bluuebunny/crossref_metadata_2025 huggingface dataset:
Between the square and the circle: a view from the ‘representative standpoint’
Authors: Gentile Fusillo Clementina Giulia Maria
Published: September 2023

Despite the transformation it introduced in theories of democratic representation, the so-called ‘constructivist turn’ left unchallenged the epistemology that had characterised traditional accounts: the questions at stake in current debates on representation are still mostly elicited by a ‘passive’ image of representation as ultimately the phenomenon of being represented by others. Nowhere has the focus explicitly been placed on the experience of representing others. This article proposes a recalibration of current constructivist accounts of representation by introducing what I term the representative standpoint, an epistemological perspective which discloses neglected aspects of the nature and the value of democratic representation. In particular, I suggest that from the representative standpoint, we are able to configure representation as the periodic motion between two spaces: the square, where the representative meets with their constituents, and the circle, where the representative meets with the representatives of other constituencies. The essence of democratic representation lies precisely in the constant moving back and forth between these two spaces. I finally suggest that, configured in these terms, representation may be acknowledged and valued also for providing liberal democracies with an in-built device for a kind of civic education, the beneficiaries of which are the representatives themselves.
Simplification is Not Indoctrination
Authors: Gollwitzer Mario , Prager Johannes , Altenmüller Marlene S. , Zein Rizqy Amelia
Published: September 2023

Bartels (2023; this issue) argues that (a) classic studies and topics covered in psychological textbooks and introductory classes are often misrepresented, (b) that there is an ideological bias among scholars in psychology towards the left side of the political spectrum, and (c) this bias is responsible for the misrepresentation of studies and topics in textbooks. In our commentary, we argue that claims (a) and (b) may be correct, but they have nothing to do with each other. Thus, claim (c) – that a liberal bias among scholars and course instructors leads to “indoctrination” in introductory courses and textbooks – is unsubstantiated and actually detrimental.
Environmentally-Friendly Stadium Travel of Football Fans: A Stated Preferences Study
Authors: Thormann Tim F. , Wicker Pamela
Published: September 2023

Drawing on a rational choice framework, this study investigates fans’ stated preferences for (more) environmentally-friendly stadium travel (bicycles/e-scooters) on game days. Data from fans of a German Football Bundesliga club were collected using an online survey in 2021 ( n = 1,652). Travel preferences were assessed using the contingent behavior method. The results of regression analyses indicate that the likelihood of using environmentally-friendly transportation means increases with perceived benefits, while perceived costs decrease this likelihood. Specifically, perceived environmental benefits and being an environmental role model had a positive effect, while monetary, convenience, and time-related costs had a negative effect.
Hydroxytyrosol produced by engineered Escherichia coli strains activates Nrf2/HO-1 pathway: An in vitro and in vivo study
Authors: Simos Yannis V , Zerikiotis Stelios , Lekkas Panagiotis , Zachariou Christianna , Halabalaki Maria , Ververidis Filippos , Trantas Emmanouil A , Tsamis Konstantinos , Peschos Dimitrios , Angelidis Charalampos , Vezyraki Patra
Published: September 2023

This study explores the biological effects of hydroxytyrosol (HT), produced by the metabolic engineering of Escherichia coli, in a series of in vitro and in vivo experiments. In particular, a metabolically engineered Escherichia coli strain capable of producing HT was constructed and utilized. HEK293 and HeLa cells were exposed to purified HT to determine non-toxic doses that can offer protection against oxidative stress (activation of Nrf2/HO-1 signaling pathway). Male CD-1 mice were orally supplemented with HT to evaluate (1) renal and hepatic toxicity, (2) endogenous system antioxidant response, and (3) activation of Nrf2/HO-1 system in the liver. HT protected cells from oxidative stress through the activation of Nrf2 regulatory network. Activation of Nrf2 signaling pathway was also observed in the hepatic tissue of the mice. HT supplementation was safe and produced differential effects on mice’s endogenous antioxidant defense system. HT biosynthesized from genetically modified Escherichia coli strains is an alternative method to produce high-quality HT that exerts favorable effects in the regulation of the organism’s response to oxidative stress. Nonetheless, further investigation of the multifactorial action of HT on the antioxidant network regulation is needed.
Effects of Varicocele Surgical Repair on Serum Hormone and Inhibin B Levels for Patients With Varicocele: A Systematic Review and Meta-Analysis
Authors: Tian Daxue , Yang Chenchen , Xie Bing , Li Haijuan , Li Jie , Yang Diandong , Zhu Zaisheng
Published: September 2023

Varicocele surgical repair can improve the function of the testis for patients with varicocele. We carried out a systematic review and meta-analysis to assess the effects of varicocele surgical repair on serum hormones and inhibin B levels in patients with varicocele. A literature search was performed in August 2022, and no language or geographic region restrictions were applied. The search included the following databases: PubMed, Embase, and Medline. A literature review was performed to identify all published clinical trials assessing serum hormone and inhibin B levels before and after varicocele surgical repair. The reference lists of retrieved studies were also investigated. A systematic review and meta-analysis were conducted. Eight articles were selected from 162 articles, including 452 patients. The combined analysis showed that after surgical treatment, mean serum testosterone, inhibin B, and sperm concentration levels increased compared with preoperative levels ( p < .05). After surgical treatment, mean serum follicle-stimulating hormon (FSH), and Luteinizing hormone (LH) levels decreased compared with preoperative levels ( p < .05). This meta-analysis demonstrates that varicocele surgical repair can improve testicular function, increase serum testosterone, and inhibin B levels and decrease serum FSH and LH levels in patients with varicocele. This might be related to the improvement of infertility. A large-scale multicenter randomized controlled study is needed for further confirmation.
Prospective Nutraceutical Effects of Cinnamon Derivatives Against Insulin Resistance in Type II Diabetes Mellitus—Evidence From the Literature
Authors: Mohsin Saima Naz , Saleem Faiza , Humayun Ayesha , Tanweer Afifa , Muddassir Ambreen
Published: September 2023

Apart from advances in pharmaceutical antidiabetic agents, efforts are being made toward hypoglycemic agents derived from natural sources. Cinnamon has been reported to have significant benefits for human health, particularly as an anti-inflammatory, antidiabetic, and anti-hypertriglyceridemic agent. The phytochemicals in cinnamon can be extracted from different parts of plant by distillation and solvent extraction. These chemicals help in decreasing insulin resistance and can act against hyperglycemia and dyslipidemia, inflammation and oxidative stress, obesity, overweight, and abnormal glycation of proteins. Cinnamon has shown to improve all of these conditions in in vitro, animal, and/or human studies. However, the mechanism of action of active ingredients found in cinnamon remains unclear. The current review presents the outstanding ability of cinnamon derivatives to control diabetes by various pathways modulating insulin release and insulin receptor signaling. It was also found that the type and dosage of cinnamon as well as subject characteristics including drug interactions are likely to affect the response to cinnamon. Future research directions based on this review include the synergistic usage of various cinnamon derivatives in managing and/or preventing diabetes and possible other relevant chronic diseases.
The Effects of the Traumatic in the Weaving of Memorialistic Narratives
Authors: Mariano Lívia de Oliveira , Moreira Jacqueline de Oliveira , Malta Amanda Lessa , de Jesus Karinne Vieira
Published: September 2023

This paper analyzes the speech demands of young people participating in three different psychoanalytic research experiences to investigate social phenomena. The Memorialistic Narratives were adopted as the data collection method. Following the proposed strategy, such requests emerged after these young people narrated their life stories. It is observed that those who demand new speech spaces in the three studies in reference are those who went through traumatic experiences, with particular emphasis on young people who acquired disabilities due to gunshot wounds. Therefore, this study develops an analysis of these speech demands based on the Freudian theory of trauma.
Metformin treatment of juvenile mice potentiates innate immune response to bacterial lipopolysaccharide in males
Authors: Sun Yujie , Zhu Yun , Bartke Andrzej , Lin Lin , Yuan Rong
Published: September 2023

Objective: Metformin is a widely used drug, with a good safety profile, for treatment of type 2 diabetes. Recently, it has been found to also exhibit immunomodulatory potential. We aim to preliminarily explore the potential role of metformin in regulating innate immunity using UM-HET3 mice.

Methods: In this study, we treated juvenile UM-HET3 mice with metformin and investigated the alteration of the innate immune response. Peripheral blood of HET3 mice was treated with ex-vivo lipopolysaccharide (LPS) stimulation to induce a leukocyte inflammatory response, which was detected by analyzing the expression of LPS receptors TLR4 and CD14 on leukocytes with flow cytometry. Furthermore, cytokine release induced by LPS was measured in isolated cell culture supernatants with ELISA.

Results: In this study LPS treatment triggered a downregulation of TLR4 as well as an upregulation of CD14 expressed on the cell surface. Besides, it enhanced the secretion of pro-inflammatory cytokines TNF-α, IL-1β and IL-6. The results showed that metformin treatment led to a significant ( p < .05) increase in the expression of CD14 and pro-inflammatory cytokines, including IL-1β and IL-6, as well as increased proportion of TLR4 downregulation on the cell surface in response to LPS, specifically in males.

Conclusions: This study indicates that treating juvenile mice with metformin enhances the innate immune response to bacterial endotoxin in males, but not in females.
Globally responsible leadership: The courageous case of Angela Merkel
Authors: Tirmizi S Aqeel
Published: September 2023

Angela Merkel has stood out as a global leader during her 16-years tenure as Chancellor of Germany. Her chancellorship included navigating dynamics of human rights issues (support for migrants - particularly Syrian refugees), environmental protections, citizens’ wellbeing, and economic development. This paper examines the nature of her complex leadership journey, successes, and challenges through the lens of responsible leadership theory and serves three purposes. Firstly, it is an effort to provide a window into Merkel’s leadership and the lessons it offers for leading in a world amidst crises, polarization, and complexity. Major insights in this regard include acting with courage, navigating crises with persistence, pursing multilateral collaborations, and building a nonconforming leadership profile. Secondly, it critically examines the relevance of responsible leadership theory as a framework for globally responsible leadership, especially outside the realm of business organizations. In doing so, the paper particularly explores the role of ethical grounding, relational competence, and adaptive and systems capability as key dimensions of responsible leadership. Finally, it identifies some gaps in and blind spots of responsible leadership conceptualizations and offers considerations to expand the field.
Amnesia in healthy people via hippocampal inhibition: A new forgetting mechanism
Authors: Anderson Michael C , Subbulakshmi S
Published: September 2023

Structural damage to the hippocampus gives rise to a severe memory deficit for personal experiences known as organic amnesia. Remarkably, such structural damage may not be the only way of creating amnesia; windows of amnesia can also arise when people deliberately disengage from memory via a process known as retrieval suppression. In this review, we discuss how retrieval suppression induces systemic inhibition of the hippocampus, creating “amnesic shadow” intervals in people’s memory for their personal experiences. When new memories are encoded or older memories are reactivated during this amnesic shadow, these memories are disrupted, and such disruption even arises when older memories are subliminally cued. Evidence suggests that the systemic inhibition of the hippocampus during retrieval suppression that gives rise to the amnesic shadow may be mediated by engagement of hippocampal GABAergic inhibitory interneurons. Similar amnesic shadow effects are observed during working memory tasks like the n-back, which also induce notable hippocampal downregulation. We discuss our recent proposal that cognitive operations that require the disengagement of memory retrieval, such as retrieval suppression, are capable of mnemonic process inhibition (the inhibition of mnemonic processes such as encoding, consolidation, and retrieval and not simply individual memories). We suggest that people engage mnemonic process inhibition whenever they shift attention from internal processes to demanding perceptual-motor tasks that may otherwise be disrupted by distraction from our inner world. This hitherto unstudied model of inhibition is a missing step in understanding what happens when attentional shifts occur between internally and externally oriented processes to facilitate goal-directed behaviour. This process constitutes an important novel mechanism underlying the forgetting of life events.
The effect of an internal, external and holistic focus on the learning of a soccer shooting task in male children
Authors: Abedanzadeh Rasool , Mousavi Seyyed Mohammadreza , Becker Kevin
Published: September 2023

The benefits of an external focus in motor learning have been well-established in adults, but findings in studies with children have been far more variable. Recent research also suggests that a holistic focus of attention may also enhance motor learning relative to an internal focus, but few studies have tested this strategy with children. Therefore, this study aimed to determine the effect of an internal (IF), external (EF), holistic focus (HF) and no focus control condition on the learning of a soccer shooting task in male children. Male participants ( N = 60) between the ages of 9 and 11 completed 60 acquisition trials shooting at a low target at a distance of 7 m while focusing on an assigned cue. After 48 h, participants returned for a 10-trial retention test and a 10-trial transfer test shooting from a distance of 8 m. Results showed that the EF group was more accurate than control throughout acquisition ( p = .027). In retention, all focus groups were more accurate than control ( p's < .001), and an EF trended toward being more accurate than in IF ( p = .059). In transfer, all focus groups were more accurate than control ( p's < .001), and EF was more accurate than HF ( p = .009). To our surprise, a clear benefit of an EF and HF relative to an IF was not observed. Future work should consider whether this may be due to the nature of the cues selected, or if there are other constraints that may influence when children do or do not benefit from an EF and HF.
Distal radial fractures: a nationwide register study on corrective osteotomies after malunion
Authors: Raudasoja Leena , Vastamäki Heidi , Aspinen Samuli , Ryhänen Jorma , Hulkkonen Sina
Published: September 2023

The aim of the present study was to explore the incidence of corrective osteotomies after conservatively treated distal radial fracture and the risk for late correction depending on the patient’s age. Based on data from the Finnish National Care Register of Health Care, Specialist Care, on all corrective osteotomies carried out in Finland during 2015–2019 in adults aged ≥20 years, we calculated the mean annual incidence rates per 100,000 person-years, standardized with the European Standard Population 2013. Using multivariable logistic regression, we calculated the risk of corrective osteotomies in various age groups. In total, 41,418 distal radial fractures were identified. Of those, 10,577 received surgical treatment in the acute phase. The incidence rate of primary operations for distal radial fractures was 47.9 per 100, 000 person-years. A total of 321 conservatively treated fractures needed corrective osteoteomy, with a surprisingly low mean annual incidence rate of 1.5 per 100,000 person-years. The risk for this was highest in patients in their fourth or fifth decade.

Level of evidence: III
Working Mothers in Indonesian Public Organizations: Investigating the Effect of Work-Family Conflict on Positive Discipline Parenting Via Well-being
Authors: Kadir Abdul , Wirawan Hillman , Salam Rudi , Zahra Novina Sabila
Published: September 2023

Through the lens of the conservation of resources (COR) theory and gender-role perspective, this research investigates the effect of work-family conflict (WFC) on positive discipline parenting (PDP) via well-being among working mothers in Indonesian public organizations. A total of 218 mothers who worked in public organizations such as schools and hospitals were selected as participants. All participants had children attending schools from elementary to senior high school. Data were collected online with a three-wave data collection technique and analyzed using IBM SPSS AMOS ver. 26 and Hayes’ PROCESS macro on SPSS ver. 26. The results showed that WFC directly reduced the mothers’ PDP or indirectly lowered their well-being. In Indonesia, mothers are responsible for child-rearing and working in public organizations can cause resource imbalance. Scholars and practitioners should consider the existence of WFC and how it influences working mothers in public organizations. This study is among a few studies investigating WFC’s impact on working mothers’ well-being and parenting.
Environmental crisis or an act of contemporary racism? A flint effect on maternal health disparities
Authors: Henderson Kionna L. , Shortridge Ashton , Sadler Richard C.
Published: September 2023

Background

Racial injustices, both within the social and environmental aspect, are increasingly in national discussions due to impacts from the COVID-19 pandemic and persistent violence perpetrated by police against Black civilians that resulted in tragic deaths. An ongoing environmental injustice that began in 2014 is the Flint Water Crisis (FWC). The purpose of this study is to conduct a quasi-experimental research design to compare Flint to a sociodemographically similar city to determine what effect, if any, the FWC had on maternal health from 2012 to 2017 across three time periods: pre-during-and-post-FWC.

Methods

The Centers for Disease Control and Prevention (CDC)'s 21 severe maternal morbidity (SMM) rates severed as indicators of maternal health status and were collected from the Michigan Inpatient Database. Differences between non-Hispanic Black and non-Hispanic White race codes determined the maternal health disparity gap. R-statistical software and k-mean analysis were used to analyze cities that were comparable to Flint. Difference-in-difference methodology was used to compare the difference in SMM rates for Flint and a sociodemographically comparable city.

Results

On average, non-Hispanic Black women had a higher odds of experiencing a SMM across all three time periods: pre-FWC = 1.29, during-FWC = 1.2, and post-FWC = 1.05.

Conclusions

Maternal health outcomes observed in Flint during the FWC are significantly influenced by race. The study showed that regardless of a woman giving birth in a predominantly Black city, an environmental hazard, and her age range, maternal health disparities are still present if that woman identifies as Black.
Putting the ‘public’ back into public schools in the US
Authors: Drake Rodriguez Akira
Published: September 2023

Public schools serve as vital centers of urban life. However, the long history of these centers are racialized, classed, and produce disparate outcomes across space in the United States. This commentary outlines this history and puts forth the need to re-center the increasingly diversifying and high-need public in the production and maintenance of these critical infrastructures.
A web-based care assistant for caregivers of the elderly: Development and pilot study
Authors: Jeon Hwawoo , Choi Yong Suk , Lim Yoonseob
Published: September 2023

Background

The aging population in Korea has driven a surge in demand for elderly care services, leading to significant growth in elderly welfare facilities, particularly Adult Daycare Centers (ADCs). However, despite advancements in care facilities, caregivers continue to face challenges in providing suitable elderly care due to difficulties arising from gaps in the latest information on the elderly and their coping abilities.

Objective

The objective of this study is to develop and evaluate the effectiveness of the elderly care assistant system, which facilitates the sharing of information and knowledge necessary for elderly care among caregivers.

Methods

The ECA system was designed to support knowledge sharing through a knowledge management system based on an ontological knowledge model, with a web-based user interface for improved accessibility. A field trial was conducted at ADC in Seoul from August 17 to September 21, with eight caregivers participating. A mixed-methods approach, involving both surveys and interviews, was employed to gauge the ECA system's effectiveness.

Results

The study found that the use of the ECA was beneficial in promoting knowledge sharing among caregivers. Additionally, caregivers noted the potential benefits of using the ECA in conjunction with family caregivers, who can offer additional information and perspectives on elderly care.

Conclusions

This study presents preliminary evidence of the potential benefits of a care knowledge sharing system among various caregivers in elderly care. Although the elderly care assistant effectively promotes knowledge sharing, more research is needed to fully understand its impact on elderly care outcomes.
Self-Referential Processing and Depression: A Systematic Review and Meta-Analysis
Authors: Collins Amanda C. , Winer E. Samuel
Published: September 2023

Reward devaluation theory posits that depressed individuals avoid and devalue positivity, suggesting that they may hold fewer positive self-schemas. Previous meta-analytic reviews have supported this theoretical framework regarding positivity but have not assessed for self-referential stimuli. Self-referential encoding and recall tasks assess for self-schemas and thus provide further insight into how depressed individuals process self-referential positivity. The aim of this systematic review and meta-analysis was to examine the extent to which depressed individuals differ in processing self-referential positivity and negativity and whether this processing differs when depressed individuals think of others (i.e., other-referential). Results indicate that depressed individuals recall and endorse fewer self-referential positive words than negative words and fewer self-referential positive words than other-referential positive words than nondepressed individuals. These findings support reward devaluation theory and suggest that conceptualizing self-referential processing in depression as merely based on negativity biases can overlook crucial information about how depressed individuals devalue self-referential positive information.
Safety and Efficacy of Bone Marrow–Derived Mesenchymal Stem Cells for Chronic Patellar Tendinopathy (With Gap >3 mm) in Patients: 12-Month Follow-up Results of a Phase 1/2 Clinical Trial
Authors: Soler Robert , Rodas Gil , Rius-Tarruella Joan , Alomar Xavier , Balius Ramon , Ruíz-Cotorro Ángel , Masci Lorenzo , Maffulli Nicola , Orozco Lluís
Published: September 2023

Background:

In a previous study, the authors found that at 6 months after treatment with a 20 × 106 dose of bone marrow–derived mesenchymal stem cells (BM-MSCs), patients showed improved tendon structure and regeneration of the gap area when compared with treatment using leukocyte-poor platelet-rich plasma (Lp-PRP). The Lp-PRP group (n = 10), which had not seen tendon regeneration at the 6-month follow-up, was subsequently offered treatment with BM-MSCs to see if structural changes would occur. In addition, the 12-month follow-up outcomes of the original BM-MSC group (n = 10) were evaluated.

Purpose:

To evaluate the outcomes of all patients (n = 20) at 12 months after BM-MSC treatment and observe if the Lp-PRP pretreated group experienced any type of advantage.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Both the BM-MSC and original Lp-PRP groups were assessed at 12 months after BM-MSC treatment with clinical examination, the visual analog scale (VAS) for pain during daily activities and sports activities, the Victorian Institute of Sport Assessment–Patella score for patellar tendinopathy, dynamometry, and magnetic resonance imaging (MRI). Differences between the 2 groups were compared with the Student t test.

Results:

The 10 patients originally treated with BM-MSCs continued to show improvement in tendon structure in their MRI scans ( P < .0001), as well as in the clinical assessment of their pain by means of scales ( P < .05). Ten patients who were originally treated with Lp-PRP and then with BM-MSCs exhibited an improvement in tendon structure in their MRI scans, as well as a clinical pain improvement, but this was not significant on the VAS for sports ( P = .139). Thus, applying Lp-PRP before BM-MScs did not yield any type of advantage.

Conclusion:

The 12-month follow-up outcomes after both groups of patients (n = 20) received BM-MSC treatment indicated that biological treatment was safe, there were no adverse effects, and the participants showed a highly statistically significant clinical improvement ( P < .0002), as well as an improvement in tendon structure on MRI ( P < .0001). Preinjection of Lp-PRP yielded no advantages.
Jordanian Community People's Knowledge of and Attitudes Toward Dementia
Authors: Abdalrahim Asem , Alamoush Khaled Mohammad , ALBashtawy Mohammed , Hamaideh Shaher H. , Mohammad Khitam Ibrahem , Alkhawaldeh Abdullah , Alazzam Manar , Alhroub Nisser , Suliman Mohammad , ALBashtawy Bayan
Published: September 2023

Introduction

Limited research exists on the knowledge and attitudes of Jordanian community residents toward people with dementia (PwD). As the prevalence of dementia is anticipated to increase, there is a critical need for informed knowledge and positive attitudes toward dementia in the Jordanian community.

Objectives

This study aimed to evaluate people's knowledge of and attitudes toward PwD and identify the predictors of dementia knowledge and attitudes.

Methods

The study employed a cross-sectional research design and utilized a self-administered questionnaire as the primary data collection method. The study employed the Alzheimer's Disease Knowledge Scale (ADKS) to evaluate the knowledge of the participants, and the Dementia Attitudes Scale (DAS) was utilized to assess their attitudes in the Jordanian community. Multiple regression analysis was performed to find relevant factors influencing knowledge of and attitude toward dementia.

Results

The study's 346 participants revealed limited knowledge about dementia, with an average ADKS score of 17.21 out of 30. However, participants showed a positive attitude toward dementia, as evidenced by a mean DAS score of 88 out of 140. Statistical analysis demonstrated significantly higher knowledge scores among employed individuals ( P < .05), while females exhibited significantly higher attitude scores ( P < .05). Participants with experience in geriatric clinical practice, dementia education or training, informal caregiving experience, and a desire to learn more about dementia also exhibited significantly higher knowledge and attitude scores ( P < .05).

Conclusion

The study offers preliminary insights into the knowledge and attitudes toward dementia in the Jordanian population. The findings underscore the importance of continuing education and training to increase knowledge and understanding of dementia. Improving dementia care and support in Jordan requires enhancing knowledge and attitudes toward dementia. The study findings were presented to policymakers, with recommendations for strategic planning and the development of awareness programs. Future research can build upon these findings and promote evidence-based practices in dementia care and community awareness programs.
Combined Anterior Cruciate Ligament Reconstruction and Lateral Extra-Articular Tenodesis: The “Over-the-Top” Technique
Authors: Zaffagnini Stefano , Grassi Alberto , Lucidi Gian Andrea , Dal Fabbro Giacomo , Ambrosini Luca
Published: September 2023

Background:

The anterior cruciate ligament (ACL) is a primary restraint to anteroposterior as well as rotatory knee laxity. In case of concomitant lesion of menisci or other ligamentous structures, further dynamic instability is encountered. A lateral extra-articular tenodesis (LET) augmentation has been proposed by the Authors to treat or prevent residual laxity.

Indications:

ACL reconstruction is recommended in young athletes involved in pivoting sports, non-contact pivoting injuries, high-grade pivot shift, deep notch sign and double bone bruise, meniscal loss, and revision of previous bone-patellar tendon-bone autograft.

Technique Description:

A 2 to 3 cm oblique incision is made over the pes anserinus. Gracilis and semitendinosus tendons are harvested with their attachment preserved and sutured together. Tibial tunnel is reamed after positioning of a guide pin. A wire-loop passer is directed from the tibial tunnel to the anteromedial portal. A 2 to 3 cm longitudinal incision is made superior-laterally, the ileotibial band is divided and retracted anteriorly. A suture-loop is retrieved from the lateral incision through the anteromedial portal with a curved Kelly clamp. The suture is placed into the wire-loop and retrieved with it from the tibial tunnel. The graft is retrieved from the lateral incision, tensioned with the knee at 70° to 90° of flexion and foot in neutral rotation and secured with 2 staples to the femur. A 1-cm skin incision is performed just below the Gerdy tubercle. The graft is retrieved from this incision below the fascia with a small Kelly clamp, tensioned and secured with a staple. The iliotibial tract defect is closed.

Results:

At long-term follow-up, a revision rate of 3% has been reported, while patient-reported outcome measures (PROMs) were excellent. At very-long-term follow-up, most patients were still involved in sports with a very low rate of positive Lachman and pivot shift tests. No overconstraint and lateral osteoarthritis were encountered. Medial osteoarthritis was related only to medial meniscectomy.

Discussion/Conclusion:

The ACL reconstruction plus LET over-the-top technique is a safe and reliable surgery with a low rate of reoperations and peri-operative complications at very-long-term follow-up.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Return to Sport Following ACL Reconstruction With Slope-Correcting High Tibial Osteotomy in the Elite Athlete
Authors: Lowe Walter R. , Mansour Alfred , Higbie Steven , Galloway Connor , Kleihege Jacquelyn , Bailey Lane
Published: September 2023

Background:

Increased posterior tibial slope is a strong predictor of anterior cruciate ligament (ACL) graft re-injury. A concomitant slope-reducing high tibial osteotomy (HTO) has been suggested to decrease re-tear risk in these cases although little is known regarding outcomes following ACL reconstruction with HTO, especially in elite athletic patients.

Indications:

A 19-year-old National Collegiate Athletics Association (NCAA) Division 1 running back presented with an ACL tear, lateral meniscus tear, and posterior tibial slope of 19° (case 1). A 19-year-old NCAA Division 1 soccer forward presented with an ACL graft re-tear and posterior tibial slope of 21° (case 2).

Technique:

Anterior closing wedge HTOs were performed along with a primary ACL reconstruction with quadriceps tendon autograft (case 1) and a revision ACL reconstruction with quadriceps tendon autograft (case 2). Following the arthroscopic procedures, an anterior approach was used to insert the first guide wire distal to the patellar tendon insertion from anterior to posterior aiming toward the posterior curve of the tibia. A second guide wire was placed at the previously templated distance. The osteotomy was then performed utilizing a saw and then osteotome. The reduction was performed by gently lifting the ankle anteriorly and applying axial pressure, and a new posterior tibial slope was calculated. After the osteotomy site was reduced, a preliminary reduction was performed by applying a clamp to both wires followed by placing a wire across the osteotomy site aiming from anterolateral to posteromedial. An anterolateral proximal tibial plate was applied, as well as a lag screw across the osteotomy site.

Results:

At 6 months after surgery, case 1 demonstrated >90% Limb Symmetry Indices (LSI) with quadriceps strength, single leg hop tests, and change of direction tests. At 12 months after surgery, case 2 demonstrated >90% LSI with all functional testing and competed in 17 games. Both patients returned to preinjury performance metrics including top speed and vertical jump height. No significant postoperative complications or instability was observed.

Discussion/Conclusion:

Primary or revision ACL reconstruction with HTO shows potential to assist athletes in returning to high-level sport while reducing posterior slope.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Medial Meniscal Allograft Transplantation: The Bone Plug Technique
Authors: Bartsch Anna , Anderson Forrest L. , Neubauer Markus , Vel Monica S. , Sherman Seth L.
Published: September 2023

Background:

The medial and lateral menisci act as shock absorbers for the knee joint by converting and redistributing axial load into circumferential hoop stresses. Disruptions of these hoop stresses occur in the setting of meniscal deficiency and lead to long-term degenerative changes. Therefore, maintaining the distinctive composition and organization of the menisci is essential. In selective cases of meniscal deficiency, meniscus allograft transplantation can be a valuable treatment option.

Indications:

Meniscus transplantation should be considered in patients with symptomatic meniscal deficiency, without the presence of advanced degenerative pathologies, who have failed all conservative treatments.

Technique description:

We can divide the surgery into 4 steps: (1) graft preparation, (2) arthroscopic joint preparation, (3) allograft attachment preparation, and (4) graft fixation.

Results:

Meniscus allograft transplantation yields good to excellent results in up to 85% of cases. Improvement of pain and knee function occurs in approximately 70% of the patients at 10 years. The associated complications are mainly joint stiffness, early osteoarthritis, and incomplete healing accompanied by graft failure. Graft failure is the most feared complication, yet shows good results over the midterm.

Conclusion:

The bone plug technique we have shown here is a hybrid approach combining soft tissue and bone fixation techniques. It provides synergistic advantages with good osseous integration and is minimally invasive through arthroscopy without true arthrotomy. In our experience, this approach elegantly eases the complexity of this demanding surgery while yielding excellent results for patients.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Effects of sotatercept on haemodynamics and right heart function: analysis of the STELLAR trial
Authors: Souza Rogerio , Badesch David B. , Ghofrani H. Ardeschir , Gibbs J. Simon R. , Gomberg-Maitland Mardi , McLaughlin Vallerie V. , Preston Ioana R. , Waxman Aaron B. , Grünig Ekkehard , Kopeć Grzegorz , Meyer Gisela , Olsson Karen M. , Rosenkranz Stephan , Lin Jianxin , Johnson-Levonas Amy O. , de Oliveira Pena Janethe , Humbert Marc , Hoeper Marius M.
Published: September 2023

Background

In the phase 3 STELLAR trial, sotatercept, an investigational first-in-class activin signalling inhibitor, demonstrated beneficial effects on 6-min walk distance and additional efficacy endpoints in pre-treated participants with pulmonary arterial hypertension (PAH).

Methods

Thispost hocanalysis evaluated data from right heart catheterisation (RHC) and echocardiography (ECHO) obtained from the STELLAR trial. Changes from baseline in RHC and ECHO parameters were assessed at 24 weeks. An analysis of covariance (ANCOVA) model was used to estimate differences in least squares means with treatment and randomisation stratification (mono/doubleversustriple therapy; World Health Organization functional class IIversusIII) as fixed factors, and baseline value as covariate.

Results

Relative to placebo, treatment with sotatercept led to significant (all p<0.0001 except where noted) improvements from baseline in mean pulmonary artery (PA) pressure (−13.9 mmHg), pulmonary vascular resistance (−254.8 dyn·s·cm−5), mean right atrial pressure (−2.7 mmHg), mixed venous oxygen saturation (3.84%), PA elastance (−0.42 mmHg·mL−1·beat−1), PA compliance (0.58 mL·mmHg−1), cardiac efficiency (0.48 mL·beat−1·mmHg−1), right ventricular (RV) work (−0.85 g·m) and RV power (−32.70 mmHg·L·min−1). ECHO showed improvements in tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure ratio (0.12 mm·mmHg−1), end-systolic and end-diastolic RV areas (−4.39 cm2and −5.31 cm2, respectively), tricuspid regurgitation and RV fractional area change (2.04% p<0.050). No significant between-group changes from baseline were seen for TAPSE, heart rate, cardiac output, stroke volume or their indices.

Conclusion

In pre-treated patients with PAH, sotatercept demonstrated substantial improvements in PA pressures, PA compliance, PA–RV coupling and right heart function.
Rinmaker: a fast, versatile and reliable tool to determine residue interaction networks in proteins
Authors: Spanò Alvise , Fanton Lorenzo , Pizzolato Davide , Moi Jacopo , Vinci Francesco , Pesce Alberto , Dongmo Foumthuim Cedrix J. , Giacometti Achille , Simeoni Marta
Published: September 2023

Background

Residue Interaction Networks (RINs) map the crystallographic description of a protein into a graph, where amino acids are represented as nodes and non-covalent bonds as edges. Determination and visualization of a protein as a RIN provides insights on the topological properties (and hence their related biological functions) of large proteins without dealing with the full complexity of the three-dimensional description, and hence it represents an invaluable tool of modern bioinformatics.

Results

We present RINmaker, a fast, flexible, and powerful tool for determining and visualizing RINs that include all standard non-covalent interactions. RINmakeris offered as a cross-platform and open source software that can be used either as a command-line tool or through a web application or a web API service. We benchmark its efficiency against the main alternatives and provide explicit tests to show its performance and its correctness.

Conclusions

RINmakeris designed to be fully customizable, from a simple and handy support for experimental research to a sophisticated computational tool that can be embedded into a large computational pipeline. Hence, it paves the way to bridge the gap between data-driven/machine learning approaches and numerical simulations of simple, physically motivated, models.
Multiomics comparative analysis of the maize large grain mutant tc19 identified pathways related to kernel development
Authors: Cai Qing , Jiao Fuchao , Wang Qianqian , Zhang Enying , Song Xiyun , Pei Yuhe , Li Jun , Zhao Meiai , Guo Xinmei
Published: September 2023

Background

The mechanism of grain development in elite maize breeding lines has not been fully elucidated. Grain length, grain width and grain weight are key components of maize grain yield. Previously, using the Chinese elite maize breeding line Chang7-2 and its large grain mutant tc19, we characterized the grain size developmental difference between Chang7-2 and tc19 and performed transcriptomic analysis.

Results

In this paper, using Chang7-2 and tc19, we performed comparative transcriptomic, proteomic and metabolomic analyses at different grain development stages. Through proteomics analyses, we found 2884, 505 and 126 differentially expressed proteins (DEPs) at 14, 21 and 28 days after pollination, respectively. Through metabolomics analysis, we identified 51, 32 and 36 differentially accumulated metabolites (DAMs) at 14, 21 and 28 days after pollination, respectively. Through multiomics comparative analysis, we showed that the phenylpropanoid pathways are influenced at transcriptomic, proteomic and metabolomic levels in all the three grain developmental stages.

Conclusion

We identified several genes in phenylpropanoid biosynthesis, which may be related to the large grain phenotype of tc19. In summary, our results provided new insights into maize grain development.
Diversification of plant SUPPRESSOR OF MAX2 1 (SMAX1)-like genes and genome-wide identification and characterization of cotton SMXL gene family
Authors: Ma Bin , Zhu Jianbo , Huang Xianzhong
Published: September 2023

Background

Strigolactones (SLs) are a recently discovered class of plant hormones. SUPPRESSOR OF MAX2 1 (SMAX1)-like proteins, key component of the SL signaling pathway, have been studied extensively for their roles in regulating plant growth and development, such as plant branching. However, systematic identification and functional characterization of SMXL genes in cotton (Gossypium sp.), an important fiber and oil crop, has rarely been conducted.

Results

We identified 210 SMXL genes from 21 plant genomes and examined their evolutionary relationships. The structural characteristics of the SMXL genes and their encoded proteins exhibited both consistency and diversity. All plant SMXL proteins possess a conserved Clp-N domain, P-loop NTPase, and EAR motif. We identified 63 SMXL genes in cotton and classified these into four evolutionary branches. Gene expression analysis revealed tissue-specific expression patterns of GhSMXL genes, with some upregulated in response to GR24 treatment. Protein co-expression network analysis showed that GhSMXL6, GhSMXL7-1, and GhSMXL7-2 mainly interact with proteins functioning in growth and development, while virus-induced gene silencing revealed that GhSMAX1-1 and GhSMAX1-2 suppress the growth and development of axillary buds.

Conclusions

SMXL gene family members show evolutionary diversification through the green plant lineage. GhSMXL6/7–1/7–2 genes play critical roles in the SL signaling pathway, while GhSMXL1-1 and GhSMXL1-2 function redundantly in growth of axillary buds. Characterization of the cotton SMXL gene family provides new insights into their roles in responding to SL signals and in plant growth and development. Genes identified in this study could be used as the candidate genes for improvement of plant architecture and crop yield.
The role of WRKY transcription factors, FaWRKY29 and FaWRKY64, for regulating Botrytis fruit rot resistance in strawberry (Fragaria × ananassa Duch.)
Authors: Lee Man Bo , Han Hyeondae , Lee Seonghee
Published: September 2023

Background

The cultivated strawberry (Fragaria × ananassa Duch.) is one of the most economically important horticultural crops worldwide. Botrytis fruit rot (BFR) caused by the necrotrophic fungal pathogen Botrytis cinerea is the most devasting disease of cultivated strawberries. Most commercially grown strawberry varieties are susceptible to BFR, and controlling BFR relies on repeated applications of various fungicides. Despite extensive efforts, breeding for BFR resistance has been unsuccessful, primarily due to lack of information regarding the mechanisms of disease resistance and genetic resources available in strawberry.

Results

Using a reverse genetics approach, we identified candidate genes associated with BFR resistance and screened Arabidopsis mutants using strawberry isolates of B. cinerea. Among the five Arabidopsis T-DNA knockout lines tested, the mutant line with AtWRKY53 showed the greatest reduction in disease symptoms of BFR against the pathogen. Two genes, FaWRKY29 and FaWRKY64, were identified as orthologs in the latest octoploid strawberry genome, ‘Florida Brilliance’. We performed RNAi-mediated transient assay and found that the disease frequencies were significantly decreased in both FaWRKY29- and FaWRKY64-RNAi fruits of the strawberry cultivar, ‘Florida Brilliance’. Furthermore, our transcriptomic data analysis revealed significant regulation of genes associated with ABA and JA signaling, plant cell wall composition, and ROS in FaWRKY29 or FaWRKY64 knockdown strawberry fruits in response to the pathogen.

Conclusion

Our study uncovered the foundational role of WRKY transcription factor genes, FaWRKY29 and FaWRKY64, in conferring resistance against B. cinerea. The discovery of susceptibility genes involved in BFR presents significant potential for developing resistance breeding strategies in cultivated strawberries, potentially leveraging CRISPR-based gene editing techniques.