bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone turnover, areal BMD, and bone microarchitecture by second-generation high-resolution peripheral quantitative computed tomography in transfusion-dependent thalassemia
Authors: Das Liza , Khadwal Alka , Malhotra Pankaj , Ghosh Jayaditya , Dhiman Vandana , Sharma Vivek , Singhmar Shallu , Ahuja Chirag Kamal , Saikia Uma Nahar , Bhadada Sanjay Kumar , Dutta Pinaki
Published: August 2024

Thalassemic osteopathy includes low bone mass and impaired bone microarchitecture. We aimed to evaluate the prevalence and determinants of bone quantity (osteoporosis) and quality (microarchitecture) in a cohort of adult patients with transfusion-dependent thalassemia (TDT). Patients with TDT (n = 63) and age- and BMI-matched controls (n = 63) were recruited in the study. Areal bone mineral density (BMD) was measured using DXA Hologic scanner. P1NP and β-CTX were estimated by electrochemiluminescence assay. Bone geometry and volumetric BMD (vBMD) were estimated by second-generation high-resolution peripheral quantitative computed tomography. Bone turnover marker β-CTX was significantly lower in the TDT group, but there was no difference in P1NP levels. Low bone mass (Z ≤ −2) was present in greater proportion of patients both at lumbar spine (LS) (54 vs 0%; p = .001) and femoral neck (FN) (33 vs 8%; p = .001). Hypogonadism was associated with low BMD at FN (OR 10.0; 95% CI, 1.2–86; p = .01) and low hemoglobin with low BMD at LS (OR 1.58; 95% CI, 0.96–2.60; p = .07). The mean trabecular bone score was also significantly lower in patients compared with controls (1.261 ± 0.072 vs 1.389 ± 0.058). Total, cortical and trabecular vBMD were significantly lower in cases than controls. The trabecular number and cortical thickness were significantly lower and trabecular separation higher in cases than controls. Adults with TDT have significantly lower areal, cortical and trabecular vBMD. The bone microarchitecture is also significantly impaired in terms of lower number and wider spacing of trabeculae as well as lower cortical thickness and area at both radius and tibia.
Functional and evolutionary insights into chemosensation and specialized herbivory from the genome of the red milkweed beetle, Tetraopes tetrophthalmus (Cerambycidae: Lamiinae)
Authors: Adams Richard , Sylvester Terrence , Mitchell Robert F , Price Mathew A , Shen Rongrong , McKenna Duane D
Published: August 2024

Tetraopes are aposematic longhorn beetles (Cerambycidae) that feed primarily on toxic plants in the genus Asclepias (milkweeds). Studies of Tetraopes and their host plants have revealed compelling evidence for insect–plant coevolution and cospeciation. We sequenced, assembled, and annotated the genome of the common red milkweed beetle, Tetraopes tetrophthalmus, and explored gene content and evolution, focusing on annotated genes putatively involved in chemosensation, allelochemical detoxification, and phytophagy. Comparisons were made to the Asian longhorned beetle (Anoplophora glabripennis) genome. The genome assembly comprised 779 Mb distributed across 1,057 contigs, with an N50 of 2.21 Mb and 13,089 putative genes, including 97.3% of expected single-copy orthologs. Manual curation identified 122 putative odorant receptors (OR) and 162 gustatory receptors (GR), the former number similar to A. glabripennis but the latter only 69% of the A. glabripennis suite. We also documented a greater percentage of pseudogenic GRs and ORs compared to A. glabripennis, suggesting an ongoing reduction in chemosensory function, perhaps related to host specialization. We found lower diversity within certain well-studied gene families predicted to encode putative plant cell wall degrading enzymes in the T. tetrophthalmus genome, perhaps also due to host specialization. Exploring genes relevant to stress and allelochemical detoxification revealed evidence of an abundance of ABC-family genes in the T. tetrophthalmus genome, which may be related to sequestering toxic cardiac glycosides. Our studies further illuminate the genomic basis and evolution of chemosensation in longhorn beetles and provide a new vantage point from which to explore the ecology and evolution of specialized plant-feeding in Tetraopes and other phytophagous beetles.
Understanding VA Maternity Care Coordinators Interactions and Collaboration With Primary Care Providers
Authors: Farkas Amy H , Bopp Katherine , Ndakuya-Fitzgerald Florine , Lopez Alexa A , Haeger Kristin O , Whittle Jeffrey , Mu Qiyan
Published: August 2024

Introduction

Maternal morbidity is higher among the Veteran population in part because of high rates of chronic medical and mental health conditions. To improve care for pregnant Veterans, the Department of Veteran Affairs created the position of the Maternity Care Coordinator (MCC) to provide care coordination during a Veteran’s pregnancy. Maternity Care Coordinators must work with primary care providers (PCPs); yet, little is known about their collaboration and interaction. The objective of this work is to better understand how MCCs interact with PCPs.

Method

Between March and May of 2021, we conducted qualitative interviews with 30 MCCs using a semi-structured interview guide to learn about their role and interactions with PCPs.

Results

We identified 3 main themes in interactions between MCCs and PCPs, which correlated to times during the Veteran’s pregnancy: initial interactions, care coordination during the pregnancy, and end of pregnancy transitions of care. Most MCCs indicated a positive and collaborative relationship with PCPs. There was significant variability in how closely MCCs worked with PCPs. MCCs reported that PCPs were not always comfortable caring for pregnant Veterans.

Discussion

Although MCCs generally indicated a positive and collaborative interaction with PCPs, our data suggest that there are opportunities to improve communication between PCPs and MCCs and to educate PCPs on knowledge of maternity benefits, the role of the MCC, and how to care for pregnant and postpartum Veterans. The Veteran Affairs MCC can also serve as a model for other health systems aiming to improve care coordinator among pregnant patients.
TOI-2490b – the most eccentric brown dwarf transiting in the brown dwarf desert
Authors: Henderson Beth A , Casewell Sarah L , Jordán Andrés , Brahm Rafael , Henning Thomas , Gill Samuel , Mayorga L C , Ziegler Carl , Stassun Keivan G , Goad Michael R , Acton Jack , Alves Douglas R , Anderson David R , Apergis Ioannis , Armstrong David J , Bayliss Daniel , Burleigh Matthew R , Dragomir Diana , Gillen Edward , Günther Maximilian N , Hedges Christina , Hesse Katharine M , Hobson Melissa J , Jenkins James S , Jenkins Jon M , Kendall Alicia , Lendl Monika , Lund Michael B , McCormac James , Moyano Maximiliano , Osborn Ares , Pinto Marcelo Tala , Ramsay Gavin , Rapetti David , Saha Suman , Seager Sara , Trifonov Trifon , Udry Stéphane , Vines Jose I , West Richard G , Wheatley Peter J , Winn Joshua N , Zivave Tafadzwa
Published: August 2024

We report the discovery of the most eccentric transiting brown dwarf in the brown dwarf desert, TOI-2490b. The brown dwarf desert is the lack of brown dwarfs around main-sequence stars within $\sim 3$ au and is thought to be caused by differences in formation mechanisms between a star and planet. To date, only $\sim 40$ transiting brown dwarfs have been confirmed. TOI-2490b is a $73.6\pm 2.4$  $M_{\rm J}$, $1.00\pm 0.02$  $R_{\rm J}$ brown dwarf orbiting a $1.004_{-0.022}^{+0.031}$  ${\rm M}_{\odot }$, $1.105_{-0.012}^{+0.012}$  ${\rm R}_{\odot }$ sun-like star on a 60.33 d orbit with an eccentricity of $0.77989\pm 0.00049$. The discovery was detected within Transiting Exoplanet Survey Satellite sectors 5 (30 min cadence) and 32 (2 min and 20 s cadence). It was then confirmed with 31 radial velocity measurements with FEROS by the WINE collaboration and photometric observations with the Next Generation Transit Survey. Stellar modelling of the host star estimates an age of $\sim 8$ Gyr, which is supported by estimations from kinematics likely placing the object within the thin disc. However, this is not consistent with model brown dwarf isochrones for the system age suggesting an inflated radius. Only one other transiting brown dwarf with an eccentricity higher than 0.6 is currently known in the brown dwarf desert. Demographic studies of brown dwarfs have suggested such high eccentricity is indicative of stellar formation mechanisms.
Understanding spectral artefacts in SKA-Low 21-cm cosmology experiments: the impact of cable reflections
Authors: O’Hara Oscar S D , Dulwich Fred , de Lera Acedo Eloy , Dhandha Jiten , Gessey-Jones Thomas , Anstey Dominic , Fialkov Anastasia
Published: August 2024

The Cosmic Dawn was marked by the formation of the first stars, and preceded the Epoch of Reionization (EoR), when the Universe underwent a fundamental transformation caused by the radiation from these first stars and galaxies. Interferometric 21-cm experiments aim to probe redshifted neutral hydrogen signals from these periods, constraining the conditions of the early Universe. The SKA-Low instrument of the Square Kilometre Array (SKA) is envisaged to be the largest and most sensitive radio telescope at metre and centimetre wavelengths. The latest Aperture Array Verification Systems feature 7-m coaxial transmission lines connecting the low noise amplifiers to optical transmitters at the front of the analogue-receiving chain. An impedance mismatch between these components results in a partially reflected electromagnetic signal, introducing chromatic aberrations into the instrument bandpass. This causes power from the foreground signals to appear at higher delays, potentially contaminating the ‘EoR window’, a region in which the 21-cm signal should be detectable. We present an end-to-end simulation pipeline for SKA-Low using a composite sky model combining radio foregrounds from the Galactic and Extragalactic All-Sky MWA (GLEAM) Survey, Haslam 408 MHz, and a 1.5-cGpc 21-cm brightness temperature cube generated with the 21cm space simulator. We derive a model for the scattering parameters of a coaxial transmission line in terms of its specifications and bulk material properties. Assuming identical cables of length $\le 15.0$ m with impedance mismatch $\le 10\, \Omega$, the reflection is confined below the EoR window. However, we demonstrate that even a 0.1 per cent length tolerance introduces contamination with an absolute fractional difference of ~10 per cent across all accessible k-modes.
Periplasmic carbonic anhydrase CAH1 contributes to high inorganic carbon affinity in Chlamydomonas reinhardtii
Authors: Shimamura Daisuke , Ikeuchi Tomoaki , Matsuda Ami , Tsuji Yoshinori , Fukuzawa Hideya , Mochida Keiichi , Yamano Takashi
Published: August 2024

Carbonic anhydrase (CA), an enzyme conserved across species, is pivotal in the interconversion of inorganic carbon (Ci; CO2, and HCO3−). Compared to the well-studied intracellular CA, the specific role of extracellular CA in photosynthetic organisms is still not well understood. In the green alga Chlamydomonas (Chlamydomonas reinhardtii), carbonic anhydrase 1 (CAH1), located at the periplasmic space, is strongly induced under CO2-limiting conditions by the Myb transcription factor LCR1. While the lcr1 mutant shows decreased Ci-affinity, the detailed mechanisms behind this phenomenon are yet to be elucidated. In this study, we aimed to unravel the LCR1-dependent genes essential for maintaining high Ci-affinity. To achieve this, we identified a total of 12 LCR1-dependent inducible genes under CO2-limiting conditions, focusing specifically on the most prominent ones—CAH1, LCI1, LCI6, and Cre10.g426800. We then created mutants of these genes using the CRISPR–Cas9 system, all from the same parental strain, and compared their Ci-affinity. Contrary to earlier findings that reported no reduction in Ci-affinity in the cah1 mutant, our cah1-1 mutant exhibited a decrease in Ci-affinity under high HCO3−/CO2-ratio conditions. Additionally, when we treated wild-type cells with a CA inhibitor with low membrane permeability, a similar reduction in Ci-affinity was observed. Moreover, the addition of exogenous CA to the cah1 mutant rescued the decreased Ci-affinity. These results, highlighting the crucial function of the periplasmic CAH1 in maintaining high Ci-affinity in Chlamydomonas cells, provide insights into the functions of periplasmic CA in algal carbon assimilation.
Exploring the role of spinal astrocytes in the onset of hyperalgesic priming signals in acid-induced chronic muscle pain
Authors: Abdelaziz Mohamed Abbas , Chen Wei-Hsin , Chang Yu-Wang , Mindaye Selomon Assefa , Chen Chien-Chang
Published: August 2024

Hyperalgesic priming, a form of pain plasticity initiated by initial injury, leads to heightened sensitivity to subsequent noxious stimuli, contributing to chronic pain development in animals. While astrocytes play active roles in modulating synaptic transmission in various pain models, their specific involvement in hyperalgesic priming remains elusive. Here, we show that spinal astrocytes are essential for hyperalgesic priming formation in a mouse model of acid-induced muscle pain. We observed spinal astrocyte activation 4 h after initial acid injection, and inhibition of this activation prevented chronic pain development upon subsequent acid injection. Chemogenetic activation of spinal astrocytes mimicked the first acid-induced hyperalgesic priming. We also demonstrated that spinal phosphorylated extracellular regulated kinase (pERK)-positive neurons were mainly vesicular glutamate transporter-2 positive (Vglut2+) neurons after the first acid injection, and inhibition of spinal pERK prevented astrocyte activation. Furthermore, pharmacological inhibition of astrocytic glutamate transporters glutamate transporter-1 and glutamate–aspartate transporter abolished the hyperalgesic priming. Collectively, our results suggest that pERK activation in Vglut2+ neurons activate astrocytes through astrocytic glutamate transporters. This process eventually establishes hyperalgesic priming through spinal D-serine. We conclude that spinal astrocytes play a crucial role in the transition from acute to chronic pain.
Heterogeneous Real Estate Agents and the Housing Cycle
Authors: Gilbukh Sonia , Goldsmith-Pinkham Paul
Published: August 2024

The real estate market is highly intermediated, with 90% of buyers and sellers hiring an agent. However, low barriers to entry and fixed commission rates result in large market share for inexperienced intermediaries. Using micro-level data on 8.5 million listings and a novel research design, we show that house listings by inexperienced agents have a lower probability of selling, and this effect is strongest during the housing bust. We estimate that 3.7% more listings would have been sold in a flexible commission equilibrium. Eighty percent of this improvement comes from competition and the remainder from commission variation across experience.
Sociodemographic Factors Associated with Delayed Presentation in Craniosynostosis Surgery at a Tertiary Children’s Hospital
Authors: Jolibois Marah I. , Roohani Idean , Moshal Tayla , Lasky Sasha , Urata Maya , Munabi Naikhoba C.O. , Johns Alexis L. , Sader Nicholas , Durham Susan R. , Urata Mark M.
Published: August 2024

Background:

Craniosynostosis is a common diagnosis requiring early referral to a pediatric plastic surgeon; however, disparities in healthcare may influence presentation timing and affect treatment options and outcomes. This study aimed to explore sociodemographic factors contributing to delay in craniosynostosis surgical consultation.

Methods:

A retrospective cohort study of 694 California-based craniosynostosis patients at a tertiary children’s hospital was performed from 2006 to 2023. State-specific Area Deprivation Index (ADI) and distance to the hospital were calculated using ZIP codes. Multivariate linear and logistic regressions considered race, insurance type, syndromic status, suture type, and ZIP code-based socioeconomic factors.

Results:

Median age of presentation was 4.5 [interquartile range: 2.6–7.6] months with racial/ethnic breakdown of Hispanic/Latinx (41.2%), White (23.6%), Asian (3.7%), Black/African American (2.0%), or other/unreported (29.5%) with 58.4% having public insurance and an average distance to the hospital of 48.3 km. Median ADI was 5.4 [interquartile range: 4.0–7.1]. By linear regression, public insurance (P< 0.001) and higher ADI decile (P< 0.001) independently contributed to an older age of presentation. Patients with public insurance (odds ratio 1.90;P= 0.002) were more likely to present after 4 months of age.

Conclusions:

Patients who had public insurance or resided in more disadvantaged areas presented later for craniosynostosis surgical consultation. Eliminating disparities in these populations ensures more equitable access to surgical options and can improve patient outcomes.
Improved Sympathetic Activity With Short-Term Effects of Yoga in Young Adults
Authors: Nakayama Natsuki , Kono Aoi , Moriwaki Yoshimi , Niihara Momoka , Aizawa Rika , Ookabe Sota , Kita Etsuko , Kaneko Hiroshi
Published: August 2024

The purpose of this study was to clarify the heart rate variability (HRV) transition after a single yoga program. Participants were 22 females who were healthy university students and had never practiced yoga before. They practiced yoga while recording their HRV. Heart rate (HR), high frequency (HF; 0.15-0.4 Hz) as parasympathetic and low frequency (LF; 0.04–0.15 Hz) components were extracted, and then the LF/HF ratio as sympathetic and normalized units of HF HFnu = HF/(LF + HF) as parasympathetic modulation in autonomic activity were calculated. HR and HRV indices after yoga were divided into four 5-minute periods (after 5, 10, 15, and 20 minutes) and compared before yoga. HR and LF/HF at all periods after yoga were significantly lower than before yoga (P < .01, all). HF after yoga was not significantly changed, but HFnu after 5, 10, and 15 minutes was significantly higher than before yoga (P < .01, <.01, and =.02, respectively). The short-term effects of yoga on HRV implied a decrease in sympathetic modulation and a relative increase in parasympathetic modulation. Therefore, yoga may be used as a fast-acting alternative therapy to significantly improve sympathetic activity.
Explore the Status of Communication Between Nursing Staff and Patients on Complementary Therapy Issues
Authors: Lee Tzu-Yueh , Lin Ruei-Jhen , Huang Cheng-Yi
Published: August 2024

This study investigates the state of communication between nursing staff and patients concerning complementary and alternative medicine (CAM) in a university hospital in Taiwan. The study employed a validated cross-sectional survey to gather data from 90 nurses in the internal medicine ward. The results indicate a notable need for more initiation and documentation of CAM discussions by nurses, with less than a quarter recording patients’ CAM usage. Barriers such as limited time, access to evidence-based information, and workplace culture were identified as significant obstacles. Additionally, nurse characteristics like age, experience, and seniority also played a role in the extent of CAM communication. The study underscores the urgent need for health care institutions to prioritize CAM communication as a vital component of patient-centered care. It suggests the development of strategies to facilitate proactive discussions and referrals.
Ocular Mucous Membrane Pemphigoid Presenting as Recurrent Pterygium
Authors: Tallapelly Haritha G. , Shanbhag Swapna S. , Basu Sayan , Kate Anahita
Published: August 2024

Purpose:

The aim of this series was to report recurrent pterygium as a presenting feature of ocular mucous membrane pemphigoid (oMMP).

Methods:

A retrospective review was performed, and patients with biopsy positive oMMP who presented with recurrent pterygia were included. Data on the demographic profile, clinical characteristics, and details of the surgical intervention were collected.

Results:

A total of 5 patients with recurrent pterygium were included. All the patients were men. The median age was 63 years. History of pterygium surgery was present in 8/10 eyes (80%), of which 6 eyes (60%) developed a recurrent pterygium. A symblepharon was present in 4/6 eyes (67%). Forniceal shortening was present in 10/10 (100%) eyes. All eyes were subjected to a conjunctival biopsy for direct immunofluorescence, of which 9 eyes (90%) had positive results consistent with oMMP. Systemic immunomodulatory therapy (IMT) with either methotrexate or azathioprine was initiated in all 5 patients.

Conclusions:

Recurrent pterygium can be a presenting feature of oMMP. The presence of symblepharon formation or forniceal shortening, especially in the fellow eye, warrants a conjunctival biopsy and prompt initiation of IMT to prevent disease progression.
Endoscopic Removal of Uncovered Metallic Airway Stents
Authors: Rausch Mathilde , Briault Amandine , Aboussouan Marie-Pierre , Berger Jean-Eric , Francony Gilles , Atallah Ihab
Published: August 2024

Background:

Self-expandable uncovered metallic stents (SEUMS) have been used in benign tracheobronchial stenosis. Stent complications may require risky removal due to SEUMS integration in the tracheobronchial wall. Our study aims to report techniques, including a novel one, and outcomes of SEUMS removal by rigid bronchoscopy.

Methods:

We studied a case series of 7 patients from a tertiary medical center, who underwent SEUMS removal from 2017 to 2022. SEUMS removals were performed through rigid bronchoscopy. We used a new technique with bronchoscopic hook scissors to gradually dissect the stent from the airway wall.

Results:

Nine SEUMS were removed from 7 patients. The mean duration of stenting was 7 years (5 to 12 y). Indications for stent removal included mostly recurrent pulmonary infections, obstructive granulation tissue, and stents’ fractures. We used the usually described technique in the literature known as the “piecemeal fashion” without dissection in 4 SEUMS removals and a new dissection technique in 5 procedures. We reported one major intraoperative complication using the former technique in the form of tracheal tear with mediastinal breach, while we did not experience any major complications with the later one. One patient died 8 days after surgery from respiratory failure.

Conclusion:

Dissection and “piecemeal fashion techniques” can be used to remove SEUMS by rigid bronchoscopy even after long-term stenting. SEUMS removal is a very risky procedure and must be performed by a trained operator. Patients should be aware of possible severe complications.
The Influence of Thoracic Ultrasound on the Clinical Practice of Pulmonologists in Portugal
Authors: Silva Bruno S. , Ferraz Beatriz , Costa Maria Inês , Brandão Maria Esteves , Cortesão Nuno
Published: August 2024

Background:

Thoracic ultrasound (TUS) has garnered increased recognition, both in aiding pleural procedures and as a complement to physical examination. Operator ability is essential to obtain reliable findings. This study aimed to inquire pulmonology specialists and residents about their confidence with the technique and to determine future needs.

Methods:

A self-administered online survey, including a total of 24 questions, was sent to pulmonology specialists and residents registered as members of the Portuguese Pulmonology Society. Participation was pseudoanonymized and voluntary.

Results:

One hundred fourteen valid answers were obtained. Most responders had prior TUS training. The primary method for knowledge consolidation was unsupervised practice. The majority had an ultrasound machine available in their daily practice; only 17% performed TUS more than 3 times per week. Overall confidence in TUS usage for diagnostic purposes (median: 7/10), disease monitoring (median: 7/10), and invasive procedures (median: 8/10) were high. There was a significant relation between higher levels of confidence and regularly attending TUS courses and performing TUS more than 3 times per week. The main reasons cited as preventing regular use of TUS were the availability/cost of courses and the availability/cost of equipment.

Conclusion:

Regular TUS training and utilization are essential to boost user’s confidence degree. Its use is already a regular feature in the daily practice of pulmonologists in Portugal, but further and better structured training is required to meet the needs of clinicians. The inclusion of mandatory TUS training in residency programs should be considered in the future.
Metachronous Colorectal Neoplasia in Young Adults With Advanced Neoplasia Undergoing Colonoscopy
Authors: Thomas Raj Jessica , Ali Adel Hajj , Bolwell Jacquelyn , Butler Robert , Burke Carol A. , Liska David , Macaron Carole
Published: August 2024

Background:

The risk of metachronous advanced colorectal neoplasia (mACRN) in young adults with advanced lesions at baseline colonoscopy is not well defined.

Aims:

To examine the risk for (mACRN) in adults <50 years old who had advanced neoplasia (AN) at baseline colonoscopy and determine factors associated with mACRN in these patients.

Method:

Patients 18 to 49 years of age with ≥1 AN [tubular adenoma (TA) ≥10 mm or with villous features or high-grade dysplasia (HGD), sessile serrated lesion (SSL) ≥10 mm or with dysplasia, traditional serrated adenoma (TSA)] on baseline colonoscopy between 2011 and 2021 who had surveillance colonoscopy >6 months after their baseline examination were included. Outcomes were assessed based on age at baseline colonoscopy, <45 years versus 45 to 49 years, and by follow-up colonoscopy findings: (1) normal, (2) nonadvanced neoplasia (NAN), and (3) AN.

Results:

Three hundred sixty-six patients with AN underwent ≥1 surveillance colonoscopy: 310 (84.7%) <45 years versus 56 (15.3%) 45 to 49 years. The mean follow-up time was longer for the <45-year-olds versus the 45 to 49-year-olds (43±26.4 vs. 28.4±12.8 mo respectively,P<0.001). The absolute risk of mACRN was 13.5% in the <45 age group versus 16.1% in the 45 to 49 age group,P=0.28. The 3-year cumulative incidence rates of mACRN were comparable for patients <45 and 45 to 49 years old: 10% (95% CI: 10% to 42%) versus 20% (95% CI: 7% to 15%),P=0.065. BMI was the only risk factor associated with mACRN OR 1.045 [95% CI (1.001 to 1.09)].

Conclusions:

In our cohort of patients <50 years old with AN at baseline, mACRN occurred at a similar rate to that reported by guidelines in 50 years and older, suggesting that current recommended post polypectomy surveillance is appropriate for this age group. BMI was independently associated with mACRN. Future studies should examine how weight management in patients with high BMI mitigates the recurrence of advanced neoplasia.
More Than Just a Pain in the Back
Authors: Rainbow Jessica G. , Chou Kerry , Bethel Claire , Rothers Janet , Sans-Fuentes Maria A. , Dudding Katherine M.
Published: August 2024

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.
The Value of a Nurse’s Voice in Political Discourse
Authors: Bradley Carol
Published: August 2024

Nurse leaders have an important opportunity to develop and support nurses’ participation in public policy and advocacy. Many issues today are healthcare related and would benefit from a nurse’s perspective. There are many opportunities for nurses to engage in policy but voting is the most basic and important action we can take.
Empowering Night Shift Through Building a Stronger Foundation for Shared Governance
Authors: McIntyre Linda , Moss Rebecca , Hebb Abigail
Published: August 2024

A 341-bed Magnet® designated facility expanded its shared governance structure by incorporating a night shift council. The formation of this council allowed for more robust communication and collaboration between disciplines among night shift staff while increasing engagement scores. The council has established many initiatives to support night shift staff that can be adapted for use by other hospitals and health systems interested in expanding their shared governance structure.
Bone Formation in Unilateral Cleft Lip and Palate Patients after Early Secondary Gingivoalveoloplasty and Bone Graft: Long-Term Study
Authors: Autelitano Luca , Hamaui Daniele , Battista Valeria M. A. , Biglioli Federico , Meazzini Maria C.
Published: August 2024

Background:

The aim of this study was to conduct a comparative analysis, using computed tomographic scans, of ossification patterns in unilateral cleft lip and palate patients who underwent early secondary gingivoalveoloplasty (esGAP) versus those who underwent traditional alveolar bone grafting harvested from the iliac crest (IC).

Methods:

Computed tomographic scans of 22 consecutively treated patients with esGAP were compared with those of 21 patients treated with bone grafting from the IC. Inclusion criteria were nonsyndromic unilateral cleft lip and palate patients in permanent dentition. Two parameters were considered: the alveolar thickness, measured at 3 levels, and the nasoalveolar height. All measurements were normalized and ratios of the affected versus nonaffected sides were provided as in addition to the statistical comparison between the 2 groups’ ossification outcomes.

Results:

In the esGAP sample, nasoalveolar height was categorized as ideal and good in 86.36% and in 13.64% of the cases, and no mediocre or insufficient ossification was detected; whereas in the bone grafting sample, 38.10% had ideal and good ossification, 14.29% had mediocre ossification, and 9.52% had insufficient ossification. As regards the alveolar thickness, when we consider the average of 3 levels, the esGAP sample was ideal and good in 57.57% and in 30.30% of the cases; for the IC sample, the alveolar thickness was ideal and good 41.27% and in 25.40% of the cases, respectively. The analysis detected a statistically significant difference in the ossification outcomes in the 2 samples.

Conclusion:

The esGAP yields superior ossification grades in comparison to IC bone grafting.

Clinical Relevance Statement:

In unilateral cleft lip and palate patients, esGAP seems to allow for a higher grade of ossification compared to IC bone grafting.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
“Primary anterior septoplasty in a cleft repair improves deviation of the anterior septum but not that of the posterior bone structure.”
Authors: Ndrianarivony Simon Carnot , Maggiulli Federica , Herman Fanchon , Picot Marie-Chritine , Captier Guillaume
Published: August 2024

Background:

Evaluation of the result on the nasal septum (NS) of primary anterior septoplasty in cleft surgery is lacking. The deviation in patients with a cleft between those with (S+) and without (S-) primary anterior septoplasty during a cleft lip repair was compared.

Methods:

This was a retrospective, descriptive, single-center study. The NS was evaluated on computed tomography scans obtained pre-operatively from patients who underwent surgery for an alveolar cleft defect. Deviation of the NS was evaluated based on the following parameters: 3D configuration of the NS; anterior, middle, or posterior severity of the NS deviation; location of the most projected point; and severity index.

Results:

The mean age of evaluation was 6.18 years. A total of 44 (S-) and 48 (S+) patients were included. The NS was less prominent in the (S+) than in (S-) group, 6.25% vs 25%. respectively. In the anterior part, the NS was normal in 79% (S+) and 1% (S-) of the patients. In the posterior region, the prominent deviation rate was approximately 7% in both groups. The greatest deviation point location was identical in both groups. The severity index was higher in the (S-) than in (S+) group, except in the middle part of the NS.

Conclusions:

Primary anterior septoplasty corrects only the anterior aspect of the NS in most children with CL and CLP. However, the posterior aspect of the NS remains deviated. A posterior deviation is likely to lead to nasal obstruction therefore regular monitoring is required all along the growing period.
Preliminary Analysis of Solute Carrier Family in Nucleotide Rescue Synthesis in Glioma
Authors: Chen Yang , Sun Qikai , Li Zefu
Published: August 2024

Glioma is a highly proliferative and aggressive tumor type that arises from glial cells in the central nervous system. The nucleotides required for the proliferation and replication of glioma cells are crucial to their pathogenesis and often cannot be synthesized entirely de novo by tumor cells. These nucleotides must be taken up from the extracellular milieu to achieve the purpose of proliferation, a process that is mediated by solute carriers in the SLC28, SLC29, and SLC43 families. The expression of these solute carriers is linked to the proliferation of glioma cells, indicating their key role in glioma metabolism. Understanding the mechanisms underlying nucleotide transport and metabolism in gliomas may lead to the development of novel therapeutics that target these metabolic pathways and improve the prognosis for patients with glioma. Solute carrier family SLC28-, SLC29-, and SLC43-mediated nucleotide transport is involved in the proliferation of glioma and plays an important role in the proliferation and invasion of glioma. Among them, SLC43A3 is a potential biomarker for glioma proliferation, and the data presented here provide evidence for solute carrier involvement in glioma metabolism and construct a prognostic model.
Arthroscopic Discectomy Technique: A Beneficial Approach for Managing Disk Perforations in the Temporomandibular Joint
Authors: Jerez Daniel , Laissle German , Díaz-Báez David , Martin-Granizo López Rafael , Vicente González Luis
Published: August 2024

Disk perforation can result in degenerative changes within the joint structures. While discectomy has demonstrated enduring benefits, it has traditionally been described using an open approach, with the disadvantages inherent to this method. This study aims to present a series of patients who underwent arthroscopic discectomy technique and to report the outcomes.

Methods

Patients diagnosed with internal disorders of the temporomandibular joint underwent arthroscopic arthroscopic discectomy technique. Surgical outcomes were assessed by changes in pain using a visual analog scale and the maximum incisal opening.

Results

One hundred seventy-eight joints from 106 patients who underwent arthroscopic surgery were included. Discectomy was performed on 22 joints. Prior to surgery, patients reported an average visual analog scale pain score of 6.5, which decreased to an average of 0.5 at 6 months postsurgery (P<0.001). Before surgery, the average maximum incisal opening was 30 mm, which increased to 41 mm at 6 months postsurgery (P<0.001).

Conclusions

The described technique represents an excellent alternative for managing patients with disk perforations.
Obesity is a predictor of abdominal computed tomography imaging in pediatric trauma patients
Authors: Colosimo Christina , Otaibi Banan , Bhogadi Sai Krishna , Nelson Adam , Spencer Audrey L. , Anand Tanya , Stewart Collin , Magnotti Louis J. , Joseph Bellal
Published: August 2024

BACKGROUND

Computed tomography (CT) has helped to reduce the morbidity due to missed injuries. However, CT imaging is associated with radiation exposure and thus has limited indications in pediatric patients. In this study, we aimed to identify the association between obesity and abdominal CT imaging in pediatric trauma patients.

METHODS

We performed a 4-year retrospective analysis of the American College of Surgeons Trauma Quality Improvement 2017–2020. We identified all pediatric trauma patients aged between 7 and 17 years presenting with isolated abdominal trauma (nonabdominal Abbreviated Injury Scale score, 0). We excluded patients undergoing hemorrhage control surgeries and those with missing information in height and weight. Patients were stratified by body mass index into four groups (underweight, normal, overweight, and obese [body mass index, ≥30 kg/m2]). Outcomes were predictors of undergoing CT imaging of the abdomen. Descriptive statistics and multivariable logistic regression analyses were performed.

RESULTS

We identified a total of 10,204 pediatric trauma patients. The mean age was 13 years, 68% were male, and 77% were White. The median abdominal Abbreviated Injury Scale score in all the four groups was 2. On univariate analysis, underweight patients had lowest rates (25%), whereas obese patients had highest rates of CT imaging (38%) (p < 0.001). On multivariable regression analysis, increasing age (adjusted odds ratio [aOR], 1.08; 95% confidence interval [CI], 1.06–1.10; p < 0.001), male sex (aOR, 1.14; 95% CI, 1.03–1.26; p = 0.009), White race (aOR, 0.84; 95% CI, 0.76–0.92; p < 0.011), penetrating injury (aOR, 1.16; 95% CI, 1.03–1.32; p = 0.017), obesity (aOR, 1.30; 95% CI, 1.07–1.57; p = 0.008), and management at American College of Surgeons level II (aOR, 1.63; 95% CI, 1.44–1.85; p < 0.001) and level III or lower centers (aOR, 1.17; 95% CI, 1.06–1.26; p = 0.002) were identified as independent predictors of receiving CT imaging.

CONCLUSION

Obesity is associated with increased odds of undergoing CT imaging in pediatric trauma patients independent of injury characteristics. Future efforts to define the appropriate indications for CT imaging in pediatric trauma patients are warranted to reduce the adverse effects of CT radiation.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.
Substantial role of rare inherited variation in individuals with developmental disorders
Authors: Samocha Kaitlin E. , Kartik Chundru V. , Fu Jack M. , Gardner Eugene J. , Danecek Petr , Wigdor Emilie M. , Malawsky Daniel S. , Lindsay Sarah J. , Campbell Patrick , Singh Tarjinder , Eberhardt Ruth Y. , Gallone Giuseppe , Wright Caroline F. , Martin Hilary C. , Firth Helen V. , Hurles Matthew E.
Published: August 2024

While the role ofde novoand recessively-inherited coding variation in risk for rare developmental disorders (DDs) has been well established, the contribution of damaging variation dominantly-inherited from parents is less explored. Here, we investigated the contribution of rare coding variants to DDs by analyzing 13,452 individuals with DDs, 18,613 of their family members, and 3,943 controls using a combination of family-based and case/control analyses. In line with previous studies of other neuropsychiatric traits, we found a significant burden of rare (allele frequency < 1×10-5) predicted loss-of-function (pLoF) and damaging missense variants, the vast majority of which are inherited from apparently unaffected parents. These predominantly inherited burdens are strongest in DD-associated genes or those intolerant of pLoF variation in the general population, however we estimate that ∼10% of the excess of these variants in DD cases is found within the DD-associated genes, implying many more risk loci are yet to be identified. We found similar, but attenuated, burdens when comparing the unaffected parents of individuals with DDs to controls, indicating that parents have elevated risk of DDs due to these rare variants, which are overtransmitted to their affected children. We estimate that 6-8.5% of the population attributable risk for DDs are due to rare pLoF variants in those genes intolerant of pLoF variation in the general population. Finally, we apply a Bayesian framework to combine evidence from these analyses of rare, mostly-inherited variants with priorde novomutation burden analyses to highlight an additional 25 candidate DD- associated genes for further follow up.
Monitoring seizure cycles with seizure diaries
Authors: Reynolds Ashley , Stirling Rachel E. , Håkansson Samuel , Karoly Philippa , Lai Alan , Grayden David B. , Cook Mark J. , Nurse Ewan , Peterson Andre
Published: August 2024

Objective

The periodicity of seizures, ranging from circadian to circannual cycles, is increasingly recognized as a significant opportunity to advance epilepsy management. Current methods for detecting seizure cycles rely on intrusive techniques or specialised biomarkers, limiting their accessibility. This study evaluates a non-invasive seizure cycle detection method using seizure diaries and compares its accuracy with cycles identified from intracranial electroencephalography (iEEG) seizures and interictal epileptiform discharges (IEDs).

Approach

Using data from a previously published first in-human iEEG device trial (n=10), we analysed seizure cycles identified through diary reports, iEEG seizures and IEDs. Cycle similarities across diary reports, iEEG seizures and iEDs were evaluated at periods of 1 to 45 days using spectral coherence, accuracy, precision and recall scores.

Main results

Spectral coherence of the raw signals averaged over frequencies and participants indicated moderately similar frequency components between diary seizures/day and iEEG seizures/day (Median=0.43, IQR=0.68). In contrast, there was low coherence between diary seizures/day and IEDs/day (Median=0.11, IQR=0.18) and iEEG seizures/day and IEDs/day (Median=0.12, IQR=0.19). Mean accuracy, precision and recall of iEEG seizure cycles from diary seizure cycles was significantly higher than chance across all participants (Accuracy: Mean=0.95, SD=0.02; Precision: Mean=0.56, SD=0.19; Recall: Mean=0.56, SD=0.19). Accuracy, precision and recall scores between seizures cycles using diary or iEEG compared to IED cycles did not perform above chance, on average. Recall scores were compared across good diary reporters, under-reporters and over-reporters, with recall scores generally performing better in good reporters and under-reporters (Mean=0.74, SD=0.02) compared to over-reporters (Mean=0.37, SD=0.06).

Significance

These findings suggest that iEEG seizure cycles can be identified with diary reports, even in both under- and over-reporters. This approach offers a practical, accessible alternative for monitoring seizure cycles compared to more invasive methods.

Key points

Seizure cycles identified from seizure diaries can identify the same cycle periods to those detected by intracranial electroencephalography with high accuracy.

Seizure under and overreporting reduces the accuracy of seizure cycle detection from diaries.
Maternal humoral factors modulate offspring gut immune homeostasis to mitigate diabetes development
Authors: Strachan Erin , Pessoa-Soares Luisa , Ju Tingting , Schcolnik-Cabrera Alejandro , Wang Henry , Akbari Masoud , Basso Paulo Jose , Winer Daniel A. , Huang Carol , Julien Olivier , Willing Benjamin P. , Clemente-Casares Xavier , Tsai Sue
Published: August 2024

Environmental risk factors possess the potential to modulate the pathogenesis of type I diabetes (T1D). Foremost among these factors are early life influences impacting the gastrointestinal (GI) tract. During infancy, both the microbiota and immune system are influenced by maternal factors contributing to key events in the neonatal GI tract. Despite the well-known importance of maternal factors on infant immune development, whether maternal immune dysregulation and dysbiosis can perpetuate the same in offspring remains largely unknown. To explore how these maternal factors impact offspring disease development, we used IgA-deficiency induced maternal dysbiosis in Non-Obese Diabetic (NOD) dams to study T1D development in their progeny. We found that maternal dysbiosis led to changes in IgA-sufficient offspring immune development resulting in heightened GI immune activity. Maternal dysbiosis also contributed to altered microbiome establishment in progeny, such that pups exhibited reduced colonic abundance ofAkkermansia muciniphilaandClostridoides difficile. In adulthood, these mice exhibited a lowered incidence of T1D. This protection was replicated by fostering high incidence offspring to dysbiotic dams, prompting us to propose that altered breast milk composition in dysbiotic dams can influence immune development and microbiome establishment in offspring, contributing to T1D resistance.
A two-dose regimen of Qβ virus-like particle-based vaccines elicit protective antibodies against heroin and fentanyl
Authors: Romano Isabella G. , Johnson-Weaver Brandi , Core Susan B. , Jamus Andzoa N. , Brackeen Marcus , Blough Bruce , Dey Subhakar , Huang Yumei , Staats Herman , Wetsel William C. , Chackerian Bryce , Frietze Kathryn M.
Published: August 2024

Opioid overdoses and the growing rate of opioid use disorder (OUD) are major public health concerns, particularly in the United States. Current treatment approaches for OUD have failed to slow the growth of the opioid crisis. Opioid vaccines have shown pre-clinical success in targeting multiple different opioid drugs. However, the need for many immunizations can limit their clinical implementation. In this study, we investigate the development of novel opioid vaccines by independently targeting fentanyl and the active metabolites of heroin using a bacteriophage virus-like particle (VLP) vaccine platform. We establish the successful conjugation of haptens to bacteriophage Qβ VLPs and demonstrate immunogenicity of Qβ-fentanyl, Qβ-morphine, and Qβ-6-acetylmorphine in animal models after one or two immunizations. We show that in independently or in combination, these vaccines elicit high-titer, high-avidity, and durable antibody responses. Moreover, we reveal their protective capacities against heroin or fentanyl challenge after two immunizations. Overall, these findings establish Qβ-VLP conjugated vaccines for heroin and fentanyl as very promising opioid vaccine candidates.
State-Threatened Gopher Tortoise (Gopherus polyphemus) Gut Microbiome Analysis Reveals Health Insights into Southeastern Florida Population
Authors: Giakoumas Dimitrios S. , Moore Jon , Stamper Ericca , Bernot Kelsie M. , Mincer Tracy J.
Published: August 2024

The gopher tortoise (Gopherus polyphemus), endemic to the southeastern part of the United States, is a keystone species that provides ecological support to over 350 species. Deforestation, urbanization, road mortality, and disease, over the past 100 years, have caused population decline by over 80%, causing Florida to declare the gopher tortoise a threatened species. Little is known about the gopher tortoise gut microbiome, which could play a major role in tortoise health. This study aimed to better understand the health and biology of this threatened keystone species through the characterization and analysis of their gut microbiomes in the Abacoa Greenway of Southeastern Florida using next-generation sequencing to survey the gut microbiome. Major findings include: high levels of alpha diversity; lack of significant difference of male and female alpha diversity and taxonomic composition profiles and, counterintuitively, male beta diversity was less disparate than female beta diversity; phyla associated with fiber fermentation short-chain fatty acid metabolism, Firmicutes and Bacteroidetes, predominated all samples. Notable probiotic taxa present included: Lachnospiraceae andClostridium butyricum. Potentially pathogenic taxa included:Helicobactersp. and Mollicutes sp. Pathogenetic taxa undetected: gopher tortoiseHelicobacter, andMycoplasmaspp. These results add to the understudied reptiles and tortoise gut microbiome.