bluuebunny/crossref_metadata_2025 huggingface dataset:
6 February 2023, orthopedic experience in Kahramanmaraş earthquake and surgical decision in patients with crush syndrome
Authors: Kundakci Bugra , Mirioglu Akif , Tekin Mustafa , Bagir Melih , Bicer Omer Sunkar , Arslan Yusuf Kemal , Ozkan Cenk , Ozbarlas Hilmi Serdar
Published: July 2023

Background

The decision of fasciotomy or amputation in crush syndrome is controversial and challenging for surgeons. We aimed to share our experiences after the Kahramanmaraş earthquake, to predict the severity of crush syndrome and mortality, and to guide the surgical decision.

Methods

The clinical data of patients during their first week of hospitalization were analyzed retrospectively. Totally, 233 crush syndrome patients were included. Demographic data, physical and laboratory findings, surgical treatments, and outcomes were recorded.

Results

The mean time under the rubble was 41.89 ± 29.75 h. Fasciotomy and amputation were performed in 41 (17.6%) and 72 (30.9%) patients. One hundred and two patients (56.7%) underwent hemodialysis. Fifteen patients (6.4%) died. Lower extremity injury, abdominal trauma, and thoracic trauma were associated with mortality. Mortality was significantly increased in patients with thigh injuries (p = 0.028). The mean peak CK concentration was 69.817.69 ± 134.812.04 U/L. Peak CK concentration increased substantially with amputation (p = 0.002), lower limb injury (p < 0.001), abdominal trauma (p = 0.011), and thoracic trauma (p = 0.048).

Conclusions

Thigh injury is associated with the severity of crush syndrome and mortality. Late fasciotomy should not be preferred in crush syndrome. Amputation is life-saving, especially in desperate lower extremity injuries.
Reconstruction of a 3D-printed endoprosthesis after joint-preserving surgery with intraoperative physeal distraction for childhood malignancies of the distal femur
Authors: Gong Taojun , Lu Minxun , Min Li , Luo Yi , Tu Chongqi
Published: July 2023

Background

Joint-salvage surgery has been proposed in children with metaphysis malignancy of the distal femur. However, there is still some drawbacks regarding to the surgical technique and endoprosthetic design. In this study, we evaluated the efficacy of a joint-sparing surgical technique for the distal femur in pediatric patients using intraoperative physeal distraction and reconstruction of a 3D-printed endoprosthesis.

Methods

We retrospectively analyzed pediatric patients with distal femoral malignancy who underwent intraoperative physeal distraction and 3D-printed endoprosthetic reconstruction. Clinically, we evaluated functional outcomes using the 1993 version of the Musculoskeletal Tumor Society (MSTS-93) score pre- and post-operation. Complications were also recorded.

Results

Seven children with a median age of 11 years (range 8–15 years) were finally included in our study. The median follow-up time was 30 months (range 27–59 months). The median postoperative functional MSTS-93 score was increased compared with the preoperative scores. The bone-implant interface showed good osseointegration. One patient developed deep infection and another had lung metastasis after surgery. Endoprosthetic complications were not observed.

Conclusion

We recommended that joint-preserving surgery with intraoperative physeal distraction and a 3D-printed endoprosthesis for reconstruction as an option for malignancies of the distal femur in selected pediatric patients.
Novel pathogenic NPR2 variants in short stature patients and the therapeutic response to rhGH
Authors: Chen Hong , Zhang Suping , Sun Yunteng , Chen Jiao , Yuan Ke , Zhang Ying , Yang Xiaohong , Lin Xiangquan , Chen Ruimin
Published: July 2023

Objective

Heterozygous loss-of-function variants in theNPR2gene cause short stature with nonspecific skeletal abnormalities and account for about 2 ~ 6% of idiopathic short stature. This study aimed to analyze and identify pathogenic variants in theNPR2gene and explore the therapeutic response to recombinant growth hormone (rhGH).

Methods

NPR2was sequenced in three Chinese Han patients with short stature via exome sequencing. In vitro functional experiments, homology modeling and molecular docking analysis of variants were performed to examine putative protein changes and the pathogenicity of the variants.

Result

Three patients received rhGH therapy for two years, and twoNPR2heterozygous variants were identified in three unrelated cases: c.1579 C > T,p.Leu527Phe in patient 1 and c.2842dupC,p.His948Profs*5 in patient 2. Subsequently, a small gene model was constructed, and transcriptional analysis of the synonymous variant (c.2643G > A) was performed in patient 3, which revealed the deletion of exon 17 and the premature formation of a stop codon (p.His840Gln*). Functional studies showed that both NPR2 variants, His948Profs*5 and His840Gln*, failed to produce cGMP in the homozygous state. Furthermore, the Leu527Phe variant of NPR2 was almost unresponsive to the stimulatory effect of ATP on CNP-dependent guanylyl cyclase activity. This loss of response to ATP has not been previously reported. The average age of patients at the start of treatment was 6.5 ± 1.8 years old, and their height increased by 1.59 ± 0.1 standard deviation score after 2 years of treatment.

Conclusion

In this report, two novel variants inNPR2gene were described. Our findings broaden the genotypic spectrum ofNPR2variants in individuals with short stature and provid insights into the efficacy of rhGH in these patients.
Bi- and trispecific immune cell engagers for immunotherapy of hematological malignancies
Authors: Tapia-Galisteo Antonio , Álvarez-Vallina Luis , Sanz Laura
Published: July 2023

Immune cell engagers are engineered antibodies with at least one arm binding a tumor-associated antigen and at least another one directed against an activating receptor in immune effector cells: CD3 for recruitment of T cells and CD16a for NK cells. The first T cell engager (the anti-CD19 blinatumomab) was approved by the FDA in 2014, but no other one hit the market until 2022. Now the field is gaining momentum, with three approvals in 2022 and 2023 (as of May): the anti-CD20 × anti-CD3 mosunetuzumab and epcoritamab and the anti-B cell maturation antigen (BCMA) × anti-CD3 teclistamab, and another three molecules in regulatory review. T cell engagers will likely revolutionize the treatment of hematological malignancies in the short term, as they are considerably more potent than conventional monoclonal antibodies recognizing the same tumor antigens. The field is thriving, with a plethora of different formats and targets, and around 100 bispecific T cell engagers more are already in clinical trials. Bispecific NK cell engagers are also in early-stage clinical studies and may offer similar efficacy with milder side effects. Trispecific antibodies (engaging either T cell or NK cell receptors) raise the game even further with a third binding moiety, which allows either the targeting of an additional tumor-associated antigen to increase specificity and avoid immune escape or the targeting of additional costimulatory receptors on the immune cell to improve its effector functions. Altogether, these engineered molecules may change the paradigm of treatment for relapsed or refractory hematological malignancies.
LncRNA RBAT1 reduces chemosensitivity of cancer cells to carboplatin/paclitaxel by sponging miR‑27b in endometrial carcinoma
Authors: Fan Lingye , Wang Chunyan , Zhan Ping , Liu Yaofang
Published: July 2023

Background

A recent study reported the role of long non-coding RNA (lncRNA) RBAT1 in promoting the development of retinoblastoma and bladder cancer. However, its function in other cancers is unclear. We then studied the role of RBAT1 in endometrial carcinoma (EC).

Methods

The expression of RBAT1 and miR-27b in EC and paired non-tumor samples from advanced EC patients, as well as in plasma samples of EC patients and healthy controls were detected by RT-qPCR. The direct interaction between RBAT1 and miR-27b, and the subcellular location of RBAT1 were determined by RNA-RNA pulldown assay and subcellular fractionation assay, respectively.

Results

EC tissues showed increased expression levels of RBAT1 and decreased expression levels of miR-27b compared to that in non-tumor tissues. Moreover, EC patients showed higher plasma expression levels of RBAT1 and lower plasma expression levels of miR-27b compared to that in the controls. Drug-resistant (DR) patients showed higher expression levels of RBAT1 and lower expression levels of miR-27b in both EC tissues and plasma samples. RBAT1 was detected in both nuclear and cytoplasm and it directly interacted with miR-27b. RBAT1 and miR-27b did not affect the expression of each other. Upregulation of RBAT1 promoted the expression of multidrug-resistant-related protein (P-gp, MRP1, and BCRP). Overexpression of RBAT1 and inhibition of miR-27b promoted cell viability and impeded cell apoptosis and cell cycle arrest at G0-G1 phase, while knockdown of RBAT1 and overexpression of miR-27b inhibited cell viability and induced cell apoptosis and cell cycle arrest at G0-G1 phase. Moreover, miR-27b could abolish RBAT1-induced effects on cell viability, apoptosis and cell cycle.

Conclusion

RBAT1 may reduce the chemosensitivity of EC cells to carboplatin/paclitaxel by sponging miR-27b in EC.
‘Good farmers’ and ‘real vets’: social identities, behaviour change and the future of bovine tuberculosis eradication
Authors: Enticott Gareth
Published: July 2023

This paper considers the role of social research and human behaviour in attempts to eradicate bTB. Future attempts to eradicate bTB are likely to involve an increasing range of sophisticated technologies. However, the acceptance and use of these technologies is likely to depend on a range of behavioural incentives. The use of appropriate behavioural nudges may facilitate bTB eradication, but the paper contends that of more value are socio-cultural approaches to understanding behaviour. Specifically, the concepts of the ‘good farmer’ and ‘real vets’ are discussed to show how bTB eradication is dependent on social identities. In conclusion, the paper outlines four key roles for social research in assisting with future bTB eradication policies.
Arthroscopic Bankart repair versus conservative treatment for first-time traumatic anterior shoulder dislocation: a systematic review and meta-analysis
Authors: Hu Bin , Hong Jianqiao , Zhu Hanxiao , Yan Shigui , Wu Haobo
Published: July 2023

Background

Shoulder is vulnerable to dislocation owing to its anatomical structure and the increasing popularity of contact sports in young population. The management of first-time anterior shoulder dislocation in this group is still controversial and the prognosis are varied. This review aimed to compare the results of arthroscopic Bankart repair and conservative management for first-time traumatic anterior shoulder dislocation in young active patients.

Methods

Databases were searched till November 2021, and comparative studies between arthroscopic Bankart repair and conservative management for first-time traumatic anterior shoulder dislocation in young population were selected. Methodological quality of the studies was assessed according to the Cochrane Back Review Group 12-item scale. Outcome measures included recurrence of instability, return to play, subsequent instability surgery, and shoulder functional scores.

Results

The search returned 12 eligible trials with 786 participants. All the trials were of prospective design. After arthroscopic Bankart repair, patients experienced significantly less re-dislocation (7.5% vs. 53.0%,p < 0.00001,I2 = 0%), subluxation (3.1% vs. 24.2%,p < 0.0001,I2 = 0%), positive apprehension test (7.3% vs. 25.8%,p = 0.002,I2 = 11%), and subsequent surgical treatment for instability (5.6% vs. 37.8%,p < 0.00001,I2 = 0%) when compared with those underwent conservative management. And more patients returned to play (83.5% vs. 66.0%,p = 0.03,I2 = 81%) after arthroscopic Bankart repair. Outcomes regarding the functional scores did not reach a significant difference between the two cohorts.

Conclusions

Arthroscopic Bankart repair showed superiority over conservative management in terms of recurrence, return to play, and subsequent instability surgery during the follow-up in young active patients that encountered first episode of dislocation. As long-term prognosis is comparable, an immediate surgical stabilization might not be suitable for everyone.
TGF-β promotes the proliferation and osteogenic differentiation of dental pulp stem cells a systematic review and meta-analysis
Authors: Gao Pengfei , Liu Chanjuan , Dong Hui , Li Qi , Chen Yunfang
Published: July 2023

Background

Dental pulp stem cells (DPSCs) are adult stem cells with multi-directional differentiation potential derived from ectoderm. Vitro experiments have shown that adding cytokines can help DPSCs to be transformed from multipotent stem cells to osteoblasts. TGF-β has been proved to have an effect on the proliferation and mineralization of bone tissue, but its effect on the osteogenesis and proliferation of dental pulp stem cells is still uncertain. We aim to determine the effect of TGF-β on the osteogenesis and proliferation of dental pulp stem cells.

Methods

We have identified studies from the Cochrane Central Register of Controlled Trials, PubMed, Embase, and China national knowledge infrastructure (CNKI) for studies interested in TGF-β and proliferation and differentiation of dental pulp stem cells in the following indicators: A490 (an index for evaluating cell proliferation), bone sialoprotein (BSP), Col plasmid-1 (Col-1), osteocalcin (OCN), runt-related transcription factor 2 (Runx-2); and the number of mineralized nodules. Any language restrictions were rejected. Furthermore, we drew a forest plot for each outcome. We conducted a sensitivity analysis, data analysis, heterogeneity, and publication bias test. We evaluate the quality of each study under the guidance of Cochrane's tool for quality assessment.

Results

The pooled data showed that TGF-β could promote the proliferation and ossification of dental pulp stem cells. All the included results support this conclusion except for the number of mineralized nodules: TGF-β increases the A490 index (SMD 3.11, 95% CI [0.54–5.69]), promotes the production of BSP (SMD 3.11, 95% CI [0.81–6.77]), promotes the expression of Col-1 (SMD 4.71, 95% CI [1.25–8.16]) and Runx-2 (SMD 3.37, 95% CI [− 0.63 to 7.36]), increases the content of OCN (SMD 4.32, 95% CI [1.20–7.44]) in dental pulp, and has no significant effect on the number of mineralized nodules (SMD 3.87, 95% CI [− 1.76 to 9.51]) in dental pulp stem cells.

Conclusions

TGF-β promotes the proliferation and osteogenesis of dental pulp stem cells.
The long-term gut bacterial signature of a wild primate is associated with a timing effect of pre- and postnatal maternal glucocorticoid levels
Authors: Anzà Simone , Schneider Dominik , Daniel Rolf , Heistermann Michael , Sangmaneedet Somboon , Ostner Julia , Schülke Oliver
Published: July 2023

Background

During development, elevated levels of maternal glucocorticoids (GCs) can have detrimental effects on offspring morphology, cognition, and behavior as well as physiology and metabolism. Depending on the timing of exposure, such effects may vary in strength or even reverse in direction, may alleviate with age, or may concern more stable and long-term programming of phenotypic traits. Maternal effects on gut bacterial diversity, composition, and function, and the persistence of such effects into adulthood of long-lived model species in the natural habitats remain underexplored.

Results

In a cross-sectional sample of infant, juvenile, and adult Assamese macaques, the timing of exposure to elevated maternal GCs during ontogeny was associated with the gut bacterial community of the offspring. Specifically, naturally varying maternal GC levels during early but not late gestation or lactation were associated with reduced bacterial richness. The overall effect of maternal GCs during early gestation on the gut bacterial composition and function exacerbated with offspring age and was 10 times stronger than the effect associated with exposure during late prenatal or postnatal periods. Instead, variation in maternal GCs during the late prenatal or postnatal period had less pronounced or less stable statistical effects and therefore a weaker effect on the entire bacterial community composition, particularly in adult individuals. Finally, higher early prenatal GCs were associated with an increase in the relative abundance of several potential pro-inflammatory bacteria and a decrease in the abundance ofBifidobacteriumand other anti-inflammatory taxa, an effect that exacerbated with age.

Conclusions

In primates, the gut microbiota can be shaped by developmental effects with strong timing effects on plasticity and potentially detrimental consequences for adult health. Together with results on other macaque species, this study suggests potential detrimental developmental effects similar to rapid inflammaging, suggesting that prenatal exposure to high maternal GC concentrations is a common cause underlying both phenomena. Our findings await confirmation by metagenomic functional and causal analyses and by longitudinal studies of long-lived, ecologically flexible primates in their natural habitat, including developmental effects that originate before birth.
Multispecies fish tracking across newly created shallow and deep habitats in a forward-restored lake
Authors: van Leeuwen Casper H. A. , de Leeuw Joep J. , van Keeken Olvin A. , Volwater Joey J. J. , Seljee Ferdi , van Aalderen Roland , van Emmerik Willie A. M. , Bakker Elisabeth S.
Published: July 2023

Background

Freshwater fish communities typically thrive in heterogenous ecosystems that offer various abiotic conditions. However, human impact increasingly leads to loss of this natural heterogeneity and its associated rich fish communities. To reverse this trend, we need guidelines on how to effectively restore or recreate habitats for multiple fish species. Lake Markermeer in the Netherlands is a human-created 70,000-ha lake with a uniform 4 m-water depth, steep shorelines, high wind-induced turbidity, and a declining fish community. In 2016, a forward-looking restoration project newly created a 1000-ha five-island archipelago in this degrading lake, which offered new sheltered shallow waters and deep sand excavations to the fish community.

Methods

In 2020, we assessed how omnivorous and piscivorous fish species used these new habitats by tracking 78 adult fish of five key species across local and lake-scales. We monitored spring arrival of adult fish and assessed local macro-invertebrate and young-of-the-year fish densities.

Results

Adult omnivorous Cyprinidae and piscivorous Percidae arrived at the archipelago in early spring, corresponding with expected spawning movements. During the productive summer season, 12 species of young-of-the-year fish appeared along the sheltered shorelines, with particularly high densities of common roach (Rutilus rutilus) and European perch (Perca fluviatilis). This suggests the sheltered, shallow, vegetated waters formed new suitable spawning and recruitment habitat for the fish community. Despite highest food densities for adult fish in the shallowest habitats (< 2-m), adult fish preferred minimally 2-m deep water. After spawning most Cyprinidae left the archipelago and moved long distances through the lake system, while most Percidae remained resident. This may be related to (1) high densities of young-of-the-year fish as food for piscivores, (2) medium food densities for omnivores compared to elsewhere in the lake-system, or (3) the attractiveness of 30-m deep sand excavations that were newly created and frequently used by one-third of all tracked fish.

Conclusions

New littoral zones and a deep sand excavation constructed in a uniform shallow lake that lacked these habitat types attracted omnivorous and piscivorous fish species within four years. Both feeding guilds used the littoral zones for reproduction and nursery, and notably piscivorous fish became residents year-round.
Mitochondrial DNA mutations in Medulloblastoma
Authors: Funke Viktoria L. E. , Sandmann Sarah , Melcher Viktoria , Seggewiss Jochen , Horvath Judit , Jäger Natalie , Kool Marcel , Jones David T. W. , Pfister Stefan M. , Milde Till , Rutkowski Stefan , Mynarek Martin , Varghese Julian , Sträter Ronald , Rust Stephan , Seelhöfer Anja , Reunert Janine , Fiedler Barbara , Schüller Ulrich , Marquardt Thorsten , Kerl Kornelius
Published: July 2023

To date, several studies on genomic events underlying medulloblastoma (MB) biology have expanded our understanding of this tumour entity and led to its division into four groups—WNT, SHH, group 3 (G3) and group 4 (G4). However, there is little information about the relevance of pathogenic mitochondrial DNA (mtDNA) mutations and their consequences across these. In this report, we describe the case of a female patient with MB and a mitochondriopathy, followed by a study of mtDNA variants in MB groups. After being diagnosed with G4 MB, the index patient was treated in line with the HIT 2000 protocol with no indications of relapse after five years. Long-term side effects of treatment were complemented by additional neurological symptoms and elevated lactate levels ten years later, resulting in suspected mitochondrial disease. This was confirmed by identifying a mutation in the MT-TS1 gene which appeared homoplasmic in patient tissue and heteroplasmic in the patient’s mother. Motivated by this case, we explored mtDNA mutations across 444 patients from ICGC and HIT cohorts. While there was no statistically significant enrichment of mutations in one MB group, both cohorts encompassed a small group of patients harbouring potentially deleterious mtDNA variants. The case presented here highlights the possible similarities between sequelae caused by MB treatment and neurological symptoms of mitochondrial dysfunction, which may apply to patients across all MB groups. In the context of the current advances in characterising and interpreting mtDNA aberrations, recognising affected patients could enhance our future knowledge regarding the mutations’ impact on carcinogenesis and cancer treatment.
The potential of fibre optic UV-Vis-NIR spectroscopy to distinguish vital and devitalised forms of microbial contamination of paper substrates
Authors: Paračková Patrícia , Čeppan Michal , Kaliňáková Barbora , Reháková Milena , Gál Lukáš
Published: July 2023

Microorganisms, especially microscopic filamentous fungi, represent one of the most significant factors influencing the degradation of cultural heritage cellulosic objects. Early detection, identification and characterisation of microbial communities can help select a suitable conservation intervention and, in addition, allow possible control of its effectiveness. A combination of spectral methods and statistical data processing appears to be a suitable alternative to conventional methods for monitoring microbial contamination. The main goal of the presented research was the investigation of the spectral properties of vital and devitalised filamentous fungi Alternaria alternata, Aspergillus niger, Cladosporium herbarum, Penicillium chrysogenum, and Trichoderma atroviride, inoculated on a paper substrate Whatman in two phases—dormant (conidia) and active (mycelium). The combination of the UV-Vis-NIR and NIR Fibre Optics Reflection Spectroscopy (FORS) with the Principal Component Analysis (PCA) was set to determine whether the spectra of vital and devitalised forms of studied samples differ. The obtained results prove differences between the spectra of vital and devitalised forms of filamentous fungi, at least in one studied spectral region. Therefore, UV-Vis-NIR and NIR FORS combined with PCA seems to be a promising tool for monitoring paper-based objects' microbial contamination.
The significance of sample preparation of historical and contemporary poly(vinyl chloride) objects to investigate the distribution and changes of molar mass by SEC-MALS-dRI
Authors: Rijavec Tjaša , Pawcenis Dominika , Kruczała Krzysztof , Strlič Matija , Kralj Cigić Irena
Published: July 2023

The distribution of molar mass of historical and contemporary poly(vinyl chloride) objects was determined using size exclusion chromatography with multi-angle light scattering detection. The weight average molar mass was determined for a collection of 57 samples, ranging from 75 to 186 kg/mol with a median of 102 kg/mol. Rigid PVC objects were found to have a significantly lower weight average molar mass (Mw = 81 kg/mol) than plasticized ones (Mw = 102 kg/mol). Thin objects also exhibited significantly lower Mw than bulky objects. A substantial presence of aggregates was noted and characterized as an ‘aggregate ratio’ for the entire collection. Heating a solution of poly(vinyl chloride) in THF at 55 °C for 5 h proved successful in the dissociation of the aggregates and allowed for an accurate determination of molar mass. The uncertainty of the Mw determination was statistically evaluated and used to study the effects of accelerated degradation on Mw. No statistically significant changes in Mw were observed in samples artificially aged at 50 °C to 80 °C for up to 15 weeks, indicating that Mw does not decrease during degradation of a PVC heritage object and that accelerated degradation does not lead to polymer crosslinking.
Feasibility, clinical efficacy, and well-being outcomes of an online singing intervention for postnatal depression in the UK: SHAPER-PNDO, a single-arm clinical trial
Authors: Bind Rebecca H. , Sawyer Kristi , Hazelgrove Katie , Rebecchini Lavinia , Miller Celeste , Ahmed Subeyda , Dazzan Paola , Sevdalis Nick , Bakolis Ioannis , Davis Rachel , Lopez Maria Baldellou , Woods Anthony , Crane Nikki , Manoharan Manonmani , Burton Alexandra , Dye Hannah , Osborn Tim , Greenwood Lorna , Perkins Rosie , Fancourt Daisy , Pariante Carmine M. , Estevao Carolina
Published: July 2023

Background

Postnatal depression (PND) affects over 12% of mothers, with numbers rising during COVID-19. Singing groups can support mothers with PND; however, online delivery has never been evaluated. SHAPER-PNDO, a single-arm clinical trial, evaluated the feasibility, clinical efficacy, and well-being outcomes of a 6-week online version of Breathe Melodies for Mums (M4M) singing intervention developed for mothers with PND during COVID-19 lockdowns.

Methods

The primary objective of this study was to assess the feasibility of a group online singing intervention for new mothers with postnatal depression. This was ascertained through recruitment rates, study retention rates, attendance rates to the singing sessions, and study completion rates. The secondary objective of the study was to assess the clinical efficacy and well-being outcomes of the singing intervention. Specifically, we measured change in Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and Office for National Statistics Wellbeing Scale (ONS) scores from baseline to end-of-intervention (week 6); follow-up assessments were completed at weeks 3, 16, and 32. Mothers were eligible if they scored ≥10 on the baseline EPDS.

Results

Eighty-seven percent of the 37 recruited mothers completed the study, attending, on average, 5 of the 6 group singing sessions. With regard to secondary outcomes, at end-of-treatment, mothers experienced significant reductions in depression (EPDS, 16.6 ± 3.7 to 11.2 ± 5.3, 95% CI [0.79,1.65]), anxiety (STAI-S, 48.4 ± 27.1 to 41.7 ± 26.8, 95% CI [4.96, 17.65]) and stress (PSS, 29.0 ± 5.7 to 19.7 ± 5.3, 95% CI [1.33, 7.07]); and, furthermore, significant improvements in life satisfaction (ONS, 50.5 ± 23.0 to 72.8 ± 11.7, 95% CI [− 39.86, − 4.64]) and feelings of worthwhileness (ONS, 51.7 ± 30.4 to 78.6 ± 15.1, 95% CI [− 52.79, − 0.85]). Reduction on the EPDS correlated with a reduction on the BDI and the STAI-S and maternal childhood maltreatment was predictive of a smaller treatment response.

Conclusions

M4M online was feasible to mothers who partook in the programme. Furthermore, M4M online supports the mental health and well-being of new mothers experiencing PND, especially when barriers to in-person treatment are present.

Trial registration

ClinicalTrials.gov NCT04857593. Registered 22 April 2021, retrospectively registered;
Efficacy of pure beta tricalcium phosphate graft in dentoalveolar surgery: a retrospective evaluation based on serial radiographic images
Authors: Choi Young-Jin , Chang Hoon-Je , Kim Min Jae , Lee Jee-Ho , Lee Bu-Kyu
Published: July 2023

Background

The use of beta-tricalcium phosphate (beta-TCP) in dental surgery is limited owing to its rapid absorption compared to mixed formulations of hydroxyapatite. However, newly developed pure beta-TCP crystals have demonstrated slow absorption; hence, they last longer within the defect and act as a scaffold until new bone formation. The oral environment is unique and can prove unfavorable for bone grafts due to the high infection rate in the oral cavity and the fragile condition of the oral mucosa. The aim of this study was to evaluate the feasibility of using pure beta-TCP bone grafts in various dental treatments.

Methods

Panoramic X-ray images of 25 patients who underwent bone grafting during dental surgery were analyzed. A specially treated pure beta-TCP crystal, Neo Bone® (Neo Bone®, SN Biologics Co., Ltd, Seoul, Korea), was used in this study. The bone density at the graft site was compared with that of the surrounding bone using the ImageJ software (Wayne Rasband, NIH USA).

Results

Six months after surgery, the bone graft density was similar to that of the surrounding bone in 20 patients and increased in 5 patients. No adverse effects, such as infection, dehiscence, or graft failure, were observed.

Conclusion

The newly developed pure beta-TCP crystal was slowly absorbed and served as support until new bone formation at the defect site, thus demonstrating its potential for use in various oral conditions requiring bone grafting.
Iatrogenic uvular injury after endotracheal intubation: recommendations for clinical practice
Authors: Zameer Sheharyar , Inam Syed Muhammad , Faisal Mahvish , Khan Huma Ahmed , Fatima Anmol , Anwar Umer
Published: July 2023

Background

Uvular injury is a rare complication of endotracheal intubation. It presents as a triad of sore throat, foreign body sensation in pharynx, and halitosis.

Case presentation

A 26-year-old male who underwent endotracheal intubation for general anesthesia developed sore throat and foreign body sensation after the procedure. The patient was diagnosed as a case of iatrogenic uvular necrosis (grade III uvular injury) leading to auto-amputation (grade IV uvular injury) attributed to compression of the uvula due to the endotracheal tube placement. The patient was counseled regarding the etiology of the disease and was treated conservatively.

Conclusions

Uvular injury is a rare complication that can easily be prevented by corrections in technique and experience. This report emphasizes the establishment of principles of diagnosis, prevention, and treatment of uvular injury.
The “dark” side of terlipressin: a case report of ischemic skin necrosis and review of literature
Authors: Shastri Arpit , Rose Sweta , Vojjala Nikhil , Bhagat Naveen , De Arka
Published: July 2023

Background

Terlipressin is a commonly used drug in cirrhotic patients with acute variceal bleed (AVB) due to its vasoconstrictor effects. Ischemic complications are uncommon adverse events associated with worse outcomes.

Case presentation

We present a case of alcohol-related cirrhosis, who was started on terlipressin for AVB. However, he developed bilateral lower limb gangrene with ischemic skin necrosis and ultimately succumbed to death.

Conclusion

Although ischemic adverse events are uncommon with terlipressin, it is important to be aware of these complications as they may be severe and potentially life threatening.
The role of the Beclin-1: a gene related to autophagy in rheumatoid arthritis
Authors: Sarhan Shymaa A. , Saad Hassan Asmaa Ahmed , Said Nora M. , Kamal Doaa E.
Published: July 2023

Background

Rheumatoid arthritis (RA) is a chronic autoimmune disorder. Autophagy, a regulator of cell homeostasis, can impact innate and adaptive immune cells activation and contribute to the pathogenesis of RA. The purpose of this study was to assess the significance of autophagy in RA, by investigating the autophagy signaling Beclin-1 in RA patients.

Results

In RA patients, the Beclin-1 gene expression level was higher than the healthy controls with a statistically highly significant difference (P < 0. 001) where the gene expression mean was 3.33 ± 0.45 in patients and 0.98 ± 0.070 in controls. There was a significant positive correlation between Beclin-1 gene expression and disease duration (p = 0.013*), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and rheumatoid factor (RF) titer (P = 0.018*, 0.027*, and 0.023* respectively). Beclin-1 gene overexpression is significantly correlated with disease activity parameters (DAS 28, patient and physician global health assessment). Furthermore, the Beclin-1 gene overexpression is highly correlated with the disability index, Modified Health Assessment Questionnaire (MHAQ) (P < 0.001).

Conclusion

The elevated autophagy-related gene Beclin-1 expression in RA patients can contribute to RA probability, high disease activity, and severity. Therefore, suppressing autophagy may be a therapeutic target for RA.
Clinical Implication of HER2 Aberration in Patients With Metastatic Cancer Using Next-Generation Sequencing: A Pan-Tumor Analysis
Authors: Jung Jaeyun , Kim Seung Tae , Ko Jihoon , Hong Jung Yong , Park Joon Oh , Ha Sang Yun , Lee Jeeyun
Published: July 2023

PURPOSE

Human epidermal growth factor receptor 2 (HER2) protein expression or gene amplification is a significant predictive biomarker for identifying patients with cancer, who may benefit from HER2-targeted therapy. The aim of this study was to survey the proportion of patients who had HER2 aberration and to investigate the correlation between HER2 amplification and HER2 overexpression in immunohistochemistry (IHC) as a real-world data.

METHODS

We surveyed the incidence of HER2 aberration including mutation (single-nucleotide variant [SNV]), amplification (copy-number variation), and fusion by next-generation sequencing (NGS) in 2,119 patients with cancer from Samsung Medical Center in South Korea.

RESULTS

Of 2,119 patients with cancer, 189 patients (8.9%) had HER2 aberration in their tumor specimen. Of 189 patients, 113 (5.3%) patients had HER2 amplification, 82 (3.9%) patients had HER2 mutations, and 11 (0.5%) patients had HER2 fusion. Of note, 10 patients (0.5%) had concurrent HER2 amplification and HER2 fusion. In addition, we identified that HER2 protein overexpression was strongly related to HER2 amplification by NGS. Of 74 patients with HER2 amplification only by NGS test, 64 patients (86.5%) had HER2 overexpression by IHC. Of 10 patients with concurrent HER2 amplification and fusion, 80% patients were HER2 overexpression. Among 51 patients with only HER2 mutation (SNV), 9 patients (17.6%) were HER2 (+). Interestingly, almost all patients with colorectal cancer (11 of 12) with HER2 amplification had very strong HER2 overexpression (3+) in their tumor specimen.

CONCLUSION

In conclusion, we showed that when patients with metastatic cancer receive NGS test, approximately 8.9% have HER2 aberrations in their tumor specimen. Most patients have HER2 amplification, and a small percentage of patients have HER2 fusion. A great majority of patients with HER2 amplification and/or HER2 fusion had HER2 (+) tumor by IHC.
Associations of Glucose Metabolism Status with Brain Macrostructure and Microstructure: Findings from the UK Biobank
Authors: Li Ruyi , Geng Tingting , Li Lin , Lu Qi , Li Rui , Chen Xue , Ou Yunjing , Liu Sen , Lin Xiaoyu , Tian Qingying , Qiu Zixin , Zhu Kai , Tang Ziyue , Yang Kun , Pan An , Liu Gang
Published: July 2023

Context

Evidence linking glucose metabolism status with brain macro- and microstructure is limited and inconsistent.

Objective

We aim to investigate the associations of glucose metabolism status with brain macrostructure and microstructure, including brain volumes, subcortical gray matter volumes, and white matter microstructural metrics.

Methods

This study enrolled 29 251 participants from the UK Biobank. Glucose metabolism status was classified into normal glucose metabolism (NGM), prediabetes, type 2 diabetes (T2D) with HbA1c <7%, and T2D with HbA1c ≥7%. Brain macrostructural metrics included volumes of total and subcortical gray matter, white matter, white matter hyperintensity (WMH), cerebrospinal fluid, and brain stem. Brain microstructural metrics included fractional anisotropy (FA) and mean diffusivity in white matter tracts. Multivariable linear regression models were used to estimate β values and 95% CI.

Results

After multivariable adjustment including demographic and lifestyle factors, medical history, and total intracranial volume, those with prediabetes had smaller total and subcortical gray matter volumes than participants with NGM, while atrophy of total and subcortical gray matter was more pronounced in those with T2D (all P trend < .05). Moreover, participants with T2D had larger volumes of white matter and WMH (both P trend < .05). For brain microstructure, participants with prediabetes had lower FA values in commissural fibers (β −0.04; 95% CI −0.08, −0.003). Global and tract-specific microstructural abnormalities of white matter were observed in participants with T2D, especially for T2D with HbA1c ≥ 7% (all P trend < .05), except for FA values in projection fibers.

Conclusion

These findings suggest that interventions for hyperglycemia at an earlier stage may help protect brain health.
Leptin Decreases Gluconeogenesis and Gluconeogenic Substrate Availability in Patients With Lipodystrophy
Authors: Quaye Emmanuel , Chacko Shaji , Startzell Megan , Brown Rebecca J
Published: July 2023

Context

The effects of leptin, an adipocyte-derived hormone that signals overall energy sufficiency, can only be studied in leptin-deficient conditions. In patients with lipodystrophy, a rare disease and unique model of leptin deficiency, treatment with recombinant leptin (metreleptin) improves glycemia and decreases energy expenditure. We hypothesized that these improvements might be mediated by reduced gluconeogenesis (GNG), an energy-requiring process.

Objective

To determine the effects of metreleptin on GNG and GNG substrates.

Methods

This was a single-arm prospective study of metreleptin administration in 15 patients with lipodystrophy, 9 of whom had data on GNG (NIH, 2013-2018). We analyzed total GNG, insulin-mediated suppression of GNG, glycerol, palmitate, alanine, lactate, peripheral and hepatic insulin sensitivity, and markers of glycemia (eg, HbA1c, glucose, fasting insulin).

Results

Metreleptin administration decreased basal GNG, increased insulin-mediated suppression of GNG, and improved insulin sensitivity and markers of glycemic control. Metreleptin reduced carbon sources for GNG, including plasma alanine and lactate, and rate of appearance (Ra) of glycerol, and decreased Ra of palmitate, a driver of GNG. Glycerol and palmitate Ra correlated with GNG prior to but not during metreleptin administration. Alanine strongly correlated with GNG both before and during metreleptin administration.

Conclusions

Metreleptin treatment in patients with lipodystrophy reduced GNG likely through decreased availability of carbon sources for gluconeogenesis, such as alanine, lactate, and glycerol. Associations between alanine and GNG persisted after metreleptin treatment while correlations with glycerol and palmitate Ra did not persist, suggesting reduced importance of lipolysis as a driver of GNG in the leptin-replete state.
A Commons beyond the Human
Authors: Er Yanbing
Published: July 2023

This article critiques current theories of the commons as having been produced and sustained by human-centered paradigms of intellectual reasoning. It develops a commons beyond the human in response, which offers another way to envisage the commons and its pledge to the construction of better, alternate futures. Rather than advance yet another definition of the commons, this article examines how its means of knowledge production might ensue differently by dislocating the concept from its existing points of epistemological orientation. At the heart of this inquiry lies an attempt to rethink the commons concept beyond its regulating logics of liberal humanism, a radical reconsideration of the kinds of politics it should and might still enable beyond the lure of progressive reason. Turning to a reading of Alexis Wright’s 2013 novel The Swan Book, the article argues that a commons beyond the human gathers in the text through the more-than-human existence engendered between a young Aboriginal girl, Oblivia, and a flock of black swans. The novel presents neither the disavowal of the inherited knowledges of the commons nor a concrete policy to herald its appearance in a conjectural future, but a critical expansion of its transitive acts of worlding. This is made feasible by its insistence on upholding an Indigenous Australian ontological reality as the structuring provision for its narratives—one that has long stressed its dissonance from dominant Western genres of thinking and being.
New Materialism and the Eco-Marxist Challenge
Authors: Skiveren Tobias
Published: July 2023

In recent years, the critical vocabulary of the environmental humanities has shifted. After a decade burgeoning with new materialist explorations of intra-active entanglements and nonhuman vitalities, scholars are today becoming increasingly interested in the environmental effects of capitalism, its ecological rifts, fossil economy, and omnipresent wastescapes. Driving this shift is a reinvigoration of eco-Marxist thinking, which not only offers new focus points but also launches philosophical polemics against the field’s longstanding turn to matter. Facing these polemics, scholars in the environmental humanities are currently facing a difficult choice: should we opt for an “old” or a “new” materialism? This essay argues that this confrontation between new materialism and eco-Marxism pivots not on ontological differences, as is often assumed, but on diverging attitudes toward critical methodologies. It claims specifically that many of the recent polemics practice a kind of philosophical shadowboxing that blurs a more fundamental disagreement about the role and status of “critique.” Staging an encounter between Andreas Malm’s The Progress of This Storm (2018) and Jane Bennett’s Influx and Efflux (2020), the essay makes its case by demonstrating, first, how an attachment to critical methodologies drives eco-Marxists to polemicize against ontologies that, in fact, resemble their own. It then shows how new materialists advance such ontologies to supplement these critical methodologies with more affectively engaged modes of scholarship. By framing the debate in this way, the essay ultimately aims to push back against the methodological dogmatism of eco-Marxists who take critique to be the only legitimate mode of inquiry.
The Correlation of Global Spinal Realignment With the Quality of Life After Corrective Surgery for Delayed Thoracolumbar Osteoporotic Fracture–Related Kyphosis
Authors: Zhong Junlong , Lin Sijian , Xiong Jiachao , Zhou Zhenhai , Yu Honggui , Ma Shengbiao , Cao Kai
Published: July 2023

BACKGROUND AND OBJECTIVES:

Few studies have been conducted to evaluate the precise impact of corrective surgery on sagittal spinal realignment and clinical outcomes in cases of delayed thoracolumbar osteoporotic fracture–related kyphosis. To assess the efficacy of corrective surgery on sagittal spinal alignment and investigate the relationship between spinal alignment and health-related quality of life (HRQoL) in patients with delayed thoracolumbar osteoporotic fracture–related kyphosis.

METHODS:

A total of 78 patients were enrolled. The characteristics and surgical variables were meticulously documented. The sagittal spinal parameters were measured, and the HRQoL was evaluated using Oswestry Disability Index (ODI), SF-12 Physical Component Score (SF-12 PCS), and Scoliosis Research Society-22 Patient Questionnaire (SRS-22) before and after surgery. The changes in spinal parameters and HRQoL were analyzed through the paired t-test. The Pearson correlation analysis was performed to analyze the correlation of parameters with HRQoL. Then, a multiple stepwise regression analysis was performed with HRQoL scores as the dependent variable and spinal parameters as the independent variable.

RESULTS:

The operative time was 185.9 ± 33.2 min, and the estimated blood loss was 782.8 ± 145.2 mL. The results of the paired t-test revealed a significant difference preoperatively and at the final follow-up in the thoracic kyphosis, thoracolumbar kyphosis (TLK), lumbar lordosis, T9 tilt, pelvic tilt, sacral slope, sagittal vertical axis, and spinosacral angle as well as the ODI, SF-12 PCS, and SRS-22 (P < .05). Multiple stepwise regression analysis revealed that TLK and pelvic tilt, TLK and sagittal vertical axis, and TLK were the primary parameters affecting the ODI, SF-12 PCS, and SRS-22, respectively.

CONCLUSION:

Corrective surgery can effectively realign the global spine and improve HRQoL in patients with delayed thoracolumbar osteoporotic fracture–related kyphosis. The change of TLK is a driving factor to realign the global spine.
Novel Nerve-Sparing In Situ Assembly of an Expandable Titanium Cage to Maximize Endplate Coverage After Posterior Corpectomy for Comminuted Lumbar Burst Fractures
Authors: Felton Jason , John Albin A. , Daneshfar Shahriar C. , Cox Cameron T. , Grochmal Joey
Published: July 2023

BACKGROUND AND OBJECTIVES:

The ability to maximize corpectomy cage endcap size and vertebral endplate coverage after corpectomy for lumbar burst fractures (L1-L5) is limited by the presence of lumbar nerve roots and the larger cross-sectional area of the lumbar endplates relative to the restrictive corridor for cage insertion. This work aims to provide details and clinical examples of a novel operative technique for 3-column reconstruction and stabilization of comminuted lumbar burst fractures.

METHODS:

Through a standard posterior midline approach and following posterior instrumentation and lateral extracavitary corpectomy, an in-situ assembly of a modular corpectomy cage that respects adjacent neural structures, restores segmental alignment, and maximizes endplate coverage across a lordotic segment is completed.

RESULTS:

Radiographic evidence of anatomic spinal reconstruction and stabilization with complete or near-complete endplate coverage without incurrence of new clinical deficit after this novel treatment of lumbar burst fractures.

CONCLUSION:

The fixation approach described in this report may be a valuable modification to a long-standing technique used for treating comminuted lumbar burst fractures (L1-L5) from a posterior-only approach without incurring additional neurological deficits and by improving endplate and apophyseal ring coverage.