bluuebunny/crossref_metadata_2025 huggingface dataset:
S181. ANALYSIS OF THE AMELIORATING EFFECT OF D-SERINE ON GLUN2D DEFICIENT MICE
Authors: Mallien Anne , Herb Anne , Monyer Hannah , Inta Dragos , Gass Peter
Published: May 2020

Background

The glutamate hypothesis of schizophrenia postulates NMDA receptor (NMDAR) hypofunction as a major pathophysiological mechanism based on clinical observations and preclinical evidence. Mice with globally reduced NMDAR expression display hyperlocomotion, sensorimotor gating deficits, cognitive deficits and social withdrawal. NMDARs are tetramers composed of 2 obligatory GluN1 (NR1) and 2 variable GluN2A-D (NR2A-D) subunits. GluN2A and GluN2B are the main cortical NMDAR subunits, but genetic models provided evidence that psychosis-like effects of NMDAR antagonists are mediated by GluN2C/GluN2D subunits. Previous data suggest a role also of the GluN2D subunit in schizophrenia-associated abnormalities [1].

Methods

We aimed to assess a comprehensive behavioural phenotyping of GluN2D deficient mice, including locomotion, affective behaviours and general welfare, but drew special focus on cognitive functions, including spatial learning, short-term and long-term memory, as well as puzzle solving. We further investigated the effect of D-Serine on the GluN2D KO mice. D-Serine is a NMDAR modulator and acts as an agonist at the glycine site. Previous work in clinical trials suggests significant therapeutic effects of D-serine on negative and positive symptoms, cognitive deficits and motor symptoms. We used the chronic application of D-Serin by supplementing it into the drinking water of the subjects.

Results

Preliminary data indicate no effect on locomotor alterations of the GluN2D mice, however a potential improvement in short-term memory and wellbeing-associated parameters. They indicate a role of the GluN2D subunit and a beneficial effect of D-serine on schizophrenia-induced parameters, including physiological, welfare-associated burrowing and cognitive performance in the short term task of the puzzle box test.

Discussion

Our preliminary data indicate a role of the GluN2D subunit in the emergence of cognitive deficits associated with schizophrenia and a potential therapeutic effect of D-serine in alleviating these deficits. Further investigations are planned to further validate these findings.

Reference
S184. IN SILICO PREDICTION OF T-CELL-MEDIATED MOLECULAR MIMICRY IN TOXOPLASMOSIS AND SCHIZOPHRENIA
Authors: Thylur David , Lori Adriana , Avramopoulos Dimitri , Mulle Jennifer , Goes Fernando , Conneely Karen , Pulver Ann , Pearce Brad
Published: May 2020

Background

Exposure to Toxoplasma gondii (TOXO) has been consistently associated with the development of schizophrenia, but the neurobiological mechanism through which this occurs is not well elucidated. Emerging data has broadly implicated the adaptive immune system as a possible pathway from TOXO infection to schizophrenia. In order to explore the hypothesis that crossreactive T cells could help mediate this relationship, we built upon the genetic analysis from our psychiatrically-enriched Ashkenazi Jewish cohort using an in silico approach to predict HLA reactivity to TOXO epitopes, with the aim of identifying host proteins that could be susceptible to T-cell-mediated molecular mimicry.

Methods

We used netMHCpan v4.0 to generate a library of 2182 oligopeptides from the TOXO proteome that were predicted to be strongly antigenic for individuals with HLA-C*04:01, an allele of interest since our analysis indicated that the odds ratio for TOXO infection were in the opposite direction for those with schizophrenia compared to controls. A predicted binding affinity less than 500 nM was used to identify epitopes that were likely to be biologically relevant. Epitopes identified by this approach were compared with human peptides for local sequence similarity using BLAST optimized for short peptide sequences in order to identify host proteins that could mimic TOXO antigens. Ingenuity Pathway Analysis was then used to interpret and synthesize possible biological relationships between predicted autoantigens and schizophrenia.

Results

Our pipeline identified 38 candidate proteins for molecular mimicry at a threshold of P<.05 after correcting for multiple testing. A number of these genes have been strongly linked to schizophrenia through genetic studies, including HSPA9, PSMA4, and ZDHHC5. Pathway and gene ontology analysis revealed that these genes were involved in networks of regulation of gene expression as well as ubiquitination, which participates in antigen presentation.

Discussion

Using an in silico approach, we identified 38 human proteins that could be targeted by a crossreactive T cell autoimmune response after exposure to TOXO. Several of these candidate proteins are highly relevant for genetic risk of schizophrenia and participate in molecular pathways that mediate antigen processing. CD8+ T cells contribute to autoimmunity through cytokine release and have been implicated in the relationship between TOXO exposure and schizophrenia. Though these results will need experimental confirmation, we hope that they will spur further research on the role of the adaptive immune system in toxoplasmosis and schizophrenia.
The Dynamics of Brokering in Second Generation Transnationalism
Authors: Gutierrez Armand
Published: May 2020

This study uses the concept of brokerage to explain how the transnational ties of the children of migrants born in the host country, i.e., the second generation, are initiated and sustained. By examining second generation Mexican- and Filipino-Americans, two groups that differ in linguistic proficiency, geographical proximity to the home country, and interpersonal contact with nonmigrants, this study highlights the common role of a broker for both groups. These findings also reveal the ways in which second generation ties can differ. The second generation utilized middleman brokerage, in which a broker is present throughout each connection; and catalyst brokerage, in which a broker facilitates only the initial ties. Overall, these forms of brokerage were shaped by the type of cross-border connection, linguistic proficiency, interpersonal contact, and emotional attachments between nonmigrants and the second generation. While Filipino-Americans in the sample generally required a middleman broker to be present throughout each connection, Mexican-Americans had a greater capacity to eventually engage in dyadic connections. Given the triadic nature of connections, cross-border ties were shaped and limited by the capacities and emotional attachments of those in the ancestral homeland, immigrant brokers, and the second generation.
Highly Hydrophilic Polyurethane Foam Dressing Versus Early Hydrophilic Polyurethane Foam Dressing on Skin Graft Donor Site Healing in Patients with Diabetes: An Exploratory Clinical Trial
Authors: Namgoong Sik , Jung Jae-Eun , Yoon Young-Don , Han Seung-Kyu , Lee Ye-Na , Son Ji-Won
Published: May 2020

OBJECTIVE

To compare the effects of early hydrophilic polyurethane (EHP) foam dressing and highly hydrophilic polyurethane (HHP) foam dressing on wound healing in patients with diabetes.

METHODS

Twenty patients with diabetes with skin graft donor sites on the lateral thigh were enrolled in this study. Each donor site was divided into two equal-sized areas for the application of HHP or EHP foam dressing. The study endpoint was the time required for healing, defined as complete epithelialization of the donor site without discharge. All possible adverse events were also documented.

MAIN RESULTS

Donor site healing was faster in 15 patients on the HHP half and 1 patient on the EHP half. In four patients, healing rates were the same between the HHP and EHP areas. Donor sites treated with HHP and EHP foam dressings healed in 17.2 ± 4.4 and 19.6 ± 3.7 days (P = .007), respectively. During the study period, no adverse event associated with the dressings occurred in either group.

CONCLUSIONS

The HHP foam dressing might provide faster healing than EHP foam dressing for skin graft donor sites in patients with diabetes.
EQual Rubric Evaluation of the Association of American Medical Colleges’ Core Entrustable Professional Activities for Entering Residency
Authors: Meyer Eric G. , Taylor David R. , Uijtdehaage Sebastian , Durning Steven J.
Published: May 2020

Purpose

To have subject matter experts evaluate the Core Entrustable Professional Activities for Entering Residency (Core EPAs) with the EQual rubric to determine if revisions were required and, if applicable, how to focus revision efforts.

Method

Ten entrustable professional activity (EPA) experts were invited to evaluate the 13 Core EPAs. Experts had a 6-month window (December 2018–May 2019) to complete the evaluation, which contained the complete EQual rubric and 3 additional prompts, one of which—“Do you think this EPA requires revision?”—was limited to a “yes/no” response. Descriptive statistics for overall and domain-specific EQual rubric scores for each of the 13 Core EPAs were calculated. Free-text responses to why and/or how a Core EPA should be revised were summarized for any Core EPA that scored below a cutoff or for which the majority of experts recommended revision.

Results

Six experts completed the evaluation. Most Core EPAs’ (9/13) overall score was above the cutoff, indicating that they align with the key domains of the EPA construct. The remaining 4 Core EPAs (2, 7, 9, and 13) scored below the overall cutoff, suggesting that they may require revision. A majority of experts felt that Core EPAs 6, 7, 9, and 13 required revision. With regard to domain-specific scores, Core EPAs 2, 3, 7, 9, and 13 were below the discrete units of work cutoff; Core EPAs 7, 9, and 13 were below the entrustable, essential, and important tasks of the profession of medicine cutoff; and Core EPA 9 was below the curricular role cutoff.

Conclusions

The Core EPAs represent a promising initial framework of EPAs for undergraduate medical education. Some Core EPAs might benefit from revision. The process of improving the Core EPAs must continue if they are to standardize outcomes for medical school graduates.
MD–PhD Program Graduates’ Engagement in Research: Results of a National Study
Authors: Andriole Dorothy A. , Grbic Douglas , Yellin Jodi , McKinney Ross
Published: May 2020

Purpose

To determine if specialty, among other professional development and demographic variables, predicted MD–PhD program graduates’ research engagement.

Method

The authors merged the 2015 Association of American Medical Colleges (AAMC) National MD–PhD Program Outcomes Survey database with selected data from the AAMC Student Records System, Graduation Questionnaire, and Graduate Medical Education (GME) Track Resident Survey. At the person level, they tested variables of interest for independent associations with MD–PhD graduates’ research engagement using chi-square, Pearson correlations, and analysis of variance tests and logistic and linear regressions.

Results

Of 3,297 MD–PhD graduates from 1991–2010 who were no longer in GME training in 2015, 78.0% (2,572/3,297) reported research engagement. In models controlling for several variables, a neurology (vs internal medicine; adjusted odds ratio [AOR]: 2.48; 95% confidence interval [CI]: 1.60–3.86) or pathology (vs internal medicine; AOR: 1.89; 95% CI: 1.33–2.68) specialty, full-time faculty/research scientist career intention at graduation (vs all other career intentions; AOR: 3.04; 95% CI: 2.16–4.28), and ≥ 1 year of GME research (vs no GME research year[s]; AOR: 2.45; 95% CI: 1.96–3.06) predicted a greater likelihood of research engagement. Among graduates engaged in research, the mean percentage of research time was 49.9% (standard deviation 30.1%). Participation in ≥ 1 year of GME research (beta [β] coefficient: 7.99, P < .001) predicted a higher percentage of research time, whereas a radiation oncology (β: −28.70), diagnostic radiology (β: −32.92), or surgery (β: −29.61) specialty, among others, predicted a lower percentage of research time (each P < .001 vs internal medicine).

Conclusions

Most MD–PhD graduates were engaged in research, but the extent of their engagement varied substantially among specialties. Across specialties, participation in research during GME may be one factor that sustains MD–PhD graduates’ subsequent early- to midcareer research engagement.
The Post-caregiving Health Model
Authors: Corey Magan Kristin , McCurry Mary K. , Sethares Kristen A. , Bourbonniere Meg , Meghani Salimah H. , Hirschman Karen B.
Published: May 2020

Presently, there is a dearth of theoretical models to guide research on the population of former dementia caregivers. The purpose of this article is to describe the development of the Post-caregiving Health Model and its potential for generating a more nuanced understanding of the health of family caregivers following the death of a care recipient with dementia. The model highlights the impact of personal and environmental characteristics, appraisal, coping, and emotion on long-term health outcomes in this population and offers a viable framework for studying long-term health outcomes among caregivers following the care recipient's death.
School Discipline Experiences Among Youth With Disabilities From the Perspective of School Nurses
Authors: Fraley Hannah E. , Capp Gordon , Aronowitz Teri
Published: May 2020

Youth with disabilities disproportionately experience harsh discipline. Exploring perspectives of behavior and discipline could increase inclusivity, yet school nurses' perspectives are unexplored. Using the Peace and Power Conceptual Model, school nurses' perspectives were explored employing secondary qualitative analysis using Thorne's typology of analytic expansion. Parent study included interviews with school nurses, 24 data files comprised the sample for secondary analysis. Three peace-power versus power-over themes emerged: “having discordant perspectives,” “being mislabeled,” and “placing at higher risks.” School nurses are equipped to build healthy school communities through changes in discipline practices, policies, and understanding of how youth with disabilities are impacted.
Patient and Parent Decision-Making in the Setting of Chemotherapy-Induced Sensorineural Hearing Loss
Authors: Schulz Ginny L. , Hayashi Susan , Spence Anne , Lieu Judith , King Allison , Hayashi Robert J. , Mohrmann Caroline
Published: May 2020

Objectives:

Children with malignancies may be exposed to ototoxic therapies resulting in sensorineural hearing loss (SNHL). There is no consensus as to when intervention with amplification is necessary due to a variety of factors such as disease status, speech and language development, perceived difficulty with communication, and limitations of technology to fit these challenging losses. The decision to proceed with amplification after cancer can be difficult for patients and families. The purpose of this study is (1) to understand the decision-making (DM) process of childhood cancer survivors (CCSs) with SNHL and their parents and (2) to identify their decisional needs.

Design:

Semi-structured interviews guided by the Ottawa’s decision support framework were recorded and transcribed verbatim. Inclusion criteria were CCSs ages 8 to 30 years old with a Chang grade >1b SNHL and off-therapy; parents of this group were also eligible. Patients with active disease were excluded. Prompts inquired of sources of decisional conflict, role in DM, and DM behaviors. Inductive content analysis of the narrative qualitative data was used.

Results:

Seven parents of CCSs and 6 CCSs participated. Themes in the CCS group included: (1) making sense of ototoxic SNHL; (2) desiring personalized education and treatment of SNHL; (3) playing an active role in the joint DM process; and (4) accepting hearing aids requires time and effort. The parent group shared the first and last theme with the CCS group and had two unique themes: (1) needing experts to respect the individual’s journey to SNHL acceptance and (2) moving past the cancer experience to acceptance. Parents more often framed their DM within the context of already experiencing the trauma of cancer, whereas CCSs did not. One parent said, “You see all the rubble and you’ve lived through the devastation of the storm, but now you got to figure out what’s broken.” CCSs expressed bodily concerns regarding amplification, such as discomfort to the ear and difficulty in adjusting to the volume. The following needs were identified: early, re-enforced education regarding late effects risks; open communication among providers, CCSs, and parents; and audiogram result interpretations in patient- and parent-friendly language.

Conclusions:

Understanding the DM process from the CCS and parent’s perspectives should be considered when providing counseling for hearing amplification in the setting of cancer-related SNHL. Earlier and consistent delivery of late effects education, open communication regarding risk for SNHL, and improved delivery of audiogram results should be targets for meeting unmet needs. These findings should inform the development of decision aids to reduce decisional conflict in this population.
A dynamic knee extension device improves flexion contracture before total knee arthroplasty: a randomized controlled trial
Authors: Stone Andrea H. , Turcotte Justin J. , Fowler M. Brook , MacDonald James H. , Brassard Marc F. , King Paul J.
Published: May 2020

Background:

Postoperative flexion contracture (FC) after total knee arthroplasty (TKA) affects gait and causes pain and fatigue, which can result in poor patient outcomes and decreased satisfaction. This study evaluates a dynamic extension brace that may help improve extension and decrease the rate of postoperative FC.

Methods:

This study was a prospective randomized controlled trial of 101 patients with a FC of ≥10 degrees scheduled to undergo TKA. Primary outcome was change in maximal active extension during the perioperative period; secondary outcomes were patient-reported outcomes. Data were collected at enrollment, preoperative appointments, and 2-week postoperative appointments. Chi-squared, t tests and repeated measures analysis of variance (ANOVA) were used to evaluate the results between and within groups.

Results:

Fifty-five patients were in the control group and 46 in the experimental group. The mean FC in the experimental group was significantly worse at enrollment (14.22 degrees vs. 15.76 degrees, P=0.049), but improved by the preoperative appointment (15.76 degrees to 12.52 degrees, P<0.001), while the control group FC remained stable. The experimental group experienced a greater improvement in Knee Society Knee Scores and a smaller decline in Knee Society Function Scores compared with the control group. The experimental group experienced a significant improvement in Knee Injury and Osteoarthritis Outcome Score (KOOS) score through all time points (29.47 degrees to 35.84 degrees to 51.33 degrees, P<0.001), while the control group only had significant improvement from enrollment to postoperative appointment (35.06 degrees to 49.15 degrees, P<0.001).

Conclusions:

Patients with FC that used a dynamic knee extension brace preoperatively had improved extension before surgery and more rapid improvement in outcome measures when compared to patients treated with a standard program alone.

Level of Evidence:

Level I.
Treatment of Displaced Intra-articular Calcaneal Fractures With an Interlocking Nail (C-Nail)
Authors: Veliceasa Bogdan , Filip Alexandru , Pinzaru Roxana , Pertea Mihaela , Ciuntu Bogdan , Alexa Ovidiu
Published: May 2020

Objectives:

To assess the outcome of the sinus tarsi approach and C-Nail fixation of displaced intra-articular calcaneal fractures (DIACFs).

Design:

Prospective study.

Setting:

University Trauma Department.

Patients:

Sixty-four patients (mean age 44.3 years, 48 men and 16 women) with 75 DIACFs were treated between October 1, 2016 and December 31, 2018.

Intervention:

In all cases, the posterior facet was reduced through the sinus tarsi approach and fixed with one or 2 screws. After reducing all fragments to the articular block, the final fixation was performed percutaneously with C-Nail, locked with 6 screws.

Main Outcome Measurements:

Patients were assessed for restoration of the Böhler angle, complications, and overall fracture reduction. To assess the functional outcome, we used the Mean American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score and Maryland Foot Score after 12 months.

Results:

The Böhler angle improved from −0.5 degrees preoperatively to 28.6 degrees postoperatively. The articular step-off was reduced from 5.4 mm preoperatively to 0.6 mm postoperatively. The postoperative radiologic calcaneal score was 2.9, on average. Superficial wound edge necrosis was seen in 3 patients (4%) and superficial infection was observed in one (1.3%). After a 1-year follow-up, we recorded a mean American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score of 90.2 and a mean Maryland Foot Score of 91.2.

Conclusions:

After obtaining an anatomic reduction of the articular surface of the posterior facet with lag screws, the C-Nail represented a viable alternative to plate stabilization in the treatment of DIACFs, combining primary stability with low soft tissue complications.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Reliability of Radiographic Union Scoring in Humeral Shaft Fractures
Authors: Schneble Christopher A. , Li Don T. , Kahan Joseph , Brand Jordan , Socci Adrienne , Haims Andrew , Yoo Brad J.
Published: May 2020

Objectives:

To establish the reliability of 2 radiographic union scoring systems for nonoperative humeral shaft fractures.

Design:

Retrospective medical record review. Patients identified had humeral shaft fractures and radiographs at various follow-up time points, which were graded according to the both the standard (RUST) and modified radiographic union scoring systems (mRUST).

Setting:

A single North American Level-1 Trauma center in Connecticut, including emergency department and clinic follow-up visits.

Patients/Participants:

Forty-five adult patients (162 image sets) met the following inclusion criteria: diaphyseal humerus fracture, initial nonoperative management, and greater than 2 weeks of follow-up with imaging.

Intervention:

All 162 image sets of anterior–posterior and lateral radiographs were scored and divided into 4 tiers based on increasing score. Anterior–posterior and lateral image sets were randomly selected from each tier for a total of 50 that were then scored by 7 different reviewers using both the RUST and mRUST systems.

Main Outcome Measures:

The intraclass correlation coefficients for the cortical and system scores for the RUST and mRUST systems.

Results:

Interobserver reliability was 0.795 for the RUST system and 0.801 for mRUST. Intraobserver reliability was 0.909 for RUST and 0.949 for mRUST. For mRUST, 92% of values were within ± 1 point from each other.

Conclusions:

The RUST and mRUST systems can be applied to humeral shaft fractures with excellent reliability. They have the potential to assist in the diagnosis of humeral shaft union by providing an objective and standardized method to assess healing of bone over time.
Coronal Remodeling Potential of Pediatric Distal Radius Fractures
Authors: Lynch Kyle A. , Wesolowski Michael , Cappello Teresa
Published: May 2020

Background:

Distal radius fractures in the pediatric population are common injuries with a remarkable capability to remodel. The degree of angulation that can reasonably be expected to remodel is controversial though, particularly when it comes to angulation in the coronal plane. The purpose of this study was to quantify the rate of coronal remodeling, via the distal radius physis, present in a retrospective cohort of skeletally immature patients with coronally angulated distal radius fractures.

Methods:

A retrospective chart review was performed to identify skeletally immature patients treated for an angulated distal radius fracture with over 10 degrees of angulation in the coronal plane during the healing process at a single institution by either a pediatric orthopaedic surgeon or an orthopaedic trauma surgeon from 2009 to 2018. Coronal angulation was measured at every visit where radiographs were available from time of injury to the final follow-up visit to determine the rate of remodeling.

Results:

In total, 36 patients with distal radius fractures with a mean age of 7.93 years (range, 4 to 12 y) at the time of injury were identified. The median peak angulation during the healing process in the coronal plane was 17 degrees (range, 12.4 to 30.4 degrees). The mean follow-up period was 6.4 months from the time of maximum angulation to the final visit. The median time from cast removal to final follow-up was 6.59 months (range, 2.5 to 8.72 mo). At final follow-up, the median coronal angulation was 3.35 degrees (range, 0.24 to 14.0 degrees). At the 95% confidence level, remodeling rates ranged from 2.00 to 2.59 degrees per month. The mean rate of coronal angulation remodeling from maximum angulation to final follow-up was 2.30 degrees per month.

Conclusions:

Distal radius fractures have a large capacity to remodel in the pediatric population. This remodeling occurs in a predictable and reliable manner, even in the coronal plane. On the basis of this study, coronal angulation was shown to remodel at a rate of at least 2 degrees per month for the first 6 months following the injury, which should likely continue at a similar rate for the first year after the injury. Repeat manipulation is not indicated in skeletally immature patients where the maximum coronal angulation is <24 degrees, which provides a conservative estimate of the amount of remodeling that can be expected to occur in the first year after fracture.

Level of Evidence:

Level III—retrospective comparative study.
Comparison of Clinical Outcomes Between Posterior Instrumented Fusion With and Without Interbody Fusion for Isthmic Spondylolisthesis
Authors: Chan Vivien , Nataraj Andrew , Bailey Christopher , Abraham Edward , Soroceanu Alex , Johnson Michael , Paquet Jérôme , Christie Sean , Stratton Alexandra , Hall Hamilton , Manson Neil , Rampersaud Y. Raja , Thomas Kenneth , Fisher Charles
Published: May 2020

Study Design:

A multicenter ambispective study using the Canadian Spine Outcomes and Research Network to compare clinical outcomes in adult patients with isthmic spondylolisthesis who received surgery.

Objective:

The purpose of this study is to compare 1-year postoperative clinical outcomes between posterior instrumented fusion with and without interbody fusion in patients with isthmic spondylolisthesis.

Summary of Background Data:

Despite the increased use of interbody fusion in patients with isthmic spondylolisthesis, clinical superiority has not been demonstrated. It remains unclear what the optimal surgical approach is for this population.

Materials and Methods:

The primary outcome was changed in leg pain at 1 year. Secondary outcomes were changed in Oswestry Disability Index, Short Form-12 Physical Component Score, and back pain at 1-year postoperative follow-up, estimated intraoperative blood loss, length of surgery, length of stay, number of transfusions, and adverse events. Descriptive statistics, Student t test, χ2 test, and stepwise multivariable regression were used for analysis.

Results:

In total, 300 patients were included in this study. Of the 300 patients, 252 received posterolateral instrumented fusion with interbody fusion and 48 received posterolateral instrumented fusion alone. There were no significant differences in primary and secondary clinical outcomes at 1-year postoperative follow-up between the 2 groups. There were no significant differences in estimated blood loss (441 vs. 356 mL), length of surgery (210 vs. 224 min), length of stay (4 vs. 4 d), rate of transfusions (5.6% vs. 8.3%), and number of adverse events (33% vs. 23%) between patients who received interbody fusion and patients who did not. The addition of interbody fusion was not a significant variable for primary and secondary clinical outcomes in the stepwise multivariable regression analysis.

Conclusions:

There were no significant differences in clinical outcomes at 1 year or in the number of early complications between patients who received posterolateral fusion or posterior/transformational lumbar interbody fusion.

Level of Evidence:

Level III.
TUG1 knockdown inhibits the tumorigenesis and progression of prostate cancer by regulating microRNA-496/Wnt/β-catenin pathway
Authors: Li Gang , Yang Jie , Chong Tie , Huang Yue’e , Liu Ying , Li Hongliang
Published: May 2020

Our study aimed to further investigate the roles and molecular mechanisms of lncRNA taurine upregulated gene 1 (TUG1) in the development and progression of PC. RT-qPCR assay was carried out to measure expression of TUG1, miR-496, together with β-catenin, cyclin D1 and c-myc. Protein levels of β-catenin, cyclin D1 and c-myc were detected by western blot assay. Cell proliferative ability was assessed by colony formation assay and CCK-8 assay. Cell migratory and invasive capacities were evaluated by Transwell migration and invasion assay. The interaction between miR-496 and TUG1 was explored by bioinformatics analysis, luciferase reporter assay and RNA immunoprecipitation assay. Mouse xenograft experiments were performed to further investigate the roles and molecular basis of TUG1 in the tumorigenesis of PC in vivo. TUG1 was highly expressed in PC tissues and cells (DU145 and PC3). TUG1 knockdown inhibited proliferation, migration and invasion in DU145 and PC3 cells. Moreover, TUG1 suppressed miR-496 expression by direct interaction. TUG1 overexpression abrogated miR-96-mediated antiproliferation, anti-migration and anti-invasion effects in DU145 and PC3 cells. TUG1 knockdown inactivated Wnt/β-catenin signaling pathway by upregulating miR-496 in DU145 and PC3 cells. Additionally, TUG1 knockdown inhibited DU145 cells derived PC xenograft growth by upregulating miR-496 and inactivating Wnt/β-catenin signaling in vivo. TUG1 knockdown suppressed PC cell proliferation, migration and invasion in vitro and curbed PC xenograft growth in vivo by regulating miR-496/Wnt/ β-catenin signaling pathway, deepening our understanding on etiology of PC.
Decompressive Craniectomy Is Associated With Good Quality of Life Up to 10 Years After Rehabilitation From Traumatic Brain Injury
Authors: Rauen Katrin , Reichelt Lara , Probst Philipp , Schäpers Barbara , Müller Friedemann , Jahn Klaus , Plesnila Nikolaus
Published: May 2020

Objectives:

Traumatic brain injury is the number one cause of death in children and young adults and has become increasingly prevalent in the elderly. Decompressive craniectomy prevents intracranial hypertension but does not clearly improve physical outcome 6 months after traumatic brain injury. However, it has not been analyzed if decompressive craniectomy affects traumatic brain injury patients’ quality of life in the long term.

Design:

Therefore, we conducted a cross-sectional study assessing health-related quality of life in traumatic brain injury patients with or without decompressive craniectomy up to 10 years after injury.

Setting:

Former critical care patients.

Patients:

Chronic traumatic brain injury patients having not (n = 37) or having received (n = 98) decompressive craniectomy during the acute treatment.

Measurements and Main Results:

Decompressive craniectomy was necessary in all initial traumatic brain injury severity groups. Eight percent more decompressive craniectomy patients reported good health-related quality of life with a Quality of Life after Brain Injury total score greater than or equal to 60 compared with the no decompressive craniectomy patients up to 10 years after traumatic brain injury (p = 0.004). Initially, mild classified traumatic brain injury patients had a median Quality of Life after Brain Injury total score of 83 (decompressive craniectomy) versus 62 (no decompressive craniectomy) (p = 0.028). Health-related quality of life regarding physical status was better in decompressive craniectomy patients (p = 0.025). Decompressive craniectomy showed a trend toward better health-related quality of life in the 61–85-year-old reflected by median Quality of Life after Brain Injury total scores of 62 (no decompressive craniectomy) versus 79 (decompressive craniectomy) (p = 0.06).

Conclusions:

Our results suggest that decompressive craniectomy is associated with good health-related quality of life up to 10 years after traumatic brain injury. Thus, decompressive craniectomy may have an underestimated therapeutic potential after traumatic brain injury.
The Novel Coronavirus Disease (COVID-19) and Its Impact on Cardiovascular Disease
Authors: Golemi Minga Iva , Golemi Lolita , Tafur Alfonso , Pursnani Amit
Published: May 2020

The coronavirus disease 2019 (COVID-19) pandemic has placed a significant strain on healthcare providers. As the number of patients continue to surge, healthcare workers are now forced to find different approaches to practicing medicine that may affect patient care. In addition, COVID-19 has many cardiovascular complications that affect the clinical course of patients. In this article, we summarize the cardiovascular impact of COVID-19 and some of the challenges that patients and the healthcare system will face during this pandemic.
Perceived Role of Built and Social Environments on Childhood Obesity
Authors: Rosado Javier I. , Rivera Alexa , Fernandez Tatiana
Published: May 2020

The childhood obesity epidemic in the United States is well documented; however, limited attention has been given to Latino children from migrant farmworking families, and there is little research on how environmental and social factors contribute to overweight among this population. This article presents qualitative themes related to the role of the built and social environments in influencing diet, physical activity, and ultimately, health and weight status. Themes were identified through the PhotoVoice method, with 13 parent participants representing 30 children from a rural farmworking community in Southwest Florida.
Opposing Discourses Surrounding Type 2 Diabetes in Eastern Appalachian Kentucky
Authors: Della Lindsay J. , Ashlock Mary Z. , Hartson Kimberly R. , King Kristi M. , Basta Tania B.
Published: May 2020

Type 2 diabetes disproportionately affects individuals in Appalachia. This study investigated discourse among friends and family with different diabetes risk levels in Central Appalachia. Eighteen semistructured, in-depth interviews were conducted with Appalachian Kentuckians. Thematic analysis revealed 2 dialectic tensions centered on disease management (health as a personal problem vs diabetes management requiring social support) and disclosure (openness vs closedness). Health professionals should consider the powerful influence of speech with respect to family relations and support, along with the need to communicate early, clearly, and often in a manner that emphasizes family, friends, and connectedness.
Family
Authors: McKinley Catherine E. , Roh Soonhee , Lee Yeon-Shim , Liddell Jessica
Published: May 2020

Cancer disparities among American Indian (AI) women are alarming, yet a dearth of research focuses on the role of family support for such women. The purpose of this research was to examine the composition of AI women cancer survivors' family support networks and the types of support that they provided. We used a qualitative descriptive methodology with 43 AI women cancer survivors and qualitative content analysis, which indicated that 38 participants (approximately 90%) reported that their families provided integral and varied forms of support, especially instrumental support throughout cancer experiences. Families were the bedrock of support for AI women cancer survivors.
Racial Differences in the Influence of Health Care System Factors on Informal Support for Cancer Care Among Black and White Breast and Lung Cancer Survivors
Authors: Ellis Katrina R. , Black Kristin Z. , Baker Stephanie , Cothern Carol , Davis Kia , Doost Kay , Goestch Christina , Griesemer Ida , Guerrab Fatima , Lightfoot Alexandra F. , Padilla Neda , Samuel Cleo A. , Schaal Jennifer C. , Yongue Christina , Eng Eugenia
Published: May 2020

This retrospective, secondary qualitative analysis investigates whether health system factors influence social support among Black and white breast and lung cancer survivors and racial differences in support. These data come from race- and cancer-stratified focus groups (n = 6) and interviews (n = 2) to inform a randomized controlled trial utilizing antiracism and community-based participatory research approaches. Findings indicate social support was helpful for overcoming treatment-related challenges, including symptom management and patient-provider communication; racial differences in support needs and provision were noted. Resources within individual support networks reflect broader sociostructural factors. Reliance on family/friends to fill gaps in cancer care may exacerbate racial disparities.
A Case for a Local Flap as Primary Reconstruction for Hidradenocarcinoma of the Leg
Authors: McMains Conner J. , Hung Rex W. , Deng Tom , Masden Derek L.
Published: May 2020

Hidradenocarcinomas are rare, aggressive sweat gland tumors typically occurring in the scalp and upper extremities. They have rarely been described in the lower extremity. Due to their rarity, there is little consensus on optimal adjuvant therapy for these tumors after resection. Regardless, it is important to plan tumor excision and subsequent reconstruction with adjuvant therapy in mind. This case report describes a patient for whom a local muscle flap with skin graft provided adequate wound coverage after excision of hidradenocarcinoma and negative-pressure wound therapy. The surgical site then withstood adjuvant radiation therapy. When radiation is planned to a wound bed after tumor excision, a local muscle flap is the excellent first choice over skin graft alone regardless of wound bed characteristics.
The Whole Glove Tourniquet Technique Revisited With Video Instruction
Authors: Steve Anna K. , Shine Julien J. , Nickerson Duncan
Published: May 2020

This article revisits the whole glove tourniquet technique with video instruction. The whole glove tourniquet is a digital device that can be used to improve patient safety during hand surgery procedures performed under local anesthesia. Major benefits include of using this device are lower risk of the tourniquet being inadvertently left on the finger after completion of the procedure and improved sterile field in patients with heavily soiled extremities. The procedure is simple to use and does not require any specialized equipment, making it ideal for a wide variety of economic environments.
New Simple Technique for Syndactyly Release
Authors: Grahn Petra M. , Nietosvaara Noora N. , Sommarhem Antti J. , Nietosvaara Yrjana A.
Published: May 2020

Background:

Can good functional and cosmetic result be achieved in syndactyly separation using a straight midline incision with a hexagonal dorsal skin flap?

Methods:

We performed 39 web reconstructions at a median of 20 months of age (11–43 months) to 26 consecutive children (21 male) with 30 simple, 4 complex, and 5 complicated syndactylies. Eighteen of the simple syndactylies were incomplete, ending at the proximal interphalangeal joint in 15 and at the distal interphalangeal joint in 3. Inguinal skin grafts were used in 2 children with either complex or complicated syndactyly. Operation time was recorded. Complications were registered. Height of the new web spaces was calculated. Parents’ satisfaction on both functional and cosmetic outcome was assessed using a Visual Analog Scale from 0 to 100.

Results:

Duration of one web reconstruction ranged from 50 to 95 minutes in simple incomplete, 56 to 135 in simple complete, 116 to 151 in complex, and 72 to 123 in complicated syndactylies. One child had a self-induced bilateral postoperative infection that lead to web creep. Two patients developed hypertrophic scars, which responded well to silicone treatment. Mean cosmetic and functional Visual Analog Scale scores were 87 (45–100) and 92 (63–100), respectively, at a mean follow-up of 1.3 years (range, 0.5–3.7).

Conclusion:

Web reconstruction using a hexagonal dorsal skin flap and straight midline incisions with closure at mid-lateral lines is safe, with good cosmetic and functional outcome in our short-term follow-up.
Radiofrequency-Assisted Endofistulectomy: Treating Coexisting Lacrimal Fistulae During Endoscopic Dacryocystorhinostomy
Authors: Bothra Nandini , Ali Mohammad Javed
Published: May 2020

Purpose:

To assess the efficacy of radiofrequency-assisted endofistulectomy in patients with lacrimal fistulae communicating with the lacrimal sac.

Methods:

Retrospective interventional case series of patients undergoing endoscopic dacryocystorhinostomy with endofistulectomy from June 2016 to January 2020 were studied. The indications of endoscopic dacryocystorhinostomy were associated refractory complex congenital nasolacrimal duct obstructions and primary-acquired nasolacrimal duct obstruction. The communication of the fistulae with the lacrimal sac was ascertained. Specific surgical parameters and technique were used, and the variables assessed include patient demographics, clinical presentation, indications, surgical technique, recurrences, and outcomes.

Results:

Six eyes of 6 patients with mean age of 23.33 years underwent radiofrequency-assisted endofistulectomy. The surgical technique was found to be minimally invasive, easy to perform with multiple advantages like absence of a skin incision, targeting of the complete extent of the fistula, and complete closure of the external and internal openings of the fistulae. At 4 weeks, dacryocystorhinostomy ostium was well mucosalized and patent with a dynamic common canalicular opening. The fistula site had healed well with no epiphora or discharge or residual scarring.

Conclusion:

Radiofrequency-assisted endofistulectomy is a minimally invasive and viable alternative to incisional fistulectomy in select group of patients of congenital or acquired fistulae which communicate with the lacrimal sac.
Lateral Tarsoconjunctival Flap Suspension Treatment of Post Blepharoplasty Lower Eyelid Retraction
Authors: Conger Jordan R. , Grob Seanna R. , Limongi Roberto M. , Tao Jeremiah P.
Published: May 2020

Purpose:

To describe and evaluate the use of a lateral tarsoconjunctival suspension flap (TCSF) for the management of post blepharoplasty lower eyelid retraction.

Methods:

Two-center, retrospective chart review of patients who received a lateral TCSF between 2010 and 2018 for correction of post blepharoplasty lower eyelid retraction. The postoperative follow-up was a minimum of 3 months. Pre- and postoperative lower eyelid position (margin reflex distance 2 on standard photographs), degree of ocular surface disease, symptoms, complications, and need for further intervention were recorded. Pre- and postoperative photographs were scored using an objective grading system for cosmetic surgical results (MDACS).

Results:

Forty-eight eyelids from 30 patients met inclusion criteria for this study. Twenty (67%) of the patients were female. Age ranged from 55 to 89 (mean, 73.2). After the TCSF, ocular surface exposure improved in all cases. Lower eyelid retraction (average margin reflex distance 2 pre- vs. postintervention) improved in 98% of cases. Objective scoring of appearance improved; the mean MDACS score was 8 pre- and 3 post-TCSFs (p < 0.0001). One patient required midface lift and lateral canthoplasty 7 months later for undercorrected eyelid retraction. Another case required partial resection due to visibility of the flap in the interpalpebral zone. Postoperative pyogenic granulomas were noted in 8% (4/48) of eyelids.

Conclusions:

The lateral TCSF was safe and effective in improving both functional and esthetic parameters in this series of post blepharoplasty eyelid retraction patients.
Ophthalmic Surgeries and Systemic Medical Conditions Associated With the Development of Involutional Ptosis
Authors: Cohen Liza M. , Campbell Benjamin C. , Esfandiari Mahtash , Goldberg Robert A. , Rootman Daniel B.
Published: May 2020

Purpose:

To investigate the associations between systemic medical conditions and types of ocular surgery and the development of aponeurotic ptosis.

Methods:

In this case-control observational cohort study, the relative prevalence of involutional ptosis in a large population of adult patients was assessed. Deidentified patient data from a 10-year time period was obtained from the electronic medical records of 5 large academic medical centers. Patients were selected based on ICD9 and ICD10 codes for involutional ptosis. Control patients were age and gender matched and randomly selected from a general adult population. Systemic comorbidities were determined based on ICD9 and ICD10 codes, and prior ocular surgeries based on CPT codes. The influence of systemic comorbidities and ocular surgery was examined utilizing logistic regression analysis.

Results:

The study cohort consisted of 8297 adult patients with involutional blepharoptosis and 13,128 matched controls. The average age was 65 years. The 3 significant risk factors for developing ptosis were ocular surgery, hyperthyroidism, and type II diabetes with odds ratios of 4.2, 2.5, and 1.45, respectively (p < 0.05). Strabismus, cornea, and glaucoma surgeries were more highly associated with developing ptosis (p < 0.05). Strabismus surgery had the greatest odds ratio of 3.37, followed by cornea surgery at 2.31, and glaucoma surgery at 1.56.

Conclusions:

Involutional ptosis is likely a multifactorial process. This study demonstrates that risk factors for the development of ptosis include ocular surgery, specifically strabismus, cornea, and glaucoma surgery, as well as hyperthyroidism and type II diabetes.
A Simple Bone Cyst Requiring Exenteration: A Case Report With Literature Review
Authors: Yi Wen Lim , Singh Sujaya , Mohamad Nor Fadhilah Binti , Toh Yen-Fa , Khalil Alizan Abdul Khalil
Published: May 2020

Simple bone cyst is a benign osteolytic lesion, found primarily in the mandible, occasionally in the maxilla, and rarely in the zygoma. A 17-year-old male patient with 6-month history of left facial mass presented with worsening proptosis and displacement of left eyeball associated with reduced OS vision. The lesion was painless to start with, but with time, he reported OS pain. There was no history of any trauma. CT scan and MRI of orbit performed revealed cystic bony lesion involving greater wing of sphenoid. He subsequently had excision of the left facial mass with exenteration of OS due to poor visual prognosis, followed by reconstruction with osteomyocutaneous flap from left scapular region. The histopathologic features were consistent with a diagnosis of simple bone cyst of zygomatic arch.