bluuebunny/crossref_metadata_2025 huggingface dataset:
Interplay of the transcription factor MRTF-A and matrix stiffness controls mammary acinar structure and protrusion formation
Authors: Melcher Marie-Luise , Block Ines , Kropf Karolin , Singh Anurag Kumar , Posern Guido
Published: October 2022

Background

Ongoing differentiation processes characterize the mammary gland during sexual development and reproduction. In contrast, defective remodelling is assumed to be causal for breast tumorigenesis. We have shown recently that the myocardin-related transcription factor A (MRTF-A) is essential for forming regular hollow acinar structures. Moreover, MRTF-A activity is known to depend on the biochemical and physical properties of the surrounding extracellular matrix. In this study we analysed the mutual interaction of different matrix stiffnesses and MRTF-A activities on formation and maintenance of mammary acini.

Methods

Human MCF10A acini and primary mature organoids isolated from murine mammary glands were cultivated in 3D on soft and stiff matrices (200–4000 Pa) in conjunction with the Rho/MRTF/SRF pathway inhibitor CCG-203971 and genetic activation of MRTF-A.

Results

Three-dimensional growth on stiff collagen matrices (> 3000 Pa) was accompanied by increased MRTF-A activity and formation of invasive protrusions in acini cultures of human mammary MCF10A cells. Differential coating and synthetic hydrogels indicated that protrusion formation was attributable to stiffness but not the biochemical constitution of the matrix. Stiffness-induced protrusion formation was also observed in preformed acini isolated from murine mammary glands. Acinar outgrowth in both the MCF10A acini and the primary organoids was partially reverted by treatment with the Rho/MRTF/SRF pathway inhibitor CCG-203971. However, genetic activation of MRTF-A in the mature primary acini also reduced protrusion formation on stiff matrices, whilst it strongly promoted luminal filling matrix-independently.

Conclusion

Our results suggest an intricate crosstalk between matrix stiffness and MRTF-A, whose activity is required for protrusion formation and sufficient for luminal filling of mammary acini.
Quantitative measurement of resistance force and subsequent attenuation during passive isokinetic extension of the wrist in patients with mild to moderate spasticity after stroke
Authors: Kawamura Kentaro , Etoh Seiji , Noma Tomokazu , Hayashi Ryota , Jonoshita Yuiko , Natsume Keisuke , Niidome Seiichi , Yu Yong , Shimodozono Megumi
Published: October 2022

Background

Spasticity is evaluated by measuring the increased resistance to passive movement, primarily by manual methods. Few options are available to measure spasticity in the wrist more objectively. Furthermore, no studies have investigated the force attenuation following increased resistance. The aim of this study was to conduct a safe quantitative evaluation of wrist passive extension stiffness in stroke survivors with mild to moderate spastic paresis using a custom motor-controlled device. Furthermore, we wanted to clarify whether the changes in the measured values could quantitatively reflect the spastic state of the flexor muscles involved in the wrist stiffness of the patients.

Materials and methods

Resistance forces were measured in 17 patients during repetitive passive extension of the wrist at velocities of 30, 60, and 90 deg/s. The Modified Ashworth Scale (MAS) in the wrist and finger flexors was also assessed by two skilled therapists and their scores were averaged (i.e., average MAS) for analysis. Of the fluctuation of resistance, we focused on the damping just after the peak forces and used these for our analysis. A repeated measures analysis of variance was conducted to assess velocity-dependence. Correlations between MAS and damping parameters were analyzed using Spearman’s rank correlation.

Results

The damping force and normalized value calculated from damping part showed significant velocity-dependent increases.

There were significant correlations (ρ = 0.53–0.56) between average MAS for wrist and the normalized value of the damping part at 90 deg/s. The correlations became stronger at 60 deg/s and 90 deg/s when the MAS for finger flexors was added to that for wrist flexors (ρ = 0.65–0.68).

Conclusions

This custom-made isokinetic device could quantitatively evaluate spastic changes in the wrist and finger flexors simultaneously by focusing on the damping part, which may reflect the decrease in resistance we perceive when manually assessing wrist spasticity using MAS.

Trial registration UMIN Clinical Trial Registry, as UMIN000030672, on July 4, 2018
Laparoscopic versus open emergent colectomy for ischemic colitis: a propensity score-matched comparison
Authors: Chen Yi-Chang , Tsai Yuan-Yao , Chang Sheng-Chi , Chen Hung-Chang , Ke Tao-Wei , Fingerhut Abe , Chen William Tzu-Liang
Published: October 2022

Introduction

Laparoscopic colectomy is rarely performed for ischemic colitis. The aim of this propensity score-matched study was to compare preoperative characteristics, intraoperative details and short-term outcomes for emergent laparoscopic colectomy versus the traditional open approach for patients with ischemic colitis.

Methods

Retrospective review of 96 patients who underwent emergent colectomy for ischemic colitis between January 2011 and December 2020 (39 via laparoscopy, 57 via laparotomy) was performed. We compared short-term outcomes after using a one-to-one ratio and nearest-neighbor propensity score matching to obtain similar preoperative and intraoperative parameters in each group.

Results

Patients in the open group experienced more surgical site complications (52.6% vs. 23.0%, p = 0.004), more intra-abdominal abscesses (47.3% vs. 17.9%, p = 0.003), longer need for ventilator support (20 days vs. 0 days, p < 0.001), more major complications (77.2% vs. 43.5%, p = 0.001), higher mortality (49.1% vs. 20.5%, p = 0.004), and longer hospital stay (32 days vs. 19 days, p = 0.001). After propensity score matching (31 patients in each group), patients undergoing open (vs. laparoscopy) had more surgical site complications (45.1% vs. 19.4%, p = 0.030) and required longer ventilator support (14 vs. 3 days, p = 0.039). After multivariate analysis, Charlson Comorbidity Index (p = 0.024), APACHE II score (p = 0.001), and Favier’s classification (p = 0.023) were independent predictors of mortality.

Conclusions

Laparoscopic emergent colectomy for ischemic colitis is feasible and is associated with fewer surgical site complications and better respiratory function, compared to the open approach.
Metabolic engineering of Escherichia coli BW25113 for the production of 5-Aminolevulinic Acid based on CRISPR/Cas9 mediated gene knockout and metabolic pathway modification
Authors: Ye Changchuan , Yang Yuting , Chen Xi , Yang Lijie , Hua Xia , Yang Mengjie , Zeng Xiangfang , Qiao Shiyan
Published: October 2022

Background

5-Aminolevulinic acid (ALA) recently received much attention due to its potential application in many fields. In this study, an ALA production strain of Escherichia coli was constructed by rational metabolic engineering and stepwise improvement based on known regulatory and metabolic information and CRISPR/Cas9 mediated gene knockout.

Results

A metabolic strategy to produce ALA directly from glucose in this recombinant E. coli via the C5 pathway was applied herein. The rational metabolic engineering by gene knockouts significantly improved ALA production from 662.3 to 1601.7 mg/L. In addition, we managed to synergistically produce ALA via the C4 pathway in recombinant strain. The expression of a modified hemA gene, encoding an ALA synthase from Rhodobacter sphaeroides, improved ALA production from 1601.7 to 2099.7 mg/L. After 24 h cultivation, a yield of 0.210 g ALA per g glucose was achieved by constructed E. coli D5:FYABD-RSA.

Conclusion

Our study revealed that an industrially competitive strain can be efficiently developed by metabolic engineering based on combined rational modification and optimization of gene expression.
Experimentally designed electrochemical sensor for therapeutic drug monitoring of Ondansetron co-administered with chemotherapeutic drugs
Authors: Abdel Rahman Mona A. , Atty Shimaa A. , El-Mosallamy Sally S. , Elghobashy Mohamed R. , Zaazaa Hala E. , Saad Ahmed S.
Published: October 2022

The experimental design extracts valuable information about the main effects and interactions from the least number of experiments. The current work constructs a solid-state sensor for selective assay of Ondansetron (OND) in pharmaceutical dosage form and plasma samples. During optimization, the Design Expert®statistical package constructed a custom design of 15 sensors with different recipes. We fed the software with the experimentally observed performance parameters for each sensor (slope, LOQ, correlation coefficient, and selectivity coefficient for sodium ions). The computer software analyzed the results to construct a prediction model for each response. The desirability function was adjusted to optimize the Nernstian slope, minimize the LOQ and selectivity coefficients, and maximize the correlation coefficient (r). The practical responses of the optimized sensor were close to those predicted by the model (slope = 60.23 mV/decade slope, LOQ = 9.09 × 10–6 M, r = 0.999, sodium selectivity coefficient = 1.09 × 10−3). The sensor successfully recovered OND spiked to tablets and human plasma samples with mean percentage recoveries of 100.01 ± 1.082 and 98.26 ± 2.227, respectively. Results were statistically comparable to those obtained by the reference chromatographic method. The validated potentiometric method can be used for fast and direct therapeutic drug monitoring of OND co-administered with chemotherapeutic drugs in plasma samples.
Nationwide molecular survey of Dirofilaria immitis and Dirofilaria repens in companion dogs and cats, United States of America
Authors: Smith Rachel , Murillo Daniel Felipe Barrantes , Chenoweth Kelly , Barua Subarna , Kelly Patrick John , Starkey Lindsay , Blagburn Byron , Wood Theresa , Wang Chengming
Published: October 2022

Background

Heartworms, Dirofilaria immitis, are known to be widespread in dogs and cats in the USA, but there have been no country-wide prevalence studies performed to date. There have also been no large-scale studies to determine whether the closely related species, Dirofilaria repens, occurs in the USA.

Methods

To provide this large-scale data, we examined whole blood samples (n = 2334) submitted from around the USA to the Molecular Diagnostic Laboratory at Auburn University between 2016 and 2022. Quantitative PCRs for D. immitis (targeting 16S rRNA) and D. repens (targeting cytochrome c oxidase subunit 1 gene) were performed to determine the presence of Dirofilaria DNA. DNA sequencing was performed to confirm the results.

Results

Dirofilaria immitis DNA was found in 6.3% (68/1080) of the dogs from 17/39 states, and 0.3% (4/1254) of the cats from 4/42 states. None of the dogs or cats were positive for D. repens. The average 16S rRNA copy number of D. immitis in the dogs was 1,809,604 in 200 µl whole blood, while only a single copy was found in each of the four D. immitis-positive cats. The prevalence of D. immitis in dogs of different ages, sexes, and breeds did not differ significantly, but the prevalence in Southern states (7.5%, 60/803) was significantly higher than in the Western (1.7%, 1/58), Midwest (3.3%, 4/120), and Northeastern states (3.1%, 3/98) (P < 0.05). Dogs positive for D. immitis were identified in each study year (2016: 4.2%, 2/48; 2017: 9.8%, 4/41; 2018: 5.1%, 8/156; 2019: 4.9%, 15/306; 2020: 9.8%, 26/265; 2021: 4.9%, 13/264). Interestingly, dogs infected with Hepatozoon spp. (11.8%, 37/313) were significantly more likely to also be positive for D. immitis than dogs without evidence of Hepatozoon infection (3.9%, 30/760) (P < 0.0001).

Conclusions

To our knowledge, this is the first nationwide molecular survey of Dirofilaria spp. in dogs and cats in the USA, and the largest molecular survey of canine and feline dirofilariosis worldwide. Further studies are warranted to combine PCR with standard heartworm diagnostics to better understand the prevalence of Dirofilaria spp. and aid in determining the risks posed to dogs and cats in the USA.

Graphical Abstract
CTpathway: a CrossTalk-based pathway enrichment analysis method for cancer research
Authors: Liu Haizhou , Yuan Mengqin , Mitra Ramkrishna , Zhou Xu , Long Min , Lei Wanyue , Zhou Shunheng , Huang Yu-e , Hou Fei , Eischen Christine M. , Jiang Wei
Published: October 2022

Background

Pathway enrichment analysis (PEA) is a common method for exploring functions of hundreds of genes and identifying disease-risk pathways. Moreover, different pathways exert their functions through crosstalk. However, existing PEA methods do not sufficiently integrate essential pathway features, including pathway crosstalk, molecular interactions, and network topologies, resulting in many risk pathways that remain uninvestigated.

Methods

To overcome these limitations, we develop a new crosstalk-based PEA method, CTpathway, based on a global pathway crosstalk map (GPCM) with >440,000 edges by combing pathways from eight resources, transcription factor-gene regulations, and large-scale protein-protein interactions. Integrating gene differential expression and crosstalk effects in GPCM, we assign a risk score to genes in the GPCM and identify risk pathways enriched with the risk genes.

Results

Analysis of >8300 expression profiles covering ten cancer tissues and blood samples indicates that CTpathway outperforms the current state-of-the-art methods in identifying risk pathways with higher accuracy, reproducibility, and speed. CTpathway recapitulates known risk pathways and exclusively identifies several previously unreported critical pathways for individual cancer types. CTpathway also outperforms other methods in identifying risk pathways across all cancer stages, including early-stage cancer with a small number of differentially expressed genes. Moreover, the robust design of CTpathway enables researchers to analyze both bulk and single-cell RNA-seq profiles to predict both cancer tissue and cell type-specific risk pathways with higher accuracy.

Conclusions

Collectively, CTpathway is a fast, accurate, and stable pathway enrichment analysis method for cancer research that can be used to identify cancer risk pathways. The CTpathway interactive web server can be accessed here http://www.jianglab.cn/CTpathway/. The stand-alone program can be accessed here https://github.com/Bioccjw/CTpathway.
The relationship between core muscle endurance and functional movement screen scores in females with lumbar hyperlordosis: a cross-sectional study
Authors: Fallahasady Eiva , Rahmanloo Nafise , Seidi Foad , Rajabi Reza , Bayattork Mohammad
Published: October 2022

Background

Core muscle endurance is essential for proper movement and lower extremity injury prevention. In addition, the Functional Movement Screen (FMS) score is a tool to assess body movement patterns to predict the risk of injury. Although various researches have investigated the relationship between the core muscle endurance and the FMS score, no study has ever assessed the effect of postural deformity on the FMS score. This study investigates the relationship between core muscle endurance and FMS scores in females with lumbar hyperlordosis.

Methods

42 healthy females aged 24.03 ± 4.4 years with hyperlordosis ( > = 45/66 degrees) participated in this study. Core muscle endurance was assessed by the McGill stability test. Correlations were evaluated between the FMS score, McGill test, and lordosis angle using spearman correlation coefficients (p ≤ 0.05).

Results

Most individual FMS scores were not correlated with the McGill test except stability trunk push up. Also, lordosis angle was not correlated with the FMS composite score (r=-0.077; p = 0.631), while it was negatively correlated with the McGill test (r=-0.650; p = 0.000).

Conclusion

The lack of correlation between the FMS score and the McGill test implies that one’s level of core endurance may not influence their functional movement patterns. In contrast, the lumbar lordosis angle might impact one’s core muscle endurance but not their functional movement patterns.
Why do ‘OFF’ periods still occur during continuous drug delivery in Parkinson’s disease?
Authors: Rota Silvia , Urso Daniele , van Wamelen Daniel J. , Leta Valentina , Boura Iro , Odin Per , Espay Alberto J. , Jenner Peter , Chaudhuri K. Ray
Published: October 2022

Continuous drug delivery (CDD) is used in moderately advanced and late-stage Parkinson’s disease (PD) to control motor and non-motor fluctuations (‘OFF’ periods). Transdermal rotigotine is indicated for early fluctuations, while subcutaneous apomorphine infusion and levodopa-carbidopa intestinal gel are utilised in advanced PD. All three strategies are considered examples of continuous dopaminergic stimulation achieved through CDD. A central premise of the CDD is to achieve stable control of the parkinsonian motor and non-motor states and avoid emergence of ‘OFF’ periods. However, data suggest that despite their efficacy in reducing the number and duration of ‘OFF’ periods, these strategies still do not prevent ‘OFF’ periods in the middle to late stages of PD, thus contradicting the widely held concepts of continuous drug delivery and continuous dopaminergic stimulation. Why these emergent ‘OFF’ periods still occur is unknown. In this review, we analyse the potential reasons for their persistence. The contribution of drug- and device-related involvement, and the problems related to site-specific drug delivery are analysed. We propose that changes in dopaminergic and non-dopaminergic mechanisms in the basal ganglia might render these persistent ‘OFF’ periods unresponsive to dopaminergic therapy delivered via CDD.
Clinical research diagnostic criteria for bipolar illness (CRDC-BP): rationale and validity
Authors: Ghaemi S. Nassir , Angst Jules , Vohringer Paul A. , Youngstrom Eric A. , Phelps James , Mitchell Philip B. , McIntyre Roger S. , Bauer Michael , Vieta Eduard , Gershon Samuel
Published: October 2022

Background

In the 1970 s, scientific research on psychiatric nosology was summarized in Research Diagnostic Criteria (RDC), based solely on empirical data, an important source for the third revision of the official nomenclature of the American Psychiatric Association in 1980, the Diagnostic and Statistical Manual, Third Edition (DSM-III). The intervening years, especially with the fourth edition in 1994, saw a shift to a more overtly “pragmatic” approach to diagnostic definitions, which were constructed for many purposes, with research evidence being only one consideration. The latest editions have been criticized as failing to be useful for research. Biological and clinical research rests on the validity of diagnostic definitions that are supported by firm empirical foundations, but critics note that DSM criteria have failed to prioritize research data in favor of “pragmatic” considerations.

Results

Based on prior work of the International Society for Bipolar Diagnostic Guidelines Task Force, we propose here Clinical Research Diagnostic Criteria for Bipolar Illness (CRDC–BP) for use in research studies, with the hope that these criteria may lead to further refinement of diagnostic definitions for other major mental illnesses in the future. New proposals are provided for mixed states, mood temperaments, and duration of episodes.

Conclusions

A new CRDC could provide guidance toward an empirically-based, scientific psychiatric nosology, and provide an alternative clinical diagnostic approach to the DSM system.
Relationship between inflammatory biomarkers, vitamin D levels, and depressive symptoms in late pregnancy and during the postpartum period: a prospective, observational study
Authors: Nassr Ola Ali , Mohammed Mohammed Mahmood , Showman Hind Abdulkhaliq
Published: October 2022

Background

Perinatal depression impacts maternal and fetal health, and exhibits a high rate of continuity postpartum. Not only does it impair the maternal quality of life, it also increases the risk of adverse birth and developmental problems in offspring. Vitamin D deficiency and excessive inflammation have been associated with perinatal depression. There is a scarcity of evidence regarding the biological causes of maternal depression in Iraq, therefore, the present study aims to assess perinatal depressive symptoms associations with inflammatory markers and vitamin D levels, and to investigate the interaction between vitamin D and the inflammatory markers. A prospective, observational study design was utilized to recruit healthy pregnant women from private obstetrics clinic in Baghdad, Iraq, from April to September 2021. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms during the third trimester and at 6 months postpartum. Serum levels of interleukin (IL)-6, C-reactive protein (CRP), and 25-hydroxy vitamin D (25-OH-D) were quantified, using a fully automated chemiluminescence immunoassay analyzer.

Results

Eighty patients were eligible for inclusion. The antenatal EPDS scores demonstrated a significant association with square root IL-6 (B = – 0.025, p = 0.040) and no association with CRP or vitamin D levels. The severity of postpartum depressive symptoms tended towards a positive association, with larger increases of CRP concentration (p = 0.065). In contrast, the association between marital relationship quality and CRP was statistically significant (p = 0.001). There was a statistically significant association between CRP and vitamin D concentration (p = 0.041). Antepartum EPDS significantly predicted the postpartum EPDS score (p = 0.000, B = 0.180, R2 for the model = 0.976, CI (0.17–0.19)).

Conclusions

The study findings show a significant association between third trimester depressive symptoms and IL-6 concentration. CRP and vitamin D levels do not correlate with perinatal depressive symptoms and a poor marital relationship significantly elevates the CRP level. In addition, vitamin D level was associated with CRP level and antepartum depressive symptoms predict postpartum EPDS score. Future studies involving a larger population and including women with pregnancy complications would provide a further insight into the role of inflammation and vitamin D deficiency in the etiology of perinatal depression.
Cautious Artificial Intelligence Improves Outcomes and Trust by Flagging Outlier Cases
Authors: Kanse Abhiraj S. , Kurian Nikhil C. , Aswani Himanshu P. , Khan Zakia , Gann Peter H. , Rane Swapnil , Sethi Amit
Published: October 2022

PURPOSE

Artificial intelligence (AI) models for medical image diagnosis are often trained and validated on curated data. However, in a clinical setting, images that are outliers with respect to the training data, such as those representing rare disease conditions or acquired using a slightly different setup, can lead to wrong decisions. It is not practical to expect clinicians to be trained to discount results for such outlier images. Toward clinical deployment, we have designed a method to train cautious AI that can automatically flag outlier cases.

MATERIALS AND METHODS

Our method—ClassClust—forms tight clusters of training images using supervised contrastive learning, which helps it identify outliers during testing. We compared ClassClust's ability to detect outliers with three competing methods on four publicly available data sets covering pathology, dermatoscopy, and radiology. We held out certain diseases, artifacts, and types of images from training data and examined the ability of various models to detect these as outliers during testing. We compared the decision accuracy of the models on held-out nonoutlier images also. We visualized the regions of the images that the models used for their decisions.

RESULTS

Area under receiver operating characteristic curve for outlier detection was consistently higher using ClassClust compared with the previous methods. Average accuracy on held-out nonoutlier images was also higher, and the visualizations of image regions were more informative using ClassClust.

CONCLUSION

The ability to flag outlier test cases need not be at odds with the ability to accurately classify nonoutliers in AI models. Although the latter capability has received research and regulatory attention, AI models for clinical deployment should possess the former as well.
A Pragmatic Cluster-Randomized Trial of a Standing Order Entry Intervention for Colony-Stimulating Factor Use Among Patients at Intermediate Risk for Febrile Neutropenia
Authors: Hershman Dawn L. , Bansal Aasthaa , Sullivan Sean D. , Barlow William E. , Arnold Kathryn B. , Watabayashi Kate , Bell-Brown Ari , Le-Lindqwister Nguyet A. , Dul Carrie L. , Brown-Glaberman Ursa A. , Behrens Robert J. , Vogel Victor , Alluri Nitya , Ramsey Scott D.
Published: October 2022

PURPOSE

Primary prophylactic colony-stimulating factors (PP-CSFs) are prescribed to reduce febrile neutropenia (FN) but their benefit for intermediate FN risk regimens is uncertain. Within a pragmatic, randomized trial of a standing order entry (SOE) PP-CSF intervention, we conducted a substudy to evaluate the effectiveness of SOE for patients receiving intermediate-risk regimens.

METHODS

TrACER was a cluster randomized trial where practices were randomized to usual care or a guideline-based SOE intervention. In the primary study, sites were randomized 3:1 to SOE of automated PP-CSF orders for high FN risk regimens and alerts against PP-CSF use for low-risk regimens versus usual care. A secondary 1:1 randomization assigned 24 intervention sites to either SOE to prescribe or an alert to not prescribe PP-CSF for intermediate-risk regimens. Clinicians were allowed to over-ride the SOE. Patients with breast, colorectal, or non–small-cell lung cancer were enrolled. Mixed-effect logistic regression models were used to test differences between randomized sites.

RESULTS

Between January 2016 and April 2020, 846 eligible patients receiving intermediate-risk regimens were registered to either SOE to prescribe (12 sites: n = 542) or an alert to not prescribe PP-CSF (12 sites: n = 304). Rates of PP-CSF use were higher among sites randomized to SOE (37.1% v 9.9%, odds ratio, 5.91; 95% CI, 1.77 to 19.70; P = .0038). Rates of FN were low and identical between arms (3.7% v 3.7%).

CONCLUSION

Although implementation of a SOE intervention for PP-CSF significantly increased PP-CSF use among patients receiving first-line intermediate-risk regimens, FN rates were low and did not differ between arms. Although this guideline-informed SOE influenced prescribing, the results suggest that neither SOE nor PP-CSF provides sufficient benefit to justify their use for all patients receiving first-line intermediate-risk regimens.
Does a Screening Trial for Spinal Cord Stimulation in Patients With Chronic Pain of Neuropathic Origin Have Clinical Utility (TRIAL-STIM)? 36-Month Results From a Randomized Controlled Trial
Authors: Eldabe Sam , Nevitt Sarah , Griffiths Sara , Gulve Ashish , Thomson Simon , Baranidharan Ganesan , Houten Rachel , Brookes Morag , Kansal Anu , Earle Jenny , Bell Jill , Taylor Rod S. , Duarte Rui V.
Published: October 2022

BACKGROUND:

Screening trials before full implantation of a spinal cord stimulation device are recommended by clinical guidelines and regulators, although there is limited evidence for their use. The TRIAL-STIM study showed that a screening trial strategy does not provide superior patient pain outcome at 6-month follow-up compared with not doing a screening trial and that it was not cost-effective.

OBJECTIVE:

To report the long-term follow-up results of the TRIAL-STIM study.

METHODS:

The primary outcome of this pragmatic randomized controlled trial was pain intensity as measured on a numerical rating scale (NRS) and secondary outcomes were the proportion of patients achieving at least 50% and 30% pain relief at 6 months, health-related quality of life, and complication rates.

RESULTS:

Thirty patients allocated to the “Trial Group” (TG) and 36 patients allocated to the “No Trial Group” (NTG) completed outcome assessment at 36-month follow-up. Although there was a reduction in NRS pain and improvements in utility scores from baseline to 36 months in both groups, there was no difference in the primary outcome of pain intensity NRS between TG and NTG (adjusted mean difference: −0.60, 95% CI: −1.83 to 0.63), EuroQol-5 Dimension utility values (adjusted mean difference: −0.02, 95% CI: −0.13 to 0.10), or proportion of pain responders (33% TG vs 31% NTG). No differences were observed between the groups for the likelihood of spinal cord stimulation device explant or reporting an adverse advent up to 36-month follow-up.

CONCLUSION:

The long-term results show no patient outcome benefit in undertaking an SCS screening trial.
Unilateral Approaches for Posterior Spinal Canal Decompression in Cervical Spondylotic Myelopathy—An Evaluation of Conceptual Feasibility
Authors: Siller Sebastian , Pannenbaecker Laura , Tonn Joerg-Christian , Zausinger Stefan
Published: October 2022

BACKGROUND:

Patients with cervical spondylotic myelopathy (CSM) can be treated with posterior approaches for spinal canal decompression.

OBJECTIVE:

We compared the patients' outcome after 2 different unilateral and a bilateral posterior approach for decompression to elucidate feasibility and potential procedure-related differences.

METHODS:

Medical records of 98 patients with CSM undergoing posterior decompression between 2012 and 2018 were assessed. Patients were divided into 3 groups: (1) unilateral interlaminar fenestration with over-the-top “undercutting” (laminotomy) for compression limited to a ligamentum flavum hypertrophy, (2) unilateral hemilaminectomy for lateralized compression with a combination of ligamentous hypertrophy and osseus stenosis, and (3) laminectomy/laminoplasty for circular osseous-ligamentous spinal canal narrowing.

RESULTS:

The mean age was 73 years (m:f = 1.4:1), and most frequent symptoms (mean duration: 15 months) were ataxia (69%) and sensory changes (57%). Main location of stenoses (median Naganawa Score = 3; mean anteroposterior spinal canal diameter = 7.7 ± 2.2 mm) was C3 to C6. Thirty-one percent of the patients were assigned for a laminotomy procedure, 20% for a hemilaminectomy, and 49% for a laminectomy/laminoplasty. There were no significant differences of patients' characteristics, blood loss, and operation time between the 3 groups. Independent from the mode of surgery, the spinal canal was significantly widened (median Naganawa Score = 0; mean anteroposterior diameter = 11.4 ± 3.6 mm) and myelopathy (mJOA Score) improved (P < .001); a higher body mass index was significantly correlated with a worse mJOA improvement (r = 0.293/P = .003). Quality of life (Short-Form 36v2 Health Survey/Neck Disability Index) and reduction of the neck pain level were similar in the 3 groups at last follow-up (mean: 28 months).

CONCLUSION:

To minimize patients' periprocedural burden in CSM with dorsal compression, individual tailoring of the posterior approach according to the underlying compressive pathology achieves sufficient decompression and comparable long-term results.
Ten-Step 3-Dimensional-Navigated Single-Stage Lateral Surgery With Microtubular Decompression: A Case Series
Authors: McGrath Lynn B. , Gadjradj Pravesh S. , Hussain Ibrahim , Takoushian Eric , Kirnaz Sertac , Goldberg Jacob L. , Sommer Fabian , Navarro-Ramirez Rodrigo , Mykolajtchuk Catherine , Ng Amanda Z. , Basilious Mark , Medary Branden , Härtl Roger
Published: October 2022

BACKGROUND:

Single-stage lateral lumbar interbody fusion is a safe and effective procedure that relies on indirect decompression and fusion to treat various lumbar pathologies. This technique, however, has an overall 9% rate of indirect decompression failure, which may require additional surgery to achieve adequate direct decompression. To address this concern, we modified this technique by adding a minimally invasive, direct tubular decompression in lateral position when indicated. No study has described the technical nuances of incorporating a microtubular decompression into the single-stage lateral lumbar interbody fusion workflow (SSLLIF+).

OBJECTIVE:

To report on the procedural steps and clinical outcomes of the SSLLIF+.

METHODS:

In this retrospective case series of prospectively collected data, we present the detailed surgical approach of the SSLLIF+ with a single-center case series over a 5-year period. Surgical and clinical outcomes are presented.

RESULTS:

A total of 7 patients underwent a SSLLIF+ with a total of 18 levels fused and 7 levels decompressed. The SSLLIF+ was successfully performed in all cases without the occurrence of intraoperative complications in this case series. There was 1 revision after 20 months of follow-up because of adjacent segment disease. There was no need for further direct decompression in a delayed fashion.

CONCLUSION:

SSLLIF with direct microtubular decompression in lateral position is a safe and effective procedure in patients where indirect decompression alone may not achieve the surgical goal. Adherence to minimally invasive spine surgery principles and thoughtful patient selection facilitate the successful management of these patients while demonstrating short hospital stay and low-risk of perioperative complications.
Diaphragmatic Hernia With Incarcerated Spleen as a Complication After Lateral Anterior Column Realignment
Authors: Jamshidi Aria M. , Martin Joel R. , Kutlu Onur C. , Wang Michael Y.
Published: October 2022

BACKGROUND:

The creation of sagittal balance of the spine is critical in the treatment adult spinal deformity. Anterior column release (ACR) has gained traction as a minimally invasive alternative to pedicle subtraction osteotomy. By releasing the anterior longitudinal ligament, the anterior column can be lengthened and physiologic lordosis restored. Risks such as transient psoas weakness and thigh numbness have been well documented in the literature; however, diaphragmatic hernia has never been reported.

OBJECTIVE:

To highlight the difficulties encountered in diagnosing, managing, and treating iatrogenic diaphragmatic hernia in the setting of ACR and stress the relevant retropleural, retroperitoneal, and diaphragmatic structures during the surgical approach.

METHODS:

In this technical note, we discuss the relevant anatomy in a direct lateral approach to the thoracolumbar junction and the management of an iatrogenic diaphragmatic hernia, which occurred in a patient who underwent a L1 ACR.

RESULTS:

Three months after surgery, our patient was assessed in clinic and endorsed significant improvements in her pain and mobility. Her 3-month postoperative scoliosis x-rays demonstrated a significant improvement in her sagittal alignment, and she experienced no further negative sequelae from the iatrogenic hernia.

CONCLUSION:

Iatrogenic diaphragmatic hernia with an intrathoracic spleen after direct lateral ACR is a risk spine surgeons should be aware of and address promptly.
Techniques for Safe Removal of Spinal Cord Stimulation Paddle Leads
Authors: Topp Gregory , Harland Tessa , Spurgas Morgan , Rock Andrew , Pilitsis Julie G.
Published: October 2022

BACKGROUND:

Spinal cord stimulation (SCS) is a safe neuromodulatory treatment used to treat failed back surgery syndrome, chronic neuropathic pain, and complex regional pain syndrome. Despite its efficacy, some patients fail to achieve pain relief and elect to undergo removal of SCS paddle leads. The safety and best practices of these procedures have not been defined.

OBJECTIVE:

In this article, we describe our technique and complication rate in a series of SCS paddle removals.

METHODS:

All patients who underwent SCS paddle removal at the Albany Medical Center between 2011 and 2020 were identified. Medical charts were reviewed for demographic data, operative technique, and incidence of complications within 30 days of the procedure.

RESULTS:

Thirty-two (91%) patients underwent a thoracic paddle removal, whereas 3 (9%) underwent a cervical paddle removal. All cases underwent preoperative imaging with computed tomography or MRI, and all cases were performed with neuromonitoring and fluoroscopy. The technique required for paddle removal depended on the extent of local scar formation and ranged from soft tissue dissection to additional laminectomy at an adjacent level. Cases took on average 2 ± 0.09 hours with 23.21 ± 4.29 cc blood loss. Two patients had superficial infections, which were cleared with 1 week of oral antibiotics. There were no other adverse events.

CONCLUSION:

Thirty-five patients successfully underwent paddle removal with the minor complications reported. In this article, we show that by using neuromonitoring, fluoroscopy, and the techniques described, SCS paddle removal can be performed with minimal risk.
Arteriovenous Fistulas Fed by Spinal Arterial Feeders at the Craniocervical Junction Region
Authors: Song Zihao , Ma Yongjie , Hong Tao , Zhang Hongqi
Published: October 2022

BACKGROUND:

Arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) region with spinal arterial feeders are rare. There are few reports on such diseases. This study retrospectively reviewed 20 consecutive cases with CCJ AVFs with spinal arterial feeders from our neurosurgical center, which can enrich the experience of diagnosis and treatment of such arteriovenous fistulas.

OBJECTIVE:

To further explain the clinical manifestations, angiographic characteristics, and treatment strategies of CCJ AVFs with spinal arterial feeders and share the treatment experience of our neurosurgical center.

METHODS:

A total of 113 patients with CCJ AVFs treated at our institution between January 2013 and December 2020 were enrolled. After analyzing their imaging data, 20 patients with CCJ AVFs with spinal arterial feeders were included. Clinical presentation, angiographic characteristics, intraoperative findings, and treatment outcomes were analyzed.

RESULTS:

The median age was 52 years (IQR 45-58 years). Twenty-four fistulas were included in this study and were classified based on angiographic characteristics: dural AVF (1 [4.2%] of 24), radicular AVF (15 [62.5%] of 24), epidural AVF (2 [8.3%] of 24), and perimedullary AVF (6 [25.0%] of 24). Subarachnoid hemorrhage occurred in 19 cases (95.0%) and was the main clinical manifestation. Thirteen patients (65.0%) were treated with microsurgery only, 6 (30.0%) with embolization and microsurgery, and 1 (5.0%) with interventional electrocoagulation. Nineteen patients (95.0%) had favorable outcomes.

CONCLUSION:

Subarachnoid hemorrhage was the most common presentation of CCJ AVFs with spinal arterial feeders. Different treatment strategies should be selected based on different angioarchitecture.
The Lingual Process of the Sphenoid Bone and the Petrolingual Ligament: Surgical Anatomy, Landmarks, and Clinical Relevance
Authors: Leonel Luciano César P. C. , Rezende Natalia Cerqueira , Alexander Alex Yohan , Agosti Edoardo , Rush Deja , Kenning Tyler J. , Link Michael J. , Pinheiro-Neto Carlos D. , Peris-Celda Maria
Published: October 2022

BACKGROUND:

The lingual process of the sphenoid bone (LP) and the petrolingual ligament (PLL) surround laterally the internal carotid artery within the middle cranial fossa (MCF).

OBJECTIVE:

To study the LP and the PLL and anatomical variations considering their relationships with different structures and landmarks within the MCF, especially oriented toward the endoscopic endonasal approaches.

METHODS:

Seventy-two sides of dry skulls and 20 sides of embalmed specimens were studied. The measurements of the LP and the PLL were obtained, considering important landmarks in the MCF.

RESULTS:

The LP had a mean length and height of 5 mm and 3 mm, respectively. Its distance from the foramen lacerum was 6 mm, from the foramen ovale 10 mm, foramen rotundum 15 mm, and petrous apex 9 mm. In 44 sides (61.11%), the LP partially closed the lateral aspect of the carotid sulcus; in 17 sides (23.61%), it was found as a near-ring; and in 11 sides (15.2%), it was considered rudimentary. Considering the PLL, its length and height were, respectively, 9 mm, and 4 mm.

CONCLUSION:

The LP and PLL separate the carotid artery at the inferior aspect of Meckel's cave and constitute important landmarks for endoscopic endonasal approaches to Meckel's cave and MCF, and their identification and removal is essential for internal carotid artery mobilization in this area.
Drosophila hemocytes recognize lymph gland tumors of mxc mutants and activate the innate immune pathway in a reactive oxygen species-dependent manner
Authors: Kinoshita Suzuko , Takarada Kazuki , Kinoshita Yuriko , Inoue Yoshihiro H.
Published: October 2022

Mechanisms of cancer cell recognition and elimination by the innate immune system remains unclear. The immune signaling pathways are activated in the fat body to suppress the tumor growth in mxcmbn1 hematopoietic tumor mutants in Drosophila by inducing antimicrobial peptides (AMP). Here, we investigated the regulatory mechanism underlying the activation in the mutant. Firstly, we found that reactive oxygen species (ROS) accumulated in the hemocytes due to induction of dual oxidase and one of its activators. This was required for the AMP induction and the tumor growth suppression. Next, more hemocytes transplanted from normal larvae were associated with the mutant tumor than normal lymph glands (LGs). Matrix metalloproteinase 1 and 2 (MMP2) were highly expressed in the tumors. The basement membrane components in the tumors were reduced and ultimately lost inside. Depletion of the MMP2 rather than MMP1 resulted in a significantly reduced AMP expression in the mutant larvae. The hemocytes may recognize the disassembly of basement membrane in the tumors and activate the ROS production. Our findings highlight the mechanism via which macrophage-like hemocytes recognize tumor cells and subsequently convey the information to induce AMPs in the fat body. They contribute to uncover the role of innate immune system against cancer.
High-resolution ribosome profiling reveals translational selectivity for transcripts in bovine preimplantation embryo development
Authors: Zhu Linkai , Zhou Tong , Iyyappan Rajan , Ming Hao , Dvoran Michal , Wang Yinjuan , Chen Qi , Roberts R. Michael , Susor Andrej , Jiang Zongliang
Published: October 2022

High-resolution ribosome fractionation and low-input ribosome profiling of bovine oocytes and preimplantation embryos has enabled us to define the translational landscapes of early embryo development at an unprecedented level. We analyzed the transcriptome and the polysome- and non-polysome-bound RNA profiles of bovine oocytes (germinal vesicle and metaphase II stages) and early embryos at the two-cell, eight-cell, morula and blastocyst stages, and revealed four modes of translational selectivity: (1) selective translation of non-abundant mRNAs; (2) active, but modest translation of a selection of highly expressed mRNAs; (3) translationally suppressed abundant to moderately abundant mRNAs; and (4) mRNAs associated specifically with monosomes. A strong translational selection of low-abundance transcripts involved in metabolic pathways and lysosomes was found throughout bovine embryonic development. Notably, genes involved in mitochondrial function were prioritized for translation. We found that translation largely reflected transcription in oocytes and two-cell embryos, but observed a marked shift in the translational control in eight-cell embryos that was associated with the main phase of embryonic genome activation. Subsequently, transcription and translation become more synchronized in morulae and blastocysts. Taken together, these data reveal a unique spatiotemporal translational regulation that accompanies bovine preimplantation development.
Shortened lifespan induced by a high-glucose diet is associated with intestinal immune dysfunction in Drosophila sechellia
Authors: Abe Maiko , Kamiyama Takumi , Izumi Yasushi , Qian Qingyin , Yoshihashi Yuma , Degawa Yousuke , Watanabe Kaori , Hattori Yukako , Uemura Tadashi , Niwa Ryusuke
Published: October 2022

Organisms can generally be divided into two nutritional groups: generalists that consume various types of food and specialists that consume specific types of food. However, it remains unclear how specialists adapt to only limited nutritional conditions in nature. In this study, we addressed this question by focusing on Drosophila fruit flies. The generalist Drosophila melanogaster can consume a wide variety of foods that contain high glucose levels. In contrast, the specialist Drosophila sechellia consumes only the Indian mulberry, known as noni (Morinda citrifolia), which contains relatively little glucose. We showed that the lifespan of D. sechellia was significantly shortened under a high-glucose diet, but this effect was not observed for D. melanogaster. In D. sechellia, a high-glucose diet induced disorganization of the gut epithelia and visceral muscles, which was associated with abnormal digestion and constipation. RNA-sequencing analysis revealed that many immune-responsive genes were suppressed in the gut of D. sechellia fed a high-glucose diet compared with those fed a control diet. Consistent with this difference in the expression of immune-responsive genes, high glucose-induced phenotypes were restored by the addition of tetracycline or scopoletin, a major nutritional component of noni, each of which suppresses gut bacterial growth. We propose that, in D. sechellia, a high-glucose diet impairs gut immune function, which leads to a change in gut microbiota, disorganization of the gut epithelial structure and a shortened lifespan.
Junk food consumption in relation to menstrual abnormalities among adolescent girls: A comparative cross sectional study
Authors: Latif Samreen , Naz Saima , Ashraf Shazia , Ahmed Jafri Saghir
Published: October 2022

Objectives: The study was aimed at evaluating the association between junk food consumption and BMI of adolescent girls along with the menstrual abnormalities and to compare it with controls.

Methods: A cross-sectional study was conducted among 200 girls between 13 – 19 years of age at Bahria International Hospital, Lahore based on self-administered questionnaire from July 2021 to September 2021. The total subjects were divided in two groups Viz; Group-A which comprised of 100 girls with menstrual abnormalities and Group-B included 100 girls without menstrual problem (control group). The data recorded on the questionnaire about the demographic profile, anthropometric measurements, menstrual cycle characteristics, and dietary habits was subjected to statistical analysis using SPSS version 20 and Chi-Square was used to test quantitative significance between the two groups.

Results: The mean age of participants was 17.02±1.76 years. It was observed that 40% girls had irregular menstrual cycle, 56% girls were suffering from dysmenorrhea and almost all girls of Group-I were suffering from premenstrual dysfunctions. The current study found a non-significant difference between two groups with regard to body mass index (P≥0.05). Significant difference was observed between two groups (P ≤ 0.05) as junk food consumption was high in Group-A as compared to Group-B. However, no significant difference was found between Group-A and B in relation to the consumption of salty snacks and frozen meat items (P≥0.05).

Conclusion: The results suggested that junk food consumption affects menstrual cycle negatively however more studies are needed to confirm the association of BMI, consumption of salty snacks and frozen meat items with menstrual abnormalities.

doi: https://doi.org/10.12669/pjms.38.8.6177

How to cite this:Latif S, Naz S, Ashraf S, Jafri SA. Junk food consumption in relation to menstrual abnormalities among adolescent girls: A comparative cross sectional study. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.6177

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