bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of stellar contamination on low-resolution transmission spectroscopy: needs identified by NASA’s Exoplanet Exploration Program Study Analysis Group 21
Authors: Rackham Benjamin V , Espinoza Néstor , Berdyugina Svetlana V , Korhonen Heidi , MacDonald Ryan J , Montet Benjamin T , Morris Brett M , Oshagh Mahmoudreza , Shapiro Alexander I , Unruh Yvonne C , Quintana Elisa V , Zellem Robert T , Apai Dániel , Barclay Thomas , Barstow Joanna K , Bruno Giovanni , Carone Ludmila , Casewell Sarah L , Cegla Heather M , Criscuoli Serena , Fischer Catherine , Fournier Damien , Giampapa Mark S , Giles Helen , Iyer Aishwarya , Kopp Greg , Kostogryz Nadiia M , Krivova Natalie , Mallonn Matthias , McGruder Chima , Molaverdikhani Karan , Newton Elisabeth R , Panja Mayukh , Peacock Sarah , Reardon Kevin , Roettenbacher Rachael M , Scandariato Gaetano , Solanki Sami , Stassun Keivan G , Steiner Oskar , Stevenson Kevin B , Tregloan-Reed Jeremy , Valio Adriana , Wedemeyer Sven , Welbanks Luis , Yu Jie , Alam Munazza K , Davenport James R A , Deming Drake , Dong Chuanfei , Ducrot Elsa , Fisher Chloe , Gilbert Emily , Kostov Veselin , López-Morales Mercedes , Line Mike , Močnik Teo , Mullally Susan , Paudel Rishi R , Ribas Ignasi , Valenti Jeff A
Published: March 2023

Study Analysis Group 21 (SAG21) of NASA’s Exoplanet Exploration Program Analysis Group was organized to study the effect of stellar contamination on space-based transmission spectroscopy, a method for studying exoplanetary atmospheres by measuring the wavelength-dependent radius of a planet as it transits its star. Transmission spectroscopy relies on a precise understanding of the spectrum of the star being occulted. However, stars are not homogeneous, constant light sources but have temporally evolving photospheres and chromospheres with inhomogeneities like spots, faculae, plages, granules, and flares. This SAG brought together an interdisciplinary team of more than 100 scientists, with observers and theorists from the heliophysics, stellar astrophysics, planetary science, and exoplanetary atmosphere research communities, to study the current research needs that can be addressed in this context to make the most of transit studies from current NASA facilities like Hubble Space Telescope and JWST. The analysis produced 14 findings, which fall into three science themes encompassing (i) how the Sun is used as our best laboratory to calibrate our understanding of stellar heterogeneities (‘The Sun as the Stellar Benchmark’), (ii) how stars other than the Sun extend our knowledge of heterogeneities (‘Surface Heterogeneities of Other Stars’), and (iii) how to incorporate information gathered for the Sun and other stars into transit studies (‘Mapping Stellar Knowledge to Transit Studies’). In this invited review, we largely reproduce the final report of SAG21 as a contribution to the peer-reviewed literature.
Perceived COVID-19 risk and testing experiences in the San Ysidro U.S./Mexico border region
Authors: Salgin Linda , Ayers Lawrence O , Burola Maria-Linda , Engler Anne-Marie , Osuna Alexis , Gay Luis , Cain Kelli , Stadnick Nicole , Rabin Borsika , Zaslavsky Ilya , Laurent Louise C , Tukey Robert , Seifert Marva
Published: March 2023

Racial and ethnic disparities in COVID-19 incidence are pronounced in underserved U.S./Mexico border communities. Working and living environments in these communities can lead to increased risk of COVID-19 infection and transmission, and this increased risk is exacerbated by lack of access to testing. As part of designing a community and culturally tailored COVID-19 testing program, we surveyed community members in the San Ysidro border region. The purpose of our study was to characterize knowledge, attitudes, and beliefs of prenatal patients, prenatal caregivers, and pediatric caregivers at a Federally Qualified Health Center (FHQC) in the San Ysidro region regarding perceived risk of COVID-19 infection and access to testing. A cross-sectional survey was used to collect information on experiences accessing COVID-19 testing and perceived risk of COVID-19 infection within San Ysidro between December 29, 2020 and April 2, 2021. A total of 179 surveys were analyzed. Most participants identified as female (85%) and as Mexican/Mexican American (75%). Over half (56%) were between the age of 25 and 34 years old. Perceived Risk: 37% reported moderate to high risk of COVID-19 infection, whereas 50% reported their risk low to none. Testing Experience: Approximately 68% reported previously being tested for COVID-19. Among those tested, 97% reported having very easy or easy access to testing. Reasons for not testing included limited appointment availability, cost, not feeling sick, and concern about risk of infection while at a testing facility. This study is an important first step to understand the COVID-19 risk perceptions and testing access among patients and community members living near the U.S./Mexico border in San Ysidro, California.
Grapevine Fanleaf Virus RNA1-Encoded Proteins 1A and 1BHel Suppress RNA Silencing
Authors: Choi Jiyeong , Pakbaz Samira , Yepes Luz Marcela , Cieniewicz Elizabeth Jeannette , Schmitt-Keichinger Corinne , Labarile Rossella , Minutillo Serena Anna , Heck Michelle , Hua Jian , Fuchs Marc
Published: March 2023

Grapevine fanleaf virus (GFLV) (genus Nepovirus, family Secoviridae) causes fanleaf degeneration, one of the most damaging viral diseases of grapevines. Despite substantial advances at deciphering GFLV-host interactions, how this virus overcomes the host antiviral pathways of RNA silencing is poorly understood. In this study, we identified viral suppressors of RNA silencing (VSRs) encoded by GFLV, using fluorescence assays, and tested their capacity at modifying host gene expression in transgenic Nicotiana benthamiana expressing the enhanced green fluorescent protein gene ( EGFP). Results revealed that GFLV RNA1-encoded protein 1A, for which a function had yet to be assigned, and protein 1BHel, a putative helicase, reverse systemic RNA silencing either individually or as a fused form (1ABHel) predicted as an intermediary product of RNA1 polyprotein proteolytic processing. The GFLV VSRs differentially altered the expression of plant host genes involved in RNA silencing, as shown by reverse transcription-quantitative PCR. In a co-infiltration assay with an EGFP hairpin construct, protein 1A upregulated NbDCL2, NbDCL4, and NbRDR6, and proteins 1BHel and 1A+1BHel upregulated NbDCL2, NbDCL4, NbAGO1, NbAGO2, and NbRDR6, while protein 1ABHel upregulated NbAGO1 and NbRDR6. In a reversal of systemic silencing assay, protein 1A upregulated NbDCL2 and NbAGO2 and protein 1ABHel upregulated NbDCL2, NbDCL4, and NbAGO1. This is the first report of VSRs encoded by a nepovirus RNA1 and of two VSRs that act either individually or as a predicted fused form to counteract the systemic antiviral host defense, suggesting that GFLV might devise a unique counterdefense strategy to interfere with various steps of the plant antiviral RNA silencing pathways during infection.

[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 .
Induction of Glandular Trichomes to Control Bemisia tabaci in Tomato Crops: Modulation by the Natural Enemy Nesidiocoris tenuis
Authors: Riahi Chaymaa , Urbaneja Alberto , Fernández-Muñoz Rafael , Fortes Isabel M. , Moriones Enrique , Pérez-Hedo Meritxell
Published: March 2023

Whitefly-transmitted viruses are one of the biggest threats to tomato ( Solanum lycopersicum) growing worldwide. Strategies based on the introgression of resistance traits from wild relatives are promoted to control tomato pests and diseases. Recently, a trichome-based resistance characterizing the wild species Solanum pimpinellifolium was introgressed into a cultivated tomato. An advanced backcross line (BC5S2) exhibiting the presence of acylsugar-associated type IV trichomes, which are lacking in cultivated tomatoes, was effective at controlling whiteflies (Hemiptera: Aleyrodidae) and limiting the spread of whitefly-transmitted viruses. However, at early growth stages, type IV trichome density and acylsugar production are limited; thus, protection against whiteflies and whitefly-transmitted viruses remains irrelevant. In this work, we demonstrate that young BC5S2 tomato plants feeding-punctured by the zoophytophagous predator Nesidiocoris tenuis (Hemiptera: Miridae) displayed an increase (above 50%) in type IV trichome density. Acylsugar production was consistently increased in N. tenuis-punctured BC5S2 plants, which was more likely associated with upregulated expression of the BCKD-E2 gene related to acylsugar biosynthesis. In addition, the infestation of BC5S2 plants with N. tenuis effectively induced the expression of defensive genes involved in the jasmonic acid signaling pathway, resulting in strong repellence to Bemisia tabaci and attractiveness to N. tenuis. Thus, through preplant release of N. tenuis in tomato nurseries carried out in some integrated pest management programs, type IV trichome-expressing plants can be prepared to control whiteflies and whitefly-transmitted viruses at early growth stages. This study emphasizes the advantage of reinforcing constitutive resistance using defense inducers to guarantee robust protection against pests and transmitted viruses.
Bone marrow‐derived fibroblast migration via periostin causes irreversible arthrogenic contracture after joint immobilization
Authors: Iura Hirotaka , Kobayakawa Kazu , Saiwai Hirokazu , Konno Daijiro , Tanaka Masatake , Hata Kazuhiro , Tamaru Tetsuya , Haruta Yohei , Ono Gentaro , Kitade Kazuki , Kijima Ken , Kubota Kensuke , Inagaki Yutaka , Ohtsuka Masato , Okazaki Ken , Murakami Koji , Matsuda Shusaku , Tokunaga Masami , Yoshimoto Takaaki , Maeda Takeshi , Nakashima Yasuharu , Okada Seiji
Published: March 2023

Joint contracture causes distressing permanent mobility disorder due to trauma, arthritis, and aging, with no effective treatment available. A principal and irreversible cause of joint contracture has been regarded as the development of joint capsule fibrosis. However, the molecular mechanisms underlying contracture remain unclear. We established a mouse model of knee joint contracture, revealing that fibrosis in joint capsules causes irreversible contracture. RNA‐sequencing of contracture capsules demonstrated a marked enrichment of the genes involved in the extracellular region, particularly periostin (Postn). Three‐dimensional magnetic resonance imaging and immunohistological analysis of contracture patients revealed posterior joint capsule thickening with abundant type I collagen (Col1a2) and POSTN in humans. Col1a2‐GFPTG; Postn−/− mice and chimeric mice with Col1a2‐GFPTG; tdTomatoTG bone marrow showed fibrosis in joint capsules caused by bone marrow‐derived fibroblasts, and POSTN promoted the migration of bone marrow‐derived fibroblasts, contributing to fibrosis and contracture. Conversely, POSTN‐neutralizing antibody attenuated contracture exacerbation. Our findings identified POSTN as a key inducer of fibroblast migration that exacerbates capsule fibrosis, providing a potential therapeutic strategy for joint contracture.
The Postpartum Period: An Opportunity for Alcohol Screening and Counseling to Reduce Adverse Health Impacts
Authors: Board Amy , D’Angelo Denise V. , von Essen Beatriz Salvesen , Denny Clark H. , Miele Kathryn , Dunkley Janae , Park Youngjoo , Kim Shin Y.
Published: March 2023

Objectives

The postpartum period presents an opportunity to engage in discussions about alcohol consumption and related health harms. This study examined the prevalence of alcohol consumption among a sample of postpartum persons with a recent live birth and screening and brief intervention (alcohol SBI) or counseling by their providers.

Methods

We analyzed 2019 data from a telephone survey conducted 9 to 10 months postpartum among individuals who responded to the standard Pregnancy Risk Assessment Monitoring System survey in 6 states. Weighted prevalence estimates were calculated for alcohol consumption and alcohol SBI after birth through up to 10 months postpartum.

Results

Among 1790 respondents, 53.1% reported consuming alcohol postpartum. Among those who drank postpartum, 70.8% reported being asked about alcohol use by a healthcare provider. Slightly more than half of respondents who drank postpartum and were trying to get pregnant (52.4%) or were not using birth control at the time of the survey (59.8%) reported being asked about alcohol use. Approximately 25% of respondents who drank alcohol postpartum were advised about risky alcohol levels by a healthcare provider. Small proportions of individuals who drank alcohol postpartum and were pregnant or trying to get pregnant at the time of the survey were advised to reduce or stop drinking alcohol (10.6% and 2.3%, respectively).

Conclusions

These findings suggest missed opportunities to promote health and prevent adverse alcohol-related health outcomes during the postpartum period through evidence-based tools such as alcohol SBI.
To Feel Abandoned in an Insecure Situation
Authors: Lindgren Emilia Biskop , Thernström Blomqvist Ylva , Diderholm Barbro , Grandahl Maria
Published: March 2023

Background:

The COVID-19 pandemic resulted in changes in neonatal care, sometimes resulting in a separation between parents and their newborn. Knowledge about parents' experiences of this separation is limited.

Purpose:

To explore parents' experiences of separation from their newborn due to COVID-19.

Methods:

Interviews with parents (n = 11) separated from their newborn.

Results:

The parents' experiences of being separated from their newborn were expressed under 3 themes: “To create a sense of safety in an insecure situation”; “Unexpected start to parenthood”; and “To be reunited.” Parents felt abandoned and alone, even if they had support from significant others. Although they considered the separation as undesired, wanting to be with their newborn infant, it was secondary to not wanting to infect the infant with COVID-19. Furthermore, lacking information about a potentially lethal virus adds to the uncertainty that comes with having a newborn. The separation affected the whole family, some for a long time afterward.

Implications for Practice and Research:

If a new situation with potentially life-threatening effects, like the COVID-19 pandemic, occurs again, considering the experiences of these parents is paramount. Precautions should be taken to minimize the potential harm. If a separation between newborns and parents is inevitable, parents need preparation and transparent information prior to the separation and before the reunion. Well-thought-out policies must be in place to minimize the impact of a separation on both parties. Parents should be able to have a deputy parent present during an undesired but necessary separation from their newborn.
The Significance of Isolated Hip Click as a Sign of DDH: Implications on Referral Guidelines
Authors: Morris William Z. , Mayfield Laura M. , Ellis Henry B. , Gill Corey S. , Sucato Daniel J. , Podeszwa David A. , Jo Chan-Hee , Kim Harry K.W.
Published: March 2023

Background:

The clinical significance of an isolated hip click remains unclear. The rates of developmental dysplasia of the hip (DDH) in those referred for hip click vary from 0% to 28%. The purpose of this study was to evaluate the rate of DDH in patients prospectively referred for isolated hip click.

Methods:

We prospectively enrolled patients referred to a single pediatric orthopaedic center with concern for DDH secondary to isolated hip click felt by the pediatrician on examination. Patients with known sonographic abnormalities or risk factors for DDH (breech presentation or positive family history) were excluded. Ultrasounds were obtained upon initial presentation and defined as abnormal if alpha angle <60 degrees and/or femoral head coverage (FHC) <50%. Mild dysplasia, analogous to Graf IIa physiological immaturity, was defined as alpha angle 50<α<60 and/or <50% FHC in a patient <3 months age. Severe dysplasia was defined as ≤33% FHC, which has been proposed to be sonographically consistent with a hip dislocation.

Results:

Two hundred fifty-five children were referred for isolated hip click. One hundred eighty-nine patients (74%) had normal ultrasound whereas 66 patients (26%) had sonographic abnormalities (mean age 6.5±6.2 wk at initial ultrasound). Fifty patients (19.6%) demonstrated physiological immaturity, 3 patients (1.2%) demonstrated moderate sonographic dysplasia, and 13 patients (5.1%) had sonographic findings consistent with severe dysplasia or dislocated hip. Hips with severe dysplasia were younger than the remaining population (2.8±2.4 wk vs. 6.6±6.2 wk, P<0.001) with no difference in sex distribution (P=0.07) or first-born birth order (P=0.36). For those with sonographic abnormality, 18 (27%) patients were treated with Pavlik harness, 1 (2%) was treated with abduction orthosis, and the remainder (71%) were observed for resolution of physiological immaturity.

Conclusions:

Infants with isolated hip click identified by their pediatrician may have higher rates of dysplasia than previously reported. We recommend screening ultrasound and/or orthopaedic referral for all infants with isolated hip click.

Level of Evidence:

Level II—prospective prognostic study.
Role of Transcranial Motor Evoked Potential Monitoring During Traumatic Spinal Injury Surgery: A Prospective Multicenter Study of the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research
Authors: Ushirozako Hiroki , Yoshida Go , Imagama Shiro , Machino Masaaki , Ando Muneharu , Kawabata Shigenori , Yamada Kei , Kanchiku Tsukasa , Fujiwara Yasushi , Taniguchi Shinichirou , Iwasaki Hiroshi , Shigematsu Hideki , Tadokoro Nobuaki , Takahashi Masahito , Wada Kanichiro , Yamamoto Naoya , Funaba Masahiro , Yasuda Akimasa , Hashimoto Jun , Morito Shinji , Takatani Tsunenori , Kobayashi Kazuyoshi , Nakanishi Kazuyoshi , Kurosu Kenta , Matsuyama Yukihiro
Published: March 2023

Study Design.

Prospective multicenter observational cohort study

Objective.

This study aimed to investigate the role of transcranial motor evoked potential (TcMEP) monitoring during traumatic spinal injury surgery, the timing of TcMEP alerts, and intervention strategies to avoid intraoperative neurological complications.

Summary of Background Data.

Intraoperative neuromonitoring, including TcMEP monitoring, is commonly used in high-risk spinal surgery to predict intraoperative spinal cord injury; however, little information is available on its use in traumatic spinal injury surgery.

Methods.

The TcMEP monitoring data of 350 consecutive patients who underwent traumatic spinal injury surgery (mean age, 69.3 y) between 2017 and 2021 were prospectively reviewed. In this study, a TcMEP amplitude reduction ≥70% was established as a TcMEP alert. A rescue case was defined as a case with recovery of TcMEP amplitudes after certain procedures and without postoperative neurological complications.

Results.

Among the 350 patients who underwent traumatic spinal injury surgery (TcMEP derivation rate 94%), TcMEP monitoring revealed seven true-positive (TP) (2.0%), three rescue (0.9%; rescue rate 30%), 31 false-positive, one false-negative, and 287 true-negative cases, resulting in 88% sensitivity, 90% specificity, 18% positive predictive value, and 99% negative predictive value. The TP rate in patients with preoperative motor deficits (MDs) was 2.9%, which was higher than that in patients without preoperative MDs (1.1%). The most common timing of TcMEP alerts was during decompression (40%). During decompression, suspension of surgery with intravenous steroid injection was ineffective (rescue rate, 0%) and additional decompression was effective.

Conclusion.

Given the low prevalence of neurological complications (2.3%) and the low positive predictive value (18.4%), single usage of TcMEP monitoring during traumatic spinal injury surgery is not recommended. Further efforts should be made to reduce FP alert rates through better interpretation of multimodal IONMs and the incorporation of anesthesiology in order to improve the positive predictive value.

Level of Evidence.

III
Salvage Surgery: An Effective Therapy in the Management of Ileoanal Pouch Prolapse
Authors: Otero-Piñeiro Ana , Maspero Marianna , Holubar Stefan D. , Lightner Amy L. , Steele Scott R. , Hull Tracy , Turnbull Rupert B.
Published: March 2023

BACKGROUND:

Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice for patients requiring surgery for inflammatory bowel disease and, less frequently, for other pathologies. Pouch prolapse is a rare complication that compromises pouch function and negatively affects patients’ quality of life.

OBJECTIVE:

Describe our experience from a single high-volume center in this infrequent condition.

DESIGN:

Restrospective cohort study of a prospectively maintained, IRB-approved database.

SETTINGS/PATIENTS:

All consecutive eligible patients with ileal pouch-anal anastomosis and pouch prolapse were identified from 1990-2021. Patients with full-thickness prolapse treated by pouch pexy were included.

INTERVENTIONS:

Pouch pexy (with/without mesh).

MAIN OUTCOME MEASURES:

Success rate of pouch pexy, defined as no recurrence of prolapse.

RESULTS:

A total of 4,791 patients underwent ileal pouch-anal anastomosis; seven (0.1%) were diagnosed with full-thickness prolapse. Additional 18 ileal pouch-anal anastomosis patients were referred from outside institutions. Among 25 included patients, 16 (64.0%) were female and the overall mean age was 35.6+/-13.4 years. The time interval from initial pouch formation to prolapse was 4.2 (IQR 1.1-8.5) years. Nine (36.0%) patients underwent previous treatment for prolapse (physical therapy n=4, pouch pexies n=2, mesh pouch pexy n = 2, mucosal resection n = 1). All patients presented with symptoms and physical examination compatible with full-thickness prolapse. Twenty (80.0%) patients underwent surgical pouch pexy without mesh and five (20.0%) had pouch pexy with mesh placement. A diverting ileostomy was performed in one (4.0%) patient prior to pouch pexy, and in eight (32.0%) patients at the time of surgical prolapse correction. After surgery, recurrent prolapse was noted in three patients (12.0%) at a median of 6.9 (IQR 5.2-8.3) months.

LIMITATIONS:

Retrospective study, small sample size thus prone to selection and referral biases which may limit the generalizability of our findings.

CONCLUSION:

Pouch prolapse can be effectively treated with salvage surgery. Surgical intervention is safe and provides acceptable outcomes.
Mohs Surgeons Dominate Cutaneous Reconstructions in Cosmetically and Functionally Sensitive Sites: Medicare Trends From 2013 to 2019
Authors: Tan Andrea , Castner Nicholas B. , Slutsky Jordan B.
Published: March 2023

BACKGROUND

Although dermatologists perform more cutaneous reconstructions than any other specialists for the Medicare population, the perception of dermatologists as surgeons may not be as fully recognized. Mohs surgeons are trained in complex reconstructions of cosmetically and functionally sensitive (CFS) sites, although the proportion they account for is unknown.

OBJECTIVE

To quantify the proportion of cutaneous reconstructions in CFS sites performed by Mohs surgeons compared with other specialists, and to identify trends from 2013 to 2019.

METHODS

A cross-sectional analysis was performed using the Medicare Public Use Files for 2013 to 2019. Data were stratified by physician specialty, with dermatologists further subdivided into Mohs surgeons and non-Mohs dermatologists.

RESULTS

Mohs surgeons performed 75.3% of all reconstructions in 2019, a significant increase from 2013 (p < .0001). Mohs surgeons dominated nearly every type of CFS cutaneous reconstruction, with significant increases in proportion (p < .0001) from 2013 to 2019 for every category except interpolation flaps. Complex repairs were the most commonly performed cutaneous reconstruction type.

CONCLUSION

Mohs surgeons perform far more cutaneous reconstructive surgeries in CFS sites than any other specialty for the Medicare population, with significant increases in their lead over the study period.
Costunolide Protects Myocardium From Ischemia Reperfusion Injury by Inhibiting Oxidative Stress Through Nrf2/Keap1 Pathway Activation
Authors: Li Weixin , Luo Yue , Huang Zhuqi , Shen Siyuan , Dai Chengyi , Shen Sirui , Qi Xiaoxiao , Liang Guang , Luo Wu
Published: March 2023

Costunolide (Cos) is a naturally occurring sesquiterpene lactone that exhibits antioxidative properties. In this study, we demonstrate the protective mechanism of Cos against ischemia/reperfusion (I/R)-induced myocardial injury. Cos significantly decreased levels of reactive oxygen species and ameliorated apoptosis of I/R cardiomyocytes both in vitro and in vivo. Further investigation revealed that Cos increased expression of the antioxidant proteins HO-1 and NQO-1 and decreased the Bax/Bcl-2 ratio, thus protecting cardiac cells. NF-E2–related factor 2 (Nrf2) silencing significantly attenuated the protective effects of Cos in tert-butyl hydroperoxide (TBHP)-treated H9C2 cells. Additionally, Cos significantly intensified the I/R- or TBHP-induced dissociation of the Kelch-like ECH-associated protein 1 (Keap1)/Nrf2 complex both in vitro and in vivo. These results suggest that activation of Nrf2/Keap1 using Cos may be a therapeutic strategy for myocardial I/R injury.
Evaluating posttransurethral resection of prostate hematuria severity using two methods: A cross-sectional study
Authors: Hsu Chen-Hung , Wu Shin-Hsin , Lin Cheng-Chia
Published: March 2023

Background

Following transurethral resection of the prostate, postprocedure macroscopic hematuria must be evaluated. We developed a five-color table hematuria grading scale with visualized color references for health care workers to evaluate postprocedure hematuria severity and compared it with assessments made using the text hematuria grading scale.

Methods

Thirty hematuria samples from patients who had undergone transurethral resection of the prostate were evaluated twice by 17 doctors and 13 nurses. The main outcome was the postprocedure macroscopic hematuria severity, measured using the means obtained from the two hematuria grading methods (Meantext and Meanfive-color). Furthermore, we investigated the association between demographic factors including occupation, training years, and whether a urologist was involved in hematuria evaluation.

Results

The Meantext for 30 patients was 2.2489 ± 1.96*0.76862, whereas the Meanfive-color was 2.4222 ± 1.96*0.91268. The paired t test revealed a significant difference between Meantext and Meanfive-color (P = 0.00), meaning that the severity observed by medical staff was significantly milder using the text compared with the five-color hematuria grading scale. The Wilcoxon signed rank test between the variances of the two hematuria grading scales showed a Z score of −1.127 and p value of 0.026 without significant difference.

Conclusions

Our findings reveal that hematuria grading is method-dependent. Hematuria severity in patients who had undergone transurethral resection of the prostate with macroscopic hematuria assessed using a hematuria grading scale without visualized color references may be underestimated in clinical practice. With visualized color references, consistent counts did not negatively correlate to fewer years of experience in the surgery department.
Hepatocellular carcinomas, exhibiting intratumor fibrosis, express cancer-specific extracellular matrix remodeling and WNT/TGFB signatures, associated with poor outcome
Authors: Desert Romain , Chen Wei , Ge Xiaodong , Viel Roselyne , Han Hui , Athavale Dipti , Das Sukanta , Song Zhuolun , Lantvit Daniel , Cano Luis , Naba Alexandra , Musso Orlando , Nieto Natalia
Published: March 2023

Background and Aims:

HCC, the third leading cause of cancer-related death, arises in the context of liver fibrosis. Although HCC is generally poorly fibrogenic, some tumors harbor focal intratumor extracellular matrix (ECM) deposits called “fibrous nests.” To date, the molecular composition and clinical relevance of these ECM deposits have not been fully defined.

Approach and Results:

We performed quantitative matrisome analysis by tandem mass tags mass spectrometry in 20 human cancer specific matrisome (HCCs) with high or low-grade intratumor fibrosis and matched nontumor tissues, as well as in 12 livers from mice treated with vehicle, carbon tetrachloride, or diethylnitrosamine. We found 94 ECM proteins differentially abundant between high and low-grade fibrous nests, including interstitial and basement membrane components, such as several collagens, glycoproteins, proteoglycans, enzymes involved in ECM stabilization and degradation, and growth factors. Pathway analysis revealed a metabolic switch in high-grade fibrosis, with enhanced glycolysis and decreased oxidative phosphorylation. Integrating the quantitative proteomics with transcriptomics from HCCs and nontumor livers (n = 2,285 samples), we identified a subgroup of fibrous nest HCCs, characterized by cancer-specific ECM remodeling, expression of the WNT/TGFB (S1) subclass signature, and poor patient outcome. Fibrous nest HCCs abundantly expressed an 11-fibrous-nest–protein signature, associated with poor patient outcome, by multivariate Cox analysis, and validated by multiplex immunohistochemistry.

Conclusions:

Matrisome analysis highlighted cancer-specific ECM deposits, typical of the WNT/TGFB HCC subclass, associated with poor patient outcomes. Hence, histologic reporting of intratumor fibrosis in HCC is of clinical relevance.
Persistent mTORC1 activation due to loss of liver tuberous sclerosis complex 1 promotes liver injury in alcoholic hepatitis
Authors: Chao Xiaojuan , Wang Shaogui , Ma Xiaowen , Zhang Chen , Qian Hui , Williams Sha Neisha , Sun Zhaoli , Peng Zheyun , Liu Wanqing , Li Feng , Sheshadri Namratha , Zong Wei-Xing , Ni Hong-Min , Ding Wen-Xing
Published: March 2023

Background and Aims:

The aim of the study was to investigate the role and mechanisms of tuberous sclerosis complex 1 (TSC1) and mechanistic target of rapamycin complex 1 (mTORC1) in alcohol-associated liver disease.

Approach and Results:

Liver-specific Tsc1 knockout (L-Tsc1 KO) mice and their matched wild-type mice were subjected to Gao-binge alcohol. Human alcoholic hepatitis (AH) samples were also used for immunohistochemistry staining, western blot, and quantitative real-time PCR (q-PCR) analysis. Human AH and Gao-binge alcohol-fed mice had decreased hepatic TSC1 and increased mTORC1 activation. Gao-binge alcohol markedly increased liver/body weight ratio and serum alanine aminotransferase levels in L-Tsc1 KO mice compared with Gao-binge alcohol-fed wild-type mice. Results from immunohistochemistry staining, western blot, and q-PCR analysis revealed that human AH and Gao-binge alcohol-fed L-Tsc1 KO mouse livers had significantly increased hepatic progenitor cells, macrophages, and neutrophils but decreased HNF4α-positive cells. Gao-binge alcohol-fed L-Tsc1 KO mice also developed severe inflammation and liver fibrosis. Deleting Tsc1 in cholangiocytes but not in hepatocytes promoted cholangiocyte proliferation and aggravated alcohol-induced ductular reactions, fibrosis, inflammation, and liver injury. Pharmacological inhibition of mTORC1 partially reversed hepatomegaly, ductular reaction, fibrosis, inflammatory cell infiltration, and liver injury in alcohol-fed L-Tsc1 KO mice.

Conclusions:

Our findings indicate that persistent activation of mTORC1 due to the loss of cholangiocyte TSC1 promotes liver cell repopulation, ductular reaction, inflammation, fibrosis, and liver injury in Gao-binge alcohol-fed L-Tsc1 KO mice, which phenocopy the pathogenesis of human AH.
Effects of EEG burst suppression on cerebral oxygen metabolism and postoperative cognitive function in elderly surgical patients: A randomized clinical trial
Authors: Liu Min , Wang Qi-Qi , Lin Wen-Xin , Ma Bao-Xin , Lin Quan-Yang
Published: March 2023

Background:

This randomized clinical trial determined the effects of electroencephalographic burst suppression on cerebral oxygen metabolism and postoperative cognitive function in elderly surgical patients.

Methods:

The patients were placed into burst suppression (BS) and non-burst suppression (NBS) groups. All patients were under bispectral index monitoring of an etomidate target-controlled infusion for anesthesia induction and intraoperative combination sevoflurane and remifentanil for anesthesia maintenance. The cerebral oxygen extraction ratio (CERO2), jugular bulb venous saturation (SjvO2), and difference in arteriovenous oxygen (Da-jvO2) were measured at T0, T1, and T2. One day before surgery, and 1, 3, and 7 days after surgery, postoperative cognitive dysfunction was assessed using the mini-mental state examination (MMSE).

Results:

Compared with T0, the Da-jvO2 and CERO2 values were decreased, and SjvO2 was increased in the 2 groups at T1 and T2 (P < .05). There was no statistical difference in the SjvO2, Da-jvO2, and CERO2 values between T1 and T2. Compared with the NBS group, the SjvO2 value increased, and the Da-jvO2 and CERO2 values decreased at T1 and T2 in the BS group (P < .05). The MMSE scores on the 1st and 3rd days postoperatively were significantly lower in the 2 groups compared to the preoperative MMSE scores (P < .05). The MMSE scores of the NBS group were higher than the BS group on the 1st and 3rd days postoperatively (P < .05).

Conclusion:

In elderly patients undergoing surgery, intraoperative BS significantly reduced cerebral oxygen metabolism, which temporarily affected postoperative neurocognitive function.
Physician collections are 71% less for early onset scoliosis casting than for growing rod instrumentation: A retrospective cohort study
Authors: Nielsen Ena , Andras Lindsay M. , Sanders James O. , Brown Meghan , Noble Krista , Skaggs David L.
Published: March 2023

Growing rod (GR) instrumentation and the elongation, derotation, and flexion (EDF) casting technique are 2 alternatives for the treatment of early-onset scoliosis. Our purpose was to investigate the cost of these treatment options. This was a retrospective cohort study of patients with early-onset scoliosis treated at 2 institutions from 2007 to 2014 with either GR instrumentation or EDF casting. Patients with <2 years of follow-up were excluded. Physician and hospital charges and collections, total procedures, and procedure times until final follow-up or time of fusion were compared. Nineteen patients met the inclusion criteria; 8 in the GR group and 11 in the EDF casting group. There were no significant differences between the groups in age (P = .23), public versus private insurance (P = 1.0), or major curve (P = .21) at the initiation of treatment. Excluding final fusion, the EDF casting patients had an average of 2.1 (range: 0.7–6.6) procedures/year while the GR patients had an average of 1.5 (range: 0.8–2.7) procedures/year. The average procedure time for the EDF group was 104.2 minutes; the average procedure time for the GR group, excluding the index procedure, was 62.40 minutes (P = .001). Physician charges were 85% less for the EDF group (EDF= $1892.75, GR= $12,354.53, P < .001). Physician collections were 71% less for the EDF group (EDF= $731.10, GR= $2554.88, P = .001). Hospital charges and collections were similar between the groups (P = .82, P = .42). Physician charges for casting were approximately 18% of that of GRs. Compared to GRs, physician collections were 71% less for EDF casting patients per year.
Comparative evaluation of rapidity of action of benzydamine hydrochloride 0.3% oromucosal spray and benzydamine hydrochloride 3 mg lozenges in patients with acute sore throat: A phase IV randomized trial
Authors: Valerio Carmelina , Di Loreto Giorgio , Salvatori Enrica , Cattaneo Agnese
Published: March 2023

Background:

Acute sore throat (ST) can occur as part of a common cold of viral origin or caused by pharyngeal bacterial pathogens. The majority of patients with acute ST complain of pain on swallowing and dry scratchiness which can have a negative impact on the quality of life (QoL). This study aimed to evaluate the time to pain relief in patients with acute ST, following a single administration of benzydamine hydrochloride (HCl) 0.3% oromucosal spray or benzydamine HCl 3 mg lozenges.

Methods:

This multicenter, randomized, active-controlled, open label, parallel-group, international phase IV study was conducted at 12 investigational centers in Poland, Hungary, and Russian Federation. The study population consisted of 363 adult patients with recent onset (≤3 days) of ST and a diagnosis of tonsillopharyngitis. The primary endpoint was to assess the efficacy of benzydamine HCl in ST pain relief at 2 minutes after a single-dose administration. Secondary endpoints included, among others, the assessment of a first perceived ST relief at 1 minute after a single-dose administration of benzydamine HCl spray or lozenge.

Results:

Both the spray and lozenges are effective in providing a ST relief starting already at 2 minutes after a single administration, with an effect lasting up to up to 4 hours. Clinical efficacy after 7 days of treatment and a good safety profile were also demonstrated.

Conclusion:

Anesthetic and analgesic properties of benzydamine spray and lozenges effectively addressed the patient priority of a rapid relief of symptoms of upper respiratory tract infections (URTI).
Malignant transformation of meningioma: Case report
Authors: Qu Xiaoqin , Jiang Jingcheng , Wang Han , Zhang Chao , Deng Qingshan , Xu Xiaoping , Zhou Shijun , Yi Yong , Qiu Lihua
Published: March 2023

Rationale:

Meningiomas are mostly benign brain tumors with minimal malignant cases. Anaplastic meningioma has malignant morphological characteristics and a World Health Organization grade of III.

Patient concerns:

The present study reports a case of an occipital meningioma in a patient who initially chose observation and follow-up after diagnosis. The patient ultimately underwent surgery due to the enlargement of the tumor and the development of visual field defects after a decade of imaging follow-up. The postoperative pathology slides indicated the presence of an anaplastic meningioma (World Health Organization-grade III).

Diagnoses:

The patient’s diagnosis was established through cranial magnetic resonance imaging, which revealed an irregular mixed mass in the right occipital region with isointense T1 and hypointense T2 signal, irregular lobulation, and a maximum diameter of approximately 5.4 cm. Heterogenous enhancement was observed in the contrast-enhanced scan.

Interventions:

The patient opted for surgical intervention to remove the tumor, and the pathology slides of the tumor sample confirmed the diagnosis of anaplastic meningioma. The patient also received radiotherapy (40Gy/15fr).

Outcomes:

No recurrence was observed during the 9-month follow-up.

Lessons:

This case highlights the potential for low-grade meningiomas to undergo malignant transformation, particularly in the presence of irregular lobulation, peritumoral brain edema, and heterogeneous enhancement on contrast-enhanced scans. Total excision (Simpson grade I) is the preferred treatment option, and long-term imaging follow-up is recommended.
Fibrinogen to albumin ratio, a novel serum indicator for evaluating the severity of preeclampsia: A single-center retrospective study
Authors: Ren Hanxiao , Liu Wei , Niu Aijun , Zhao Xiaoqing
Published: March 2023

Preeclampsia (PE) is a disorder that affects approximately 5% to 10% of pregnant women. Timely and accurate identification of PE and assessment of its severity are crucial. Therefore, it is necessary to develop predictive indicators which are easily measured in routine antenatal examinations to enable the early detection of PE and assess its severity. We designed a single-center retrospective study in our daily work to assess whether the serum levels of fibrinogen to albumin ratio (FAR), fibrinogen (Fib), albumin (ALB), prothrombin time, calcium (Ca), activated partial thrombin time, creatinine (Cr), D-dimer(D-D), platelet, white blood cell, neutrophil, and lymphocyte counts could help in assessing PE and evaluating its severity. Our findings showed that the serum levels of FAR, Cr, Fib, and D-D were significantly higher in the severe preeclampsia group (sPE) compared with the control and mild preeclampsia groups, whereas the levels of ALB and Ca were significantly lower in sPE patients. In addition, no differences were found between the control and PE groups in terms of prothrombin time, activated partial thrombin time, platelet, white blood cell, neutrophils, and lymphocytes counts. Furthermore, FAR is a novel and better indicator for evaluating the severity of PE, which has not been reported before. And it is an independent risk factor for the development of sPE. In conclusion, the serum levels of FAR, Cr, D-D and Fib were positively correlated with PE, whereas ALB and Ca were negatively correlated with PE severity, which might be valuable in evaluating the severity of PE. FAR proved to be a feasible diagnostic marker for sPE with sensitivity and specificity comparable to those of ALB and Fib.
Mechanism of skin whitening through San-Bai decoction-induced tyrosinase inhibition and discovery of natural products targeting tyrosinase
Authors: Li Liyuan , Tang Yiran , Li Xin , Zhou Tao , Song Qiuhang , Li Aiying
Published: March 2023

Melanin deposition is the main cause of skin darkening, which can lead to severe physical and psychological distress, necessitating the development of approaches for preserving skin health and fairness. Tyrosinase (TYR) is the rate-limiting enzyme in melanin synthesis, and its activity directly determines the degree of melanin accumulation in the skin, which in turn affects skin color. Currently, TYR inhibitors derived from natural products are widely used for skin whitening. San-Bai decoction (SBD) is effective for skin whitening and softening, but its mechanism of action, efficacy and high efficiency TYR inhibitors for skin whitening remain poorly understood. Here, we employed systems biology and network pharmacology to analyze the active compounds and targets of SBD, using the follow databases: TCMIP, TCMID, and BATMAN-TCM. Construct a molecular network centered on the regulation of TYR by SBD in skin whitening, using STRING database and cytoscape. Enrichment analysis using KOBAS database and ClusterProfiler. Virtual screening of candidate TYR inhibitors using Molecular Operating Environment software and Amber 18 software. SBD may act through tyrosine metabolism, melanogenesis, and other signaling pathways to regulate TYR activity and inhibit melanogenesis. We identified TYR and ESR1 as possible key targets for the whitening effect of SBD and screened out pentagalloylglucose, 1,3,6-tri-O-galloyl-beta-D-glucose, 1,2,4,6-tetragalloylglucose, and liquiritigenin 4′,7-diglucoside as inhibitors of TYR, in addition to glycyrrhizic acid, pachymic acid methyl ester, nicotiflorin, gamma-sitosterol, and isoliensinine as inhibitors of ESR1. We also performed virtual drug screening of a library of natural small-molecule compounds (19,505 in total) and screened out lycopsamine, 2-phenylethyl b-D-glucopyranoside, and 6-beta-hydroxyhyoscyamine as inhibitors of TYR. We identified natural compounds with the potential for skin whitening through inhibition of TYR, thus advancing research on SBD and its applications.
Successful treatment of a gravida with acute type A aortic dissection in the third trimester: A case report
Authors: Wang Yue , Hong Jianmao , Xu Bijun , Wang Shiqiang , He Fan
Published: March 2023

Rationale:

Acute type A aortic dissection is a rare and catastrophic complication of pregnancy with a very high mortality rate for both the mother and the fetus.

Patient concerns:

A 40-year-old female who was 31 weeks pregnant was transferred to our hospital due to “chest and back pain for 7 hours.” Enhanced computed tomography (CT) of the aorta revealed a Standford A dissection, involving 3 branches of the aortic arch and the opening of the right coronary artery. The aortic root and ascending aorta were significantly widened.

Diagnoses:

Acute type A aortic dissection.

Interventions:

After multidisciplinary discussions, we decided to perform cesarean section first and then cardiac surgery. A live male infant was delivered successfully by Obstetrician and Gynecologist. And then, we performed the Betalls procedure with the use of a mechanical 23# aortic-valve vessel for the patient. The innominate artery openings were reinforced with felt pads.

Outcomes:

The procedure was successful. CT examination at 2 months after operation showed that the true lumen of the aorta was enlarged, and no dissection was found in the 3 branches of the aortic arch.

Lessons:

Type A aortic dissection during pregnancy is a rare event that carries a high risk of death for both mother and fetus. An optimal outcome can be achieved through early and accurate diagnosis, safe imaging techniques, timely and effective multidisciplinary discussion, and precise and individualized treatment.
Assessment of Veterans Affairs Case Management Leadership
Authors: Perla Lisa Y. , Beck Lucille B. , Grunberg Neil E.
Published: March 2023

Purpose/Objectives:

The critical work of Veterans Affairs (VA) case managers is to assist and advocate for veterans navigating the VA and civilian health care systems, aligning services, developing integrated care plans, and supporting team-based care (Hunt & Burgo-Black, 2011). The article reviews publications regarding VA case management leadership because case managers who function as leaders are likely to better coordinate health care services for veterans.

Primary Practice Setting:

VA case managers adhere to the Commission for Case Managers (CCM) scope of practice through patient advocacy, education, and resource management, while ensuring the care is safe, effective, and equitable. VA case managers are competent in veteran health care benefits, health care resources, military service, and the prevailing military culture. They work in a variety of clinical settings including more than 1,400 facilities throughout the United States.

Findings/Conclusions:

The present literature review indicates that few published articles address leadership among VA case managers. Several publications suggest that VA case managers lead, as well as manage, without indicating the extent to which they function as leaders. The literature reviewed indicates an association between unsuccessful program implementation and a lack of staff adaptability, a lack of necessary resources, a lack of ongoing involvement of senior leaders, and a fear of reprisal.

Implications for Case Management Practice:

Because of the 2018 MISSION Act, the number of veterans seeking services in the community has increased and further complicated the coordination of services for VA case managers. Understanding the leadership elements influencing successful care coordination processes is important for veterans to receive high-quality health care services.