bluuebunny/crossref_metadata_2025 huggingface dataset:
JGI Plant Gene Atlas: an updateable transcriptome resource to improve functional gene descriptions across the plant kingdom
Authors: Sreedasyam Avinash , Plott Christopher , Hossain Md Shakhawat , Lovell John T , Grimwood Jane , Jenkins Jerry W , Daum Christopher , Barry Kerrie , Carlson Joseph , Shu Shengqiang , Phillips Jeremy , Amirebrahimi Mojgan , Zane Matthew , Wang Mei , Goodstein David , Haas Fabian B , Hiss Manuel , Perroud Pierre-François , Jawdy Sara S , Yang Yongil , Hu Rongbin , Johnson Jenifer , Kropat Janette , Gallaher Sean D , Lipzen Anna , Shakirov Eugene V , Weng Xiaoyu , Torres-Jerez Ivone , Weers Brock , Conde Daniel , Pappas Marilia R , Liu Lifeng , Muchlinski Andrew , Jiang Hui , Shyu Christine , Huang Pu , Sebastian Jose , Laiben Carol , Medlin Alyssa , Carey Sankalpi , Carrell Alyssa A , Chen Jin-Gui , Perales Mariano , Swaminathan Kankshita , Allona Isabel , Grattapaglia Dario , Cooper Elizabeth A , Tholl Dorothea , Vogel John P , Weston David J , Yang Xiaohan , Brutnell Thomas P , Kellogg Elizabeth A , Baxter Ivan , Udvardi Michael , Tang Yuhong , Mockler Todd C , Juenger Thomas E , Mullet John , Rensing Stefan A , Tuskan Gerald A , Merchant Sabeeha S , Stacey Gary , Schmutz Jeremy
Published: August 2023

Gene functional descriptions offer a crucial line of evidence for candidate genes underlying trait variation. Conversely, plant responses to environmental cues represent important resources to decipher gene function and subsequently provide molecular targets for plant improvement through gene editing. However, biological roles of large proportions of genes across the plant phylogeny are poorly annotated. Here we describe the Joint Genome Institute (JGI) Plant Gene Atlas, an updateable data resource consisting of transcript abundance assays spanning 18 diverse species. To integrate across these diverse genotypes, we analyzed expression profiles, built gene clusters that exhibited tissue/condition specific expression, and tested for transcriptional response to environmental queues. We discovered extensive phylogenetically constrained and condition-specific expression profiles for genes without any previously documented functional annotation. Such conserved expression patterns and tightly co-expressed gene clusters let us assign expression derived additional biological information to 64 495 genes with otherwise unknown functions. The ever-expanding Gene Atlas resource is available at JGI Plant Gene Atlas (https://plantgeneatlas.jgi.doe.gov) and Phytozome (https://phytozome.jgi.doe.gov/), providing bulk access to data and user-specified queries of gene sets. Combined, these web interfaces let users access differentially expressed genes, track orthologs across the Gene Atlas plants, graphically represent co-expressed genes, and visualize gene ontology and pathway enrichments.
FANCD2 and RAD51 recombinase directly inhibit DNA2 nuclease at stalled replication forks and FANCD2 acts as a novel RAD51 mediator in strand exchange to promote genome stability
Authors: Liu Wenpeng , Polaczek Piotr , Roubal Ivan , Meng Yuan , Choe Won-chae , Caron Marie-Christine , Sedgeman Carl A , Xi Yu , Liu Changwei , Wu Qiong , Zheng Li , Masson Jean-Yves , Shen Binghui , Campbell Judith L
Published: August 2023

FANCD2 protein, a key coordinator and effector of the interstrand crosslink repair pathway, is also required to prevent excessive nascent strand degradation at hydroxyurea-induced stalled forks. The RAD51 recombinase has also been implicated in regulation of resection at stalled replication forks. The mechanistic contributions of these proteins to fork protection are not well understood. Here, we used purified FANCD2 and RAD51 to study how each protein regulates DNA resection at stalled forks. We characterized three mechanisms of FANCD2-mediated fork protection: (1) The N-terminal domain of FANCD2 inhibits the essential DNA2 nuclease activity by directly binding to DNA2 accounting for over-resection in FANCD2 defective cells. (2) Independent of dimerization with FANCI, FANCD2 itself stabilizes RAD51 filaments to inhibit multiple nucleases, including DNA2, MRE11 and EXO1. (3) Unexpectedly, we uncovered a new FANCD2 function: by stabilizing RAD51 filaments, FANCD2 acts to stimulate the strand exchange activity of RAD51. Our work biochemically explains non-canonical mechanisms by which FANCD2 and RAD51 protect stalled forks. We propose a model in which the strand exchange activity of FANCD2 provides a simple molecular explanation for genetic interactions between FANCD2 and BRCA2 in the FA/BRCA fork protection pathway.
The induction of p53 correlates with defects in the production, but not the levels, of the small ribosomal subunit and stalled large ribosomal subunit biogenesis
Authors: Eastham Matthew John , Pelava Andria , Wells Graeme Raymond , Lee Justine Katherine , Lawrence Isabella Rachel , Stewart Joshua , Deichner Maria , Hertle Regina , Watkins Nicholas James , Schneider Claudia
Published: August 2023

Ribosome biogenesis is one of the biggest consumers of cellular energy. More than 20 genetic diseases (ribosomopathies) and multiple cancers arise from defects in the production of the 40S (SSU) and 60S (LSU) ribosomal subunits. Defects in the production of either the SSU or LSU result in p53 induction through the accumulation of the 5S RNP, an LSU assembly intermediate. While the mechanism is understood for the LSU, it is still unclear how SSU production defects induce p53 through the 5S RNP since the production of the two subunits is believed to be uncoupled. Here, we examined the response to SSU production defects to understand how this leads to the activation of p53 via the 5S RNP. We found that p53 activation occurs rapidly after SSU production is blocked, prior to changes in mature ribosomal RNA (rRNA) levels but correlated with early, middle and late SSU pre-rRNA processing defects. Furthermore, both nucleolar/nuclear LSU maturation, in particular late stages in 5.8S rRNA processing, and pre-LSU export were affected by SSU production defects. We have therefore uncovered a novel connection between the SSU and LSU production pathways in human cells, which explains how p53 is induced in response to SSU production defects.
Three-way contact analysis characterizes the higher order organization of the Tcra locus
Authors: Dai Ranran , Zhu Yongchang , Li Zhaoqiang , Qin Litao , Liu Nan , Liao Shixiu , Hao Bingtao
Published: August 2023

The generation of highly diverse antigen receptors in T and B lymphocytes relies on V(D)J recombination. The enhancer Eα has been implicated in regulating the accessibility of Vα and Jα genes through long-range interactions during rearrangements of the T-cell antigen receptor gene Tcra. However, direct evidence for Eα physically mediating the interaction of Vα and Jα genes is still lacking. In this study, we utilized the 3C-HTGTS assay, a chromatin interaction technique based on 3C, to analyze the higher order chromatin structure of the Tcra locus. Our analysis revealed the presence of sufficient information in the 3C-HTGTS data to detect multiway contacts. Three-way contact analysis of the Tcra locus demonstrated the co-occurrence of the proximal Jα genes, Vα genes and Eα in CD4+CD8+ double-positive thymocytes. Notably, the INT2–TEAp loop emerged as a prominent structure likely to be responsible for bringing the proximal Jα genes and the Vα genes into proximity. Moreover, the enhancer Eα utilizes this loop to establish physical proximity with the proximal Vα gene region. This study provides insights into the higher order chromatin structure of the Tcra locus, shedding light on the spatial organization of chromatin and its impact on V(D)J recombination.
Single-worm long-read sequencing reveals genome diversity in free-living nematodes
Authors: Lee Yi-Chien , Ke Huei-Mien , Liu Yu-Ching , Lee Hsin-Han , Wang Min-Chen , Tseng Yung-Che , Kikuchi Taisei , Tsai Isheng Jason
Published: August 2023

Obtaining sufficient genetic material from a limited biological source is currently the primary operational bottleneck in studies investigating biodiversity and genome evolution. In this study, we employed multiple displacement amplification (MDA) and Smartseq2 to amplify nanograms of genomic DNA and mRNA, respectively, from individual Caenorhabditis elegans. Although reduced genome coverage was observed in repetitive regions, we produced assemblies covering 98% of the reference genome using long-read sequences generated with Oxford Nanopore Technologies (ONT). Annotation with the sequenced transcriptome coupled with the available assembly revealed that gene predictions were more accurate, complete and contained far fewer false positives than de novo transcriptome assembly approaches. We sampled and sequenced the genomes and transcriptomes of 13 nematodes from early-branching species in Chromadoria, Dorylaimia and Enoplia. The basal Chromadoria and Enoplia species had larger genome sizes, ranging from 136.6 to 738.8 Mb, compared with those in the other clades. Nine mitogenomes were fully assembled, and displayed a complete lack of synteny to other species. Phylogenomic analyses based on the new annotations revealed strong support for Enoplia as sister to the rest of Nematoda. Our result demonstrates the robustness of MDA in combination with ONT, paving the way for the study of genome diversity in the phylum Nematoda and beyond.
LIPID TRANSFER PROTEIN4 regulates cotton ceramide content and activates fiber cell elongation
Authors: Duan Yujia , Shang Xiaoguang , He Qingfei , Zhu Lijie , Li Weixi , Song Xiaohui , Guo Wangzhen
Published: August 2023

Cell elongation is a fundamental process for plant growth and development. Studies have shown lipid metabolism plays important role in cell elongation; however, the related functional mechanisms remain largely unknown. Here, we report that cotton (Gossypium hirsutum) LIPID TRANSFER PROTEIN4 (GhLTP4) promotes fiber cell elongation via elevating ceramides (Cers) content and activating auxin-responsive pathways. GhLTP4 was preferentially expressed in elongating fibers. Over-expression and down-regulation of GhLTP4 led to longer and shorter fiber cells, respectively. Cers were greatly enriched in GhLTP4-overexpressing lines and decreased dramatically in GhLTP4 down-regulating lines. Moreover, auxin content and transcript levels of indole-3-acetic acid (IAA)-responsive genes were significantly increased in GhLTP4-overexpressing cotton fibers. Exogenous application of Cers promoted fiber elongation, while NPA (N-1-naphthalic acid, a polar auxin transport inhibitor) counteracted the promoting effect, suggesting that IAA functions downstream of Cers in regulating fiber elongation. Furthermore, we identified a basic helix-loop-helix transcription factor, GhbHLH105, that binds to the E-box element in the GhLTP4 promoter region and promotes the expression of GhLTP4. Suppression of GhbHLH105 in cotton reduced the transcripts level of GhLTP4, resulting in smaller cotton bolls and decreased fiber length. These results provide insights into the complex interactions between lipids and auxin-signaling pathways to promote plant cell elongation.
CHLORIDE CHANNEL-b mediates vacuolar nitrate efflux to improve low nitrogen adaptation in Arabidopsis
Authors: Shi Yujiao , Liu Dong , He Yiqi , Tang Jing , Chen Haifei , Gong Pan , Luo Jin-Song , Zhang Zhenhua
Published: August 2023

The vacuole is an important organelle for nitrate storage, and the reuse of vacuolar nitrate under nitrate starvation helps plants adapt to low-nitrate environments. CHLORIDE CHANNEL-b (CLC-b) in the vacuolar membrane is a nitrate transporter; however, its regulation and effects on nitrate efflux have not been established. Here, we evaluated CLC-b expression and its effects on physiological parameters under low nitrate conditions. CLC-b expression increased significantly in the roots of wild-type Arabidopsis (Arabidopsis thaliana) Col-0 under nitrate starvation. Under low nitrate, clcb mutants showed reductions in chlorophyll content and xylem sap nitrate concentration, shoot/root nitrate ratios, shoot/root total N ratios, and biomass. CLC-b-overexpression yielded opposite phenotypes and increased nitrogen use efficiency. CLC-b mutants showed elevated chlorate tolerance and an increased proportion of vacuolar nitrate relative to the total protoplast nitrate content as compared to the wild type. Yeast 1-hybrid, EMSA, and chromatin immunoprecipitation (ChIP) experiments showed that HRS1 HOMOLOG2 (HHO2), the expression of which is downregulated under low nitrate, binds directly to the promoter of CLC-b. clcb/hho2 double mutants and HHO2-overexpressing clcb plants had similar phenotypes under low nitrate to those of clcb single mutants. Thus, CLC-b mediates vacuolar nitrate efflux and is negatively regulated by HHO2, providing a theoretical basis for improving plant adaptability to low nitrate.
The impact of administrative disciplinary proceedings on military police officers in São Paulo
Authors: Cruz Fernanda Novaes , Rodrigues de Oliveira André , Castelo Branco Frederico , Cubas Viviane de Oliveira
Published: August 2023

Studies on police institutions have argued that the internal treatment given to agents contributes to define how these agents will treat the communities to which they provide services. Brazil’s main police force has a military structure and formal ties with the Armed Forces. These military characteristics include career structure, regulations, manuals, and disciplinary regiments either copied or adapted from the Army. In this work, we analyse data from a survey applied to 298 military police officers stationed in the city of São Paulo. Using Structural Equation Modelling, we analysed whether, among the police officers who answered a Disciplinary Administrative Proceeding, their evaluation of having been granted the right to speak, treated with respect during the process, and a fair outcome at the end impact their perceptions about their relationship with peers, superiors, and their views on organizational justice. Our findings reveal that respectful treatment during the proceeding was more important than a favourable outcome, and the perception of having been treated with respect during the Disciplinary Administrative Proceeding positively impacts their views about their superiors and organizational justice. These findings help us to reflect on the impacts of the militarization of Public Security on internal relationships as well as the importance of procedural justice within this context.
‘On paper, you’re normal’: narratives of unseen health needs among women who have had children removed from their care
Authors: Grant Claire , Powell Claire , Philip Georgia , Blackburn Ruth , Lacey Rebecca , Woodman Jenny
Published: August 2023

Background

Mothers who have children removed from their care often have complex needs. These women have poor health outcomes and are dying earlier than their peers from preventable and amenable causes. Yet there is little known about how health care services might mitigate these risks. This study aimed to listen to the voices of women who had children removed from their care to understand their experiences of health and healthcare.

Methods

We used a narrative approach to collect and analyse interview data with six mothers who had experienced child removal in England. Each participant was asked to reflect on their life and main health challenges.

Results

Three narrative subplots were developed to consolidate experiences of unmet health need: (i) ‘on paper you’re normal’: narratives of complex need, (ii) ‘in my family, everyone had issues’: narratives of whole family need and (iii) ‘I’m still mummy, no matter where they are’: narratives of maternal identity and health.

Conclusions

Findings highlight limitations within current systems of support, including a culture of distrust and women falling between the gaps of services. Women’s narratives illustrate opportunities for health intervention, especially immediately following child removal.
Tristan Corbière and T. S. Eliot’s Salt-Encrusted Poetry
Authors: Evans Suzannah V
Published: August 2023

The name of Tristan Corbière (1847–1875) appears repeatedly in T. S. Eliot’s criticism, notably in his Clark and Turnbull lectures where Eliot characterized Corbière as a metaphysical poet and observed that he is a ‘finer poet, though a lesser intellect, than Laforgue’. Corbière’s influence on Eliot has long been recognized, but few critics acknowledge the particular resonance of his maritime poems. It is time to revisit Corbière’s crucial influence on Eliot, who drew on his writing for Poems (1920), and most significantly in the draft sea passages of The Waste Land. Identifying Corbière’s presence in the draft allows us to hear the French poet in the final version of ‘Death by Water’, and reveals that Eliot owes more to Corbière than has previously been acknowledged. I argue that Eliot was captivated by Corbière’s resolutely unsentimental depiction of maritime elements in Les Amours jaunes, and that this Breton poet offered Eliot a new voice.
Proteomics analyses of human plasma reveal triosephosphate isomerase as a potential blood marker of methotrexate resistance in rheumatoid arthritis
Authors: Escal Jean , Neel Tiphany , Hodin Sophie , Boussoualim Karima , Amouzougan Adamah , Coassy Astrid , Locrelle Hervé , Thomas Thierry , Delavenne Xavier , Marotte Hubert
Published: August 2023

Objective

The objective of this study was to assess differentially expressed blood proteins between patients with active RA and patients in remission after MTX treatment, with the aim of identifying a biomarker of MTX resistance (MTXR).

Methods

Two populations of RA patients treated with a stable dose of s.c. MTX for at least 3 months were constituted according to the DAS28: remission (DAS28 < 2.6; n = 24) and active disease (DAS28 > 3.2; n = 32). The two groups of RA patients were homogeneous regarding their epidemiological characteristics, except for the duration of treatment, which was longer in the remission group. After collection of a blood sample, plasma protein digestion was performed, followed by untargeted proteomics analysis. Then, a targeted analysis was performed to confirm the results of the untargeted approach.

Results

Untargeted proteomics analysis revealed eight plasma proteins that were differentially expressed between the two groups of patients. Among them, triosephosphate isomerase (TPI-1) and glucose-6-phosphate isomerase (GPI), which are main actors in glycolysis, were found down-regulated in the active group. This result was confirmed for TPI-1 in the targeted proteomics analysis.

Conclusion

A first step was achieved in the search for biomarkers of MTXR, with the identification of two actors in glycolysis (TPI-1 and GPI). The next step will be to confirm these results in a larger cohort, including samples from treatment-naive patients, to assess the predictive potential of these protein markers.
Predictors of Mortality Following a Schizophrenia Spectrum Diagnosis: Evidence From the 20-Year Follow-up of the OPUS Randomized Controlled Trial
Authors: Starzer Marie Stefanie Kejser , Hansen Helene Gjervig , Hjorthøj Carsten , Speyer Helene , Albert Nikolai , Nordentoft Merete
Published: August 2023

Background and Hypothesis

The life expectancy of patients diagnosed with schizophrenia is 10–12 years lower than in the general population and the mortality gap seems to be worsening. Many of these deaths might be avoidable. We aimed to determine mortality rates and causes of death after a first-episode psychosis, and to examine if clinical characteristics at baseline or during illness could predict mortality.

Study Design

The OPUS study was a randomized controlled trial of 578 patients first diagnosed with schizophrenia spectrum disorders. Patients were clinically assessed after 2, 5, 10, and 20 years. Information about time and cause of death was obtained from the Danish Cause of Death Register. Hazard ratios were used to assess predictors of death.

Study Results

In total, 82 (14.4%) participants died during 20 years of follow-up. The most common cause of death was suicide (27%). At baseline employment (HR 0.47 P = .049), psychotic disorder other than schizophrenia (HR 0.36, P = .017), and longer duration of untreated psychosis (HR 0.57 P = .042) predicted lower mortality while substance use predicted higher mortality (HR 2.56, P < .001). During follow-up, symptom remission without antipsychotic medication and recovery predicted lower mortality (HR 0.08 P = .013 and HR 0.21, P = .028) while substance use (HR 3.64 P < .001), and all chronic illnesses predicted increased risk.

Conclusions

There is an increased risk of early mortality in schizophrenia compared to the background population, and there is an urgent need for new efforts to improve the disparities in health that lead to this increased mortality.
Early detection of genotoxic hepatocarcinogens in rats using γH2AX and Ki-67: prediction by machine learning
Authors: Michiba Ayano , Gi Min , Yokohira Masanao , Sakurai Eiko , Teramoto Atsushi , Kiriyama Yuka , Yamada Seiji , Wanibuchi Hideki , Tsukamoto Tetsuya
Published: August 2023

Direct DNA double-strand breaks result in phosphorylation of H2AX, a variant of the histone H2 protein. Phosphorylated H2AX (γH2AX) may be a potential indicator in the evaluation of genotoxicity and hepatocarcinogenicity. In this study, γH2AX and Ki-67 were detected in the short-term responses (24 h after chemical administration) to classify genotoxic hepatocarcinogens (GHs) from non-GH chemicals. One hundred and thirty-five 6-week-old Crl: CD(SD) (SPF) male rats were treated with 22 chemicals including 11 GH and 11 non-GH, sacrificed 24 h later, and immunostained with γH2AX and Ki-67. Positivity rates of these markers were measured in the 3 liver ZONEs 1–3; portal, lobular, and central venous regions. These values were input into 3 machine learning models—Naïve Bayes, Random Forest, and k-Nearest Neighbor to classify GH and non-GH using a 10-fold cross-validation method. All 11 and 10 out of 11 GH caused significant increase in γH2AX and Ki-67 levels, respectively (P < .05). Of the 3 machine learning models, Random Forest performed the best. GH were identified with 95.0% sensitivity (76/80 GH-treated rats), 90.9% specificity (50/55 non-GH-treated rats), and 90.0% overall correct response rate using γH2AX staining, and 96.2% sensitivity (77/80), 81.8% specificity (45/55), and 90.4% overall correct response rate using Ki-67 labeling. Random Forest model using γH2AX and Ki-67 could independently predict GH in the early stage with high accuracy.
Sensor-Based Quantification of Peanut Disease Defoliation Using an Unmanned Aircraft System and Multispectral Imagery
Authors: Barocco Rebecca L. , Clohessy James W. , O’Brien G. Kelly , Dufault Nicholas S. , Anco Daniel J. , Small Ian M.
Published: August 2023

Early leaf spot (Passalora arachidicola) and late leaf spot (Nothopassalora personata) are two of the most economically important foliar fungal diseases of peanut, often requiring seven to eight fungicide applications to protect against defoliation and yield loss. Rust (Puccinia arachidis) may also cause significant defoliation depending on season and location. Sensor technologies are increasingly being utilized to objectively monitor plant disease epidemics for research and supporting integrated management decisions. This study aimed to develop an algorithm to quantify peanut disease defoliation using multispectral imagery captured by an unmanned aircraft system. The algorithm combined the Green Normalized Difference Vegetation Index and the Modified Soil-Adjusted Vegetation Index and included calibration to site-specific peak canopy growth. Beta regression was used to train a model for percent net defoliation with observed visual estimations of the variety ‘GA-06G’ (0 to 95%) as the target and imagery as the predictor (train: pseudo-R2 = 0.71, test k-fold cross-validation: R2 = 0.84 and RMSE = 4.0%). The model performed well on new data from two field trials not included in model training that compared 25 (R2 = 0.79, RMSE = 3.7%) and seven (R2 = 0.87, RMSE = 9.4%) fungicide programs. This objective method of assessing mid-to-late season disease severity can be used to assist growers with harvest decisions and researchers with reproducible assessment of field experiments. This model will be integrated into future work with proximal ground sensors for pathogen identification and early season disease detection.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
A prospective study on total hip arthroplasty outcome in hip fracture compared with matched elective cohort
Authors: Lim Jun Wei , Tan Tze Khiang , AlKandari Nourah , Ridley David , Sripada Sankar , Jariwala Arpit Chandrakant
Published: August 2023

Background:

We conducted a prospective study to compare the outcomes of THA for hip fractures with a best-matched elective cohort.

Method:

We prospectively reviewed patients underwent THA for hip fractures from 2017 to 2019. The modified Harris Hip Score (mHHS) and complications were recorded. Our control group was elective THA cases matched for the month of operation, age, gender, implants, side of operation and surgeon’s grade. Unmatched cases were excluded.

Results:

Forty-one THA for hip fractures and forty-one matched elective THA were compared. The total modified Harris Hip Score [mHHS (total)] was significantly lower preoperatively in elective cohort (trauma vs. elective: 60.3 vs. 41.4, P<0.001) and achieved significantly higher score than trauma cohort one-year postoperatively (82.6 vs. 88.2, P= 0.029). The trauma cohort had similar mHHS (function) pre- and postoperatively, and no significant difference was witnessed between both cohorts postoperatively (35.1 vs. 37.6, P= 0.142). The mHHS (pain) was significantly higher in trauma cohort preoperatively (19.8 vs. 12.7, P=0.034), but the elective cohort achieved significantly higher mHHS (pain) than trauma cohort at one-year postoperative (40.1 vs. 42.7, P=0.027). Both cohorts had similar complication rates.

Conclusions:

This is the first matched prospective study on hip fracture patients that underwent THA, with one year follow up results and the involvement of preoperative and postoperative functional outcomes. With careful patient selection, trauma THA patients can return to their pre-injured function within a year and had comparable function scores with elective THA patients, without increased complication rates.
Menopausal hormone therapy and change in physical activity in the Women's Health Initiative hormone therapy clinical trials
Authors: Peila Rita , Xue Xiaonan , LaMonte Michael J. , Shadyab Aladdin H. , Wactawski-Wende Jean , Jung Su Yon , Johnson Karen C. , Coday Mace , Richey Phyllis , Mouton Charles P. , Saquib Nazums , Chlebowski Rowan T. , Pan Kathy , Michael Yvonne L. , LeBoff Meryl S. , Manson JoAnn E. , Rohan Thomas E.
Published: August 2023

Objective

The menopausal transition results in a progressive decrease in circulating estrogen levels. Experimental evidence in rodents has indicated that estrogen depletion leads to a reduction of energy expenditure and physical activity. It is unclear whether treatment with estrogen therapy increases physical activity level in postmenopausal women.

Methods

A total of 27,327 postmenopausal women aged 50-79 years enrolled in the Women's Health Initiative randomized double-blind trials of menopausal hormone therapy. Self-reported leisure-time physical activity at baseline, and years 1, 3, and 6 was quantified as metabolic equivalents (MET)-h/wk. In each trial, comparison between intervention and placebo groups of changes in physical activity levels from baseline to follow-up assessment was examined using linear regression models.

Results

In the CEE-alone trial, the increase in MET-h/wk was greater in the placebo group compared with the intervention group at years 3 (P = 0.002) and 6 (P < 0.001). Similar results were observed when analyses were restricted to women who maintained an adherence rate ≥80% during the trial or who were physically active at baseline. In the CEE + MPA trial, the primary analyses did not show significant differences between groups, but the increase of MET-h/wk was greater in the placebo group compared with the intervention group at year 3 (P = 0.004) among women with an adherence rate ≥80%.

Conclusions

The results from this clinical trial do not support the hypothesis that estrogen treatment increases physical activity among postmenopausal women.
Comparison of Breast Reconstruction Outcomes Using Oxychlorosene versus Triple Antibiotic Solution for Pocket Irrigation
Authors: Bamba Ravinder , Tran Phu C. , Mailey Brian A. , Lin Jenny , DeBrock William , Dawson Steven , Sinha Mithun , Hartman Brett C. , Hadad Ivan , Lester Mary E. , Hassanein Aladdin H.
Published: August 2023

Background:

Breast pocket irrigation with antiseptic solutions is performed to reduce contamination with breast implants. The optimal antiseptic irrigation solution and the efficacy of individual practices are unclear. Oxychlorosene sodium is frequently used at our institution. Oxychlorosene is bactericidal with a mechanism of action of oxidation and hypochlorination. The purpose of our study was to compare the outcomes of oxychlorosene sodium irrigation with triple antibiotic solution (TAS) in implant-based breast reconstruction.

Methods:

All patients who underwent implant-based reconstruction after mastectomy were reviewed. The primary predictive variable was type of solution used for pocket irrigation (TAS or oxychlorosene). Outcome variables included surgical site infection, device removal, and wound complications.

Results:

Between 2013 and 2018, 331 implant-based breast reconstructions were performed. Of these, 62% (n = 206) received oxychlorosene for surgical pocket irrigation (group I), and 38% (n = 125) received TAS (group II). Group I had an 11.7% (n = 24) 90-day surgical site infection rate, with 4.9% (n = 10) requiring oral antibiotics, 2.4% (n = 5) requiring intravenous antibiotics without device removal, and 4.4% (n = 9) requiring prosthetic removal. Group II had an 11.2% (n = 14) 90-day infection rate, with 5.6% (n = 7) requiring oral antibiotics, 2.4% (n = 3) requiring intravenous antibiotics without device removal, and 3.2% (n = 4) requiring removal (P = 0.90). When comparing the cost of oxychlorosene irrigation with TAS irrigation, oxychlorosene was less expensive.

Conclusions:

Oxychlorosene and TAS have similar surgical site infection rates in prosthetic breast reconstruction. Ease of preparation and cost make oxychlorosene a more favorable option for antibiotic irrigation in reconstructive breast surgery with prosthetic devices.
Prognostic Nutritional Index with Postoperative Complications and 2-year Mortality in Hip Fracture Patients: An Observational Cohort Study
Authors: Wang Yilin , Jiang Yu , Luo Yan , Lin Xisheng , Song Mi , Li Jia , Zhao Jingxin , Li Ming , Jiang Yuheng , Yin Pengbin , Tang Peifu , Lyu Houchen , Zhang Licheng
Published: August 2023

Background:

The prognostic nutritional index (PNI) has been proposed as a useful prognostic tool in multiple populations. However, its prognostic value has not been fully evaluated in the hip fracture population. We aimed to assess the relationship between PNI and postoperative complications as well as 2-year all-cause mortality in the hip fracture population.

Materials and methods:

We included patients aged 45 or older who underwent surgery for hip fracture between 2000 and 2022. The baseline serum albumin and total lymphocyte count were used to calculate PNI with the following formula: 10 × serum albumin level (g/dL) + 0.005 × total lymphocyte count (per mm3). Patients were classified into low, medium, and high categories based on tertiles of PNI (≤ 43.23, 43.23-47.35, and > 47.35, respectively). Logistic regression and Cox proportional hazards models were used to calculate the odds ratio (OR) for postoperative compilations and the hazard ratio (HR) for mortality, adjusting for potential confounders.

Results:

Of 3,351 hip patients, 236 (7.04%) developed postoperative complications, and 305 (9.10%) died during the 2-year follow-up. Compared to the low-category patients, the medium- and high-category patients showed lower odds of postoperative complications (ORs 0.69, 95% CI, 0.48-0.98; and 0.61, 95% CI, 0.40-0.93, respectively), and lower hazard of 2-year mortality (HRs 0.66, 95% CI 0.49-0.88; and 0.61, 95% CI 0.42-0.88, respectively). These associations were robust across a series of analyses, including subgroup analyses and dose-response sensitivity analyses.

Conclusion:

PNI is an independent predictor of postoperative complications and 2-year all-cause mortality in hip fracture patients. PNI can be used to identify patients who may be at high risk of a poor prognosis.
Ultrasonographic Finding of Contralateral Achilles Tendon in Patients With Acute Achilles Tendon Rupture: A Prospective Observational Study
Authors: Park Young Hwan , Kim Woon , Choi Jung Woo , Kim Hak Jun
Published: August 2023

Objective:

Although the incidence of contralateral Achilles tendon in patients with Achilles tendon rupture is higher than in the general population, there are no studies evaluating the status of the contralateral Achilles tendon. The aim of this study was to investigate the status of the contralateral Achilles tendon in patients with acute Achilles tendon rupture.

Design:

Prospective observational cohort study.

Setting:

University hospital foot and ankle clinic.

Participants:

Seventy-five patients with acute Achilles tendon rupture who met the inclusion criteria.

Intervention:

Ultrasonography performed by an orthopedic surgeon who had 8 years of experience in musculoskeletal ultrasonography.

Main Outcome Measures:

Ultrasonographic abnormalities of the contralateral Achilles tendon at the time of diagnosis of acute Achilles tendon rupture. Abnormalities were categorized as intratendinous lesions, peritendinous lesions, changes in retrocalcaneal bursa, and Achilles tendon thickening.

Results:

The maximal Achilles tendon thickness had a mean of 4.8 ± 1.0 mm. Nine patients (12%) showed ultrasonographic abnormalities on the contralateral Achilles tendon, and the presence of exertional pain was the sole associating variable with ultrasonographic abnormalities.

Conclusion:

The prevalence of ultrasonographic abnormalities in the contralateral Achilles tendon shown in this study was not higher than that reported in healthy or asymptomatic Achilles tendon. Therefore, routine evaluation of the contralateral Achilles tendon is unnecessary at the time of acute Achilles tendon rupture.
A Rare Case Report of Exertional Leg Pain
Authors: Dyrek Paige , Kuwabara Anne , Fredericson Michael
Published: August 2023

The accurate diagnosis of exertional leg pain in athletes is often delayed because of vague presenting symptoms and nonspecific physical examination findings. This case report outlines exertional leg pain in a runner caused by combined popliteal artery entrapment and soleal sling syndromes, 2 uncommon causes of exertional leg pain. This case report highlights the overlapping clinical presentation of these 2 diagnoses and the intricate differences in diagnostic workup and surgical approach to management.
Ease of Use and Usefulness of a Newly Developed Mobile App to Monitor Pain and Adherence Among Individuals With an Achilles Tendinopathy Engaged in a Rehabilitation Program
Authors: Lavigne Alexandre , Lamontagne Martin , Mares Christopher , Gagnon Dany H.
Published: August 2023

Objective:

Assess the perceived ease of use and perceived usefulness of a newly developed mobile app.

Design:

Descriptive survey study.

Setting:

Home-based rehabilitation program.

Participants:

A group of 31 adults with a symptomatic Achilles tendinopathy.

Intervention:

A mobile app was developed to support the deployment of the 12-week active exercise-based rehabilitation program and facilitate the monitoring of exercise adherence twice daily and the assessment of localized Achilles tendon pain using a numeric pain rating scale on a weekly basis.

Main Outcome Measures:

Results of an online survey encompassing 10 questions, each rated on a 5-point Likert scale (5 = strongly agree; 1 = strongly disagree).

Results:

Nearly all participants agreed that the mobile app was easy to install (96.4%) and easy to use (100%). Most participants confirmed that no technical issues were encountered (96.4%). The instructional videos were deemed helpful in properly performing the recommended exercises (85.7%), whereas the prompts sent via text message were found to promote adherence (88.9%). The design and appearance of the mobile app were appreciated by a lower percentage of participants (75%).

Conclusion:

Participants confirmed the ease of use and usefulness of the newly developed mobile app and demonstrated a positive attitude toward its use.
Robot-Assisted Laparoscopic Adrenal Metastasectomy With Prior Partial or Radical Nephrectomy: Step-by-Step Technique and 1-Year Outcomes
Authors: Xuan Yundong , Cheng Qiang , Liu Kan , Li Xintao , Fan Yan , Zhang Peng , Wang Hanfeng , Zhao Xupeng , Tian Shuo , Wang Jichen , Wang Baojun , Gao Yu , Zhang Xu
Published: August 2023

Purpose:

The purpose of this study was to elucidate the feasibility and safety of the technique of robot-assisted laparoscopic adrenal metastasectomy (RAL-AME) for adrenal metastasis (AM) originating from renal cell carcinoma (RCC) with surgical history.

Materials and Methods:

From October 2015 to September 2020, RAL-AME was performed on 13 patients with AM from RCC with surgical history by using a transperitoneal approach. Whether metastasis occurs on the left or right side, adhesiolysis is required in the supine position from the contralateral side to the affected side. Three planes were established sequentially to separate the AM with patients converted into a lateral decubitus position. The first dissection plane was between the inferior side of the liver for right AM or spleen for left AM and the posterior side of the colon. The second dissections plane was established between the anterior renal fascia and the lateral aspect of perirenal fat. Care should be taken to avoid damaging the aorta or inferior vena cava when establishing the left or right plane. The third dissection plane was achieved between the retrorenal fascia and the anterior aspect of the psoas major. The metastasis was identified and en bloc–excised.

Results:

The median operative time was 127 minutes (range 60-290), and median estimated blood loss was 50 ml (range 20-500). The average time to oral intake and hospital length of stay were 2.5 and 2.8 days, respectively. Perioperative complications and conversion to open surgery were not observed. All surgical margins were negative.

Conclusions:

RAL-AME for adrenal metastasis is safe and feasible. The therapeutic effect and overall survival rate require further investigation with a larger sample size and longer follow-up.
Variability of Commercial Saw Palmetto–Based Supplements for the Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms
Authors: Chughtai Bilal , Bhojani Naeem , Zorn Kevin C. , Elterman Dean
Published: August 2023

Purpose:

Some men with mild-to-moderate benign prostatic hyperplasia/lower urinary tract symptoms use saw palmetto supplements to proactively manage their symptoms as an alternative to watchful waiting and/or to avoid prescription medication side effects. This study assessed the potency and authenticity of commercially available saw palmetto–based supplements in the United States.

Materials and Methods:

Twenty-eight saw palmetto berry powders, powdered extracts, berry blends, lipid extracts, and multiactive products (lycopene, pumpkin oil, etc) were purchased from major online retailers and retail stores. Total fatty acid content (% weight/weight) and individual fatty acid profile of each product were determined using validated gas chromatography-fatty acid methyl ester methodology and compared with the US Pharmacopeia monograph standards for lipidosterolic extracts of Serenoa repens.

Results:

Total fatty acid content ranged from 0.796% for a berry powder product to 89.923% for a lipid extract product. None of the berry powders or powdered extracts, 6 of 9 lipid extracts, and 1 multiactive product met criteria for ≥80% total fatty acid content. Only 1 of the 28 products met the US Pharmacopeia criteria for a standardized lipidosterolic extract, defined as total fatty acid content ≥80% and a fatty acid profile indicative of authentic S. repens based on the ratios of the lauric acid concentration to 9 other individual fatty acid concentrations.

Conclusions:

There is substantial heterogeneity in fatty acid content and profile in saw palmetto supplements. Lipidosterolic extracts of saw palmetto berries standardized to ≥80% fatty acids are most likely to meet established criteria for quality and identity.
VM-PATHI Correlates With Cognitive Function Improvement After Successful Treatment in Patients With Vestibular Migraine
Authors: Patel Evan J. , Hum Maxwell , Gardi Adam , Steenerson Kristen K. , Rizk Habib G. , Sharon Jeffrey D.
Published: August 2023

Objective

To assess changes in cognitive function in vestibular migraine patients undergoing treatment.

Study Design

Prospective cohort.

Setting

Single-institution tertiary-care center.

Patients

Thirty-four patients with vestibular migraine were included in the study. Average age at diagnosis was 47.9 years. A majority of patients (91.2%) were female.

Interventions

Vestibular therapies included pharmacologic treatment (67.6%), mindfulness-based stress reduction (58.8%), vestibular physical therapy (20.6%), and lifestyle changes only (2.9%).

Main Outcome Measures

Pretreatment and posttreatment questionnaires were collected including the Cognitive Failures Questionnaire (CFQ), Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI), and Dizziness Handicap Inventory.

Results

Median time between pretreatment and posttreatment questionnaire was 4.4 months (range, 2.8–15.6. mo). CFQ scores decreased in subjects who responded to treatment, as defined by those with a positive change in VM-PATHI score (average decrease, 6.5; p = 0.03). CFQ scores did not improve in subjects who had no improvement in their vestibular condition, as defined by no change or an increase in VM-PATHI score (average increase, 2.0; p = 0.53). Univariate linear regression showed that VM-PATHI score change was highly predictive of CFQ change (p < 0.01, r
2 = 0.36). Multivariate regression demonstrated that the VM-PATHI (p = 0.03) and not the Dizziness Handicap Inventory (p = 0.10) predicted changes in CFQ score.

Conclusions

Self-reported cognitive dysfunction improves with successful treatment of vestibular migraine.
Severe Acute Bacterial Infections in Children With Sickle Cell Disease in Togo
Authors: Gbadoé Adama Dodji , Guédénon Koffi Mawuse , N’zonou Magnoulelen , Adamou Mahamadou , Akolly Djatougbé , Guédéhoussou Têtê , Dagnra Anoumou Yaotsé
Published: August 2023

Background:

Bacterial infections are considered a major cause of morbidity and mortality in patients, especially children, with sickle cell disease.

Objectives:

This study aims at determining, a year after the introduction of the 13-valent pneumococcal conjugate vaccine the distribution of severe acute bacterial infections and germs in children with sickle cell disease.

Patients and methods:

Records of children 0 to 15 years of age and admitted from January 1, 2015 to December 31, 2019 (5 y), were examined retrospectively in the four sickle cell monitoring units in Lomé.

Results:

The main infections found were pleuropulmonary (46.1%), urinary tract (32.8%), and osteoarticular (9.3%). A germ was isolated in 139 of the 265 cases (52.4%). 65.5% of the microorganisms isolated were Gram-negative organisms, with mostly Escherichia coli (31.6%), and Klebsiella pneumoniae (18%) being the main germs. They were mainly responsible of urinary tract and osteoarticular infections. The majority of these Enterobacteriaceae was Extended-Spectrum Beta-Lactamase-Producing (41.1%, n = 37). Gram-positive cocci were represented by Staphylococcus sp (25.9%), Streptococcus sp (4.3%), Streptococcus pneumoniae (2.9%), and Enterococcus (1.4%). Staphylococcus aureus was the most common germ in pleuropulmonary (40%), osteoarticular (47.3%), and sepsis (28.6%) infections.

Conclusion:

Even if the infections found remained classic, there is a redistribution of germs with a decline in Salmonella and increase of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus.
The Yield, Safety, and Cost-effectiveness of Decreasing Repeat Blood Cultures Beyond 48 Hours in a Pediatric Hematology-Oncology Unit
Authors: Prather Cassandra S. , Wood James B. , Mueller Emily L. , Christenson John C. , Alali Muayad
Published: August 2023

Clear recommendations are needed on when repeat blood cultures (BCxs) in hospitalized children with cancer should be obtained. We reviewed all BCx obtained on the Hematology-Oncology Unit at Riley Hospital for Children, regardless of reason for patient admission or neutropenia status, between January 2015 and February 2021. Patients with positive BCx within 48 hours of initial cultures, history of stem cell transplant, or admitted to the intensive care unit were excluded. Medical records of patients with new positive BCx drawn >48 hours after initial BCx were reviewed. Seven (1.2%) hospitalization episodes grew new pathogens, or commensals treated as pathogens, on cultures beyond 48 hours. All patients with new, true pathogens were hemodynamically unstable or had recurrent fever when the new positive BCx was obtained. Twenty-three (4.0%) hospitalization episodes had contaminant cultures beyond 48 hours, with 74 (5.4%) of 1362 BCx collected beyond 48 hours being contaminated, resulting in an additional cost of $210,519 from increased length of stay. In conclusion, repeat BCx beyond 48 hours in pediatric hematology-oncology patients with negative initial cultures are low yield and costly. Repeat BCx can be safely and cost-effectively ceased after 48 hours of negative cultures in hemodynamically and clinically stable patients.
The CSN5/HSF/SPI1/PU.1 Axis Regulates Cell Proliferation in Hypocellular Myelodysplastic Syndrome Patients
Authors: Yu Zheng-Ping , Jian Zi-Ying , Sun Ai-Ning , Chen Bao-An , Ge Zheng
Published: August 2023

Objective:

This study explored the relationship between the activation of the jak/stat3 signaling pathway and the CSN5 gene transcript and protein expression levels in the hematopoietic stem cells of patients with myelodysplastic syndromes (MDSs). This study also aimed to investigate the correlation between the expression level of CSN5 and the deubiquitination of HSF1, as well as the transcript level of the spi1/pu.1 genes to explore the pathogenesis of MDS.

Materials and Methods:

We isolated cells from normal individuals and MDS patients, and the mRNA and protein expression levels of spi1/pu.1 in cd34+ cells (hematopoietic stem cells) were measured by PCR and western blotting, respectively. A ChIP assay was used to detect the binding of HSF1 to the spi1/pu.1 promoter in cd34+ cells. The ubiquitination of HSF1 in cd34+ cells was detected by CO-IP. The binding of HSF1 and Fbxw7α was detected in in cd34+ cells by CO-IP. The binding of HSF1 and CSN5 was evaluated. A luciferase reporter assay was used to detect the effect of STAT3 on CSN5 promoter activation in cd34+ cells. Western blotting was used to detect the phosphorylation of STAT3 in cd34+ cells of MDS patients. The binding of STAT3 and C/EBP beta in cd34+ cells was detected by CO-IP.

Results:

Inhibition of SPI1/PU.1 expression was observed in MDS samples with low proliferation ability. Further experiments proved that phosphorylation of STAT3 affected CSN5 function and mediated the ubiquitination of HSF, the upstream regulator of SPI1/PU.1 transcription, which led to the inhibition of SPI1/PU.1 expression. Restoration of CSN5 rescued the inhibition of HSF1 ubiquitination, causing SPI1/PU.1 transcription to resume and increasing SPI1/PU.1 expression, promoting the recovery of cell proliferation in hypocellular MDS.

Conclusions:

Our research revealed the regulatory role of the CSN5/HSF/SPI1/PU.1 axis in hypocellular MDS, providing a probable target for clinical intervention.