bluuebunny/crossref_metadata_2025 huggingface dataset:
The Personal Vote in a Polarized Era
Authors: Dancey Logan , Henderson John , Sheagley Geoffrey
Published: July 2023

This study offers experimental tests of the “personal vote” in an era of heightened partisanship and polarization. Using three national surveys, we randomly present information about a hypothetical legislator's voting record, committee assignment, and district‐oriented work. After evaluating the legislator, respondents are presented with information about a challenger running on a nationalized message. Respondents, especially out‐partisans, report much greater satisfaction with the legislator when told about his district‐oriented activities, but increased willingness to vote for the legislator is more limited and mostly reserved for independents. In varying information about the legislator's voting record, we also find scant evidence that bipartisan legislators are better at securing a personal vote. In two experimental extensions, we show that our findings generalize to evaluations of real senators, and that nationalizing elections is one possible way that opponents can thwart incumbent efforts at winning the votes of independents and out‐partisans through traditional district‐oriented appeals.
“Shame: The Misplaced Debt of Structural Sin”
Authors: Streufert Mary J.
Published: July 2023

Although sexual violence and economic distress are often understood and responded to as individual problems, they are rooted in and must be understood within the social systems of patriarchy and advanced global capitalism, both of which normalize these traumas. The problem is that social systems divert guilt for structural sin onto individuals in the form of shame, which I argue is the misplaced debt of structural sin. Through narrative and analysis, I demonstrate the problems of silence, judgement, and death associated with the misplaced debt of shame in structural sin. Preliminarily, I suggest that the theology of the cross enables Christians to name structural sin for what it actually is; judge who or what is truly guilty; and remove shame and guilt from survivors to foster flourishing.
Type 1 diabetes and low carbohydrate diets—Defining the degree of nutritional ketosis
Authors: Ozoran Hakan , Matheou Michael , Dyson Pam , Karpe Fredrik , Tan Garry D.
Published: July 2023

Aims

Adopting a low‐ or very low‐carbohydrate (LCD or VLCD) diet in type 1 diabetes mellitus (T1D) is a controversial intervention. The main fear is that these diets may increase the risk of diabetic ketoacidosis. However, there is little data about the ketoacidosis risk and the level of physiological nutritional ketosis in individuals following these diets. We aimed to define the level of ketosis in those with T1D following carbohydrate restricted diets in a real‐world observational study.

Methods

Patients with T1D who had self‐selected dietary carbohydrate restriction were enrolled from local clinics and were compared to those following an unrestricted regular carbohydrate control diet (RCCD). Participants completed a 3‐day diary, documenting food intake, ketones, and blood/interstitial glucose concentrations.

Results

Participants were divided into three groups according to mean carbohydrate intake: VLCD (<50 g carbohydrates/day) n = 6, LCD (50–130 g carbohydrates/day) n = 6, and RCCD (>130 g carbohydrates/day) n = 3. Mean beta‐hydroxybutyrate (BOHB) concentrations were 1.2 mmol/l (SD 0.14), 0.3 mmol/l (SD 0.12) and 0.1mmol/l (SD 0.05) in the VLCD, LCD and RCCD groups, respectively (p = 0.02). Post hoc Dunn test demonstrated this reached statistical significance between the VLCD and RCCD groups (p = 0.02).

Conclusion

Carbohydrate restricted diets, in particular VLCDs, are associated with a higher BOHB level. However, the degree of ketosis seen is much lower than we expected, and significantly lower than the level typically associated with diabetic ketoacidosis. This may suggest the risk of ketoacidosis is lower than feared, although safety will need to be evaluated further in large scale randomised trials.
The effect of littoral complexity on the diel distribution of early juvenile fish communities in temperate freshwater reservoirs
Authors: Sajdlová Zuzana , Jůza Tomáš , Draštík Vladislav , Seďa Jaromír , Čech Martin
Published: July 2023

The diel distribution of early juvenile fish communities from two temperate freshwater reservoirs that differed in cover of submerged aquatic vegetation was investigated. In the daytime, about 99.9% of the juvenile fish community from the plant‐rich Žlutice Reservoir was found in the nearshore belt of submerged aquatic vegetation reaching an average abundance of ~7982 inds. 1000 m−3. In contrast, in the pelagic habitat, few fish were found at day. In the plant‐poor Římov Reservoir, 98.9% of juveniles occupied the pelagic habitat during daytime and reached an average abundance of ~333 inds. 1000 m−3. Vertical distribution of fish in the pelagic habitat in both water bodies was affected by steep thermal and oxygen stratification and no individuals occurred below 6 m depth. At night, 88.8% of the juvenile fish community from the plant‐rich Žlutice Reservoir was in the pelagic habitat with an average abundance of ~1423 inds. 1000 m−3. Their diel horizontal shifts were much more pronounced compared to the community from the Římov Reservoir that reached an average nighttime pelagic abundance of ~523 inds. 1000 m−3. Only 1.1% of the juvenile fish community in the Římov Reservoir was found in the littoral during the daytime and 0.7% at night reaching an average daytime abundance of ~1688 inds. 1000 m−3 and average nighttime time abundance of ~1664 inds. 1000 m−3. This study indicates that if a well‐developed littoral zone with abundant aquatic vegetation is present, early juvenile fish will perform diel horizontal movement in temperate stratified reservoirs.
Homebound oral care for older adults: A qualitative study of professional carers' perspectives in Perth, Western Australia
Authors: Idris Safaa , Aghanwa Somto , O'Halloran Jane , Durey Angela , Slack‐Smith Linda
Published: July 2023

Objective

To examine professional support workers and case managers' (professional carers) perspectives of what promoted or compromised oral health care in homebound adults aged over 65 years in Perth, Western Australia and identify professional carers' need for support in this context.

Background

Accessing dental services can be difficult to navigate and unaffordable for homebound older adults. Paid carers often play a substantial role in facilitating access to services yet there is limited qualitative evidence of the perspectives of these stakeholders.

Methods

Given limited evidence in this area, this simple qualitative study was informed by constructivist grounded theory. Participants comprised 15 professional carers of homebound older adults. Transcripts were analysed to identify participant perceptions of key barriers and enablers to providing oral health care.

Results

Barriers to clients accessing dental care included participants' uncertainty around navigating the dental system, low priority of oral health care, affordability and confusion around who was responsible to provide oral care. Enablers included participants supporting clients' autonomy around oral care, better integration of oral care into primary health care and education and opportunity for training for professional carers.

Conclusion

Ensuring oral health is part of primary health plans, clarifying roles and responsibilities around delivering oral health care to homebound older adults and training carers were key findings. Inter‐sectoral collaboration between the dental and aged care sectors can benefit dental practitioners and professional carers in shared learning and has likely flow‐on effects for homebound older adults.
Four‐year treatment continuation rates of osteoporosis drugs with different dosing intervals throughout Japan
Authors: Idei Koichi , Ryu Kazuteru , Miura Seiji , Hiraga Kenichi , Hayama Yohsuke , Suzuki Arata , Okubo Naoki , Arai Yuji , Takahashi Kenji
Published: July 2023

Introduction

There are approximately 13 million patients with osteoporosis in Japan; however, only 20% of them receive treatment. This study compared the 4‐year continuation rates of osteoporosis drugs at different dosing intervals across throughout Japan.

Materials and methods

Receipt data were analyzed to determine the continuation of osteoporosis medication in patients who began treatment at 210 hospitals throughout Japan between October 2016 and September 2017. Continuation rates were compared using Kaplan–Meier curves and log‐rank tests.

Results

The 4‐year continuation rates of daily, weekly, monthly, semi‐annual, and yearly medications nationwide were 8.6%, 16.5%, 13.5%, 31.0%, and 26.0%, respectively. The 4‐year continuation rates for semi‐annual and yearly drugs were significantly higher than daily, weekly, monthly drugs.

Conclusion

Throughout Japan, the 4‐year treatment continuation rates of daily, weekly, monthly, semi‐annual, and yearly osteoporosis drugs all decreased over time. However, the continuation rates of semi‐annual and yearly drugs in the fourth year were significantly higher than those for the other dosing regimens. Therefore, injectable drugs with dosing intervals ≥6 months may improve continuation rates of osteoporosis drugs. Geriatr Gerontol Int 2023; 23: 665–670.
Dynamic monitoring and correlation analysis of flavour quality and bacterial community during sufu fermentation
Authors: Wang Xiaodan , Wang Cuilian , Hu Feng , Yu Maosong , Zhu Xianming , Wu Duo , Jiang Shaoping , Tian Jiaxue , Chang Ping
Published: July 2023

Dynamic changes in the flavour quality and microbial composition of sufu in the whole fermentation were studied, and the correlation between them was analyzed. Totally, 135 volatile flavours were identified. The types of volatile substances in sufu ripening for 90 days reached 44, which mainly contributed to volatile components of odour including 1‐octen‐3‐ol (ROAV = 89.89), phenylethyl alcohol (ROAV = 25.05), benzaldehyde (ROAV = 46.82), octanoic acid ethyl ester (ROAV = 49.01) and 2‐pentyl furan (ROAV = 100). Glutamate acid, aspartic acid and 5′‐guanylate contributed significantly to sufu post‐fermentation (TAV >1). The microorganisms in sufu were identified using internal transcribed spacer sequencing technology. The correlations among volatile flavour, taste substances and bacterial community structure were tested via Spearman analysis. Monascus kaoliang promoted the accumulation of most taste components and ethyl ester flavour substances, while Actinomucor elegans inhibited the accumulation of most flavour substances in sufu. This study could potentially help with the rational design of microbial communities to improve sufu quality.
Crystal structure investigation of spinel‐type LiAlON with multiple atomic disorders
Authors: Wang Zhian , Tu Bingtian , Chen Qiangguo , Wang Hao , Wang Weimin , Fu Zhengyi
Published: July 2023

Spinel‐type lithium aluminum oxynitride (LiAlON) contains atomic disorders at every crystallographic position, including vacancies, cation, and anion disorders. In this work, the crystal structure of spinel‐type LiAlON with multiple atomic disorders was systematically studied by first‐principles calculation, solid‐state NMR, and the Rietveld crystal structure refinement. The theoretical simulations demonstrate that the Li+ occupies octahedral positions and prefers to be far away from the N3− and cation vacancies in the crystal structure of LiAlON. A spinel‐type LiAlON compound with chemical formula of Li0.06Al2.72O3.77N0.23 was prepared by solid‐state reaction. The local structure of Li+ and Al3+ was probed by 7Li and 27Al solid‐state NMR technology. Combined with theoretical calculations and solid‐state NMR, the crystal structure of Li0.06Al2.72O3.77N0.23 was fully resolved by the Rietveld refinement. This work provides a deep understanding on the disordered crystal structure of the spinel‐type LiAlON solid solution.
Neuropeptidergic control circuits in the spinal cord for male sexual behaviour: Oxytocin–gastrin‐releasing peptide systems
Authors: Oti Takumi , Sakamoto Hirotaka
Published: July 2023

The neuropeptidergic mechanisms controlling socio‐sexual behaviours consist of complex neuronal circuitry systems in widely distributed areas of the brain and spinal cord. At the organismal level, it is now becoming clear that “hormonal regulations” play an important role, in addition to the activation of neuronal circuits. The gastrin‐releasing peptide (GRP) system in the lumbosacral spinal cord is an important component of the neural circuits that control penile reflexes in rats, circuits that are commonly referred to as the “spinal ejaculation generator (SEG).” Oxytocin, long known as a neurohypophyseal hormone, is now known to be involved in the regulation of socio‐sexual behaviors in mammals, ranging from social bonding to empathy. However, the functional interaction between the SEG neurons and the hypothalamo‐spinal oxytocin system remains unclear. Oxytocin is known to be synthesised mainly in hypothalamic neurons and released from the posterior pituitary into the circulation. Oxytocin is also released from the dendrites of the neurons into the hypothalamus where they have important roles in social behaviours via non‐synaptic volume transmission. Because the most familiar functions of oxytocin are to regulate female reproductive functions including parturition, milk ejection, and maternal behaviour, oxytocin is often thought of as a “feminine” hormone. However, there is evidence that a group of parvocellular oxytocin neurons project to the lower spinal cord and control male sexual function in rats. In this report, we review the functional interaction between the SEG neurons and the hypothalamo‐spinal oxytocin system and effects of these neuropeptides on male sexual behaviour. Furthermore, we discuss the finding of a recently identified, localised “volume transmission” role of oxytocin in the spinal cord. Findings from our studies suggest that the newly discovered “oxytocin‐mediated spinal control of male sexual function” may be useful in the treatment of erectile and ejaculatory dysfunction.
The role of N‐terminal pro‐brain natriuretic peptide, chromogranin A, and 5‐hydroxyindoleacetic acid in screening for carcinoid heart disease
Authors: Johnson Karen Kristina Nyvold , Stemann Lau Tobias , Mark Dahl Baunwall Simon , Elisabeth Villadsen Gerda , Guldbrand Rasmussen Vibeke , Grønbæk Henning , Oksjoki Riina Karoliina , Dam Gitte
Published: July 2023

Carcinoid heart disease (CHD) is a serious complication for patients with neuroendocrine tumors (NETs), and early detection is crucial. We aimed to investigate N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), chromogranin A (CgA), and plasma 5‐hydroxyindoleacetic acid (P‐5‐HIAA) as a screening tool for detection of CHD. We prospectively included patients with disseminated small intestinal NETs (SI‐NETs) and performed transthoracic echocardiography (TTE), questionnaires, and biochemical assessment of NT‐proBNP, CgA, and P‐5‐HIAA. The presence and severity of CHD was assessed using a scoring system based on echocardiographic characteristics. A total of 93 patients were included in the final analysis. Fifteen (16%) were diagnosed with CHD. The median NT‐proBNP (219 ng/L vs. 124 ng/L, p = .05), CgA (3930 pmol/L vs. 256 pmoL/L, p < .0001), and P‐5‐HIAA (1160 nmol/L vs. 210 nmoL/L, p < .0001) were significantly higher in patients with CHD compared to non‐CHD patients. For NT‐proBNP, the area under the receiver operating characteristic (AUROC) curve for detection of CHD was 0.67 (95% CI: 0.50–0.84), and at a 260 ng/L cutoff level, the sensitivity and specificity were 46% and 79%. For CgA, the AUROC was 0.91 (95% CI: 0.84–0.97), and at a cutoff level of 598 pmol/L, the sensitivity and specificity were 100% and 69%. For P‐5‐HIAA, the AUROC was 0.89 (95% CI: 0.80–0.98), and at a cutoff level of 752 nmol/L, the sensitivity and specificity were 92% and 85%. In conclusion, CgA and P‐5‐HIAA proved excellent markers of CHD while NT‐proBNP lacked the required diagnostic accuracy to be used as a screening tool.
Synopsis of the Peruvian species of Epidendrum (Orchidaceae: Laeliinae) belonging to the Scabrum group, subgroup Soratae: diversity and description of a new species
Authors: QUISPE-MELGAR HAROLD RUSBELTH , SANTIAGO AYALA ELIZABETH , LLACUA-TINEO YASHIRA STEFANI , HÁGSATER ERIC
Published: July 2023

We present a synopsis of the species of the genus Epidendrum belonging to Soratae subgroup, Scabrum group in Peru. Information on their distribution, elevation ranges, phenology, and conservation status in Peru is provided. For this purpose, we conducted a review of herbarium plant material, the AMO-DATA herbarium database, and the original publications of the species. We recorded 27 species with the greatest species richness in the eastern cordillera from north to south and the highest concentration of endemic species in the central region of the Peruvian Andes. Epidendrum centralense is described and illustrated as a new species and compared with Epidendrum soratae, which is the closest species. The new species differs mainly in the color of the flowers that are green-brown with an irregular red brown tinge, the length and shape of the leaves that are 2.0–2.5 cm long, lanceolate, obtuse, the cuniculus forming a small vesicle in the pedicel, and the size and shape of the lip that is 3.1–4 × 5 mm, transversely reniform and apically obtuse. The new species represents an important record for the flora associated with the high elevation Andean Forest of Polylepis from central Peru. We provide a key to the Peruvian members of Epidendrum belonging to the Soratae subgroup.
A flower in paradise: citizen science helps to discover Thismia paradisiaca (Thismiaceae), a new species from the Chocó Biogeographic region in Colombia
Authors: GUZMÁN-GUZMÁN SANTIAGO , PLATA-TORRES ANGELO
Published: July 2023

A new species, Thismia paradisiaca (Thismiaceae), discovered on the basis of a record at the iNaturalist platform is described and illustrated. The new species is recorded for the Pacific slope of the Western Cordillera of the Andes. It is assigned to sect. Ophiomeris, differing from all the other species of the section by having dimorphic stamens, incurved upper outer tepal, and lateral outer tepals slightly revolute at their bases. In addition, pollen morphology of T. paradisiaca is described, and interaction of pollen with a dipteran found inside the floral chamber is discussed. Finally, a distribution map of the genus in Colombia and a taxonomic key for the subgen. Ophiomeris are provided.
Miscellaneous notes on specimens collected in Surat, Johanna Island and Cácota de Suratá, with emphasis on the Linnaean Herbarium (LINN)
Authors: MORAES PEDRO LUÍS RODRIGUES DE
Published: July 2023

The aim of this paper was to investigate whether specimens in the Linnaean Herbarium (LINN), with Linnaean annotations of provenance as from Suratte/Suratt or Johanna Island, would be original material for their respective species names. As Linnaeus did not explicitly cite a specimen in the protolog of those names, neither the collector for most of them, the possible origin of each individual specimen was checked and searched from independent evidence, such as an explicit annotation, or a link to a dated list or letter among Linnaeus’s surviving correspondence, or from Linnaeus’s Paper Slips. Regarding the typification of those names, published choices of type have been found, but on a careful evaluation some were found to be ineffective or supersedable. This was the case for Cenchrus muricatus L. and Utricularia stellaris L.f., whose lectotypifications are proposed here.
Moelleriella simaoensis, a new entomogenous species of Moelleriella (Clavicipitaceae, Hypocreales) from Southwestern China
Authors: YANG ZHI-LI , WANG ZHI-QIN , MA JIN-MEI , YU HONG
Published: July 2023

A new species of Moelleriella, described as Moelleriella simaoensis from Pu’er City, Yunnan Province, was discovered during a diversity survey of entomopathogenic fungi in Southwestern China. It was characterized by producing brightly colored and thin-pulvate stromata, subglobose to ovoid perithecia, cylindrical asci, disarticulating part-spores inside the ascus, and fusiform conidia. Both anamorphic and teleomorphic states were most often found on the same stroma, and the orange conidiomata were aggregated in the center of the stroma. Conidiomata were widely open with several locules per stroma. Multigenes phylogenetic analyses based on nrLSU, tef-1α and rpb1 sequences showed that this species formed a distinct clade and was closely related to Moelleriella puerensis and Moelleriella raciborskii. The Description and illustration of the new species were provided in the present study.
Lepanthes cordillerana (Orchidaceae) a new species and the landscape threats to its wild populations
Authors: PARRA-SÁNCHEZ EDICSON , RESTREPO EUGENIO , ALEGRÍA-VALENCIA MELISA , MORENO JUAN SEBASTIÁN , GALINDO-TARAZONA ROBINSON
Published: July 2023

Extensive fieldwork carried out on the Andean forests of Colombia resulted in the discovery of Lepanthes cordillerana, described here as a novel taxon. The new species is most similar to Lepanthes teres from Ecuador, from which it can be easily distinguished by the ciliated margins of the leaf, the oblong-acute lower lobe of the petals and the capitate, cuneate basally, apically caved, villose appendix. Despite its wide distribution across the three Colombian mountain ranges, a landscape analysis shows that 50% of the recorded wild populations of the endemic Lepanthes cordillerana are under threat of habitat loss and landscape fragmentation. Conservation efforts should be directed to reduce landscape scale threats to their populations.
Asplenium atlanticum (Aspleniaceae), a new endemic fern from the Brazilian Atlantic Forest
Authors: LINO VANESSA , REIS ATILES , DA SILVA SYLVESTRE LANA , MASSI MYNSSEN CLAUDINE
Published: July 2023

Asplenium atlanticum (Aspleniaceae), a new species from the Atlantic Forest of Brazil, is described and compared to similar species. It is morphologically related to Asplenium martianum, from which it differs by having deltoid to lanceolate laminae, ovate pinnules with an obtuse apex, elliptic and linear sori, and longer stem scales. It is also similar to Asplenium muellerianum, from which it differs by having longer stem scales, deltoid to lanceolate laminae, and pinnae with an obtuse to acute apex, and to Asplenium pseudonitidum, from which it differs by having shorter and dull petiole, laminae with dentate margins, and pinnules always with obtuse apex. Asplenium atlanticum is known from Paraná, Rio Grande do Sul, and Santa Catarina states. The new species is illustrated, and an identification key to its closely related species is provided.
Taxonomy, Typification and distribution of Thyrsia zea (Poaceae)
Authors: CHORGHE ALOK R. , HALDER SUMAN , KULLOLI R.N.
Published: July 2023

The nomenclature of the name Thyrsia zea has been discussed here along with the second step lectotypification. Taxonomy and distribution of Thyrsia zea in India and its relation with the two closely related African species are also discussed in this paper.
Effect of Tibiofemoral Rotation Angle on Graft Failure After Anterior Cruciate Ligament Reconstruction
Authors: Leite Chilan Bou Ghosson , Merkely Gergo , Farina Evan M. , Smith Richard , Görtz Simon , Hazzard Sean , Asnis Peter , Lattermann Christian
Published: July 2023

Background:

Coronal and sagittal malalignment of the knee are well-recognized risk factors for failure after anterior cruciate ligament (ACL) reconstruction (ACLR). However, the effect of axial malalignment on graft survival after ACLR is yet to be determined.

Purpose:

To evaluate whether increased tibiofemoral rotational malalignment, namely, tibiofemoral rotation angle (TFA) and tibial tubercle–trochlear groove (TT-TG) distance, is associated with graft failure after ACLR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

In this retrospective matched control study of a single center’s database, 151 patients who underwent revision ACLR because of graft failure (ACLR failure group, defined as symptomatic patients with anterior knee instability and an ACL graft tear appreciated on magnetic resonance imaging [MRI] and confirmed during arthroscopic surgery) were compared with a matched control group of 151 patients who underwent primary ACLR with no evidence of failure after ≥2-year follow-up (intact ACLR group). Patients were matched by sex, age, and meniscal injury during primary ACLR. Axial malalignment was assessed on preoperative MRI through the TFA and the TT-TG distance. Sagittal alignment was measured through the posterior tibial slope on MRI. The optimal TFA cutoff associated with graft failure was identified by a receiver operating characteristic curve. The Kaplan-Meier curve with log-rank analysis was performed to evaluate the influence of the TFA on ACLR longevity.

Results:

The mean age was 25.7 ± 10.4 years for the ACLR failure group and 25.9 ± 10.0 years for the intact ACLR group. Among all the included patients, 174 (57.6%) were male. In the ACLR failure group, the mean TFA was 5.8°± 4.5° (range, −5° to 16°), while it was 3.0°± 3.3° (range, −3° to 15°) in the intact ACLR group ( P < .001). Neither the TT-TG distance nor the posterior tibial slope presented statistical differences between the groups. The receiver operating characteristic curve suggested an optimal TFA cutoff of 4.5° for graft failure (area under the curve = 0.71; P < .001; sensitivity, 68.2%; specificity, 75.5%). Considering this a threshold, patients who had a TFA ≥4.5° had 6.6 times higher odds of graft failure compared with patients with a TFA <4.5° ( P < .001). Survival analysis demonstrated a 5-year survival rate of 81% in patients with a TFA <4.5°, while it was 44% in those with a TFA ≥4.5° ( P < .001).

Conclusion:

An increased TFA was associated with increased odds of ACLR failure when the TFA was ≥4.5°. Measuring the TFA in patients with ACL tears undergoing reconstruction may inform the surgeon about additional factors that may require consideration before ACLR for a successful outcome.
Posterior Tibial Slope in Patients Undergoing Bilateral Versus Unilateral ACL Reconstruction: MRI and Radiographic Analyses
Authors: Garra Sharif , Li Zachary I. , Triana Jairo , Rao Naina , Alaia Michael J. , Strauss Eric J. , Gonzalez-Lomas Guillem , Jazrawi Laith M.
Published: July 2023

Background:

An increased posterior tibial slope (PTS) is a risk factor for primary anterior cruciate ligament (ACL) tears and graft failure, but the PTS has not been well-defined in those who have experienced bilateral ACL injuries.

Purpose:

The primary aim was to compare the PTS, as well as the rate of an elevated PTS (>12° on lateral radiography; >7° on magnetic resonance imaging [MRI]), between patients who have undergone bilateral ACL reconstruction (ACLR) versus unilateral ACLR. A secondary purpose was to examine whether these associations remained consistent on both plain radiography and MRI.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

We retrospectively identified patients who underwent primary ACLR at our institution from the years 2012 to 2020. Patients who underwent nonsimultaneous bilateral ACLR (n = 53) were matched to those who underwent unilateral ACLR (n = 53) by age, sex, and body mass index. Exclusion criteria were rotated lateral radiographs, MRI scans of inadequate quality, and concomitant ligament injuries or fractures. Those who had undergone unilateral ACLR with <5-year follow-up were further excluded. There were 3 blinded readers who measured the PTS on lateral radiographs, while the medial PTS (MPTS) and lateral PTS (LPTS) were measured on MRI scans. Bivariate regression was performed to determine the correlation between radiographic and MRI measurements.

Results:

The PTS on radiography (11.26° vs 10.13°, respectively; P = .044) and the LPTS on MRI (7.32° vs 6.08°, respectively; P = .012) in the bilateral ACLR group were significantly greater than those in the unilateral ACLR group but not the MPTS on MRI (4.55° vs 4.17°, respectively; P = .590). The percentage of patients in the bilateral group with a radiographic PTS >12° was 41.0% compared with 13.2% in the unilateral group ( P = .012). The bilateral group had a significantly higher rate of an LPTS >7° compared with the unilateral group (53.8% vs 32.1%, respectively; P = .016) but not for an MPTS >7° ( P = .190). On MRI, the LPTS (6.90°± 2.73°) was significantly greater than the MPTS (4.41°± 2.92°) ( P < .001). There was a weak correlation between MPTS and radiographic PTS measurements ( R = 0.24; P = .021), but LPTS and radiographic PTS measurements were not significantly correlated ( R = 0.03; P = .810).

Conclusion:

Patients who underwent bilateral ACLR had a significantly greater PTS on radiography and a significantly greater LPTS on MRI compared with those who underwent unilateral ACLR. The rate of a radiographic PTS >12° was 2.4 times greater among patients undergoing bilateral ACLR compared with those undergoing unilateral ACLR. PTS measurements on radiography demonstrated a weak to negligible correlation with PTS measurements on MRI, suggesting that future normative PTS values should be reported specific to the imaging modality.
The Influence of Glenoid Bone Loss and Graft Positioning on Graft and Cartilage Contact Pressures After the Latarjet Procedure
Authors: Ernstbrunner Lukas , Robinson Dale L. , Huang Yichen , Wieser Karl , Hoy Greg , Ek Eugene T. , Ackland David C.
Published: July 2023

Background:

Glenohumeral joint contact loading before and after glenoid bone grafting for recurrent anterior instability remains poorly understood.

Purpose:

To develop a computational model to evaluate the influence of glenoid bone loss and graft positioning on graft and cartilage contact pressures after the Latarjet procedure.

Study Design:

Controlled laboratory study.

Methods:

A finite element model of the shoulder was developed using kinematics, muscle and glenohumeral joint loading of 6 male participants. Muscle and joint forces at 90° of abduction and external rotation were calculated and employed in simulations of the native shoulder, as well as the shoulder with a Bankart lesion, 10% and 25% glenoid bone loss, and after the Latarjet procedure.

Results:

A Bankart lesion as well as glenoid bone loss of 10% and 25% significantly increased glenoid and humeral cartilage contact pressures compared with the native shoulder ( P < .05). The Latarjet procedure did not significantly increase glenoid cartilage contact pressure. With 25% glenoid bone loss, the Latarjet procedure with a graft flush with the glenoid and the humerus positioned at the glenoid half-width resulted in significantly increased humeral cartilage contact pressure compared with that preoperatively ( P = .023). Under the same condition, medializing the graft by 1 mm resulted in humeral cartilage contact pressure comparable with that preoperatively ( P = .097). Graft lateralization by 1 mm resulted in significantly increased humeral cartilage contact pressure in both glenoid bone loss conditions ( P < .05).

Conclusion:

This modeling study showed that labral damage and greater glenoid bone loss significantly increased glenoid and humeral cartilage contact pressures in the shoulder. The Latarjet procedure may mitigate this to an extent, although glenoid and humeral contact loading was sensitive to graft placement.

Clinical Relevance:

The Latarjet procedure with a correctly positioned graft should not lead to increased glenohumeral joint contact loading. The present study suggests that lateral graft overhang should be avoided, and in the situation of large glenoid bone defects, slight medialization (ie, 1 mm) of the graft may help to mitigate glenohumeral joint contact overloading.
Healthcare costs for hospitalized COVID-19 patients in a Japanese university hospital: a cross-sectional study
Authors: Uno Shunsuke , Goto Rei , Honda Kimiko , Tokuda Machiko , Kamata Hirofumi , Chubachi Shotaro , Yamamoto Ryo , Sato Yukio , Homma Koichiro , Uchida Sho , Namkoong Ho , Uwamino Yoshifumi , Sasaki Junichi , Fukunaga Koichi , Hasegawa Naoki
Published: July 2023

Background

A health-economic evaluation related to COVID-19 is urgently needed to allocate healthcare resources efficiently; however, relevant medical cost data in Japan concerning COVID-19 are scarce.

Methods

This cross-sectional study investigated the healthcare cost for hospitalized COVID-19 patients in 2021 at Keio University Hospital. We calculated the healthcare costs during hospitalization using hospital claims data and investigated the variables significantly related to the healthcare cost with multivariable analysis.

Results

The median healthcare cost per patient for the analyzed 330 patients was Japanese yen (JPY) 1,304,431 (US dollars ~ 11,871) (interquartile range: JPY 968,349–1,954,093), and the median length of stay was 10 days. The median healthcare cost was JPY 798,810 for mild cases; JPY 1,113,680 for moderate I cases; JPY 1,643,909 for moderate II cases; and JPY 6,210,607 for severe cases. Healthcare costs increased by 4.0% for each additional day of hospitalization; 1.26 times for moderate I cases, 1.64 times for moderate II cases, and 1.84 times for severe cases compared to mild cases; and 2.05 times for cases involving ICU stay compared to those not staying in ICU.

Conclusions

We clarified the healthcare cost for hospitalized COVID-19 patients by severity in a Japanese university hospital. These costs contribute as inputs for forthcoming health economic evaluations for strategies for preventing and treating COVID-19.
Maresin1 alleviates liver ischemia/reperfusion injury by reducing liver macrophage pyroptosis
Authors: Li Tong , Zeng Houshuai , Xian Wenjing , Cai Hongxing , Zhang Jianbo , Zhou Shiji , Yang Yingxue , Luo Min , Zhu Peng
Published: July 2023

Background

Cell pyroptosis has a strong proinflammatory effect, but it is unclear whether pyroptosis of liver macrophages exacerbates liver tissue damage during liver ischemia‒reperfusion (I/R) injury. Maresin1 (MaR1) has a strong anti-inflammatory effect, and whether it can suppress liver macrophage pyroptosis needs further study.

Methods

This study aimed to investigate whether MaR1 can alleviate liver I/R injury by inhibiting macrophage pyroptosis. The effects of MaR1 on cell pyroptosis and mitochondrial damage were studied by dividing cells into control, hypoxia/reoxygenation, and hypoxia/reoxygenation + MaR1 groups. Knocking out RORa was used to study the mechanism by which MaR1 exert its protective effects. Transcriptome analysis, qRT‒PCR and Western blotting were used to analyze gene expression. Untargeted metabolomics techniques were used to analyze metabolite profiles in mice. Flow cytometry was used to assess cell death and mitochondrial damage.

Results

We first found that MaR1 significantly reduced liver I/R injury. We observed that MaR1 decreased liver I/R injury by inhibiting liver macrophage pyroptosis. Then, we discovered that MaR1 promotes mitochondrial oxidative phosphorylation, increases the synthesis of ATP, reduces the generation of ROS, decreases the impairment of mitochondrial membrane potential and inhibits the opening of mitochondrial membrane permeability transition pores. MaR1 inhibits liver macrophage pyroptosis by protecting mitochondria. Finally, we found that MaR1 exerts mitochondrial protective effects through activation of its nuclear receptor RORa and the PI3K/AKT signaling pathway.

Conclusions

During liver I/R injury, MaR1 can reduce liver macrophage pyroptosis by reducing mitochondrial damage, thereby reducing liver damage.
Gegen-Qinlian decoction alleviates anxiety-like behaviors in methamphetamine-withdrawn mice by regulating Akkermansia and metabolism in the colon
Authors: Lu Xue , Fan Yu , Peng Yaqin , Pan Weichao , Du Demin , Xu Xing , Li Nanqin , He Teng , Nie Jiaxun , Shi Pengbo , Ge Feifei , Liu Dekang , Chen Yugen , Guan Xiaowei
Published: July 2023

Background

Anxiety is a prominent withdrawal symptom of methamphetamine (Meth) addiction. Recently, the gut microbiota has been regarded as a promising target for modulating anxiety. Gegen-Qinlian decoction (GQD) is a classical Traditional Chinese Medicine applied in interventions of various gut disorders by balancing the gut microbiome. We aim to investigate whether GQD could alleviate Meth withdrawal anxiety through balancing gut microbiota and gut microenvironment.

Methods

Meth withdrawal anxiety models were established in mice. GQD were intragastric administrated into Meth-withdrawn mice and controls. Gut permeability and inflammatory status were examined in mice. Germ-free (GF) and antibiotics-treated (Abx) mice were used to evaluate the role of gut bacteria in withdrawal anxiety. Gut microbiota was profiled with 16s rRNA sequencing in feces. Metabolomics in colon tissue and in Akkermansia culture medium were performed.

Results

Meth withdrawal enhanced anxiety-like behaviors in wild-type mice, and altered gut permeability, and inflammatory status, while GQD treatment during the withdrawal period efficiently alleviated anxiety-like behaviors and improved gut microenvironment. Next, we found Germ-free (GF) and antibiotics-treated (Abx) mice did not develop anxiety-like behaviors by Meth withdrawal, indicating the essential role of gut bacteria in Meth withdrawal induced anxiety. Then, it was observed that gut microbiota was greatly affected in Meth-withdrawn mice, especially the reduction in Akkermansia. GQD can rescue the gut microbiota and reverse Akkermansia abundance in Meth-withdrawn mice. Meanwhile, GQD can also restore the Meth-impaired Akkermansia growth in vitro. Further, GQD restored several common metabolite levels both in colon in vivo and in Akkermansia in vitro.

Conclusions

We revealed a novel effect of GQD on Meth withdrawal anxiety and identified its pharmacological target axis as “Akkermansia-Akkermansia metabolites-gut metabolites-gut microenvironment”. Our findings indicated that targeting gut bacteria with TCM, such as GQD, might be a promising therapeutic strategy for addiction and related withdrawal symptoms.
Nasal polyposis in pediatric patients with Cornelia de Lange syndrome: endoscopic diagnosis, treatment and follow up in two case reports
Authors: Onesimo Roberta , Santis Rita De , Leoni Chiara , Rigante Mario , Piastra Marco , Sforza Elisabetta , Selicorni Angelo , Zampino Giuseppe
Published: July 2023

Background

Cornelia de Lange syndrome is a rare genetic disease with otolaryngological involvement. The classic phenotype is characterized by distinctive facial features, intellectual disability, growth delay, hirsutism, and upper-limb reduction. Nasal polyposis was previously reported in association with chronic rhinosinusitis, however data about prevalence, diagnosis, treatment and prognosis are lacking for this cohort of patients, affected by rare disease.

Case presentation

We describe the whole diagnostic and therapeutic workflow of nasal polyps in two pediatric patients with Cornelia de Lange, successfully diagnosed and treated by nasal endoscopy.

Conclusion

Our report confirm that nasal endoscopy is a safe and useful tool in the diagnosis, treatment and follow-up of nasal polyps, even in Cornelia de Lange syndrome pediatric patients. We want to increase the alert for the detection of nasal polyps in patients with Cornelia de Lange syndrome since pediatric age. We recommend endoscopy in all patients with Cornelia de Lange syndrome and symptoms of chronic nasal obstruction and/or OSAS. Multidisciplinary team and sedation service could be useful in the management of Cornelia de Lange syndrome patients with airway obstruction symptoms and sleep disturbance when severe intellectual disability, autism or psychiatric findings are present.
Development of High-Resolution Melting Curve Analysis for rapid detection of SEC23B gene mutation causing Congenital Dyserythropoietic Anemia type II in Indian population
Authors: Saptarshi Arati Nandan , Dongerdiye Rashmi K. , More Tejashree Anil , Kedar Prabhakar S.
Published: July 2023

Background

Congenital dyserythropoietic anemias (CDAs) are a very rare and heterogeneous group of disorders characterized by ineffective erythropoiesis. CDA II is caused by mutations in the SEC23B gene. The most common mutation reported in India is c.1385 A > G, p.Y462C. There is no simple and cost-effective confirmatory diagnostic test available for CDA, and therefore, many patients remain undiagnosed. High-resolution melting curve (HRM) analysis is a polymerase chain reaction (PCR) based technique applied to identify genetic differences and scan nucleic acid sequences. HRM can be used to rapidly screen the common mutation causing CDA II in the Indian population. Thus, we studied the use of High-Resolution Melting Curve Analysis to detect common mutation causing CDA II in the Indian population.

Method

11 patients having SEC23B (Y462C) mutation causing CDA II are considered for this study. HRM was used to check the presence of Y462C mutation. To verify the accuracy of the HRM analysis, we compared HRM results with the results of Sanger sequencing. This helped us to confirm the diagnosis.

Results

We have described the clinical, hematological, and genetic data of eleven patients suffering from CDAII. According to HRM and Sanger sequencing, a homozygous SEC23B (Y462C) mutation was present in all patients, whereas a heterozygous Y462C mutation was present in their parents.

Conclusion

Our data showed that High-Resolution Melting (HRM) analysis could be used to rapidly screen common SEC23B mutation that causes CDA II in the Indian population.
AI-based detection of contrast-enhancing MRI lesions in patients with multiple sclerosis
Authors: Schlaeger Sarah , Shit Suprosanna , Eichinger Paul , Hamann Marco , Opfer Roland , Krüger Julia , Dieckmeyer Michael , Schön Simon , Mühlau Mark , Zimmer Claus , Kirschke Jan S. , Wiestler Benedikt , Hedderich Dennis M.
Published: July 2023

Background

Contrast-enhancing (CE) lesions are an important finding on brain magnetic resonance imaging (MRI) in patients with multiple sclerosis (MS) but can be missed easily. Automated solutions for reliable CE lesion detection are emerging; however, independent validation of artificial intelligence (AI) tools in the clinical routine is still rare.

Methods

A three-dimensional convolutional neural network for CE lesion segmentation was trained externally on 1488 datasets of 934 MS patients from 81 scanners using concatenated information from FLAIR and T1-weighted post-contrast imaging. This externally trained model was tested on an independent dataset comprising 504 T1-weighted post-contrast and FLAIR image datasets of MS patients from clinical routine. Two neuroradiologists (R1, R2) labeled CE lesions for gold standard definition in the clinical test dataset. The algorithmic output was evaluated on both patient- and lesion-level.

Results

On a patient-level, recall, specificity, precision, and accuracy of the AI tool to predict patients with CE lesions were 0.75, 0.99, 0.91, and 0.96. The agreement between the AI tool and both readers was within the range of inter-rater agreement (Cohen’s kappa; AI vs. R1: 0.69; AI vs. R2: 0.76; R1 vs. R2: 0.76). On a lesion-level, false negative lesions were predominately found in infratentorial location, significantly smaller, and at lower contrast than true positive lesions (p < 0.05).

Conclusions

AI-based identification of CE lesions on brain MRI is feasible, approaching human reader performance in independent clinical data and might be of help as a second reader in the neuroradiological assessment of active inflammation in MS patients.

Critical relevance statement

Al-based detection of contrast-enhancing multiple sclerosis lesions approaches human reader performance, but careful visual inspection is still needed, especially for infratentorial, small and low-contrast lesions.

Graphical Abstract
Preoperative prediction of Lauren classification in gastric cancer: a radiomics model based on dual-energy CT iodine map
Authors: Li Min , Qin Hongtao , Yu Xianbo , Sun Junyi , Xu Xiaosheng , You Yang , Ma Chongfei , Yang Li
Published: July 2023

Objective

To investigate the value of a radiomics model based on dual-energy computed tomography (DECT) venous-phase iodine map (IM) and 120 kVp equivalent mixed images (MIX) in predicting the Lauren classification of gastric cancer.

Methods

A retrospective analysis of 240 patients undergoing preoperative DECT and postoperative pathologically confirmed gastric cancer was done. Training sets (n = 168) and testing sets (n = 72) were randomly assigned with a ratio of 7:3. Patients are divided into intestinal and non-intestinal groups. Traditional features were analyzed by two radiologists, using logistic regression to determine independent predictors for building clinical models. Using the Radiomics software, radiomics features were extracted from the IM and MIX images. ICC and Boruta algorithm were used for dimensionality reduction, and a random forest algorithm was applied to construct the radiomics model. ROC and DCA were used to evaluate the model performance.

Results

Gender and maximum tumor thickness were independent predictors of Lauren classification and were used to build a clinical model. Separately establish IM-radiomics (R-IM), mixed radiomics (R-MIX), and combined IM + MIX image radiomics (R-COMB) models. In the training set, each radiomics model performed better than the clinical model, and the R-COMB model showed the best prediction performance (AUC: 0.855). In the testing set also, the R-COMB model had better prediction performance than the clinical model (AUC: 0.802).

Conclusion

The R-COMB radiomics model based on DECT-IM and 120 kVp equivalent MIX images can effectively be used for preoperative noninvasive prediction of the Lauren classification of gastric cancer.

Critical relevance statement

The radiomics model based on dual-energy CT can be used for Lauren classification prediction of preoperative gastric cancer and help clinicians formulate individualized treatment plans and assess prognosis.

Graphical abstract
Splenic abscess due to non-operative management of splenic injury: a case report
Authors: Moghimi Zahra , Sadeghian Ehsan , Notash Aidin Yaghoobi , Sobhanian Ehsan
Published: July 2023

Background

Splenic abscess is a rare disease, with incidence of 0.2–0.7% in previous studies. It often appears with left upper quadrant abdominal pain, fever, chills. Splenic abscess often happens because of hematogenous spreading of infections, endocarditis, angioembolization and some other rare reasons. Treatment relies on one of these two methods: percutaneous drainage or surgery.

Case presentation

A 68-year-old diabetic Asian female (Asian woman) presented with generalized abdominal pain, low blood pressure, tachycardia, fever, lethargy and elevated level of blood sugar. She had history of conservative therapy in intensive care unit due to blunt abdominal trauma and splenic injury. She had a huge splenic abscess in ultrasonography and computed tomography scan so she went under splenectomy. Our patient had a splenic abscess without performing any intervention like angioembolization.

Conclusion

Immune compromised patients who are selected for nonoperative management after splenic injury need close follow up and evaluating about abscess formation for at least 2 weeks. Early diagnosis and treatment with two methods including percutaneous drainage or splenectomy should be considered and it depends on patient’s risk factors, vital signs, general conditions and presence or absence of sepsis.