bluuebunny/crossref_metadata_2025 huggingface dataset:
A new G-quadruplex-specific photosensitizer inducing genome instability in cancer cells by triggering oxidative DNA damage and impeding replication fork progression
Authors: Deiana Marco , Andrés Castán José María , Josse Pierre , Kahsay Abraha , Sánchez Darío Puchán , Morice Korentin , Gillet Natacha , Ravindranath Ranjitha , Patel Ankit Kumar , Sengupta Pallabi , Obi Ikenna , Rodriguez-Marquez Eva , Khrouz Lhoussain , Dumont Elise , Abad Galán Laura , Allain Magali , Walker Bright , Ahn Hyun Seo , Maury Olivier , Blanchard Philippe , Le Bahers Tangui , Öhlund Daniel , von Hofsten Jonas , Monnereau Cyrille , Cabanetos Clément , Sabouri Nasim
Published: May 2023

Photodynamic therapy (PDT) ideally relies on the administration, selective accumulation and photoactivation of a photosensitizer (PS) into diseased tissues. In this context, we report a new heavy-atom-free fluorescent G-quadruplex (G4) DNA-binding PS, named DBI. We reveal by fluorescence microscopy that DBI preferentially localizes in intraluminal vesicles (ILVs), precursors of exosomes, which are key components of cancer cell proliferation. Moreover, purified exosomal DNA was recognized by a G4-specific antibody, thus highlighting the presence of such G4-forming sequences in the vesicles. Despite the absence of fluorescence signal from DBI in nuclei, light-irradiated DBI-treated cells generated reactive oxygen species (ROS), triggering a 3-fold increase of nuclear G4 foci, slowing fork progression and elevated levels of both DNA base damage, 8-oxoguanine, and double-stranded DNA breaks. Consequently, DBI was found to exert significant phototoxic effects (at nanomolar scale) toward cancer cell lines and tumor organoids. Furthermore, in vivo testing reveals that photoactivation of DBI induces not only G4 formation and DNA damage but also apoptosis in zebrafish, specifically in the area where DBI had accumulated. Collectively, this approach shows significant promise for image-guided PDT.
Photometric analysis on RZ Horologii: An evolved and active Algol with a δ Scuti component
Authors: Zhang Huiting , Qian Shengbang , Liao Wenping
Published: May 2023

RZ Hor (TIC 31653503) is a long-period (P = 6.68 d) EA-type eclipsing binary that exhibits both chromospheric activity and oscillation. The physical properties of RZ Hor are determined with binary modelling for the first time. It is found that it has a semi-detached configuration with a low mass ratio of q = 0.1606(13), where the secondary component is filled with its Roche lobe. By analyzing all available eclipse times, it is shown that the orbital period of RZ Hor is decreasing at a rate of dP/dt = −5.48 × 10−6 d yr−1. In a typical Algol, a rapid mass transfer from the secondary to the primary should cause the orbital period to be increasing and then the secondary will be temporarily detached from the critical Roche lobe. The present configuration reveals that RZ Hor has undergone a rapid mass transfer and the period decrease can be explained by magnetic stellar wind. We estimate the rate of mass loss initially to be $10^{-8}\, M_{\odot }\, \mathrm{yr}^{-1} < \vert \dot{M}\vert < 10^{-6}\, M_{\odot }$ yr−1. The variations and the asymmetries of the light curve are interpreted by adding a migrating cool spot on the surface of the late-type secondary. After subtracting the eclipsing changes from the light curve data, we analyzed the pulsation in the light residuals. Twenty-five frequencies of signal-to-noise amplitude ratio (S/N) larger than 5.2, including four multiples of tidally split frequencies, were detected. A total of 17 independent frequencies containing 2 radial modes, and 10 non-radial p modes were identified. All the investigations suggest that RZ Hor is an evolved Algol-type binary with a δ Sct-type primary and an active secondary.
Considerations for privacy and confidentiality in adolescent health care service delivery
Authors: Agostino Holly , Toulany Alene
Published: May 2023

A hallmark of delivering quality adolescent health care services is the provision of confidential care. Key tenets when providing confidential care for adolescents include time alone with a health care provider, maintaining the privacy of health information, and securing informed consent for services without permission from a parent, guardian, or caregiver. While confidentiality is a basic principle for all health care encounters regardless of age, the unique considerations for capable adolescent patients are not always realized or appreciated. By ensuring appropriate quantity and quality of confidential care for adolescents, clinicians are better equipped to elicit a comprehensive history and physical examination, while empowering the adolescent involved to develop agency, autonomy, trust, and responsibility for their own health care decision-making and management.
Exhumation of an Archean Granulite Terrane by Paleoproterozoic Orogenesis: Evidence from the North China Craton
Authors: Wang Dan , Mitchell Ross N , Guo Jinghui , Liu Fulai
Published: May 2023

Granulites represent high-grade metamorphic rocks of the deep continental crust. The metamorphism and exhumation of granulites from Archean terranes provide insights into the crustal evolution of Archean cratons and shed light on the formation and reactivation of cratons. We present petrology, U–Pb geochronology (zircon, rutile, and titanite), and pressure–temperature (P–T) paths for metadiabase dikes in an Archean granulite terrane of the North China Craton. Garnet (Grt) coronae in the metadiabase dikes are developed between plagioclase (Pl) and clinopyroxene (Cpx) via the reaction Pligneous + Cpx → Pl1 + Grt ± quartz. The reaction proceeds inward within the plagioclase, progressively consuming Pligneous (XAn = 0.65–0.69) and leaving Ca-poor Pl1 (XAn = 0.46–0.53) as the residue. Geothermobarometry and P–T pseudosections suggest peak conditions for garnet formation at ~800°C and 10–13 kbar. During retrograde metamorphism, Grt broke down to Ca-rich Pl2 (XAn = 0.73–0.74), and ilmenite replaced rutile. Geothermobarometry and Zr-in-titanite temperatures constrain the P–T conditions of retrograde metamorphism at 700–750°C and 4.5–7.5 kbar. Zircon and titanite U–Pb geochronology shows that the protolith of the metadiabase dike was formed at 2.4 Ga and underwent granulite-facies metamorphism at 1.86 Ga. The intrusion of mafic dikes into the Archean granulite terrane indicates that the Archean basement was also heated and buried in the Paleoproterozoic. The metadiabase dikes and the hosting Archean basement underwent Paleoproterozoic granulite-facies metamorphism at a depth of ~40 km, followed by near-isothermal decompression and subsequent near-isobaric cooling (cooling rate of 1–3°C Myr−1) at depths of 15–25 km. Crustal shortening and thickening may have been caused by the underplating of the Khondalite series beneath the Archean basement during the amalgamation of supercontinent Columbia. The Paleoproterozoic orogeny induced a second generation of metamorphism of the Archean basement along the margin of the craton and drove the exhumation of the Archean granulite terranes to the middle crust (~15 km).
Transient gap generation in BaFe2As2 driven by coherent lattice vibrations
Authors: Warshauer Jacob A , Bustamante Lopez Daniel Alejandro , Dong Qingxin , Chen Genfu , Hu Wanzheng
Published: May 2023

Iron-based superconductors provide a rich platform to investigate the interplay between unconventional superconductivity, nematicity, and magnetism. The electronic structure and the magnetic properties of iron-based superconductors are highly sensitive to the pnictogen height. Coherent excitation of the A1g phonon by femtosecond laser directly modulates the pnictogen height, which has been used to control the physical properties of iron-based superconductors. Previous studies show that the driven A1g phonon resulted in a transient increase of the pnictogen height in BaFe2As2, favoring an enhanced Fe magnetic moment. However, there are no direct observations on either the enhanced Fe magnetic moments or the enhanced spin-density wave (SDW) gap. Here, we use time-resolved broadband terahertz spectroscopy to investigate the dynamics of BaFe2As2 in the A1g phonon-driven state. Below the SDW transition temperature, we observe a transient gap generation at early-time delays. A similar transient feature is observed in the normal state up to room temperature.
A prospective investigational study of vitamin D status in patients with hospital-acquired pneumonia
Authors: Ratansi Munira , Cox Anthony R
Published: May 2023

Introduction

Hospital-acquired pneumonia (HAP) is the most common healthcare-associated infection (HCAI) contributing to death. Rising antimicrobial resistance has resulted in few effective antibiotics for HAP. Stimulation of human immunity and immunomodulation have been reported as a role of vitamin D.

Objectives

The objectives of this study were to investigate vitamin D status of HAP patients and to examine if vitamin D status was related to the severity of HAP.

Method

Patients with a diagnosis were recruited for a 3-month period from two acute hospitals. Vitamin D levels of participants were obtained.

Key findings

Sixty-one participants were recruited with a mean age 72 years, with 77% of the participants over 65 years of age. Severe HAP was diagnosed in 92% of the participants, 5% had moderate and 3% had mild HAP. Vitamin D deficiency (<50 nmol/L) was found in 80% of the participants and 41% of the participants were found to be suffering from severe vitamin D deficiency (<15 nmol/L). Participants that had adequate vitamin D levels (12/61) (20%) were all taking prophylactic vitamin D on admission. Overall, 26/61 (43%) of the participants were taking prescribed prophylactic vitamin D supplementation on admission and despite this supplementation,14/26 (54%) were found to be vitamin D deficient.

Conclusion

Vitamin D deficiency was highly prevalent in the HAP participants. Vitamin D deficiency was also present in some participants, despite prescribed prophylactic supplementation. Vitamin D stimulates immunity and hence vitamin D deficiency would have potentially increased the susceptibility of acquiring HAP.
The effect of timing of Improvest administration on growth performance and carcass characteristics in gilts
Authors: Vasquez-Hidalgo Manuel A , Mellencamp Martha A , Amodie Deborah , Galina Pantoja Lucina , Vonnahme Kimberly A
Published: May 2023

Improvest (IMP; Zoetis Inc., Parsippany, NJ) has been approved by the U.S. Food and Drug Administration for use in gilts. Improvest is administered twice: the first dose should be administered no earlier than 9 wk of age and the second dose (D2) at least 4 wk after the first dose. The aim of this study was to determine how the timing of IMP before harvest affects growth performance and carcass characteristics in gilts. A total of 1,632 gilts were allocated to four groups (12 pens/treatment; 34 gilts/pen): 1) a control group did not receive IMP; 2) T-early gilts received IMP on day 7 (day 0 = 10 wk postweaning), and D2 on day 40 (i.e., 35 d prior to first removal for harvest); 3) T-medium gilts received IMP on day 21 and D2 on day 56 (i.e., 19 d prior to first removal for harvest); 4) T-late gilts received IMP on day 35 and D2 on day 70 (i.e., 5 d before first removal for harvest). Pigs were selected for harvest by visual observation on days 75, 89, 103, and 117: 1) the heaviest 7 gilts/pen for each treatment on day 75; 2) the heaviest 10 gilts/pen of each treatment at day 89; 3) the heaviest 10 gilts/pen of each treatment on day 103; and 4) the remaining 7 gilts/pen on day 117. Weights and feed disappearance were recorded every 2 wk and during harvest dates to calculate average daily gain (ADG), average daily feed intake (ADFI), and feed efficiency (Gain:Feed; G:F). Generalized linear mixed models of SAS were used to analyze all variables. The increase in ADFI over Control gilts was observed 15 d post D2 and continued through 77 d post D2, with advantages in ADG occurring between 15 and 35 d post D2. Control and IMP treated gilts had similar G:F 15 to 33 d post D2. The overall ADG and ADFI from day 0 to market, final live weights, and hot carcass weights were significantly greater (P ≤ 0.05) in IMP gilts compared to Control. When G:F based on live weight was averaged across all groups (i.e., from day 0 to market), T-early had the lowest (P ≤ 0.05) G:F compared to Control, T-medium, and T-late gilts, which did not differ. Carcasses from IMP gilts had increased (P < 0.01) backfat, but similar (P = 0.5) Longissimus muscle depth, compared to Control. Within a cohort of similar aged gilts finishing during the summer, this study indicates that the trajectory of growth is enhanced within a similar window post D2 of IMP. Gilts treated with IMP had heavier carcasses with increased backfat and similar Longissimus muscle depth.
High-fat diet promotes multiple binges-induced liver injury via promoting hepatic macrophage proinflammatory polarization
Authors: Wang Yi-Ran , Xie Na , Zhang Yan-Jing , Wang Lin , Sun Zhan , Zeng Tao
Published: May 2023

High-fat diet (HFD) and ethanol could synergistically induce liver damage, but the underlying mechanisms remain to be elucidated. M1-polarized macrophages have been demonstrated to be key players in ethanol-induced liver damage. The current study was designed to investigate whether hepatic steatosis could promote ethanol-induced liver injury by promoting liver macrophage M1 polarization. In the in vivo study, 12 weeks of HFD feeding induced a moderate increase in the F4/80 expression and protein levels of p-IKKα/β, p-IκBα, and p-p65, which was suppressed by single binge. In contrast, 8 weeks of HFD and multiple binges (two binges per week during the last 4 weeks) synergistically increased the F4/80 expression, mRNA levels of M1 polarization biomarkers including Ccl2, Tnfa, and Il1b, and protein levels of p65, p-p65, COX2, and Caspase 1. In the in vitro study, a nontoxic free fatty acids (FFAs) mixture (oleic acid/palmitic acid = 2: 1) induced a moderate increase of protein levels of p-p65 and NLRP3 in murine AML12 hepatocytes, which was inhibited by ethanol co-exposure. Ethanol alone induced proinflammatory polarization of murine J774A.1 macrophages evidenced by the enhanced secretion of TNF-α, increased mRNA levels of Ccl2, Tnfa, and Il1b, and upregulated protein levels of p65, p-p65, NLRP3, and Caspase 1, which was augmented by FFAs exposure. Collectively, these results suggest that HFD and multiple binges could synergistically induce liver damage by promoting the proinflammatory activation of macrophages in mice livers.
Xylella fastidiosa Requires the Type II Secretion System for Pathogenicity and Survival in Grapevine
Authors: Ingel Brian , Castro Claudia , Burbank Lindsey , Her Nancy , De Anda N. Itzel , Way Hannah , Wang Peng , Roper M. Caroline
Published: May 2023

Xylella fastidiosa is a xylem-limited bacterial pathogen that causes Pierce's disease (PD) of grapevine. In host plants, this bacterium exclusively colonizes the xylem, which is primarily non-living at maturity. Understanding how X. fastidiosa interfaces with this specialized conductive tissue is at the forefront of investigation for this pathosystem. Unlike many bacterial plant pathogens, X. fastidiosa lacks a type III secretion system and cognate effectors that aid in host colonization. Instead, X. fastidiosa utilizes plant cell-wall hydrolytic enzymes and lipases as part of its xylem colonization strategy. Several of these virulence factors are predicted to be secreted via the type II secretion system (T2SS), the main terminal branch of the Sec-dependent general secretory pathway. In this study, we constructed null mutants in xpsE and xpsG, which encode for the ATPase that drives the T2SS and the major structural pseudopilin of the T2SS, respectively. Both mutants were non-pathogenic and unable to effectively colonize Vitis vinifera grapevines, demonstrating that the T2SS is required for X. fastidiosa infection processes. Furthermore, we utilized mass spectrometry to identify type II–dependent proteins in the X. fastidiosa secretome. In vitro, we identified six type II–dependent proteins in the secretome that included three lipases, a β-1,4-cellobiohydrolase, a protease, and a conserved hypothetical protein.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Applying the Theory of Guided Participation to Clinical Practice
Authors: Limbo Rana , Pridham Karen F.
Published: May 2023

We present an evidence-based clinical teaching and learning method based on the middle-range theory of Guided Participation (GP). Typically, teaching and learning in a clinical setting refer to providing information based on the learner's diagnosed condition. With GP, the relationship between guide and patient or client is central to how GP sessions proceed. The guide uses GP processes to identify issues important to the learner and to heighten the learner's competencies for self-care or for caregiving within the family and the community. Through reflection, GP practice heightens competencies in the guide as well. Teaching and learning occur in tandem with learning goals cocreated to help learners resolve, change, and even transform their health-related issues. Learning is embedded in participatory experience that the guide structures, often with the learner. A dynamic process, GP is fashioned and refashioned as the learner develops competencies or acquires new health-related needs. Guided participation assumptions are illustrated with clinical cases drawn from GP practice, and we discuss skills and supports needed for the practice and future directions for extending the method.
A Concept Analysis of Trust Within the Surrogate Decision Maker to Health Care Professional Relationship in the Adult ICU Setting
Authors: Armstrong Caleb
Published: May 2023

Surrogate decision maker (SDM)–health care professional (HCP) trust is vital to the provision of high-quality care in the adult intensive care unit setting. This concept analysis, using Walker and Avant's methodology, examines the concept of SDM-HCP trust and provides a conceptual definition conducive to instrument development and future quantitative research into this topic. Trust in the SDM-HCP relationship exists on a spectrum and involves the voluntary placement of oneself into a position of vulnerability in relation to another party who is believed to have integrity, be reliable, and hold beneficent intent toward the truster.
Acute External Fixation and Delayed Primary Subtalar Fusion After Comminuted Joint-depression Calcaneus Fracture
Authors: Anastasio Albert T. , Tabarestani Troy Q. , McGroarty Neil K. , DeBaun Malcolm R. , Parekh Selene G.
Published: May 2023

Joint-depression calcaneus fractures, such as Sanders type IV, can be complex injuries to treat surgically due to significant comminution of the posterior facet of the calcaneus. Although nonoperative management is reasonable in a nonsurgical candidate, residual calcaneal deformity and articular gap can accelerate posttraumatic arthritis. Open reduction and internal fixation remains ideal treatment in surgical candidates, and anatomic restoration of the articular surface is critical to mitigate the risk of posttraumatic arthritis. In certain circumstances, when anatomic reduction is unlikely, or in patients with an unclear prognosis, surgical fixation with subtalar arthrodesis allows for correction of calcaneal height, width, and alignment and provides a stable hindfoot. The technique presented exemplifies a stage-wise approach for the treatment of a comminuted joint-depression calcaneus fracture in a patient who ultimately recovered from a traumatic brain injury with an unclear prognosis at presentation.

Level of Evidence: Level V.
Primary Epithelioid Sarcoma of the Conchal Bowl in a 64-Year-Old Male: A Case Report and Review of the Literature
Authors: Li Liping , Bailiff Oksana A. , Blanchard Brielle , Gardner Jerad M.
Published: May 2023

Epithelioid sarcoma (ES) is a distinctive malignant mesenchymal neoplasm with atypical epithelioid cells palisading around a central zone of necrosis. ES is a rare entity even in soft tissue pathology. Immunohistochemically, tumors usually show diffuse epithelial membrane antigen and cytokeratin expression and loss of nuclear INI1 (SMARCB1) expression. Here, we report a case of a 64-year-old man with ES arising in the left conchal bowl. Given the clinical presentation including patient's age, sun-exposed area of skin, and slow-growing, asymptomatic, small pink pearly papule, this patient was initially misdiagnosed with basal cell carcinoma clinically and treated with topical imiquimod at an outside facility. The lesion continued to grow and eventually became symptomatic despite the treatment after which biopsy was obtained. Despite the unusual anatomic site and the patient's age, the microscopic and immunohistochemical findings were characteristic of conventional-type ES. Our case shows that ES can arise in rare locations and in older adults where it may be more easily misdiagnosed clinically and pathologically as a nonmelanoma skin cancer.
Re-evaluating the Timing of Surgery after Isolated Orbital Floor Fracture
Authors: Soliman Luke , Sawicki Nicholas , Sobti Nikhil , Swartz Solomon , Rao Vinay , Woo Albert S.
Published: May 2023

Background:

Orbital floor fractures are among the most common facial injuries. Although urgent surgical repair may be indicated, most patients require interval follow-up to assess for symptom onset and need for definitive operative intervention. This study aimed to evaluate the time to operative indication after these injuries.

Methods:

A retrospective review was conducted of all patients with isolated orbital floor fractures at a tertiary academic medical center from June 2015 to April 2019. Patient demographic and clinical data were recorded from the medical record. Time until operative indication was evaluated by the Kaplan-Meier product limit method.

Results:

Of 307 patients meeting inclusion criteria, 9.8% (30/307) developed indications for repair. Among these, 60% (18/30) were recommended surgery on the day of initial evaluation. Of 137 follow-up patients, 8.8% (12/137) developed operative indications based on clinical evaluation. The median period to decision for surgery was 5 days (range, 1–9). No patients developed symptoms suggesting the need for surgery beyond 9 days after trauma.

Conclusions:

Our investigation demonstrates that only about 10% of patients presenting with isolated orbital floor fracture develop an indication for surgery. For patients undergoing interval clinical follow-up, we found that patients demonstrated symptoms within 9 days of trauma. No patients demonstrated need for surgery beyond 2 weeks of injury. We believe these findings will assist to establish standards of care and inform clinicians on the appropriate length of follow-up for these injuries.
Advanced practice nursing students' perspectives of learning screening, brief intervention, and referral to treatment in interprofessional settings
Authors: Hagle Holly , Kameg Brayden , Lindsay Dawn , Matthews Emily , Mitchell Ann
Published: May 2023

Screening, brief intervention, and referral to treatment (SBIRT) is a public health approach to early intervention for substance use through universal screening. Utilization of SBIRT was taught in an interprofessional setting to nurse practitioner, nurse anesthetist, and dental hygiene students through integrated educational grant projects. A qualitative analysis was done across 10 SBIRT data sets collected over 4 years. The researchers used a nominal group consensus method to review the data, and six themes were identified. Results showed that students desired more training on motivational interviewing techniques. Furthermore, students identified that to effectively work interprofessionally, students must be exposed to such collaboration throughout their professional educational programs.
Improving human papilloma virus vaccination rates among adolescents
Authors: Biehl Renee , Efre Andrea
Published: May 2023

Background:

The human papilloma virus (HPV) is the leading cause of cervical cancer worldwide and is responsible for genital warts and five other types of cancers. The HPV vaccine was introduced in 2006 and demonstrated to be safe and more effective than expected, yet adolescent rates of immunization in the United States remain low.

Local problem:

Adolescent HPV vaccine rates were below the national average, and effective vaccine recommendation strategies were not used at an urban pediatric primary care office in southern Florida.

Methods:

The percentage of HPV vaccine rates in this primary care office were measured among adolescents ages 13–17 years using data obtained from Florida's state vaccine registry before implementation of the intervention, after the intervention, and monthly over a 90-day period.

Interventions:

Interventions aimed to improve vaccine rates included implementing an HPV protocol consisting of education on providing a strong bundled recommendation, appointing a vaccine champion, implementing standing vaccine orders, and educational materials.

Results:

The vaccine rates among adolescents increased by 11% for the initial dose, 7% for the second dose, and 6% for the vaccine completion rate. Chi-square test demonstrated statistical significance,

for the initial vaccine.

Conclusion:

A nurse practitioner–led application of an evidenced-based HPV vaccine protocol positively affected the care of adolescents in this primary care setting.
Biometric Profiling to Quantify Lung Injury Through Ex Vivo Lung Perfusion Following Warm Ischemia
Authors: Kim Jung-Lye , Gouchoe Doug A. , Reader Brenda F. , Dumond Curtis , Lee Yong Gyu , Black Sylvester M. , Whitson Bryan A.
Published: May 2023

Standard physiologic assessment parameters of donor lung grafts may not accurately reflect lung injury or quality. A biometric profile of ischemic injury could be identified as a means to assess the quality of the donor allograft. We sought to identify a biometric profile of lung ischemic injury assessed during ex vivo lung perfusion (EVLP). A rat model of lung donation after circulatory death (DCD) warm ischemic injury with subsequent EVLP evaluation was utilized. We did not observe a significant correlation between the classical physiological assessment parameters and the duration of the ischemic. In the perfusate, solubilized lactate dehydrogenase (LDH) as well as hyaluronic acid (HA) significantly correlated with duration of ischemic injury and length of perfusion (p < 0.05). Similarly, in perfusates, the endothelin-1 (ET-1) and Big ET-1 correlated ischemic injury (p < 0.05) and demonstrated a measure of endothelial cell injury. In tissue protein expression, heme oxygenase-1 (HO-1), angiopoietin 1 (Ang-1), and angiopoietin 2 (Ang-2) levels were correlated with the duration of ischemic injury (p < 0.05). Cleaved caspase-3 levels were significantly elevated at 90 and 120 minutes (p < 0.05) demonstrating increased apoptosis. A biometric profile of solubilized and tissue protein markers correlated with cell injury is a critical tool to aid in the evaluation of lung transplantation, as accurate evaluation of lung quality is imperative and improved quality leads to better results.

http://links.lww.com/ASAIO/B49
Prevalence and predictors of neck pain among Bangladeshi community dwellers during COVID-19 pandemic: analysis of a matched case-control data
Authors: Ali Mohammad , Mehjabin Tajnuva
Published: May 2023

Background:

Extant literature has established a significant association between COVID-19 and musculoskeletal health complaints. Despite this, there remains a paucity of data regarding the relationship between COVID-19 and neck pain among community-dwelling individuals. The primary objective of this study was to ascertain the prevalence and predictors of neck pain in this population in Bangladesh. This was achieved via screening the musculoskeletal health of post-acute COVID-19 survivors and their age and sex-matched unaffected counterparts.

Methods:

This study employs a case-control design and includes 878 Bangladeshi individuals aged 18 years or older, of which 439 were post-acute COVID-19 patients. Data were collected between 24 February and 7 April 2022. Neck pain was assessed using the musculoskeletal subscale of subjective health complaints. Descriptive analysis was conducted to determine the prevalence of neck pain and to compare its prevalence across subgroups. Furthermore, multiple logistic regression analysis was utilized to identify the predictors of neck pain.

Results:

Out of 878 participants, 15.1% reported experiencing neck pain. However, neck pain was significantly higher among those with post-acute COVID-19 than those without the infection (21.4% vs. 8.9%, P<0.001). An adjusted analysis found that COVID-19 infection was independently associated with neck pain (adjusted odds ratio=2.626%, 95% CI=1.666–4.140).

Conclusion:

The results of this study suggest a link between COVID-19 and neck pain. Therefore, it is recommended that healthcare service providers are prepared to manage the increased incidence of neck pain among patients who have recovered from COVID-19.
Endoscopic unilateral anterior ethmoid artery flap with or without cartilage graft for nasal septal perforation repair
Authors: Bayoumi Ahmed , Elamin Abubaker , El-Sawy Abdelhamid , Hussein Ahmed Y.Z. , Ezzat Abdelrahman
Published: May 2023

Introduction:

The septal perforation is a challenging condition that faces the otolaryngologist. The aim of our work was to evaluate this endoscopic repair of this septal perforation using a unilateral anterior ethmoid artery flap with or without a cartilage graft.

Patients and methods:

The authors conducted a retrospective cohort study between June 2020 and June 2022. Our study included all adult patients with septal perforation due to trauma (operative and self-induced) lasting for more than one year. Patients underwent an endoscopic repair of a perforation and a questionnaire regarding subjective quality of life was completed at 3 months postoperatively.

Results:

A total of 18 patients were included in our study. The main symptoms were crusting (100%), bleeding (38.85%), whistling (16.6%), anosmia (16.6), and nasal obstruction sensation (11%). The mean perforation size was 13.6 mm, ranging between 4 mm and 28 mm. Number of years with the perforation (ranged between 2 and 16 years) with a mean of 4.876±1.645 years and a mode of 2 years. All cases were repaired using an endoscopic unilateral anterior ethmoid artery flap with or without cartilage.

There were no intraoperative complications but postoperatively, these included pain, ranging between a score of 2 and 8 on the pain score chart, (the mean score was five and mode was four, appeared in six patients), which was treated with over-the-counter painkillers. In addition, there was one patient (5%) with a residual small perforation (2 mm). All patients were happy to fill out postoperative patient satisfaction questionnaires after 3 months. The mean was 21.8889 ±1.655 points and the mode, 25 points (highest possible score), appeared four times. The lowest scoring questionnaire summated to 15 points.

Conclusions:

The endoscopic unilateral anterior ethmoid artery nasal flap with or without cartilage graft has proven to be a reliable and a valuable graft that, with proper planning, can provide excellent results with minimal morbidity for nasal septal perforation repair.
Suicidality and Implicit Dependency in Child and Adolescent Inpatients With Histories of Trauma
Authors: Szymanski Kate , Hartmann Vanessa , Springer Carolyn , Bornstein Robert
Published: May 2023

There is lack of empirical findings on a direct link between suicidality and dependency in youth. This is particularly relevant for children and adolescents with a trauma history, since traumatization is a well-established risk factor for suicidality in this population. Research on dependency predominantly uses self-report assessments, which may be susceptible to biases. In this study, performance-based interpersonal dependency scores in inpatient children and adolescents with trauma history were compared with patients' suicidal behavior (suicidal ideation and suicidal attempts) as derived from chart records. The results showed a gender effect. High dependency scores were associated with higher suicidal ideation for girls and with lower suicidal attempts for boys. These findings demonstrate that a relationship between dependency and suicidality for hospitalized traumatized youth is impacted by gender.
Study Protocol Using Cohort Data and Latent Variable Modeling to Guide Sampling Women With Type 2 Diabetes and Depressive Symptoms
Authors: Perez Nicole Beaulieu , D’Eramo Melkus Gail , Yu Gary , Brown-Friday Janet , Anastos Kathryn , Aouizerat Brad
Published: May 2023

Background

Depression affects one in three women with Type 2 diabetes, and this concurrence significantly increases the risks of diabetes complications, disability, and early mortality. Depression is underrecognized because of wide variation in presentation and the lack of diagnostic biomarkers. Converging evidence suggests inflammation is a shared biological pathway in diabetes and depression. Overlapping epigenetic associations and social determinants of diabetes and depression implicate inflammatory pathways as a common thread.

Objectives

This article describes the protocol and methods for a pilot study aimed to examine associations between depressive symptoms, inflammation, and social determinants of health among women with Type 2 diabetes.

Methods

This is an observational correlational study that leverages existing longitudinal data from the Women’s Interagency HIV Study (WIHS), a multicenter cohort of HIV seropositive (66%) and HIV seronegative (33%) women, to inform purposive sampling of members from latent subgroups emergent from a prior retrospective cohort-wide analysis. Local active cohort participants from the Bronx study site are then selected for the study. The WIHS recently merged with the Multicenter Aids Cohort Study (MACS) to form the MACS/WIHS Combined Cohort Study. Latent subgroups represent distinct symptom trajectories resultant from a growth mixture model analysis of biannually collected depressive symptom data. Participants complete surveys (symptom and social determinants) and provide blood samples to analyze plasma levels and DNA methylation of genes that encode for inflammatory markers (CRP, IL-6, TNF-α). Correlation and regression analysis will be used to estimate the effect sizes between depressive symptoms and inflammatory markers, clinical indices (body mass index, hemoglobin A1C, comorbidities), and social determinants of health.

Results

The study began in January 2022, and completed data collection is estimated by early 2023. We hypothesize that depressive symptom severity will associate with higher levels of inflammation, clinical indices (e.g., higher hemoglobin A1C), and exposure to specific social determinants of health (e.g., lower income, nutritional insecurity).

Discussion

Study findings will provide the basis for future studies aimed at improving outcomes for women with Type 2 diabetes by informing the development and testing of precision health strategies to address and prevent depression in populations most at risk.
Doris Howes Calloway
Authors: Yates Allison A. , Butte Nancy F. , Murphy Suzanne P. , Kretsch Molly J. , King Janet C. , Blackburn Mary L.
Published: May 2023

Throughout her career, Doris Howes Calloway sought to understand what influences human protein and energy requirements and metabolism in controlled and field settings. Much of her research became the basis for national and international dietary recommendations, many of which are in use today. She served on many committees of the US Food and Nutrition Board/National Research Council/Institute of Medicine and the Food and Agriculture Organization/World Health Organization of the United Nations. Concerned about populations where marginal malnutrition is often overlooked, Dr Calloway led a major United States Agency for International Development–funded multiuniversity research project in low-income countries to better understand the effects of moderate malnutrition on growth and health. She led this extensive multinational study while serving as provost, the first woman in the senior administration at the University of California, Berkeley campus. Toward the end of her professional career, she was appointed chair of the 1995 Dietary Guidelines for Americans Advisory Committee. Her interest in food and nutrition policy helped reorient dietary guidance both in the United States and internationally. Dr Calloway's scientific and humanitarian accomplishments were extended further through the subsequent research and leadership activities of her colleagues, graduate students, and others whom she mentored.
Evaluation of the Resources and Inequities Among Pediatric Critical Care Facilities in Pakistan
Authors: Abbas Qalab , Shahbaz Fatima Farrukh , Hussain Muhammad Zaid H. , Khan Mustafa Ali , Shahbaz Hamna , Atiq Huba , Siddiqui Naveed ur Rehman , Gowa Murtaza Ali , Jamil Muhammad Tariq , Ali Farman , Khan Ata Ullah , Ahmed Abdul Rahim , Haque Anwar ul , Hamid Muhammad Haroon , Latif Asad , Bhutta Adnan
Published: May 2023

OBJECTIVES:

To evaluate nationwide pediatric critical care facilities and resources in Pakistan.

DESIGN:

Cross-sectional observational study.

SETTING:

Accredited pediatric training facilities in Pakistan.

PATIENTS:

None.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A survey was conducted using the Partners in Health 4S (space, staff, stuff, systems) framework, via email or telephone correspondence. We used a scoring system in which each item in our checklist was given a score of 1, if available. Total scores were added up for each component. Additionally, we stratified and analyzed the data between the public and private healthcare sectors. Out of 114 hospitals (accredited for pediatric training), 76 (67%) responded. Fifty-three (70%) of these hospitals had a PICU, with a total of 667 specialized beds and 217 mechanical ventilators. There were 38 (72%) public hospitals and 15 (28%) private hospitals. There were 20 trained intensivists in 16 of 53 PICUs (30%), while 25 of 53 PICUs (47%) had a nurse-patient ratio less than 1:3. Overall, private hospitals were better resourced in many domains of our four Partners in Health framework. The Stuff component scored more than the other three components using analysis of variance testing (p = 0.003). On cluster analysis, private hospitals ranked higher in Space and Stuff, along with the overall scoring.

CONCLUSIONS:

There is a general lack of resources, seen disproportionately in the public sector. The scarcity of qualified intensivists and nursing staff poses a challenge to Pakistan’s PICU infrastructure.
An Abdominoplasty Modification for Postpregnancy Abdomen with Rectus Diastasis and Midline Hernia: The Technique and Results
Authors: Tuominen Reetta , Peltoniemi Hilkka , Jahkola Tiina , Vironen Jaana
Published: May 2023

After pregnancy, some women experience severe rectus diastasis (RD), with body control dysfunction, midline hernia, or other quality-of-life impairment. The purpose of this study was to describe the authors’ experience using hydrodissection and epidural anesthesia for lateral plication modification of abdominoplasty to restore abdominal wall firmness. A total of 46 consecutive patients with RD after pregnancy were enrolled. The mean intraoperative inter-rectus distance was 4.6 cm. RD is not always the only structure that has been elongated. Firmness of the abdominal wall also depends on lateral fascia structures. This study reports the total plicated distance addressing the lateral laxity in the abdominal wall. In this series, total plication was 7.8 cm, and 16 patients had a midline hernia. No hernia recurrences occurred, and the rectus bellies were less than 5 mm apart from each other in all participants, verified with ultrasound after 2 years of follow-up. Patient perspective of care and surgical outcome were recorded. Health-related quality-of-life domains were significantly improved postoperatively. Lumbar back pain visual analogue scale score was 4.5 ± 2.3 preoperatively and 0.5 ± 0.9 postoperatively. The ability to perform sit-ups increased from zero to 11, suggesting better motor control. The total complication rate was 10.9%. Hydrodissection and epidural anesthesia for lateral plication modification offers a reliable and effective treatment method for RD repair with and without a small midline hernia with a low complication rate.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Complications following Breast Augmentation in Transfeminine Individuals: A Systematic Review and Meta-Analysis
Authors: Liu Chenyu , Shahid Mohammed , Yu Qian , Orra Susan , Ranganath Bharat , Chao Jerry W.
Published: May 2023

Background:

Breast augmentation is the most commonly performed procedure for gender affirmation in transfeminine individuals. Although adverse events among breast augmentation in cisgender women are well described, their relative incidence in transfeminine patients is less elucidated. This study aims to compare complication rates after breast augmentation between cisgender women and transfeminine patients and to evaluate the safety and efficacy of breast augmentation in transfeminine individuals.

Methods:

PubMed, the Cochrane Library, and other resources were queried for studies published up to January of 2022. A total of 1864 transfeminine patients from 14 studies were included in this project. Primary outcomes including complications (capsular contracture, hematoma or seroma, infection, implant asymmetry/malposition, hemorrhage, skin or systemic complications), patient satisfaction, and reoperation rates were pooled. A direct comparison of these rates was performed against historical rates in cisgender women.

Results:

Within the transfeminine group, the pooled rate of capsular contracture was 3.62% (95% CI, 0.0038 to 0.0908); the hematoma/seroma rate was 0.63% (95% CI, 0.0014 to 0.0134); the infection incidence was 0.08% (95% CI, 0.0000 to 0.0054); and implant asymmetry rate was 3.89% (95% CI, 0.0149 to 0.0714). There was no statistical difference between rates of capsular contracture (P = 0.41) and infection (P = 0.71) between the transfeminine versus cisgender groups, whereas there were higher rates of hematoma/seroma (P = 0.0095) and implant asymmetry/malposition (P < 0.00001) in the transfeminine group.

Conclusion:

Breast augmentation is an important procedure for gender affirmation and, in transfeminine individuals, carries relatively higher rates of postoperative hematoma and implant malposition relative to cisgender women.
Unfractionated Heparins, Low-Molecular-Weight Heparins, and Indirect Factor Xa Inhibitors in Plastic and Reconstructive Surgery: An Evidence-Based Review
Authors: Othman Sammy , Bertolaccini Corinne M. , Pannucci Christopher J.
Published: May 2023

Venous thromboembolism can present with devastating complications and sequalae, particularly in the surgical patient. Current data support prophylactic anticoagulant use in high-risk hospitalized patients, defined as those with a Caprini Risk Assessment Model score of 7 or greater. The most frequently used chemoprophylaxis agents include unfractionated heparin, low-molecular-weight heparin, and indirect factor Xa inhibitors. The authors review the mechanisms of action, metabolism, reversal agents, indications, contraindications, advantages, and disadvantages of these medications in plastic and reconstructive surgery.
Longitudinal Three-Dimensional Follow-Up and Secondary Treatment Aspects after Endoscopic and Open Scaphocephaly Surgery
Authors: de Jong Guido A. , Meulstee Jene W. , van Lindert Erik J. , Borstlap Wilfred A. , Maal Thomas J. J. , Delye Hans H. K.
Published: May 2023

Background:

This retrospective cohort study evaluated the longitudinal three-dimensional cranial shape developments and the secondary treatment aspects after endoscopically assisted craniosynostosis surgery (EACS) with helmet therapy and open cranial vault reconstruction (OCVR) for scaphocephaly.

Methods:

Longitudinally collected three-dimensional photographs from scaphocephaly patients and healthy infants were evaluated. Three-dimensional cranial shape measurements and growth maps were compared between the groups over time. Secondary treatment aspects were compared for the treatment groups.

Results:

Both surgical techniques showed their strongest changes directly after surgery, with mean parietal three-dimensional growths up to 10 mm. At age 24 months, comparison of head shapes showed mean three-dimensional differences less than ±2 mm, with OCVR resulting in a lower vertex and longer cranial length when compared with EACS. At 48 months of age, no measurements were significantly different between treatment groups. Only the total head volume was somewhat larger in the male EACS group at age 48 months (P = 0.046). Blood loss in EACS (mean, 18 mL; range, 0 to 160 mL) was lower than in OCVR (mean, 100 mL; range, 15 to 300 mL; P < 0.001). Median length of stay after surgery was shorter for EACS (mean, 2 days; range, 1 to 5 days) compared with OCVR (mean, 5 days; range, 3 to 8 days; P < 0.001).

Conclusions:

The authors conclude that EACS for scaphocephaly shows equal craniometric results at age 48 months and has a better surgery profile compared with OCVR. Early diagnostics and referral for suspected scaphocephaly to allow EACS is therefore recommended.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Specialist dementia nursing models and impacts: a systematic review
Authors: Brown Pat , Burton Alexandra , Ayden Jordan , Harrison Dening Karen , Hoe Juanita , Cooper Claudia
Published: May 2023

Purpose of review

Dementia policy priorities recommend that people who are living with dementia and their family should have access to support and interventions delivered by dementia specialists, including specialist nurses. However, specialist dementia nursing models and role-related competencies are not clearly defined. We systematically review the current evidence regarding specialist dementia nursing models and their impacts.

Recent findings

Thirty-one studies from across three databases, and grey literature were included in the review. One framework defining specific specialist dementia nursing competencies was found. We did not find convincing evidence of the effectiveness of specialist nursing dementia services, relative to standard models of care from the current, limited evidence base, although families living with dementia valued it. No Randomised Controlled Trial (RCT) has compared the impact of specialist nursing on client and carer outcomes relative to less specialist care, although one nonrandomised study reported that specialist dementia nursing reduces emergency and inpatient service use compared with a usual care group.

Current models of specialist dementia nursing are numerous and heterogeneous. Further exploration of the specialist nursing skills and the impact of specialist nursing interventions is needed to usefully inform workforce development strategies and clinical practice.