bluuebunny/crossref_metadata_2025 huggingface dataset:
The spin of a stellar black hole 4U 1543−47 determined by Insight-HXMT
Authors: Chen Jiashi , Wang Wei
Published: October 2023

We present a spectral analysis of Insight-HXMT observations of the low-mass X-ray binary 4U 1543−47 which locates in our Milky Way galaxy during the 2021 outburst. We focus on the observations in its soft state, and attempt to determine the spin of the black hole candidate through thermal continuum-fitting (CF) method. The spin derived from CF method is highly dependent on black hole mass, distance and inclination angle of inner disc. In this article, we have adopted the preferred range of parameters: M = 9.4 ± 1 M⊙, D = 7.5 ± 0.5 kpc, and $\mathrm{ \mathit{ i}}=36.3^{+5.3}_{-3.4}$ degrees. We attain a moderate spin, a = 0.46 ± 0.12, which is consistent with previous results measured in the 2002 outburst. Besides, we notice the spectra show a wide blue-shifted absorption feature between 8–10 keV which would originate from the highly ionized iron line. We try to fit the feature with xstar model and suggest that this feature may come from relativistic disc wind with a velocity of vwind ∼ 0.2 c. We attribute this relativistic disc wind to the super-Eddington accretion during the black hole outburst.
COALAS II. Extended molecular gas reservoirs are common in a distant, forming galaxy cluster
Authors: Chen Z , Dannerbauer H , Lehnert M D , Emonts B H C , Gu Q , Allison J R , Champagne J B , Hatch N , Indermüehle B , Norris R P , Pérez-Martínez J M , Röttgering H J A , Serra P , Seymour N , Shimakawa R , Thomson A P , Casey C M , De Breuck C , Drouart G , Kodama T , Koyama Y , Lagos C D P , Macgregor P , Miley G , Rodríguez-Espinosa J M , Sánchez-Portal M , Ziegler B
Published: October 2023

This paper presents the results of 475h of interferometric observations with the Australia Telescope Compact Array towards the Spiderweb protocluster at z=2.16. We search for large, extended molecular gas reservoirs among 46 previously detected CO(1−0) emitters, employing a customised method we developed. Based on the CO emission images and position–velocity diagrams, as well as the ranking of sources using a binary weighting of six different criteria, we have identified 14 robust and 7 tentative candidates that exhibit large extended molecular gas reservoirs. These extended reservoirs are defined as having sizes greater than 40 kpc or supergalactic scale. This result suggests a high frequency of extended gas reservoirs, comprising at least 30 percent of our CO-selected sample. An environmental study of the candidates is carried out based on Nth nearest neighbour and we find that the large molecular gas reservoirs tend to exist in denser regions. The spatial distribution of our candidates is mainly centred on the core region of the Spiderweb protocluster. The performance and adaptability of our method are discussed. We found 13 (potentially) extended gas reservoirs located in eight galaxy (proto)clusters from the literature. We noticed that large extended molecular gas reservoirs surrounding (normal) star-forming galaxies in protoclusters are rare. This may be attributable to the lack of observations low-J CO transitions and the lack of quantitative analyses of molecular gas morphologies. The large gas reservoirs in the Spiderweb protocluster are potential sources of the intracluster medium seen in low redshift Virgo- or Coma-like galaxy clusters.
What’s in a binary black hole’s mass parameter?
Authors: Tiwari Vaibhav
Published: October 2023

The black hole (BH) masses measured from gravitational wave observations appear to cluster around specific mass values. Consequently, the primary (and chirp) mass distribution of binary black holes (BBHs) inferred using these measurements shows four emerging peaks. These peaks are approximately located at a primary (chirp) mass value of 10 $\, \mathrm{M}_\odot$ (8$\, \mathrm{M}_\odot$), 20 $\, \mathrm{M}_\odot$ (14 $\, \mathrm{M}_\odot$), 35 $\, \mathrm{M}_\odot$ (28 $\, \mathrm{M}_\odot$), and 63 $\, \mathrm{M}_\odot$ (49 $\, \mathrm{M}_\odot$). Although the presence of the first and third peaks has been attributed to BBH formation in star clusters or due to the evolution of stellar binaries in isolation, the second peak has received relatively less attention because it lacks significance in the primary mass distribution. In this article, we report that confidence in the second peak depends on the mass parameter we choose to model the population on. Unlike primary mass, this peak is significant when modelled on the chirp mass. We discuss the disparity as a consequence of mass asymmetry in the observations that cluster at the second peak. Finally, we report this asymmetry as part of a potential trend in the mass ratio distribution manifested as a function of the chirp mass, but not as a function of primary mass, when we include the observation GW190814 in our modelling. The chirp mass is not a parameter of astrophysical relevance. Features present in the chirp mass, but not in the primary mass, are relatively difficult to explain and expected to garner significant interest.
ADCdb: the database of antibody–drug conjugates
Authors: Shen Liteng , Sun Xiuna , Chen Zhen , Guo Yu , Shen Zheyuan , Song Yi , Xin Wenxiu , Ding Haiying , Ma Xinyue , Xu Weiben , Zhou Wanying , Che Jinxin , Tan Lili , Chen Liangsheng , Chen Siqi , Dong Xiaowu , Fang Luo , Zhu Feng
Published: October 2023

Antibody-drug conjugates (ADCs) are a class of innovative biopharmaceutical drugs, which, via their antibody (mAb) component, deliver and release their potent warhead (a.k.a. payload) at the disease site, thereby simultaneously improving the efficacy of delivered therapy and reducing its off-target toxicity. To design ADCs of promising efficacy, it is crucial to have the critical data of pharma-information and biological activities for each ADC. However, no such database has been constructed yet. In this study, a database named ADCdb focusing on providing ADC information (especially its pharma-information and biological activities) from multiple perspectives was thus developed. Particularly, a total of 6572 ADCs (359 approved by FDA or in clinical trial pipeline, 501 in preclinical test, 819 with in-vivo testing data, 1868 with cell line/target testing data, 3025 without in-vivo/cell line/target testing data) together with their explicit pharma-information was collected and provided. Moreover, a total of 9171 literature-reported activities were discovered, which were identified from diverse clinical trial pipelines, model organisms, patient/cell-derived xenograft models, etc. Due to the significance of ADCs and their relevant data, this new database was expected to attract broad interests from diverse research fields of current biopharmaceutical drug discovery. The ADCdb is now publicly accessible at: https://idrblab.org/adcdb/.
PharmGWAS: a GWAS-based knowledgebase for drug repurposing
Authors: Kang Hongen , Pan Siyu , Lin Shiqi , Wang Yin-Ying , Yuan Na , Jia Peilin
Published: October 2023

Leveraging genetics insights to promote drug repurposing has become a promising and active strategy in pharmacology. Indeed, among the 50 drugs approved by FDA in 2021, two-thirds have genetically supported evidence. In this regard, the increasing amount of widely available genome-wide association studies (GWAS) datasets have provided substantial opportunities for drug repurposing based on genetics discoveries. Here, we developed PharmGWAS, a comprehensive knowledgebase designed to identify candidate drugs through the integration of GWAS data. PharmGWAS focuses on novel connections between diseases and small-molecule compounds derived using a reverse relationship between the genetically-regulated expression signature and the drug-induced signature. Specifically, we collected and processed 1929 GWAS datasets across a diverse spectrum of diseases and 724 485 perturbation signatures pertaining to a substantial 33609 molecular compounds. To obtain reliable and robust predictions for the reverse connections, we implemented six distinct connectivity methods. In the current version, PharmGWAS deposits a total of 740 227 genetically-informed disease-drug pairs derived from drug-perturbation signatures, presenting a valuable and comprehensive catalog. Further equipped with its user-friendly web design, PharmGWAS is expected to greatly aid the discovery of novel drugs, the exploration of drug combination therapies and the identification of drug resistance or side effects. PharmGWAS is available at https://ngdc.cncb.ac.cn/pharmgwas.
PRMD: an integrated database for plant RNA modifications
Authors: Lang Xiaoqiang , Yu Chunyan , Shen Mengyuan , Gu Lei , Qian Qian , Zhou Degui , Tan Jiantao , Li Yiliang , Peng Xin , Diao Shu , Deng Zhujun , Ruan Zhaohui , Xu Zhi , Xing Junlian , Li Chen , Wang Runfeng , Ding Changjun , Cao Yi , Liu Qi
Published: October 2023

The scope and function of RNA modifications in model plant systems have been extensively studied, resulting in the identification of an increasing number of novel RNA modifications in recent years. Researchers have gradually revealed that RNA modifications, especially N6-methyladenosine (m6A), which is one of the most abundant and commonly studied RNA modifications in plants, have important roles in physiological and pathological processes. These modifications alter the structure of RNA, which affects its molecular complementarity and binding to specific proteins, thereby resulting in various of physiological effects. The increasing interest in plant RNA modifications has necessitated research into RNA modifications and associated datasets. However, there is a lack of a convenient and integrated database with comprehensive annotations and intuitive visualization of plant RNA modifications. Here, we developed the Plant RNA Modification Database (PRMD; http://bioinformatics.sc.cn/PRMD and http://rnainformatics.org.cn/PRMD) to facilitate RNA modification research. This database contains information regarding 20 plant species and provides an intuitive interface for displaying information. Moreover, PRMD offers multiple tools, including RMlevelDiff, RMplantVar, RNAmodNet and Blast (for functional analyses), and mRNAbrowse, RNAlollipop, JBrowse and Integrative Genomics Viewer (for displaying data). Furthermore, PRMD is freely available, making it useful for the rapid development and promotion of research on plant RNA modifications.
RAVAR: a curated repository for rare variant–trait associations
Authors: Cao Chen , Shao Mengting , Zuo Chunman , Kwok Devin , Liu Lin , Ge Yuli , Zhang Zilong , Cui Feifei , Chen Mingshuai , Fan Rui , Ding Yijie , Jiang Hangjin , Wang Guishen , Zou Quan
Published: October 2023

Rare variants contribute significantly to the genetic causes of complex traits, as they can have much larger effects than common variants and account for much of the missing heritability in genome-wide association studies. The emergence of UK Biobank scale datasets and accurate gene-level rare variant–trait association testing methods have dramatically increased the number of rare variant associations that have been detected. However, no systematic collection of these associations has been carried out to date, especially at the gene level. To address the issue, we present the Rare Variant Association Repository (RAVAR), a comprehensive collection of rare variant associations. RAVAR includes 95 047 high-quality rare variant associations (76186 gene-level and 18 861 variant-level associations) for 4429 reported traits which are manually curated from 245 publications. RAVAR is the first resource to collect and curate published rare variant associations in an interactive web interface with integrated visualization, search, and download features. Detailed gene and SNP information are provided for each association, and users can conveniently search for related studies by exploring the EFO tree structure and interactive Manhattan plots. RAVAR could vastly improve the accessibility of rare variant studies. RAVAR is freely available for all users without login requirement at http://www.ravar.bio.
mHapBrowser: a comprehensive database for visualization and analysis of DNA methylation haplotypes
Authors: Hong Yuyang , Liu Leiqin , Feng Yan , Zhang Zhiqiang , Hou Rui , Xu Qiong , Shi Jiantao
Published: October 2023

DNA methylation acts as a vital epigenetic regulatory mechanism involved in controlling gene expression. Advances in sequencing technologies have enabled characterization of methylation patterns at single-base resolution using bisulfite sequencing approaches. However, existing methylation databases have primarily focused on mean methylation levels, overlooking phased methylation patterns. The methylation status of CpGs on individual sequencing reads represents discrete DNA methylation haplotypes (mHaps). Here, we present mHapBrowser, a comprehensive database for visualizing and analyzing mHaps. We systematically processed data of diverse tissues in human, mouse and rat from public repositories, generating mHap format files for 6366 samples. mHapBrowser enables users to visualize eight mHap metrics across the genome through an integrated WashU Epigenome Browser. It also provides an online server for comparing mHap patterns across samples. Additionally, mHap files for all samples can be downloaded to facilitate local processing using downstream analysis toolkits. The utilities of mHapBrowser were demonstrated through three case studies: (i) mHap patterns are associated with gene expression; (ii) changes in mHap patterns independent of mean methylation correlate with differential expression between lung cancer subtypes; and (iii) the mHap metric MHL outperforms mean methylation for classifying tumor and normal samples from cell-free DNA. The database is freely accessible at http://mhap.sibcb.ac.cn/.
Comparing Adult Smokers Who Switched to JUUL versus Continuing Smokers: Biomarkers of Exposure and of Potential Harm and Respiratory Symptoms
Authors: Shiffman Saul , Oliveri Douglas R , Goldenson Nicholas I , Liang Qiwei , Black Ryan A , Mishra Snigdha
Published: October 2023

Objectives

Real-world evidence on exposure to harmful and potentially harmful constituents (HPHCs) and on biological effects in cigarette smokers who switch to electronic nicotine delivery systems (ENDS) can inform the health effects of switching.

Aims and Methods

This cross-sectional, observational study assessed adults who had smoked ≥10 cigarettes/day for ≥10 years, comparing 124 continuing cigarette smokers (Smokers) to 140 former smokers who switched to JUUL-brand ENDS exclusively for ≥6 months (Switchers). Assessments included biomarkers of exposure (BOEs) to select HPHCs, biomarkers of potential harm (BOPHs) related to smoking-related diseases, psychometric assessments of dependence on cigarettes and ENDS, respectively, and respiratory symptoms. Planned analyses compared geometric means, adjusted for demographic covariates; further analyses adjusted for additional lifestyle and smoking history covariates.

Results

Nicotine levels were significantly higher in Switchers (median time switched = 3 years), who were unusually heavy users of JUUL. All other BOEs, including NNAL and HPMA3 (primary endpoints), were significantly lower in Switchers than Smokers. Most BOPHs (sICAM-1 [primary], and eg, white blood cell count, MCP1, HbA1c) were significantly lower in Switchers than Smokers; HDL was significantly higher. Switchers reported significantly lower dependence on JUUL than Smokers did on cigarettes, and respiratory symptom scores were significantly lower among Switchers than Smokers.

Conclusions

Compared to continuing smokers, smokers who switched to JUUL had substantially lower exposures to multiple HPHCs, favorable differences in markers of inflammation, endothelial function, oxidative stress, and cardiovascular risk, and fewer respiratory symptoms. These findings suggest that switching from cigarettes to JUUL likely reduces smokers’ health risks.

Implications

Short-term confinement studies and randomized clinical trials demonstrate that adult smokers who switch completely to ENDS experience substantial reductions in exposure to many smoking-related toxicants. This study extends those findings to longer periods of switching to JUUL-brand ENDS (almost 3 years on average) under naturalistic use conditions in real-world settings and also found that switching to JUUL resulted in favorable differences in BOPHs more proximally related to smoking-induced disease, as well as in respiratory symptoms. Smokers who switch to ENDS reduce their exposure to toxicants, likely reducing their disease risk.
“If You Just Tell Me You’re 18, I’ll Still Sell to You”: A Qualitative Study of Underage Tobacco Product Purchasing Experiences in a Tobacco 21 Compliance Study
Authors: West Tyler A , Awadalla Josephine , Ackerman Christopher , Sesay Mahdi , Hrywna Mary , Giovenco Daniel P , Kong Amanda Y , Lee Joseph G L
Published: October 2023

Background

Tens of thousands of underage tobacco buy attempts are conducted each year for research, compliance, and public health surveillance. However, little research has qualitatively examined the perceptions and experiences of underage buyers participating in these programs. We sought to understand underage buyers’ experiences and gather recommendations for protocol improvements.

Methods

We conducted semi-structured interviews in the fall of 2022 to assess experiences with underage tobacco product purchasing. Participants (N = 19, 58% male, 42% White) were research assistants aged 18–20 in New Jersey, New York, or North Carolina. Interviews examined purchasing experiences in relation to store characteristics, clerk interactions, and buyer identities. We used deductive and inductive thematic coding to explore key themes related to buyer experiences.

Results

We identified four themes: (1) non-chain stores lacked consistency in verifying age; (2) female data collectors experienced uncomfortable situations more frequently than male data collectors; (3) not identifying with the store’s typical demographics impacted purchase attempts; and (4) participants suggested improvements for inspections and research during training.

Discussion

Retailer education, widespread adoption of ID scanners, and enforcement could increase standardization of ID requests and verification. Male and female buyers can be trained on what they might expect based on their gender, as well as how to maneuver through unwanted situations. Consideration of shared identity is important for future waves of data collection and research. Efforts to improve training include more extensive mock purchase training with supervisors well-versed in this area.

Implications

Electronic ID verification and promoting compliance at non-chain retailers could impact access to tobacco products for underage buyers. Training for underage buyers in research and compliance assessments should focus on ways to enhance data collectors’ confidence when making a purchase attempt, which may improve the validity of the rate of sales to individuals under 21.
Alcohol dehydrogenases regulated by a MYB44 transcription factor underlie Lauraceae citral biosynthesis
Authors: Zhao Yunxiao , Chen Yicun , Gao Ming , Wang Yangdong
Published: October 2023

Lineage-specific terpenoids have arisen throughout the evolution of land plants and are believed to play a role in interactions between plants and the environment. Species-specific gene clusters in plants have provided insight on the evolution of secondary metabolism. Lauraceae is an ecologically important plant family whose members are also of considerable economic value given their monoterpene contents. However, the gene cluster responsible for the biosynthesis of monoterpenes remains yet to be elucidated. Here, a Lauraceae-specific citral biosynthetic gene cluster (CGC) was identified and investigated using a multifaceted approach that combined phylogenetic, collinearity, and biochemical analyses. The CGC comprises MYB44 as a regulator and 2 alcohol dehydrogenases (ADHs) as modifying enzymes, which derived from species-specific tandem and proximal duplication events. Activity and substrate divergence of the ADHs has resulted in the fruit of mountain pepper (Litsea cubeba), a core Lauraceae species, consisting of more than 80% citral. In addition, MYB44 negatively regulates citral biosynthesis by directly binding to the promoters of the ADH-encoding genes. The aggregation of citral biosynthetic pathways suggests that they may form the basis of important characteristics that enhance adaptability. The findings of this study provide insights into the evolution of and the regulatory mechanisms involved in plant terpene biosynthesis.
Suicidal ideation in female individuals with fibromyalgia and comorbid obesity: prevalence and association with clinical, pain-related, and psychological factors
Authors: Varallo Giorgia , Scarpina Federica , Arnison Tor , Giusti Emanuele Maria , Tenti Micheal , Rapelli Giada , Cattivelli Roberto , Landi Giulia , Tossani Eliana , Grandi Silvana , Franceschini Christian , Baldini Valentina , Plazzi Giuseppe , Capodaglio Paolo , Castelnuovo Gianluca
Published: October 2023

Objective

Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity—a risk factor for suicidal ideation per se—could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation.

Methods

In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected.

Results

3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation.

Discussion

The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation.
Exchange Rate Dynamics and Monetary Spillovers with Imperfect Financial Markets
Authors: Akinci Özge , Queralto Albert
Published: October 2023

We develop a quantitative model with imperfections in domestic and international financial markets that generates strong effects of U.S. monetary policy on emerging markets (EMs). Financial imperfections prevent arbitrage both between local EM lending and borrowing rates, and between local-currency and dollar borrowing rates. An adverse feedback effect between financial health and external conditions amplifies the domestic “financial accelerator,” leading to large cross-border spillovers of U.S. monetary policy shocks. The model implies a link between uncovered interest parity violations and local credit spreads, a prediction we show the data strongly supports.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Prognostic value and predictors of the alteration of the diffusing capacity of the lungs for carbon monoxide in systemic lupus erythematosus
Authors: Le Tallec Erwan , Bourg Corentin , Bouzillé Guillaume , Belhomme Nicolas , Le Pabic Estelle , Guillot Stéphanie , Droitcourt Catherine , Perlat Antoinette , Jouneau Stéphane , Donal Erwan , Lescoat Alain
Published: October 2023

Objectives

SLE is a systemic autoimmune disease characterized by heterogeneous manifestations and severity, with frequent lung involvement. Among pulmonary function tests, the measure of the diffusing capacity of the lungs for carbon monoxide (DLCO) is a noninvasive and sensitive tool assessing pulmonary microcirculation. Asymptomatic and isolated DLCO alteration has frequently been reported in SLE, but its clinical relevance has not been established.

Methods

This retrospective study focused on 232 SLE patients fulfilling the 2019 EULAR/ACR classification criteria for SLE. Data were collected from the patient’s medical record, including demographic, clinical and immunological characteristics, while DLCO was measured when performing pulmonary function tests as part of routine patient follow-up.

Results

At the end of follow-up, DLCO alteration (<70% of predicted value) was measured at least once in 154 patients (66.4%), and was associated with a history of smoking as well as interstitial lung disease, but was also associated with renal and neurological involvement. History of smoking, detection of anti-nucleosome autoantibodies and clinical lymphadenopathy at diagnosis were independent predictors of DLCO alteration, while early cutaneous involvement with photosensitivity was a protective factor. DLCO alteration, at baseline or any time during follow-up, was predictive of admission in intensive care unit and/or of all-cause death, both mainly due to severe disease flares and premature cardiovascular complications.

Conclusion

This study suggests a link between DLCO alteration and disease damage, potentially related to SLE vasculopathy, and a prognostic value of DLCO on death or intensive care unit admission in SLE.
The lncRNA H19/miR-29a-3p/SNIP1/c-myc regulatory axis is involved in pulmonary fibrosis induced by Nd2O3
Authors: Bu Ning , Wang Shurui , Ma Yupeng , Xia Haibo , Zhao Yuhang , Shi Xuemin , Liu Qizhan , Wang Suhua , Gao Yanrong
Published: October 2023

Some rare earth elements are occupational and environmental toxicants and can cause organ and systemic damage; therefore, they have attracted global attention. Neodymium oxide (Nd2O3) is a rare earth element that is refined and significantly utilized in China. The long noncoding RNA (lncRNA) H19 is encoded by the H19/IGF2 imprinted gene cluster located on human chromosome 11p15.5. H19 has become a research focus due to its ectopic expression leading to the promotion of fibrosis. However, the mechanisms by which it causes pulmonary fibrosis are elusive. This investigation indicates that biologically active Nd2O3 increases H19, SNIP1, and c-myc, decreases miR-29a-3p, accelerates macrophage M2 polarization, and causes pulmonary fibrosis in mice lung tissues. In macrophage-differentiated THP-1 cells, Nd2O3 (25 μg/ml) enhanced H19, SNIP1, and c-myc, reduced miR-29a-3p, accelerated macrophages M2 polarization, and stimulated fibrogenic cytokine (TGF-β1) secretion. Furthermore, the coculturing of Nd2O3-treated macrophage-differentiated THP-1 cells. And human embryonic lung fibroblast cells activated lung fibroblast, which increases the levels of collagen I, α-SMA, p-Smad2/3, and Smad4, whereas H19 knockdown or miR-29a-3p upregulation in macrophages had opposite effects. Moreover, it was revealed that H19/miR-29a-3p/SNIP1/c-myc regulatory axis is involved in pulmonary fibrosis induced by Nd2O3. Therefore, this study provides new molecular insights into the mechanism of pulmonary fibrosis by Nd2O3.
Long-term Outcomes with Spinal versus General Anesthesia for Hip Fracture Surgery: A Randomized Trial
Authors: Vail Emily A. , Feng Rui , Sieber Frederick , Carson Jeffrey L. , Ellenberg Susan S. , Magaziner Jay , Dillane Derek , Marcantonio Edward R. , Sessler Daniel I. , Ayad Sabry , Stone Trevor , Papp Steven , Donegan Derek , Mehta Samir , Schwenk Eric S. , Marshall Mitchell , Jaffe J. Douglas , Luke Charles , Sharma Balram , Azim Syed , Hymes Robert , Chin Ki-Jinn , Sheppard Richard , Perlman Barry , Sappenfield Joshua , Hauck Ellen , Tierney Ann , Horan Annamarie D. , Neuman Mark D. ,   for the REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) Investigators
Published: October 2023

Background

The effects of spinal versus general anesthesia on long-term outcomes have not been well studied. This study tested the hypothesis that spinal anesthesia is associated with better long-term survival and functional recovery than general anesthesia.

Methods

A prespecified analysis was conducted of long-term outcomes of a completed randomized superiority trial that compared spinal anesthesia versus general anesthesia for hip fracture repair. Participants included previously ambulatory patients 50 yr of age or older at 46 U.S. and Canadian hospitals. Patients were randomized 1:1 to spinal or general anesthesia, stratified by sex, fracture type, and study site. Outcome assessors and investigators involved in the data analysis were masked to the treatment arm. Outcomes included survival at up to 365 days after randomization (primary); recovery of ambulation among 365-day survivors; and composite endpoints for death or new inability to ambulate and death or new nursing home residence at 365 days. Patients were included in the analysis as randomized.

Results

A total of 1,600 patients were enrolled between February 12, 2016, and February 18, 2021; 795 were assigned to spinal anesthesia, and 805 were assigned to general anesthesia. Among 1,599 patients who underwent surgery, vital status information at or beyond the final study interview (conducted at approximately 365 days after randomization) was available for 1,427 (89.2%). Survival did not differ by treatment arm; at 365 days after randomization, there were 98 deaths in patients assigned to spinal anesthesia versus 92 deaths in patients assigned to general anesthesia (hazard ratio, 1.08; 95% CI, 0.81 to 1.44, P = 0.59). Recovery of ambulation among patients who survived a year did not differ by type of anesthesia (adjusted odds ratio for spinal vs. general, 0.87; 95% CI, 0.67 to 1.14; P = 0.31). Other outcomes did not differ by treatment arm.

Conclusions

Long-term outcomes were similar with spinal versus general anesthesia.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Disconnected: Electronic Patient-Reported Outcome Measure Collection in Orthopaedic Patients is Less Successful Than In-Person Collection at an Urban Safety Net Trauma Center
Authors: Tucker Nicholas J. , Shah Ananya , Mauffrey Cyril , Hammerberg E. Mark , Parry Joshua A.
Published: October 2023

Objectives:

Electronic patient-reported outcome measure (E-PROM) collection is a technological advancement that has the potential to facilitate PROM collection in orthopaedic trauma. The purpose of this study was to compare E-PROM versus in-person PROM collection.

Design:

This is a retrospective comparative study.

Setting:

Urban Level I trauma center.

Patients/Participants:

One hundred and fifty consecutive operative orthopaedic trauma patients.

Intervention:

The Percent of Normal single assessment numerical evaluation and patient-reported outcomes measurement information system physical function were collected through automated e-mails from an online patient-engagement platform (PatientIQ, Chicago, IL) 2-week, 6-week, 3-month, and 6-month postoperatively. The Percent of Normal was also administered to patients in clinic at the same time intervals.

Main Outcome Measurements:

Completion of PROMs; Loss to follow-up.

Results:

The median clinical follow-up time was 4 months (interquartile range: 1.3–6 months), and 42.7% (64/150) were lost to follow-up. Loss to follow-up was associated with a more disadvantaged area deprivation index [observed difference, 7.0, 95% confidence interval, 1.0 to 13.0; P = 0.01] and noncommercial/no insurance (observed difference 34.8%, confidence interval, 20.9%–45.5%; P < 0.0001). In-person PROM collection was more successful than E-PROM collection at all intervals [2-week (51.3% vs 20.7), 6-week (46.7% vs 20.0%), 3-month (50.0% vs 18.7%), and 6-month (38.0% vs 18.7%), P < 0.0001]. Patients who completed 3-month E-PROMs had longer clinical follow-up (5.2 vs. 3.0 months, P = 0.004) and a trend of being less likely to be lost to follow-up (28.6% vs 45.9%, P = 0.13).

Conclusion:

E-PROMs were less successful than in-person PROM collection in trauma patients at an urban safety net trauma center.

Level of Evidence:

Diagnostic Level III.
Use of 3D Printing Technology in Fracture Management: A Review and Case Series
Authors: Richard Raveesh D. , Heare Austin , Mauffrey Cyril , McGinley Beau , Lencioni Alex , Chandra Arjun , Nasib Vareesha , Chaiken Brian L. , Trompeter Alex
Published: October 2023

Three-dimensional (3D) offers exciting opportunities in medicine, particularly in orthopaedics. The boundaries of 3D printing are continuously being re-established and have paved the way for further innovations, including 3D bioprinting, custom printing refined methods, 4D bioprinting, and 5D printing potential. The quality of these applications have been steadily improving, increasing their widespread use among clinicians. This article provides a review of the current literature with a brief introduction to the process of additive manufacturing, 3D printing, and its applications in fracture care. We illustrate this technology with a case series of 3D printing used for correction of complex fractures/nonunion. Factors limiting the use of this technology, including cost, and potential solutions are discussed. Finally, we discuss 4D bioprinting and 5D printing and their potential role in fracture surgery.
Cultivating Relationships as a Community-Based Recruitment Strategy in Transdisciplinary Aging Research
Authors: Diallo Ana F. , Mackiewicz Marissa , Sargent Lana , Roman Youssef M. , Slattum Patricia W. , Waters Leland , Bennett Johnathan , Battle Kimberly , Zanjani Faika , Gendron Tracey , Winship Jodi , Ford Gregory , Falls Katherine , Price Elvin T. , Parsons Pamela , Chung Jane
Published: October 2023

Participation of Black American older adults in community-engaged research remains challenging in health sciences. The objectives of this study were to describe the specific efforts, successes, and challenges in recruiting Black American older adults in research led by the Health and Wellness in Aging Across the Lifespan core, part of the Virginia Commonwealth University Institute for Inclusion, Inquiry, and Innovation (iCubed). We conducted a cross-case analysis of 6 community-engaged research projects using the community-engaged research continuum model. Successful recruitment strategies comprised a multifaceted approach to community-based collaboration, including a wellness program with a long standing relationship with the community, engaging key stakeholders and a community advisory board, and building a community-based coalition of stakeholders. Posting flyers and modest monetary compensation remain standard recruitment strategies. The cross-case analysis offered critical lessons on the community's nature and level of engagement in research. Relationship building based on trust and respect is essential to solving complex aging issues in the community.
Effectiveness of placing prophylactic mesh with the Sugarbaker technique via laparoscopic abdominoperineal resection for rectal cancer: 1-year results
Authors: Vinh Ngoc Truong Pham , Nguyen Thinh Huu , Le Triet Minh , Tran Huy Duc
Published: October 2023

Background

The aim of this study was to assess the efficacy of parastomal hernia prevention with the Sugarbaker technique via laparoscopic abdominoperineal resection for rectal cancer after a 1-year follow-up at University Medical Center in Ho Chi Minh City, Vietnam.

Materials and Methods

Prospective study. Between November 2018 and July 2022, 43 patients with low rectal cancer underwent laparoscopic abdominoperineal resection and were divided into 2 groups: study (n = 15) with prophylactic mesh placement with the Sugarbaker technique and control (n = 28). All patients were tracked for at least a year and had an abdominal computed tomography scan. The Kaplan-Meier method was used to calculate the rate of parastomal hernia after 1 year. To compare the rates of parastomal hernia in 2 groups, the log-rank test was used.

Results

This study included 43 patients, the male-to-female ratio was approximately equal to 1:1, the median age was 62 years, the youngest age was 40 years, and the oldest age was 92 years. Rectal cancer stage III was found in 41.8% of people. Neoadjuvant chemoradiotherapy was used in 27.9% of cases. The average duration of operation was 184 minutes. The average time for mesh placement was 15 minutes. The overall complication rate was 16.4%. There were no issues with mesh placement. At 1 year, the control group had a higher cumulative rate of parastomal hernia than the study group (35.7% vs 0%; log-rank test, 6.4; P = 0.01).

Conclusions

Prophylactic mesh placement with the Sugarbaker technique via laparoscopic abdominoperineal resection for rectal cancer is safe, does not increase complications, and reduces the cumulative rate of a parastomal hernia at 1 year in patients who have undergone prophylactic mesh placement.
Minimal posterior pole vitrectomy and fixing the inverted ILM flap with DisCoVisc® for macular hole: no gas or air tamponade
Authors: Liu Yajun , Jiang Feng , Chen Feifei , Liu Yuanyuan , Zhang Wenwen , Zhang Si , He Zifang , Cheng Xinxuan , Xie Zhenggao
Published: October 2023

Purpose:

To investigate an alternative surgical method for macular hole (MH) repair without fluid-air exchange, gas tamponade, and prone positioning.

Methods:

Eighteen eyes of 17 patients with MHs underwent minimal posterior pole vitrectomy with an inverted internal limiting membrane (ILM) flap technique. Ophthalmic viscosurgical device(OVD) was used to fix the inverted ILM flap in the balanced salt solution. No fluid-air exchange, gas tamponade, or prone positioning was needed. Follow-ups were performed at 1 day, 1 week, and the last visit (ranging from 3 to 6 months) after surgery. Optical coherence tomography (OCT) examination, intraocular pressure (IOP), and best-corrected visual acuity (BCVA) measurements were performed preoperatively and at every follow-up postoperatively.

Results:

Primary closure of the MH was observed in all 18 eyes (100%). OCT showed U-type closure in 12 eyes, V-type closure in 5 eyes, and W-type closure in 1 eye. Preoperative, postoperative 1 week, and last follow-up BCVA were 0.90 (Snellen equivalent 20/159) ± 0.31 LogMAR, 0.72 (Snellen equivalent 20/105) ± 0.33 LogMAR, and 0.48 (Snellen equivalent 20/60) ± 0.32 LogMAR, respectively. Postoperative visual acuity was significantly improved compared with preoperative values (F=19.250, P=0.000). No significant difference in IOP was found compared with preoperative values (F=1.933, P=0.168). No significant complications were observed.

Conclusion:

This surgical method can effectively close MHs, improve visual acuity, enhance surgical efficiency, reduce surgical complications, and improve patients' postoperative experience without the need for fluid-air exchange, gas tamponade, or prone positioning.
Hyperreflective Foci not seen as Hyperpigmentary Abnormalities on Color Fundus Photographs in Age-Related Macular Degeneration
Authors: Goh Kai Lyn , Wintergerst Maximilian W.M. , Abbott Carla J. , Hadoux Xavier , Jannaud Maxime , Kumar Himeesh , Hodgson Lauren A.B. , Guzman Gabriela , Janzen Simon , van Wijngaarden Peter , Finger Robert P. , Guymer Robyn H. , Wu Zhichao
Published: October 2023

Purpose:

To investigate the prognostic value of quantifying optical coherence tomography (OCT)-defined hyperreflective foci (HRF) that do not correspond to hyperpigmentary abnormalities (HPAs) on color fundus photographs (CFPs) - HRF

(OCT+/CFP-)

- when considered in addition to HPA extent, for predicting late age-related macular degeneration (AMD) development. We also sought to understand the impact of HRF(OCT+/CFP-) extent on visual sensitivity.

Methods:

280 eyes from 140 participants with bilateral large drusen underwent imaging and microperimetry at baseline, and then 6-monthly for 3-years. The extent of HPAs on CFPs and HRF(OCT+/CFP-) on OCT was quantified at baseline. Predictive models for progression to late AMD, accounting for drusen volume and age, were developed using HPA extent, with and without HRF(OCT+/CFP-) extent. The association between HPA and HRF(OCT+/CFP-) extent with sector-based visual sensitivity was also evaluated.

Results:

Incorporating HRF(OCT+/CFP-) extent did not improve the predictive performance for late AMD development (P≥0.32). Increasing HPA and HRF(OCT+/CFP-) extent in each sector were independently and significantly associated with reduced sector-based visual sensitivity (P≤0.004).

Conclusions:

The addition of HRF(OCT+/CFP-) extent to HPA extent did not improve the prediction of late AMD development. HRF(OCT+/CFP-) extent was also independently associated with local reductions in visual sensitivity, after accounting for HPAs.
Ophthalmic manifestations of Whipple's disease
Authors: Rasool Nailyn
Published: October 2023

Purpose of review

Whipple's disease is an infectious cause of uveitis that may present with nonspecific findings of intraocular inflammation, which can precede the development of neurologic symptoms and signs. Whipple's disease, then, may evade consideration in the differential diagnosis for uveitis.

Recent findings

Molecular tests can be helpful in identifying the presence of Tropheryma whipplei from ocular specimens. The application of metagenomic sequencing for ocular specimens is promising, as it offers the opportunity to identify the pathogen when suspicion for an intraocular infection is high. Whipple's disease demonstrates the ability to abrogate the host immune response, which gives some insight into its pathogenesis.

Whipple's disease should be suspected in patients who have uveitis refractory to anti-inflammatory therapy. Knowledge of this important pathogen can help direct the timely implementation of diagnostic testing.
Fifty years of pain research and clinical advances: highlights and key trends
Authors: Basbaum Allan I. , Jensen Troels S. , Keefe Francis J.
Published: October 2023

This article highlights advances in basic science preclinical pain research, clinical research, and psychological research occurring over the 50 years since the International Association for the Study of Pain was founded. It presents important findings and key trends in these 3 areas of pain science: basic science preclinical research, clinical research, and psychological research.
The value of the International Association for the Study of Pain to career development: perspectives of trainee and early career members
Authors: Sharma Saurab , Birnie Kathryn A. , Wang Shan , Fernandes Gomes Francisco Isaac , Gibbs Jennifer L. , Mittinty Manasi Murthy
Published: October 2023

Supporting its young members has been a key priority of the International Association for the Study of Pain (IASP) for the past 5 decades. The IASP, along with its federations, chapters, and special interest groups, has provided benefits to its trainee and early career members for their career development. This article summarizes various key IASP initiatives and benefits offered to IASP members and how these benefits have positively impacted their careers, including examples from the authors of this article. Suggestions are made for future directions that the IASP could implement to enhance the value provided to its trainee and early career members, which will in turn contribute to IASP achieving its mission to stimulate and support the study of pain and to translate that knowledge into improved pain relief worldwide.
The role of evolving concepts and new technologies and approaches in advancing pain research, management, and education since the establishment of the International Association for the Study of Pain
Authors: Flor Herta , Noguchi Koichi , Treede Rolf-Detlef , Turk Dennis C.
Published: October 2023

The decades since the inauguration of the International Association for the Study of Pain have witnessed major advances in scientific concepts (such as the biopsychosocial model and chronic primary pain as a disease in its own right) and in new technologies and approaches (from molecular biology to brain imaging) that have inspired innovations in pain research. These have guided progress in pain management and education about pain for healthcare professionals, the general public, and administrative agencies.
Future perspectives: the next fifty years of the International Association for the Study of Pain
Authors: Sommer Claudia , Calvo Margarita , Cervero Fernando , Loeser John D.
Published: October 2023

The International Association for the Study of Pain (IASP) has become the leading professional association dedicated to promoting pain research and management. Through its many activities, including research funding, educational programs, advocacy initiatives, and global collaborations, the Association has significantly contributed to the understanding and treatment of pain. Looking into the future, the IASP is determined to continue its mission of reducing the burden of pain on individuals and societies worldwide. Here, we explore how current and past activities of the IASP will shape the future of pain research, treatment, education, and advocacy as well as provide a valuable service to its members across the world.
A Biomarker of Stress and Self-reported Caregiving Distress Predict Poor Quality of Life in Family Caregivers of Patients With Heart Failure
Authors: Liu Ya-Ching , Chou Man-Chun , Chiang Ming-Chu , Hang Chih-Ling , Chen Shyh-Ming , Chung Misook L. , Lin Chin-Yen , Huang Tsuey-Yuan
Published: October 2023

Background

Family caregivers are at a high risk for low quality of life due to caregiving-related stress. Caregivers' stress is commonly assessed using self-reported measures, which reflect relatively subjective and long-term stress related to caregiving, but objective biological markers of stress are rarely used for caregivers. The purposes of this study were (1) to determine whether caregiver characteristics were associated with stress assessed using a stress biomarker (serum cortisol) and a self-reported caregiving distress measure (Caregiver Burden Inventory) and (2) to determine the predictability of both stress measures for quality of life in caregivers of patients with heart failure.

Methods

Taiwanese family caregivers (N = 113; mean age, 54.5 years; 70.8% female) of patients with heart failure completed surveys including caregiving distress and quality of life measured by the Caregiver Burden Inventory and the Short Form-36 (physical and psychological well-being subscales), respectively, and provided blood samples for serum cortisol. Independent t tests, correlation, and hierarchical regression were conducted.

Results

Single caregivers had higher serum cortisol levels than married caregivers (P = .002). Men had significantly higher serum cortisol levels than women (P = .010), but men reported lower caregiving distress than women (P = .049). Both serum cortisol (β = −0.32, P = .012) and caregiving distress (β = −0.29, P = .018) were significant predictors of quality of life in the physical well-being scale while controlling for caregivers' characteristics and depressive symptoms. Serum cortisol (β = −0.28, P = .026) and caregiving distress (β = −0.25, P = .027) also predicted quality of life in the psychological well-being scale.

Conclusions

Serum cortisol and self-reported caregiving distress have similar predictability for quality of life in family caregivers of patients with heart failure. Reducing stress and caregiving distress is critical to improving quality of life in this population.