bluuebunny/crossref_metadata_2025 huggingface dataset:
Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty
Authors: Authom Thierry , Lascar Tristan , Wahab Hassan , Gournay Antoine , Beaudouin Emmanuel , Muller Jacobus H , Saffarini Mo , Nourissat Geoffroy
Published: March 2023

Background

The purpose was to report mid-term to long-term clinical outcomes in a multicentre series of patients who received stemless total shoulder arthroplasty (TSA). The hypothesis was that stemless TSA would be a safe and effective treatment with satisfactory clinical outcomes.

Methods

Authors retrospectively reviewed records of 62 stemless TSAs implanted between March 2013 and December 2014. Six were excluded because they had fractures or muscular impairment, which left 56: primary osteoarthritis (n = 49), rheumatoid arthritis (n = 4), avascular necrosis (n = 1), or glenoid dysplasia (n = 2). Outcomes were absolute Constant Score (CS), age-/sex-adjusted CS, and the American Shoulder and Elbow Surgeons (ASES) score. Proportions of patients that achieved substantial clinical benefits for absolute CS and ASES scores were determined.

Results

Of the 56 patients, 8 (14%) died (unrelated to TSA), 5 (9%) were lost to follow-up, and 2 (4%) refused participation. One patient was reoperated for infection with implant removal (excluded from analysis), and one for periprosthetic fracture without implant removal. At 7.6 ± 0.5 years (range 6.8-9.3), the remaining 40 patients, aged 71.0 ± 8.5 years, achieved net improvements of 40.7 ± 15.8 (CS), 62%±23% (age-/sex-adjusted CS), and 59.7 ± 16.4 (ASES). Of patients with complete absolute CS (n = 37) and ASES score (n = 28), respectively, 33 (89%) and 27 (96%) achieved substantial clinical benefits.

Conclusions

Stemless TSA yields improvements in functional outcomes at mid-term to long-term that exceed the substantial clinical benefits of the absolute CS and ASES score at a mean follow-up of 7.6 years. Although the findings of this study revealed low complications and revision rates, more studies are needed to confirm long-term benefits of stemless TSA.

Level of evidence

IV, case series.
The multidisciplinary team in diagnosing and treatment of patients with diabetes and comorbidities: A scoping review
Authors: Andersen Jonas Dahl , Jensen Morten Hasselstrøm , Vestergaard Peter , Jensen Vigga , Hejlesen Ole , Hangaard Stine
Published: March 2023

Background

Multidisciplinary Teams (MDTs) has been suggested as an intervention to overcome some of the complexities experienced by people with diabetes and comorbidities in terms of diagnosis and treatment. However, evidence concerning MDTs within the diabetes field remains sparse.

Objective

This review aims to identify and map available evidence on key characteristics of MDTs in the context of diagnosis and treatment in people with diabetes and comorbidities.

Methods

This review followed the PRISMA-ScR guidelines. Databases PubMed, EMBASE, and CINAHL were systematically searched for studies assessing any type of MDT within the context of diagnosis and treatment in adult people (≥ 18 years) with diabetes and comorbidities/complications. Data extraction included details on study characteristics, MDT interventions, digital health solutions, and key findings.

Results

Overall, 19 studies were included. Generally, the MDTs were characterized by high heterogeneity. Four overall components characterized the MDTs: Both medical specialists and healthcare professionals (HCPs) of different team sizes were represented; interventions spanned elements of medication, assessment, nutrition, education, self-monitoring, and treatment adjustment; digital health solutions were integrated in 58% of the studies; MDTs were carried out in both primary and secondary healthcare settings with varying frequencies. Generally, the effectiveness of the MDTs was positive across different outcomes.

Conclusions

MDTs are characterized by high diversity in their outline yet seem to be effective and cost-effective in the context of diagnosis and treatment of people with diabetes and comorbidities. Future research should investigate the cross-sectorial collaboration to reduce care fragmentation and enhance care coordination.
Isolated Frontosphenoidal Synostosis: Early Clinical Management of a Rare Condition With Distraction Osteogenesis
Authors: Rodriguez Megan M. , Green Jackson C. , Clark Paul R. , Sandberg David I. , Greives Matthew R. , Nguyen Phuong D.
Published: March 2023

Isolated frontosphenoidal synostosis (FSS) is an extremely rare pathology in which premature fusion of the frontal and sphenoid bones produces asymmetry of the forehead in a newborn or young child. If left untreated, these children may suffer significant esthetic and neurologic symptoms. Therefore, surgery is time-sensitive and necessary for correction. This report details the case of a male infant who presented to clinic at 3 months of age with unilateral, isolated FSS. Clinical features of this patient included an asymmetric forehead with flattening of the right frontal temporal area, indentation of the right temporal sphenoid area, and inferiorly displaced right orbit. Previous reports have been in older patients who were treated with open fronto-orbital advancement. With the patient’s early presentation, the primary surgical approach deployed here included anterior cranial vault remodeling with right distractor placement and fronto-orbital osteotomy. Four months following the procedure, the patient returned with increased right-sided hypoglobus and enophthalmos. CT imaging revealed a pseudomeningocele, secondary to a dural tear. Consequently, the 7-month-old underwent a second surgery, which included fronto-orbital advancement reconstruction. The child remains stable with improved forehead symmetry at 11 months of age. Due to the rare nature of FSS, treatment options are limited and traditional in their approach. This report aims to contribute additional clinical insights and treatment guidance to the growing body of literature surrounding FSS.
The possibility of possibility: Between ethnography and social theory
Authors: Knight Daniel M. , Manley Gabriela
Published: March 2023

This paper considers how ‘the possibility of possibility’ as freedom of choice and audacious obligation towards newness found in philosophical works of such scholars as Søren Kierkegaard and Michel Serres is tempered by socio-historical circumstance. Ethnographic material from Scotland and Greece demonstrates contrasting ways that possibilities are impacted by the various timespaces that open or foreclose pathways to the future. Possibility shapes notions of the Self and Society since people are propelled to (in)action by way of recurring and reinterpreted pasts, are pulled through futural horizons in present-day practice or become stuck on the threshold of becoming. In the context of the independence movement in Scotland, possibility plays an active role in political life of independence campaigners with a feedback loop between past-present-future providing momentum to actualise the possible. In Greece, a decade of crisis has foreclosed previously possible futures with people feeling stuck in a repeating spin-cycle where horizons of the possible cannot be crossed. The ethnographic examples showcase how the multiplicities of human life affect the possibility of possibility and how visions of the elsewhere, elsewhen, and otherwise emerge in more or less ‘positive’ scenarios.
Why is Success of South Korea's Covid-19 Response Fading?
Authors: Hong Seung Yeun , Lim Ji Hye
Published: March 2023

South Korea demonstrated its ability to respond effectively with rapid policy measures and implementation in the early stages of the pandemic. However, at the end of second year of the pandemic, South Korea reached a peak in its number of daily new cases. Why didn’t South Korea maintain the initial successful performance? To answer the question, this study examined South Korea's pandemic response process through Complex Adaptive Systems (CAS), focusing on actors’ behavior according to the phase transition. We found that the South Korean government failed to interact with the rapidly evolving public due to the different evolving pace. Dissonance between the government and the public resulted in distrust, fatigue, and resistance to the government's policy among people. From the case study of South Korea, this study emphasizes that not only individual governments, but also the international community, should anticipate and interact with the rapidly evolving public to prepare for the pandemic and post-pandemic era.
Physiological and clinical variables identify ARDS classes and therapeutic heterogeneity to glucocorticoids: a retrospective study
Authors: Liao Qingbo , Pu Yufan , Jin Xiaoer , Zhuang Zhiwei , Xu Xiaowen , Ren Xiaoqiang , Liu Gaoqing , Ding Qi
Published: March 2023

Objective

We aimed to identify new classes in acute respiratory distress syndrome (ARDS) using physiological and clinical variables and to explore heterogeneity in the effects of glucocorticoid therapy between classes.

Methods

Using the Medical Information Mart for Intensive Care-IV database, we identified patients with ARDS. Potential profile analysis was used to identify classes with physiological and clinical data as delineating variables. Baseline characteristics and clinical outcomes were compared between classes. The effect of glucocorticoid treatment was explored by stratifying by class and glucocorticoid treatment.

Results

From 2008 to 2019, 1104 patients with ARDS were enrolled in the study. The 2-class potential analysis model had the best fit (P < 0.0001), with 78% of patients falling into class 1 and 22% into class 2. Additional classes did not improve the model fit. Patients in class 2 had higher anion gap, lactate, creatinine, and glucose levels and lower residual base, blood pressure, and bicarbonate compared with class 1. In-hospital mortality and 28-day mortality were significantly higher among patients in class 2 than those in class 1 (P < 0.001). Heterogeneity of glucocorticoid treatment was observed, stratified by class and treatment, with no significant effect in class 1 (P = 0.496), increased mortality in class 2 (P = 0.001), and a significant interaction (P = 0.0381). In class 2, 28-day survival was significantly lower with glucocorticoid treatment compared with no hormone treatment (P = 0.001).

Conclusion

We used clinical and physiological variables to identify two classes of non-COVID-19-associated ARDS with different baseline characteristics and clinical outcomes. The response to glucocorticoid therapy varied among different classes of patients.
Bayesian network modelling to identify on-ramps to childhood obesity
Authors: Zhu Wanchuang , Marchant Roman , Morris Richard W. , Baur Louise A. , Simpson Stephen J. , Cripps Sally
Published: March 2023

Background

When tackling complex public health challenges such as childhood obesity, interventions focused on immediate causes, such as poor diet and physical inactivity, have had limited success, largely because upstream root causes remain unresolved. A priority is to develop new modelling frameworks to infer the causal structure of complex chronic disease networks, allowing disease “on-ramps” to be identified and targeted.

Methods

The system surrounding childhood obesity was modelled as a Bayesian network, using data from The Longitudinal Study of Australian Children. The existence and directions of the dependencies between factors represent possible causal pathways for childhood obesity and were encoded in directed acyclic graphs (DAGs). The posterior distribution of the DAGs was estimated using the Partition Markov chain Monte Carlo.

Results

We have implemented structure learning for each dataset at a single time point. For each wave and cohort, socio-economic status was central to the DAGs, implying that socio-economic status drives the system regarding childhood obesity. Furthermore, the causal pathway socio-economic status and/or parental high school levels → parental body mass index (BMI) → child’s BMI existed in over 99.99% of posterior DAG samples across all waves and cohorts. For children under the age of 8 years, the most influential proximate causal factors explaining child BMI were birth weight and parents’ BMI. After age 8 years, free time activity became an important driver of obesity, while the upstream factors influencing free time activity for boys compared with girls were different.

Conclusions

Childhood obesity is largely a function of socio-economic status, which is manifest through numerous downstream factors. Parental high school levels entangle with socio-economic status, and hence, are on-ramp to childhood obesity. The strong and independent causal relationship between birth weight and childhood BMI suggests a biological link. Our study implies that interventions that improve the socio-economic status, including through increasing high school completion rates, may be effective in reducing childhood obesity prevalence.
Ceftazidime-Avibactam plus aztreonam synergistic combination tested against carbapenem-resistant Enterobacterales characterized phenotypically and genotypically: a glimmer of hope
Authors: Taha Rawan , Kader Ola , Shawky Sherine , Rezk Shahinda
Published: March 2023

Background

Carbapenemase-producing Enterobacterales (CPE) show rapid global dissemination and pose a significant therapeutic challenge. This study aimed to characterize carbapenemase-producing Klebsiella spp. and Escherichia coli (E. coli) phenotypically and genotypically and evaluate the effect of ceftazidime/ avibactam plus aztreonam combination.

Methods

A total of 219 Klebsiella species and 390 E. coli strains were isolated from clinical samples, in which 80 Klebsiella spp. and 20 E coli isolates were resistant to tested carbapenems (imipenem, ertapenem, meropenem) by disk diffusion/broth dilution method and Vitek-2 compact system. MASTDISCS Combi Carba plus discs and real time PCR were used to determine type of carbapenemase phenotypically and genotypically, respectively. Interestingly, the synergistic effect between ceftazidime-avibactam (E-test) and aztreonam (disc) was tested against the CPE isolates.

Results

Out of the carbapenem-resistant isolates, 76.25% Klebsiella spp. isolates were extensively drug-resistant (XDR) while 18.75% were pan drug-resistant (PDR), and 5% were multidrug-resistant (MDR). Regarding E. coli, 5% were PDR, 20% were MDR and 75% were XDR. More than one carbapenemase gene was detected in 99% of the isolates. In comparison between MAST-Carba plus discs and PCR results, sensitivity and specificity were (85.42–97.92%) in Klebsiella spp., and (69.64–100%) in E. coli, respectively. Moreover, a strong association was detected between both test results among Klebsiella spp. (p < 0.001) and E. coli (p = 0.012) isolates. Finally, ceftazidime-avibactam and aztreonam combination showed a synergistic effect in 98.8% of Klebsiella spp. and 95% of E coli. All 16 PDR isolates showed synergy.

Conclusion

This synergistic effect spots the light on new therapeutics for XDR and PDR CPE.
Isoginkgetin-loaded reactive oxygen species scavenging nanoparticles ameliorate intervertebral disc degeneration via enhancing autophagy in nucleus pulposus cells
Authors: Yu Hao , Teng Yun , Ge Jun , Yang Ming , Xie Haifeng , Wu Tianyi , Yan Qi , Jia Mengting , Zhu Qing , Shen Yanping , Zhang Lianxue , Zou Jun
Published: March 2023

Excessive reactive oxygen species (ROS) in nucleus pulposus cells (NPCs) promote extracellular matrix (ECM) degradation and cellular inflammatory responses by activating a variety of cellular pathways, ultimately inducing cell apoptosis and leading to the development of low back pain. Here, we designed and fabricated an isoginkgetin-loaded ROS-responsive delivery system (IGK@SeNP) based on diselenide block copolymers. Successfully encapsulated IGK was released intelligently and rapidly in a microenvironment with high ROS levels in degenerative disc. Controlled-release IGK not only efficiently scavenged ROS from the intervertebral disc together with diselenide block copolymers but also effectively enhanced autophagy in NPCs to inhibit ECM degradation and cell apoptosis, and showed significant therapeutic effects in the rat intervertebral disc degeneration (IDD) model. Overall, the synergistic effects of IGK@SeNP in ROS scavenging and autophagy enhancement endowed it with an attractive therapeutic strategy for IDD treatment.
Circ_0000479 promotes proliferation, invasion, migration and inflammation and inhibits apoptosis of rheumatoid arthritis fibroblast-like synoviocytes via miR-766/FKBP5 axis
Authors: Zhao Peng , Ma Guobin , Ma Lintong
Published: March 2023

Circular RNAs have been demonstrated to play a critical role in the progression of autoimmune diseases. This study aimed to investigate the function of circ_0000479 in rheumatoid arthritis (RA) fibroblast-like synoviocytes (FLSs). Circ_0000479 was found to be upregulated in RA-FLSs. Flow cytometry analysis, cell counting Kit-8, transwell, wound-healing and enzyme-linked immunosorbent assays were conducted to evaluate RA-FLS apoptosis, proliferation, invasion, migration and inflammation. The results confirmed that circ_0000479 knockdown suppressed pathogenic properties of RA-FLSs. Through bioinformatics analysis and screening, we obtained 18 miRNAs that can bind to circ_0000479, of which miR-766 was most significantly up-regulated after circ_0000479 knockdown. MiR-766 was confirmed to be down-regulated in RA-FLSs and the combination between circ_0000479 and miR-766 was verified by dual-luciferase reporter assays. Moreover, the inhibitory effect of circ_0000479 knockdown in RA-FLS progression was attenuated by miR-766 inhibitor. By intersecting the target genes of miR-766 with the up-regulated genes in RA, we obtained 8 genes, of which FKBP5 was most significantly down-regulated after miR-766 overexpression. The results of dual-luciferase reporter assays also verified that FKBP5 was the target gene of miR-766. In addition, FKBP5 overexpression abated the inhibition of RA-FLS progression caused by circ_0000479 silencing. In summary, circ_0000479 binds to miR-766 to promote RA progression via FKBP5.
Construction of land-use change matrix and estimation of greenhouse gas inventory focusing on settlements in South Korea
Authors: Choi Sol-E , Hong Segi , Song Cholho , Kim Jiwon , Kim Whijin , Ha Ram , Lee Woo-Kyun
Published: March 2023

Background

Five ministries are involved in estimating the greenhouse gas (GHG) inventory in the South Korean land use, land-use change, and forestry (LULUCF) sectors. However, these ministries have not established a consistent land classification standard between land-use categories. Therefore, the GHG inventory is estimated at the approach 1 level with no spatial clarity between land-use categories. Moreover, the settlements category is not estimated because activity data and the spatial scope are lacking. This study proposed a methodology for constructing a land-use change (LUC) matrix in the LULUCF sector for improving approach level and estimating the GHG inventory in the settlements.

Result

We examined 10 sets of spatiotemporal data in South Korea to construct a LUC matrix. To maintain consistency in the spatial land classification, we constructed a LUC matrix using cadastral maps, which provide useful data for consistent land-use classification in South Korea. The LUC matrix was divided into remaining and land-converted settlements between 2005 and 2019 with estimated areas of 878,393.17 and 203,260.42 ha, respectively. CO2 emissions, according to Intergovernmental Panel Climate Change’s Guideline Tier 1, were estimated at 18.94 MtCO2 for 15 years, with an annual CO2 emission of 1.26 MtCO2 yr−1. CO2 emission by land conversion type was found to be the largest at 16.93 MtCO2 in the case of forest converted to settlements. In addition, the area with the largest CO2 emission density was Sejong-si at 7.59 tCO2/ha.

Conclusion

Based on reviewing available spatial data in South Korea, it is possible to improve Approach 3, which is more advanced than previous Approach 1 in the settlement category. In addition, the national GHG inventory also can be estimated by our constructed LUC matrix and activity data in this study. Under the many discussions about developing the Approach system, this study can provide in-detail information on developing LUC in South Korea in the settlement category as well as suggesting a methodology for constructing the LUC matrix for countries with similar problems to South Korea.
CytoSorb hemoperfusion markedly attenuates circulating cytokine concentrations during systemic inflammation in humans in vivo
Authors: Jansen Aron , Waalders Nicole J. B. , van Lier Dirk P. T. , Kox Matthijs , Pickkers Peter
Published: March 2023

Background

The CytoSorb hemoadsorption device has been demonstrated to be capable of clearing inflammatory cytokines, but has not yet been shown to attenuate plasma cytokine concentrations. We investigated the effects of CytoSorb hemoperfusion on plasma levels of various cytokines using the repeated human experimental endotoxemia model, a highly standardized and reproducible human in vivo model of systemic inflammation and immunological tolerance induced by administration of bacterial lipopolysaccharide (LPS).

Methods

Twenty-four healthy male volunteers (age 18–35) were intravenously challenged with LPS (a bolus of 1 ng/kg followed by continuous infusion of 0.5 ng/kg/hr for three hours) twice: on day 0 to quantify the initial cytokine response and on day 7 to quantify the degree of endotoxin tolerance. Subjects either received CytoSorb hemoperfusion during the first LPS challenge (CytoSorb group), or no intervention (control group). Plasma cytokine concentrations and clearance rates were determined serially. This study was registered at ClinicalTrials.gov (NCT04643639, date of registration November 24th 2020).

Results

LPS administration led to a profound increase in plasma cytokine concentrations during both LPS challenge days. Compared to the control group, significantly lower plasma levels of tumor necrosis factor (TNF, − 58%, p < 0.0001), interleukin (IL)-6 ( − 71%, p = 0.003), IL-8 ( − 48%, p = 0.02) and IL-10 ( − 26%, p = 0.03) were observed in the CytoSorb group during the first LPS challenge. No differences in cytokine responses were observed during the second LPS challenge.

Conclusions

CytoSorb hemoperfusion effectively attenuates circulating cytokine concentrations during systemic inflammation in humans in vivo, whereas it does not affect long-term immune function. Therefore, CytoSorb therapy may be of benefit in conditions characterized by excessive cytokine release.
Serum immuno-oncology markers carry independent prognostic information in patients with newly diagnosed metastatic breast cancer, from a prospective observational study
Authors: Gunnarsdottir Frida Björk , Bendahl Pär-Ola , Johansson Alexandra , Benfeitas Rui , Rydén Lisa , Bergenfelz Caroline , Larsson Anna-Maria
Published: March 2023

Background

Metastatic breast cancer (MBC) is a challenging disease, and despite new therapies, prognosis is still poor for a majority of patients. There is a clinical need for improved prognostication where immuno-oncology markers can provide important information. The aim of this study was to evaluate serum immuno-oncology markers in MBC patients and their respective relevance for prediction of survival.

Patients and methods

We investigated a broad panel of 92 immuno-oncology proteins in serum from 136 MBC patients included in a prospective observational study (NCT01322893) with long-term follow-up. Serum samples were collected before start of systemic therapy and analyzed using multiplex proximity extension assay (Olink Target 96 Immuno-Oncology panel). Multiple machine learning techniques were used to identify serum markers with highest importance for prediction of overall and progression-free survival (OS and PFS), and associations to survival were further evaluated using Cox regression analyses. False discovery rate was then used to adjust for multiple comparisons.

Results

Using random forest and random survival forest analyses, we identified the top nine and ten variables of highest predictive importance for OS and PFS, respectively. Cox regression analyses revealed significant associations (P < 0.005) of higher serum levels of IL-8, IL-10 and CAIX with worse OS in multivariable analyses, adjusted for established clinical prognostic factors including circulating tumor cells (CTCs). Similarly, high serum levels of IL-8, IL-10, ADA and CASP8 significantly associated with worse PFS. Interestingly, high serum levels of FasL significantly associated with improved OS and PFS. In addition, CSF-1, IL-6, MUC16, TFNSFR4 and CD244 showed suggestive evidence (P < 0.05) for an association to survival in multivariable analyses. After correction for multiple comparisons, IL-8 still showed strong evidence for correlation to survival.

Conclusion

To conclude, we found six serum immuno-oncology markers that were significantly associated with OS and/or PFS in MBC patients, independently of other established prognostic factors including CTCs. Furthermore, an additional five serum immuno-oncology markers provided suggestive evidence for an independent association to survival. These findings highlight the relevance of immuno-oncology serum markers in MBC patients and support their usefulness for improved prognostication.

Trial registration Clinical Trials (NCT01322893), registered March 25, 2011.
Efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with coronary atherosclerotic heart disease and gastrointestinal disease undergoing percutaneous coronary intervention: study protocol for a non-inferiority randomized controlled trial
Authors: Zhou Tienan , Gong Yinghui , Li Jingyuan , Wang Yasong , Wang Xiaozeng
Published: March 2023

Background

Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is recommended for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI) to antithrombosis, meanwhile, increasing the risks of gastrointestinal bleeding. Rivaroxaban, a novel oral anticoagulant, combined with a P2Y12 receptor inhibitor reduces adverse events in patients with CHD and atrial fibrillation who underwent PCI. The effect of rivaroxaban plus P2Y12 inhibitor on reducing bleeding events in patients with CHD and gastrointestinal disease (GID) undergoing PCI remains unclear.

Method

The study is a prospective, single-center, randomized controlled trial. A total of 1020 patients with CHD and GID undergoing PCI will be enrolled. Patients are randomized (1:1) to receive either rivaroxaban 10 mg plus clopidogrel 75 mg daily or aspirin 100 mg plus clopidogrel 75 mg daily; both treatments will last 6 months. The primary endpoint is Bleeding Academic Research Consortium (BARC) type 2–5 bleeding requiring medical intervention. The secondary endpoint is a composite of major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, cardiac death, nonfatal myocardial infarction, stent thrombosis, ischemia-driven target vessel revascularization, and stroke.

Discussion

The objective of this study is to evaluate the efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with CHD and GID undergoing PCI. We aim to explore an optimized antithrombotic strategy, which achieves the same anti-ischemic effect as standard DAPT without increasing the risk of GIB, for patients with CHD and GID undergoing PCI.

Trial registration

This protocol is registered at the Chinese Clinical Trial Registry under the number ChiCTR2100044319. And this publication is based on version 1.4 of the trial protocol dated Sep 6, 2021.
TAK-715 alleviated IL-1β-induced apoptosis and ECM degradation in nucleus pulposus cells and attenuated intervertebral disc degeneration ex vivo and in vivo
Authors: Wang Kun , Yao Dengbo , Li Yuxi , Li Ming , Zeng Weike , Liao Zhuangyao , Chen Engming , Lu Shixin , Su Kaihui , Che Zhen , Liang Yuwei , Wang Peng , Huang Lin
Published: March 2023

Background

Intervertebral disc degeneration (IDD) is one of the most common disorders related to the spine. Inflammation, apoptosis and extracellular matrix (ECM) degradation contribute to disc degeneration in nucleus pulposus cells (NPCs). This study focused on the role and mechanism of the p38 inhibitor TAK-715 in intervertebral disc degeneration.

Methods

NPCs were treated with IL-1β to mimic apoptosis, followed by the addition of TAK-715. It was determined that apoptosis, inflammatory mediators (COX-2), inflammatory cytokines (HMGB1), and ECM components (collagen II, MMP9, ADAMTS5, and MMP3) existed in NPCs. In addition, the p38MAPK signaling pathways were examined. The role of TAK-715 in vivo was determined by acupuncture-induced intervertebral disc degeneration. Following an intradiscal injection of TAK-715, MRI and a histopathological analysis were conducted to assess the degree of degeneration.

Results

IL-1β-induced apoptosis was alleviated by TAK-715 in vitro, and antiapoptotic proteins were upregulated. Furthermore, TAK-715 blocked IL-1β-induced inflammatory mediator production (COX-2) and inflammatory cytokine production (HMGB1) and degraded the ECM (collagen II, MMP9, ADAMTS5, and MMP3). By inhibiting the phosphorylation of p38, TAK-715 exerted its effects. In a rat tail model, TAK-715 ameliorates puncture-induced disc degeneration based on MRI and histopathology evaluations.

Conclusion

TAK-715 attenuated intervertebral disc degeneration in vitro and in vivo, suggesting that it might be an effective treatment for IDD.
Early-detection scheme based on sequential tests for low-latency communications
Authors: Barragán-Guerrero Diego , Au Minh , Gagnon Ghyslain , Gagnon François , Giard Pascal
Published: March 2023

We propose an early-detection scheme to reduce communications latency based on sequential tests under finite blocklength regime for a fixed-rate transmission without any feedback channel. The proposed scheme processes observations sequentially to decide in favor of one of the candidate symbols. Such a process stops as soon as a decision rule is satisfied or waits for more samples under a given accuracy. We first provide the optimal achievable latency in additive white Gaussian noise channels for every channel code given a probability of block error. For example, for a rate $$R = 0.5$$

R
=
0.5

and a blocklength of 500 symbols, we show that only $$63\%$$

63
%

of the symbol time is needed to reach an error rate equal to $$10^{-5}$$

10

-
5

. Then, we prove that if short messages can be transmitted in parallel Gaussian channels via a multi-carrier modulation, there exists an optimal low-latency strategy for every code. Next, we show how early detection can be effective with band-limited orthogonal frequency-division multiplexing signals while maintaining a given spectral efficiency by random coding or pre-coding random matrices. Finally, we show how the proposed early-detection scheme is effective in multi-hop systems.
Light-level geolocation as a tool to monitor polar bear (Ursus maritimus) denning ecology: a case study
Authors: Merkel Benjamin , Aars Jon , Laidre Kristin L. , Fox James W.
Published: March 2023

Background

Monitoring polar bears is logistically challenging and expensive. Traditionally, reproductive history has been assessed using permanent marks from physically captured individuals, which requires assumptions about reproductive history based on their status at the time of capture. This is often supplemented with economically costly satellite telemetry (ST) collars restricted to adult females, which yield data on space use and reproductive history.

Methods

This study assesses the potential of adapting light-level geolocation (Global location sensing or GLS) tags, developed for birds and fish, to estimate life history metrics for polar bears. Traditionally, GLS uses light intensity and time of day to estimate approximate twice-daily locations. This information, combined with temperature data, can be used to assess approximate locations of maternity denning events, denning timing, general space use, and population connectivity.

Results

Adult females (n = 54) were equipped, some several times, with a total of 103 GLS in Svalbard and Greenland from 2012 to 2021. Of these, 44 were also equipped with 80 ST collars during this period. This yielded GLS and ST data records for each individual up to 9.4 years (mean (Ø) 4.0 years) and 5.1 years (Ø 1.5 years), respectively. Combined with capture information, the GLS and ST collars were used to score reproductive history (determined presence or absence of maternity denning events) for 72–54% of bear winters during this period, respectively. Using GLS yielded on average 4.3 years of unbroken reproductive history records (up to 8 years for some individuals) including denning phenology and age at first reproduction. Additionally, geographic locations could be estimated during spring and autumn (when twilight was present) with an average daily accuracy of 93 km (4–1042 km) and 58 km (5–550 km) when aggregating by season.

Conclusions

This study establishes GLS as a powerful, low-cost method for polar bear population monitoring that can provide data on reproductive history, including age at first reproduction, and maternity denning location and phenology in programs with ongoing recapture. GLS can also be used to monitor males and immatures that cannot wear ST collars.
Performance, safety and efficiency comparison between 10,000 and 5000 cuts per minute vitrectomy using a 25G cutter: a prospective randomized controlled study
Authors: Fung Nicholas S. K. , Mak Anthony K. H. , Brelen Marten , Tsang Chi Wai , Mohamed Shaheeda , Lam Wai Ching
Published: March 2023

Purpose

This study aims to compare the performance of the 25+® UltraVit® 5000 cuts per minute (cpm) vitrectomy probe versus the 25+ ® Ultravit 10,000 cpm® beveled tip, dual drive vitrectomy probe.

Method

In this prospective randomised controlled clinical trial, 52 eyes of 52 consecutive patients were randomized into either the 10,000 cpm (25 patients) or 5000 cpm vitrectomy group (27 patients). Patients were evaluated preoperatively, intraoperatively, and postoperatively on the first day, and at 1 week, 1 month and 3 months. The main outcome measures were vitrectomy time, and secondary endpoints were time to induction of posterior vitreous detachment, intraoperative complications, and number of instruments used.

Results

The vitrectomy time was shorter in the 10,000 cpm group (413.7 s) compared to the 5000 cpm group (463.4 s), although there was no significant difference (p = 0.5999).

One patient had an iatrogenic retinal break in the 10,000 cpm group while two patients had an iatrogenic retinal break in the 5000 cpm group. The time for posterior vitreous detachment (PVD) induction and the number of instruments used were not significantly different between the two groups.

Conclusion

The difference in vitrectomy times between the 10,000 cpm vitrectomy probe and the 5000 cpm cutter were not statistically significant. This may suggest that other factors affect efficiency rather than the limitations of equipment.
Power quality enhancement in islanded microgrids via closed-loop adaptive virtual impedance control
Authors: Wang Yang , Tang Junmiao , Si Jiandong , Xiao Xianyong , Zhou Peter , Zhao Jinshuai
Published: March 2023

The high proportion of nonlinear and unbalanced loads results in power quality issues in islanded microgrids. This paper presents a novel control strategy for harmonic and unbalanced power allocation among distributed generators (DGs) in microgrids. Different from the existing sharing strategies that allocate the harmonic and unbalanced power according to the rated capacities of DGs, the proposed control strategy intends to shape the lowest output impedances of DGs to optimize the power quality of the microgrid. To achieve this goal, the feasible range of virtual impedance is analyzed in detail by eigenvalue analysis, and the findings suggest a simultaneous adjustment of real and imaginary parts of virtual impedance. Because virtual impedance is an open-loop control that imposes DG to the risk of overload, a new closed-loop structure is designed that uses residual capacity and absorbed power as feedback. Accordingly, virtual impedance can be safely adjusted in the feasible range until the power limit is reached. In addition, a fuzzy integral controller is adopted to improve the dynamics and convergence of the power distribution, and its performance is found to be superior to linear integral controllers. Finally, simulations and control hardware-in-the-loop experiments are conducted to verify the effectiveness and usefulness of the proposed control strategy.
Pituitary stalk interruption syndrome (PSIS) presenting in a Jordanian male patient with short stature and delayed puberty: a case report
Authors: Mabreh Loai Q. , Al Rabab’ah Aseel M.
Published: March 2023

Background

Pituitary stalk interruption syndrome is a rare congenital pituitary anatomical defect manifested with wide and various clinical presentations. Short stature and delayed puberty are present in most cases and may be combined with extra pituitary malformations. Magnetic resonance imaging is considered the key factor for reaching the definite diagnosis as it reveals the different radiological presentations of this syndrome.

Case presentation

A 17-year-old male patient from Jordan was presented to the radiology department for pituitary MRI. The patient presents with multiple pituitary hormonal deficiency, short stature, and under-developed secondary sexual characteristics. The bone age of the patient was significantly less than the chronological age. MRI pituitary gland showed hypoplasia of the anterior pituitary, absence of the pituitary stalk and ectopic posterior pituitary gland located posterior to the optic chiasm. These findings were consistent with pituitary stalk interruption syndrome.

Conclusions

Considering uncommon incidence of pituitary stalk interruption syndrome, magnetic resonance imaging of the pituitary should be considered while examining a patient with pituitary deficiency for prompt diagnosis and treatment. Hormone replacement medication is the primary treatment for pituitary stalk interruption syndrome and should be started as soon as feasible. Thus, early diagnosis and monitoring of individuals are crucial.
Parent-Offspring Associations in Body Composition: Findings From the Southampton Women's Survey Prospective Cohort Study
Authors: Moon Rebecca J , D’Angelo Stefania , Holroyd Christopher R , Crozier Sarah R , Godfrey Keith M , Davies Justin H , Cooper Cyrus , Harvey Nicholas C
Published: March 2023

Context

Children born to parents who are overweight or obese have a high risk of adult obesity, but it is unclear if transgenerational associations relating to unfavorable body composition differ by parent.

Objective

To examine differential mother-offspring and father-offspring associations in body composition in early childhood.

Methods

A total of 240 mother-father-offspring trios from a prospective UK population-based pre-birth cohort (Southampton Women's Survey) were included for anthropometry and dual-energy x-ray absorptiometry assessment of whole-body-less-head body composition in the offspring at 3 different ages (4, 6-7, and 8-9 years) and in the mother and father at the 8- to 9-year offspring visit. Associations were assessed using linear regression adjusting for the other parent.

Results

Positive associations between mother-daughter body mass index (BMI) and fat mass were observed at ages 6 to 7 (BMI: β = .29 SD/SD, 95% CI = .10, .48; fat mass β = .27 SD/SD, 95% CI = .05, .48) and 8 to 9 years (BMI: β = .33 SD/SD, 95% CI = .13, .54; fat mass β = .31 SD/SD, 95% CI = .12, .49), with similar associations at age 4 years but bounding the 95% CI. The mother-son, father-son, and father-daughter associations for BMI and fat mass were weaker at each of the ages studied.

Conclusion

A strong association between the fat mass of mothers and their daughters but not their sons was observed. In contrast, father-offspring body composition associations were not evident. The dimorphic parent-offspring effects suggest particular attention should be given to early prevention of unfavorable body composition in girls born to mothers with excess adiposity.
Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis
Authors: Singh Raj , Bowden Greg , Mathieu David , Perlow Haley K. , Palmer Joshua D. , Elhamdani Shahed , Shepard Matthew , Liang Yun , Nabeel Ahmed M. , Reda Wael A. , Tawadros Sameh R. , Abdelkarim Khaled , El-Shehaby Amr M.N. , Emad Reem M. , Elazzazi Ahmed Hesham , Warnick Ronald E. , Gozal Yair M. , Daly Megan , McShane Brendan , Addis-Jackson Marcel , Karthikeyan Gokul , Smith Sian , Picozzi Piero , Franzini Andrea , Kaisman-Elbaz Tehila , Yang Huai-che , Wei Zhishuo , Legarreta Andrew , Hess Judith , Templeton Kelsey , Pikis Stylianos , Mantziaris Georgios , Simonova Gabriela , Liscak Roman , Peker Selcuk , Samanci Yavuz , Chiang Veronica , Niranjan Ajay , Kersh Charles R. , Lee Cheng-Chia , Trifiletti Daniel M. , Lunsford L. Dade , Sheehan Jason P.
Published: March 2023

BACKGROUND:

There are limited data regarding outcomes for patients with gastrointestinal (GI) primaries and brain metastases treated with stereotactic radiosurgery (SRS).

OBJECTIVE:

To examine clinical outcomes after SRS for patients with brain metastases from GI primaries and evaluate potential prognostic factors.

METHODS:

The International Radiosurgery Research Foundation centers were queried for patients with brain metastases from GI primaries managed with SRS. Primary outcomes were local control (LC) and overall survival (OS). Kaplan-Meier analysis was used for univariate analysis (UVA) of prognostic factors. Factors significant on UVA were evaluated with a Cox multivariate analysis proportional hazards model. Logistic regressions were used to examine correlations with RN.

RESULTS:

We identified 263 eligible patients with 543 brain metastases. Common primary sites were rectal (31.2%), colon (31.2%), and esophagus (25.5%) with a median age of 61.6 years (range: 37-91.4 years) and a median Karnofsky performance status (KPS) of 90% (range: 40%-100%). One-year and 2-year LC rates were 83.5% (95% CI: 78.9%-87.1%) and 73.0% (95% CI: 66.4%-78.5%), respectively. On UVA, age >65 years (P = .001), dose <20 Gy (P = .006) for single-fraction plans, KPS <90% (P < .001), and planning target volume ≥2cc (P = .007) were associated with inferior LC. All factors other than dose were significant on multivariate analysis (P ≤ .002). One-year and 2-year OS rates were 68.0% (95% CI: 61.5%-73.6%) and 31.2% (95% CI: 24.6%-37.9%), respectively. Age > 65 years (P = .006), KPS <90% (P = .005), and extracranial metastases (P = .05) were associated with inferior OS.

CONCLUSION:

SRS resulted in comparable LC with common primaries. Age and KPS were associated with both LC and OS with planning target volume and extracranial metastases correlating with LC and OS, respectively. These factors should be considered in GI cancer patient selection for SRS.
The identification of high-performing antibodies for transmembrane protein 106B (TMEM106B) for use in Western blot, immunoprecipitation, and immunofluorescence
Authors: Ayoubi Riham , Fotouhi Maryam , Southern Kathleen , Bhajiawala Ritika , Fanti Rebeka , Prinos Panagiotis , McPherson Peter S. , Laflamme Carl ,   NeuroSGC/YCharOS/EDDU collaborative group,   ABIF Consortium
Published: March 2023

Transmembrane protein 106B (TMEM106B), a protein that is localized to the lysosome, is genetically linked to many neurodegenerative diseases and forms fibrils in diseased brains. The reproducibility of TMEM106B research would be enhanced if the community had access to well-characterized anti-TMEM106B antibodies. In this study, we characterized six commercially available TMEM106B antibodies for their performance in Western blot, immunoprecipitation, and immunofluorescence, using a standardized experimental protocol based on comparing read-outs in knockout cell lines and isogenic parental controls. We identified many high-performing antibodies and encourage readers to use this report as a guide to select the most appropriate antibody for their specific needs.
Economic evaluation of a collaborative model of pharmaceutical care in an Irish hospital: cost-utility analysis
Authors: Kirwan Gráinne , O'Leary Aisling , Walsh Cathal , Grimes Tamasine
Published: March 2023

Background: A complex, collaborative pharmaceutical care intervention including medication review and reconciliation demonstrated a statistically significant reduction in the prevalence of discharge medication error and improved quality of prescribing for hospitalised adults.  This study sought to assess the cost-effectiveness of this intervention.

Methods: A cost-utility analysis was undertaken using a decision-analytic framework. The evaluation was undertaken from the Health Service Executive’s perspective, the payer for primary and secondary care settings. Direct costs associated with managing hypothetical harm consequent to intercepted discharge medication error and consequences in terms of quality-adjusted life years loss were key input parameters. Analysis was structured within a decision tree model in Microsoft Excel® populated with consequences as utilities, estimated costs using macro- and micro-costing approaches, and event probabilities generated from the original study. Incremental analysis, one-way and probabilistic sensitivity analyses were performed.

Results: The results of analysis for the base-care demonstrated that the intervention dominated standard care with an incremental cost-effectiveness ratio of -€36,537.24/quality-adjusted life year, indicating that the intervention is less costly and more effective. The one-way and probabilistic sensitivity analyses both demonstrated that the intervention dominated standard care. The model was relatively robust to variation in input parameters through one-way sensitivity analysis. The cost of discharge medication error and effect parameters relating to standard care were most sensitive to change.

Discussion: The analysis demonstrated the cost-effectiveness of a complex pharmaceutical intervention which will support decision-making regarding implementation. This is the first cost-utility analysis of a complex, collaborative pharmaceutical care intervention, adding to the scant evidence-base in the field.
Diagnosis and treatment of interstitial cystitis - literature review
Authors: Siedlak Agnieszka , Kułakowska Aleksandra , Lepczyński Bartłomiej , Kłakowicz Philip , Lechowski Sebastian
Published: March 2023

Interstitial cystitis (IC) also known as bladder pain syndrome (BPS) is the presence of chronic or recurrent pain, feelings of tightness or discomfort perceived as associated with the bladder, accompanied by at least one lower urinary tract symptom in the absence of infection or other identifiable causes [1]. These symptoms are pain or burning while urinating; frequent urination; feeling the need to urinate despite having an empty bladder; bloody urine; pressure or cramping in the groin or lower abdomen. There is no laboratory test to make a diagnosis, it is often a diagnosis based on the exclusion of other diseases, one of the diagnostic methods is cystoscopy with the collection of specimens from the bladder and their histopathological examination [2]. Currently there is no causal treatment, only symptomatic treatment is used, such as intravesical administration of hyaluronic acid or surgical methods.