bluuebunny/crossref_metadata_2025 huggingface dataset:
396 Rotator Cuff Assessment Following Traumatic Anterior Shoulder Dislocation
Authors: Nair G. , Ramasubbu R. , Wilson S. , Liao Q. , Chambers M. , Chan K.
Published: February 2022

Aim

Glenohumeral joint dislocation is the most common traumatic joint dislocation with a high recurrence rate correlating with age at first dislocation. There is an associated increased incidence in concurrent rotator cuff tears with increasing age affecting 40% aged 40–60. Patient care was assessed against BESS/BOA standard: These patients should have rotator cuff assessment and those aged 40–60 should undergo routine MRI/Ultrasound imaging.

Method

All patients admitted to the emergency departments of the 3 Lanarkshire hospitals undergoing first time traumatic anterior dislocation of the shoulder in February 2021 were included. This was the third cycle of this audit. Previous interventions were presentation at a CPD meeting after cycle one and an NHS Lanarkshire regional meeting after cycle two.

Results

Cycle one (2018)-14 patients. 3/14 underwent rotator cuff assessment. 5/14 aged 40–60. 1/5 underwent rotator cuff imaging.

Cycle two (2020)-11 patients. 0/9 underwent rotator cuff assessment (Two excluded as managed operatively). 4/11 aged 40–60. 0/4 underwent rotator cuff imaging.

Cycle three (2021)-13 patients. 3/11 underwent rotator cuff assessment (Two excluded as managed operatively). 3/13 aged 40–60. 0/3 underwent rotator cuff imaging.

Conclusions

Although a slight improvement has been made over the 3 cycles with rotator cuff assessment the BOA standard is not being met. There has been no improvement in the additional imaging required in traumatic anterior shoulder dislocations in those aged 40–60 over the 3 cycles. These patients may develop pain, reduced function, and rotator cuff arthropathy. There is now an aim to introduce a pathway for these patients across the health board.
398 Abdominal X-Rays: Are They Still Relevant? a Review of Outcomes Following Emergency Abdominal Plain Films
Authors: Van P.T.M. , Masoodi S. , Cribbs E. , Pawa N.
Published: February 2022

Background

Abdominal plain films (AXR) have historically been a routine investigation in Surgical and Emergency Departments (ED), however when considering CT imaging yields significantly more diagnostic information, AXRs are ineffectual in comparison as an aid to decision making. With CT scanning and reporting readily available 24/7, are AXRs still practical?

Aim

To assess the utilisation and outcomes of emergency abdominal films.

Method

All emergency AXRs performed across the trust in a 15-day period were identified retrospectively from our electronic database and were compared with outcomes obtained from our electronic record system.

Results

248 emergency AXRs were performed, 153 Emergency Department and 95 inpatient (IP) requests. 163 (66%) were reported normal, 85 (34%) as abnormal. Of those reported as normal, 26% had further imaging (30% from ED, 17% from IP). Of those reported abnormal, 49% had no further imaging performed (62% from ED, 37% from IP). The odds ratio of admission between ED patients with a significant AXR and an insignificant AXR was 1.34 (95%CI: 0.68–2.83, p<0.05).

Conclusions

One quarter of AXRs reported as normal underwent further imaging, but almost half of the AXRs with reported pathologies did not. This suggests that the usefulness of AXRs acutely is limited, as the presence or absence of abnormalities on the AXR was not a reliable predictor of further investigation nor patient outcome. We therefore suggest re-examination of their utilisation.
408 Blood Parameters as an Early Indicator of Complications Following Oesophagogastric Resection
Authors: Nair G. , Haque S. , Wilson M.
Published: February 2022

Aim

Oesophageal and gastric cancers are the eighth and fifth most prevalent cancers with a high degree of morbidity and mortality. Oesophagogastric resections are associated with a high degree of complications postoperatively. Complications following resection are associated with poorer hospital recovery, recurrence of cancer, readmission to hospital and increased mortality. A study was carried out to examine if there was an association between post-operative bloods and the development of complications.

Method

Data was collected from theatre logbooks, Integrated Clinical Environment (ICE) and clinical portal. Patients undergoing oesophagogastric resection for gastric and oesophageal cancer between October 2010 and November 2014 were included. Complications were organised using the Clavien Dindo classification. Data was analysed using the Student’ T test and Chi-Squared test. A P-value of 0.05 was classed as being statiscally significant.

Results

94 patients met the inclusion criteria for this study. 55 patients (58.5%) underwent Oesophagectomy, 18 (19.1%) total gastrectomy and 21 (22.3%) partial gastrectomy. A significant association was seen between development of complications and higher Day 5 White Cell count (WCC) (p = 0.048), lower Day 2–5 Albumin (Day 2 Albumin p = 0.038) and higher Day 2–5 C Reactive Protein (CRP) (Day 2 CRP p<0.001).

Conclusions

This study suggests Albumin, CRP and WCC may be used to predict postoperative complications in patients undergoing oesophagogastric resections for malignancy. Changes in the blood parameters present as early as day 2 postoperatively and can highlight patients who require closer monitoring, allowing earlier re-intervention if required.
411 Mesenchymal Stem Cells for Shoulder Tendon Injury and Osteoarthritis
Authors: Yasen Z. , Funk L.
Published: February 2022

Introduction

In recent years there has been a boom in the advancements and research in mesenchymal stem cells (MSCs) injections for tissue regeneration. This has led to commercial products and early adoption of the technology. High profile cases, media and internet prominence of stem cell therapies have led to a patient demand for the treatment for numerous traumatic and degenerative musculoskeletal conditions.

Aim

In this article we aim to review the evidence for mesenchymal stem cell therapy so far, focusing on its use in osteoarthritis and specifically tendon repair within the shoulder.

Method

Through the database PubMed, the search included all animal models and clinical trials assessing the use of mesenchymal stem cells for treatment of osteoarthritis or rotator cuff pathology, up to the year 2018.

Results

We identified 20 animal studies (95% positive findings) and 17 human studies (94% positive findings) for Osteoarthritis (OA) (399 patients assessed), however all therapy was targeted at the knee. Rotator cuff tear studies yielded 8 animal studies findings and 3 human studies (100% positive findings in both) (106 patients assessed).

Conclusions

There is a reasonable body of evidence to support its use for the early stages of OA and as such phase III trials should be implicated. Evidence to support use of MSCs for rotator cuff tendon pathology is still in early stages with variable significance, but promising. More trials need to be done to assess its efficacy for injection both at the point of surgical repair and in non-surgical patients.
419 Medium- Long Term Clinical Outcome of Distal Metaphyseal Metatarsal Osteotomy (DMMO) for Lesser Toe Metatarsalgia
Authors: Ekpo E. , Inegbedion E. , Ball T.
Published: February 2022

Aim

The surgical management of metatarsalgia is usually with an intra-articular Weil’s type of metatarsal osteotomy. Minimally invasive surgery has become increasing successful for a variety of forefoot conditions. Performing a distal metaphyseal metatarsal osteotomy to decompress the affected ray may result in substantial improvement to quality of life. The aim of this study was to evaluate the outcome of patients following minimally invasive distal metaphyseal metatarsal osteotomy surgery (DMMO).

Method

This is a single-centre consecutive series of 12 patients who underwent DMMO. The aim was to decompress the affected rays and restore metatarsal parabola. DMMO was performed under image intensifier, using burrs inserted via stab incisions. Clinical data was recorded and pre-operatively and immediately post operatively Manchester-Oxford Foot Questionnaire (MOXFQ) scores were collected. Another MOXFQ score was then collected with a minimum follow-up period of 12 months to ascertain is scores had improved in the interim.

Results

Average age of patients was 57years. The sex ratio was M:F 8:4. The average pre-operative MOXFQ score was 36. The average immediate post-operative MOXFQ score was 25. The average follow-up MOXFQ was 16. The reduction in MOXFQ score with a minimum of 12 months follow up was statistically significant (p<0.0040)

Conclusions

DMMO is a safe and effective method for the treatment of metatarsalgia with low complication rates. Our study highlights that clinical improvement of patient’s symptoms may take up to 12 months and beyond following surgery. This should be reiterated to patients prior to surgical intervention.
420 ResPect Forms for ENT Inpatients: An Audit (Complete Cycle)
Authors: Hussain S. , Collines R. , Thakar S.
Published: February 2022

Aim

To ascertain the percentage of ReSPECT forms completed by the time of consultant review for ENT patients (section 4, resuscitation decision).

Method

Complete cycle, retrospective audit of ENT inpatient. Data was collected for three weeks. During first cycle there was total 42 patients included. In second phase there was 37 patients. Data was collected from patients' notes. We excluded patients whose ResPect form was not counter signed by the consultant within 24 hours of admission. Also, we excluded patients whose ResPect was signed after 72 hours of admission.

Results

We identified 42 patients between three weeks period from 18th of November-08th of December 2020. Out of which 40.47 % (n = 17) in patients had section 4, resuscitation decision completed. In second phase, we identified 37 patients between three weeks period from 12th of December 2020–1st of January 2021. Out of which 64.86 % (n = 17) in patients had section 4, resuscitation decision completed (Figure 1).

After the first phase, we added some recommendations, everyone needs to complete their RESPECT training (via ESR), check Respect form on ward round and SHO’s to complete Respect form when clerking new patient.

We added flow chart as well in our second phase to make sure, we adhere with the policy.

Conclusions

Add ReSPECT introduction in induction, especially when new SHO's are rotating. In additon, ReSPECT should be part of plan.
16 To What Extent, if Any, Do Software Developers Owe Patients a Duty of Care in the Event of Injury to Them When Clinicians Negligently Use AI Innovations and Technologies?
Authors: Kazzazi F.
Published: February 2022

Introduction

Artificial Intelligence software (AIS) brings the ability to assimilate and analyse tremendous amounts of information at super-human levels. This dawns an exhilarating era for diagnosis, investigation, resource-utility, and management. However, one must ensure that medicine's future evolves so to not jeopardize patients' health and rights in favour of operational gains. This work examines the duty of care that software developers (SD) may hold for patients.

Method/Results

In three sections, legal case analysis and medico-legal reasoning is used to explore how patient journeys, patient-doctor relationships, and hospital environments are changing. The first section discusses the medicolegal sphere in which AIS has developed. In section II, the hypothetical case of “Rogers & SD v. Whitaker” stimulates discussion on the first two components of the “three-stage” test for duty of care outlined in Caparo v. Dickmann. It scrutinizes the foreseeability of medical AIS outcomes and the proximity between SDs & patients.

The final section establishes the circumstances under which it may be “fair, just, and reasonable” for SDs to owe patients a duty of care. It deliberates the special relationships and “third agents” that emerge in traditional patient-doctor interactions. It examines how SDs design and deliver their AIS, and why this may impact rulings on a duty.

A modified threshold test is proposed that incorporates the idiosyncrasies of medical AIS when establishing the duty of care that SDs have towards patients. This test is re-applied to “Rogers & SD v. Whitaker” for insight into its real-world applicability.

Conclusions

Under specific conditions, SDs owe patients a duty of care.
62 Single- Versus Double-Layer Uterine Closure After Cesarean Section Delivery: A Systematic Review and Meta-Analysis
Authors: Kar I. , Qayum K.
Published: February 2022

Aim

To compare single-layer (SL) with double-layer (DL) uterine closure techniques after caesarean section in terms of ultrasonographic findings and rate of CS complications.

Method

PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant randomized clinical trials (RCTs). Retrieved articles were screened, and relevant studies were included in a meta-analysis. Continuous data were pooled as mean difference (MD) with 95% confidence interval (CI), and dichotomous data were pooled as relative risk (RR) and 95% CI. Analysis was conducted using RevMan software (Version 5.4).

Results

Eighteen RCTs were included in our study. Pooled results favoured DL uterine closure in terms of residual myometrial thickness (MD = -1.15, 95% CI [-1.69, -0.60], P < 0.0001) and dysmenorrhea (RR = 1.36, 95% CI [1.02, 1.81], P = 0.04), while SL closure had shorter operation time than DL closure (MD = -2.25, 95% CI [-3.29, -1.21], P < 0.00001). Both techniques had similar results in terms of uterine dehiscence or rupture (RR = 1.88, 95% CI [0.63, 5.62], P = 0.26), healing ratio (MD = -5.00, 95% CI [-12.40, 2.39], P = 0.18), maternal infectious morbidity (RR = 0.94, 95% CI [0.66, 1.34], P = 0.72), hospital stay (MD = -0.12, 95% CI [-0.30, 0.06], P = 0.18), and readmission rate (RR = 0.95, 95% CI [0.64, 1.40], P = 0.78).

Conclusions

DL closure of caesarean uterine scar is associated with more residual myometrial thickness and less dysmenorrhea compared with SL uterine closure. But SL closure has the advantage of the shorter operation time.
69 Hot Saline Irrigation for Haemostasis in Functional Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis
Authors: Ranford D. , Fu B. , Surda P. , Rudd J.
Published: February 2022

Aim

The aim of this study was to perform a systematic review and meta-analysis of existing evidence on the role of hot saline irrigation (HSI) in patients undergoing functional endoscopic sinus surgery (FESS) and its impact on the visibility of the surgical field (VSF).

Method

A search of PubMed, Cochrane, Ovid (including Embase, Medline and Allied and Complementary Medicine Database) databases as well as Google Scholar was performed.

Results

Three randomised control trials (RCT) were included. All three were pooled into meta-analysis which demonstrated a statistically significant better VSF (MD -0.51; 95% CI -0.84, -0.18; P = 0.003), a reduction in total blood loss (TBL) (MD -56.40ml; 95% CI -57.30. -55.51; P = <0.0001) and a reduction in operating time (OT) (MD -7.01mins; 95% CI 9.02mins; 95% CI -11.76, -6.28; P = <0.0001) during FESS in the HSI group compared with the room temperature irrigation control group. Further subgroup analysis of studies that did not use topical vasoconstrictors showed a significant reduction in TBL and OT. There were no reported adverse events related to HSI.

Conclusions

This is the first systematic review that addresses HSI for haemostasis in FESS. The results suggest that HSI in FESS for chronic rhinosinusitis may significantly improve VSF, reduce TBL by 20% and decrease OT by 9 minutes. HSI is cheap and a readily available intervention with a low risk of morbidity and adverse events. However, there are limitations of the study due to significant heterogeneity of methods, quality, and size of the studies.
163 A 12-Month Analysis of the Management of Patients with Potential Cauda Equina Syndrome (CES) via Virtual Consultations During the COVID-19 Pandemic
Authors: Bolton W. , Ktayen H. , Hartley B.
Published: February 2022

Aim

Approximately 2.6 million people see their GP for lower back pain (LBP) each year. Referrals for spinal surgery are increasing with varying effectiveness. Screening for neurosurgical red flags is critical to quickly identify the rare but serious causes of LBP, such as CES. The primary aim was to explore what effect COVID-19 had on the management pathway of these patients in primary care to investigate causes of LBP including ruling out CES.

Method

A service evaluation of all patients presenting to a large primary care provider in West Yorkshire with lower back pain who underwent MRI lumbar/sacral spine investigation between March 2020 and March 2021 was conducted.

Results

A total of 105 patients with matched MRI scans were included. Neurosurgical red flag screening was performed by virtual appointment only in 32 (30.5%) of patients. In 10 cases (9.5%), red flag screening was not documented. Radiological outcomes revealed three (2.9%) cases of CES. Thirty (28.6%) required onward referral to neurosurgery. The majority (n=56; 53%) had demonstrated radiological pathology amenable to conservative management.

Conclusions

During the pandemic, almost a third of patients in primary care did not receive a face-to-face examination to rule out red flags in lieu of virtual appointments and history alone. The majority of imaging revealed pathology that was amenable to conservative management. The safety of virtual consultations including telephone appointments to screen for neurosurgical pathology needs further investigation. If deemed safe, virtual patient pathways may be optimised to achieve effective recognition patients at risk of CES requiring neurosurgical intervention.
254 Simulation Matrix: Using Virtual Reality to Help Medical Students Transition into Clinical Practice During COVID-19
Authors: Sudin E. , Hiddema L. , Bahri S. , Khin-Htun S.Y. , Kythreotis N. , Coughlin T.
Published: February 2022

Aim

The COVID-19 pandemic has greatly impacted on undergraduate surgical education, as traditional teaching methods have been compromised leading to hesitancy and anxiety amongst medical students. This project provided an alternative teaching method using virtual reality (VR) headsets reducing the impact of the restrictions caused by COVID-19.

Method

23 medical students were enrolled. Clinical scenarios were randomly allocated. Each student completed pre- and post-session questionnaires. Student anxiety and mental preparedness were assessed using a 5-point Likert scale. Paired t-tests were used to analyse impact, and one-sample t-tests were used to assess student perceptions of VR. Results are presented as mean and 95% confidence intervals.

Results

VR simulations were found to have significantly increased clinical confidence in managing acutely unwell patients (0.91±0.39 points; p<0.0001) and improved mental preparedness to work in clinical setting (0.52±0.48 points; p=0.036). Our study also showed that VR simulation reduced students’ anxiety in managing acutely unwell patients (0.78±0.43 points; p=0.0011). 95.7% students strongly agreed that VR provides a psychologically safe training environment, and overall agreement was highly significant (mean score: 4.96±0.09, p<0.0001). 91.3% strongly agreed that VR training is a useful tool to help mental preparation for transition into clinical practice, and overall agreement was highly significant (mean score: 4.87±0.19, p<0.0001).

Conclusions

VR simulation can significantly improve student experience of, and mental preparedness, for transitioning into clinical practice. We would advocate regular use of VR headsets within the rapidly evolving world of surgical education.
318 Monopolar Versus Bipolar TURBT: Bradford Experience
Authors: Kale S. , Anwar A. , Gkikas C.
Published: February 2022

Aim

To compare the safety and efficacy of monopolar vs bipolar TURBT.

Method

This was a randomized control trial done over 18 months with patients being allotted randomly into the bipolar and monopolar arms. The study was carried out in the department of urology at BRI and YC. All consecutive patients undergoing TURBT for suspected bladder tumors were eligible for the study. The diagnosis was based on imaging and/or cystoscopy. Exclusion criteria included refusal to participate, unfitness for spinal anesthesia, and lack of tumor in the lateral wall. The primary objective was to compare the incidence of obturator jerk in monopolar and bipolar TURBT. The secondary objective was to study and compare the quality of histopathology specimen, detrusor muscle identification, and bladder perforation.

Results

A total of 95 transurethral resections were done over the study period. All these patients were eligible for inclusion in the study, 50 in monopolar and 45 in the bipolar arms, were analyzed. Both the study groups were comparable for age, sex, and tumor size. The incidence of obturator jerk was greater in the bipolar arm (8.8 %% vs 2%, P- value=2.25). The difference in the incidence of obturator jerk in the two arms was not statistically significant (Chi-Square test). There was no significant difference in either of the secondary outcomes.

Conclusions

The bipolar transurethral resection of the bladder tumor was not superior to monopolar resection concerning the obturator jerk, bladder perforation, and histopathological quality of the resected specimen.
361 Short Term Outcomes of Urological Cancers During COVID-19, an Analysis of the COVIDSurg-Cancer Study
Authors: Chan V.W.S. ,   COVIDSurg-Cancer Collaborators,   British Urology Researchers in Surgical Training Collaborators
Published: February 2022

Aim

We assessed the short-term outcomes and characteristics of urological cancer patients operated on during the COVID-19 pandemic. This is the first time these outcomes are assessed in urological patients on a large scale.

Method

All bladder, kidney, and prostate cancer patients who underwent elective cancer surgery between March 2020 and July 2020 in the international COVIDSurg-Cancer collaborative database were included in the study. The primary outcome was 30-day mortality. Secondary outcomes were respiratory complications within 30-days and the factors associated with COVID-19 infection.

Results

A total of 1,902 patients were included in the study. A total of 21 (0.1%) mortalities and 40 (0.2%) respiratory complications (acute respiratory distress syndrome or pneumonia) were observed within 30-days of operation. Mortality was more likely in patients aged 80 or above, ASA grade 3 or 4, ECOG grade 1 or above, undergoing major surgery, and amongst patients who had concurrent COVID-19 infection (OR 31.9, 95%CI 12.4–81.42, p<0.001; univariable logistic regression). Respiratory complications were more likely in patients aged over 70, from an area with high community risk, with a revised cardiac risk index of 1 or higher or with a concurrent COVID-19 infection (OR 40.6, 95%CI 11.41–144.45, p<0.001; multivariate). A total of 42 (0.2%) patients were diagnosed with COVID-19 during their inpatient stay; designated COVID-19 sites were not associated with increased COVID-19 infections.

Conclusions

Major urological cancer surgeries are safe to perform during the COVID-19 pandemic on well-selected patients with appropriate risk-stratification. Concurrent COVID-19 infection is associated with a higher risk of mortality and respiratory complications.
413 Evaluation of the Validity of Virtual Reality Simulators in the Preclinical Training of Robotic Surgery
Authors: Ali T.
Published: February 2022

Aim

Robotic surgeries are a form of minimally invasive procedures that decrease a patient’s recovery time. They have been increasing in numbers and scope over the past decade. Yet, they do not have a standardized method of training nor accreditation. The significant learning curve associated with it makes it intimidating to approach despite its benefits. This structured review aims to evaluate the validity of virtual reality simulators–tools that help surgeons overcome the learning curve of robotic surgery in a pressure-free environment that ensures patients’ safety. Virtual reality simulators have the potential of increasing the efficiency of robotic surgery as well as its uptake in general.

Method

Literature electronic databases SCOPUS, MEDLINE and PubMed were searched and interrogated for studies related to the aim. Inclusion and exclusion criteria were then applied to filter out more relevant studies. Redundant studies were eliminated, and the s of the remaining studies were examined until relevant studies were selected.

Results

Four prospective clinical trials were found and critically appraised by the Support Unit for Research Evidence (SURE) checklist. All studies comprised the evaluation of the face, content, and construct validity of a VR simulator.

Conclusions

The studies confirmed face, content, and construct validation of specific VR simulators. Hence, they encourage the use of VR simulators in the development of training and accreditation programs for robotic surgery. However, more predictive, and concurrent validation studies must be performed in order to establish the legitimacy of VR simulators as valid tools of training and accreditation.
Interrelation of striatal dopamine, brain metabolism and cognition in dementia with Lewy bodies
Authors: Yoo Han Soo , Jeong Seong Ho , Oh Kyeong Taek , Lee Sangwon , Sohn Young H , Ye Byoung Seok , Yun Mijin , Lee Phil Hyu
Published: February 2022

Dementia with Lewy bodies (DLB), the second most common neurodegenerative dementia, is characterized by cognitive decline, fluctuation of cognition and alertness, visual hallucinations, rapid eye movement sleep behaviour disorder and parkinsonism. Imaging biomarkers are of great importance in diagnosing patients with DLB and associated with characteristic clinical features including cognitive decline. In this study, we investigate interrelation between nigrostriatal dopamine depletion, brain metabolism and cognition in DLB. We enrolled 55 patients with probable DLB (15 with prodromal DLB and 40 with DLB) and 13 healthy controls. All subjects underwent N-(3-[18F]fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl) nortropane PET/CT, 18F-fluorodeoxyglucose PET/CT, 18F-florbetaben PET/CT and detailed neuropsychological testing. The relationship between striatal dopamine transporter availability and regional brain metabolism was assessed using general linear models, and the effect of striatal dopamine transporter availability and brain metabolism on specific cognitive function was evaluated by multivariate linear regression analysis. Path analyses were used to evaluate the relationship between striatal dopamine transporter availability, fluorodeoxyglucose uptake and cognitive function scores. Additionally, a linear mixed model was used to investigate the association between baseline dopamine transporter availability or brain metabolism and longitudinal cognitive decline. Independent of amyloid deposition, caudate and putamen dopamine transporter availabilities were positively correlated with brain metabolism in the DLB-specific hypometabolic regions, most prominently in the occipital and lateral parietal cortices. Both reduced caudate dopamine and brain hypometabolism were associated with low z-scores of Rey–Osterrieth Complex Figure Test copy, Seoul Verbal Learning Test immediate recall and Controlled Oral Word Association Test (COWAT)–animal. Path analyses showed that the effect of reduced caudate dopamine on the Rey-Osterrieth Complex Figure Test copy z-score was completely mediated by brain hypometabolism, whereas it affected the Seoul Verbal Learning Test immediate recall z-score both directly and via the mediation of brain hypometabolism. Caudate dopamine depletion was directly associated with the COWAT–animal z-score, not mediated by brain hypometabolism. Both baseline caudate dopamine transporter availability and brain hypometabolism were associated with longitudinal cognitive decline, with brain hypometabolism being more relevant. Our findings suggest that in DLB, striatal dopaminergic depletion and brain hypometabolism are closely related, and they differentially affect cognitive dysfunction in an item-specific manner. Additionally, brain hypometabolism would be more relevant to longitudinal cognitive outcomes than striatal dopaminergic degeneration.
Properties and fate of human mesenchymal stem cells upon miRNA let-7f-promoted recruitment to atherosclerotic plaques
Authors: Egea Virginia , Megens Remco Theodorus Adrianus , Santovito Donato , Wantha Sarawuth , Brandl Richard , Siess Wolfgang , Khani Sajjad , Soehnlein Oliver , Bartelt Alexander , Weber Christian , Ries Christian
Published: February 2022

Aims

Atherosclerosis is a chronic inflammatory disease of the arteries leading to the formation of atheromatous plaques. Human mesenchymal stem cells (hMSCs) are recruited from the circulation into plaques where in response to their environment they adopt a phenotype with immunomodulatory properties. However, the mechanisms underlying hMSC function in these processes are unclear. Recently, we described that miRNA let-7f controls hMSC invasion guided by inflammatory cytokines and chemokines. Here, we investigated the role of let-7f in hMSC tropism to human atheromas and the effects of the plaque microenvironment on cell fate and release of soluble factors.

Methods and results

Incubation of hMSCs with LL-37, an antimicrobial peptide abundantly found in plaques, increased biosynthesis of let-7f and N-formyl peptide receptor 2 (FPR2), enabling chemotactic invasion of the cells towards LL-37, as determined by qRT-PCR, flow cytometry, and cell invasion assay analysis. In an Apoe−/− mouse model of atherosclerosis, circulating hMSCs preferentially adhered to athero-prone endothelium. This property was facilitated by elevated levels of let-7f in the hMSCs, as assayed by ex vivo artery perfusion and two-photon laser scanning microscopy. Exposure of hMSCs to homogenized human atheromatous plaque material considerably induced the production of various cytokines, chemokines, matrix metalloproteinases, and tissue inhibitors of metalloproteinases, as studied by PCR array and western blot analysis. Moreover, exposure to human plaque extracts elicited differentiation of hMSCs into cells of the myogenic lineage, suggesting a potentially plaque-stabilizing effect.

Conclusions

Our findings indicate that let-7f promotes hMSC tropism towards atheromas through the LL-37/FPR2 axis and demonstrate that hMSCs upon contact with human plaque environment develop a potentially athero-protective signature impacting the pathophysiology of atherosclerosis.
Depressive symptom severity is a major risk factor for frailty in community-dwelling older adults with depression. A prospective study
Authors: Oyon Joaquim , Serra-Prat Mateu , Limon Esther , Ferrer Mariona , Pastor Núria , Palomera Elisabet , Burdoy Emili
Published: February 2022

Background

Depression and frailty are closely related, but the mechanisms by which depressed older adults are at an increased risk of becoming frail are still not well understood.

Aim

To assess socioeconomic and depression-related risk factors for frailty in older adults with depression.

Methods

Observational and prospective cohort study, with 12-month follow-up, of nonfrail community-dwelling subjects aged ≥70 years old with depression. The main study factors were clinical characteristics of depression, including symptom severity (Hamilton Depression Rating Scale), accompanying anxiety and cognitive symptoms, pharmacological treatment, and social factors including educational level, income, housing conditions and living circumstances, and social network. Frailty status was established according to Fried criteria.

Results

We recruited and analysed 216 subjects (mean age 76.5 years; 74% women), 65 (30%) of whom were lost to follow-up. Annual incidence of frailty was 23.2 new cases/100 persons. Age, female gender, osteoarthritis, pain, number of medications, major depression, first-degree family history of depression, depressive symptom severity, low educational level, and low-income level were risk factors for frailty. The multivariate analysis showed that age (odds ratio [OR] = 1.16; 95% confidence interval [CI]: 1.04–1.29), visual analogue scale (VAS)-pain (OR = 1.25; 95% CI: 1.01–1.55), and severe or very severe depressive symptoms (OR = 37.36; 95% CI: 2.68–518.53) were significantly associated with incident frailty at 12 months of follow-up.

Conclusions

Both clinical and social characteristics are risk factors for frailty, but severity of depressive symptoms had the highest independent effect on frailty in depressed aged subjects. Frailty requires a multidisciplinary approach that pays special attention to pain and depressed mood.
Do biomass partitioning and growth efficiency contribute to growth heterosis in inter-specific hybrid larchLarix x eurolepis?
Authors: Pâques Luc E , Lejeune Vincent , Veisse Dominique
Published: February 2022

Hybrid larch (Larix decidua x L.kaempferi) is a fast growing species with high potential for reforestation outside the native range of European larch. Its superiority over its parents is well documented but still today little is known about the genetic background of heterosis and even less about the physiological mechanisms supporting it. In this paper, we hypothesize that a different allocation of biomass and/or growth efficiency could explain growth differences between larch species. To examine heterosis sensu stricto, we used a subset of progeny from an intra−/inter-specific diallel-mating design represented by connected pedigrees from the three species (Hybrid larch, European larch and Japanese larch). Six years after planting, we harvested the trees, excavated roots and measured dry weights of above- and belowground parts. The best allometric relationships were determined for predicting the biomass of each compartment. Heterosis for stem volume exceeded 108 per cent and 81 per cent for total tree biomass over mid-parent values. Hybrid superiority was visible for all biomass compartments and particularly for needles and branches, so that aboveground biomass heterosis reached 2.5 times that for the roots. In addition to a greater biomass, the hybrid benefited from a modified allocation of biomass with a slightly higher proportion of branch and needle biomasses and a reduced proportion of root biomass. Hybrid and European larches had a significantly greater growth efficiency than Japanese larch. Whereas the differential of productivity between European and Japanese larch did not increase with size, it greatly increased for hybrids with fine root mass increase. A heavier crown, a reduced proportion of root biomass and greater root efficiency in hybrid larch should enhance photosynthesis and reduce root respiration cost, providing more carbon-based resources for use in stem wood production. Implications for breeding are briefly discussed.
Negative regulation of root-knot nematode parasitic behavior by root-derived volatiles of wild relatives of Cucumis metuliferus CM3
Authors: Xie Xiaoxiao , Ling Jian , Mao Zhenchuan , Li Yan , Zhao Jianlong , Yang Yuhong , Li Yanlin , Liu Mingyue , Gu Xingfang , Xie Bingyan
Published: February 2022

Root-knot nematodes (RKN; Meloidogyne spp.) cause a significant decrease in the yield of cucumber crops every year. Cucumis metuliferus is an important wild germplasm that has resistance to RKN in which plant root volatiles are thought to play a role. However, the underlying molecular mechanism is unclear. To investigate it, we used the resistant C. metuliferus line CM3 and the susceptible cucumber line Xintaimici (XTMC). CM3 roots repelled Meloidogyne incognita second-stage larvae (J2s), while the roots of XTMC plants attracted the larvae. CM3 and XTMC were found to contain similar amounts of root volatiles, but many volatiles, including nine hydrocarbons, three alcohols, two aldehydes, two ketones, one ester, and one phenol, were only detected in CM3 roots. It was found that one of these, (methoxymethyl)-benzene, could repel M. incognita, while creosol and (Z)-2-penten-1-ol could attract M. incognita. Interestingly, creosol and (Z)-2-penten-1-ol effectively killed M. incognita at high concentrations. Furthermore, we found that a mixture of CM3 root volatiles increased cucumber resistance to M. incognita. The results provide insights into the interaction between the host and plant-parasitic nematodes in the soil, with some compounds possibly acting as nematode biofumigation, which can be used to manage nematodes.
The effect of technology and regulation on the co-evolution of product and industry architecture
Authors: Burton Nicholas , Galvin Peter
Published: February 2022

This paper explores the co-evolution of product and industry architecture by drawing on a longitudinal study of the UK personal pensions industry between 2005 and 2020. It provides qualitative evidence for the way in which institutional structures, particularly regulation, entwine with firm strategic choices to shape the contours of an industry value chain (IVC). We draw upon modularity theory and the literature on industry architecture to consider how strategic bottlenecks emerged and how value shifted between layers of the IVC. Furthermore, we examine the interplay between the agendas of the regulator and firm strategic responses to unpack how firms (product providers) responded by pursuing integrative innovation and less specialization to mitigate the effects of value migration to strategic bottlenecks. Our findings extend recent work on product and industry architecture, highlighting how markets evolve toward less modular product configurations and less industry specialization in response to these dynamics.
The role of behavioural variation in the success of artisanal fishers who interact with dolphins
Authors: Valle-Pereira João V S , Cantor Mauricio , Machado Alexandre M S , Farine Damien R , Daura-Jorge Fábio G
Published: February 2022

Understanding the dynamics of small-scale fisheries requires considering the diversity of behaviours and skills of fishers. Fishers may have different abilities and tactics that can translate into different fishing outcomes. Here, we investigate variation in fishing behaviours among traditional net-casting fishers that are assisted by wild dolphins, and how this variation interacts with environmental conditions and influences fishing success. By combining in situ environmental sampling with fine-scale behavioural tracking from overhead videos, we found a higher probability of catching fish among fishers well-positioned in the water and that cast their nets wide-open and closer to dolphins. These differences in net-casting performance affect their chance of catching any fish over and above environmental conditions related to fish availability. This finding suggests that fishers’ success may not be simply an outcome of variations in resource availability, but also result from subtle variations in fishing behaviours. We discuss how such behavioural variations can represent skills acquired over the years, and how such skills can be crucial for fishers to benefit and keep interacting with dolphins. Our study demonstrates the role of behavioural variation in the dynamics of a century-old fishery and highlights the need to consider fishers’ behaviours in co-management of small-scale fisheries.
Long-duration transit and food and water deprivation alter behavioral activities and aggressive interactions at the feed bunk in beef feedlot steers
Authors: Heiderscheit Katie J , Freestone Alyssa D , Beenken Aubree M , Deters Erin L , Peschel Joshua M , Hansen Stephanie L
Published: February 2022

The objective of these experiments was to assess the effects of food and water deprivation and transit duration on the behavior of beef feedlot steers. In Experiment 1, 36 Angus-cross steers (353 ± 10 kg) were stratified to 6 pens and assigned one of three treatments (n = 12 steers per treatment): control (CON; stayed in home pens with ad libitum access to feed and water), deprived (DEPR; stayed in home pens but deprived of feed and water for 18 h), or transported (TRANS; subjected to 18-h transit event and returned to home pens). In Experiment 2, 60 Angus-cross steers (398 ± 5 kg; 6 steers per pen) were transported either 8 (8H) or 18 (18H) h. Four 8H pens (n = 24 steers) and six 18H pens (n = 36 steers) were used for behavioral analysis. In both experiments, the time to eat, drink, and lay down was recorded for each steer upon return to home pens. Total pen displacements from the feed bunk were also assessed for the 2 h following feed access in both experiments. Data were analyzed using Proc Mixed of SAS 9.4, with treatment as a fixed effect. Steer was the experimental unit for behavioral activities, while pen was the experimental unit for bunk displacements. Displacements were analyzed as repeated measures with the repeated variable of time. In Experiment 1, the time to eat and drink was similar across treatments (P ≥ 0.17). However, TRANS laid down in 16.5 min while DEPR did not lay down until 70.5 min post-arrival to pen (P < 0.01). Deprived steers had greater bunk displacements in the first 70 min post-feed access than CON or TRANS, though displacements among treatments from 100 to 120 min post-feed access were similar (treatment × time: P = 0.02). In Experiment 2, both 8H and 18H steers laid down approximately 25 min post-home pen arrival (P = 0.14). There was no effect of transit duration or duration by time on bunk displacements (P ≥ 0.20), though displacements were greater from 0 to 20 min than from 20 to 30 min post-feed access (time: P = 0.04). Steers that were deprived of feed and water were highly motivated to access those resources, while transported steers prioritized laying down. Producers should consider these priorities when preparing to receive cattle from a long transit event.
Local grasses for the control of the invasive vine Mikania micrantha
Authors: Zhou Sheng , Wang Min , Yuan Linglong , Chen Hao , Yan Linyuan , Yao Sitong , Zhang Bipei
Published: February 2022

Mikania micrantha (Asteraceae) is an invasive vine found in tropical and southern subtropical Asian and the Pacific Islands. The current methods used to control this vine are inadequate, which warrants the development of ecologically sustainable methods. Therefore, we investigated the ability of four grass species to prevent the invasion of M. micrantha, with an ultimate goal of developing ecologically sustainable control methods for widespread application. The clumps of native grass species from China (Panicum incomtum, Pennisetum purpureum, Saccharum arundinaceum and Microstegium vagans) were established. We sowed M. micrantha seeds and transplanted the seedlings into the grass clumps to examine whether the clumps could eliminate the new M. micrantha plants. In addition, we transplanted M. micrantha into existing grass clumps to examine whether the grass clumps could prevent the re-invasion of M. micrantha. Furthermore, we grew M. micrantha with P. incomtum and P. purpureum in the field to examine whether the grasses could outcompete M. micrantha. Mikania micrantha seeds germinated hardly in the grass clumps, and all seedlings died within 3 months. It was difficult for the vine to survive in the grass clumps. Our field experiments showed that the coverage of M. micrantha was significantly lower than that of the grass species in the first year, and that the vine was outcompeted after 2 years. To the best of our knowledge, this study is the first to reveal that tall grasses, particularly P. incomtum and P. purpureum, have potential to serve as bio-control agents for M. micrantha.
Blepharoptosis as a complication of percutaneous ethanol injection of thyroid cyst
Authors: Kitazawa Takeshi , Suito Motomu , Nagaya Hiroyuki
Published: February 2022

Complications of percutaneous ethanol injection (PEI) for thyroid cyst are rare. Almost all complications reported have been transient, including Horner’s syndrome. We provide herein the first description of persistent blepharoptosis subsequent to PEI, necessitating surgical correction. A 54-year-old woman presented to our hospital with left blepharoptosis that had occurred the day after PEI for a thyroid cyst. She showed 2 mm of blepharoptosis and 1 mm of miosis in the left eye compared to the right eye. Magnetic resonance imaging of the brain demonstrated no abnormalities, and computed tomography detected no lesions in the neck or chest other than the already known cyst. Instillation of phenylephrine eye drops allowed elevation of the left upper eyelid. Considering these findings, we diagnosed the blepharoptosis as part of Horner’s syndrome. The ptosis was corrected by levator aponeurosis advancement. No recurrence has been observed as of 9 months postoperatively.
Land snail assemblages and microhabitat preferences in the urban areas of Kolkata, India
Authors: Nandy Gargi , Barman Himangshu , Pramanik Soujita , Banerjee Sampa , Aditya Gautam
Published: February 2022

Due to the minimal dispersal capabilities and dependency on particular microhabitat, the land snails are susceptible to anthropogenic and natural disturbances. Considering the increasing anthropogenic threats, especially in urban areas, information on species’ requirements for particular habitat is very essential for land snail conservation and sustenance. In the present commentary, diversity and distribution of small-sized land snails in relation to their microhabitat preference in urban habitats of Kolkata, West Bengal, had been carried out through the quadrat method. The information on the richness and abundance of snails and their habitat places in Kolkata, India, was used to construct a bipartite network. A total of 13 land snail species were linked with 16 microhabitats. The network indices were used to justify the specialist or generalist nature of the snail species in the context of microhabitat preference. The snail species Succinea daucina and Allopeas gracile were observed to be associated with the maximum number of habitats while species strength was highest for S. daucina. The low value of connectance (0.288, <0.5) and niche overlap (0.34), the high value of specialization index H2′ (0.58) and d′ (0.44) indicate that the snail–microhabitat interactions were highly specialized. The network ecology of snail–microhabitats illustrated in the present instance will enable the identification of preferred microhabitats, which are required for the enhancement of the population of land snails in urban areas like Kolkata, India.