bluuebunny/crossref_metadata_2025 huggingface dataset:
Cellular Evidence for Telocytes Mediating Electroacupuncture to Ameliorate Obesity in Mice
Authors: Mei Lu , Zhu Qianmei , Bai Xuebing , Zhang Yingxin , Huang Haixiang , Yang Min , Shi Yonghong , Liang Chunhua , Zhang Zhenwei , Chen Qiusheng
Published: August 2023

Electroacupuncture has been generally applied to target obesity, the principle of which is based on the meridian in traditional Chinese medicine. Although Telocytes (TCs) have been reported as the potential essence of meridians, their specific role in the electroacupuncture treatment of obesity remains unclear. Thus, we investigated the cellular evidence for TC-mediated electroacupuncture to alleviate obesity. Mice were divided into three groups as follows: electroacupuncture group (EA), control group (CG), and normal group (NG). The present study showed that the weight of perirenal white adipose tissue (rWAT), the serum level of total cholesterol, and the low-density lipoprotein cholesterol were all significantly decreased after electroacupuncture. Ultrastructurally, the prolongations (telopodes, Tps) of TCs were in direct contact with adipocytes, and lipid droplets were distributed on the surface of Tps. The proportions of double-positive fluorescent areas of TCs (CD34 and PDGFRα) were significantly elevated with concomitant elongated Tps in EA mice, as compared to those in CG mice. The expression of Cx43 and CD63 (gap junction and exosome markers) was significantly enhanced. These characteristics facilitated the transmission of electroacupuncture stimulation from skin to rWAT. We conclude that electroacupuncture relieved obesity by activating TCs morphologically, upregulating the gap junctions between TCs, and increasing the exosomes around TCs.
Authentication and Quality Control of the Brazilian Traditional Herb “Espinheira-Santa” (Monteverdia ilicifolia) by Morpho-Anatomy and Microscopy
Authors: Antunes Kevin A , Monteiro Luciane M , Almeida Valter P , Monchak Irailson T , Perera Wilmer H , Heiden Gustavo , Guarino Ernestino S G , Santos Vera L P , Farago Paulo V , Raman Vijayasankar , Khan Ikhlas A , Manfron Jane
Published: August 2023

The leaves of Monteverdia ilicifolia (syn. Maytenus ilicifolia), commonly called espinheira-santa, are widely used in South American traditional medicines to treat gastritis and ulcers. Several products labeled as espinheira-santa are sold as dietary supplements in retail stores and via e-commerce. Many different species with similar leaf morphology are often mistaken for Monteverdia ilicifolia and used as espinheira-santa, including Monteverdia aquifolia (Celastraceae), Citronella gongonha (Cardiopteridaceae), Jodina rhombifolia (Santalaceae), Sorocea bonplandii (Moraceae), and Zollernia ilicifolia (Fabaceae). This study aimed to characterize M. ilicifolia and distinguish it from adulterants using morphological and microscopic techniques. In addition, foreign matter and powder characteristics of botanical materials sold as “espinheira-santa” were analyzed. The morphoanatomical studies of the leaves and stems of M. ilicifolia and its five adulterant species have revealed noteworthy features that can help species identification and quality control of commercial espinheira-santa. This study showed that many commercial espinheira-santa materials were adulterated and of inferior quality.
What can be learnt from a highly informative X-ray occultation event in NGC 6814? A marvellous absorber
Authors: Kang Jia-Lai , Wang Jun-Xian , Fu Shu-Qi
Published: August 2023

A unique X-ray occultation event in NGC 6814 during an XMM–Newton observation in 2016 has been reported, providing useful information of the absorber and the corona. We revisit the event with the aid of the hardness ratio (HR)–count rate (CR) plot and comparison with two other absorption-free XMM exposures in 2009 and 2021. NGC 6814 exhibits a clear ‘softer-when-brighter’ variation pattern during the exposures, but the 2016 exposure significantly deviates from the other two in the HR–CR plot. While spectral fitting does yield transient Compton-thin absorption corresponding to the eclipse event in 2016, rather than easing the tension between exposures in the HR–CR plot, correcting the transient Compton-thin absorption results in new and severe deviation within the 2016 exposure. We show that the eclipsing absorber shall be clumpy (instead of a single Compton-thin cloud), with an inner denser region composed of both Compton-thin and Compton-thick clouds responsible for the previously identified occultation event, and an outer sparser region with Compton-thin clouds which eclipses the whole 2016 exposure. With this model, all the tension in the HR–CR plots could be naturally erased, with the observed spectral variability during the 2016 exposure dominated by the variation of absorption. Furthermore, the two warm absorbers (with different ionization and column densities but similar outflowing velocities) detected in the 2016 exposure shall also associate with the transient absorber, likely due to ablated or tidal stretched/disrupted fragments. This work highlights the unique usefulness of the HR–CR plot while analysing rare occultation events.
EDGE: the shape of dark matter haloes in the faintest galaxies
Authors: Orkney Matthew D A , Taylor Ethan , Read Justin I , Rey Martin P , Pontzen A , Agertz Oscar , Kim Stacy Y , Delorme Maxime
Published: August 2023

Collisionless dark matter only (DMO) structure formation simulations predict that dark matter (DM) haloes are prolate in their centres and triaxial towards their outskirts. The addition of gas condensation transforms the central DM shape to be rounder and more oblate. It is not clear, however, whether such shape transformations occur in ‘ultra-faint’ dwarfs, which have extremely low baryon fractions. We present the first study of the shape and velocity anisotropy of ultra-faint dwarf galaxies that have gas mass fractions of fgas(r < Rhalf) < 0.06. These dwarfs are drawn from the Engineering Dwarfs at Galaxy formation’s Edge (EDGE) project, using high-resolution simulations that allow us to resolve DM halo shapes within the half-light radius (∼100 pc). We show that gas-poor ultra-faints (M200c ≤ 1.5 × 109 M⊙; fgas < 10−5) retain their pristine prolate DM halo shape even when gas, star formation, and feedback are included. This could provide a new and robust test of DM models. By contrast, gas-rich ultra-faints (M200c > 3 × 109 M⊙; fgas > 10−4) become rounder and more oblate within ∼10 half-light radii. Finally, we find that most of our simulated dwarfs have significant radial velocity anisotropy that rises to $\tilde{\beta } \gt 0.5$ at R ≳ 3Rhalf. The one exception is a dwarf that forms a rotating gas/stellar disc because of a planar, major merger. Such strong anisotropy should be taken into account when building mass models of gas-poor ultra-faints.
Adiabatic energy change in the inner heliosheath: how does it affect the distribution of pickup protons and energetic neutral atom fluxes?
Authors: Baliukin I I , Izmodenov V V , Alexashov D B
Published: August 2023

The hydrogen atoms penetrate the heliosphere from the local interstellar medium, and while being ionized, they form the population of pickup protons. The distribution of pickup protons is modified by the adiabatic heating (cooling) induced by the solar wind plasma compression (expansion). In this study, we emphasize the importance of the adiabatic energy change in the inner heliosheath that is usually either neglected or considered improperly. The effect of this process on the energy and spatial distributions of pickup protons and energetic neutral atoms (ENAs), which originate in the charge exchange of pickup protons, has been investigated and quantified using a kinetic model. The model employs the global distributions of plasma and hydrogen atoms in the heliosphere from the simulations of a kinetic-magnetohydrodynamic model of solar wind interaction with the local interstellar medium. The findings indicate that the adiabatic energy change is responsible for the broadening of the pickup proton velocity distribution and the significant enhancement of ENA fluxes (up to ∼5 and ∼20 times in the upwind and downwind directions at energies ∼1–2 keV for an observer at 1 au). It sheds light on the role of adiabatic energy change in explaining the discrepancies between the ENA flux observations and the results of numerical simulations.
Pyoderma gangrenosum after surgery for forefoot deformity in a patient with rheumatoid arthritis: A case report
Authors: Mori Yu , Izumiyama Takuya , Otsuka Kazuaki , Kanabuchi Ryuichi , Yamamoto Jun , Sekine Mana , Mori Naoko , Asano Yoshihide , Aizawa Toshimi
Published: August 2023

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease characterised by skin ulcers that are associated with autoimmune diseases. Although the effectiveness of immunosuppression with glucocorticoids and tumour necrosis factor inhibitors in treating PG has been reported, the utility of negative-pressure wound therapy (NPWT) for severe ulcerative lesions in patients with PG remains controversial. Herein, we report the case of a 76-year-old woman with rheumatoid arthritis who developed PG after undergoing surgery for a forefoot deformity. The patient showed improvement in deep ulcer lesions through NPWT while receiving treatment with abatacept and systemic glucocorticoids. Subsequent topical glucocorticoid therapy led to the remission of the PG. This case suggests that NPWT, when used under immunosuppressive conditions, does not exacerbate the pathergy and may be beneficial for treating severe ulcerative PG.
tRNA queuosine modification is involved in biofilm formation and virulence in bacteria
Authors: Díaz-Rullo Jorge , González-Pastor José Eduardo
Published: August 2023

tRNA modifications are crucial for fine-tuning of protein translation. Queuosine (Q) modification of tRNAs is thought to modulate the translation rate of NAU codons, but its physiological role remains elusive. Therefore, we hypothesize that Q-tRNAs control those physiological processes involving NAU codon-enriched genes (Q-genes). Here, we report a novel bioinformatic strategy to predict Q-genes, revealing a widespread enrichment in functions, especially those related to biofilm formation and virulence in bacteria, and particularly in human pathogens. Indeed, we experimentally verified that these processes were significantly affected by altering the degree of tRNA Q-modification in different model bacteria, representing the first report of a general mechanism controlling biofilm formation and virulence in Gram-positive and Gram-negative bacteria possibly through the coordination of the expression of functionally related genes. Furthermore, we propose that changes in Q availability in a microbiome would affect its functionality. Our findings open the door to the control of bacterial infections and biofilm formation by inhibition of tRNA Q-modification.
RAP80 phase separation at DNA double-strand break promotes BRCA1 recruitment
Authors: Qin Caolitao , Wang Yun-Long , Zhou Jin-Ying , Shi Jie , Zhao Wan-Wen , Zhu Ya-Xi , Bai Shao-Mei , Feng Li-Li , Bie Shu-Ying , Zeng Bing , Zheng Jian , Zeng Guang-Dong , Feng Wei-Xing , Wan Xiang-Bo , Fan Xin-Juan
Published: August 2023

RAP80 has been characterized as a component of the BRCA1-A complex and is responsible for the recruitment of BRCA1 to DNA double-strand breaks (DSBs). However, we and others found that the recruitment of RAP80 and BRCA1 were not absolutely temporally synchronized, indicating that other mechanisms, apart from physical interaction, might be implicated. Recently, liquid–liquid phase separation (LLPS) has been characterized as a novel mechanism for the organization of key signaling molecules to drive their particular cellular functions. Here, we characterized that RAP80 LLPS at DSB was required for RAP80-mediated BRCA1 recruitment. Both cellular and in vitro experiments showed that RAP80 phase separated at DSB, which was ascribed to a highly disordered region (IDR) at its N-terminal. Meanwhile, the Lys63-linked poly-ubiquitin chains that quickly formed after DSBs occur, strongly enhanced RAP80 phase separation and were responsible for the induction of RAP80 condensation at the DSB site. Most importantly, abolishing the condensation of RAP80 significantly suppressed the formation of BRCA1 foci, encovering a pivotal role of RAP80 condensates in BRCA1 recruitment and radiosensitivity. Together, our study disclosed a new mechanism underlying RAP80-mediated BRCA1 recruitment, which provided new insight into the role of phase separation in DSB repair.
Translocating RNA polymerase generates R-loops at DNA double-strand breaks without any additional factors
Authors: Lim Gunhyoung , Hwang Seungha , Yu Kilwon , Kang Jin Young , Kang Changwon , Hohng Sungchul
Published: August 2023

The R-loops forming around DNA double-strand breaks (DSBs) within actively transcribed genes play a critical role in the DSB repair process. However, the mechanisms underlying R-loop formation at DSBs remain poorly understood, with diverse proposed models involving protein factors associated with RNA polymerase (RNAP) loading, pausing/backtracking or preexisting transcript RNA invasion. In this single-molecule study using Escherichia coli RNAP, we discovered that transcribing RNAP alone acts as a highly effective DSB sensor, responsible for generation of R-loops upon encountering downstream DSBs, without requiring any additional factors. The R-loop formation efficiency is greatly influenced by DNA end structures, ranging here from 2.8% to 73%, and notably higher on sticky ends with 3′ or 5′ single-stranded overhangs compared to blunt ends without any overhangs. The R-loops extend unidirectionally upstream from the DSB sites and can reach the transcription start site, interfering with ongoing-round transcription. Furthermore, the extended R-loops can persist and maintain their structures, effectively preventing the efficient initiation of subsequent transcription rounds. Our results are consistent with the bubble extension model rather than the 5′-end invasion model or the middle insertion model. These discoveries provide valuable insights into the initiation of DSB repair on transcription templates across bacteria, archaea and eukaryotes.
New twists of a TAIL: novel insights into the histone binding properties of a highly conserved PHD finger cluster within the MLR family of H3K4 mono-methyltransferases
Authors: Zraly Claudia B , Schultz Richard , Diaz Manuel O , Dingwall Andrew K
Published: August 2023

Enhancer activation by the MLR family of H3K4 mono-methyltransferases requires proper recognition of histones for the deposition of the mono-methyl mark. MLR proteins contain two clusters of PHD zinc finger domains implicated in chromatin regulation. The second cluster is the most highly conserved, preserved as an ancient three finger functional unit throughout evolution. Studies of the isolated 3rd PHD finger within this cluster suggested specificity for the H4 [aa16–20] tail region. We determined the histone binding properties of the full three PHD finger cluster b module (PHDb) from the Drosophila Cmi protein which revealed unexpected recognition of an extended region of H3. Importantly, the zinc finger spacer separating the first two PHDb fingers from the third is critical for proper alignment and coordination among fingers for maximal histone engagement. Human homologs, MLL3 and MLL4, also show conservation of H3 binding, expanding current views of histone recognition for this class of proteins. We further implicate chromatin remodeling by the SWI/SNF complex as a possible mechanism for the accessibility of PHDb to globular regions of histone H3 beyond the tail region. Our results suggest a two-tail histone recognition mechanism by the conserved PHDb domain involving a flexible hinge to promote interdomain coordination.
scPlantDB: a comprehensive database for exploring cell types and markers of plant cell atlases
Authors: He Zhaohui , Luo Yuting , Zhou Xinkai , Zhu Tao , Lan Yangming , Chen Dijun
Published: August 2023

Recent advancements in single-cell RNA sequencing (scRNA-seq) technology have enabled the comprehensive profiling of gene expression patterns at the single-cell level, offering unprecedented insights into cellular diversity and heterogeneity within plant tissues. In this study, we present a systematic approach to construct a plant single-cell database, scPlantDB, which is publicly available at https://biobigdata.nju.edu.cn/scplantdb. We integrated single-cell transcriptomic profiles from 67 high-quality datasets across 17 plant species, comprising approximately 2.5 million cells. The data underwent rigorous collection, manual curation, strict quality control and standardized processing from public databases. scPlantDB offers interactive visualization of gene expression at the single-cell level, facilitating the exploration of both single-dataset and multiple-dataset analyses. It enables systematic comparison and functional annotation of markers across diverse cell types and species while providing tools to identify and compare cell types based on these markers. In summary, scPlantDB serves as a comprehensive database for investigating cell types and markers within plant cell atlases. It is a valuable resource for the plant research community.
Evaluation of Feasibility and Acceptability of a Text-Messaging Intervention for Tobacco Cessation in India
Authors: Nadkarni Abhijit , Gaikwad Leena , Sequeira Miriam , Velleman Richard , D'souza Joseline , Hoble Ankita , Haldankar Rajanish , Murthy Pratima , Naughton Felix
Published: August 2023

Introduction

The aim of our study was to assess the feasibility and acceptability of a brief behavioral intervention for tobacco cessation delivered via mobile phone text messaging in India.

Aims and Methods

We conducted an uncontrolled intervention cohort study in adult current users of tobacco. The participants received intervention messages on their mobile phones for eight weeks. We collected qualitative data about participants’ perceptions of intervention delivery and receipt, acceptability, and feasibility of the intervention. The outcomes measured at 3 months post-recruitment were self-reported 7- and 28-day point-prevalence abstinence, and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) risk categories for tobacco—low (0–3), moderate (4–26), and high (≥27).

Results

We recruited 26 eligible participants, and 22 completed the outcome assessments. The participants generally perceived the intervention content to be simple to access and useful in facilitating a change in tobacco use. None of the participants indicated that they wanted to discontinue receiving the intervention messages. Some suggestions for enhancing acceptability included supplementing text messaging with more intensive counseling and the use of multimedia content. Eighteen percent of participants reported abstinence in the past 7 and 28 days. A greater proportion of those who used smokeless tobacco were abstinent at follow-up compared to those who smoked (42.9% vs. 6.7%; p = .04).

Conclusions

If effective, simple and low-cost mobile phone text messaging can be used to deliver interventions for tobacco use, and has the potential to be scaled up so it can be delivered to populations of smokers interested in receiving cessation support.

Implications

Our study is an important step towards the development of a contextually relevant intervention suited for low- and middle-income countries and which is responsive to the needs of both those who use smoked and smokeless tobacco. If found to be effective, our intervention would be a scalable solution to overcome the human resource related barrier to accessing tobacco cessation services in low resource settings.
MITOGEN-ACTIVATED PROTEIN KINASE3 enhances disease resistance of edr1 mutants by phosphorylating MAPKKK5
Authors: Wang Wei , Chen Shuling , Zhong Guitao , Gao Chenyang , Zhang Qin , Tang Dingzhong
Published: August 2023

Mitogen-activated protein kinase (MAPK/MPK) cascades are key signaling modules that regulate plant immunity. ENHANCED DISEASE RESISTANCE1 (EDR1) encodes a Raf-like MAPK kinase kinase (MAPKKK) that negatively regulates plant defense in Arabidopsis (Arabidopsis thaliana). The enhanced resistance of edr1 requires MAPK KINASE4 (MKK4), MKK5, and MPK3. Although the edr1 mutant displays higher MPK3/6 activation, the mechanism by which plants increase MAPK cascade activation remains elusive. Our previous study showed that MAPKKK5 is phosphorylated at the Ser-90 residue in edr1 mutants. In this study, we demonstrated that the enhanced disease resistance of edr1 required MAPKKK5. Phospho-dead MAPKKK5S90A partially impaired the resistance of edr1, and the expression of phospho-mimetic MAPKKK5S90D in mapkkk5-2 resulted in enhanced resistance to the powdery mildew Golovinomyces cichoracearum strain UCSC1 and the bacterial pathogen Pseudomonas syringae pv. tomato (Pto) strain DC3000. Thus, Ser-90 phosphorylation in MAPKKK5 appears to play a crucial role in disease resistance. However, MAPKKK5-triggered cell death was not suppressed by EDR1. Furthermore, activated MPK3 phosphorylated the N terminus of MAPKKK5, and Ser-90 was one of the phosphorylated sites. Ser-90 phosphorylation increased MAPKKK5 stability, and EDR1 might negatively regulate MAPK cascade activation by suppressing the MPK3-mediated feedback regulation of MAPKKK5. Taken together, these results indicate that MPK3 phosphorylates MAPKKK5 to enhance MAPK cascade activation and disease resistance in edr1 mutants.
Synthetic Communities Increase Microbial Diversity and Productivity of Agave tequilana Plants in the Field
Authors: Flores-Núñez Víctor M. , Camarena-Pozos David A. , Chávez-González J. Daniel , Alcalde-Vázquez Raúl , Vázquez-Sánchez M. Nélida , Hernández-Melgar Alan G. , Xool-Tamayo Jorge , Moreno-Ulloa Aldo , Martínez Laila P. Partida
Published: August 2023

Agaves are plants native to North America that sustain life in arid and semiarid ecosystems. Previous studies revealed that cultivated plants of Agave tequilana had lower microbial diversity and functionality than wild Agave species. Here, we tested if synthetic communities (syncoms), based on microbial hubs or taxa with enriched microbial functions, could increase microbial diversity, plant health, and productivity in A. tequilana. We applied 10 syncoms to the phyllospheres of 6-month-old plants of A. tequilana in the field and monitored their development for 2 years. Amplicon sequencing of 16S-rRNA-V4 and ITS2 revealed that the inoculated syncoms played a negligible or minor role in the assembly of the prokaryotic and eukaryotic phyllospheric communities associated with A. tequilana, respectively. However, syncoms based on microbial hubs, particularly those observed in the phyllosphere associated with wild A. salmiana (PFCS), promoted microbial communities with higher alpha diversity. Some of these syncom-derived phyllospheric communities consumed a greater variety of carbon sources; had more complex co-occurrence networks; and increased the content of sugars (oBrix, a measure of productivity in agaves) in the stem and changed the leaf metabolome. Our work demonstrates that the application of syncoms formulated based on predicted microbe–microbe interactions and metagenomic analyses of microbial communities in cultivated and wild plant species represents an effective tool to improve the sustainability and productivity of crops in arid ecosystems.

[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 .
Development of a qPCR Assay for Species-Specific Detection of the Tar Spot Pathogen Phyllachora maydis
Authors: Roggenkamp Emily M. , Check Jill C. , Biswal Akshaya K. , Floyd Crystal M. , Miles Laura A. , Nicolli Camila P. , Shim Sujoung , Salgado-Salazar Catalina , Alakonya Amos E. , Malvick Dean K. , Smith Damon L. , Telenko Darcy E. P. , Chilvers Martin I.
Published: August 2023

Phyllachora maydis is a fungal plant pathogen that causes tar spot of corn ( Zea mays) in North and South America, causing devastating yield losses under favorable conditions. Although the causal agent is relatively easy to diagnose via macroscopic and microscopic observations, other diseases and conditions, such as insect frass, have been mistaken for tar spot of corn. Furthermore, conidia and ascospores in isolation can be difficult to visually distinguish from other fungi, and the development of signs and symptoms of the disease may not be observed until 12 to 20 days after infection. Therefore, we developed a TaqMan quantitative polymerase chain reaction (qPCR) assay for the detection and quantification of this pathogen to be used for diagnostics and airborne spore quantification. The assay was designed for the internal transcribed spacer region of P. maydis. The specificity of the assay was confirmed and tested against various nontarget Phyllachora species, corn pathogens, endophytes, and P. maydis samples from several states in the Midwest and from Mexico. The detection limit of this assay was determined to be 100 fg of genomic P. maydis DNA. To demonstrate the transferability of this technology, the assay was tested in different labs using various qPCR thermal cyclers. This assay can be used in downstream research involving latency period, disease prediction, and diagnostics.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Parental leave, childcare policies, and workplace bias for hepatology professionals: A national survey
Authors: Feld Lauren D. , Sarkar Monika , Au Jennifer S. , Flemming Jennifer A. , Gripshover Janet , Kardashian Ani , Muir Andrew J. , Nephew Lauren , Orloff Susan L. , Terrault Norah , Rabinowitz Loren , Volerman Anna , Arora Vineet , Farnan Jeanne , Villa Erica
Published: August 2023

Background:

The presence of workplace bias around child-rearing and inadequate parental leave may negatively impact childbearing decisions and sex equity in hepatology. This study aimed to understand the influence of parental leave and child-rearing on career advancement in hepatology.

Methods:

A cross-sectional survey of physician members of the American Association for the Study of Liver Diseases (AASLD) was distributed through email listserv in January 2021. The 33-item survey included demographic questions, questions about bias, altering training, career plans, family planning, parental leave, and work accommodations.

Results:

Among 199 US physician respondents, 65.3% were women, and 83.4% (n = 166) were attendings. Sex and racial differences were reported in several domains, including paid leave, perceptions of bias, and child-rearing. Most women (79.3%) took fewer than the recommended 12 paid weeks of parental leave for their first child (average paid leave 7.5 wk for women and 1.7 for men). A majority (75.2%) of women reported workplace discrimination, including 83.3% of Black and 62.5% of Hispanic women. Twenty percent of women were asked about their/their partners’ pregnancy intentions or child-rearing plans during interviews for training. Women were more likely to alter career plans due to child-rearing (30.0% vs. 15.9%, p = 0.030). Women were also more likely to delay having children than men (69.5% vs.35.9%).

Conclusions:

Women reported sex and maternity bias in the workplace and during training interviews, which was more frequently experienced by Black and Hispanic women. As two-thirds of women had children during training, it is a particularly influential time to reevaluate programmatic support to address long-term gender disparities in career advancement.
Cost-effectiveness analysis of interventional liver-directed therapies for downstaging of HCC before liver transplant
Authors: Wu Xiao , Kwong Allison , Heller Michael , Lokken R. Peter , Fidelman Nicholas , Mehta Neil
Published: August 2023

Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are the 2 most used modalities for patients with HCC while awaiting liver transplant. The purpose of this study is to perform a cost-effectiveness analysis comparing TACE and TARE for downstaging (DS) patients with HCC. A cost-effectiveness analysis was performed comparing TACE and TARE in DS HCC over a 5-year time horizon from a payer’s perspective. The clinical course, including those who achieved successful DS leading to liver transplant and those who failed DS with possible disease progression, was obtained from the United Network for Organ Sharing. Costs and effectiveness were measured in US dollars and quality-adjusted life years (QALYs). Probabilistic and deterministic sensitivity analyses were performed. TARE achieved a higher effectiveness of 2.51 QALY (TACE: 2.29 QALY) at a higher cost of $172,162 (TACE: $159,706), with the incremental cost-effectiveness ratio of $55,964/QALY, making TARE the more cost-effective strategy. The difference in outcome was equivalent to 104 days (nearly 3.5 months) in compensated cirrhosis state. Probabilistic sensitivity analyses showed that TARE was more cost-effective in 91.69% of 10,000 Monte Carlo simulations. TARE was more effective if greater than 48.2% of patients who received TACE or TARE were successfully downstaged (base case: 74.6% from the pooled analysis of multiple published cohorts). TARE became more cost-effective when the cost of TACE exceeded $4,831 (base case: $12,722) or when the cost of TARE was lower than $43,542 (base case: $30,609). Subgroup analyses identified TARE to be the more cost-effective strategy if the TARE cohort required 1 fewer locoregional therapy than the TACE cohort. TARE is the more cost-effective DS strategy for patients with HCC exceeding Milan criteria compared to TACE.
Clinical Neurology in Practice
Authors: Mathis Stéphane , Solé Guilhem , Damon-Perrière Nathalie , Rouanet-Larrivière Marie , Duval Fanny , Prigent Julia , Nadal Louis , Péréon Yann , Le Masson Gwendal
Published: August 2023

Background:

The tongue is an essential organ for the development of certain crucial functions, such as swallowing and language. The examination of the tongue can be very useful in neurology, as the various types of lingual alterations can lead to certain specific diagnoses, the tongue being a kind of “mirror” of some neurological function.

Review Summary:

In this study, we reviewed the literature on anatomy, physiology, and the various aspects of the examination of the tongue.

Conclusions:

Examination of the tongue should be an integral part of the clinical examination of the cranial nerves. This study aimed to demonstrate the importance of tongue motor and non-motor functions in neurological practice.
Thrombolysis Versus Nonthrombolyzed in Patients With Mild Strokes and Large Vessel Occlusions
Authors: Luo Xintong , Huo Tiantian , Cao Pengkai , Zhao Jingru , Zhang Yue , Tan Guojun
Published: August 2023

Background

The safety and efficacy of intravenous thrombolysis (IVT) in acute ischemic stroke patients with large vessel occlusions and mild neurological deficits are controversial.

Methods:

Data of stroke patients presenting with mild initial stroke, which was defined as the National Institutes of Health Stroke Scale score (NIHSS) ≤5 and large vessel occlusion, were extracted from a large provincewide stroke registry.

Results:

A total of 619 IVT and 2170 non-IVT patients were identified in this study. IVT patients had higher rates of favorable functional outcome Modified Rankin Scale(mRS) ≤1 (74.6% vs. 70.6%; P=0.047), lower mRS scores (1 vs. 1, P=0.001), and higher NIHSS score decreased (1 vs. 0, P<0.001) at discharge compared with the non-IVT patients. The rates were similar in symptomatic intracranial hemorrhage (2.1% vs. 2.0%, P=0.853), severe systemic bleeding (0.8% vs. 0.6%, P=0.474), and mortality at discharge (0.2% vs. 0.2%, P=0.906) between the 2 groups. A multiple Logistic regression model found that age above 80 years [adjusted OR (aOR) 2.056 (95% CI, 1.125 to 3.756)], history of stroke [aOR 1.577 (95% CI, 1.303 to 1.910)], hyperlipidemia [aOR 2.156 (95% CI, 1.059 to 4.388)], high admission NIHSS score [aOR 1.564 (95% CI, 1.473 to 1.611)], and non-IVT [aOR 1.667 (95% CI, 1.337 to 2.077)] were independent risk factors for mRS >1.

Conclusions:

IVT administration is safe and effective in eligible acute ischemic stroke patients. Age above 80 years, with a history of stroke and hyperlipidemia, high admission NIHSS score, and non-IVT were independent risk factors for mRS >1 at discharge in these patients.
Case Report: Vision Loss in a Child Caused by Streptococcus constellatus
Authors: Xiaoyan Liu , Wenjuan Luo , Wanna Ren
Published: August 2023

Purpose

We present a rare case of Streptococcus constellatus-induced odontogenic orbital cellulitis.

Methods

An 8-year-old boy presented to an outpatient clinic with complaints of right-sided toothache, right eye swelling, and decreased visual acuity. He was referred to a pediatric critical care department for further management. Comprehensive diagnostic assessments, such as ophthalmic examination, blood tests, computed tomography (CT), and magnetic resonance imaging, were performed.

Results

On presentation, the best-corrected visual acuities were 20/250 and 20/20 in the right and left eyes, respectively. Examination revealed grade 2+ eyelid edema and erythema and grade 4+ chemosis and exophthalmos in the right eye. The patient displayed restricted eye movements in all directions. Blood tests revealed a total white cell count of 12,100 cells/μL. Axial and coronal CT revealed right-sided maxillary sinus, ethmoidal sinus, and orbital abscesses. Therefore, the patient was diagnosed with septicemia, orbital cellulitis, and orbital apex syndrome in the right eye. Intravenous antibiotics were administered; paracentesis of the orbital abscess was performed under local anesthesia. However, the patient’s condition worsened, resulting in a complete loss of light perception in the right eye. Accordingly, surgery was performed under general anesthesia within 24 h of admission; the surgery involved drainage of the orbital abscess through an inferior intraorbital incision, as well as drainage of the ethmoid sinus and maxillary sinus abscesses via nasal endoscopy. A culture obtained from the orbital abscess yielded S. constellatus. The infection was managed by a combination of surgical intervention, antibiotics, steroids, and hyperbaric oxygen therapy. However, because of optic nerve injury, vision in the affected eye partially recovered to 20/200.

Conclusions

S. constellatus-induced pediatric orbital cellulitis can result in significant morbidity. The significant improvement in vision, from no light perception to 20/200, emphasizes the importance of timely diagnosis and treatment in patients who present with acute orbital cellulitis and vision loss symptoms.
Intereye Differences in the Clinical Assessment of Intraocular Pressure and Ocular Biomechanics
Authors: Yuhas Phillip T. , McHugh-Morrison Cora , Canavan Joshua , Jeyandran Joshua , Mahmoud Ashraf M. , Roberts Cynthia J.
Published: August 2023

SIGNIFICANCE

Clinicians and researchers will have evidence whether intereye differences confound clinical measurements of intraocular pressure or of ocular biomechanical parameters.

PURPOSE

The purpose of this study was to determine whether intraocular pressure and biomechanical parameters, as measured by the Ocular Response Analyzer (ORA) and by Cornea Visualization with Scheimpflug Technology (CorVis ST), are different between the first and second eye measured.

METHODS

Intraocular pressure and biomechanical parameters were collected from both eyes of healthy participants (N = 139). The ORA measured corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, and corneal hysteresis. The CorVis ST measured biomechanically corrected intraocular pressure, stiffness parameter at first applanation, and stiffness parameter at highest concavity. For each measurement, a paired t test compared the value of the first eye measured against that of the second eye measured.

RESULTS

For the ORA, Goldmann-correlated intraocular pressure was significantly higher (P = .001) in the first eye (14.8 [3.45] mmHg) than in the second eye (14.3 [3.63] mmHg). For the CorVis ST, biomechanically corrected intraocular pressure was significantly higher (P < .001) in the second eye (14.7 [2.14] mmHg) than in the first eye (14.3 [2.11] mmHg). Stiffness parameter at first applanation (intereye difference, 6.85 [9.54] mmHg/mm) was significantly (P < .001) higher in the first eye than in the second eye. Stiffness parameter at highest concavity was significantly higher (P = .01) in the second eye (14.3 [3.18] mmHg/mm) than in the first eye (14.0 [3.13] mmHg/mm).

CONCLUSIONS

Although there were statistically significant intereye differences in intraocular pressure and in biomechanical parameters for both devices, the variations were small and thus unlikely to affect clinical outcomes.
Clinical Remission of Severe Crohn’s Disease with Empagliflozin Monotherapy in a Pediatric Patient with Glycogen Storage Disease Type 1b
Authors: Collen Lauren V. , Newburger Peter E. , Snapper Scott B.
Published: August 2023

Glycogen storage disease type 1b (GSD1b) is associated with inflammatory bowel disease and congenital neutropenia. Neutropenia in GSD1b is caused by the accumulation of 1,5-anhydroglucitol-6-phosphate. Empagliflozin is an antidiabetic drug that promotes renal excretion of this metabolite. We report on a patient with refractory GSD1b-associated inflammatory bowel disease who is in clinical remission on empagliflozin monotherapy.
User perspectives of digital manufacturing for lower-limb prosthetic sockets
Authors: Phillips Clara , Li Lynn , Miguel Marian , Eshraghi Arezoo , Heim Winfried , Dilkas Steven , Devlin Michael , Wasilewski Marina , Verweel Lee , MacKay Crystal
Published: August 2023

Background:

There is growing interest to use digital technology (DT) for manufacturing lower-limb prosthetic sockets to improve efficiency and clinical outcomes. However, little is known about how lower-limb prosthesis users perceive DTs, such as 3D scanning and 3D printing.

Objectives:

This study aimed to provide an understanding of perceptions and experiences with DT for prosthetic socket manufacturing from the perspective of prosthesis users.

Study design:

A qualitative descriptive research study.

Methods:

Nine lower-limb prosthesis users (mean age 56; 5 female; 4 male) participated in one-on-one semistructured telephone interviews. Inductive thematic analysis was performed to identify a codebook and emerging themes from the interview transcripts.

Results:

Two major themes were identified: (1) expectations and prioritization of 3D printed socket usability and (2) facilitators and barriers to uptake of DT among patients.

Conclusion:

DT methods were found to be acceptable and feasible from a patient perspective, although technological advancements are still required, and real-time communication about the process may be vital for ensuring patient engagement. Consideration of these findings may improve patient satisfaction to emerging prosthesis treatment plans and ultimately support widespread adoption of DT as an additional tool for fabricating prosthetic sockets.
Artificial Intelligence–Based Modeling Can Predict Face Shape Based on Underlying Craniomaxillofacial Bone
Authors: Arjmand Hanieh , Clement Allison , Hardisty Michael , Fialkov Jeffrey A. , Whyne Cari M.
Published: August 2023

Reconstructing facial deformities is often challenging due to the complex 3-dimensional (3D) anatomy of the craniomaxillofacial skeleton and overlying soft tissue structures. Bilateral injuries cannot benefit from mirroring techniques and as such preinjury information (eg, 2D pictures or 3D imaging) may be utilized to determine or estimate the desired 3D face shape. When patient-specific information is not available, other options such as statistical shape models may be employed; however, these models require registration to a consistent orientation which may be challenging. Artificial intelligence (AI) has been used to identify facial features and generate highly realistic simulated faces. As such, it was hypothesized that AI can be used to predict 3D face shape by learning its relationship with the underlying bone surface anatomy in a subject-specific manner. An automated image processing and AI modeling workflow using a modified 3D UNet was generated to estimate 3D face shape using the underlying bone geometry and additional metadata (eg, body mass index and age) obtained from 5 publicly available computed tomography imaging datasets. Visually, the trained models provided a reasonable prediction of the contour and geometry of the facial tissues. The pipeline achieved a validation dice=0.89 when trained on the combined 5 datasets, with the highest dice=0.925 achieved with the single HNSCC dataset. Estimated predefect facial geometry may ultimately be used to aid preoperative craniomaxillofacial surgical planning, providing geometries for intraoperative templates, guides, navigation, molds, and forming tools. Automated face shape prediction may additionally be useful in forensic studies to aid in the identification of unknown skull remains.
Lateral Osteotomy for the Surgical Treatment of the Asian Wide Nose
Authors: Zhang Jinsong , Chen Aihong , Liu Ye , Herrler Tanja , Yu Baofu , Fang Linsen , Zhu Fei , Li Xiaojing , Dai Chuanchang , Wei Jiao
Published: August 2023

Objective:

Narrowing of the nasal dorsum allows for a more pleasing moderate width. We here introduce a lateral osteotomy technique that is less traumatic and easier to perform than commonly used procedures in Asian and share our experiences in the application.

Methods:

After a blunt dissection of the periosteum at the mucosal side of the nasal bone, all patients who underwent treatment using nasal osteotomy at the level of the maxillary nasal process were retrospectively analyzed. The bony nasal width, height, and the nasal lateral wall slope of bone before and after surgery were measured. The postoperative outcomes, complications, and patient satisfaction were analyzed and evaluated.

Results:

From January 2008 to January 2018, nasal dorsum narrowing was implemented in 106 patients. On average, nasal width was significantly decreased and no change in nose height after the nasal osteotomy. The nasal width was significantly reduced by 8.51 ± 2.16 mm compared with before surgery. The slope of the nasal lateral wall was reduced from the mean of 155.0 ± 7.63-degree preoperation to the mean of 135.25 ± 7.50-degree postoperation. The follow-up period ranged from 6 months to 4 years, with an average of 10.3 months.

Conclusions:

This type of nasal bone base osteotomy is a simple and feasible method for the treatment of wide Asian noses with a high patient acceptance and stable postoperative results.

Level of Evidence:

Level IV.
Tracheostomy, the Not So Definitive Airway?: Tracheostomy Morbidity in Pediatric Craniofacial Patients
Authors: La-Anyane Okensama M. , Whitney Natalia B. , Harmon Kelly A. , Karas Anatoli F. , Jeffe Jill S. , Tragos Christina
Published: August 2023

Background:

Tracheostomy is the definitive treatment for airway management in severe cases of craniofacial-associated upper airway obstruction, like the Pierre-Robin sequence, but is associated with significant morbidity. The purpose of this study was to examine tracheostomy-associated morbidities and mortalities in craniofacial patients to identify opportunities to improve clinical care and patient prognosis.

Methods:

The study was a retrospective review of pediatric craniofacial patients who were tracheostomized between 2016 and 2022. Data regarding their demographics, craniofacial diagnoses, endoscopic airway anomalies, intubation grade of view classification, tracheostomy-related complications, and causes of mortality were analyzed.

Results:

Sixteen of the 17 tracheostomized pediatric patients had the Pierre-Robin sequence, with 5 of those patients having an additional syndromic craniofacial diagnosis. Additional airway anomalies were found in 82.4% of the patients. The mean length of hospital stay after tracheostomy was 4.08 months. Infection was the most common complication, observed in 94.1% of patients, followed by stomal granulation in 76.5% of patients. Two mortalities were observed: one following the compassionate removal of ventilator support and the other following the accidental dislodgment of the tracheostomy tube.

Conclusions:

Tracheostomy-related complications were observed in all craniofacial patients in this group. Compared with the general pediatric population, tracheostomized craniofacial patients may endure longer hospital stays and greater stomal granulation rates. Mandibular distraction osteogenesis may allow for tracheostomy avoidance in these patients, and future research should focus on comparing the long-term complication rates and outcomes between tracheostomy mandibular distraction osteogenesis in this challenging patient population.
A large Pleomorphic Adenoma in Nasal Cavity Misdiagnosed as Inverted Papilloma
Authors: Kim Seung Ho , Park Moon Hyang , In Seung Min , Jeong Hyo Yeon , Lee Seon-Min , Lee Ki-Il
Published: August 2023

Pleomorphic adenoma (PA) is a benign tumor characterized by slow-growing mixed tumors in the craniofacial area. It is relatively common in salivary glands; however, PA of the nasal cavity, which arises in the minor salivary glands, is rare. We present the case of a large PA in the nasal cavity of an adult immunocompetent woman with nasal obstruction and intermittent epistaxis. Based on preoperative radiologic examinations, she was misdiagnosed with an inverted papilloma. Endoscopic resection was performed under general anesthesia. Pathologically, the patient was confirmed to have PA, which has great cellularity and few stromal components. No complications or recurrences during the 1-year follow-up period were observed.
Effect of Tissue Pedicle Position on Postoperative Recovery From Severe Auricular Laceration
Authors: Wang Weihao , Wang Wangshu , Zhang Wanqi , Jin Manqiu , Shao Ying
Published: August 2023

Background:

Postoperative recovery from severe auricular lacerations varies significantly. However, few studies have sought to clarify the risk factors associated with the prognosis of severe auricular lacerations, and little attention has been paid to the intraoperative management of severe auricular lacerations and early postoperative intervention. The purpose of this study was to analyze the risk factors that may affect the prognosis of severe auricular lacerations.

Methods:

Case data and imaging data of patients with severe auricular lacerations treated in our department between January 2018 and September 2022 were collected. A total of 90 patients (90 severe auricular lacerations) were included in the analysis and were divided into good group (68 cases) and poor group (22 cases) according to postoperative recovery, which was defined as poor postoperative recovery when postoperative auricular blood supply disorders required interventional treatment or second stage plastic surgery.

Results:

The percentage of ventral tissue pedicles in the poor recovery group was 77.3% (P<0.001). The proportion of ventral tissue pedicle was significantly higher in the poor postoperative group than in the good postoperative group, and ventral tissue pedicle [odds ratio (OR)=12.22, P=0.002] was an independent risk factor for poor postoperative recovery from severe auricular laceration.

Conclusions:

The prognosis of patients with severe auricular lacerations differs between the different tissue pedicle locations, and prophylactic treatment of patients with ventral tissue pedicles is beneficial. In addition, patients with ventral tissue pedicles should be informed in advance of their increased risk of surgical failure.