bluuebunny/crossref_metadata_2025 huggingface dataset:
Biceps Augmentation Outperforms Tear Completion Repair or In Situ Repair for Bursal-Sided Partial-Thickness Rotator Cuff Tears in a Rabbit Model
Authors: Xu Junjie , Li Yufeng , Ye Zipeng , Wu Chenliang , Han Kang , Zheng Ting , Jiang Jia , Yan Xiaoyu , Su Wei , Zhao Jinzhong
Published: November 2021

Background:

There is an ongoing debate on the treatment of bursal-sided partial-thickness rotator cuff tears (PTRCTs), including ideal repair techniques. Augmentation using a collagen patch has been introduced as a new surgical approach to treat PTRCTs, while the effect of autogenous biceps augmentation (BA) has not been investigated.

Purpose:

To analyze the effects of BA on bursal-sided PTRCTs and compare its histological and biomechanical results with those of tear completion followed by repair and in situ repair (ISR).

Study Design:

Controlled laboratory study.

Methods:

Unilateral chronic PTRCTs were created in 96 mature New Zealand White rabbits, which were randomly divided into 4 groups: no repair, tear completion repair (TCR), ISR, and BA. A new bicipital groove was fabricated in BA for the biceps tendon that was transferred to augment the bursal-sided PTRCT repair. In each group, we sacrificed 6 rabbits for biomechanical testing of the whole tendon-to-bone complex (WTBC) and 6 for histological evaluation of bursal- and articular-sided layers at 6 and 12 weeks postoperatively. Healing responses between the biceps and new bicipital groove in the BA group were determined using histological analysis, and final groove morphologies were evaluated using micro–computed tomography.

Results:

The remaining tendon and enthesis in bursal-sided PTRCTs progressively degenerated over time. WTBCs of ISR exhibited a larger failure load than those of TCR, although better healing properties in the bursal-sided repaired site were achieved using TCR based on histological scores and superior articular-sided histological scores were observed using ISR. However, WTBCs of BA displayed the best biomechanical results and superior histological scores for bursal- and articular-sided regions. The new bicipital groove in BA remodeled over time and formed similar morphologies to a native groove, which provided a mature bone bed for transferred biceps tendon healing to augment bursal-sided PTRCTs.

Conclusion:

BA achieved better biomechanical and histological results for repairing bursal-sided PTRCTs as compared with TCR and ISR. When compared with that of TCR, the WTBC of ISR exhibited a higher failure load, showing histological superiority in the articular-sided repair and inferiority in the bursal-sided repair.

Clinical Relevance:

BA may be an approach to improve bursal-sided PTRCT repair in humans, which warrants further clinical investigation.
Rotator Cuff Tear Size Regulates Fibroadipogenic Progenitor Number and Gene Expression Profile in the Supraspinatus Independent of Patient Age
Authors: Davies Michael R. , Chi Hannah , Kaur Gurbani , Liu Mengyao , Ma C. Benjamin , Kim Hubert T. , Liu Xuhui , Feeley Brian T.
Published: November 2021

Background:

Fatty infiltration of rotator cuff muscle is a limiting factor in the success of repairs. Fibroadipogenic progenitors (FAPs) are a population of stem cells within the rotator cuff that can differentiate into white adipocytes, fibroblasts, and beige adipocytes. The effects of patient age and rotator cuff tendon tear size on the number, differentiation patterns, and gene expression profiles of FAPs have not yet been analyzed.

Purpose:

To determine if patient age and rotator cuff tear size independently regulate FAP number, differentiation patterns, and gene expression profiles.

Study Design:

Controlled laboratory study.

Methods:

Supraspinatus muscle samples were collected from 26 patients between the ages of 42 and 76 years with partial- or full-thickness rotator cuff tears. FAPs were quantified using fluorescence-activated cell sorting. Gene expression analysis was performed across a custom 96-gene panel using NanoString. In vitro differentiation assays of FAPs were conducted using adipogenic, fibrogenic, and beige-inducing (amibegron-treated) media, and quantitative polymerase chain reaction was used to assess gene expression differences between adipogenic and amibegron media conditions. Multivariable linear regressions were performed using Stata to independently analyze the effects of age and rotator cuff tear size on FAP number, differentiation, and gene expression.

Results:

Increasing age and tear size were independently correlated with increased FAP number (βage = 0.21, P = .03; βtear size = 3.86, P = .05). There was no clear association between age and gene expression of freshly sorted FAPs. Under adipogenic and fibrogenic media conditions, increasing age and tear size were independently associated with increased adipogenic and fibrogenic differentiation of FAPs. Under amibegron treatment conditions, age positively correlated with increased beige differentiation (β = 1.03; P < .0001), while increasing tear size showed a trend toward decreased beige differentiation (β = −4.87; P = .1). When gene expression patterns between adipogenic and amibegron media conditions were compared, larger tear size strongly inhibited beige gene expression, while advanced age did not.

Conclusion:

Patient age and rotator cuff tear size independently regulated FAP number, differentiation, and gene expression. Age and tear size were positively correlated with increased FAP number and fibrogenic/adipogenic differentiation. Advancing patient age did not limit FAP beige differentiation and gene expression, while increasing rotator cuff tear size strongly inhibited these processes.
Biomechanics Related to Increased Softball Pitcher Shoulder Stress: Implications for Injury Prevention
Authors: Friesen Kenzie B. , Saper Michael G. , Oliver Gretchen D.
Published: November 2021

Background:

Softball pitchers exhibit high throwing shoulder distraction force, which is a theorized mechanism of throwing shoulder overuse injury. Windmill pitching involves a variety of highly individualistic pitching styles, and certain kinematics preceding ball release likely influence the amount of shoulder stress that a pitcher accrues.

Purpose:

To examine the association of trunk and throwing arm kinematics, kinetics, and timing variables with peak throwing shoulder distraction force in high school softball pitchers.

Study Design:

Descriptive laboratory study.

Methods:

A total of 37 high school pitchers (mean ± SD; height, 1.71 ± 0.06 m; weight, 75.53 ± 16.12 kg; age, 16 ± 2 years) threw 10 fastball pitches at regulation distance (43 ft [13.1 m]) and with maximum effort. Kinematic data were collected at 240 Hz using an electromagnetic motion capture system synced with motion analysis software. The 3 fastest pitches were averaged and analyzed. Kinematic, kinetic, and timing variables were entered into a stepwise linear regression analysis.

Results:

Four variables were included in the significant model ( F4,39 = 147.51; P < .001) and explained peak shoulder distraction force ( R2 = 0.944; adjusted R2 = 0.938; SE = 0.036): increased peak elbow distraction force ( t = 19.90; P < .001) and extension moment ( t = 3.63; P = .001), as well as decreased elbow flexion velocity ( t = −2.37; P = .023) and trunk flexion at foot contact of the pitch ( t = −3.00; P = .005).

Conclusion:

Elbow kinetics and angular velocity, as well as trunk positioning at foot contact, are associated with peak throwing shoulder distraction force in high school softball pitchers.

Clinical Relevance:

Variables associated with peak throwing shoulder distraction force provide information regarding injury mechanism and coachable cues that might reduce shoulder injury risk among pitchers.
Ten Measurements That Can Reduce Anxiety in Physicians and Their Patients Undergoing Breast Augmentation Surgery
Authors: Brown Tim , Murphy Tracey
Published: November 2021

There are numerous measuring systems that practitioners employ as part of their presurgical assessment for breast implant surgery. These range from direct measurements of patients using a tape measure, to assessment of standardized photographs and 3-dimensional scanning technologies. This personal view describes the authors system, developed over 20 years. The data yielded have assisted in assessing breast symmetry, ptosis, and match of implant to patient, with proven benefits for managing patient outcomes and expectations. It is simple, rapid to undertake, and requires inexpensive measuring equipment to provide useful data.
Attitude control strategy for unmanned wheel-legged hybrid vehicles considering the contact of the wheels and ground
Authors: Liu Hui , Liu Baoshuai , Han Ziyong , Qin Yechen , Ren Xiaolei , Han Lijin
Published: November 2021

During patrol and surveillance tasks, attitude control is crucial for improving the terrain adaptability of unmanned wheel-legged hybrid vehicles. This paper proposes an attitude control strategy for unmanned wheel-legged hybrid vehicles, considering the contact of the wheels and ground. The proposed method can naturally achieve torque control efficiently of each joint actuator and wheel-side actuator and avoid the discrepancy between off-road terrain and stability. First, an inverse kinematics model is established to resolve the body and each joint rotation angle, and the dynamic model is built based on the multi rigid body theory, considering the contact points planning of wheel and ground. Considering the nonholonomic constraint of the structure scheme, a hierarchical real-time attitude controller for a wheel-legged vehicle is proposed. The upper layer calculates the contact points of each wheel and the ground through the quadratic programming algorithm, and the lower layer is divided into a legged motion generator and a wheel motion generator by a mathematical analysis method. Finally, the proposed method is applied to achieve the tracking and control of the whole-body trajectory. The proposed strategy can achieve the decoupling of wheeled motion generator and legged motion generator, and improve control efficiency.
Effects of Diet and Exercise Interventions to Prevent Gestational Diabetes Mellitus in Pregnant Women With High-Risk Factors in China: A Randomized Controlled Study
Authors: Deng Yafang , Hou Yixuan , Wu Liping , Liu Yanping , Ma Liangkun , Yao Aimin
Published: November 2021

This is a randomized controlled study to determine whether diet and exercise interventions can reduce the incidence of gestational diabetes mellitus (GDM) in pregnant women with high-risk factors. Ninety-four pregnant women were randomly divided into the intervention ( n = 47) and control ( n = 47) groups. A diet and exercise program was provided for the intervention group by researchers and was adjusted every 2 weeks by outpatient or WeChat intervention. The control group only received the routine health management in the hospital. Follow-up continued until the birth of the baby. The incidence of GDM (23.9%) in the intervention group was lower than in the control group (51.1%) ( p = .007). Weight gain did not differ significantly between the two groups throughout pregnancy ( p = .572). It is concluded that diet and exercise interventions can reduce the incidence of GDM in pregnant women with high-risk factors.
Practicability of Bivalirudin plus Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing Percutaneous Coronary Intervention: A Meta-Analysis
Authors: Li Senjie , Lv Dongqing , Liu Caihong , Jia Yongping
Published: November 2021

A variety of antithrombotic drugs are used during percutaneous coronary interventions (PCIs). We aimed to investigate the practicability of the use of bivalirudin and GPIs in patients receiving PCI. We searched 7 of 629 relevant records from PubMed, the Cochrane Library, EMBASE, and Web of Science for randomised controlled trials. There were no significant differences in the rates of major adverse cardiac events (MACE) between bivalirudin plus GPI and heparin (all P  >  .05). Bivalirudin plus planned GPI was similar to bivalirudin monotherapy in terms of the risk of MACE (risk ratio [RR] = 1.07; 95% confidence interval [CI] = .91 − 1.27; P = .55). Bivalirudin plus provisional GPI was associated with lower bleeding risk (RR = .57; 95% CI = .47 − .69; P < .01) compared to using heparin plus GPI. Compared to bivalirudin alone, bivalirudin plus planned GPI evidently increased bleeding risk (RR = 2.20; 95% CI = 1.73 − 2.79; P < .01). Patients receiving bivalirudin or heparin therapy had semblable efficacy endpoints, but those receiving bivalirudin had a significantly lower bleeding risk. For high-risk bleeding patients, bivalirudin plus provisional GPI can have a better antithrombotic effect than heparin, without increasing the bleeding risk.
Safety, efficacy, and timing of Nd:YAG laser goniopuncture after nonpenetrating deep sclerectomy for glaucoma: A retrospective cohort study
Authors: Slagle Grant , Bahr Tyler , Welburn Kyle , Katuri Joshua , Quittner-Strom Ezekiel , Sponsel William
Published: November 2021

Background

Neodymium-doped yttrium aluminum garnet laser goniopuncture is an adjuvant procedure for nonpenetrating deep sclerectomy. We investigated optimal laser goniopuncture timing and the effect of laser iridoplasty on success rates

Methods

This single-center retrospective cohort study compared intraocular pressure control in patients with early versus late laser goniopuncture after nonpenetrating deep sclerectomy and evaluated the effects of laser iridoplasty pretreatment. A 3-month cut-off was used to define early versus late laser goniopuncture. The primary outcome was the proportion of patients maintaining intraocular pressure control according to definitions of complete (no medications) and qualified (with medications) success at 15, 18, and 21 mmHg thresholds. Data were analyzed using right-censored Kaplan–Meier estimation and log-rank testing

Results

A total of 124 eyes of 124 patients were analyzed. Complete success rates after 3 years were 9.2%, 14.6%, and 23.3% for early laser goniopuncture and 21.8%, 26.0%, and 55.4% for late laser goniopuncture for 15, 18, and 21 mmHg, respectively (all p < .01). Qualified success rates after 3 years were 16.6%, 24.8%, and 40.9% for early laser goniopuncture and 21.5%, 56.1%, and 69.6% for late laser goniopuncture for 15, 18, and 21 mmHg, respectively ( p  =  .096, .0026, .0061). Late laser goniopuncture was associated with decreased risk of iris incarceration and bleb collapse. Iridoplasty pretreatment was not associated with improved outcomes

Conclusion

Late laser goniopuncture (3-month cut-off) was associated with better intraocular pressure control and less adverse events than early laser goniopuncture.
Social capital in video game studies: A scoping review
Authors: Korkeila Henry
Published: November 2021

This study explored how social capital has been utilized in video-game studies by conducting a scoping review. In total, 74 peer-reviewed publications were analysed from three different databases. The following aspects pertaining to social capital were analysed: definition, methodology, game or genre as stimulus, its utilization inside or outside the stimulus, whether it was the sole concept or variable, how it was utilized, whether social capital was used to predict variables or whether variables were used to predict it, and what where the predicted or predicting variables. The results of the analysis show that Putnam’s research, the quantitative method and Massively Multiplayer Online Role-Playing Games were most commonly combined. Social capital was predominantly utilized in binary form. It was utilized almost equally inside and outside the video games’ sphere of influence. The study then presents the main findings and discusses future research avenues.
The effects of neoliberalism: Teachers’ experiences and ethical dilemmas to policy initiatives within vocational education and training in Australia
Authors: Nakar Sonal , Olssen Mark
Published: November 2021

Neoliberal policy reforms have had a marked influence on nearly every aspect of education, including the enrolment practices employed by institutions, teaching and assessment practices, and even the outcomes for students and society. There is a widespread expectation that teachers should contribute to quality outcomes for students along with their moral/ethical development and character formation while at the same time behaving ethically in the currently challenging environment of the education sector, including the Vocational Education and Training (VET) sector. However, this apparent pressure for maintaining quality education while simultaneously conforming to the ethicality of professional practices in the context of rapid policy changes of a neoliberal sort masks considerable controversy around the meaning of quality education with respect to both moral/ethical behaviour in education and the appropriate forms of practice that would constitute this area of education. A recent research project into the impact of the changing contemporary cultural context of VET on the creation of moral dilemmas facing VET teachers in their work has identified the VET teachers’ perspectives of the ethical dilemmas experienced, by identifying the tensions between competing values and the resulting interactions. The research design for the study drew primarily on exploratory and discursive interviews with 18 VET teachers in South-East Queensland, selected from those responding to a call for participation in the study. The study pointed to the value of dilemmas as constructs through which to generate knowledge of ethical conflicts arising from contextual changes in policy. Four drivers that they attributed to causing those dilemmas were identified: changing immigration rules, changing funding requirements, changing culture and philosophy of RTOs, and inadequate teacher preparation. In each of these respects, the ambitious business expectations engendered by neoliberal restructuring and reform in recent years can be seen as articulating or presupposing values pertaining to standards of practice and performance of the RTO, which in turn can be seen to compromise traditional norms associated with teacher professionalism. It is with these values and conflicts that we are concerned in this paper.
Intimate Partner Violence and Mental Health Outcomes Among Hispanic Women in the United States: A Scoping Review
Authors: Reyes Miranda E. , Simpson Lauren , Sullivan Tami P. , Contractor Ateka A. , Weiss Nicole H.
Published: November 2021

Hispanic women in the United States experience disproportionate mental health impacts of intimate partner violence (IPV). Following the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines, we synthesized the existing knowledge based on IPV and mental health outcomes among Hispanic women in the United States. In May 2020, we searched five electronic databases (i.e., MEDLINE, PILOTS, PSYCInfo, PSYCArticles, and EMBASE). From the initial 1,180 results, 13 articles met inclusion criteria for this review (written in English, empirical study, focus on the experiences of victimization from an intimate partner, focus on mental health outcomes occurring in the person experiencing IPV, included women who identify as Hispanic, and included participants residing in the United States), representing 4,060 women. Findings highlighted significant positive associations between IPV ( n = 13; 4,060 women) and general mental health outcomes ( n = 4; 759 women) as well as the specific outcomes of depression ( n = 12; 2,661 women), anxiety ( n = 1; 274 women), post-traumatic stress disorder ( n = 3; 515 women), and substance misuse ( n = 2; 1,673 women) among Hispanic women in the United States. Limitations included heterogeneity across Hispanic populations and methodological differences between studies. Key avenues for future research were identified, including the need to examine mental health outcomes understudied in relation to IPV among Hispanic women (e.g., personality, obsessive-compulsive, and eating disorders) and to identify cultural and demographic factors (e.g., nativity status, level of acculturation) that may influence relations between IPV and mental health outcomes among Hispanic women. Such research can inform prevention and intervention efforts aimed at improving mental health among Hispanic women in the Untied States experiencing IPV.
Arterial Preparation by Longitudinal Micro-Incisions Before Balloon Angioplasty of the Superficial Femoral and Popliteal Artery: Acute and 12-Month Results
Authors: Dexpert Jean-Baptiste , Hayoz Daniel , Engelberger Rolf P. , Krieger Caroline , Meyer Marie-Antoinette Rey , Périard Daniel
Published: November 2021

Purpose:

Percutaneous transluminal angioplasty (PTA) with conventional plain old balloon (POBA) and/or drug-coated balloon (DCB) is the primary intervention to treat peripheral artery stenoses. However, acute dissections during the procedure and potential for future target lesion revascularization remain procedural complications. The purpose of this study was to assess the acute and 12-month outcomes in patients who underwent novel vessel preparation with longitudinal, controlled-depth micro-incisions prior to PTA.

Materials and Methods:

Patients with symptomatic lower extremity peripheral arterial disease with a Rutherford class of 2 to 6 and >70% de novo stenosis of the superficial femoral or popliteal arteries were included in this retrospective study. Patients with thrombotic or embolic lesions, restenosis, or in-stent restenosis were excluded. The FLEX Vessel Prep System (FLEX VP) was used to prepare the vessel prior to PTA by creating micro-incisions at the target lesion. The FLEX VP was followed by POBA or paclitaxel DCB.

Results:

The study included 65 patients. Lesion characteristics were 90% median stenosis (range = 70%–100%), 75.4% mild-to-severe calcifications, and 33.8% occlusion rate, and median lesion length was 196 (range = 10–480) mm. Following vessel preparation, 82.1% of the patients had low severity dissection or no flow-limiting dissection. The provisional stent rate postprocedure was 16.9%, with a median stent length of 60 mm. The freedom from target lesion revascularization (FFTLR) in 63 evaluable patients at 6 and 12 months was 98.4% and 93.7%, respectively. Freedom from amputation was 100%.

Conclusion:

In this real-world/all-comers patient population with long, stenotic lesions across the calcification spectrum, vessel preparation with longitudinal micro-incisions prior to PTA was associated with low dissection rate, low dissection severity, low stent implantation, and high FFTLR with the absence of amputation at 12 months relative to published reports in long-lesion cohorts. These results support vessel preparation via micro-incisions.
Theorizing Gentrification as a Process of Racial Capitalism
Authors: Rucks-Ahidiana Zawadi
Published: November 2021

Academics largely define gentrification based on changes in the class demographics of neighborhood residents from predominately low-income to middle-class. This ignores that gentrification always occurs in spaces defined by both class and race. In this article, I use the lens of racial capitalism to theorize gentrification as a racialized, profit-accumulating process, integrating the perspective that spaces are always racialized to class-centered theories. Using the prior literature on gentrification in the United States, I demonstrate how the concepts of value, valuation, and devaluation from racial capitalism explain where and how gentrification unfolds. Exposure to gentrification varies depending on a neighborhood’s racial composition and the gentrification stakeholders involved, which contributes to racial differences in the scale and pace of change and the implications of those changes for processes of displacement. Revising our understanding of gentrification to address the racialization of space helps resolve seemingly contradictory findings across qualitative and quantitative studies.
Biobank Participants’ Attitudes Toward Data Sharing and Privacy: The Role of Trust in Reducing Perceived Risks
Authors: Kasperbauer T.J. , Halverson Colin , Garcia Abby , Schwartz Peter H.
Published: November 2021

Biobank participants are often unaware of possible uses of their genetic and health information, despite explicit descriptions of those uses in consent forms. To explore why this misunderstanding persists, we conducted semi-structured interviews and knowledge tests with 22 participants who had recently enrolled in a research biobank. Results indicated that participants lacked understanding of privacy and data-sharing topics but were mostly unconcerned about associated risks. Participants described their answers on the knowledge test as largely driven by their trust in the healthcare system, not by a close reading of the information presented to them. This finding may help explain the difficulties in increasing participant understanding of privacy-related topics, even when such information is clearly presented in biobank consent forms.
Work-related stress among headteachers in Wales: Prevalence, sources, and solutions
Authors: Scott Stuart , Limbert Caroline , Sykes Peter
Published: November 2021

The purpose of this study was to investigate the prevalence, sources, and underlying causes of work-related stress among headteachers in Wales and to identify possible solutions. An online questionnaire was sent to all 1588 headteachers across Wales. The questionnaire included demographic questions, Cohen’s Perceived Stress Scale (PSS), the Health and Safety Executive (HSE) Management Standards Tool, a list of known stressors, and open questions exploring the underlying causes and possible solutions. A total of 359 (22.6%) headteachers completed the survey. Two-thirds of participants reported experiencing levels of stress that were rated as ‘high’. Pressures of managing greater demands and increasing workload with fewer financial resources and a lack of support from local authorities were the main sources of stress. Solutions focused on improved funding to enhance staffing and resources at a school level, reduced accountability, and improved support. The findings indicated that a multi-faceted, multi-level, intervention approach, extending beyond improving personal resilience and individual school improvements, into regional and national opportunities for change, is likely to be most effective in reducing work-related stress within the profession.
FAST-ED scale smartphone app-based prediction of large vessel occlusion in suspected stroke by emergency medical service
Authors: Frank Benedikt , Lembeck Thomas , Toppe Nina , Brune Bastian , Bozkurt Bessime , Deuschl Cornelius , Nogueira Raul G. , Dudda Marcel , Risse Joachim , Kill Clemens , Forsting Michael , Kleinschnitz Christoph , Köhrmann Martin
Published: November 2021

Background and Purpose:

Considering the highly time-dependent therapeutic effect of endovascular treatment in patients with large vessel occlusion–associated acute ischemic stroke, prehospital identification of large vessel occlusion and subsequent triage for direct transport to a comprehensive stroke center offers an intriguing option for optimizing patient pathways.

Methods:

This prospective in-field validation study included 200 patients with suspected acute ischemic stroke who were admitted by emergency medical service to a comprehensive stroke center. Ambulances were equipped with smartphones running an app-based Field Assessment Stroke Triage for Emergency Destination scale for transmission prior to admission. The primary measure was the predictive accuracy of the transmitted Field Assessment Stroke Triage for Emergency Destination for large vessel occlusion and the secondary measure the predictive accuracy for endovascular treatment.

Results:

A Field Assessment Stroke Triage for Emergency Destination ⩾4 revealed very good accuracy to detect large vessel occlusion–related acute ischemic stroke with a sensitivity of 82.4% (95% confidence interval = 65.5–93.2), specificity of 78.3% (95% confidence interval = 71.3–84.3), and an area under the curve c-statistics of 0.89 (95% confidence interval = 0.85–0.94). Field Assessment Stroke Triage for Emergency Destination ⩾4 correctly identified 84% of patients who received endovascular treatment [73.5% specificity (95% confidence interval = 66.4–79.8)] with an area under the curve c-statistics of 0.82 (95% confidence interval = 0.74–0.89). In a hypothetical triage model of an urban setting, one secondary transportation would be avoided with every fifth patient screened.

Conclusion:

A smartphone app-based stroke triage completed by emergency medical service personnel showed adequate quality for the Field Assessment Stroke Triage for Emergency Destination to identify large vessel occlusion–associated acute ischemic stroke. We demonstrate feasibility of the use of a medical messaging service in prehospital stroke care. Based on these first results, a randomized trial evaluating the clinical benefit of such a triage system in an urban setting is currently in preparation. Clinical Trial Registration: https://clinicaltrials.gov Unique identifier: NCT04404504.
Anti-Apoptosis and Autophagy Effects of Melatonin Protect Rat Chondrocytes against Oxidative Stress via Regulation of AMPK/Foxo3 Pathways
Authors: Chen Zhaoxun , Zhao Chen , Liu Pengcheng , Huang Haohan , Zhang Shuhong , Wang Xiaoqing
Published: November 2021

Objective

Emerging evidence has indicated that excessive reactive oxygen species (ROS) have detrimental effects on osteoarthritis (OA). This study aimed to elucidate the effects of melatonin (MT), an antioxidant indolamine secreted from the pineal gland, on chondrocyte senescence and cartilage degeneration, thereby clarifying the underlying mechanisms of ROS-induced OA pathogenesis.

Design

Hydrogen peroxide (H2O2) was used to induce oxidative stress in rat chondrocytes. ROS levels were evaluated using cytometry and immunofluorescence. Cell viability was detected using the Cell Counting Kit-8 (CCK-8) assay. Western blotting and qPCR (Quantiative Real-Time Polymerase Chain Reaction) were used to examine apoptosis and autophagy. For in vivo experiments, male Sprague-Dawley rats were randomly divided into a sham-operated group, DMM (destabilization of the medial meniscus) surgery group, and surgery groups that received melatonin. Knee joints were collected and stained for histological analysis.

Results

The data demonstrated that melatonin treatment significantly suppressed H2O2-induced matrix degradation and apoptosis, and maintained mitochondrial redox homeostasis. In addition, an enhancement of autophagic flux was observed through western blotting. These findings corresponded with activation of the AMPK/Foxo3 signaling pathways upon melatonin treatment. Histological staining and transmission electron microscopy (TEM) micrographs also demonstrated that melatonin alleviated cartilage ossification and chondrocyte hypertrophy in vivo.

Conclusions

Our results indicated that melatonin protected chondrocytes via mitochondrial redox homeostasis and autophagy. The effects of melatonin on senescence may apply to other age-related diseases. Thus, melatonin may have multiple potential therapeutic applications.
Potential Impact of Pass/Fail Scores on USMLE Step 1: Predictors of Excellence in Obstetrics and Gynecology Residency Training
Authors: Tamakuwala Sejal , Dean Joshua , Kramer Katherine J. , Shafi Adib , Ottum Sarah , George Joshua , Kaur Satinder , Chao Conrad R. , Recanati Maurice-Andre
Published: November 2021

AIM

The study aims to determine resident applicant metrics most predictive of academic and clinical performance as measured by the Council of Resident Education in Obstetrics and Gynecology (CREOG) examination scores and Accreditation Council for Graduate Medical Education (ACGME) clinical performance (Milestones) in the aftermath of United States Medical Licensing Examination Scores (USMLE) Step 1 becoming a pass/fail examination.

METHODS

In this retrospective study, electronic and paper documents for Wayne State University Obstetrics and Gynecology residents matriculated over a 5-year period ending July 2018 were collected. USMLE scores, clerkship grade, and wording on the letters of recommendation as well as Medical Student Performance Evaluation (MSPE) were extracted from the Electronic Residency Application Service (ERAS) and scored numerically. Semiannual Milestone evaluations and yearly CREOG scores were used as a marker of resident performance. Statistical analysis on residents (n = 75) was performed using R and SPSS and significance was set at P < .05.

RESULTS

Mean USMLE score correlated with CREOG performance and, of all 3 Steps, Step 1 had the tightest association. MSPE and class percentile also correlated with CREOGs. Clerkship grade and recommendation letters had no correlation with resident performance. Of all metrics provided by ERAS, none taken alone, were as useful as Step 1 scores at predicting performance in residency. Regression modeling demonstrated that the combination of Step 2 scores with MSPE wording restored the predictive ability lost by Step 1.

CONCLUSIONS

The change of USMLE Step 1 to pass/fail may alter resident selection strategies. Other objective markers are needed in order to evaluate an applicant’s future performance in residency.
Some Determinants of Crime Reporting Among Economic and Financial Crime Victims: The Case of Azerbaijan
Authors: Shahbazov Ingilab , Afandiyev Zaur , Balayeva Ayshem
Published: November 2021

Relatively limited attention has been paid by scholars to explore the crime reporting behavior of white-collar crime victims, especially in developing countries, such as Azerbaijan, where some forms of white-collar crimes are widespread. Using the dataset of the first nationwide victimization survey (n = 1,214) in Azerbaijan, the current paper attempts to explore the determinants of crime reporting among 4 specific white-collar offense (fraud, request for bribery, sale of unsafe good and sale of unsafe food for consumption) among randomly selected, yet unrepresentative subsample of victims (n = 186). Offenses were categorized in two groups for analysis—financial/economic offenses and non-financial/economic offenses, hence two models in a binary logistic regression analysis. The results indicate that the extent of financial loss predicts the crime reporting behavior for victims of financial offenses. Those with a higher level of the perceived probability of being victimized by a violent crime were more likely to have notified the authorities of their victimization. Applicable for non-financial crimes only, the level of income has an inverse association with a decision to invoke the law. The relationship of a victim to an offender predicted a decision to contact the authorities—cases in which the offender was identified as a stranger were less likely to be reported to the law enforcement authorities than cases in which the offender had not been identified. No socio-demographic variable has a predictive capacity for either crime category. In addition, as the main motives for not mobilizing the law, almost half of the cases have been resolved in between the offender and victims, such as through compensation. The findings have several theoretical implications for white-collar crime literature. Suggestions for further research, as well as the limitations, are discussed toward the end of the paper.
Evaluation and Management of Reflex Vasovagal Syncope—A Review
Authors: Udyavar Ameya , Deshpande Saurabh
Published: November 2021

Syncope is a symptom that is commonly encountered in the practice and may point to a cardiac or neurological diagnosis. The evaluation of syncope rests on a thorough clinical evaluation, aided by electrocardiogram (ECG) findings, followed by risk stratification of the particular case. Once high-risk factors have been ruled out, the patient can be further diagnosed as having a reflex syncope (RS), orthostatic hypotension, or cardiac syncope based on specific clues. If the initial evaluation is not confirmatory various diagnostic tests may be used to guide further management (eg, long-term ECG monitoring, tilt table testing, etc). The management should be based on the overall profile of the patient and not only on any single test. In this review, we discuss the evaluation of a patient with RS and give an overview of treatments available for the patients.
Phase 1/dose expansion trial of brentuximab vedotin and lenalidomide in relapsed or refractory diffuse large B-cell lymphoma
Authors: Ward Jeffrey P. , Berrien-Elliott Melissa M. , Gomez Felicia , Luo Jingqin , Becker-Hapak Michelle , Cashen Amanda F. , Wagner-Johnston Nina D. , Maddocks Kami , Mosior Matthew , Foster Mark , Krysiak Kilannin , Schmidt Alina , Skidmore Zachary L. , Desai Sweta , Watkins Marcus P. , Fischer Anne , Griffith Malachi , Griffith Obi L. , Fehniger Todd A. , Bartlett Nancy L.
Published: November 2021

New therapies are needed for patients with relapsed/refractory (rel/ref) diffuse large B-cell lymphoma (DLBCL) who do not benefit from or are ineligible for stem cell transplant and chimeric antigen receptor therapy. The CD30-targeted, antibody-drug conjugate brentuximab vedotin (BV) and the immunomodulator lenalidomide (Len) have demonstrated promising activity as single agents in this population. We report the results of a phase 1/dose expansion trial evaluating the combination of BV/Len in rel/ref DLBCL. Thirty-seven patients received BV every 21 days, with Len administered continuously for a maximum of 16 cycles. The maximum tolerated dose of the combination was 1.2 mg/kg BV with 20 mg/d Len. BV/Len was well tolerated with a toxicity profile consistent with their use as single agents. Most patients required granulocyte colony-stimulating factor support because of neutropenia. The overall response rate was 57% (95% CI, 39.6-72.5), complete response rate, 35% (95% CI, 20.7-52.6); median duration of response, 13.1 months; median progression-free survival, 10.2 months (95% CI, 5.5-13.7); and median overall survival, 14.3 months (95% CI, 10.2-35.6). Response rates were highest in patients with CD30+ DLBCL (73%), but they did not differ according to cell of origin (P = .96). NK cell expansion and phenotypic changes in CD8+ T-cell subsets in nonresponders were identified by mass cytometry. BV/Len represents a potential treatment option for patients with rel/ref DLBCL. This combination is being further explored in a phase 3 study (registered on https://clinicaltrials.org as NCT04404283). This trial was registered on https://clinicaltrials.gov as NCT02086604.
An improved index for diagnosis and mortality prediction in malignancy-associated hemophagocytic lymphohistiocytosis
Authors: Zoref-Lorenz Adi , Murakami Jun , Hofstetter Liron , Iyer Swaminathan , Alotaibi Ahmad S. , Mohamed Shehab Fareed , Miller Peter G. , Guber Elad , Weinstein Shiri , Yacobovich Joanne , Nikiforow Sarah , Ebert Benjamin L. , Lane Adam , Pasvolsky Oren , Raanani Pia , Nagler Arnon , Berliner Nancy , Daver Naval , Ellis Martin , Jordan Michael B.
Published: November 2021

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening inflammatory syndrome that may complicate hematologic malignancies (HMs). The appropriateness of current criteria for diagnosing HLH in the context of HMs is unknown because they were developed for children with familial HLH (HLH-2004) or derived from adult patient cohorts in which HMs were underrepresented (HScore). Moreover, many features of these criteria may directly reflect the underlying HM rather than an abnormal inflammatory state. To improve and potentially simplify HLH diagnosis in patients with HMs, we studied an international cohort of 225 adult patients with various HMs both with and without HLH and for whom HLH-2004 criteria were available. Classification and regression tree and receiver-operating curve analyses were used to identify the most useful diagnostic and prognostic parameters and to optimize laboratory cutoff values. Combined elevation of soluble CD25 (>3900 U/mL) and ferritin (>1000 ng/mL) best identified HLH-2004–defining features (sensitivity, 84%; specificity, 81%). Moreover, this combination, which we term the optimized HLH inflammatory (OHI) index, was highly predictive of mortality (hazard ratio, 4.3; 95% confidence interval, 3.0-6.2) across diverse HMs. Furthermore, the OHI index identified a large group of patients with high mortality risk who were not defined as having HLH according to HLH-2004/HScore. Finally, the OHI index shows diagnostic and prognostic value when used for routine surveillance of patients with newly diagnosed HMs as well as those with clinically suspected HLH. Thus, we conclude that the OHI index identifies patients with HM and an inflammatory state associated with a high mortality risk and warrants further prospective validation.
Clofarabine-fludarabine-busulfan in HCT for pediatric leukemia: an effective, low toxicity, TBI-free conditioning regimen
Authors: Versluijs A. Birgitta , de Koning Coco C. H. , Lankester Arjan C. , Nierkens Stefan , Kollen Wouter J. , Bresters Dorine , Lindemans Caroline A. , Boelens Jaap Jan , Bierings Marc
Published: November 2021

We prospectively studied clofarabine-fludarabine-busulfan (CloFluBu)-conditioning in allogeneic hematopoietic cell therapy (HCT) for lymphoid and myeloid malignancies and hypothesized that CloFluBu provides a less toxic alternative to conventional conditioning regimens, with adequate antileukemic activity. All patients receiving their first HCT, from 2011-2019, were included and received CloFluBu. The primary endpoint was event-free survival (EFS). Secondary endpoints were overall survival (OS), graft-versus-host disease (GvHD)-relapse-free survival (GRFS), treatment-related mortality (TRM), cumulative incidence of relapse (CIR), acute and chronic GvHD (aGvHD and cGvHD), and veno-occlusive disease (VOD). Cox proportional hazard and Fine and Gray competing-risk models were used for data analysis. One hundred fifty-five children were included: 60 acute lymphoid leukemia (ALL), 69 acute myeloid leukemia (AML), and 26 other malignancies (mostly MDS-EB). The median age was 9.7 (0.5 to 18.6) years. Estimated 2-year EFS was 72.0% ± 6.0 in ALL patients, and 62.4% ± 6.0 in AML patients. TRM in the whole cohort was 11.0% ± 2.6, incidence of aGvHD 3 to 4 at 6 months was 12.3% ± 2.7, extensive cGvHD at 2 years was 6.4% ± 2.1. Minimal residual disease-positivity prior to HCT was associated with higher CIR, both in ALL and AML. CloFluBu showed limited toxicity and encouraging EFS. CloFluBu is a potentially less toxic alternative to conventional conditioning regimens. Randomized prospective studies are needed.
Identification of candidate genes and enriched biological functions for feed efficiency traits by integrating plasma metabolites and imputed whole genome sequence variants in beef cattle
Authors: Li Jiyuan , Mukiibi Robert , Wang Yining , Plastow Graham S. , Li Changxi
Published: November 2021

Background

Feed efficiency is one of the key determinants of beef industry profitability and sustainability. However, the cellular and molecular background behind feed efficiency is largely unknown. This study combines imputed whole genome DNA variants and 31 plasma metabolites to dissect genes and biological functions/processes that are associated with residual feed intake (RFI) and its component traits including daily dry matter intake (DMI), average daily gain (ADG), and metabolic body weight (MWT) in beef cattle.

Results

Regression analyses between feed efficiency traits and plasma metabolites in a population of 493 crossbred beef cattle identified 5 (L-valine, lysine, L-tyrosine, L-isoleucine, and L-leucine), 4 (lysine, L-lactic acid, L-tyrosine, and choline), 1 (citric acid), and 4 (L-glutamine, glycine, citric acid, and dimethyl sulfone) plasma metabolites associated with RFI, DMI, ADG, and MWT (P-value < 0.1), respectively. Combining the results of metabolome-genome wide association studies using 10,488,742 imputed SNPs, 40, 66, 15, and 40 unique candidate genes were identified as associated with RFI, DMI, ADG, and MWT (P-value < 1 × 10−5), respectively. These candidate genes were found to be involved in some key metabolic processes including metabolism of lipids, molecular transportation, cellular function and maintenance, cell morphology and biochemistry of small molecules.

Conclusions

This study identified metabolites, candidate genes and enriched biological functions/processes associated with RFI and its component traits through the integrative analyses of metabolites with phenotypic traits and DNA variants. Our findings could enhance the understanding of biochemical mechanisms of feed efficiency traits and could lead to improvement of genomic prediction accuracy via incorporating metabolite data.
Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
Authors: Zhu Alex , Zembower Teresa , Qi Chao
Published: November 2021

Background

Despite its low sensitivity, fungal culture remains one of the key methods for diagnosis and treatment of fungal infections, as it identifies the etiology at the genus and species level and affords the opportunity for susceptibility testing. The Manual of Clinical Microbiology recommends that fungal culture screening for all pathogens should routinely be held for 4 weeks to maximize the recovery of slow-growing species. Information on the optimal fungal culture time in this era of expansion of immunocompromised populations and availability of molecular diagnostics is lacking. We reviewed our experience with fungal culture to determine the optimal culture incubation time. In addition, our experience of broad-range ITS PCR for diagnosis of culture-negative fungal infections was also reviewed.

Methods

Fungal culture and ITS PCR results from January 1, 2013, to December 31, 2017, were reviewed.

Results

This study included 4234 non-duplicated positive cultures. Ninety-six percent (4058) of the positive cultures were detected in the first 7 days of incubation. During the second week of incubation, 111 (2.8%) positives were detected from day 8 to day 10, and 71 (1.7%) were detected from day 11 to day 14. Only 6 (0.1%) positive cultures were detected in the third week of incubation, and no positive culture was detected in the fourth week of incubation. No clinically significant fungal isolates were recovered after 14 days. Clinically significant pathogens were detected in 16 (0.2%) culture-negative samples by ITS PCR.

Conclusion

Extending culture incubation beyond 2 weeks did not generate clinically relevant results. When culture failed to make a laboratory diagnosis, broad-range internal transcribed spacer (ITS) rRNA gene PCR followed by sequencing produced clinically significant results.