (OR: 6.91 [95% CI 0.4–58.7, P = 0.178]).

CONCLUSIONS:

Ballistic fractures of the pelvis and acetabulum rarely required operative fixation (3.2%) or irrigation and debridement. Neither retained foreign body nor presumed bowel contamination of pelvic fractures had a statistically significant association with infection, which further supports conservative management of these injuries. Patients with diabetes, neurologic deficit on presentation, vascular injury necessitating intervention, and orthopaedic fixation of pelvic fracture are associated with increased risk of postinjury sequelae.

LEVEL OF EVIDENCE:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
High-Energy Transsyndesmotic Ankle Fracture Dislocation—Does Deltoid Ligament Repair Influence the Progression of Posttraumatic Arthritis in Logsplitter Injuries?
Authors: Sogbein Olawale A. , Saad Lorenzo , Barton Kristen I. , Halai Mansur , Sanders David W. , Lawendy Abdel Rahman , MacLeod Mark , Del Balso Christopher
Published: July 2024

OBJECTIVE:

To determine the effect of deltoid ligament repair on the development of posttraumatic arthritis in logsplitter ankle injuries.

METHODS:

Design:

Retrospective cohort.

Setting:

Academic, Level I trauma center.

Patient Selection Criteria:

Patients ≥18 years of age with logsplitter injuries (OTA/AO 44B, 44C) treated with open reduction internal fixation (ORIF) with or without deltoid ligament repair from January 2008 to October 2021.

Outcome Measures and Comparison:

The rate of posttraumatic arthritis (PTOA) development at the final follow-up (minimum 6 months) after ORIF was evaluated using the Kellgren–Lawrence scale. The achievement of acceptable reduction indicated by articular reduction <2 mm, and a medial clear space ≤4 mm was assessed at 6 weeks postoperatively with weight-bearing radiographs. The effect of deltoid ligament repair on the development of PTOA was investigated.

RESULTS:

Fifty-nine patients aged 49.1 ± 17.2 years met inclusion criteria with a mean follow-up of 16.6 months (range = 6 to 96). Twenty-six of 59 patients (44%) had developed PTOA at the final follow-up. Acceptable reduction was achieved in 83.1% (49/59) of fractures. The acceptable reduction rate in fractures undergoing deltoid ligament repair was 100% versus 78% in those without deltoid ligament repair (13/13 vs. 36/46, P = 0.017). The rate of PTOA development was significantly lower in patients who underwent deltoid ligament repair (15%) than those who did not (52%), P = 0.026. Patients who underwent deltoid ligament repair had a significantly reduced rate of PTOA development leading to arthrodesis compared with those who did not (0% vs. 17%, P = 0.013).

CONCLUSIONS:

Logsplitter injuries resulted in a high rate of development of posttraumatic arthritis. An acceptable reduction is required to minimize the risk of development of PTOA and progression to arthrodesis. Deltoid ligament repair during ORIF may facilitate acceptable reduction and decrease the rate of PTOA and progression to arthrodesis in these injuries.

LEVEL OF EVIDENCE:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Left Atrial Appendage Occlusion as a Strategy for Reducing Stroke Risk in Nonvalvular Atrial Fibrillation
Authors: Moras Errol , Gandhi Kruti , Yakkali Shreyas , Frishman William H. , Aronow Wilbert S.
Published: July 2024

Nonvalvular atrial fibrillation (AF) is a common rhythm disorder of middle-aged to older adults that can cause ischemic strokes and systemic embolism. Stroke prevention is a crucial aspect of management, considering the increasing AF population and the associated morbidity and mortality. The left atrial appendage (LAA) has been identified as a predominant source of AF-associated thrombus and stroke, with at least 90% of the thrombi originating from this anatomical structure. Lifelong use of oral anticoagulants reduces the risk of these ischemic events but increases the risk of major and clinically relevant hemorrhages. In addition, these medications also require strict compliance for efficacy and have high failure rates in higher-risk patients. LAA occlusion (LAAO) has emerged as an alternative strategy for stroke prevention with encompassing various percutaneous and surgical techniques. Randomized controlled trials evaluating this intervention have shown promising results in stroke reduction replacing anticoagulation therapy. In this review, we aim to provide a comprehensive overview on the anatomy of the LAA and its role in thrombus formation, the emergence of various LAAO techniques and devices, and provide evidence on the role of LAAO in the reduction of stroke risk among patients with nonvalvular AF.
Preparing the Heart for a New Baby: Management of Pregnancy in Heart Transplant Recipients
Authors: Hussien Merna , Lorente-Ros Marta , Lam Phillip H. , Frishman William H. , Aronow Wilbert S. , Gupta Richa
Published: July 2024

Heart transplant (HT) recipients are more frequently reaching childbearing age given improvement in median survival and outcomes after HT. Although most pregnancies in HT recipients have favorable outcomes, poor fetal outcomes and maternal complications such as hypertensive disorders of pregnancy are more common in HT recipients than in the general population. In this review, we summarize the current evidence to guide the management of pregnancy in HT recipients. Preconception counseling, focused on risk stratification and optimal timing of conception, is the first important step to optimize pregnancy outcomes. During pregnancy and in the postpartum period, frequent monitoring of graft function and immunosuppressive levels is recommended. Calcineurin inhibitors and corticosteroids should be the mainstay of treatment for both prevention and treatment of graft rejection. Delivery planning should follow usual obstetric indications, preferably with vaginal delivery at term using regional anesthesia. A multidisciplinary care team should be involved in management through all stages of pregnancy to ensure success.
From maca to marijuana: cultural influences on joint pain symptoms and management in urban perimenopausal and early postmenopausal Latinas
Authors: Cortés Yamnia I. , Altemus Margaret , Reame Nancy E.
Published: July 2024

Objective

The purpose of this qualitative study was to explore the symptom experience and coping strategies for managing joint pain during the menopause transition in urban Latina women.

Methods

We conducted focus groups with 13 English-speaking peri and early postmenopausal Latinas living in Upper Manhattan in New York City in 2014. Eligible participants were self-identified Latinas aged 45 to 60 years with new onset or worsening joint pain and spontaneous amenorrhea, recruited through flyers and snowball sampling. Focus group interviews conducted in English were audiotaped, transcribed, and analyzed by a bilingual research team, using NVivo software (QSR International) to organize and code themes.

Results

On average, participants were aged 51.7 ± 4.8 years and overweight (body mass index of 29.3 ± 6.7 kg/m2); 10 (76.9%) were Puerto Rican, and the last menstrual period was 1 month to 5 years ago. The following four themes emerged: 1) menopause and joint pain are an alarming package; 2) pain disrupts life and livelihood; 3) medical management is unsatisfactory and raises worries about addiction; and 4) home remedies for coping with pain—from maca to marijuana. Despite access to a world-class medical facility in their neighborhood, women seeking pain relief preferred to self-manage joint pain with exercise, over-the-counter products, and other culturally valued home remedies. Many suffered through it.

Conclusions

For midlife Latinas, joint pain symptoms may emerge or worsen unexpectedly as part of the menopause transition and carry distressing consequences for daily activities and quality of life. There is a need to develop more culturally specific approaches for menopause-related pain management in this underserved population.
Public awareness and provider counseling regarding postmenopausal bleeding as a symptom of endometrial cancer
Authors: Wise Meredith K. , Schefter Alexandra M. , Brill Joshua , Bharucha Kharmen A. , Tessier Katelyn M. , Terrell Carrie A. , Erickson Britt K.
Published: July 2024

Objectives

Our study aims to understand public knowledge of postmenopausal bleeding as an endometrial cancer symptom and how past provider counseling on postmenopausal bleeding affects knowledge and care-seeking behaviors related to postmenopausal bleeding.

Methods

This was a cross-sectional survey study of people assigned female at birth. Study participants were recruited at a university research facility located at the Minnesota State Fair in September 2021. Participants answered questions about demographics, endometrial cancer knowledge, whether they had received counseling about postmenopausal bleeding, and whether and when they would present for care after experiencing postmenopausal bleeding.

Results

Six hundred forty-eight surveys were completed and included in analyses. Sixty-three percent of participants identified postmenopausal bleeding as a symptom of endometrial cancer. Those who correctly selected this symptom were more likely to be born in the United States, have a college education or higher, and have private insurance. Of the 145 postmenopausal participants, 46.5% reported that their provider counseled them on postmenopausal bleeding. Fifty-nine percent of the postmenopausal participants reported that they would tell their provider if they had postmenopausal bleeding after only one episode.

Conclusions

There is a need for increased recognition of postmenopausal bleeding and provider counseling on postmenopausal bleeding, and educational interventions should focus on public and provider awareness of endometrial cancer risks and symptoms.
Genomic and transcriptomic analyses of chemical hepatocarcinogenesis aggravated by oncoprotein loss
Authors: Wang Xinyi , Liu Yingluo , Zhang Shuo , Zhang Jiemeng , Lin Xiaoxue , Liang Yan , Zong Min , Hanley Kaisa L. , Lee Jin , Karin Michael , Feng Gen-Sheng
Published: July 2024

Background and Aims:

The chemical carcinogen diethylnitrosamine (DEN) is often used to induce HCC in mice. Curiously, several labs have reported that the removal of oncoproteins from hepatocytes exacerbated DEN-induced HCC, with mechanisms unknown. This study aimed at deciphering molecular mechanisms underlying the tumor suppressive effect of oncoproteins.

Approach and Results:

We generated mutant mouse lines with hepatocyte-specific deletions of Met, Ptpn11/Shp2, Ikkβ, or Ctnnb1/β-catenin and assessed DEN-induced tumorigenesis in the wild-type and mutant mice. To systematically examine genetic and molecular signaling alterations, we performed whole exome and RNA-sequencing on liver samples collected at the pre-cancer and established cancer stages. Although the mutational profiles of DEN-induced tumors were barely different in wild-type and mutant mice, oncoprotein ablation increased DEN-induced mutational burdens, especially in Shp2-deficient tumors. RNA-sequencing revealed multiple changes in signaling pathways, in particular, upregulated epithelial-mesenchymal transition, cell migration, and tumor metastasis, as well as downregulated small molecule metabolism that was affected by oncoprotein ablation. We identified key molecules and pathways that are associated with hepatic innate immunity and implicated in liver tumorigenesis. In addition, we unveiled markedly changed expression of a few miRNAs in the human HCC database.

Conclusions:

The aggravation of DEN-induced HCC progression seen on oncoprotein ablation could be caused by common and distinct genomic and signaling alterations. This study reveals a new level of complexity in hepatocarcinogenesis and elucidates molecular mechanisms underlying tumor evolution and recurrence.
Attitudes and Behaviors Regarding Compliance With Contact Lens Wear and Care Among Contact Lens Users at a University Hospital in Turkey
Authors: Oruz Oğuzhan , Harbiyeli İbrahim İnan , Erdem Elif , Yağmur Meltem , Ateş Eylem Gül
Published: July 2024

Objectives:

To investigate the level of compliance with contact lens (CL) care habits among CL wearers of different age and occupation groups.

Methods:

This survey study included 205 CL wearers followed in the tertiary reference center between 2016 and 2022. The survey was employed to probe each user's demographic data and noncompliant behaviors. To this end, the study compared CL compliance levels of patients in different age and occupation groups.

Results:

There were 85 (41.5%) patients in the good compliant group, 72 (35.1%) in the average compliant group, and 48 (23.4%) in the poor compliant group. The most common noncompliant behavior was disruption of aftercare visits. Except for two noncompliant behaviors (storage of fresh lens solution and exceeding the recommended lens case replacement time), other noncompliant behaviors were found more frequently in the ≤25 age group. The differences between the age groups were significant in hand washing and water activities (P=0.004 and P=0.023, respectively). Exceeding lens replacement time and sleeping with lenses criteria were found to be significantly noncompliant in health care workers compared to non-health care workers (P=0.006 and P=0.001, respectively). The level of compliance was found to be lower in users with 6 to 7 days of CL use per week than in those with fewer days (P=0.006).

Conclusion:

We found that the compliance rate was lower in younger patients and health care workers. We also observed that long-term use of CL reduces the level of compliance. Therefore, it might be necessary to focus on modifiable risk factors in these patient groups.
Delayed Induction of Noninflammatory SARS-CoV-2 Spike-Specific IgG4 Antibodies Detected 1 Year After BNT162b2 Vaccination in Children
Authors: Kobbe Robin , Rau Cornelius , Schulze-Sturm Ulf , Stahl Felix , Fonseca-Brito Luis , Diemert Anke , Lütgehetmann Marc , Addo Marylyn M. , Arck Petra , Weskamm Leonie M.
Published: July 2024

Humoral immune responses after BNT162b2 vaccination are predominantly composed of immunoglobulin (Ig) G1 and IgG3 subclass antibodies. As previously described in adults, S1-specific and receptor-binding domain–specific IgG4 levels increase significantly 1 year after the second BNT162b2 vaccination in children 5-11 years of age. Understanding mRNA vaccine–specific IgG4 responses in all age groups is crucial as more mRNA vaccines will reach licensure in the coming years.