bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular disease in older patients with end-stage renal disease and chronic dialysis in Vietnam
Authors: Nguyen T , Pham T X T , Nguyen T V
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Background

Patients with chronic kidney disease, especially end-stage renal disease, exhibit a very high cardiovascular risk. In Vietnam, chronic kidney disease and cardiovascular disease (CVD) are very common in older people. However, there is limited studies on the complexity of CVD and other geriatric syndromes in older patients with end-stage renal disease and chronic dialysis.

Purpose

In this study in older patients with end-stage renal disease and chronic dialysis, we aim to: (1) Examine the prevalence of CVD and its impact on hospitalization, and (2) Compare the burden of common geriatric syndromes in patients with and without CVD.

Methods

This is a prospective, observational, multi-centre study conducted at two dialysis units of two major hospitals in Vietnam. Consecutive patients aged 60 years or older who were diagnosed with end-stage renal disease and on chronic dialysis were recruited from November 2020 to June 2021. CVD was defined as having one of these conditions: heart failure, ischemic heart disease, and stroke. Participants were assessed for these common geriatric conditions: frailty (defined as a Clinical Frailty Scale total score ≥5), malnutrition (defined as a total score ≤7 from the Mini Nutritional Assessment Short Form), impairment in activities of daily living (defined as ADL score <6), impairment in instrumental activities of daily living (defined as IADL score <8), high risk of falls (assessed by the STEADI questionnaire), and polypharmacy (defined as the concurrent use of ≥5 medications). Participants were followed for 6 months after discharge. Multivariable logistic regression analysis was applied to examine the impact of CVD on 6-month hospitalization, adjusting for age, sex, and the geriatric conditions. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs).

Results

There were 175 participants (mean age 72.4 ± 8.5, 58.9% female). CVD was present in 80% of the participants (ischemic heart disease: 49.7%, heart failure: 60.0%, stroke 25.7%). Participants with CVD had significantly higher prevalence of geriatric syndromes compared to those without CVD (Table 1). During 6-month follow-up, 48.6% of the participants had at least one hospitalization. In multivariable logistic regression model, the presence of CVD increased the risk of hospitalization (adjusted OR 4.70, 95%CI 1.72 – 12.85), allowing for age, sex, frailty, ADL impairment, IADL impairment, fall risk, malnutrition, polypharmacy (Table 2).

Conclusion

In this study, there was a very high prevalence of CVD in older patients with end-stage renal disease and chronic dialysis. Participants with CVD had higher burden of geriatric syndromes and their risk of 6-month hospitalization increased by approximately 5 times.
System delays and target points: analysis of STEMI response program a single center
Authors: Toledano B , Garganera K B , Prado J P , Sabas M L , Martinez G S
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Introduction

STEMI carries the highest risk among the AMI and the mortality is influenced by many factors. Hospital delays are the most easily audited and should be analyzed and improved.

Methodology

Participants were adults aged > 19 years enrolled in the AMI registry due to STEMI and treated with emergency PCI from January 2019 to June 2021. The door-to-balloon times and STEMI diagnosis-to-wire cross times were divided into Met and Unmet groups and time frames were compared using the Mann Whitney U test. For time frames with no significant difference, the median of the Met group was adopted while in time frames with a significant difference, the optimal target points were chosen from the highest percentages of Met if ≤ and Unmet if > the target point. Odds ratio (OR) with 95% confidence intervals from binary logistic regression were done to predict the Met status.

Results

A total of 113 participants were analyzed. Significant delays were seen in ECG-Paging

(p=<0.034), CFOD arrival-to-STEMI diagnosis (p=0.008), STEMI diagnosis-to-consent (p= <0.001), consent-to-Cath lab (p=<0.001) and Cath lab-to-puncture (p=0.003). The optimal targets in minutes: Door-ECG (median 9), ECG-Paging (≤1/>, 56.67%, 62.65%, OR 2.19, p=0.069), paging-to-CFOD arrival (median <2), CFOD arrival-to-STEMI diagnosis ( ≤/>3, 66.67%, 51.81% OR 2.15, p=0.086), STEMI diagnosis-to-consent (≤/>10, 78.26%, 67.78%, OR 7.57, p=<0.001), consent-to-Cath lab (≤/>24, 73.91%, 67.78%, OR 15.38, p=<0.001), Cath lab-to-puncture (≤/>12, 65.22%, 58.89%, OR 2.68, p=<0.043).

Conclusion

In a developing country and during the COVID-19 pandemic, the most significant delays of our STEMI program occurred in obtaining consent for emergency percutaneous coronary intervention and transferring the patient to the catheterization laboratory. Optimal target points for every time frame can provide concrete objectives that may increase the chance of achieving the door-to-balloon and STEMI diagnosis-to-wire cross goals.
Outcomes after cryoballoon ablation of paroxysmal atrial fibrillation with the PolarX or the Arctic Front Advance Pro: a prospective multicentre experience
Authors: Tanese Nikita , Almorad Alexandre , Pannone Luigi , Defaye Pascal , Jacob Sophie , Kilani Mouna Ben , Chierchia Gianbattista , Venier Sandrine , Cardin Christèle , Jacon Peggy , Combes Stéphane , Deschamps Elodie , Menè Roberto , de Asmundis Carlo , Boveda Serge
Published: January 2023

Aims

The aim of this study was to compare procedural efficacy and safety, including 1-year freedom from AF recurrence, between the novel cryoballoon system PolarX (Boston Scientific) and the Arctic Front Advance Pro (AFA-Pro) (Medtronic), in patients with paroxysmal AF undergoing PVI.

Methods and results

This multicentre prospective observational study included 267 consecutive patients undergoing a first cryoablation procedure for paroxysmal AF (137 PolarX, 130 AFA-Pro). Kaplan-Meier curves with the log-rank test was used to compare the 1-year freedom from AF recurrence between both groups. Multivariate Cox model was performed to evaluate whether the type of procedure (PolarX vs. AFA-Pro) had an impact on the occurrence of AF recurrences after adjustment on potentially confounding factors. The PolarX reaches lower temperatures than the AFA-Pro (LSPV 52 ± 5, vs. 59 ± 6; LIPV 49 ± 6 vs. 56 ± 6; right superior pulmonary vein: 49 ± 6 vs. 57 ± 7; right inferior pulmonary vein: 52 ± 6 vs. 59 ± 6; P < 0.0001). A higher rate of transient phrenic nerve palsy was found in patients treated with the PolarX system (15% vs. 7%, P = 0.05). After a mean follow-up of 15 ± 5 months, 20 patients (15%) had recurrences in AFA-Pro group and 27 patients (19%) in PolarX group (P = 0.35). Based on survival analysis, no significant difference was observed between both groups with a 12-month free of recurrence survival of 91.2% (85.1–95.4%) vs. 83.7% (76.0%–89.1%) (log-rank test P = 0.11). In multivariate Cox model hazard ratio of recurrence for PolarX vs. AFA-Pro was not significant [HR = 1.6 (0.9–2.8), P = 0.12].

Conclusion

PolarX and AFA-Pro have comparable efficacy and safety profiles for pulmonary veins isolation in paroxysmal atrial fibrillation.
Adverse Childhood Experiences and Poor Sleep Quality in Older Adults: The Influence of Emotion Regulation
Authors: Sheffler Julia L , Burchard Valeria , Pickett Scott
Published: January 2023

Background

Adverse childhood experiences (ACEs) are associated with sleep impairment across the life span, but little is known about modifiable factors that may ameliorate this relationship, such as adaptive emotion regulation (ER) skills.

Methods

Data were obtained from an online questionnaire completed by a community sample of older adults (N = 278). The questionnaire included the Pittsburgh Sleep Quality Index, an Adverse Childhood Experiences questionnaire, the Cognitive Emotion Regulation Questionnaire (CERQ), and measures of health conditions, and other sample demographics. Moderation analyses were used to examine the interaction between ACEs and 5 adaptive ER skills of CERQ on sleep quality in older adults, while accounting for the effects of age, sex, income, body mass index, and health.

Results

ACEs were significantly associated with worse sleep quality in older adults, and this effect was moderated by positive reappraisal and refocusing on planning (all ps < .05). For individuals reporting greater use of these ER skills, ACEs had no effect on sleep quality, whereas for individuals reporting less frequent use of these ER skills, ACEs were associated with substantially worse sleep quality. This relationship remained significant after accounting for age, sex, income, body mass index, and health conditions in the model.

Conclusions

The effects of ACEs on sleep quality persist into older age; however, greater use of ER skills that focus on positively reframing negative events and identifying strategies for coping protect against sleep impairment in individuals with higher ACEs.
Short-term outcomes of curved periacetabular osteotomy and factors influencing patient dissatisfaction
Authors: Suzuki Masahiro , Kinoshita Koichi , Sakamoto Tetsuya , Seo Hajime , Yoshimura Ichiro , Yamamoto Takuaki
Published: January 2023

This study aimed to evaluate clinical outcomes based on patient-reported outcome measures and to analyze factors influencing patient dissatisfaction at 1 year after curved periacetabular osteotomy (CPO). This retrospective review involved 98 hips of 98 consecutive patients with symptomatic acetabular dysplasia who underwent CPO from March 2016 to June 2020. The clinical outcomes were evaluated based on the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire, the Medical Outcomes Study 36-Item Short-Form Health Survey and the Harris Hip Score. Patients were divided into satisfied and unsatisfied groups according to the 85th percentile cut-off on the postoperative visual analog scale (VAS) for dissatisfaction. A multiple logistic regression analysis was performed to investigate the factors impacting patient dissatisfaction after CPO; the explanatory variables were age, body mass index, postoperative Tönnis grade of ≥2, postoperative VAS score for pain, lateral femoral cutaneous nerve (LFCN) injury and radiographic complications (non-union of the pubis, non-union of the ischium after posterior column fracture and ischial ramus stress fracture). The 85th percentile of the postoperative VAS score for dissatisfaction was 60 mm. The unsatisfied group comprised 15 patients at 1 year after CPO. The multiple logistic regression analysis results showed that the postoperative VAS scores for pain [odds ratio (OR), 1.064; 95% confidence interval (CI), 1.026–1.104; P = 0.001] and LFCN injury (OR, 6.775; 95% CI, 1.308–33.256; P = 0.018) were associated with postoperative dissatisfaction. LFCN injury and the postoperative VAS score for pain independently impacted postoperative dissatisfaction at 1 year after CPO.
Investigating the racial gap in prostate cancer screening with prostate-specific antigen among younger men from 2012 to 2020
Authors: Qian Zhiyu , Al Khatib Khalid , Chen Xi , Belani Sanvi , Labban Muhieddine , Lipsitz Stuart , Cole Alexander P , Iyer Hari S , Trinh Quoc-Dien
Published: January 2023

Background

The United States Preventive Services Task Force recommended against prostate-specific antigen (PSA) screening in 2012, which was modified in 2018 into shared decision making for men aged 55-70 years with a life expectancy over 10 years. We studied the trends in PSA screening in younger Black and White men with the implementation of the 2012 and 2018 guidelines.

Methods

Younger Black and White men (aged 40-54 years) were identified using the Behavioral Risk Factor Surveillance System database biennially from 2012 to 2020. Our primary outcome was PSA screening within 2 years of the survey. An adjusted logistic regression model with 2-way interaction assessment between race and survey year was used to investigate the temporal trend of PSA screening in younger Black and White men.

Results

A total of 142 892 men were included. We saw steadily decreasing odds of PSA screening among both younger Black and White men in 2014, 2016, 2018, and 2020 compared with 2012 (for younger Black men: odds ratio [OR]2014 = 0.77, 95% confidence interval [CI] = 0.62 to 0.96, OR2016 = 0.51, 95% CI = 0.41 to 0.63, OR2018 = 0.33, 95%CI = 0.27 to 0.42, OR2020 = 0.25, 95% CI = 0.18 to 0.32; and for younger White men: OR2014 = 0.81, 95% CI = 0.76 to 0.87, OR2016 = 0.66, 95% CI = 0.61 to 0.71, OR2018 = 0.41, 95%CI = 0.37 to 0.44, OR2020 = 0.36, 95% CI = 0.33 to 0.39). Younger Black men showed a brisker decrease in PSA screening in 2016, 2018, and 2020 compared with younger White men (all P < .05).

Conclusions

PSA screening among younger men steadily decreased over the past decade since the 2012 United States Preventive Services Task Force guidelines, demonstrating a narrowing racial gap. How such an observed trend translates to long-term clinical outcomes for younger Black men remains to be seen.
Flying to high-altitude destinations: Is the risk of acute mountain sickness greater?
Authors: Burtscher Johannes , Swenson Erik R , Hackett Peter H , Millet Grégoire P , Burtscher Martin
Published: January 2023

Background

Altitude sojourns increasingly attract individuals of all ages and different health statuses due to the appeal of high-altitude destinations worldwide and easy access to air travel. The risk of acute mountain sickness (AMS) when flying to high-altitude destinations remains underemphasized. Thus, this review aims to evaluate the altitude-dependent AMS incidence depending on the mode of ascending, e.g. by air vs terrestrial travel.

Methods

A literature search was performed to identify the observational studies assessing AMS incidence after acute ascent of primarily healthy adults to real high altitude. In addition, placebo arms of interventional trials evaluating the prophylactic efficacy of various drugs have been separately analysed to confirm or refute the findings from the observational studies. Linear regression analyses were used to evaluate the altitude-dependent AMS incidence.

Results

Findings of 12 observational studies, in which the AMS incidence in 11 021 individuals ascending to 19 different altitudes (2200–4559 m) was evaluated, revealed an impressive 4.5-fold steeper increase in the AMS incidence for air travel as compared with slower ascent modes, i.e. hiking or combined car and/or air travel and hiking. The higher AMS incidence following transportation by flight vs slower means was also confirmed in placebo-treated participants in 10 studies of drug prophylaxis against AMS.

Conclusions

Due to the short time span in going from low to high altitude, reduced acclimatization likely is the main reason for a higher AMS risk when travelling to high-altitude destinations by flight. To avoid frustrating travel experiences and health risks, appropriate and timely medical advice on how to prepare for air travel to high altitude is of vital importance. Effective preparation options include the use of modern pre-acclimatization strategies and pharmacological prophylaxis by acetazolamide or dexamethasone, or even considering alternate itineraries with more gradual ascent.
Lessons From COVID-19 for the Next War: Crisis Standards of Care in the Role 3 Intensive Care Unit
Authors: Steinlage Arnold J , Steinlage Corinne B , Curell Angela M
Published: January 2023

The rationing of medical resources became a common practice during the SARS-CoV-2 (COVID-19) pandemic. To cope with overwhelming patient numbers, hospitals were forced to adopt “crisis standards of care” (CSC) guidelines, which allow physicians to navigate the task of rationing health care resources in both an effective and ethically sound manner. The Military Health System currently has clinical guidelines for mass casualty incident (MCI) triage but lacks deployed Role 3 intensive care unit (ICU) CSC guidelines. In future peer and near-peer conflicts, this gap may prove detrimental when thousands of casualties following a single battle create a continuous and prolonged mass casualty event. The challenges of providing critical care in a battlefield hospital during a large conflict are unique and numerous, but lessons from COVID-19 ICUs such as transitioning to a utilitarian ethic, clear definitions, decision points, and decision authorities, as well as the establishment of clinical practice guidelines formulated from evidence-based protocols, can better prepare the U.S. expeditionary medical force for future conflicts. A battlefield CSC will allow military critical care physicians and nurses to manage overwhelmed ICUs and make better triage decisions, allowing them to provide a higher quality of care to the collective. In this commentary, we explore the need for Wartime CSC in the battlefield Role 3 ICU and the tools and methods used by civilian and military institutions to create and enact CSCs throughout the COVID-19 pandemic.
Candida khanbhaisp. nov., a new clinically relevant yeast within theCandida haemuloniispecies complex
Authors: de Jong Auke W , Al-Obaid Khaled , Mohd Tap Ratna , Gerrits van den Ende Bert , Groenewald Marizeth , Joseph Leena , Ahmad Suhail , Hagen Ferry
Published: January 2023

Invasive fungal infections caused by non-albicans Candida species are increasingly reported. Recent advances in diagnostic and molecular tools enabled better identification and detection of emerging pathogenic yeasts. The Candida haemulonii species complex accommodates several rare and recently described pathogenic species, C. duobushaemulonii, C. pseudohaemulonii, C. vulturna, and the most notorious example is the outbreak-causing multi-drug resistant member C. auris. Here, we describe a new clinically relevant yeast isolated from geographically distinct regions, representing the proposed novel species C. khanbhai, a member of the C. haemulonii species complex. Moreover, several members of the C. haemulonii species complex were observed to be invalidly described, including the clinically relevant species C. auris and C. vulturna. Hence, the opportunity was taken to correct this here, formally validating the names of C. auris, C. chanthaburiensis, C. konsanensis, C. metrosideri, C. ohialehuae, and C. vulturna.
Measuring the variability of directly imaged exoplanets using vector Apodizing Phase Plates combined with ground-based differential spectrophotometry
Authors: Sutlieff Ben J , Birkby Jayne L , Stone Jordan M , Doelman David S , Kenworthy Matthew A , Panwar Vatsal , Bohn Alexander J , Ertel Steve , Snik Frans , Woodward Charles E , Skemer Andrew J , Leisenring Jarron M , Strassmeier Klaus G , Charbonneau David
Published: January 2023

Clouds and other features in exoplanet and brown dwarf atmospheres cause variations in brightness as they rotate in and out of view. Ground-based instruments reach the high contrasts and small inner working angles needed to monitor these faint companions, but their small fields of view lack simultaneous photometric references to correct for non-astrophysical variations. We present a novel approach for making ground-based light curves of directly imaged companions using high-cadence differential spectrophotometric monitoring, where the simultaneous reference is provided by a double-grating 360○ vector Apodizing Phase Plate (dgvAPP360) coronagraph. The dgvAPP360 enables high-contrast companion detections without blocking the host star, allowing it to be used as a simultaneous reference. To further reduce systematic noise, we emulate exoplanet transmission spectroscopy, where the light is spectrally dispersed and then recombined into white-light flux. We do this by combining the dgvAPP360 with the infrared Arizona Lenslets for Exoplanet Spectroscopy integral field spectrograph on the Large Binocular Telescope Interferometer. To demonstrate, we observed the red companion HD 1160 B (separation ∼780 mas) for one night, and detect $8.8{{\ \rm per\ cent}}$ semi-amplitude sinusoidal variability with an ∼3.24 h period in its detrended white-light curve. We achieve the greatest precision in ground-based high-contrast imaging light curves of sub-arcsecond companions to date, reaching $3.7{{\ \rm per\ cent}}$ precision per 18-min bin. Individual wavelength channels spanning 3.59–3.99 μm further show tentative evidence of increasing variability with wavelength. We find no evidence yet of a systematic noise floor; hence, additional observations can further improve the precision. This is therefore a promising avenue for future work aiming to map storms or find transiting exomoons around giant exoplanets.
Self-regulation of black hole accretion via jets in early protogalaxies
Authors: Su Kung-Yi , Bryan Greg L , Haiman Zoltán , Somerville Rachel S , Hayward Christopher C , Faucher-Giguère Claude-André
Published: January 2023

The early growth of black holes (BHs) in high-redshift galaxies is likely feedback regulated. While radiative feedback has been extensively studied, the role of mechanical feedback has received less scrutiny to date. Here, we use high-resolution parsec-scale hydrodynamical simulations to study jet propagation and its effect on 100 M⊙ BH accretion in the dense, low-metallicity gas expected in early protogalaxies. As the jet propagates, it shocks the surrounding gas forming a jet cocoon. The cocoon consists of a rapidly cooling cold phase at the interface with the background gas and an overpressured subsonic phase of reverse shock-heated gas filling the interior. We vary the background gas density and temperature, BH feedback efficiency, and the jet model. We found that the width of the jet cocoon roughly follows a scaling derived by assuming momentum conservation in the jet-propagation direction and energy conservation in the lateral directions. Depending on the assumed gas and jet properties, the cocoon either stays elongated to large radii or isotropizes before reaching the Bondi radius, forming a nearly spherical bubble. Lower jet velocities and higher background gas densities result in self-regulation to higher momentum fluxes and elongated cocoons. In all cases, the outward cocoon momentum flux balances the inward inflowing gas momentum flux near the Bondi radius, which ultimately regulates BH accretion. The time-averaged accretion rate always remains below the Bondi rate, and exceeds the Eddington rate only if the ambient medium is dense and cold, and/or the jet is weak (low velocity and mass loading).
Observed and self-reported COVID-19 health protection behaviours on a university campus and the impact of a single simple intervention
Authors: Davies Rachel , Weinman John , Rubin G James
Published: January 2023

During the COVID-19 pandemic, most data on adherence to health protective behaviours were collected via a self-report. We quantified the discrepancy between self-report data and discretely observed behaviour in a sample of university staff and students. We assessed the prevalence of cleaning hands, wearing a face-covering and maintaining distance from others. We also tested whether additional signage reminding people that these behaviours were mandatory improved observed adherence. Prevalence estimates based on self-report were higher than those based on observations. Signage was associated with improvements for observed behaviours (all χ2 ≥ 6.0, P < 0.05). We caution that self-reported data can produce misleading adherence rates.
Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis
Authors: Kreuter Michael , Bonella Francesco , Blank Norbert , Riemekasten Gabriela , Müller-Ladner Ulf , Henes Jörg , Siegert Elise , Günther Claudia , Kötter Ina , Pfeiffer Christiane , Schmalzing Marc , Zeidler Gabriele , Korsten Peter , Susok Laura , Juche Aaron , Worm Margitta , Jandova Ilona , Ehrchen Jan , Sunderkötter Cord , Keyßer Gernot , Ramming Andreas , Schmeiser Tim , Kreuter Alexander , Kuhr Kathrin , Lorenz Hanns-Martin , Moinzadeh Pia , Hunzelmann Nicolas
Published: January 2023

Objectives

Gastroesophageal reflux disease (GERD) occurs frequently in patients with SSc. We investigated whether the presence of GERD and/or the use of anti-acid therapy, specifically proton-pump inhibitors (PPIs), are associated with long-term outcomes, especially in SSc-associated interstitial lung disease (SSc-ILD).

Methods

We retrospectively analysed patients with SSc and SSc-ILD from the German Network for Systemic Sclerosis (DNSS) database (2003 onwards). Kaplan–Meier analysis compared overall survival (OS) and progression-free survival (PFS) in patients with GERD vs without GERD (SSc and SSc-ILD), and PPI vs no PPI use (SSc-ILD only). Progression was defined as a decrease in either percentage predicted forced vital capacity of ≥10% or single-breath diffusing capacity for carbon monoxide of ≥15%, or death.

Results

It was found that 2693/4306 (63%) registered patients with SSc and 1204/1931 (62%) with SSc-ILD had GERD. GERD was not associated with decreased OS or decreased PFS in patients in either cohort. In SSc-ILD, PPI use was associated with improved OS vs no PPI use after 1 year [98.4% (95% CI: 97.6, 99.3); n = 760 vs 90.8% (87.9–93.8); n = 290] and after 5 years [91.4% (89.2–93.8); n = 357 vs 70.9% (65.2–77.1); n = 106; P < 0.0001]. PPI use was also associated with improved PFS vs no PPI use after 1 year [95.9% (94.6–97.3); n = 745 vs 86.4% (82.9–90.1); n = 278] and after 5 years [66.8% (63.0–70.8); n = 286 vs 45.9% (39.6–53.2); n = 69; P < 0.0001].

Conclusion

GERD had no effect on survival in SSc or SSc-ILD. PPIs improved survival in patients with SSc-ILD. Controlled, prospective trials are needed to confirm this finding.
Relationalvsrepresentational social cognitive processing: a coordinate-based meta-analysis of neuroimaging data
Authors: Arioli Maria , Cattaneo Zaira , Parimbelli Simone , Canessa Nicola
Published: January 2023

The neurocognitive bases of social cognition have been framed in terms of representing others’ actions through the mirror system and their mental states via the mentalizing network. Alongside representing another person’s actions or mental states, however, social cognitive processing is also shaped by their (mis)match with one’s own corresponding states. Here, we addressed the distinction between representing others’ states through the action observation or mentalizing networks (i.e. representational processing) and detecting the extent to which such states align with one’s own ones (i.e. relational processing, mediated by social conflict). We took a meta-analytic approach to unveil the neural bases of both relational and representational processing by focusing on previously reported brain activations from functional magnetic resonance imaging studies using false-belief and action observation tasks. Our findings suggest that relational processing for belief and action states involves, respectively, the left and right temporo-parietal junction, likely contributing to self-other differentiation. Moreover, distinct sectors of the posterior fronto-medial cortex support social conflict processing for belief and action, possibly through the inhibition of conflictual representations. These data might pave the way for further studies addressing social conflict as an important component of normal and pathological processing, and inform the design of rehabilitative treatments for social deficits.
Transcriptome analysis highlights the role of ferroptosis in palmitic acid–induced endothelial dysfunction
Authors: Tan Xiao-Hui , Gu Yang-Yang , Song Wen-Peng , Nan Tie-Gui , Song Wei-Dong , Fang Dong , Yuan Yi-Ming , Xin Zhong-Cheng , Li Xue-Song , Guan Rui-Li
Published: January 2023

Background

Palmitic acid (PA) has a lipotoxic effect on blood vessels, leading to endothelial dysfunction and cell death. The underlying mechanisms are not yet fully understood.

Aim

We sought to investigate the effects of PA on endothelial cells, with an emphasis on ferroptosis.

Methods

Rat corpus cavernosum endothelial cells (RCCECs) and human umbilical vein endothelial cells (HUVECs) were treated with PA to induce a pattern of cell death, as evidenced by the evaluation of cell viability. The differentially expressed genes were measured via RNA sequencing to reveal potential mechanisms. The intracellular levels of glutathione (GSH), malondialdehyde (MDA), ferrous ion (Fe2+), and reactive oxygen species (ROS) were evaluated using commercial kits. Western blot was performed to determine the expressions of relative proteins.

Outcomes

At the end of the study period, the evaluated outcomes were cell viability, transcriptome profiles, the expressions of glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11), as well as levels of GSH, MDA, Fe2+, and ROS.

Results

PA-induced cell death of RCCECs and HUVECs was demonstrated in a dose- and time-dependent manner. Based on the findings of RNA-sequencing (RNA-seq), enrichment of many biological processes associated with cell cycle and response to stimulus occurred. More importantly, ferroptosis was highlighted in the bioinformatic analysis of both endothelial cells. The levels of intracellular Fe2+, MDA, and ROS were significantly increased following PA exposure while GSH was decreased, suggesting excessive iron accumulation, development of lipid peroxidation, and imbalanced redox homeostasis. Mechanistically, PA decreased the protein expression levels of GPX4 and SLC7A11 in endothelial cells, both of which played crucial roles in ferroptotic cell death.

Clinical Translation

This study suggests that ferroptosis may be a useful target for novel therapeutic interventions for endothelial dysfunction and cell death in vascular diseases such as erectile dysfunction.

Strengths and Limitations

In this study, we found that ferroptosis could participate in PA-induced endothelial dysfunction and cell death. A limitation of the study is that it did not shed light on the overall mechanisms of this process. Therefore, further research on the intricate networks of regulating ferroptosis is needed.

Conclusion

Overall, the occurrence of ferroptosis was demonstrated in the PA-treated HUVECs and RCCECs in this study.
PERCLOS-based technologies for detecting drowsiness: current evidence and future directions
Authors: Abe Takashi
Published: January 2023

Drowsiness associated with sleep loss and circadian misalignment is a risk factor for accidents and human error. The percentage of time that the eyes are more than 80% closed (PERCLOS) is one of the most validated indices used for the passive detection of drowsiness, which is increased with sleep deprivation, after partial sleep restriction, at nighttime, and by other drowsiness manipulations during vigilance tests, simulated driving, and on-road driving. However, some cases have been reported wherein PERCLOS was not affected by drowsiness manipulations, such as in moderate drowsiness conditions, in older adults, and during aviation-related tasks. Additionally, although PERCLOS is one of the most sensitive indices for detecting drowsiness-related performance impairments during the psychomotor vigilance test or behavioral maintenance of wakefulness test, no single index is currently available as an optimal marker for detecting drowsiness during driving or other real-world situations. Based on the current published evidence, this narrative review suggests that future studies should focus on: (1) standardization to minimize differences in the definition of PERCLOS between studies; (2) extensive validation using a single device that utilizes PERCLOS-based technology; (3) development and validation of technologies that integrate PERCLOS with other behavioral and/or physiological indices, because PERCLOS alone may not be sufficiently sensitive for detecting drowsiness caused by factors other than falling asleep, such as inattention or distraction; and (4) further validation studies and field trials targeting sleep disorders and trials in real-world environments. Through such studies, PERCLOS-based technology may contribute to preventing drowsiness-related accidents and human error.
Effects of partially replacing dietary corn with sugars in a dual-flow continuous culture system on the ruminal microbiome
Authors: Ravelo Anay D , Arce-Cordero Jose A , Lobo Richard R , Liu Ting , Jeong Kwang C , Faciola Antonio
Published: January 2023

The objective of this study was to evaluate the effects of feeding sugars as a replacement for starch on the ruminal microbiome using a dual-flow continuous culture system. Four periods of 10 days each were conducted with 8 fermenters in a 4 × 4 replicated Latin square design. Treatments included: 1) control with corn—CON, 2) molasses—MOL, 3) untreated condensed whey permeate—CWP, and 4) CWP treated with a caustic agent—TCWP as a partial substitute for corn. Sugars were defined as the water-soluble carbohydrates (WSC) concentration. Diets were formulated by replacing 4% of the diet DM in the form of starch from corn with the sugars in byproducts. Microbial samples for DNA analysis were collected from the solid and liquid effluent containers at 3, 6, and 9 h after feeding. Bacterial community composition was analyzed with sequencing the V4 region of the 16S rRNA gene using Illumina MiSeq platform. Data were analyzed with R 4.1.3 packages vegan, lmer, and ggplot to determine the effects of treatment on the relative abundance of taxa in the solid and liquid fractions, as well as the correlation of Acetate: Propionate ratio and pH to taxa relative abundance. Treatments did not affect alpha or beta diversity. At the phylum level the relative abundance of Proteobacteria was increased in CON compared to sugars in the solid fraction. In the liquid fraction, Firmicutes had greater relative abundance in sugar treatments while Bacteroidota and Spirochaetota were present in lower relative abundance in CWP. For solid and liquid samples, the family Lachnospiraceae had greater relative abundance in sugar treatments compared to CON. The decreased relative abundance of Christensenellaceae and Rikenellaceae paired with the greater relative abundance of Selenomonadaceae in CWP could help explain greater propionate molar proportion and decreased ruminal pH previously observed for this treatment. The genera Olsenella a lactic acid-producing bacterium, had the greatest relative abundance in MOL. Incorporating TCWP or MOL as a partial replacement for starch was more conservative of fibrolytic bacterial taxa compared to CWP. Additionally, TCWP did not increase bacterial taxa associated with synthesis of lactate as compared to MOL. Overall, replacing starch with sugars is mostly conservative of the ruminal microbiome; however, changes observed coincide with differences observed in acetate and propionate proportions and ruminal pH.
Short Implicit Voice Training Affects Listening Effort During a Voice Cue Sensitivity Task With Vocoder-Degraded Speech
Authors: Biçer Ada , Koelewijn Thomas , Başkent Deniz
Published: January 2023

Objectives:

Understanding speech in real life can be challenging and effortful, such as in multiple-talker listening conditions. Fundamental frequency (f

o
) and vocal-tract length (vtl) voice cues can help listeners segregate between talkers, enhancing speech perception in adverse listening conditions. Previous research showed lower sensitivity to f

o
and vtl voice cues when speech signal was degraded, such as in cochlear implant hearing and vocoder-listening compared to normal hearing, likely contributing to difficulties in understanding speech in adverse listening. Nevertheless, when multiple talkers are present, familiarity with a talker’s voice, via training or exposure, could provide a speech intelligibility benefit. In this study, the objective was to assess how an implicit short-term voice training could affect perceptual discrimination of voice cues (f

o

+vtl), measured in sensitivity and listening effort, with or without vocoder degradations.

Design:

Voice training was provided via listening to a recording of a book segment for approximately 30 min, and answering text-related questions, to ensure engagement. Just-noticeable differences (JNDs) for f

o

+vtl were measured with an odd-one-out task implemented as a 3-alternative forced-choice adaptive paradigm, while simultaneously collecting pupil data. The reference voice either belonged to the trained voice or an untrained voice. Effects of voice training (trained and untrained voice), vocoding (non-vocoded and vocoded), and item variability (fixed or variable consonant-vowel triplets presented across three items) on voice cue sensitivity (f

o

+vtl JNDs) and listening effort (pupillometry measurements) were analyzed.

Results:

Results showed that voice training did not have a significant effect on voice cue discrimination. As expected, f

o

+vtl JNDs were significantly larger for vocoded conditions than for non-vocoded conditions and with variable item presentations than fixed item presentations. Generalized additive mixed models analysis of pupil dilation over the time course of stimulus presentation showed that pupil dilation was significantly larger during f

o

+vtl discrimination while listening to untrained voices compared to trained voices, but only for vocoder-degraded speech. Peak pupil dilation was significantly larger for vocoded conditions compared to non-vocoded conditions and variable items increased the pupil baseline relative to fixed items, which could suggest a higher anticipated task difficulty.

Conclusions:

In this study, even though short voice training did not lead to improved sensitivity to small f

o

+vtl voice cue differences at the discrimination threshold level, voice training still resulted in reduced listening effort for discrimination among vocoded voice cues.
Geriatric Patients Presenting With Isolated Pubic Rami Fractures and Inability to Mobilize May Have Occult Lateral Compression Pelvic Ring Injuries With Dynamic Instability
Authors: Tucker Nicholas J. , Scott Bryan , Mauffrey Cyril , Parry Joshua A.
Published: January 2023

Objectives:

To determine the incidence of patients with isolated pubic rami fractures on computed tomography scans who have dynamic instability secondary to occult lateral compression pelvic ring injuries.

Design:

Retrospective comparison study.

Setting:

Urban level 1 trauma center.

Patients/Participants:

This study included geriatric patients with isolated pubic rami fractures and inability to mobilize secondary to pain.

Intervention:

Lateral stress radiographs of pelvis to evaluate for ≥1 cm dynamic instability.

Main Outcome Measurements:

Physical therapy clearance, hospital length of stay, and discharge location.

Results:

A total of 19 patients were identified over 12 months. Patients were predominantly geriatric (median age: 75 years, interquartile range: 67 to 90), woman (11/19), with unilateral (17/19) comminuted distal rami fractures (12/19) sustained in ground-level falls (12/19). Dynamic instability was identified in 42% of patients (8/19). Magnetic resonance imaging, obtained in 6 of these patients, demonstrated occult posterior ring fractures in all cases. Patients with dynamic instability were more likely to have comminuted distal rami fractures (Nakatani type 1b) and a longer hospital length of stay. There was also a trend for these patients to be unable to clear physical therapy by discharge (63% (5/8) versus 36% (4/11)). The 90-day mortality rate of the cohort was 16% (3/19).

Conclusions:

Patients presenting with seemingly isolated pubic rami fractures on radiographs and computed tomography scans who are unable to mobilize may have occult lateral compression injuries with dynamic instability.

Level of Evidence:

Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Return to Driving Is Safe 6 Weeks After Anterior Cervical Surgery for Symptomatic Cervical Degenerative Disc Disease
Authors: Ding Benjamin Tze Keong , Chan Mei Leng , Yu Chun Sing , Oh Jacob Yoong-Leong
Published: January 2023

Study Design:

Prospective Cohort Study.

Objectives:

This study aims to determine the timing and clinical parameters for a safe return to driving.

Summary of Background Date:

Returning to driving after cervical spine surgery remains a controversial topic, with no clear consensus on how to best assess a patient’s fitness to drive. Previous studies using brake reaction time or subjective questionnaires recommend a return to driving 6 weeks after surgery.

Methods:

Patients above 18 years of age who underwent anterior cervical spine surgery for symptomatic cervical degenerative disk disease and possessed a valid motorcar driving license were recruited from 2018 to 2020. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) scores, range of motion, and functional strength of the cervical spine were collected preoperatively and at 2-, 4-, 6- and 12 weeks postsurgery. Patients underwent a standard functional driving assessment protocol at the institution to determine their fitness to drive. This comprised of a clinic-based off-road screening tests and on-road driving test in a real-world environment.

Results:

Twenty-one patients were recruited. The mean age was 56.6±8.9 years. Eighty-one percent of the patients passed the on-road driving assessment at 6 weeks. Patients who passed the driving assessment had lower mean NDI scores, 3.4±3.1 versus 10.8±8.0 (P=0.006), and higher mean mJOA scores 16.1±0.6 versus 15.0±1.8 (P=0.045). Patients who passed the driving assessment also had higher functional cervical flexor strength, 21.1s±5.8s versus 13.0s±10.2s (P=0.042) in a supine position but not correlated with a range of motion of the spine in all directions.

Conclusion:

Most patients undergoing single or dual-level anterior cervical surgery for symptomatic cervical degenerative disk disease demonstrate the ability to pass a standardized driving assessment and are safe to return to driving more than 6 weeks after surgery. Driving ability appears to be correlated with NDI scores ≤3 (P=0.006), mJOA scores ≥16 (P=0.045), and cervical flexion endurance of ≥21s (P=0.042).

Level of Evidence:

Level II.
Physical activity and exercise for hot flashes: trigger or treatment?
Authors: Witkowski Sarah , Evard Rose , Rickson Jacquelyn J. , White Quinn , Sievert Lynnette Leidy
Published: January 2023

Importance and Objective

Hot flashes (HFs) are a prevalent feature of menopause. Hot flashes can be bothersome and affect quality of life. However, HFs have also been associated with the risk for cardiovascular disease. Therefore, providing current evidence on the effect of therapies to reduce HFs can help patients and providers with decision making. This review provides details on the scientific evidence to date related to the effect of physical activity (PA) and exercise to alter the HF experience in women.

Methods

The PubMed database was searched between June 2020 and June 2022 for currently available evidence regarding the relation between PA and exercise and HFs. Our analysis included randomized control trials on exercise training, epidemiological studies, and studies evaluating acute exercise on the self-reported and objectively measured HF experience in addition to systematic reviews on the topic published as of June 2022.

Discussion and Conclusions

The majority of evidence from randomized control trials indicates that aerobic and resistance exercise training lead to a decrease in subjectively experienced HFs. The limited available studies on acute exercise indicate that a bout of moderate-intensity exercise may decrease objectively measured and self-reported HFs but acute increases in PA intensity above accustomed levels may influence subjective HF experience. Some evidence suggests that for those with depression, habitual PA may be an effective way to reduce HF symptoms. Weighing the available evidence, for people who experience HFs, engaging in regular moderate-intensity PA, including aerobic and resistance exercise, may be an effective therapy to reduce HFs and women should be counseled on the benefits of regular, moderate exercise. However, significant gaps in knowledge remain about the optimal exercise prescription, effectiveness for a diverse population, meaning of differences between objective and subjective experience, and mechanisms that lead to changes in HFs.
Priorities for alleviating menopausal symptoms after cancer
Authors: Lan Qinying , Hickey Martha , Peate Michelle , Marino Jennifer L.
Published: January 2023

Objective

To determine treatment priorities in women cancer patients attending a dedicated Menopausal Symptoms After Cancer service.

Methods

Cancer type and stage were abstracted from medical records. Women ranked up to three symptoms as treatment priorities from the list “hot flushes/night sweats,” “mood changes,” “vaginal dryness or soreness,” “sleep disturbances,” “feeling tired or worn out (fatigue),” “sexual problems and/or pain with intercourse,” “joint pain,” and “something else” with free-text response. For each prioritized symptom, patients completed standardized patient-reported outcome measures to determine symptom severity and impact.

Results

Of 189 patients, most had breast cancer (48.7%, n = 92), followed by hematological (25.8%, n = 49), gynecological (18.0%, n = 34), or colorectal (2.6%, n = 5). The highest (first-ranked) treatment priority was vasomotor symptoms (33.9%, n = 64), followed by fatigue (18.0%, n = 34), vaginal dryness/soreness (9.5%, n = 18), and sexual problems/pain with intercourse (9.5%, n = 18). Symptoms most often selected in the top three (“prioritized”) were fatigue (57.7%, n = 109), vasomotor symptoms (57.1%, n = 108), and sleep disturbance (49.2%, n = 93). In patients who prioritized vasomotor symptoms, medians on the “problem,” “distress,” and “interference” dimensions of the Hot Flash Related Daily Interference Scale were, respectively, 6.0 (interquartile range [IQR], 5.0-8.0), 5.5 (IQR, 3.0-8.0), and 5.0 (IQR, 3.-7.0), indicating moderate severity. In patients who prioritized fatigue, the median Fatigue Scale score was 28 (IQR, 19-36), 37% worse than general population.

Conclusions

Vasomotor symptoms, fatigue, sexual problems, and vaginal dryness/soreness were the leading priorities for treatment. Understanding symptom severity and patient priorities will inform better care for this growing population.
PEELED INTERNAL LIMITING MEMBRANE REPOSITION FOR IDIOPATHIC MACULAR HOLES
Authors: Tian Tian , Tan Hongsheng , Zhu Xiuyu , Zhang Xiang , Zhao Peiquan
Published: January 2023

Purpose:

To compare the functional and anatomical outcomes of peeled internal limiting membrane reposition and traditional internal limiting membrane peeling for the treatment of idiopathic macular hole.

Methods:

This is a randomized, single-center, and double-blinded, pilot, controlled trial.

Results:

Of the 30 patients enrolled, 27 (13 in Group 1 and 14 in Group 2) were included in the primary analysis (22 women [81.5%]; mean [SD] age, 61.7 [6.8] years). The BCVA was 0.23 ± 0.18 logMAR in the reposition group and 0.44 ± 0.24 logMAR in the peeling group at 6 months postoperatively (P = 0.02). The primary MH closure rate is 86.7% in the reposition group and 93.3% in the peeling group (P = 0.60). The range of the inner retinal dimpling was significantly lower in the reposition group at 6 months postoperatively (P < 0.0001). The thickness of the full parafovea (P = 0.0092), inner parafovea (P = 0.0007), inner perifovea (P = 0.0044), and outer fovea (P = 0.0392) was significantly greater in the reposition group than that in the peeling group at 6 months postoperatively. The sensitivity threshold and mfERG P1 wave amplitude density in rings one, four, and five were higher in the reposition group than in the peeling group at 6 months postoperatively.

Conclusion:

Our findings suggest that the novel technique of peeled internal limiting membrane reposition has advantages over the traditional internal limiting membrane peeling in better microstructural outcomes of inner retina and functional recoveries. Furthermore, larger RCT studies are warranted.