bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of resection of forearm soft tissue sarcoma
Authors: Nakata Eiji , Fujiwara Tomohiro , Kunisada Toshiyuki , Nakahara Ryuichi , Katayama Haruyoshi , Itano Takuto , Ozaki Toshifumi
Published: August 2023

Purpose

Soft tissue sarcomas (STS) of the forearm are rare. We aim to assess their oncological and functional outcomes.

Methods

We retrospectively evaluated 34 patients who underwent surgical excision for forearm STS at our institution between 1993 and 2020. We analyzed postoperative Musculoskeletal Tumor Society rating scale (MSTS) and local recurrence-free survival (LRFS), metastasis-free survival, and overall survival (OS) rates. The significance of the following variables was determined: age, sex, histology, tumor size, Fédération Nationale des Centres de Lutte contre le Cancer grade, American Joint Committee on Cancer stage, surgical margin, unplanned excision, metastases upon initial presentation, receipt of chemotherapy, and radiotherapy (RT).

Results

The postoperative median MSTS score was 28. Bone resection or major nerve palsy was the only factor that influenced MSTS scores. The median MSTS scores in patients with or without bone resection or major nerve palsy were 24 and 29, respectively (P < 0.001). The 5-year LRFS rates was 87%. Univariate analysis revealed that the histological diagnosis of myxofibrosarcoma was the only factor that influenced LRFS (P = 0.047). The 5-year MFS rates was 71%. In univariate analysis, no factors were associated with MFS. The 5-year OS rates was 79%. Age was the only factor that influenced OS (P = 0.01).

Conclusion

In the treatment of forearm STS, reconstruction of the skin and tendon can compensate for function, while bone resection and major nerve disturbance cannot. Careful follow-up is important, especially in patients with myxofibrosarcoma, due to its likelihood of local recurrence.
Who needs their descending thoracic aorta anyway? Extra-anatomic bypass for aorto-bronchial fistula after TEVAR
Authors: Newman Joshua S. , Pupovac Stevan S. , Scheinerman S. Jacob , Tseng Jui-Chuan , Hemli Jonathan M. , Brinster Derek R.
Published: August 2023

Background

Aortobronchial fistula after TEVAR remains a vexing clinical problem associated with high mortality. Although a combination of endovascular and open surgical strategies have been reported in managing this pathology, there is as yet no definitive treatment algorithm that can be used for all patients. We discuss our approach to an aortobronchial fistula associated with an overtly infected aortic endograft.

Case presentation

A 49-year-old female sustained a traumatic aortic transection 14 years prior, managed by an endovascular stent-graft. Due to persistent endoleak, she underwent open replacement of her descending thoracic aorta 4 years later. Ten years after her open aortic surgery, the patient presented with hemoptysis, and a pseudoaneurysm at her distal aortic suture line was identified on computed tomography, whereupon she underwent placement of an endograft. Eight weeks later, she presented with dyspnea, recurrent hemoptysis, malaise and fever, with clinical and radiographic evidence of an aortobronchial communication and an infected aortic stent-graft. The patient underwent management via a two-stage open surgical approach, constituting an extra-anatomic bypass from her ascending aorta to distal descending aorta and subsequent radical excision of her descending aorta with all associated infected prosthetic material and repair of the airway.

Conclusion

Aortobronchial fistula after TEVAR represents a challenging complex clinical scenario. Extra-anatomic aortic bypass followed by radical debridement of all contaminated tissue may provide the best option for durable longer-term outcomes.
Endovascular treatment for massive haemoptysis due to pulmonary pseudoaneurysm: report of 23 cases
Authors: Li Fen-Qiang , Su Dong-Jun , Zhang Wan-Jia , Chen Zhong-Ke , Li Geng-Xiang , Li Shuang-Xi , Peng Yu-xing , Dang Lei , Wang Wen-Hui
Published: August 2023

Purpose

To evaluate the safety and effectiveness of endovascular treatment for massive haemoptysis caused by pulmonary pseudoaneurysm (PAP).

Methods

The clinical data, imaging data, and endovascular treatment protocol of 23 patients with massive haemoptysis caused by continuous PAP were retrospectively analysed. The success, complications, postoperative recurrence rate, and influence of the treatment on pulmonary artery pressure were also evaluated.

Results

Nineteen patients with a bronchial artery-pulmonary artery (BA-PA) and/or nonbronchial systemic artery-pulmonary artery (NBSA-PA) fistula underwent bronchial artery embolization (BAE) and/or nonbronchial systemic artery embolization (NBSAE) + pulmonary artery embolization (PAE). The pulmonary artery (PA) pressures before and after embolization were 52.11 ± 2.12 (35–69 cmH2O) and 33.58 ± 1.63 (22–44 cmH2O), respectively (P = 0.001). Four patients did not have a BA-PA and/or NBSA-PA fistula. Embolization was performed in two patients with a distal PAP of the pulmonalis lobar arteria. Bare stent-assisted microcoils embolization was performed in the other two patients with a PAP of the main pulmonary lobar arteries. The PA pressures of the four patients before and after treatment were 24.50 ± 1.32 (22–28 cmH2O) and 24.75 ± 1.70 (22–29 cmH2O), respectively (P = 0.850). The technique had a 100% success rate with no serious complications and a postoperative recurrence rate of 30%.

Conclusion

Endovascular treatment is safe and effective for massive haemoptysis caused by PAP. BAE and/or NBSAE can effectively reduce pulmonary hypertension in patients with a BA-PA and/or NBSA-PA fistula.
Profiling tyrosine kinase inhibitors as AD therapeutics in a mouse model of AD
Authors: Lee Hyun-ju , Hwang Jeong-Woo , Park Jin-Hee , Jeong Yoo Joo , Jang Ji-Yeong , Hoe Hyang-Sook
Published: August 2023

Alzheimer’s disease (AD) is a neurodegenerative disease characterized by Aβ deposition, tauopathy, neuroinflammation, and impaired cognition. The recent identification of associations between protein kinases and AD pathology has spurred interest in tyrosine kinase inhibitors (TKIs) as potential strategic therapeutic agents for AD. In the present study, we investigated whether the TKIs ibrutinib, PD180970, and cabozantinib, which have different on-targets, selectively regulate AD pathology in 3.5- to 4-month-old 5xFAD mice (a model of the early phase of AD). Ibrutinib (10 mg/kg, i.p.) effectively reduced amyloid-β (Aβ) plaque number, tau hyperphosphorylation and neuroinflammation in 5xFAD mice. Surprisingly, PD180970 (10 mg/kg, i.p.) did not alter Aβ plaque number or neuroinflammatory responses and exacerbated tau hyperphosphorylation in 5xFAD mice. Cabozantinib (10 mg/kg, i.p.) had no effect on amyloidopathy but partially relieved tau hyperphosphorylation and astrogliosis. Taken together, our results suggest that not all TKIs have therapeutic effects on AD pathology in a mouse model of AD. Consequently, optimization of drug dosage, injection periods and administration routes should be considered when repurposing TKIs as novel AD therapeutics.
Prevention of incisional hernia after kidney transplantation: study protocol for a randomized controlled trial
Authors: Gómez-Dos-Santos Victoria , López-Plaza José Antonio , Molina-Villar José Manuel , Blázquez-Hernando Luis , Diez-Nicolás Víctor , Jiménez-Cidre Miguel , Porrero-Guerrero Belén , Rodríguez-Patrón Rafael , Arias-Fúnez Fernando , Muriel-García Alfonso , Fernández-Cebrián José María , Burgos-Revilla Francisco Javier
Published: August 2023

Background

Incisional hernia is a common complication after kidney transplantation with an incidence of 1.6–18%. Concerning non-transplant patients, a recently published meta-analysis describes a reduction of the incidence of incisional hernia of up to 85% due to prophylactic mesh replacement in elective, midline laparotomy. The aim of our study is to show a reduction of the incidence of incisional hernia after kidney transplantation with minimal risk for complication.

Methods/design

This is a blinded, randomized controlled trial comparing time to incisional hernia over a period of 24 months between patients undergoing kidney transplantation and standardized abdominal closure with or without prophylactic placement of ProGrip™ (Medtronic, Fridley, MN, USA) mesh in an onlay position. As we believe that the mesh intervention is superior to the standard procedure in reducing the incidence of hernia, this is a superiority trial.

Discussion

The high risk for developing incisional hernia following kidney transplantation might be reduced by prophylactic mesh placement. ProGrip™ mesh features polylactic acid (PLA) microgrips that provide immediate, strong and uniform fixation. The use of this mesh combines the effectiveness demonstrated by the macropore propylene meshes in the treatment of incisional hernias, a high simplicity of use provided by its capacity for self-fixation that does not increase significantly surgery time, and safety.

Trial registration

ClinicalTrials.gov NCT04794582. Registered on 08 March 2021. Protocol version 2.0. (02–18-2021).
Efficiency of mitochondrial genes and nuclear Alu elements in detecting human DNA in blood meals of Anopheles stephensi mosquitoes: a time-course study
Authors: Talebzadeh Fahimeh , Ghadipasha Masoud , Gharehdaghi Jaber , Raoofian Reza , Azam Kamal , Koosha Mona , Oshaghi Mohammad Ali
Published: August 2023

Background

The time required for PCR detection of DNA in human blood meals in vector mosquitoes may vary, depending on the molecular markers used, based on the size and copy number of the amplicons. Detailed knowledge of the blood-feeding behavior of mosquito populations in nature is an essential component for evaluating their vectorial capacity and for assessing the roles of individual vertebrates as potential hosts involved in the transmission of vector-borne diseases.

Methods

Laboratory experiments were conducted to compare the time course of PCR detection of DNA in human blood meals from individual blood-fed Anopheles stephensi mosquitoes, using loci with different characteristics, including two mitochondrial DNA (mtDNA) genes, cytB (228 bp) and 16S ribosomal RNA (rRNA) (157 bp) and nuclear Alu-repeat elements (226 bp) at different time points after the blood meal.

Results

Human DNA was detectable up to 84–120 h post-blood-feeding, depending on the length and copy number of the loci. Our results suggest that 16S rRNA and Alu-repeat markers can be successfully recovered from human DNA up to 5 days post-blood-meal. The 16S rDNA and Alu-repeat loci have a significantly (P = 0.008) slower decline rate than the cytB locus. Median detection periods (T50) for the amplicons were 117, 113 and 86.4 h for Alu-repeat, 16S rDNA and cytB, respectively, suggesting an inverse linear relationship between amplicon size/copy number and digestion time.

Conclusion

This comparative study shows that the Alu-repeat locus is the most efficient marker for time-course identification of human DNA from blood meals in female mosquitoes. It is also a promising tool for determining the anthropophilic index (AI) or human blood index (HBI), i.e. the proportion of blood meals from humans, which is often reported as a relative measure of anthropophagy of different mosquito vectors, and hence a measure of the vector competence of mosquito species collected in the field.

Graphical Abstract
Causal relationship between PCSK9 inhibitor and autoimmune diseases: a drug target Mendelian randomization study
Authors: Xie Weijia , Li Jiaxin , Du Hao , Xia Jian
Published: August 2023

Background

In addition to decreasing the level of cholesterol, proprotein convertase subtilis kexin 9 (PCSK9) inhibitor has pleiotropic effects, including immune regulation. However, the impact of PCSK9 on autoimmune diseases is controversial. Therefore, we used drug target Mendelian randomization (MR) analysis to investigate the effect of PCSK9 inhibitor on different autoimmune diseases.

Methods

We collected single nucleotide polymorphisms (SNPs) of PCSK9 from published genome-wide association studies statistics and conducted drug target MR analysis to detect the causal relationship between PCSK9 inhibitor and the risk of autoimmune diseases. 3-Hydroxy-3-methylglutaryl-assisted enzyme A reductase (HMGCR) inhibitor, the drug target of statin, was used to compare the effect with that of PCSK9 inhibitor. With the risk of coronary heart disease as a positive control, primary outcomes included the risk of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), myasthenia gravis (MG), multiple sclerosis (MS), asthma, Crohn’s disease (CD), ulcerative colitis (UC), and type 1 diabetes (T1D).

Results

PCSK9 inhibitor significantly reduced the risk of SLE (OR [95%CI] = 0.47 [0.30 to 0.76], p = 1.74 × 10−3) but increased the risk of asthma (OR [95%CI] = 1.15 [1.03 to 1.29], p = 1.68 × 10−2) and CD (OR [95%CI] = 1.38 [1.05 to 1.83], p = 2.28 × 10−2). In contrast, HMGCR inhibitor increased the risk of RA (OR [95%CI] = 1.58 [1.19 to 2.11], p = 1.67 × 10−3), asthma (OR [95%CI] = 1.21 [1.04 to 1.40], p = 1.17 × 10−2), and CD (OR [95%CI] = 1.60 [1.08 to 2.39], p = 2.04 × 10−2).

Conclusions

PCSK9 inhibitor significantly reduced the risk of SLE but increased the risk of asthma and CD. In contrast, HMGCR inhibitor may be a risk factor for RA, asthma, and CD.
Evaluation of a two step testing algorithm to improve diagnostic accuracy and stewardship of Clostridioides difficile infections
Authors: Bettger Caitlin C. , Giancola Stephanie E. , Cybulski Robert J. , Okulicz Jason F. , Barsoumian Alice E.
Published: August 2023

In response to national guidelines, we implemented a two-step testing algorithm for Clostridioides difficile in an effort to improve diagnostic accuracy. Following implementation, we analyzed treatment frequency between discordant and concordant patients. We found that the majority of discordant cases were treated with no significant differences in patient characteristics or outcomes between the concordant and discordant groups. Additionally, there were no differences in outcomes when discordant patients were further stratified by treatment status. Given little added diagnostic accuracy with the addition of EIA toxin testing, our facility resumed diagnosis by PCR testing alone. Further studies are needed to investigate alternative processes for improvement in diagnostic accuracy aside from toxin EIA testing including stool submission criteria and educational programs.
Multi-domain knowledge graph embeddings for gene-disease association prediction
Authors: Nunes Susana , Sousa Rita T. , Pesquita Catia
Published: August 2023

Background

Predicting gene-disease associations typically requires exploring diverse sources of information as well as sophisticated computational approaches. Knowledge graph embeddings can help tackle these challenges by creating representations of genes and diseases based on the scientific knowledge described in ontologies, which can then be explored by machine learning algorithms. However, state-of-the-art knowledge graph embeddings are produced over a single ontology or multiple but disconnected ones, ignoring the impact that considering multiple interconnected domains can have on complex tasks such as gene-disease association prediction.

Results

We propose a novel approach to predict gene-disease associations using rich semantic representations based on knowledge graph embeddings over multiple ontologies linked by logical definitions and compound ontology mappings. The experiments showed that considering richer knowledge graphs significantly improves gene-disease prediction and that different knowledge graph embeddings methods benefit more from distinct types of semantic richness.

Conclusions

This work demonstrated the potential for knowledge graph embeddings across multiple and interconnected biomedical ontologies to support gene-disease prediction. It also paved the way for considering other ontologies or tackling other tasks where multiple perspectives over the data can be beneficial. All software and data are freely available.
Semantic segmentation of textured mosaics
Authors: Cote Melissa , Dash Amanda , Branzan Albu Alexandra
Published: August 2023

This paper investigates deep learning (DL)-based semantic segmentation of textured mosaics. Existing popular datasets for mosaic texture segmentation, designed prior to the DL era, have several limitations: (1) training images are single-textured and thus differ from the multi-textured test images; (2) training and test textures are typically cut out from the same raw images, which may hinder model generalization; (3) each test image has its own limited set of training images, thus forcing an inefficient training of one model per test image from few data. We propose two texture segmentation datasets, based on the existing Outex and DTD datasets, that are suitable for training semantic segmentation networks and that address the above limitations: SemSegOutex focuses on materials acquired under controlled conditions, and SemSegDTD focuses on visual attributes of textures acquired in the wild. We also generate a synthetic version of SemSegOutex via texture synthesis that can be used in the same way as standard random data augmentation. Finally, we study the performance of the state-of-the-art DeepLabv3+ for textured mosaic segmentation, which is excellent for SemSegOutex and variable for SemSegDTD. Our datasets allow us to analyze results according to the type of material, visual attributes, various image acquisition artifacts, and natural versus synthetic aspects, yielding new insights into the possible usage of recent DL technologies for texture analysis.
Association of low-level lead exposure with all-cause and cardiovascular disease mortality in US adults with hypertension: evidence from the National Health and Nutrition Examination Survey 2003–2010
Authors: Wang Lili , Wang Chaofan , Liu Tao , Xuan Haochen , Li Xiaoqun , Shi Xiangxiang , Dai Feng , Chen Junhong , Li Dongye , Xu Tongda
Published: August 2023

Background

To explore the association of low-level lead exposure with all-cause mortality and cardiovascular disease (CVD) mortality among hypertensive patients.

Methods

This cohort study enrolled 6453 adults with hypertension from the National Health and Nutrition Examination Survey 2003–2010 and followed mortality information through December 31, 2019. The baseline population were divided into four groups based on quartiles of blood lead levels (Q1: < 1.2 μg/dL, Q2: 1.2–1.6 μg/dL, Q3: 1.7–2.4 μg/dL, Q4: 2.5–4.9 μg/dL). The correlation of blood lead levels to mortality was investigated by Kaplan–Meier survival curves, restricted cubic spline (RCS), proportional hazard regression model, and subgroup analysis.

Results

During a median follow-up period of 136 (interquartile range 113, 164) months, a total of 1943 (30.1%) deaths were documented, among which 553 (28.5%) were due to CVD. Blood lead showed a linear dose–response relationship with all-cause and CVD mortality. After adequate adjusting for confounders, the risk of all-cause death rose by 23% for each unit increase in continuous variable blood lead (hazard ratio (HR): 1.23; 95% confidence interval (CI):1.16–1.30). When blood lead was a quartile group variable, participants in the Q 4 group had a 73% higher risk of death than those in the Q 1 group (HR:1.73; 95% CI: 1.43–2.10; P for trend < 0.001). The association for CVD mortality was analogous. The concordant results were achieved in the subgroup analysis.

Conclusion

Elevated blood lead levels were strongly associated with an increased all-cause and CVD mortality in adults with hypertension, even at the reference range of blood lead.
Engineering the advances of the artificial neural networks (ANNs) for the security requirements of Internet of Things: a systematic review
Authors: Ali Yasir , Khan Habib Ullah , Khalid Muhammad
Published: August 2023

Internet of Things (IoT) driven systems have been sharply growing in the recent times but this evolution is hampered by cybersecurity threats like spoofing, denial of service (DoS), distributed denial of service (DDoS) attacks, intrusions, malwares, authentication problems or other fatal attacks. The impacts of these security threats can be diminished by providing protection towards the different IoT security features. Different technological solutions have been presented to cope with the vulnerabilities and providing overall security towards IoT systems operating in numerous environments. In order to attain the full-pledged security of any IoT-driven system the significant contribution presented by artificial neural networks (ANNs) is worthy to be highlighted. Therefore, a systematic approach is presented to unfold the efforts and approaches of ANNs towards the security challenges of IoT. This systematic literature review (SLR) is composed of three (3) research questions (RQs) such that in RQ1, the major focus is to identify security requirements or criteria that defines a full-pledge IoT system. This question also focusses on pinpointing the different types of ANNs approaches that are contributing towards IoT security. In RQ2, we highlighted and discussed the contributions of ANNs approaches for individual security requirement/feature in comprehensive and detailed fashion. In this question, we also determined the various models, frameworks, techniques and algorithms suggested by ANNs for the security advancements of IoT. In RQ3, different security mechanisms presented by ANNs especially towards intrusion detection system (IDS) in IoT along with their performances are comparatively discussed. In this research, 143 research papers have been used for analysis which are providing security solutions towards IoT security issues. A comprehensive and in-depth analysis of selected studies have been made to understand the current research gaps and future research works in this domain.
Effects of Bacillus coagulans and Lactobacillus plantarum on the fermentation quality, aerobic stability and microbial community of triticale silage
Authors: Li Shengnan , Ke Wencan , Zhang Qing , Undersander Dan , Zhang Guijie
Published: August 2023

Background

Due to its hollow stem, ensiling triticale presents a challenge as it may cause an overabundance of oxygen during the fermentation process. This study investigated the effects of Bacillus coagulans (BC) and Lactobacillus plantarum (LP) on the fermentation characteristics, microbial community, and aerobic stability of ensiled triticale. Fresh triticale was wilted at a dry matter content of 350 g/kg. The experiment was arranged in a 2 × 2 factorial design, with both BC and commercial LP added at 0 or 1 × 106 cfu/g of fresh weight (FW) of chopped triticale.

Results

After 60 days of ensiling, the pH, water-soluble carbohydrates (WSC), neutral detergent fiber (NDF), and ammonia nitrogen (NH3-N) of inoculated groups were lower than those of the control group (P < 0.05), especially in the LP + BC treatment (P < 0.05). The lactic acid (LA) concentration, lactic acid/acetic acid (LA/AA), and aerobic stability were also higher (P < 0.05) in the LP + BC treatment than in other treatments. The bacterial diversity was reduced, and the richness was increased by the application of LP and BC individually (P < 0.05). Compared with the control silage, LP-treated silage had higher Lactobacillus (P < 0.05), while BC-treated silage had higher Bacillus and Pediococcus (P < 0.05). The LP + BC-treated silage had higher Lactobacillus, Bacillus, Enterococcus, and Serratia (P < 0.05). Bacillus was negatively correlated with NDF (P < 0.05) and AA (P < 0.05). Lactobacillus was positively correlated with LA (P < 0.05) and LA/AA but negatively with pH and NH3-N (P < 0.05).

Conclusions

The combination of BC and LP may lead to improved ensiled triticale fermentation quality and aerobic stability by inducing alterations in the composition of bacterial communities, which is crucial for the efficient utilization of triticale resources.

Graphical Abstract
Covid Pandemic Effects on the Physical Fitness of Primary School Children: Results of the German EMOTIKON Project
Authors: Teich Paula , Fühner Thea , Bähr Florian , Puta Christian , Granacher Urs , Kliegl Reinhold
Published: August 2023

Background

In spring of 2020, the Sars-CoV-2 incidence rate increased rapidly in Germany and around the world. Throughout the next 2 years, schools were temporarily closed and social distancing measures were put in place to slow the spread of the Covid-19 virus. Did these social restrictions and temporary school lockdowns affect children’s physical fitness? The EMOTIKON project annually tests the physical fitness of all third-graders in the Federal State of Brandenburg, Germany. The tests assess cardiorespiratory endurance (6-min-run test), coordination (star-run test), speed (20-m sprint test), lower (powerLOW, standing long jump test), and upper (powerUP, ball-push test) limbs muscle power, and static balance (one-legged stance test with eyes closed). A total of 125,893 children were tested in the falls from 2016 to 2022. Primary analyses focused on 98,510 keyage third-graders (i.e., school enrollment according to the legal key date, aged 8 to 9 years) from 515 schools. Secondary analyses included 27,383 older-than-keyage third-graders (i.e., OTK, delayed school enrollment or repetition of a grade, aged 9 to 10 years), who have been shown to exhibit lower physical fitness than expected for their age. Linear mixed models fitted pre-pandemic quadratic secular trends, and took into account differences between children and schools.

Results

Third-graders exhibited lower cardiorespiratory endurance, coordination, speed and powerUP in the Covid pandemic cohorts (2020–2022) compared to the pre-pandemic cohorts (2016–2019). Children’s powerLOW and static balance were higher in the pandemic cohorts compared to the pre-pandemic cohorts. From 2020 to 2021, coordination, powerLOW and powerUP further declined. Evidence for some post-pandemic physical fitness catch-up was restricted to powerUP. Cohen’s |ds| for comparisons of the pandemic cohorts 2020–2022 with pre-pandemic cohorts 2016–2019 ranged from 0.02 for powerLOW to 0.15 for coordination. Within the pandemic cohorts, keyage children exhibited developmental losses ranging from approximately 1 month for speed to 5 months for cardiorespiratory endurance. For powerLOW and static balance, the positive pandemic effects translate to developmental gains of 1 and 7 months, respectively. Pre-pandemic secular trends may account for some of the observed differences between pandemic and pre-pandemic cohorts, especially in powerLOW, powerUP and static balance. The pandemic further increased developmental delays of OTK children in cardiorespiratory endurance, powerUP and balance.

Conclusions

The Covid-19 pandemic was associated with declines in several physical fitness components in German third-graders. Pandemic effects are still visible in 2022. Health-related interventions should specifically target those physical fitness components that were negatively affected by the pandemic (cardiorespiratory endurance, coordination, speed).
Military culture and collaborative decision-making in mental healthcare: cultural, communication and policy considerations
Authors: Treichler Emily B. H. , Reznik Samantha J. , Oakes David , Girard Vanessa , Zisman-Ilani Yaara
Published: August 2023

Military culture relies on hierarchy and obedience, which contradict the implementation and use of collaborative care models. In this commentary, a team of lived experience, clinical and research experts discuss, for the first time, cultural, communication and policy considerations for implementing collaborative care models in military mental healthcare settings.
Systemic Therapy for Melanoma: ASCO Guideline Update
Authors: Seth Rahul , Agarwala Sanjiv S. , Messersmith Hans , Alluri Krishna C. , Ascierto Paolo A. , Atkins Michael B. , Bollin Kathryn , Chacon Matias , Davis Nancy , Faries Mark B. , Funchain Pauline , Gold Jason S. , Guild Samantha , Gyorki David E. , Kaur Varinder , Khushalani Nikhil I. , Kirkwood John M. , McQuade Jennifer Leigh , Meyers Michael O. , Provenzano Anthony , Robert Caroline , Santinami Mario , Sehdev Amikar , Sondak Vernon K. , Spurrier Gilliosa , Swami Umang , Truong Thach-Giao , Tsai Katy K. , van Akkooi Alexander , Weber Jeffrey
Published: August 2023

PURPOSE

To provide guidance to clinicians regarding the use of systemic therapy for melanoma.

METHODS

American Society of Clinical Oncology convened an Expert Panel and conducted an updated systematic review of the literature.

RESULTS

The updated review identified 21 additional randomized trials.

UPDATED RECOMMENDATIONS

Neoadjuvant pembrolizumab was newly recommended for patients with resectable stage IIIB to IV cutaneous melanoma. For patients with resected cutaneous melanoma, adjuvant nivolumab or pembrolizumab was newly recommended for stage IIB-C disease and adjuvant nivolumab plus ipilimumab was added as a potential option for stage IV disease. For patients with unresectable or metastatic cutaneous melanoma, nivolumab plus relatlimab was added as a potential option regardless of BRAF mutation status and nivolumab plus ipilimumab followed by nivolumab was preferred over BRAF/MEK inhibitor therapy. Talimogene laherparepvec is no longer recommended as an option for patients with BRAF wild-type disease who have progressed on anti–PD-1 therapy. Ipilimumab- and ipilimumab-containing regimens are no longer recommended for patients with BRAF-mutated disease after progression on other therapies. This full update incorporates the new recommendations for uveal melanoma published in the 2022 Rapid Recommendation Update. Additional information is available at www.asco.org/melanoma-guidelines .
A Randomized Clinical Trial of Intravenous Methylprednisolone With 2 Protocols in Patients With Graves Orbitopathy
Authors: Li Zhangfang , Luo Yaosheng , Huang Quandi , Chen Zhi , Song Dandan , Pan Daoyan , Hu Shidi , Jiang Wei , Cai Qiuyue , Feng Xiaoting , Zhang Qing , Weng Chanyan , Zhong Qiang , Zhao Tongfeng , Li Chenzhong , Zhang Tong , Shen Jie
Published: August 2023

Context

Intravenous glucocorticoid (IVGC) is an accessible and affordable treatment for Graves orbitopathy (GO); the 4.5-g protocol is well studied, but many details of treatment protocols need to be clarified.

Objective

To compare the efficacy and safety of weekly and monthly protocol of IVGC in GO.

Methods

A prospective, randomized, observer-masked, single-center clinical trial, followed up to week 24, at the third affiliated hospital of Southern Medical University; 58 patients with active and moderate to severe GO, aged 18-60 years old, who had not received relevant treatment were included. The intervention was weekly protocol or monthly protocol of IVGC; both received a cumulative dose of methylprednisolone 4.5 g and had a duration of 12 weeks. The overall effective rate, improvement of quality of life (QOL) and signal intensity ratio (SIR) were measured.

Results

There was no significant difference in the effective rate between the 2 groups at week 12 and week 24 (86.21% vs 72.41%, P = .195; 86.21% vs 82.61%, P = .441), there was no significant difference in the improvement of clinical activity score, exophthalmos, soft tissue involvement, diplopia, and QOL. At week 24, the mean SIR and maximum SIR of the 2 groups were lower than those before treatment, and there were no statistically significant difference between the 2 groups. There was no significant difference in the incidence of adverse events between the 2 groups (31.03% vs 27.59%, P = .773).

Conclusion

The efficacy and safety of the 2 protocols are comparable; the monthly protocol could be used as an alternative to the weekly protocol.
Frequency and Predictive Factors of Hypoglycemia in Patients Treated With rhIGF-1: Data From the Eu-IGFD Registry
Authors: Bang Peter , Polak Michel , Bossowski Artur , Maghnie Mohamad , Argente Jesús , Ramon-Krauel Marta , Sert Caroline , Perrot Valerie , Mazain Sarah , Woelfle Joachim
Published: August 2023

Context

The European Increlex® Growth Forum Database (Eu-IGFD) is an ongoing surveillance registry (NCT00903110) established to collect long-term safety and effectiveness data on the use of recombinant human insulin-like growth factor-1 (rhIGF-1, mecasermin, Increlex) for the treatment of children/adolescents with severe primary insulin-like growth factor-1 deficiency (SPIGFD).

Objective

This analysis of Eu-IGFD data aimed to identify the frequency and predictive factors for hypoglycemia adverse events (AEs) in children treated with rhIGF-1.

Methods

Data were collected from December 2008 to May 2021. Logistic regression was performed to identify predictive risk factors for treatment-induced hypoglycemia AEs. Odds ratios (ORs) are presented with 95% CIs for each factor.

Results

In total, 306 patients were enrolled in the registry; 84.6% were diagnosed with SPIGFD. Patients who experienced ≥ 1 hypoglycemia AE (n = 80) compared with those with no hypoglycemia AEs (n = 224) had a lower mean age at treatment start (8.7 years vs 9.8 years), a more frequent diagnosis of Laron syndrome (27.5% vs 10.3%), and a history of hypoglycemia (18.8% vs 4.5%). Prior history of hypoglycemia (OR 0.25; 95% CI: [0.11; 0.61]; P = .002) and Laron syndrome diagnosis (OR 0.36; 95% CI: [0.18; 0.72]; P = .004) predicted future hypoglycemia AEs. Total hypoglycemia AEs per patient per treatment year was 0.11 and total serious hypoglycemia AEs per patient per treatment year was 0.01.

Conclusion

Hypoglycemia occurs more frequently in patients with prior history of hypoglycemia and/or Laron syndrome compared with patients without these risk factors, and these patients should be carefully monitored for this AE throughout treatment.
La cité de Dieu des patriotes
Authors: Tricoire Damien
Published: August 2023

Précis

Cet article étudie les origines religieuses de la Révolution, au sens de ce qui a rendu possible l'idée même de révolution. Il suggère que la Révolution a eu des origines religieuses dans un sens bien plus direct que ce que suggèrent les études sur les controverses autour du jansénisme. C'est parce que l'ordre divin était considéré comme supérieur à tout ordre créé par les humains que la rupture avec les coutumes et traditions du royaume a pu être conçue comme légitime. En ce sens, la Révolution française est comparable aux révolutions qui l'ont précédée. Cet article invite à reconsidérer la pensée politique des Lumières françaises, irriguées par la pensée théocratique. La thèse principale est que ce qui change dans la France des Lumières par rapport à celle du XVIIe siècle, c'est une insistance nouvelle sur les lois immuables et éternelles établies par Dieu. Les origines profondes de cette pensée théocratique, qui remontent à la scholastique médiévale, y sont considérées.
Child Marriage in the Feminist Imagination
Authors: Siddiqi Dina M.
Published: August 2023

This chapter historicizes the emergence of child marriage as an object of developmental concern in contemporary Bangladesh, illuminating new power constellations and frames of intervention in the process. The analysis locates the rise of this “unanticipated category” within evolving rationales of corporatized neoliberal development agendas and corresponding shifts in gendered figurations at the turn of the millennium. Highlighting new players within the global constellation through which GBVAW (gender-based violence against women) circulates, the chapter shows how international organizations pull in and rally state agencies, local activists, and NGOs to produce a new common sense around child marriage. To unravel these larger operations of power, the analysis centers women's activisms in Bangladesh; the gendered social worlds that shape young women's desires; and the ways local NGOs and activists negotiate need and skepticism in relation to global agendas
Catastrophic Aid
Authors: Hammami Rema
Published: August 2023

This chapter addresses GBVAW (gender-based violence against women) as humanitarian intervention in the context of the catastrophized space of the Gaza Strip. Over the period that Gazans have become immiserated by the combined forces of international sanctions, Israeli siege and devastating military aggressions, they became subject to a powerful assemblage of humanitarian actors and aid flows that instantiated the prevention and treatment of domestic violence under the banner of GBV as Gaza's singular gender (and violence) concern. Gaza's highly precaritized local women NGOs have been absorbed into these humanitarian GBV modalities, while actively working to subvert their everyday logics. Ultimately, the chapter argues that shifting the critical analysis of humanitarianism as a “politics of care” to a focus on the actual content of care better speaks to the exclusions of humanitarian GBV and its collusion with wider systems of exclusion that have produced the Gaza catastrophe.
What Counts as Violence?
Authors: Shakhsari Sima
Published: August 2023

This chapter analyzes the coercive power exacted by the frames of care offered by GBVAW (gender-based violence against women) as sexual humanitarianism in the international refugee regime. Centering the experiences of Iranian queer and trans asylum seekers trapped in the refugee borderland of Turkey, the chapter shows how they navigate the rigid norms and procedures that adjudicate both refugee and LGBTI recognition and eligibility for rights of asylum or citizenship. Queer refugee applicants must repeat essentialist notions of gender identity to qualify. Their narratives, their material conditions, and their complex subjectivities must be reduced to match the homonormative identity sanctioned by refugee law and reified by some diasporic queer organizations. The regulatory practices of the refugee regime trivialize the epistemic and material violence of the everyday, of the long term economic sanctions on Iran, and of the homophobic and Orientalist tropes of “forced surgeries” and “state torture” that define the worthiness of the Iranian trans refugee.
Breaking the Frame
Authors: Shackle Samira
Published: August 2023

This chapter explores the impact of media frameworks in reporting on gender-based violence, and how this dictates regional reportage. Drawing on case studies of journalistic coverage of gender-based violence, this chapter grapples with the ways in which the media sensationalizes sexual-based violence, especially as it bolsters notions of encultured patriarchy. These framings have an impact on how readers consume information and what they deem to be the most critical issues in contexts of conflict. Yet journalists operate within a media ecosystem, with pressure from editorial desks dictating what gets covered. One oft-cited solution is to let women tell their stories on their own terms. Yet insofar as women learn how to frame their experiences with sexual violence to meet requirements to appeal to aid or western audiences, a proliferation of stories with this exclusive focus risks obscuring rather than illuminating crucial issues.
Hound Dog
Authors: Weisbard Eric
Published: August 2023

Many listeners first heard “Hound Dog” when Elvis Presley's single topped the pop, country, and R&B charts in 1956. But some fans already knew the song from Big Mama Thornton's earlier recording, a giant but exclusively R&B hit. In Hound Dog Eric Weisbard examines the racial, commercial, and cultural ramifications of Elvis's appropriation of a Black woman's anthem. He rethinks the history and influences of rock music in light of Rolling Stone's replacement of Presley's “Hound Dog” with Thornton's version in its 2021 “500 Greatest Songs of All Time” list. Taking readers from Presley and Thornton to Patti Page's “Doggie in the Window,” the Stooges' “I Wanna Be Your Dog,” and other dog ditties, Weisbard uses “Hound Dog” to reflect on one of rock's fundamental dilemmas: the whiteness of the wail.
The Importance of Historically Black Colleges and Universities
Authors: Giddings Paula
Published: August 2023

As president of the nation's only two historically Black colleges for women—Spelman College and Bennett College for Women—Johnnetta Betsch Cole's speeches in this chapter affirm the importance of HBCUs. In her 1988 Spelman College inaugural address, she shares her vision for Spelman as a “mecca of Black women's studies,” weaving together poetry and sociological concepts to offer a hopeful message that captures the importance of liberal arts and the education of servant leaders. In her 2012 speech at the North Carolina Institute of Minority Economic Development HBCU Forum, she discusses the accomplishments of HBCUs and the various factors that make them successful. In her 2012 Howard University speech, she contemplates the history and origins of HBCUs, as well as their impact on African American communities and the world. The chapter concludes with a 1988 interview between Cole and Paula Giddings, which offers a candid discussion of the significance and impact of Spelman and Cole's role as a nontraditional president.
Sagittal Synostectomy With Tension Band Sutures for Correction of Sagittal Craniosynostosis
Authors: Hersh Andrew M. , Cohen Alan R.
Published: August 2023

BACKGROUND AND OBJECTIVES:

Premature fusion of the sagittal suture is the most common form of craniosynostosis and can be treated using a variety of open or endoscopic approaches. Existing approaches have varying degrees of effectiveness. Open approaches, whether performed early or late, can be associated with significant blood loss and the need for transfusion. Endoscope-assisted approaches are minimally invasive but require months of postoperative helmet therapy to help remodel the skull. Implantation of springs or distractors requires a second operation for removal of the devices. Here, we present an alternative technique for early correction of sagittal craniosynostosis combining sagittal synostectomy with tension band sutures to remodel the skull without need for transfusion or helmet therapy.

METHODS:

We retrospectively reviewed the medical records of all patients treated for sagittal craniosynostosis using a synostectomy with tension band sutures at a single tertiary care institution. Data on patient demographics, operative factors, and postoperative course were collected.

RESULTS:

Thirty-four patients underwent the novel procedure. The median preoperative cephalic index was 68 and improved to 76 immediately postoperatively. The median blood loss was 10 mL while the operative duration was 112 minutes. No blood transfusions were needed. One small dural laceration was encountered that was promptly repaired. There were no postoperative complications. Patients presenting for follow-up visits showed continued improvement in head shape and cephalic index.

CONCLUSION:

A modified sagittal craniectomy with tension band sutures to remodel the skull is effective in achieving immediate correction of sagittal craniosynostosis. The correction remains durable over long-term follow-up. Importantly, the technique can be performed with minimal blood loss and reduces transfusion risk, operative time, and overall morbidity compared with traditional open approaches while avoiding the need for helmet therapy necessitated by endoscopic approaches.
Use of an Endoscope Reduces the Size of Craniotomy Without Increasing Operative Time Compared With Conventional Microscopic Corpus Callosotomy
Authors: Yindeedej Vich , Uda Takehiro , Kawashima Toshiyuki , Koh Saya , Tanoue Yuta , Kojima Yuichiro , Kunihiro Noritsugu , Umaba Ryoko , Goto Takeo
Published: August 2023

BACKGROUND AND OBJECTIVES:

Corpus callosotomy (CC) is an epilepsy surgery that disconnects the commissural fibers at the corpus callosum, a structure that often plays a key role in propagating seizure activity. CC is particularly beneficial in patients with drop attacks. Less invasive endoscopic surgeries have recently been introduced to some fields of neurosurgery but have not yet become common in epilepsy surgery. Endoscopic surgeries offer better visualization and require a smaller corridor than conventional microscopic surgeries. Here, we presented a case series comparing endoscopic CC with microscopic CC.

METHODS:

This 2-center retrospective study involved patients who underwent all types of CC (anterior, total, or posterior CC [pCC]) between January 2014 and May 2022. We excluded patients who underwent additional craniotomy for electrocorticography rather than CC, prior craniotomy, or CC without craniotomy. The primary outcomes were comparing size of craniotomy, operative time, and surgical complications between endoscopic CC and microscopic CC.

RESULTS:

We included 14 CCs in 11 patients in the endoscopic group and 58 CCs in 55 patients in the microscopic group. No significant difference in age was seen between groups. Craniotomies were significantly smaller in the endoscopic group for anterior (13.36 ± 1.31 cm2 vs 27.55 ± 3.78 cm2; P = .001), total (14.07 ± 2.54 cm2 vs 26.63 ± 6.97 cm2; P = .001), and pCC (9.44 ± 1.18 cm2 vs 30.23 ± 10.76 cm2; P = .002). Moreover, no significant differences in operative time (anterior CC [261 ± 53.11 min vs 298.73 ± 81.08 min, P = .226], total CC [339.5 ± 48.2 min vs 321.39 ± 65.98 min, P = .452], pCC [198 ± 24.73 min vs 242.5 ± 59.12 min, P = .240]), or complication rate were seen.

CONCLUSION:

Endoscopic CC is a promising technique requiring a smaller craniotomy than microscopic CC, without significantly increasing operative time or complication rate compared with microscopic CC.
DNA damage signals from somatic uterine tissue arrest oogenesis through activated DAF-16
Authors: Sarkar Gautam Chandra , Rautela Umanshi , Goyala Anita , Datta Sudeshna , Anand Nikhita , Singh Anupama , Singh Prachi , Chamoli Manish , Mukhopadhyay Arnab
Published: August 2023

Germ line integrity is crucial for progeny fitness. Organisms deploy the DNA damage response (DDR) signaling to protect the germ line from genotoxic stress, facilitating the cell-cycle arrest of germ cells and DNA repair or their apoptosis. Cell-autonomous regulation of germ line quality in response to DNA damage is well studied; however, how quality is enforced cell non-autonomously on sensing somatic DNA damage is less known. Using Caenorhabditis elegans, we show that DDR disruption, only in the uterus, when insulin/IGF-1 signaling (IIS) is low, arrests oogenesis in the pachytene stage of meiosis I, in a FOXO/DAF-16 transcription factor-dependent manner. Without FOXO/DAF-16, germ cells of the IIS mutant escape the arrest to produce poor-quality oocytes, showing that the transcription factor imposes strict quality control during low IIS. Activated FOXO/DAF-16 senses DDR perturbations during low IIS to lower ERK/MPK-1 signaling below a threshold to promote germ line arrest. Altogether, we elucidate a new surveillance role for activated FOXO/DAF-16 that ensures optimal germ cell quality and progeny fitness in response to somatic DNA damage.