bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Ankle Injuries Are Associated With an Increased Risk of Subsequent Concussion in National Football League Players
Authors: Bergstein Victoria E. , Shu Henry T. , Bodendorfer Blake M. , DeFroda Steven , Aiyer Amiethab A.
Published: December 2023

Background:

There is a gap in the literature regarding musculoskeletal risk factors for concussion within the National Football League (NFL), which is an avenue that must be explored to promote player safety given the high incidence of both injury types. This study aims to observe if ankle injuries are associated with an increased risk of subsequent concussion in NFL players.

Methods:

The public online database ProFootballReference.com was used to identify ankle injuries and concussions in NFL players from the 2009-2010 to 2019-2020 seasons. Multivariable logistic regression for subsequent concussion and ankle injury was performed, adjusting for body mass index (BMI), age, and player position. For descriptive statistics, unpaired t tests with unequal variance were performed for continuous variables, including BMI and age. χ2 testing was performed for categorical variables, including player position, and whether the position was offensive, defensive, or on special teams.

Results:

Of the 5538 NFL players included in the study, 941 had an ankle injury, 633 had a concussion, and 240 had both an ankle injury and a subsequent concussion. The adjusted odds ratio (aOR) for concussion following a single ankle injury was 0.90 (95% CI 0.72-1.14, P = .387); however, the aOR for concussion following multiple ankle injuries was 2.87 (95% CI 1.23-6.75, P = .015). Special teams players had the lowest risk for concussion (aOR 0.17, 95% CI 0.069-0.36, P < .001) following ankle injury, and there was no significant difference in risk between offense and defense (aOR 0.91, 95% CI 0.77-1.08, P = .295).

Conclusion:

Multiple ankle injuries were associated with an increased risk of a subsequent concussion after adjusting for BMI; player position; and offense, defense, or special teams designation. These findings can inform injury prevention practices in the National Football League.

Level of Evidence:

Level III, retrospective comparative study.
A Case of 3Cs: Coronary Artery Calcification Masquerading as a Stent on Chest X-ray
Authors: Syed Zia Hussain , Parvathareddy Krishna Mala Konda Reddy , Nagula Praveen , Karumuri Suneetha , Syed Imamuddin
Published: December 2023

Coronary artery calcification in patients with coronary artery disease is associated with increased major adverse cardiovascular events. They are usually diagnosed on a computed tomography scan or on an invasive coronary angiography. A 60-year-old male was diagnosed with acute coronary syndrome after presentation with one month of worsening angina. Coronary angiography showed triple vessel disease (mid left anterior descending artery and mid right coronary artery having total occlusion and a 70% stenosis in the left circumflex artery). Apart from this, there was a heavily calcified right coronary artery with a C configuration evident on fluoroscopy. A computed tomography coronary angiography was done to visualize the distal vessels. The calcium score was 5988. Retrospectively, on inspection of the chest X-ray, there was calcification on the right heart border. The patient was medically managed and referred to a cardiothoracic vascular surgeon for coronary artery bypass grafting. Coronary artery calcification on X-ray is rare and hence being presented along with the review of the literature.
Music Education in Charter Schools: A Scoping Review
Authors: DeAngelis David R.
Published: December 2023

The purpose of this PRISMA Scoping review was to synthesize research regarding charter school music education. Findings regarding charter school music offerings were varied. At state and national levels, charter schools were less likely to offer music courses than traditional public schools; however, in large urban districts, charter schools offered music courses at comparable or greater rates. Charter school music teachers tended to be less experienced and more likely to be certified through alternative licensure programs. Disparities in music education between charter schools and traditional public schools were also intertwined with factors such as race, socioeconomic status, school size, and location, as charter schools tended to be smaller, serve higher proportions of students of color and/or from low socioeconomic backgrounds, and be in urban areas. Recommendations for music educators include considering state and local policies, administrative structures, and curricular or pedagogical foci when exploring music programs in charter schools.
Predictors of unsustained measurable residual disease negativity in patients with multiple myeloma
Authors: D’Agostino Mattia , Bertuglia Giuseppe , Rota-Scalabrini Delia , Belotti Angelo , Morè Sonia , Corradini Paolo , Oliva Stefania , Ledda Antonio , Grasso Mariella , Pavone Vincenzo , Ronconi Sonia , Vincelli Iolanda Donatella , Ballanti Stelvio , Velluti Cristina , Cellini Claudia , Gozzetti Alessandro , Palmas Angelo D. , Gamberi Barbara , Mancuso Katia , Paris Laura , Zambello Renato , Petrucci Maria Teresa , Bruno Benedetto , Musto Pellegrino , Gay Francesca
Published: December 2023

The prognostic impact of achieving and in particular maintaining measurable residual disease (MRD) negativity in multiple myeloma is now established; therefore, identifying among MRD-negative patients the ones at higher risk of losing MRD negativity is of importance. We analyzed predictors of unsustained MRD negativity in patients enrolled in the FORTE trial (NCT02203643). MRD was performed by multiparameter flow cytometry (sensitivity of 10−5) at premaintenance and every 6 months thereafter. The cumulative incidence (CI) of MRD resurgence and/or progression was analyzed in MRD-negative patients. A total of 306 of 474 (65%) MRD-negative patients were analyzed. After a median follow-up of 50.4 months from MRD negativity, 185 of 306 (60%) patients were still MRD negative and progression free, 118 (39%) lost their MRD-negative status, and 3 patients (1%) died without progression. Amp1q vs normal (4-year CI, 63% vs 34), ≥2 concomitant high-risk cytogenetic abnormalities vs 0 (4-year CI, 59% vs 33%), circulating tumor cells at baseline (high vs low at 4-year CI, 62% vs 32%), and time-to-reach MRD negativity postconsolidation vs preconsolidation (4-year CI, 46% vs 35%) were associated with a higher risk of unsustained MRD negativity in a multivariate Fine-Gray model. During the first 2 years of maintenance, patients receiving carfilzomib-lenalidomide vs lenalidomide alone had a lower risk of unsustained MRD negativity (4-year CI, 20% vs 33%).
Determining treatment tolerance and fitness for intensive chemotherapy in older adults with AML: a call to action
Authors: Bhatt Vijaya Raj , Uy Geoffrey L. , Klepin Heidi D.
Published: December 2023

Determining fitness for intensive chemotherapy in an older adult with acute myeloid leukemia (AML) is an unanswered age-old question. Geriatric assessment captures any variation in multidimensional health, which can influence treatment tolerance. A prospective study is necessary to validate fitness criteria, determine whether geriatric assessment–based fitness performs superiorly to other criteria, and what components of geriatric assessment are associated with treatment tolerance. A validation study should enroll diverse patients from both academic and community centers and patients receiving intensive and lower-intensity chemotherapy. Geriatric assessment should include at minimum measures of comorbidity burden, cognition, physical function, and emotional health, which in previous smaller studies have shown to be associated with mortality in AML. These assessments should be completed before or within a few days of initiation of chemotherapy to reduce the influence of chemotherapy on the assessment results. Treatment tolerance has been measured by rates of toxicities in patients with solid malignancies; however, during the initial treatment of AML, rates of toxicities are very high regardless of treatment intensity. Early mortality, frequently used in previous studies, can provide a highly consequential and easily identifiable measure of treatment tolerance. The key end point to assess treatment tolerance, thus, should include early mortality. Other end points may include decline in function and quality of life and treatment modifications or cessation due to toxicities. Validating fitness criteria can guide treatment selection and supportive care interventions and are crucial to guide fitness-based trial eligibility, inform the interpretation of trial results, and facilitate drug labeling.
FGF21 alleviates endothelial mitochondrial damage and prevents BBB from disruption after intracranial hemorrhage through a mechanism involving SIRT6
Authors: Wang Runfeng , Wang Jin , Zhang Zhiguo , Ma Bo , Sun Shukai , Gao Li , Gao Guodong
Published: December 2023

Background

Disruption of the BBB is a harmful event after intracranial hemorrhage (ICH), and this disruption contributes to a series of secondary injuries. We hypothesized that FGF21 may have protective effects after intracranial hemorrhage (ICH) and investigated possible underlying molecular mechanisms.

Methods

Blood samples of ICH patients were collected to determine the relationship between the serum level of FGF21 and the $$\Delta$$
Δ
GCS%. Wild-type mice, SIRT6flox/flox mice, endothelial-specific SIRT6-homozygous-knockout mice (eSIRT6−/− mice) and cultured human brain microvascular endothelial cells (HCMECs) were used to determine the protective effects of FGF21 on the BBB.

Results

We obtained original clinical evidence from patient data identifying a positive correlation between the serum level of FGF21 and $$\Delta$$
Δ
GCS%. In mice, we found that FGF21 treatment is capable of alleviating BBB damage, mitigating brain edema, reducing lesion volume and improving neurofunction after ICH. In vitro, after oxyhemoglobin injury, we further explored the protective effects of FGF21 on endothelial cells (ECs), which are a significant component of the BBB. Mitochondria play crucial roles during various types of stress reactions. FGF21 significantly improved mitochondrial biology and function in ECs, as evidenced by alleviated mitochondrial morphology damage, reduced ROS accumulation, and restored ATP production. Moreover, we found that the crucial regulatory mitochondrial factor deacylase sirtuin 6 (SIRT6) played an irreplaceable role in the effects of FGF21. Using endothelial-specific SIRT6-knockout mice, we found that SIRT6 deficiency largely diminished these neuroprotective effects of FGF21. Then, we revealed that FGF21 might promote the expression of SIRT6 via the AMPK–Foxo3a pathway.

Conclusions

We provide the first evidence that FGF21 is capable of protecting the BBB after ICH by improving SIRT6-mediated mitochondrial homeostasis.
Sustained activation of 12/15 lipoxygenase (12/15 LOX) contributes to impaired renal recovery post ischemic injury in male SHR compared to females
Authors: Mohamed Riyaz , Sullivan Jennifer C.
Published: December 2023

Background

Acute kidney injury (AKI) due to ischemia-reperfusion (IR) is a serious and frequent complication in clinical settings, and mortality rates remain high. There are well established sex differences in renal IR, with males exhibiting greater injury following an ischemic insult compared to females. We recently reported that males have impaired renal recovery from ischemic injury vs. females. However, the mechanisms mediating sex differences in renal recovery from IR injury remain poorly understood. Elevated 12/15 lipoxygenase (LOX) activity has been reported to contribute to the progression of numerous kidney diseases. The goal of the current study was to test the hypothesis that enhanced activation of 12/15 LOX contributes to impaired recovery post-IR in males vs. females.

Methods

13-week-old male and female spontaneously hypertensive rats (SHR) were randomized to sham or 30-minute warm bilateral IR surgery. Additional male and female SHR were randomized to treatment with vehicle or the specific 12/15 LOX inhibitor ML355 1 h prior to sham/IR surgery, and every other day following up to 7-days post-IR. Blood was collected from all rats 1-and 7-days post-IR. Kidneys were harvested 7-days post-IR and processed for biochemical, histological, and Western blot analysis. 12/15 LOX metabolites 12 and 15 HETE were measured in kidney samples by liquid chromatography–mass spectrometry (LC/MS).

Results

Male SHR exhibited delayed recovery of renal function post-IR vs. male sham and female IR rats. Delayed recovery in males was associated with activation of renal 12/15 LOX, increased renal 12-HETE, enhanced endoplasmic reticulum (ER) stress, lipid peroxidation, renal cell death and inflammation compared to females 7-days post-IR. Treatment of male SHR with ML355 lowered levels of 12-HETE and resulted in reduced renal lipid peroxidation, ER stress, tubular cell death and inflammation 7-days post-IR with enhanced recovery of renal function compared to vehicle-treated IR male rats. ML355 treatment did not alter IR-induced increases in plasma creatinine in females, however, tubular injury and cell death were attenuated in ML355 treated females compared to vehicle-treated rats 7 days post-IR.

Conclusion

Our data demonstrate that sustained activation 12/15 LOX contributes to impaired renal recovery post ischemic injury in male and female SHR, although males are more susceptible on this mechanism than females.
Nonlinear Control of Magnetically Coupled Rodless Cylinder Position Servo System
Authors: Zhang Yeming , Kong Demin , Jin Gonghua , Shi Yan , Cai Maolin , Li Shuping , Lv Baozhan
Published: December 2023

Magnetically coupled rodless cylinders are widely used in the coordinate positioning of mechanical arms, electrostatic paintings, and other industrial applications. However, they exhibit strong nonlinear characteristics, which lead to low servo control accuracy. In this study, a mass-flow equation through the valve port was derived to improve the control performance, considering the characteristics of the dynamics and throttle-hole flow. Subsequently, a friction model combining static, viscous, and Coulomb friction with a zero-velocity interval was proposed. In addition, energy and dynamic models were set for the experimental investigation of the magnetically coupled rodless cylinder. A nonlinear mathematical model for the position of the magnetically coupled rodless cylinder was proposed. An incremental PID controller was designed for the magnetically coupled rodless cylinder to control this system, and the PID parameters were adjusted online using RBF neural network. The response results of the PID parameters based on the RBF neural network were compared with those of the traditional incremental PID control, which proved the superiority of the optimization control algorithm of the incremental PID parameters based on the RBF neural network servo control system. The experimental results of this model were compared with the simulation results. The average error between the established model and the actual system was 0.005175054 (m), which was approximately 2.588% of the total travel length, demonstrating the accuracy of the theoretical model.
Zn‐doped MnOx nanowires displaying plentiful crystalline defects and tunable small cross-sections for an optimized volcano-type performance towards supercapacitors
Authors: Ribeiro Geyse A. C. , de Lima Scarllett L. S. , Santos Karolinne E. R. , Mendonça Jhonatam P. , Macena Pedro , Pessanha Emanuel C. , Cordeiro Thallis C. , Gardener Jules , Solórzano Guilhermo , Fonsaca Jéssica E. S. , Domingues Sergio H. , dos Santos Clenilton C. , Dourado André H. B. , Tanaka Auro A. , da Silva Anderson G. M. , Garcia Marco A. S.
Published: December 2023

MnOx-based nanomaterials are promising large-scale electrochemical energy storage devices due to their high specific capacity, low toxicity, and low cost. However, their slow diffusion kinetics is still challenging, restricting practical applications. Here, a one-pot and straightforward method was reported to produce Zn-doped MnOx nanowires with abundant defects and tunable small cross-sections, exhibiting an outstanding specific capacitance. More specifically, based on a facile hydrothermal strategy, zinc sites could be uniformly dispersed in the α-MnOx nanowires structure as a function of composition (0.3, 2.1, 4.3, and 7.6 wt.% Zn). Such a process avoided the formation of different crystalline phases during the synthesis. The reproducible method afforded uniform nanowires, in which the size of cross-sections decreased with the increase of Zn composition. Surprisingly, we found a volcano-type relationship between the storage performance and the Zn loading. In this case, we demonstrated that the highest performance material could be achieved by incorporating 2.1 wt.% Zn, exhibiting a remarkable specific capacitance of 1082.2 F.g−1 at a charge/discharge current density of 1.0 A g−1 in a 2.0 mol L−1 KOH electrolyte. The optimized material also afforded improved results for hybrid supercapacitors. Thus, the results presented herein shed new insights into preparing defective and controlled nanomaterials by a simple one-step method for energy storage applications.
High-capacity sample multiplexing for single cell chromatin accessibility profiling
Authors: Booth Gregory T. , Daza Riza M. , Srivatsan Sanjay R. , McFaline-Figueroa José L. , Gladden Rula Green , Mullen Andrew C. , Furlan Scott N. , Shendure Jay , Trapnell Cole
Published: December 2023

Single-cell chromatin accessibility has emerged as a powerful means of understanding the epigenetic landscape of diverse tissues and cell types, but profiling cells from many independent specimens is challenging and costly. Here we describe a novel approach, sciPlex-ATAC-seq, which uses unmodified DNA oligos as sample-specific nuclear labels, enabling the concurrent profiling of chromatin accessibility within single nuclei from virtually unlimited specimens or experimental conditions. We first demonstrate our method with a chemical epigenomics screen, in which we identify drug-altered distal regulatory sites predictive of compound- and dose-dependent effects on transcription. We then analyze cell type-specific chromatin changes in PBMCs from multiple donors responding to synthetic and allogeneic immune stimulation. We quantify stimulation-altered immune cell compositions and isolate the unique effects of allogeneic stimulation on chromatin accessibility specific to T-lymphocytes. Finally, we observe that impaired global chromatin decondensation often coincides with chemical inhibition of allogeneic T-cell activation.
An extract from the frass of swallowtail butterfly (Papilio machaon) larvae inhibits HCT116 colon cancer cell proliferation but not other cancer cell types
Authors: Nakano Miho , Sakamoto Takuma , Kitano Yoshikazu , Bono Hidemasa , Simpson Richard J. , Tabunoki Hiroko
Published: December 2023

Background

The frass of several herbivorous insect species has been utilised as natural medicines in Asia; however, the metabolite makeup and pharmaceutical activities of insect frass have yet to be investigated. Oligophagous Papilionidae insects utilise specific kinds of plants, and it has been suggested that the biochemicals from the plants may be metabolised by cytochrome P450 (CYP) in Papilionidae insects. In this study, we extracted the components of the frass of Papilio machaon larvae reared on Angelica keiskei, Oenanthe javanica or Foeniculum vulgare and examined the biological activity of each component. Then, we explored the expression of CYP genes in the midgut of P. machaon larvae and predicted the characteristics of their metabolic system.

Results

The components that were extracted using hexane, chloroform or methanol were biochemically different between larval frass and the host plants on which the larvae had fed. Furthermore, a fraction obtained from the chloroform extract from frass of A. keiskei-fed larvae specifically inhibited the cell proliferation of the human colon cancer cell line HCT116, whereas fractions obtained from the chloroform extracts of O. javanica- or F. vulgare-fed larval frass did not affect HCT116 cell viability. The metabolites from the chloroform extract from frass of A. keiskei-fed larvae prevented cell proliferation and induced apoptosis in HCT116 cells. Next, we explored the metabolic enzyme candidates in A. keiskei-fed larvae by RNA-seq analysis. We found that the A. keiskei-fed larval midgut might have different characteristics from the O. javanica- or F. vulgare-fed larval metabolic systems, and we found that the CYP6B2 transcript was highly expressed in the A. keiskei-fed larval midgut.

Conclusions

These findings indicate that P. machaon metabolites might be useful as pharmaceutical agents against human colon cancer subtypes. Importantly, our findings show that it might be possible to use insect metabolic enzymes for the chemical structural conversion of plant-derived compounds with complex structures.
Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology
Authors: Kemper-Koebrugge Wendy , Adriaansen Marian , Laurant Miranda , Wensing Michel
Published: December 2023

Background

Studies on care networks of home-dwelling older adults often focus on network composition. However, looking at network mechanisms (negotiation, navigation and contagion) can be helpful to improve the support generated by the care network. A European study on diabetes patients identified network types based on interaction, which can be beneficial (generative, proxy) or detrimental (struggling, avoidant) to support. This study explored whether these network types are present in care networks of home-dwelling older adults in the Netherlands, and how these types manifest in composition or mechanisms.

Methods

The present study is a cross‐sectional qualitative study of care networks supporting 19 home‐dwelling older adults. Face-to-face interviews were conducted with the older adult and their informal and formal caregivers between March and September 2016. Network composition and mechanisms were abstracted from content analysis of interview transcripts, then network type was determined for each network.

Results

Three of the 19 networks had only one respondent and were excluded, yielding 16 for analysis: eight proxy networks, three generative networks, two avoidant networks, one struggling network, and two possibly hybrid networks. In the proxy networks, all negotiation and navigation were centralised by the proxy. In generative networks, negotiation was possible if the older adult could reciprocate, and the network supported this. In avoidant networks, informal and formal caregivers had to deal with an older adult who refused support. In the struggling network, the underlying problem could not be addressed. Furthermore, two networks could either be hybrid network types or networks in a transition process from generative to proxy network.

Conclusion

Our results suggest that the network typology developed in the context of diabetes patients is relevant and mostly replicable in networks of multi-morbid older adults. We found that a care network typology based on mechanisms offered additional information beyond network composition. It also appears that the network type can change over time, but more research is needed to confirm this. This study suggests that interventions in avoidant or struggling networks are difficult. Also, actions of network participants seemed aimed at developing proxy networks. Interventions designed to develop or maintain generative networks seem underused.
Impact of the COVID-19 pandemic on services for patients with chronic kidney disease: findings of a national survey of UK kidney centres
Authors: Mackintosh Lucy , Busby Amanda , Farrington Ken , Hawkins Janine , Afuwape Sarah , Bristow Paul , Silva-Gane Maria Da , Hall Natalie , Harris Tess , Hudson Joanna , Norton Sam , Ormandy Paula , Pearce Christina J. , Santhakumaran Shalini , Sharma Shivani , Sridharan Sivakumar , Steenkamp Retha , Slevin Julie , Wellsted David , Chilcot Joseph
Published: December 2023

Background

Services for patients with kidney disease underwent radical adaptations in response to the COVID-19 pandemic. We undertook an online national survey of UK kidney centres to understand the nature, range, and degree of variation in these changes and to explore factors contributing to differing practice.

Methods

The survey was designed by a multidisciplinary team of kidney professionals, service users and researchers. It enquired about centre services and staffing, including psychosocial provision, and changes to these in response to the COVID-19 pandemic. Links to the survey were sent to all 68 UK kidney centres and remained active from December 2021 to April 2022, and a revised version to nurses in late 2022 for additional data. Quantitative data were analysed descriptively. Content analysis on free-text responses identified common themes.

Results

Analysable responses were received from 41 out of the 68 UK centres (60%), with partial data from an additional 7 (11%). Adaptations were system-wide and affected all aspects of service provision. Some changes were almost universal such as virtual consultations for outpatient appointments, with significant variation in others. Outpatient activity varied from fully maintained to suspended. Many centres reduced peritoneal dialysis access provision but in some this was increased. Centres considered that changes to transplant surgical services and for patients with advanced CKD approaching end-stage kidney disease had the greatest impact on patients. Few centres implemented adjustments aimed at vulnerable and underrepresented groups, including the frail elderly, people with language and communication needs, and those with mental health needs. Communication issues were attributed to rapid evolution of the pandemic, changing planning guidance and lack of resources. Staffing shortages, involving all staff groups particularly nurses, mainly due to COVID-19 infection and redeployment, were compounded by deficiencies in staffing establishments and high vacancy levels. Centres cited three main lessons influencing future service delivery, the need for service redesign, improvements in communication, and better support for staff.

Conclusion

Kidney centre responses to the pandemic involved adaptations across the whole service. Though some changes were almost universal, there was wide variation in other areas. Exploring the role of centre characteristics may help planning for potential future severe service disruptions.
Proteome-wide analysis reveals potential therapeutic targets for Colorectal cancer: a two-sample mendelian randomization study
Authors: Cai Yi-Xin , Wu Yi-Qing , Liu Jie , Pan Huanle , Deng Wenhai , Sun Weijian , Xie Congying , Huang Xiu-Feng
Published: December 2023

Background

Colorectal cancer (CRC) is a leading cause of cancer-related mortality, highlighting an unmet clinical need for more effective therapies. This study aims to evaluate the causal relationship between 4,489 plasma proteins and CRC to identify potential therapeutic targets for CRC.

Methods

We conducted two-sample Mendelian randomization (MR) analysis to examine the causal effects of plasma proteins on CRC. Mediation analysis was performed to assess the indirect effects of plasma proteins on CRC through associated risk factors. In addition, we conducted a phenome-wide association study using the UK Biobank dataset to examine associations between these plasma proteins and other phenotypes.

Results

Out of 4,489 plasma proteins, MR analysis revealed causal associations with CRC for 23 proteins, including VIMP, MICB, TNFRSF11B, C5orf38 and SLC5A8. Our findings also confirm the associations between reported risk factors and CRC. Mediation analysis identified mediating effects of proteins on CRC outcomes through risk factors. Furthermore, MR analysis identified 154 plasma proteins are causally linked to at least one CRC risk factor.

Conclusions

Our study evaluated the causal relationships between plasma proteins and CRC, providing a more complete understanding of potential therapeutic targets for CRC.
Early versus delayed mobilization for arthroscopic rotator cuff repair (small to large sized tear): a meta-analysis of randomized controlled trials
Authors: Hu Ching-Wei , Tsai Sung Huang Laurent , Chen Chien-Hao , Tang Hao-Che , Su Chun-Yi , Tischler Eric H. , Yang Yi-Chiang , Chan Yi-Sheng , Chiu Chih-Hao , Chen Alvin Chao Yu
Published: December 2023

Background

The timing to start passive or active range of motion (ROM) after arthroscopic rotator cuff repair remains unclear. This systematic review and meta-analysis evaluated early versus delayed passive and active ROM protocols following arthroscopic rotator cuff repair. The aim of this study is to systematically review the literature on the outcomes of early active/passive versus delayed active/passive postoperative arthroscopic rotator cuff repair rehabilitation protocols.

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) published up to April 2022 comparing early motion (EM) versus delayed motion (DM) rehabilitation protocols after arthroscopic rotator cuff repair for partial and full-thickness tear was conducted. The primary outcome was range of motion (anterior flexion, external rotation, internal rotation, abduction) and the secondary outcomes were Constant-Murley score (CMS), Simple Shoulder Test Score (SST score) and Visual Analogue Scale (VAS).

Results

Thirteen RCTs with 1,082 patients were included in this study (7 RCTs for early passive motion (EPM) vs. delayed passive motion (DPM) and 7 RCTs for early active motion (EAM) vs. delayed active motion (DAM). Anterior flexion (1.40, 95% confidence interval (CI), 0.55–2.25) and abduction (2.73, 95%CI, 0.74–4.71) were higher in the EPM group compared to DPM. Similarly, EAM showed superiority in anterior flexion (1.57, 95%CI, 0.62–2.52) and external rotation (1.59, 95%CI, 0.36–2.82), compared to DAM. There was no difference between EPM and DPM for external rotation, retear rate, CMS and SST scores. There was no difference between EAM and DAM for retear rate, abduction, CMS and VAS.

Conclusion

EAM and EPM were both associated with superior ROM compared to the DAM and DPM protocols. EAM and EPM were both safe and beneficial to improve ROM after arthroscopic surgery for the patients with small to large sized tears.
Development of a prognostic model to predict BLCA based on anoikis-related gene signature: preliminary findings
Authors: Zhu Shusheng , Zhao Qingsong , Fan Yanpeng , Tang Chao
Published: December 2023

Background

The prevalence of bladder urothelial carcinoma (BLCA) is significant on a global scale. Anoikis is a type of procedural cell death that has an important role in tumor invasion and metastasis. The advent of single-cell RNA sequencing (scRNA-seq) approaches has revolutionized the genomics field by providing unprecedented opportunities for elucidating cellular heterogeneity. Understanding the mechanisms associated with anoikis in BLCA is essential to improve its survival rate.

Methods

Data on BLCA and clinical information were acquired from the databases of The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). ARGs were obtained from Genecards and Harmonizome databases. According to univariate Cox regression analysis, the least absolute shrinkage and selection operator (LASSO) algorithm was utilized to select the ARGs associated with the overall rate (OS). A multivariate Cox regression analysis was carried out to identify eight prognostic ARGs, leading to the establishment of a risk model. The OS rate of BLCA patients was evaluated using Kaplan–Meier survival analysis. To explore the molecular mechanism in low- and high-risk groups, we employed Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSVA). Immune infiltration landscape estimation was performed using ESTIMATE, CIBERSOT, and single sample gene set enrichment analysis (ssGSEA) algorithms. Patients were categorized into different subgroups through consensus clustering analysis.

We employed biological functional enrichment analysis and conducted immune infiltration analysis to examine the disparities in potential biological functions, infiltration of immune cells, immune activities, and responses to immunotherapy.

Results

We identified 647 ARGs and 37 survival-related genes. We further developed a risk scoring model to quantitatively assess the predictive capacity of ARGs. The high-risk score group exhibited an unfavorable prognosis, whereas the low-risk score group demonstrated a converse effect. We also found that the two groups of patients might respond differently to immune targets and anti-tumor drugs.

Conclusion

The nomogram with 8 ARGs may help guide treatment of BLCA. The systematic assessment of risk scores can help to design more individualized and precise treatment strategies for BLCA patients.
Knowledge, awareness, and perception of digital dentistry among Egyptian dentists: a cross-sectional study
Authors: Hall Mohamed Ashraf , Karawia Inas , Mahmoud Ahmed Zakaria , Mohamed Osama Safwat
Published: December 2023

Background

Digital dentistry has revolutionized the way dental treatment is offered to patients. It became essential for dental practitioners to be well-informed about this technology to improve the quality of care offered and increase patient satisfaction. This study aimed to assess the level of knowledge, awareness, and perception of Egyptian dentists toward digital dentistry.

Methods

An online-based cross-sectional study was conducted using social media platforms from November 2022 to March 2023. Our study sample included dentists with different levels of experience, specialties, and working in different health sectors in Egypt. A questionnaire arranged in 4 sections and 23 questions was used as the study data collection tool. The data were tabulated and analyzed using SPSS software.

Results

A total of 402 participants filled out this questionnaire. 50.7% of which were females, 42.8% were between 20–29 years old and 42.3% were general practitioners. Furthermore, the main practice of 27.6% was in governmental dental clinics. Moreover, 47.3% and 64.2% of participants had Moderate knowledge and awareness respectively. While 75.9% of them had a high perception of practicing digital dentistry. Females and practitioners in governmental clinics had significantly lower awareness scores, while faculty teaching staff had significantly higher scores (P ≤ 0.05). On the other hand, practicing in the Great Cairo region and urban areas was associated with significantly higher knowledge scores (P ≤ 0.05). Similarly, Prosthodontists, periodontists, and restorative dentists had significantly higher scores when compared with general dentists (P ≤ 0.05).

Conclusions

About half of the study participants had Moderate knowledge and awareness levels, while about three-quarters of them had a high level of perception toward practicing digital dentistry. Therefore, more attention should be given to providing dental education programs in this important field at both the undergraduate and postgraduate levels by policymakers.
Problematic Internet use and attitudes towards persons with disabilities – cross-sectional research among Polish students
Authors: Kożybska Marta , Radlińska Iwona , Prajzner Arkadiusz , Krzywoszański Łukasz , Karakiewicz Beata
Published: December 2023

Background

Problematic Internet use (PIU) can have detrimental effects on physical, emotional, psychological, and social functioning. Besides well-described PIU correlations in psychological domains such as personality traits, or life satisfaction, and self-assessment, the social aspect of PIU risk also appeared to be important. This study aimed to investigate the association between PIU and attitudes towards persons with disabilities.

Methods

A total of 595 Polish students aged 18–29 participated in this research by completing the Internet Addiction Test, Multidimensional Attitudes Scale Towards Persons With Disabilities, and personal information form.

Results

The findings revealed that 30.6% of the respondents were at high risk for PIU. Moreover, heightened levels of PIU were more prevalent among male participants and students in technical fields of study than in those in medical and social fields of study. Increased PIU was also associated with more negative attitudes towards persons with disabilities in general and in the domains of emotions and behaviours. Additionally, prior personal contact with individuals with disabilities was related to both PIU rates and attitudes towards persons with disabilities in the domain of emotions and beliefs.

Conclusions

This study highlights the prevalence of PIU among Polish students and emphasizes the need for preventive measures, particularly targeting male students and those in technical fields of study. The results indicate a relationship between PIU and attitudes towards individuals with disabilities. Further research is required to determine the direction of the relationship. It is recommended that educational programs provide opportunities for interaction with individuals with disabilities to promote understanding and acceptance.
Entrepreneurship in care for elderly people with dementias: situated responses to NPM-based healthcare reforms in the Netherlands
Authors: van der Steen Martijn Pieter
Published: December 2023

Background

Despite the great confidence of Western governments in the principles of New Public Management (NPM) and its ability to stimulate “healthcare entrepreneurship”, it is unclear how policies seeking to reform healthcare services provoke such entrepreneurship in individual institutions providing long-term healthcare. This study examines such situated responses in a Dutch nursing home for elderly people suffering from dementias such as Alzheimer’s disease.

Methods

A four-year inductive longitudinal single-case study has been conducted. During this time period, the Dutch government imposed various NPM-based healthcare reforms and this study examines how local responses unfolded in the nursing home. Through interviews conducted with managers, administrators and supporting staff, as well as the examination of a large volume of government instructions and internal documents, the paper documents how these reforms resulted in several types of entrepreneurship, which were not all conducive to the healthcare innovations the government aspired to have.

Results

The study records three subsequent strategies deployed at the local level: elimination of healthcare services; non-healthcare related collaboration with neighboring institutions; and specialization in specific healthcare niches. These strategies were brought about by specific types of entrepreneurship – two of which were oriented towards the administrative organization rather than healthcare innovations. The study discusses the implications of having multiple variations of entrepreneurship at the local level.

Conclusion

Governmental policies for healthcare reforms may be more effective, if policymakers change output-based funding systems in recognition of the limited control by providers of long-term healthcare over the progression of clients' mental disease and ultimate passing.
Characterization and inhibition of inflammasome responses in severe and non-severe asthma
Authors: Horvat Jay C. , Kim Richard Y. , Weaver Natasha , Augood Christopher , Brown Alexandra C. , Donovan Chantal , Dupre Pierrick , Gunawardhana Lakshitha , Mayall Jemma R. , Hansbro Nicole G. , Robertson Avril A. B. , O’Neill Luke A. J. , Cooper Matthew A. , Holliday Elizabeth G. , Hansbro Philip M. , Gibson Peter G.
Published: December 2023

Background

Increased airway NLRP3 inflammasome-mediated IL-1β responses may underpin severe neutrophilic asthma. However, whether increased inflammasome activation is unique to severe asthma, is a common feature of immune cells in all inflammatory types of severe asthma, and whether inflammasome activation can be therapeutically targeted in patients, remains unknown.

Objective

To investigate the activation and inhibition of inflammasome-mediated IL-1β responses in immune cells from patients with asthma.

Methods

Peripheral blood mononuclear cells (PBMCs) were isolated from patients with non-severe (n = 59) and severe (n = 36 stable, n = 17 exacerbating) asthma and healthy subjects (n = 39). PBMCs were stimulated with nigericin or lipopolysaccharide (LPS) alone, or in combination (LPS + nigericin), with or without the NLRP3 inhibitor MCC950, and the effects on IL-1β release were assessed.

Results

PBMCs from patients with non-severe or severe asthma produced more IL-1β in response to nigericin than those from healthy subjects. PBMCs from patients with severe asthma released more IL-1β in response to LPS + nigericin than those from non-severe asthma. Inflammasome-induced IL-1β release from PBMCs from patients with severe asthma was not increased during exacerbation compared to when stable. Inflammasome-induced IL-1β release was not different between male and female, or obese and non-obese patients and correlated with eosinophil and neutrophil numbers in the airways. MCC950 effectively suppressed LPS-, nigericin-, and LPS + nigericin-induced IL-1β release from PBMCs from all groups.

Conclusion

An increased ability for inflammasome priming and/or activation is a common feature of systemic immune cells in both severe and non-severe asthma, highlighting inflammasome inhibition as a universal therapy for different subtypes of disease.
Air pollution after acute bronchiolitis is a risk factor for preschool asthma: a nested case-control study
Authors: Chung Hao-Wei , Hsieh Hui-Min , Lee Chung-Hsiang , Lin Yi-Ching , Tsao Yu-Hsiang , Feng Ming-Chu , Hung Chih-Hsing
Published: December 2023

Background

Acute bronchiolitis and air pollution are both risk factor of pediatric asthma. This study aimed to assess subsequent exposure to air pollutants related to the inception of preschool asthma in infants with acute bronchiolitis. This study aimed to assess subsequent exposure to air pollutants related to the inception of preschool asthma in infants with acute bronchiolitis.

Methods

A nested case-control retrospective study was performed at the Kaohsiung Medical University Hospital systems between 2009 and 2019. The average concentration of PM10, PM2.5, SO2, NO, NO2, and NOX was collected for three, six, and twelve months after the first infected episode. Adjusted regression models were employed to evaluate the association between asthma and air pollution exposure after bronchiolitis.

Results

Two thousand six hundred thirty-seven children with acute bronchiolitis were included. Exposure to PM10, PM2.5, SO2, NO, NO2, and NOX in the three, six, and twelve months following an episode of bronchiolitis was found to significantly increase the risk of preschool asthma in infants with a history of bronchiolitis.(OR, 95%CI: PM10 = 1.517-1.559, 1.354–1.744; PM2.5 = 2.510-2.603, 2.148–3.061; SO2 = 1.970-2.040, 1.724–2.342; ; NO = 1.915-1.950, 1.647–2.272; NO2 = 1.915-1.950, 1.647–2.272; NOX = 1.752-1.970, 1.508–2.252) In a sensitive analysis of hospitalized infants, only PM10, PM2.5, SO2, and NO were found to have significant effects during all time periods. (OR, 95%CI: PM10 = 1.613-1.650, 1.240–2.140; PM2.5 = 2.208-2.286, 1.568–3.061; SO2 = 1.679-1.622, 1.197–2.292; NO = 1.525-1.557, 1.094–2.181)

Conclusion

The presence of ambient PM10, PM2.5, SO2 and NO in the three, six, and twelve months following an episode of acute bronchiolitis has been linked to the development of preschool asthma in infants with a history of acute bronchiolitis.
Targeted changes in blood lipids improves fibrosis in renal allografts
Authors: Zhang Yang-He , Liu Bin , Meng Qingfei , Zhang Dan , Yang Hongxia , Li Guangtao , Wang Yuxiong , Zhou Honglan , Xu Zhi-Xiang , Wang Yishu
Published: December 2023

Background

Chronic interstitial fibrosis is the primary barrier against the long-term survival of transplanted kidneys. Extending the lifespan of allografts is vital for ensuring the long-term health of patients undergoing kidney transplants. However, few targets and their clinical applications have been identified. Moreover, whether dyslipidemia facilitates fibrosis in renal allograft remains unclear.

Methods

Blood samples were collected from patients who underwent kidney transplantation. Correlation analyses were conducted between the Banff score and body mass index, and serum levels of triacylglycerol, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. A rat model of renal transplantation was treated with the lipid-lowering drug, fenofibrate, and kidney fibrosis levels were determined by histochemical staining. Targeted metabolomic detection was conducted in blood samples from patients who underwent kidney transplantation and were divided into fibrotic and non-fibrotic groups. Rats undergoing renal transplantation were fed either an n-3 or n-6 polyunsaturated fatty acid (PUFA)-enriched diet. Immunohistochemical and Masson’s trichrome staining were used to determine the degree of fibrosis.

Results

Hyperlipidemia was associated with fibrosis development. Treatment with fenofibrate contributed to improve fibrosis in a rat model of renal transplantation. Moreover, n-3 PUFAs from fibrotic group showed significant downregulation compared to patients without fibrotic renal allografts, and n-3 PUFAs-enriched diet contributed to delayed fibrosis in a rat model of renal transplantation.

Conclusions

This study suggests that hyperlipidemia facilitates fibrosis of renal allografts. Importantly, a new therapeutic approach was provided that may delay chronic interstitial fibrosis in transplanted kidneys by augmenting the n-3 PUFA content in the diet.
A systematic review of the scientific evidence of venous supercharging in autologous breast reconstruction with abdominally based flaps
Authors: Hansson Emma , Ramakrishnan Venkat , Morgan Mary
Published: December 2023

Background

Abdominally based free flaps are commonly used in breast reconstruction. A frequent complication is venous congestion, which might contribute to around 40% of flap failures. One way to deal with it is venous supercharging. The primary aim of this study was to investigate the scientific evidence for the effects of venous supercharging.

Methods

A systematic literature search was conducted in PubMed, CINAHL, Embase, and Cochrane library. The included articles were critically appraised, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Results

Thirty-six studies were included. Most studies had serious study limitations and problems with directness. Three studies report ‘routine’ use of venous supercharging and performed it prophylactically in patients who did not have clinical signs of venous congestion. Seventeen studies report on flap complications, of which one is a randomised controlled trial demonstrating statistically significant lower complication rates in the intervention group. The overall certainty of evidence for the effect of a venous supercharging on flap complications, length of hospital stay and operative time, in patients without clinical signs of venous congestion, is very low (GRADE ⊕ ⊕ ⊝ ⊝), and low on and surgical takebacks (GRADE ⊕ ⊕ ⊝ ⊝). Twenty-one studies presented data on strategies and overall certainty of evidence for using radiological findings, preoperative measurements, and clinical risk factors to make decisions on venous supercharging is very low (GRADE ⊕ ⊝ ⊝ ⊝).

Conclusion

There is little scientific evidence for how to predict in which cases, without clinical signs of venous congestion, venous supercharging should be performed. The complication rate might be lower in patients in which a prophylactic venous anastomosis has been performed.

Trial registration

PROSPERO (CRD42022353591).