bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Lattice Points in Zonotopes, Lonely Runners, and Lonely Rabbits
Authors: Beck Matthias , Schymura Matthias
Published: October 2023

Let $P \subseteq {\mathbb {R}}^{d}$ be a polytope and let $\textbf {w}$ be an interior point of $P$. The coefficient of asymmetry$\operatorname {ca}(P,\textbf {w}):= \min \{ \lambda \geq 1: \textbf {w} - P \subseteq \lambda (P - \textbf {w}) \}$ of $P$ about $\textbf {w}$ has been studied extensively in the realm of Hensley’s conjecture on the maximal volume of a $d$-dimensional lattice polytope that contains a fixed positive number of interior lattice points. We zero in on the coefficient of asymmetry for lattice zonotopes, that is, Minkowski sums of line segments with integer endpoints. Our main result gives the existence of an interior lattice point for which the coefficient of asymmetry is bounded above by an explicit constant in $\Theta (d \log \log d)$, for any lattice zonotope that has an interior lattice point. Our work is both inspired by and feeds on Wills’ lonely runner conjecture from Diophantine approximation: we make intensive use of a discrete version of this conjecture (which, in fact, has been proved), and reciprocally, we reformulate the lonely runner conjecture in terms of the coefficient of asymmetry for certain lattice zonotopes.
Effectiveness of mRNA COVID-19 Monovalent and Bivalent Vaccine Booster Doses Against Omicron Severe Outcomes Among Adults Aged ≥50 Years in Ontario, Canada: A Canadian Immunization Research Network Study
Authors: Grewal Ramandip , Buchan Sarah A , Nguyen Lena , Nasreen Sharifa , Austin Peter C , Brown Kevin A , Gubbay Jonathan , Lee Nelson , Schwartz Kevin L , Tadrous Mina , Wilson Kumanan , Wilson Sarah E , Kwong Jeffrey C
Published: October 2023

We estimated the effectiveness of booster doses of monovalent and bivalent mRNA COVID-19 vaccines against Omicron-associated severe outcomes among adults aged ≥50 years in Ontario, Canada. Monovalent and bivalent mRNA COVID-19 booster doses provided similar strong initial protection against severe outcomes. Uncertainty remains around waning of protection from these vaccines.
Blood transcriptomic differences in the immune response under stressful environmental according to stocking density in pigs
Authors: Lim Seok-Won , Jeon Jung Hwan , Lim Byeonghwi , Jang Min-Jae , Kim Doo-Hwan , Kim Chan Ho , Kim Jun-Mo
Published: October 2023

The implementation of animal welfare in the pig industry is becoming a global trend, and welfare can be improved through livestock management. In modern and intensive farming systems, it has become important to find a reasonable compromise between stocking density and productivity. The simultaneous detection of behavioral and physiological parameters is helpful when considering welfare levels for stocking density. This study aimed to confirm the effect of stocking density through transcriptome linkage. A comparison of three groups according to stocking density (low density, eight pigs and 1.0 m2 per head; normal density, eight pigs and 0.8 m2 per head; and high density, eight pigs and 0.6 m2 per head) was performed, and their transcriptomic changes were observed using the RNA-Seq method. Differentially expressed genes were identified for each comparison group (low density vs. normal density, 95 upregulated genes and 112 downregulated genes; high density vs. normal density, 133 upregulated genes and 217 downregulated genes; and high density vs. low density, 245 upregulated genes and 237 downregulated genes). Biological mechanisms according to stocking density were identified through functional annotation. T-cell differentiation and immune disease pathway enriched in the high-density group caused immune imbalance through dysregulated T-cell signaling. Moreover, oxidative stress, together with DNA damage, can lead to high susceptibility to disease. Our study confirmed the biological mechanisms through immunological expression patterns according to stocking density. The study results are expected to provide comprehensive insight into systematic operation strategies considering stocking density and biomarkers for use in welfare evaluation.
Contextualizing communication for digital innovation and the future of work
Authors: Fu Jiawei Sophia , Barbour Joshua B
Published: October 2023

Digital innovation is the future of work. The ongoing and interlinked transformation of digital technologies, work, communication, and organizing raises important theoretical questions. Integrating recombination-based innovation theory and institutional theory of communication, this article contributes a novel framework that specifies the theoretical linkages between macro-level institutions and digital innovation: Social actors negotiate tensions arising from multiple institutional logics through (a) attention allocation; (b) sensemaking; and (c) external, boundary-spanning networking. The framework can advance the study of communication by (a) reconciling conflicting and inconclusive empirical findings; (b) targeting research efforts; and (c) responding to critiques of communication scholarship as failing to address social contexts. By focusing on digital innovation and the interplay between societal structures and communicative action in shaping it, this article advances scholarly discussions on the future of work, conceptualizing digital innovation as an institutional as well as communicative accomplishment.
Reading Kant as a radical empiricist: or how to find an orientation for education after progress
Authors: Vlieghe Joris
Published: October 2023

This article deals with the educational challenge of responding to the pending ecological crisis (and many other future apocalyptic scenarios that haunt our imagination). It seems we are living in a time when we have given up on the idea that progress is possible or desirable, and this questions education at its roots. In order to find a proper educational response that befits our time, it is requested that we gain a new sense of orientation (which is no longer aimed at progress). This is an idea I pick up from the recent work of Bruno Latour, which is the focus of the first part of the paper. In the second part, I start fleshing out what this new orientation could look like by turning to the work of Immanuel Kant (usually regarded as one of the most outspoken defenders of education geared to progress). Nonetheless, I try to read Kant against himself, so as to show how orientation can be understood in a non-modernist manner. I connect this in the third part to the radically immanent and empiricist work of William James, and draw out in the final section how a combined reading of Kant and James offers the orientation we need.
Testimonial justice and the voluntarism problem: the virtue of just acceptance
Authors: Kotzee Ben , Sato Kunimasa
Published: October 2023

This paper examines the ‘voluntarism’ challenge for achieving testimonial justice and advocates the virtue of just acceptance of testimony as the right target for efforts to alleviate testimonial injustice. First, we review the credibility deficit case of interpersonal testimonial injustice and explain how the doxastic voluntarism problem poses a challenge to redressing such testimonial injustice. Specifically, the voluntarism problem seems to rule out straightforward control over what and whom people believe; thus, the solution to the problem of testimonial injustice cannot lie in voluntarily self-correcting unjust credibility judgements and replacing them with just testimonial beliefs. Second, we identify three distinctive characteristics of acceptance of testimony, as distinct from belief, and argue that, while it might be difficult to form credibility judgements completely voluntarily, it is easier to control one’s attitude of acceptance towards a speaker’s testimony. We hold that shifting focus from testimonial belief to acceptance can overcome the problem of (synchronic) involuntarism about testimonial belief. Third, we articulate a vision of a virtue of just acceptance of testimony that can move a hearer to collect the right evidence to reliably find the answer to whether a speaker’s testimony is true. Finally, we demonstrate that encouraging people to take a virtuous attitude of just acceptance towards a speaker’s testimony forms the basis of a remedial vision of education that can play a distinctive role in fostering the virtue of just acceptance aimed at testimonial justice.
Mixed primary and secondary vaginal calculi: a case report
Authors: Alhajress Ghassan , Albqami Nasser , Nazer Ahmed I , Alfraidi Omar B , Balaraj Faisal Khalid , Alsaghyir Abdullah , Ghazwani Yahya
Published: October 2023

Vaginal calculi are classified according to the pathogenesis of calculus formation. Primary and secondary vaginal calculi. In this article, we present an interesting case that we believe to be a mixed primary and secondary vaginal calculi in which both originated as a result of a vesicovaginal fistula (VVF) and stitches found in the vagina. Although vaginal calculi are a rare disease, a high index of suspicion is needed, especially in patients with a history of gynecological procedures. Since the high recurrence rate of VVF along with its complications, more frequent follow-up and physical examination are required to avoid the recurrence of the disease.
Identifying social norm violation in movie plots: from Borat to American Pie
Authors: Neuman Yair , Cohen Yochai , Yin Wenpeng
Published: October 2023

The violation of social norms in TV and cinema is a well-known source of humor and catharsis, and researchers in digital humanities may benefit from the automatic identification of social norm violations. In this article, we introduce a novel methodology for identifying and analyzing the violation of social norms in textual data and illustrate it in the analysis of movie plots. The methodology leans on zero-shot classification, specifically relevant when massive, labeled datasets are unavailable. We test our methodology and provide researchers with (1) a theoretically grounded tool for screening textual data for social norm violation and with new datasets that include (2) 6,806 embarrassing situations from movie plots and their hypothesized violated norm and (3) 3,059 movie plots with their average embarrassment score.
Should We Use Rifampicin in Periprosthetic Joint Infections Caused by Staphylococci When the Implant Has Been Exchanged? A Multicenter Observational Cohort Study
Authors: Kramer Tobias Siegfried , Soriano Alex , Tedeschi Sarah , Chen Antonia F , Tattevin Pierre , Senneville Eric , Gomez-Junyent Joan , Birlutiu Victoria , Petersdorf Sabine , de Brito Vicens Diaz , Gonzalez Ignacio Sancho , Belden Katherine A , Wouthuyzen-Bakker Marjan
Published: October 2023

Background

Previous studies demonstrated the efficacy of a rifampicin-based regimen in the treatment of acute staphylococcal periprosthetic joint infections (PJIs) treated with surgical debridement. However, evidence is lacking to support the use of rifampicin in cases where the implant is exchanged during revision.

Methods

We included all consecutive cases of staphylococcal PJIs treated from January 2013 to December 2018 with revision surgery in this international, retrospective, multicenter observational cohort study. PJI was defined according to the European Bone and Joint Infection Society diagnostic criteria. A relapse or reinfection during follow-up, the need for antibiotic suppressive therapy, the need for implant removal, and PJI-related death were defined as clinical failure. Cases without reimplantation or with follow-up <12 months were excluded.

Results

A total of 375 cases were included in the final analysis, including 124 1-stage exchanges (33.1%) and 251 2-stage exchanges (66.9%). Of those, 101 cases failed (26.9%). There was no statistically significant difference in failure of patients receiving rifampicin (22.5%, 42/187) and those not receiving rifampicin (31.4%, 59/188; P = .051). A subanalysis of chronic PJIs treated by 2-stage exchange arthroplasty demonstrated a lower failure rate in cases treated with rifampicin (15%) compared with the no-rifampicin group (35.5%; P = .005). In this subgroup, the use of rifampicin and an antibiotic holiday of >2 weeks were independent predictors of clinical success (odds ratio [OR], 0.36; 95% CI, 0.15–0.88; and OR, 0.19; 95% CI, 0.04–0.90; respectively).

Conclusions

Combination treatment with rifampicin increases treatment success in patients with chronic staphylococcal PJI treated with 2-stage exchange arthroplasty.
Long noncoding RNA TRABA suppresses β-glucosidase-encoding BGLU24 to promote salt tolerance in cotton
Authors: Cui Changjiang , Wan Hui , Li Zhu , Ai Nijiang , Zhou Baoliang
Published: October 2023

Salt stress severely damages the growth and yield of crops. Recently, long noncoding RNAs (lncRNAs) were demonstrated to regulate various biological processes and responses to environmental stresses. However, the regulatory mechanisms of lncRNAs in cotton (Gossypium hirsutum) response to salt stress are still poorly understood. Here, we observed that a lncRNA, trans acting of BGLU24 by lncRNA (TRABA), was highly expressed while GhBGLU24-A was weakly expressed in a salt-tolerant cotton accession (DM37) compared to a salt-sensitive accession (TM-1). Using TRABA as an effector and proGhBGLU24-A-driven GUS as a reporter, we showed that TRABA suppressed GhBGLU24-A promoter activity in double transgenic Arabidopsis (Arabidopsis thaliana), which explained why GhBGLU24-A was weakly expressed in the salt-tolerant accession compared to the salt-sensitive accession. GhBGLU24-A encodes an endoplasmic reticulum (ER)–localized β-glucosidase that responds to salt stress. Further investigation revealed that GhBGLU24-A interacted with RING-type E3 ubiquitin ligase (GhRUBL). Virus-induced gene silencing (VIGS) and transgenic Arabidopsis studies revealed that both GhBGLU24-A and GhRUBL diminish plant tolerance to salt stress and ER stress. Based on its substantial effect on ER-related degradation (ERAD)–associated gene expression, GhBGLU24-A mediates ER stress likely through the ERAD pathway. These findings provide insights into the regulatory role of the lncRNA TRABA in modulating salt and ER stresses in cotton and have potential implications for developing more resilient crops.
The social media discourse of engaged partisans is toxic even when politics are irrelevant
Authors: Mamakos Michalis , Finkel Eli J
Published: October 2023

Prevailing theories of partisan incivility on social media suggest that it derives from disagreement about political issues or from status competition between groups. This study—which analyzes the commenting behavior of Reddit users across diverse cultural contexts (subreddits)—tests the alternative hypothesis that such incivility derives in large part from a selection effect: Toxic people are especially likely to opt into discourse in partisan contexts. First, we examined commenting behavior across over 9,000 unique cultural contexts (subreddits) and confirmed that discourse is indeed more toxic in partisan (e.g. r/progressive, r/conservatives) than in nonpartisan contexts (e.g. r/movies, r/programming). Next, we analyzed hundreds of millions of comments from over 6.3 million users and found robust evidence that: (i) the discourse of people whose behavior is especially toxic in partisan contexts is also especially toxic in nonpartisan contexts (i.e. people are not politics-only toxicity specialists); and (ii) when considering only nonpartisan contexts, the discourse of people who also comment in partisan contexts is more toxic than the discourse of people who do not. These effects were not driven by socialization processes whereby people overgeneralized toxic behavioral norms they had learned in partisan contexts. In contrast to speculation about the need for partisans to engage beyond their echo chambers, toxicity in nonpartisan contexts was higher among people who also comment in both left-wing and right-wing contexts (bilaterally engaged users) than among people who also comment in only left-wing or right-wing contexts (unilaterally engaged users). The discussion considers implications for democratic functioning and theories of polarization.
Evidence for the cardiodepressive effects of the plasticizer di-2-ethylhexyl phthalate
Authors: Swift Luther M , Roberts Anysja , Pressman Jenna , Guerrelli Devon , Allen Samuel , Haq Kazi T , Reisz Julie A , D’Alessandro Angelo , Posnack Nikki Gillum
Published: October 2023

Di-2-ethylhexyl phthalate (DEHP) is commonly used in the manufacturing of plastic materials, including intravenous bags, blood storage bags, and medical-grade tubing. DEHP can leach from plastic medical products, which can result in inadvertent patient exposure. DEHP concentrations were measured in red blood cell units stored between 7 and 42 days (17–119 μg/ml). Using these concentrations as a guide, Langendorff-perfused rat heart preparations were acutely exposed to DEHP. Sinus activity remained stable with lower doses of DEHP (25–50 μg/ml), but sinus rate declined by 43% and sinus node recovery time (SNRT) prolonged by 56.5% following 30-min exposure to 100 μg/ml DEHP. DEHP exposure also exerted a negative dromotropic response, as indicated by a 69.4% longer PR interval, 108.5% longer Wenckebach cycle length (WBCL), and increased incidence of atrioventricular (AV) uncoupling (60-min exposure). Pretreatment with doxycycline partially rescued the effects of DEHP on sinus activity, but did not ameliorate the effects on AV conduction. DEHP exposure also prolonged the ventricular action potential and effective refractory period, but had no measurable effect on intracellular calcium transient duration. Follow-up studies using human-induced pluripotent stem cell-derived cardiomyocytes confirmed that DEHP slows electrical conduction in a time (15 min–3 h) and dose-dependent manner (10–100 μg/ml). Previous studies have suggested that phthalate toxicity is specifically attributed to metabolites of DEHP, including mono-2-ethylhexylphthalate. This study demonstrates that DEHP exposure also contributes to cardiac dysfunction in a dose- and time-dependent manner. Future work is warranted to investigate the impact of DEHP (and its metabolites) on human health, with special consideration for clinical procedures that employ plastic materials.
A Comparison of Online Self-Training and Standard Bedside Training in Lung Ultrasonography for Medical Students
Authors: Jedwab Roni , Boas Stefan , Potashner Dana , Ostrovsky Daniel , Wacht Oren , Taragin Benjamin Hayatt , Gat Tomer , Dayan Roy Rafael , Fuchs Lior
Published: October 2023

Purpose

Point-of-care ultrasonography (POCUS) is increasingly integrated into medical education. Traditionally taught at the bedside using a hands-on approach, POCUS is limited by cost, time, faculty availability, and access to POCUS resources. With the recent transition to digitalization in medical education, the authors compare lung POCUS performance and pathology identification among medical students to examine whether using an online, self-learning lung POCUS module is noninferior to traditional bedside, faculty-led lung POCUS training.

Method

This study assessed the performance of 51 medical students from August to October 2021 on an elearning lung POCUS course with traditional bedside training and no training. POCUS students were scored on use of a simulator to identify pathologies, ability to identify lung ultrasonographic pathological clips, and scanning technique.

Results

The elearning group had a significantly higher median (interquartile range [IQR]) total test score (15/18 [10.5–16] vs. 12/18 [9–13]; P = .03) and scanning technique score (5/5 [4–5] vs. 4/5 [3–4]; P = .03) compared with the standard curriculum group. The median (IQR) accuracy in the clip segment of the examination was 7.5 of 10 (4–9) in the self-learning group and 6 of 10 (4–7) in the standard curriculum group (P = .18). The median (IQR) grade on the simulator segment of the examination was 2 of 3 (2–3) in the self-learning group and 2 of 3 (1–2) in the standard curriculum group (P = .06).

Conclusions

This study suggests that self-directed elearning of lung POCUS is at least noninferior to bedside teaching and possibly even a superior method of learning lung POCUS. This teaching method POCUS is feasible for medical students to learn lung ultrasonography and has potential to complement or augment the traditional learning process or eliminate or lessen the requirement for bedside teaching by reaching a larger audience while minimizing costs and human resources.
Population Pharmacokinetics of Topiramate in Patients with Epilepsy Using Nonparametric Modeling
Authors: Elewa Mandy , Alghanem Sarah S. , Al-Hashel Jasem , Thussu Anil , Al-Lanqawi Yousef , Matar Kamal
Published: October 2023

Background:

Topiramate (TPM) is used for the treatment of various epileptic seizures and the prevention of migraine. This study aimed to develop a population pharmacokinetic model and identify covariates that influence TPM behavior in patients with epilepsy in Kuwait.

Methods:

Data were collected retrospectively from 108 patients (2 years old and above) with epilepsy who were treated with oral TPM and 174 TPM blood samples from 3 hospitals in Kuwait from 2009 to 2016. Data were randomly divided into 2 groups for model development and validation. The population pharmacokinetic model was built using the nonparametric modeling algorithm (Pmetrics). The model was evaluated internally through the visual predictive check method and externally using a new data set.

Results:

A 1-compartment model with first-order elimination fitted the data well. Covariates showing a significant effect on the elimination rate constant were renal function and coadministration of carbamazepine (CBZ). The mean estimated clearance was 2.11 L/h; this was 50% higher for patients coadministered with CBZ. Age and sex were essential covariates for the volume of distribution (V). The visual predictive check of the final model could predict the measured concentrations. External validation further confirmed the favorable predictive performance of the model with low bias and imprecision for predicting the concentration in a particular population.

Conclusions:

TPM elimination was increased with CBZ coadministration and was affected by renal function. Meanwhile, age and sex were the main predictors for V. The predictive performance of the final model proved to be valid internally and externally.
Sample Matrices for Mass Spectrometry–Based Adherence Monitoring: A Systematic Critical Review
Authors: Jacobs Cathy M. , Wagmann Lea , Meyer Markus R.
Published: October 2023

Background:

Analytical monitoring of adherence using mass spectrometry (MS) plays an important role in clinical toxicology. Unambiguous detection of drugs (of abuse) and/or their metabolites in body fluids is needed to monitor intake of medication as prescribed or to monitor abstinence as a follow-up to detoxification procedures. This study focused on the advantages and disadvantages of different sample matrices used for MS-based adherence monitoring.

Methods:

Relevant articles were identified through a literature search in the PubMed database. English articles published between January 01, 2017, and December 31, 2022, were selected using the keywords “adherence assess*” or “adherence monit*” or “compliance assess*” or “compliance monit*” in combination with “mass spectrom*” in the title or abstract.

Results:

A total of 51 articles were identified, 37 of which were within the scope of this study. MS-based monitoring was shown to improve patient adherence to prescribed drugs. However, MS analysis may not be able to assess whether treatment was rigorously followed beyond the last few days before the sampling event, except when hair is the sample matrix. For medication adherence monitoring, blood-based analyses may be preferred because reference plasma concentrations are usually available, whereas for abstinence control, urine and hair samples have the advantage of extended detection windows compared with blood. Alternative sample matrices, such as dried blood samples, oral fluid, and exhaled breath, are suitable for at-home sampling; however, little information is available regarding the pharmacokinetics and reference ranges of drug (of abuse) concentrations.

Conclusions:

Each sample matrix has strengths and weaknesses, and no single sample matrix can be considered the gold standard for monitoring adherence. It is important to have sufficient information regarding the pharmacokinetics of target substances to select a sample matrix in accordance with the desired purpose.
Axillary Hidradenitis Suppurativa: A Comparison between Two Perforator Flap Reconstructive Approaches after Radical Surgical Management
Authors: Alabdulkareem Mohammad , Berkane Yanis , Le Bras Enna , Rousson Etienne , Chrelias Theodoros , Beaufils Tristan , Leclere Franck-Marie , Watier Eric , Bertheuil Nicolas
Published: October 2023

Background:

Axillary hidradenitis suppurativa (HS) can result in significant functional impairment in both personal and professional lives. Stage 3 HS requires radical surgical treatment. Flap reconstruction allows for faster healing and better functional and aesthetic outcomes. We compared the results of thoracodorsal artery perforator (TDAP) and propeller inner arm artery perforator (IAAP) flap reconstructions after radical surgical treatment of axillary HS.

Methods:

We conducted a retrospective study that included 13 consecutive patients who underwent stage 3 axillary HS treatment between August 2015 and January 2023. Seven patients underwent reconstruction by islanded TDAP flaps, whereas six patients underwent reconstruction by propeller IAAP flaps, with one patient undergoing bilateral reconstruction. The data collected from the patient records included age, gender, smoking status, body mass index, comorbidities, operative time, defect size, flap size, hospital stay, and complications.

Results:

Although not statistically significant (P = 0.1923), a higher rate of flap complications is reported here with propeller IAAP flaps (42.86 %), whereas islanded TDAP flaps had no flap complications (0%). We found a statistically significant difference in operative time (P = 0.0006), defect size (P = 0.0064), and flap size (P = 0.0012) between the two groups. All patients exhibited satisfactory functional and aesthetic outcomes. Fourteen flaps were performed in total; only one case exhibited recurrence (7.14%).

Conclusion:

After radical surgical management, both islanded TDAP and propeller IAAP flap reconstructions offer excellent outcomes for stage 3 axillary HS. We strongly encourage our peers to consider performing perforator flaps over secondary healing for these patients with a major functional impairment.
Noninvasive assessment of hepatic decompensation
Authors: Thiele Maja , Johansen Stine , Israelsen Mads , Trebicka Jonel , Abraldes Juan G. , Gines Pere , Krag Aleksander
Published: October 2023

Noninvasive tests (NITs) are used in all aspects of liver disease management. Their most prominent break-through since the millennium has been in advancing early detection of liver fibrosis, but their use is not limited to this. In contrast to the symptom-driven assessment of decompensation in patients with cirrhosis, NITs provide not only opportunities for earlier diagnoses but also accurate prognostication, targeted treatment decisions, and a means of monitoring disease. NITs can inform disease management and decision-making based on validated cutoffs and standardized interpretations as a valuable supplement to clinical acumen. The Baveno VI and VII consensus meetings resulted in tangible improvements to pathways of care for patients with compensated and decompensated advanced chronic liver disease, including the combination of platelet count and transient elastography to diagnose clinically significant portal hypertension. Furthermore, circulating NITs will play increasingly important roles in assessing the response to interventions against ascites, variceal bleeding, HE, acute kidney injury, and infections. However, due to NITs’ wide availability, there is a risk of inaccurate use, leading to a waste of resources and flawed decisions. In this review, we describe the uses and pitfalls of NITs for hepatic decompensation, from risk stratification in primary care to treatment decisions in outpatient clinics, as well as for the in-hospital management of patients with acute-on-chronic liver failure. We summarize which NITs to use when, for what indications, and how to maximize the potential of NITs for improved patient management.
HLA-DR genotypes in patients with systemic lupus erythematosus in Taiwan
Authors: Yen Chang-Yi , Wang Pin-Yi , Chen Kuan-Yu , Tseng Chia-Chun , Wu Cheng-Chin , Ou Tsan-Teng , Yen Jeng-Hsien
Published: October 2023

Background:

Different human leukocyte antigen (HLA)-DR genotypes have been known to be associated with the risk of development of systemic lupus erythematosus (SLE) in different populations, although Lu et al. have reported previously that no correlation exists between the HLA-DR genotype and disease manifestation in SLE patients in Taiwan. We investigated the effects different HLA-DR genotypes had on SLE incidence in Taiwanese patients as to whether risk alleles were associated with different clinical manifestations, and the effects risk alleles had on the age of disease onset.

Methods:

Two hundred thirty-four SLE patients and 346 healthy controls were enrolled. HLA-DR genotyping was performed with the HLA FluoGene DRDQ kit for each subject. Chi-square tests and t tests were performed for statistical analysis.

Results:

HLA-DR2 was significantly more frequently found in SLE patients than in controls (odds ratio [OR] = 2.05, 95% CI, 1.44-2.92, p < 0.001). Notably, HLA-DR6 appeared to trend toward negative correlation with SLE, whereas HLA-DR8 appeared to trend toward positive correlation. HLA-DR2 patients had an earlier onset of disease as well as a higher prevalence of oral ulcer, avascular necrosis of bone, and renal involvement (lupus nephritis).

Conclusion:

HLA-DR2 was associated with SLE susceptibility in this Taiwanese population as well as lower age of disease onset and more severe clinical manifestations.
The Effects of Exercise on Telomere Length in Persons With Heart Failure
Authors: Butts Brittany , Hope Chloe , Herring Christopher , Mueller Kenneth , Gary Rebecca A.
Published: October 2023

Background

Telomere length is reduced in persons with heart failure (HF). Inflammation is a putative mechanism contributing to telomere shortening. Although physical activity is known to increase telomere length, its effects in HF are unknown.

Objective

The aim of this study was to examine the effects of exercise on telomere length and its relationship with interleukin (IL)-1β in persons with HF.

Methods

This secondary analysis of a 3-month home-based aerobic exercise intervention measured total telomere length and IL-1β levels in persons with HF (69% with reduced ejection fraction).

Results

Total telomere length increased and plasma IL-1β levels decreased in the exercise group from baseline to 3 months. Total telomere length was negatively associated with IL-1β at baseline (r = −0.441 P = .001).

Conclusions

The association between telomere length and IL-1β suggests a relationship between inflammation and cellular aging. Moderate-intensity exercise may help maintain cellular functions. Further research is needed to examine the effects on outcomes in persons with HF.
A Comprehensive Obesity Benefit as a Guide for Employers on the Core Components of Obesity Care: Guidance From the American College of Occupational and Environmental Medicine (ACOEM) Roundtable on Obesity
Authors: Gallagher Christine , Ording Julie
Published: October 2023

Objective

The need to confront the obesity epidemic and its impact on employers requires a serious look at how we address the treatment of obesity. This article focuses on the core components of obesity care and the need for employers to offer a comprehensive obesity benefit (COB) as part of employee insurance coverage.

Methods

In May 2022, the American College of Occupational and Environmental Medicine convened a roundtable meeting, which brought together five corporate medical directors and representatives from aerospace/defense and energy industries to learn about the disease of obesity and provide clinical insights regarding health and safety in their respective industries. The goals of the program were to provide awareness of benefits for the treatment of obesity and identify the feasibility for employers of implementing a COB for their employees. Participants learned how a comprehensive approach to covering obesity treatments is necessary, and what benefits should be offered to employees.

Results

Participants were invited to review the insurance benefits they currently offer to employees and compare them to the COB. Outcomes were limited by a lack of participation by the employers invited to participate. Participants identified actions that need to be addressed for employers to develop a more comprehensive approach to obesity care.

Conclusion

Implementing a COB can help employers increase access and utilization of comprehensive obesity care by employees.
Examining Relationships Among Leadership Behaviors, Demographic and Program Factors, and Resilience in Physical Therapy Professional Education Program Directors
Authors: Herrin Shannon
Published: October 2023

Introduction.

Physical therapy professional education program directors (PDs) face stress associated with work roles and responsibilities, which can cause burnout and job turnover.

Review of Literature.

Burnout and turnover in physical therapy education PD positions are influenced by inexperience, insufficient compensation, decreased support, heavy workloads, difficulty hiring and retaining faculty, and internal conflict. Program directors also receive insufficient training in their roles. Individuals with greater resilience, or the ability to face adversity with positive outcomes, may be more resistant to stress, burnout, and turnover. Therefore, this study's purpose was to explore the relationships among leadership behaviors, demographic and program factors, and resilience in physical therapy PDs.

Subjects.

Of the 600 physical therapy PDs invited to participate in the study, 126 directors completed the survey (21% response rate).

Methods.

The survey included demographic questions, the Multifactor Leadership Questionnaire (MLQ-5X), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Correlational analyses were used to investigate relationships among leadership behaviors, demographic and program factors, and resilience.

Results.

Participants included 43 physical therapist and 82 physical therapist assistant PDs (79.4% female and 20.6% male participants; mean age, 52.0 ± 8.3 years; mean years in role, 7.3 ± 6.9 years). Mean MLQ-5X scores showed that participants primarily used transformational leadership (TFL) behaviors. The mean CD-RISC-10 score for participants was 33.06 (±4.10). Analysis revealed statistically significant positive relationships between all TFL behaviors and resilience. Exploratory regression analysis revealed that 3 leadership behaviors and one demographic factor may contribute to resilience in participants, although the proportion of variance was modest (39%).

Discussion and Conclusion.

This is the first study to offer insight regarding the relationships between leadership behaviors and resilience in physical therapy PDs. These results may help lay the foundation for future research in this area, with the goal of decreasing burnout and job turnover through increased resilience.
Metastasis-Directed Therapy for Metachronous Lung Metastases in Prostate Cancer
Authors: Mahmoud Ahmed M. , Gao Robert W. , Ahmed Mohamed E. , Orme Jacob J. , Rincón Miguel Muñiz , Harmsen William S. , Johnson Geoffrey B. , Cassivi Stephen D. , Kwon Eugene D. , Phillips Ryan M. , Andrews Jack R. , Childs Daniel S.
Published: October 2023

Introduction:

As interest in metastasis-directed therapy (MDT) for prostate cancer (PCa) grows, exploring indications and patient selection is increasingly more important. Thus far, few studies have described long-term outcomes after surgical MDT in those with disease recurrence involving the lung. The objective of our study was to compare the cumulative incidence of cancer-related death by treatment modality in men with metachronous pulmonary metastases from PCa.

Methods:

In a single-institution retrospective study, we identified 75 men from the prospectively maintained Mayo Clinic C-11 Positron Emission Tomography Choline PCa registry with recurrent prostate cancer involving the lung but no other visceral organs. Patients were categorized into 3 groups based on treatment modalities: wedge resection ± hormonal therapy, chemohormonal therapy, and hormonal therapy alone. The risk of cancer-related death after treatment at the time of lung metastases was reported as cumulative incidence estimates. Non–cancer-related deaths were treated as a competing risk of death. A univariate Cox regression model was conducted to assess the impact of treatment modality on the risk of cancer-related death.

Results:

At the time of lung metastasis, the median age was 69.5 years, and the median (IQR) prostate-specific antigen was 4 (1.3-8.6) ng/ml. Forty-seven patients (62.7%) had hormone-sensitive disease, and 28 patients (37.3%) had hormone-resistant disease. A total of 26 patients (34.7%) were treated with wedge resection ± hormonal therapy, 27 (36%) with chemohormonal therapy, and 22 (29.3%) with hormonal therapy alone. The median (IQR) follow-up time was 50.3 (31.1-78.4) months, and 21 patients (28%) died. Patients who were treated with wedge resection ± hormonal therapy had lower rated of cancer-related death compared with those who received chemohormonal therapy (Hazard Ratio [HR]: 4.14, 95% CI: 1.01-16.96, P = .048) or hormonal therapy alone (HR: 6.37, 95% CI: 1.72-23.54, P = .005).

Conclusion:

This exploratory analysis supports the safety and feasibility of surgical metastasis-directed therapy in select patients with recurrent prostate cancer involving the lung. Favorable long-term survival provides justification for further evaluation of this approach.
Phytochemicals targeting epidermal growth factor receptor (EGFR) for the prevention and treatment of HNSCC: A review
Authors: Li Shaling , Sun Yongdong
Published: October 2023

Head and neck squamous cell carcinoma (HNSCC) develops from the mucosal epithelium of the oral cavity, pharynx, and larynx, and is the most common malignancy of the head and neck, the incidence of which continues to rise. The epidermal growth factor receptor is thought to play a key role in the pathogenesis of HNSCC. Inhibition of epidermal growth factor receptor has been identified as an effective target for the treatment of HNSCC. Many phytochemicals have emerged as potential new drugs for the treatment of HNSCC. A systematic search was conducted for research articles published in PubMed, and Medline on relevant aspects. This review provides an overview of the available literature and reports highlighting the in vitro effects of phytochemicals on epidermal growth factor in various HNSCC cell models and in vivo in animal models and emphasizes the importance of epidermal growth factor as a current therapeutic target for HNSCC. Based on our review, we conclude that phytochemicals targeting the epidermal growth factor receptor are potentially effective candidates for the development of new drugs for the treatment of HNSCC. It provides an idea for further development and application of herbal medicines for cancer treatment.
Research hotspots and trends on post-cesarean section analgesia: A scientometric analysis from 2001 to 2021
Authors: Zhao Ziwei , Nie Zhongbiao , Li Yanyan , Wang Peili , Zhang Ran
Published: October 2023

This study aims to demonstrate current research priorities and predict future trends of post-cesarean section analgesia by scientometric analysis. We collected nearly 20 years (2002–2021) of publications related to post-cesarean section analgesia in the web of science database. Citespace was applied to evaluate the knowledge mapping. There are 2735 manuscripts about the post-cesarean section in total. The country, institution, and author posted the most separately are the USA, Univ Calif Irvine, and BRENDAN CARVALHO. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA (21) publishes the most articles of this type, and ANESTHESIOLOGY has the greatest impact (1496 co-citations). In addition, the most key cited reference is McDonnell, J.G (43). Post-cesarean section analgesia research, including spinal anesthesia, postoperative pain, and epidural analgesia, has been a research hotspot in recent years. Through scientometric analysis of the past 20 years, we know the TAP blocks and drug selection in patient-controlled analgesia are the focus of future research. The USA, China, and Turkey have become the main research forces in this field, with high publication rates and centrality. This is important for accurately and quickly locating trends in this field.
Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan
Authors: Al-Kuran Oqba Al , AL-Mehaisen Lama , Al-Karablieh Marah , Abu Ajamieh Maha , Flefil Salsabil , Al-Mashaqbeh Sondos , Albustanji Yaqeen , Al-Kuran Lena
Published: October 2023

Pelvic inflammatory disease (PID) is an upper genital tract infection caused by a variety of aerobic and anaerobic microorganisms ascending from the cervix or vagina. Though PID is mainly a sexually transmitted disease; 15% are non-sexually transmitted.[1] In our study, we aim to assess gynecologists’ understanding and awareness of PID; as it presents an important health issue affecting the Jordanian community and similar communities with the same cultural and religious backgrounds. A cross-sectional study was conducted using an online questionnaire that received responses from 172 gynecologists in Jordan. The questionnaire aimed at testing gynecologists’ knowledge of different aspects of PID starting with diagnosis and ending with management. 68.6% of gynecologists acknowledged that PID is a problem in Jordan. However, obvious confusion was observed in the scopes of clinical presentation, choosing the most reliable PID investigations, and treatment. PID is not being addressed properly in a sexually conservative community that has low rates of sexually transmitted diseases like Jordan, which is misleading and dangerous. In addition, we think there is a lack of certain standards on how to define PID and acknowledge its effect on the community as well as the disappointing level of knowledge about different aspects of PID gynecologists show, starting with its prevalence and ending with treatment policy. Clearer guidelines for the diagnosis, management, and prevention of PID should be adopted. These findings should be acknowledged by all doctors from neighboring countries as well as those within similar communities to Jordan.
Causality between sarcopenia-related traits and major depressive disorder: A bi-directional, two-sample Mendelian randomized study
Authors: Zhang Yu , Yang Mengfan , Li Mingquan
Published: October 2023

Observational studies have demonstrated an association between sarcopenia and depression. However, these studies may be influenced by confounding factors, and the causal relationship between sarcopenia and major depressive disorder (MDD) remains unclear. This study aimed to apply the Mendelian randomization (MR) method to address confounding factors and assess the causal effect of sarcopenia on MDD. A two-way, two-sample MR method was employed in this study. Instrumental variables of genome-wide significance level were obtained from the open large-scale genome-wide association study summary data. MR analysis was conducted using inverse variance weighted, MR-Egger, and weighted median methods. The reliability of the results was verified using the heterogeneity test, pleiotropy test, and leave-one-out method for sensitivity analysis. Grip strength (right-hand grip strength: odds ratio [OR] = 0.880, 95% confidence interval [CI] 0.786–0.987,P = .027; left-hand grip strength: OR = 0.814, 95% CI 0.725–0.913,P < .001) and usual walking pace (OR = 0.673, 95% CI 0.506–0.896,P = .007) exhibited a direct causal effect on MDD. MDD had a significant causal effect on appendicular lean mass (β = −0.065, 95% CI −0.110, −0.019,P = .005). There was a causal relationship between sarcopenia-related traits and MDD. Loss of muscle strength, rather than skeletal muscle mass, is correlated with an increased risk of MDD. Furthermore, individuals with MDD are more likely to experience loss of skeletal muscle mass.
Real-world use of avatrombopag in patients with chronic liver disease and thrombocytopenia undergoing a procedure
Authors: Satapathy Sanjaya K. , Sundaram Vinay , Shiffman Mitchell L. , Jamieson Brian D.
Published: October 2023

The phase 4 observational cohort study assessed the effectiveness and safety of the thrombopoietin receptor agonist avatrombopag in patients with chronic liver disease (CLD) and thrombocytopenia undergoing a procedure. Patients with CLD may have thrombocytopenia, increasing the risk of periprocedural bleeding. Prophylactic platelet transfusions used to reduce this risk have limitations including lack of efficacy and transfusion-associated reactions. Prophylactic thrombopoietin receptor agonists have been shown to increase platelet counts and decrease platelet transfusions. Effectiveness was assessed by change from baseline in platelet count and proportion of patients needing a platelet transfusion. Safety was assessed by monitoring adverse events (AEs). Of 50 patients enrolled, 48 were unique patients and 2 patients were enrolled twice for separate procedures. The mean (standard deviation) change in platelet count from baseline to procedure day was 41.1 × 109/L (33.29 × 109/L, n = 38), returning to near baseline at the post-procedure visit (change from baseline −1.9 × 109/L [15.03 × 109/L], n = 11). The proportion of patients not requiring a platelet transfusion after baseline and up to 7 days following the procedure was 98% (n = 49). Serious AEs were infrequent (n = 2 [4%]). No treatment-emergent AEs were considered related to avatrombopag. There were 2 mild bleeding events, no thromboembolic events or deaths, and no patients received rescue procedures (excluding transfusions). This study found that in a real-world setting, treatment with avatrombopag was well tolerated, increased the mean platelet count by procedure day, and reduced the need for intraoperative platelet transfusions in patients with CLD and thrombocytopenia.