bluuebunny/crossref_metadata_2025 huggingface dataset:
A308 AN UNUSUAL CASE OF MACE DYSFUNCTION: THE BENEFIT OF USING ANTEGRADE CONTRAST FOLLOW THROUGH MIMICKING HOME SETTINGS
Authors: Avelar Rodriguez D , Langer J , Gould M
Published: February 2024

Background

Malone Antegrade Continence Enema (MACE) is indicated in cases where medical management for constipation or faecal incontinence with laxatives or enemas has failed. MACE allows the administration of flushes with and without laxatives in an antegrade manner to mechanically empty the colon.

Aims

The aim of this case report is to illustrate an unusual case of MACE dysfunction and how it was troubleshooted.

Methods

Case report and review of the literature

Results

11-year-old female with neurogenic constipation and faecal incontinence for which MACE was being used.

She was referred to clinic for evaluation of new-onset vomiting, abdominal distention, and abdominal pain with MACE flushes. Her flushes consisted of crushed Bisacodyl, glycerin, PEG 3350 and 300 ml of saline solution. Cone enemas were also being used to completely empty her rectum, otherwise evacuation with regular flushes was not occurring, but was causing significant abdominal pain, distention and vomiting.

A contrast study was done by flushing water-soluble contrast through the MACE in an antegrade manner, while simultaneously performing a contrast enema, demonstrating good passage of contrast with no findings suggestive of obstruction.

She was admitted to hospital to complete imaging studies, bowel clean out and to better understand her MACE dysfunction. Following bowel clean out in hospital, MACE flushes were resumed, causing the same symptoms. Flushes without Bisacodyl were tried in the attempt to avoid possible colonic spasms; however symptoms re-occurred.

A second contrast study was performed (figure 1), mimicking home flushes in volume and time of administration, as well as patient’s position (sitting), completed in an antegrade fashion only. The patient developed symptoms 20 minutes after administering the contrast requiring cone enema. By the end of the study, there was poor passage of contrast through the proximal descending colon, suggesting a kink at the juncture between the sigmoid and descending colon. There was no reflux on contrast into the terminal ileum. An x-ray was done around 5 hours after, and contrast was still not seen in the rectum.

The patient underwent diagnostic laparoscopy, finding adhesions in the left upper quadrant of the descending and sigmoid colon, causing a Z-configuration hairpin obstruction, and colostomy creation. The patient has been doing well since colostomy creation with no pain.

Conclusions

MACE dysfunction can be caused by colonic adhesions distal to the MACE site Simultaneous antegrade contrast through MACE and contrast enema may miss bowel obstruction Antegrade contrast study mimicking home settings may be more helpful in situations where bowel obstruction is suspected

Funding Agencies

None
A309 THE DESCRIPTION OF NUTRITION COUNSELLING FOR IRRITABLE BOWEL SYNDROME IN THE LITERATURE IS CURRENTLY LACKING
Authors: Lau M E , Liu L W , Parker C H
Published: February 2024

Background

Dietary interventions are frequently recommended for the management of irritable bowel syndrome (IBS). Anecdotally, the nutrition counselling received by patients with IBS varies. In clinical practice, the optimal way to counsel these patients in regard to the application of dietary therapy remains unclear.

Aims

The aim of this scoping review is to summarize how the nutrition counselling component of dietary interventions for IBS is currently described in the literature.

Methods

A search of English language publications between January 1, 1994 and September 28th, 2023 was conducted using MEDLINE. Search results were limited to studies in humans and adults over age 18. The following combination of MeSH keywords was used in the search: irritable bowel syndrome AND diet food and nutrition OR counseling OR patient education OR practice guidelines OR nutrition therapy. Publications that involved providing instruction to patients to modify their diets were included. Titles and then abstracts were screened to determine if they potentially met inclusion criteria. Eligible publications were then reviewed in full. Those publications that met the inclusion criteria were included in this scoping review. Information regarding the description of nutrition counseling as a component of the dietary intervention was collected. Analysis is descriptive.

Results

The search strategy identified 683 potential articles. After title review, 251 abstracts were obtained and reviewed producing 31 publications that were reviewed in full. All 31 publications were included in the scoping review. Nutrition counselling was mentioned in all 31 publications, but the description of the components of nutrition counselling varied (Figure 1). No publication included all important components of nutrition counselling in the description of the dietary intervention.

Conclusions

Patients with IBS frequently report symptoms triggered by food. Counselling is an important component to the delivery of dietary interventions in IBS. However, the nutrition counselling components of these interventions for IBS is not well described in the literature in a reliable or standardized way. This limits the ability to provide these therapies to patients in an optimal way. Furthermore, the impact of different nutrition counselling strategies on the efficacy of dietary interventions remains unknown.

Figure 1: Results of Scoping Review.

Funding Agencies

None
A313 DISCONNECTED PANCREATIC DUCT SYNDROME: A RETROSPECTIVE OBSERVATIONAL STUDY REVIEWING AN IMPORTANT BUT OVERLOOKED COMPLICATION OF NECROTIZING PANCREATITIS
Authors: Kim H , Ashrafinia N , Fetz A , Tam L , Akhtar D , Aboalfaraj N , Gan S
Published: February 2024

Background

Disconnected pancreatic duct syndrome (DPDS) is a complication of acute necrotizing pancreatitis (ANP) characterized by a complete disruption of the main pancreatic duct, leading to the loss of continuity between the pancreatic duct and the gastrointestinal tract (figure 1). Due to unopposed leakage of residual pancreatic fluid, patients with DPDS often experience a prolonged disease course with significant morbidity, including complications such as pancreatic fistulas. However, information about the epidemiology, clinical characteristics, and outcomes of DPDS remains scarce.

Aims

To assess clinical outcomes, diagnostic delay, burden of endoscopic and surgical interventions, and complications related to DPDS.

Methods

A retrospective review was conducted for all patients diagnosed with DPDS who underwent either endoscopic ultrasound (EUS) or endoscopic retrograde cholangiopancreatography (ERCP) at our tertiary center between January 2010 and December 2022.

Results

Fifteen patients with DPDS following ANP were identified. The median age of patients at DPDS diagnosis was 56 years (range 33-86 years), with 47% being female. The most common etiology of ANP was biliary (40%), followed by idiopathic (33%) and alcoholic (27%). The median time between ANP diagnosis and DPDS diagnosis was 265 days (range 86-2023 days). Patients underwent a median of 3 (1-9) endoscopic interventions and 1 (0-5) surgical intervention between the initial ANP episode and DPDS diagnosis. 40% of patients experienced intra-abdominal sepsis secondary to infected pancreatic fluid collections. 20% developed pancreatic fistulas (two small bowel fistulas and one cutaneous fistula). 20% developed new-onset diabetes, and 13% had significant worsening of pre-existing diabetes. No mortalities were reported.

Conclusions

There is a significant delay in diagnosing DPDS following ANP, and a substantial burden of endoscopic interventions is required. Frequent complications of DPDS were pancreatic fistulas, recurrent pancreatic fluid collections, and pancreatogenic diabetes. Developing a predictive model for assessing the risk of DPDS development following ANP could aid in earlier diagnosis and potentially reduce morbidity and complications associated with DPDS.

Figure 1. Contrast enhanced CT demonstrating typical finding in DPDS in coronal (A) and axial (B) views. CT demonstrates 3cm area of necrosis involving pancreatic neck/body (asterisk) with viable upstream parenchyma in the remainder of the body and tail (white arrow). Pancreatic head/uncinate parenchyma and main duct appear intact (black arrow). B, the distal pancreatic duct is not dilated. DPDS, disconnected pancreatic duct syndrome.

Funding Agencies

None
A316 ACUTE NECROTIZING PANCREATITIS COMPLICATED BY PULMONARY EMBOLISM: A CASE REPORT AND REVIEW OF LITERATURE
Authors: Shamatutu C , Barclay R
Published: February 2024

Background

Acute pancreatitis (AP) is an inflammatory condition associated with local and systemic complications. Severe pancreatitis can include the development of peripancreatic fluid collections and necrotizing pancreatitis (NP). Vascular complications are one of the causes of morbidity and mortality in patients with AP. Splanchnic thrombosis has been well described in AP and can been seen in up to 24% of patients. Extra splanchnic vessel thrombosis, including pulmonary embolism (PE), is rare.

Aims

Describe a case of acute NP with peripancreatic fluid collection complicated with bilateral PE and review the relevant literature.

Methods

We performed a literature review for AP complicated by PE.

Results

Case: A 60-year-old man presented to the hospital with one day of abdominal pain, nausea and vomiting. His medical history was significant for obesity with a BMI of 40. He was not on any medications. He did not drink alcohol. On exam his heart rate was 58, blood pressure 149/94 mmHG, oxygen saturation was 95% on room air, he was afebrile. His abdomen was tender in the epigastric region. His labs revealed a white blood cell count of 14 x 109/L, lipase ampersand:003E 3,000 U/L, Bilirubin 40 umol/ L, AST 613 U/L, ALT 527 U/L, GGT 394 U/L, ALP 94 U/L, Creatinine 159 mmol/L. CT abdomen/pelvis revealed cholelithiasis without choledocholithiasis or biliary dilation. The pancreas was inflammed with necrosis throughout. There were two peripancreatic fluid collections (60mm x 41mm, and 148mm x 89mm). He was diagnosed with acute necrotizing pancreatitis thought secondary to gallstones. He was fluid resuscitated, started on antibiotics and unfractionated heparin (UFH) for deep vein thrombosis (DVT) prophylaxis. His oral intake remained low. Imaging on day 30 showed a large walled off necrotic collection (25cm x15cm). Vascular strucutres were patent. On day 36 he underwent endoscopic ultrasound guided drainage via lumen-apposing metal stent (LAMS). On day 43 he developed new tachycardia. CT chest revealed bilateral pulmonary emboli (Image 1). Doppler ultrasound revealed bilateral occlusive thrombus in the calf veins. He was treated with therapeutic UFH.

Literature review: We identified 10 case reports describing AP complicated by PE. The age amonst reports was variable (21 to 68). 4 cases reported additional thrombosis outside of the pulmonary vasculature. No cases which described splanchnic venous thrombosis prior. 3 cases reported pancreatic necrosis. The use of DVT prophylaxis was not reported. There is one case of PE 2 days after LAMS insertion in a patient with known thromboembolic disease.

Conclusions

PE is a rare complication of AP. Novel to this case was the recent deployment of a LAMS, the significance of which is unknown to date. Improved documentation of variables in future reports is needed to further characterize this event.

Image 1: Acute Pulmonary Embolism.

Funding Agencies

None
Total en bloc vertebrectomy and immunochemotherapy for chondrosarcoma colliding with intraosseous lymphoma
Authors: Palacios-Diaz Luis , Aguilar Martínez Antonio J , Pérez Rodríguez Francisco J , Penedo Agustín , Sánchez-Márquez Jose M , Fernández-Baillo Nicomedes
Published: February 2024

A 59-year-old woman diagnosed with a Grade I chondrosarcoma in T7 underwent total en bloc vertebrectomy. Analysis of the surgical piece established diagnosis of a Grade 1 chondrosarcoma confined to T7. Surprisingly, an infiltration with diffuse large B-cell lymphoma was found. Systemic disease was ruled out and diagnosis was established as intracompartmental Grade 1 chondrosarcoma colliding with intraosseous extranodal diffuse large B-cell lymphoma. Resection of chondrosarcoma was considered complete and treatment with four cycles of RCHOP was indicated. Two years after surgery, the patient remains at complete metabolic response. To date, this is the first reported case of chondrosarcoma colliding with lymphoma. Although Grade 1 chondrosarcoma is typically managed with local control through complete surgical resection, the mentioned finding of the lymphoma indicated the need for systemic treatment with immunochemotherapy.
Extending the usefulness of the Stryker Growing Prosthesis in pediatric patients
Authors: Sakamoto Akio , Noguchi Takashi , Matsuda Shuichi
Published: February 2024

Osteosarcoma is a highly invasive primary bone tumor that predominantly occurs in childhood and adolescence. The Stryker Growing Prosthesis provides a means of reconstructing large bone defects resulting from bone resection in skeletally immature patients. This device can be expanded as the patient grows. The possible length of extension depends on the length of the prosthesis. Because further expansion was not possible, by turning the adjustable part of the extension back to zero and adding a new permanent extension allow the prosthesis to be further adjusted as growth ensues. Using this method/device only, a separate endoprosthesis was required to be attached onto the extension. Therefore, the applicable cases are limited, because of the fact that extensive resection usually means total femoral replacement is best indicated. However, this method is still useful for reducing the number of revision surgeries in such cases. This reduces costs and increases savings for insurers/countries.
Management of retroperitoneal appendiceal perforation: a case report
Authors: Li Jinliang , Li Feng , Li Jun , Wang Chunlei , Sun Yubao , Bian Xiaowei
Published: February 2024

Retroperitoneal appendiceal perforation presents unique challenges in surgical management due to the complex nature of the retroperitoneal space. We present a case of a 57-year-old male with retroperitoneal appendiceal perforation, characterized by the presence of a large amount of gas in the retroperitoneal space. Emergent laparoscopic surgery was performed to address the retroperitoneal involvement. In retroperitoneal appendiceal perforation, surgical intervention and postoperative drainage are of great significance to prevent septic shock. The interconnectedness of the retroperitoneal space with other body regions is highlighted, underscoring the potential for severe complications. This case emphasizes the need for a tailored approach to managing retroperitoneal appendiceal perforation, preventing potential complications associated with this condition.
Ethylene-mediated stomatal responses to dehydration and rehydration in seed plants
Authors: Hasan Md Mahadi , Liu Xu-Dong , Yao Guang-Qian , Liu Jianquan , Fang Xiang-Wen
Published: February 2024

Ethylene, a plant hormone that significantly influences both plant growth and response to stress, plays a well-established role in stress signaling. However, its impact on stomatal opening and closure during dehydration and rehydration remains relatively unexplored and is still debated. Exogenous ethylene has been proven to induce stomatal closure through a series of signaling pathways, including the accumulation of reactive oxygen species, subsequent synthesis of nitric oxide and hydrogen sulfide, and SLOW ANION CHANNEL-ASSOCIATED 1 activation. Thus, it has been suggested that ethylene might function to induce stomatal closure synergistically with abscisic acid (ABA). Furthermore, it has also been shown that increased ethylene can inhibit ABA- and jasmonic acid-induced stomatal closure, thus hindering drought-induced closure during dehydration. Simultaneously, other stresses, such as chilling, ozone pollution, and K+ deficiency, inhibit drought- and ABA-induced stomatal closure in an ethylene synthesis-dependent manner. However, ethylene has been shown to take on an opposing role during rehydration, preventing stomatal opening in the absence of ABA through its own signaling pathway. These findings offer novel insights into the function of ethylene in stomatal regulation during dehydration and rehydration, giving a better understanding of the mechanisms underlying ethylene-induced stomatal movement in seed plants.
The GALAH survey: elemental abundances in open clusters using joint effective temperature and surface gravity photometric priors
Authors: Beeson Kevin L , Kos Janez , de Grijs Richard , Martell Sarah L , Buder Sven , Traven Gregor , Lewis Geraint F , Zafar Tayyaba , Bland-Hawthorn Joss , Freeman Ken C , Hayden Michael , Sharma Sanjib , De Silva Gayandhi M
Published: February 2024

The ability to measure precise and accurate stellar effective temperatures (Teff) and surface gravities (log (g)) is essential in determining accurate and precise abundances of chemical elements in stars. Measuring log (g) from isochrones fitted to colour–magnitude diagrams of open clusters is significantly more accurate and precise compared to spectroscopic log (g). By determining the ranges of ages, metallicity, and extinction of isochrones that fit the colour–magnitude diagram, we constructed a joint probability distribution of Teff and log (g). The joint photometric probability shows the complex correlations between Teff and log (g), which depend on the evolutionary stage of the star. We show that by using this photometric prior while fitting spectra, we can acquire more precise spectroscopic stellar parameters and abundances of chemical elements. This reveals higher-order abundance trends in open clusters like traces of atomic diffusion. We used photometry and astrometry provided by the Gaia DR3 catalogue, Padova isochrones, and Galactic Archaeology with HERMES (GALAH) DR4 spectra. We analysed the spectra of 1979 stars in nine open clusters, using MCMC to fit the spectroscopic abundances of 26 elements, Teff, log (g), vmic, and vbroad. We found that using photometric priors improves the accuracy of abundances and log (g), which enables us to view higher order trends of abundances caused by atomic diffusion in M67 and Ruprecht 147.
A statistical and multiwavelength photometric analysis of a young embedded open star cluster: IC 1590
Authors: Sheikh A H , Medhi Biman J
Published: February 2024

We present a statistical and multiwavelength photometric studies of young open cluster IC 1590. We identified 91 cluster members using Gaia DR3 astrometry data using ensemble-based unsupervised machine learning techniques. From Gaia EDR3 data, we estimate the best-fitting parameters for IC 1590 using the Automated Stellar Cluster Analysis package (asteca) yielding the distance d ∼ 2.87 ± 0.02 kpc, age ∼ 3.54 ± 0.05 Myr, metallicity z ∼ 0.0212 ± 0.003, binarity value of ∼ 0.558, and extinction Av ∼ 1.252 ± 0.4 mag for an Rv value of ∼ 3.322 ± 0.23. We estimate the initial mass function slope of the cluster to be α = 1.081 ± 0.112 for single stars and α = 1.490 ± 0.051 for a binary fraction of ∼ 0.558 in the mass range 1 M⊙ ≤ m (M⊙) ≤ 100 M⊙. The G-band luminosity function slope is estimated to be ∼ 0.33 ± 0.09. We use (J − H) versus (H − Ks) colour–colour diagram to identify young stellar objects (YSOs). We found that all the identified YSOs have ages ≤ 2 Myr and masses ∼ 0.35 – 5.5 M⊙. We also fit the radial surface density profile. Using the galpy, we performed orbit analysis of the cluster. The extinction map for the cluster region has been generated using the PNICER technique, and it is almost similar to the dust structure obtained from the 500 μm dust continuum emissions map of Herschel SPIRE. We finally at the end discussed the star formation scenario in the cluster region.
Magnetic field alignment in low-mass molecular clouds: the role of turbulence and density of the clouds
Authors: Barman B , Das H S
Published: February 2024

In this work, we report the role of turbulence (measured by the $^{12}\mathrm{ CO}$ linewidth, $\Delta V$) on the offset between the orientation of local magnetic field in the low-density regions of dark clouds ($\theta ^{\mathrm{ env}}_\mathrm{ B}$) and the position angle of the Galactic Plane (GP; $\theta _{\mathrm{ GP}}$) in 15 low-mass isolated molecular clouds. We find a dependency of $\Delta V$ on offset, ($\theta _{\mathrm{ off}} =|\theta ^{\mathrm{ env}}_\mathrm{ B}-\theta _{\mathrm{ GP}}|$), represented by a second-order polynomial equation, $\theta _{\mathrm{ off}}=(3.328 \pm 1.187) {\Delta V}^2 - (0.991 \pm 5.541) {\Delta V} + (4.767 \pm 5.309)$. In regions where the majority of low turbulence is observed, characterized by $\Delta V \ \lt\ 3.1 \ \mathrm{ km\,s}^{-1}$, the envelope magnetic fields closely align with the orientation of the GP ($\theta _{\mathrm{ off}}\ \lt\ 20^\circ$). Conversely, in areas exhibiting high turbulence with $\Delta V \ \gt\ 3.1 \ \mathrm{ km\,s}^{-1}$ (for clouds CB130 and CB188), the envelope magnetic field tends to misalign with the GP ($\theta _{\mathrm{ off}}\ \gt\ 50^\circ$). This suggests that turbulence could be one of the important factors influencing the alignment of the local magnetic field with the GP. We have also explored the potential link between gas density of clouds ($\rho$) and turbulence ($\Delta V$) for the first time, utilizing data from 10 isolated clouds. This analysis suggests a possible correlation, with the observed trend quantified as, $\Delta V \propto \rho ^{-0.19}$.
The Density of Regulatory Information Is a Major Determinant of Evolutionary Constraint on Noncoding DNA in Drosophila
Authors: Sabarís Gonzalo , Ortíz Daniela M , Laiker Ian , Mayansky Ignacio , Naik Sujay , Cavalli Giacomo , Stern David L , Preger-Ben Noon Ella , Frankel Nicolás
Published: February 2024

Evolutionary analyses have estimated that ∼60% of nucleotides in intergenic regions of the Drosophila melanogaster genome are functionally relevant, suggesting that regulatory information may be encoded more densely in intergenic regions than has been revealed by most functional dissections of regulatory DNA. Here, we approached this issue through a functional dissection of the regulatory region of the gene shavenbaby (svb). Most of the ∼90 kb of this large regulatory region is highly conserved in the genus Drosophila, though characterized enhancers occupy a small fraction of this region. By analyzing the regulation of svb in different contexts of Drosophila development, we found that the regulatory information that drives svb expression in the abdominal pupal epidermis is organized in a different way than the elements that drive svb expression in the embryonic epidermis. While in the embryonic epidermis svb is activated by compact enhancers separated by large inactive DNA regions, svb expression in the pupal epidermis is driven by regulatory information distributed over broader regions of svb cis-regulatory DNA. In the same vein, we observed that other developmental genes also display a dense distribution of putative regulatory elements in their regulatory regions. Furthermore, we found that a large percentage of conserved noncoding DNA of the Drosophila genome is contained within regions of open chromatin. These results suggest that part of the evolutionary constraint on noncoding DNA of Drosophila is explained by the density of regulatory information, which may be greater than previously appreciated.
Treatment of polymyalgia rheumatica: British Society for Rheumatology guideline scope
Authors: Toyoda Task , Armitstead Zoe , Bhide Sampada , Engamba Serge , Henderson Emma , Jones Claire , MacKeith Pieter , Maddock Janice , Reynolds Gary , Scrafton Nicola , Subesinghe Manil , Subesinghe Sujith , Twohig Helen , Mackie Sarah L , Yates Max
Published: February 2024

The last British Society for Rheumatology (BSR) guideline on PMR was published in 2009. The guideline needs to be updated to provide a summary of the current evidence for pharmacological and non-pharmacological management of adults with PMR. This guideline is aimed at healthcare professionals in the UK who directly care for people with PMR, including general practitioners, rheumatologists, nurses, physiotherapists, occupational therapists, pharmacists, psychologists and other health professionals. It will also be relevant to people living with PMR and organisations that support them in the public and third sector, including charities and informal patient support groups. This guideline will be developed using the methods and processes outlined in the BSR Guidelines Protocol. Here we provide a brief summary of the scope of the guideline update in development.
The influence of virginiamycin on digestion and ruminal parameters under feedlot conditions
Authors: Dias Batista Luiz F , Rivera Madeline E , Fonseca Mozart A , Tedeschi Luis O
Published: February 2024

This experiment aimed to assess the impact of virginiamycin on in vitro gas production dynamics, rumen kinetics, and nutrient digestibility in beef steers fed a grain-based diet. Nine ruminally cannulated British-crossbred steers (596 ± 49 kg) were assigned to this experiment. Animals were housed in three pens (n = 3/pen) equipped with a Calan gate feed system and water troughs. Pens were enrolled in a 3 × 3 Latin square design containing three periods of 16 d, and a 5-d washout interval between periods. Dietary treatments consisted of virginiamycin (VM) administration at 0 (VM0), 180 (VM180), or 240 mg/d (VM240). During days 15 and 16 of each period, about 600 mL of rumen fluid and urine samples were collected before (0 h), and at 4, 8, 12, and 16 h after the morning feed (0730 hours), rumen inoculum was used to take pH and redox potential measurements immediately after collection using a portable pH and redox meter, and subsamples were taken for volatile fatty acids (VFA) and NH3–N analyses, and urine samples were composited daily and analyzed for creatinine and purine derivatives (PD) content to estimate microbial crude protein flow. During the 4-h post-morning feed rumen collection, rumen inoculum was utilized to perform in vitro gas production measurements. Fecal samples were collected on day 16 of each period to estimate nutrient digestibility using acid detergent insoluble ash as an internal marker. Animals were considered the experimental unit for the statistical analyses, and periods and squares were included as random variables. The total and rate of gas production were similar among treatments (P ≥ 0.17). The second-pool (i.e., fiber) gas production increased linearly as VM inclusion increased (P = 0.01), with VM240 being greater compared to VM180 and VM0 (7.84, 6.94, and 6.89 mL, respectively). Ruminal pH linearly increased as VM increased, with VM240 being greater than VM0 and VM180 intermediate (5.90, 5.82, and 5.86, respectively; P = 0.03). The VFA concentrations did not differ (P ≥ 0.13), but the acetate-to-propionate ratio was the highest in VM240 (P = 0.005). Branched-chain VFA increased (P ≤ 0.03) while lactate concentrations decreased (P = 0.005) linearly with VM. The ruminal NH3–N concentration was the lowest in the VM0 (P = 0.006). The estimated absorbed PD, purine derivative to creatinine index, and microbial N flow increased linearly with VM (P ≤ 0.07). The provision of VM influenced rumen dynamics in a dose-dependent manner.
KCNH6 is essential for insulin secretion by regulating intracellular ER Ca2+ store
Authors: Xiong Feng‐Ran , Lu Jing , Zhu Juan‐Juan , Zhao Ru‐Xuan , Zhang Ying‐Chao , Yang Jin‐Kui
Published: February 2024

Appropriate Ca2+ concentration in the endoplasmic reticulum (ER), modulating cytosolic Ca2+ signal, serves significant roles in physiological function of pancreatic β cells. To maintaining ER homeostasis, Ca2+ movement across the ER membrane is always accompanied by a simultaneous K+ flux in the opposite direction. KCNH6 was proven to modulate insulin secretion by controlling plasma membrane action potential duration and intracellular Ca2+ influx. Meanwhile, the specific function of KCNH6 in pancreatic β‐cells remains unclear. In this study, we found that KCNH6 exhibited mainly ER localization and Kcnh6 β‐cell‐specific knockout (βKO) mice suffered from abnormal glucose tolerance and impaired insulin secretion in adulthood. ER Ca2+ store was overloaded in islets of βKO mice, which contributed to ER stress and ER stress‐induced apoptosis in β cells. Next, we verified that ethanol treatment induced increases in ER Ca2+ store and apoptosis in pancreatic β cells, whereas adenovirus‐mediated KCNH6 overexpression in islets attenuated ethanol‐induced ER stress and apoptosis. In addition, tail‐vein injections of KCNH6 lentivirus rescued KCNH6 expression in βKO mice, restored ER Ca2+ overload and attenuated ER stress in β cells, which further confirms that KCNH6 protects islets from ER stress and apoptosis. These data suggest that KCNH6 on the ER membrane may help to stabilize intracellular ER Ca2+ stores and protect β cells from ER stress and apoptosis. In conclusion, our study reveals the protective potential of KCNH6‐targeting drugs in ER stress‐induced diabetes.
TRAF2 decrease promotes the TGF‐β‐mTORC1 signal in MAFLD‐HCC through enhancing AXIN1‐mediated Smad7 degradation
Authors: Li Zhonglin , Zhao Jinfang , Wu Ya , Fan Siyuan , Yuan Hang , Xia Jing , Hu Lilin , Yang Jingze , Liu Jiazheng , Wu Xuefeng , Lin Rong , Yang Ling
Published: February 2024

According to recent research, metabolic‐associated fatty liver disease (MAFLD) has emerged as an important underlying etiology of hepatocellular carcinoma (HCC). However, the molecular mechanism of MAFLD‐HCC is still unclear. Tumor necrosis factor receptor‐associated factor 2 (TRAF2) is the key molecule to mediate the signal of inflammatory NF‐κB pathway. This study aims to investigate the potential dysregulation of TRAF2 and its biological function in MAFLD‐HCC. Huh7 TRAF2−/− demonstrated increased tumor formation ability compared to huh7 TRAF2+/+ when stimulated with transforming growth factor‐β (TGF‐β). The decisive role of TGF‐β in the development of MAFLD‐HCC was confirmed through the specific depletion of TGF‐β receptor II gene in the hepatocytes (Tgfbr2ΔHep) of mice. In TRAF2−/− cells treated with TGF‐β, both the glycolysis rate and lipid synthesis were enhanced. We proved the signal of the mechanistic target of rapamycin complex 1 (mTORC1) could be activated in the presence of TGF‐β, and was enhanced in TRAF2−/− cells. The coimmunoprecipitation (co‐IP) experiments revealed that TRAF2 fortified the Smurf2‐mediated ubiquitination degradation of AXIN1. Hence, TRAF2 depletion resulted in increased Smad7 degradation induced by AXIN1, thus promoting the TGF‐β signal. We also discovered that PLX‐4720 could bind with AXIN1 and restrained the tumor proliferation of TRAF2−/− in mice fed with high‐fat diet (HFD). Our findings indicate that TRAF2 plays a significant role in the pathogenesis of MAFLD‐HCC. The reduction of TRAF2 expression leads to the enhancement of the TGF‐β‐mTORC1 pathway by facilitating AXIN1‐mediated Smad7 degradation.
Comparison of Different Treatments of Persistent Pulmonary Hypertension of the Newborn: A Systematic Review and Network Meta-Analysis
Authors: Fei Qiang , Pan Jiarong , Zhang Feizhou , Lin Yu , Yuan Tianming
Published: February 2024

Objectives:

Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening disease. Despite being considered the gold standard treatment scheme, inhaled nitric oxide (iNO) is not readily available in settings with limited resources. Therefore, in recent years, research on related drugs is being actively pursued. Herein, we aimed to use random-effects network meta-analysis to evaluate the efficacy and associated mortality of different PPHN therapies.

Data Sources:

We electronically searched the PubMed, Embase, and Cochrane Library for data up to January 27, 2023.

Study Selection:

Randomized controlled trials involving neonates with PPHN assessing efficacy and mortality of various treatments.

Data Extraction:

Details of study population, treatments, and outcomes were extracted.

Data Synthesis:

Direct pairwise comparisons and a network meta-analysis was performed under random effects. The ranking probability was further assessed based on the surface under the cumulative ranking curve (SUCRA). We analyzed 23 randomized clinical trials involving 902 newborns with PPHN. Sixteen different treatment strategies were compared with each other and conventional therapy (CON). A median concentration of 10–20 parts per million (ppm) iNO (MNO) coupled with sildenafil orally administered at a dose of 1–3 mg/kg/dose every 6–8 hours (OSID) demonstrated the best efficacy (MNO + OSID vs. CON: odds ratio [OR] = 27.53, 95% CI, 2.36–321.75; SUCRA = 0.818, ranking first; moderate quality). OSID combined with milrinone administered IV also performed well in terms of efficacy (OSID + milrinone vs. CON: OR = 25.13, 95% CI = 1.67–377.78; SUCRA = 0.811, ranking second; low quality) and mortality reduction (CON vs. OSID + milrinone: OR = 25.13, 95% CI = 1.67–377.78; SUCRA = 0.786, ranking last; low quality).

Conclusions:

MNO + OSID is the most effective PPHN treatment. If iNO is not available, OSID + milrinone is preferred.
Associations between prenatal blood metals and vitamins and cord blood peptide hormone concentrations
Authors: Smith Anna R. , Lin Pi-I D. , Rifas-Shiman Sheryl L. , Switkowski Karen M. , Fleisch Abby F. , Wright Robert O. , Coull Brent , Oken Emily , Hivert Marie-France , Cardenas Andres
Published: February 2024

Background:

Nonessential metals have endocrine-disrupting properties, interfere with cellular processes, generate reactive oxygen, and deplete antioxidants, while essential metals and vitamins act as antioxidants. The extent to which prenatal metals and vitamins are associated with cord blood hormones involved in maternal and fetal metabolic and growth processes is unknown.

Methods:

We measured six nonessential (arsenic, barium, cadmium, cesium, lead, and mercury) and four essential (magnesium, manganese, selenium, and zinc) metals and trace elements, and two vitamins (B12 and folate) in first-trimester blood from participants in the longitudinal prebirth Project Viva cohort, who were recruited between 1999 and 2002 in eastern Massachusetts. We measured adiponectin, C-peptide, insulin-like growth factor (IGF)-1, IGF-2, IGF binding protein (IGFBP)-3, insulin, and leptin concentrations in cord blood (~n = 695). We used covariate-adjusted quantile g-computation for mixtures and linear regression for individual exposures to estimate associations with cord blood peptide hormones.

Results:

The essential metal mixture (magnesium, manganese, selenium, and zinc) was associated with higher IGF-1 (β = 3.20 ng/ml per quartile; 95% CI = 0.39, 6.01), IGF-2 (β = 10.93 ng/ml; 95% CI = 0.08, 21.79), and leptin (β = 1.03 ng/ml; 95% CI = 0.25, 1.80). Magnesium was associated with higher leptin (β = 2.90 ng/ml; 95% CI = 0.89, 4.91), while B12 was associated with lower adiponectin, IGF-2, and leptin but higher C-peptide. Other individual nonessential metals were associated with cord blood hormones.

Conclusions:

Our findings suggest that some prenatal metals and vitamins are associated with cord blood hormones, which may influence growth and development.
The Effect of Benson's Relaxation Technique on Fatigue and Quality of Life of Patients Diagnosed With Heart Failure
Authors: Heif Dunia M. , Masa'Deh Rami , AbuRuz Mohannad Eid , Hamaideh Shaher H. , Rayan Ahmad , Al-Yateem Nabeel
Published: February 2024

Patients with heart failure (HF) reported poor quality of life (QOL) due to different reasons among which fatigue is the most important. Improving QOL is a crucial objective for patients with HF and their primary health care providers. Managing fatigue with medication is not enough. Benson's relaxation technique (BRT) is a complementary therapy used to manage fatigue among different populations with limited studies checking its effect among patients diagnosed with HF. The purpose of this quasi-experimental study was to check the effect of BRT on fatigue and QOL among 140 (68 intervention and 72 control) patients diagnosed with HF. Intervention group performed BRT for 20 minutes twice a day for 2 months. Control group received regular care from their health care providers. At baseline, there were no differences between intervention and control groups regarding fatigue, physical component summary, and mental component summary. At follow-up, intervention group had higher scores in physical and mental component summaries than control group (45.48 ± 10.52 vs 37.97 ± 14.78) and (46.22 ± 8.39 vs 41.01 ± 10.36), respectively. Also, intervention group had lower levels of fatigue than control group (2.54 ± 0.87 vs 6.33 ± 0.61). In conclusion, the use of BRT as a complementary therapy for patients with HF might decrease fatigue level and improve QOL.
What Does a Community Think About Aromatherapy?
Authors: Gökkaya İçim , Koçer Gökçe Gül , Renda Gülin
Published: February 2024

The awareness and usage of aromatherapy applications are increasing day by day in society. The current study aims to evaluate the thoughts and attitudes of individuals toward aromatherapy in Türkiye and to determine factors affecting the use of aromatherapy. This community-based descriptive study is conducted throughout Türkiye. Nine hundred eighty-five questionnaires were suitable for data quality. SPSS 23.0 statistical package program was used, and the statistical significance level was accepted as P value of less than .05. Approximately 72.4% of the participants have heard of aromatherapy. The rate of hearing about the concept of aromatherapy was found to be statistically significantly higher among women (P = .000), those residing in a province/district (P = .011), and those working in an income-generating positions (P = .003). It was determined that 58.9% of the participants used any essential oil. The 5 most commonly used essential oils are lavender, tea tree, peppermint, rose, and thyme, respectively. The rate of essential oil use in women is higher than in men (P = .000). The conditions in which essential oils are most frequently used are to provide beauty to the skin (51.7%), skin diseases (51.0%), and respiratory tract diseases (46.0%), respectively. The most common sources of information about the essential oils used by the participants are the Internet/social media (57.6%) and pharmacists (53.4%). The results of this research revealed that the awareness and use of aromatherapy practice in the community are high according to the literature. Considering the high tendency to use these products among the public, physicians, pharmacists, and nurses must provide consultancy services on the use of these products.
Long-Term Results of the Linear Incision Technique With Tissue Reduction Versus Tissue Preservation for Inserting Bone-Anchored Hearing Implants: The Ongoing Optimization in Bone Implant Surgery
Authors: Lindeboom Jantine J. , Labbé Nilou , Strijbos Ruben M. , van den Elsen-Hutten Marjo , van Huffelen Wim , Teunissen Emma M. , Hol Myrthe K.S. , Bom Steven J.H.
Published: February 2024

Objective

To compare the long-term outcomes of the linear incision technique with tissue reduction (LIT-TR) and the linear incision technique with tissue preservation (LIT-TP) for inserting bone-anchored hearing implants (BAHIs).

Study design

Single-center retrospective cohort study.

Setting

Large general teaching hospital.

Patients

A total of 231 adult patients were included between August 2005 and October 2020, with a minimum follow-up time of 6 months.

Intervention

The test group received a BAHI using the LIT-TP (N = 147). The control group underwent surgery using the LIT-TR (N = 84).

Main outcome measures

Soft tissue reactions, skin thickening, postoperative complications (e.g., wound dehiscence), and implant loss were compared between the test and control group. Furthermore, Cochlear Bone Anchored Solutions AB (Mölnlycke, Sweden) and Oticon Medical AB (Askim, Sweden) implants/abutments within the LIT-TP cohort were compared. Validated questionnaires were used to quantify patients' health-related quality of life (HRQoL).

Results

Significantly more cases with wound dehiscence and adverse soft tissue reactions (Holgers ≥2) were observed in the LIT-TR cohort (p < 0.001). However, the LIT-TP cohort showed significantly more cases with skin thickening (requiring treatment) within the first 2 years after implantation. There were no differences in implant loss rates, overall soft tissue reactions (Holgers >1), and overall HRQoL between the two patient groups. Significant improvement in the patients' HRQoL after implementation of a BAHI was found in both techniques. The Ponto Wide implant/abutment showed less frequent skin thickening (requiring treatment) and fewer soft tissue reactions compared with the BIA400 implant/abutment.

Conclusion

This large-scale study demonstrates that the LIT-TP shows excellent long-term outcomes, including a low incidence of implant failure.
Cochlear Otosclerosis and Secondary Hydrops (Ménière’s Syndrome)
Authors: Rajan Dilshan , Cureoglu Sebahattin , da Costa Monsanto Rafael
Published: February 2024

This article discusses a case of cochlear otosclerosis leading to secondary hydrops and near-complete hearing loss. Histopathological examination revealed advanced multifocal otosclerosis in both temporal bones, with specific focus on cochlear invasion and significant bone resorption. The severity of the case ruled out surgical intervention due to the risk of further hearing loss. The article emphasizes the challenges in managing otosclerosis-related hydrops and highlights the potential use of advanced imaging techniques for diagnosis. The study underscores the complexity of otosclerosis-induced hearing loss, contributing to the understanding of this pathology and its impact on auditory function.
Functional Hearing Preservation in Cochlear Implantation: The Miami Cocktail Effect
Authors: Angeli Simon Ignacio , Brown C. Scott , Holcomb Meredith A. , Velandia Sandra L. , Eshraghi Adrien A. , Chiossone-Kerdel Juan Armando , Hoffer Michael E. , Sanchez Chrisanda , Telischi Fred F.
Published: February 2024

Objective

To investigate if pharmacological treatment with prednisone and L-N-acetylcysteine (STE + NAC) influence functional hearing preservation in cochlear implant (CI) surgery.

Study Designs

Preimplantation and postimplantation longitudinal case–control study.

Setting

Tertiary referral center.

Patients

Pediatric and adult recipients of CI with preimplantation functional hearing defined as an average of air-conducted thresholds at 125, 250, and 500 Hz (low-frequency pure-tone average [LFPTA]) <80 dB.

Interventions

Preimplantation and postimplantation audiometry. Weight-adjusted oral prednisone and L-N-acetylcysteine starting 2 days before surgery (Miami cocktail). Prednisone was continued for 3 days and L-N-acetylcysteine for 12 days after surgery, respectively. Cochlear implantation with conventional length electrodes.

Main Outcome Measures

Proportion of patients with LFPTA <80 dB, and LFPTA change at 1-year postimplantation.

Results

All 61 patients received intratympanic and intravenous dexamethasone intraoperatively, with 41 patients receiving STE + NAC and 20 patients not receiving STE + NAC. At 1-year postimplantation, the proportion of functional hearing preservation was 83% in the STE + NAC group compared with 55% of subjects who did not receive STE + NAC (p = 0.0302). The median LFPTA change for STE + NAC-treated and not treated subjects was 8.33 dB (mean, 13.82 ± 17.4 dB) and 18.34 dB (mean, 26.5 ± 23.4 dB), respectively (p = 0.0401, Wilcoxon rank test). Perioperative STE + NAC treatment resulted in 10 dB of LFPTA better hearing than when not receiving this treatment. Better low-frequency preimplantation hearing thresholds were predictive of postimplantation functional hearing. No serious side effects were reported.

Conclusion

Perioperative STE + NAC, “The Miami Cocktail,” was safe and superior to intraoperative steroids alone in functional hearing preservation 1-year after cochlear implantation.
Analysis of the current state of cervical cancer prevention awareness and its influencing factors among rural women in Luohe City
Authors: Zhang Qingwei , Zhang Weikai , Xu Tenghan , Song Jiayu , Li Suhong , Zhang Hewei , Fu Xiuhong
Published: February 2024

The purpose of this cross-sectional study was to identify the current awareness about cervical cancer prevention among rural women in Luohe City as well as its potential influencing factors. Meanwhile, these data were expected to provide a theoretical basis for Luohe future cervical cancer prevention and therapy. Based on geographical distribution, 40 villages in Luohe City were randomly selected, and questionnaires were given to women in each village. In this study, a total of 4665 questionnaires were distributed, and 4561 valid questionnaires were returned, with a recovery rate of 97.98%. The average score was 4.06 ± 2.46 out of 10. It was found that women had a high awareness rate of cervical cancer screening (55.25%) but a low awareness rate of human papillomavirus (HPV) and HPV vaccine (10.17%). Moreover, univariate and multivariable analyses showed that age > 45 years, low household income, low education level, being a farmer, spouse unemployment, no pregnancy or birth delivery history, no family or personal history of cervical disease, and no previous complimentary 2-cancer screening (i.e., breast cancer and cervical cancer) were all factors influencing the cognitive level of rural women in Luohe City (P < .05). However, ethnicity, marital status, and spouse education level were not correlated with cognitive level (P > .05). In conclusion, low awareness of cervical cancer prevention among rural women in Luohe was correlated with individual, family, and social factors. So it was recommended to cultivate the rural population knowledge, optimize screening strategies, and conduct targeted cervical cancer prevention and treatment in rural regions.
Effect of fire needle combined with traditional Chinese medicine on psoriasis: A systematic review and meta-analysis
Authors: Xu Jinglun , Zhou Qiujun , Xie Fan , Cao Yi , Yang Xiaohong , Tao Maocan
Published: February 2024

Background:

The mechanism of action of fire acupuncture and Chinese medicine in psoriasis is unclear. In this paper, the efficacy of the 2 therapies was compared through a comprehensive analysis of their recurrence rates for clinical reference.

Methods:

In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM data from the establishment of the databases to May 2023. The study proposed to use randomized controlled trial research methods, excluding published literature, unpublished literature, literature with incomplete or inadequate information, animal experiments, literature reviews and systematic studies. Data were processed using STATA 15.1 software.

Results:

Our group previous study found that the clinical efficacy of the fire-acupuncture group was significantly improved compared to that of Chinese herbal medicine alone (RR = 1.20, 95% CI: 1.13–1.27). Also, there were significant reductions in Psoriasis Area and Severity Index (PASI) score (SMD = −1.04,95% CI: −1.48 to −0.60), area of skin damage (SMD = −0.40,95% CI: −0.75 to −0.04), and pruritus (SMD = −1.04,95% CI: −1.32 to −0.76). Our previous study found that Dermatology Life Quality Index (DLQI) was significantly lower in the fire acupuncture group compared to herbal medicine alone (SMD = −1.61,95% CI: −3.08 to −0.15). The combined analysis found that the recurrence rate was significantly lower in the fire-acupuncture group compared to herbal medicine alone (RR = 0.21,95% CI:0.07–0.60).

Conclusion:

Fire needle can improve the efficacy of TCM in the treatment of psoriasis, including the area, severity and itching of skin lesions, and reduce the recurrence rate, which is worthy of clinical promotion.