bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 186: Repair of the Distal Biceps Tendon: A Systematic Review & Network Meta-Analysis of Biomechanical Performance
Authors: Lavoie-Gagne Ophelie , Parvaresh Kevin , Agarwalla Avinesh , Forsythe Brian , Forlenza Enrico
Published: July 2022

Objectives:

Rupture of the distal biceps is common and demonstrates excellent short- and long-term clinical outcomes following surgical repair. Prior studies have individually evaluated the biomechanical construct strength of multiple fixation devices, but none has comprehensively evaluated constructs in a head-to-head comparison. We sought to compare the failure strength, maximum strength, stiffness and displacement of available constructs for distal biceps repair.

Methods:

A network meta-analysis was conducted to determine the relative performance of 2 all-suture suture anchors, 2 intramedullary cortical buttons, 2 suture anchors, extramedullary cortical buttons, extramedullary cortical button plus interference screw, interference screw, single intramedullary cortical button, single suture anchor, trans-osseous suture, tension slide technique and tension slide technique plus suture tape. Analysis consisted of arm-based network meta-analysis under Bayesian random-effects model with Markov Chain Monte Carlo (MCMC) sampling. Geometry of the network was represented visually via a network plot with nodes representing treatments and edges representing direct comparative evidence. Biomechanical outcomes of fixation techniques were summarized as treatment effects and their corresponding 95% confidence intervals (CI). Rank probabilities were calculated and used to generate each treatment’s surface under the cumulative ranking (SUCRA) curve.

Results:

A total of 21 studies were included in the network meta-analysis. For failure strength, the two intramedullary cortical buttons ranked highest (92.73%). For maximum strength, the extramedullary cortical button alone (86.96%) and extramedullary button plus interference screw (83.40%) ranked highest. The two intramedullary cortical buttons ranked highest in stiffness (98.75%), followed by the extramedullary cortical button with interference screw (88.75%) and extramedullary cortical button (75.00%). Finally, with respect to demonstrating the least displacement after loading, the two suture anchors (89.43%) ranked highest, followed by tension slide technique with suture tape (73.14%) and extramedullary cortical button (72.71%).

Conclusions:

The fixation constructs that demonstrated the greatest overall biomechanical performance in distal biceps tendon repair were the extramedullary cortical button and two intramedullary cortical buttons. Two suture anchors demonstrated the least displacement after loading. [Figure: see text][Figure: see text][Figure: see text]
Poster 187: The Effect of Elbow Varus Torque on Medial Epicondyle in Little League Pitchers
Authors: Kida Yoshikazu , Kobayashi Yusuke , Sukenari Tsuyoshi , Minami Masataka , Kotoura Yoshihiro , Takahashi Kenji , Takatsuji Kenta
Published: July 2022

Objectives:

In baseball players, elbow varus torque is associated with the risk of medial elbow injuries. However, the effect of elbow varus torque on medial epicondyle deformity among youth baseball players has not yet been clarified. To clarify the relationship between elbow varus torque and medial epicondyle abnormality in little league pitchers.

Methods:

The participants consisted of 173 little league pitchers (mean age, 10.6±0.6 years; range, 10-12 years). The pitchers were instructed to throw a ball into a netting target at maximum effort three times. A sensor placed at the medial elbow reported elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. The medial epicondyle of each player was evaluated using ultrasound imaging (Figure 1). A questionnaire was used to investigate the background (age, height, weight) and the past or present elbow pain. The average of elbow varus torque was calculated. Players were divided into high-torque group and low-torque group depending on whether the torque is higher or lower than average elbow varus torque. The relationship between elbow varus torque and the presence of ultrasound abnormality and elbow symptom was statistically analyzed among two groups.

Results:

A medial epicondyle deformity was observed in 85 players (49%). The results of this study showed that height (146.8±6.6 cm vs. 138.9±5.9 cm), weight (39.5±7.1 kg vs. 32.4±4.8 kg), and ball velocity (72.7±7.5 km/h vs. 67.6±6.8 km/h) were significantly higher in the high torque group than in the lower torque group (P<.001), while arm slot (48.6±12.4 degrees vs. 54.9±14.4 degrees) was significantly lower in the high torque group (P<.05) (Table 1). The rate of players who experienced past elbow pain was significantly higher in the high-velocity group (P<.05), while there were no significant differences in the rate of present pain among the two groups (Table 2). The rate of medial epicondyle abnormality was significantly higher in the high-torque group than in the low-torque group (chi-square test; P<.05) (Figure 2).

Conclusions:

In this study, a medial epicondyle deformity and past elbow pain were significantly higher in the high torque group. High elbow varus torque would increase the risk of medial elbow disorder. [Table: see text][Table: see text][Figure: see text][Figure: see text]
Poster 236: There is No Difference in Early Functional Outcomes for Patients Undergoing Tele-Rehabilitation versus Standard in Office Rehab after Arthroscopic Meniscectomy: A Randomized Controlled Trial
Authors: Hurley Eoghan , Vasavada Kinjal , Lin Charles , Gonzalez-Lomas Guillem , Alaia Michael , Strauss Eric , Jazrawi Laith , Campbell Kirk , Mojica Edward
Published: July 2022

Objectives:

While a growing body of evidence has demonstrated that tele-rehabilitation is effective, the functional outcomes of patients undergoing tele-rehabilitation as compared to in-person rehabilitation after arthroscopic meniscectomy remains unclear. This is especially salient against the backdrop of COVID-19 and the Delta variant and the subsequent increased demand for remote care of these patients.

Methods:

A randomized-controlled trial was conducted including patients scheduled to undergo arthroscopic meniscectomy for meniscal injury by one of five fellowship trained sports medicine surgeons between August 2020 and May 2021. Patients were randomized to receive tele-rehabilitation, defined as exercises and stretches provided by trained physical therapists over a synchronous face-to-face video visit, or in-person rehabilitation for their post-operative course. International Knee Documentation Committee Subjective Knee Form (IKDC) score and Visual Analogue Scale (VAS) score were collected at timepoints of baseline, 3 months, 6 months, and 12 months post-operatively. Statistical analysis was conducted using Student T-test to assess for differences across the two groups.

Results:

An interim analysis was conducted on 60 patients with 6 month follow-up outcomes. There were no significant differences in VAS scores between groups at baseline (p =0.716) and 3 months postoperatively (p = 0.700). and 6 months postoperatively (p = 0.688). In addition, no significant differences in IKDC scores were seen between the groups at baseline (p = 0.146) and 3 months (p = 0.746). At 6 months, 24 patients were available with no significant differences observed across groups at this time point (IKDC; p = 0.633) (VAS; p = 0.688).

Conclusions:

Tele-rehabilitation is demonstrated to be as efficacious as traditional in-person rehabilitation following arthroscopic meniscectomy at up to 6 months post-op. This serves as a convenient and safe alternative for conventional patients during their post-operative course.
Poster 238: No Difference in Clinical Outcomes between Operative and Nonoperative Management of Minimally Retracted Proximal Hamstring Ruptures: A Matched Cohort Study
Authors: Kanakamedala Ajay , Rynecki Nicole , Markus Danielle , Song Melissa , Gonzalez-Lomas Guillem , Strauss Eric , Youm Thomas , Jazrawi Laith , Mojica Edward
Published: July 2022

Objectives:

The optimal treatment protocol for proximal hamstring ruptures, particularly when involving less than 3 cm of retraction, is not known. The purpose of this study was to compare patient-reported outcomes (PROs) between patients who underwent operative or non-operative management of proximal hamstring ruptures.

Methods:

A retrospective review of the electronic medical record identified all patients who were treated operatively or non-operatively for a proximal hamstring rupture from 2013 to 2020. Patients were stratified into two groups which were matched based on demographics including age, gender, BMI, chronicity of the injury, tendon retraction, and injury grade (complete, or three tendons, versus partial, or one or two tendons). All patients completed a battery of PROs including the Perth Hamstring Assessment Tool (PHAT), Modified Harris Hip Score (MHHS), Visual Analogue Scale for pain (VAS), and the Tegner Activity Scale. Patients from the non-surgical group were then case-matched in 2:1 fashion to their surgical counterparts.

Results:

Overall, 113 patients met inclusion criteria and were available for follow-up. Of the 113, 59 (52.2%) underwent primary hamstring tendon repair and 54 (47.8%) patients underwent non-operative treatment consisting of physical therapy. These 54 patients were case-matched to 28 surgically managed patients. When controlling for patient demographics, there were no differences in patient reported outcomes between non-operative and operative treatment of proximal hamstring in any validated outcome indicator (p > 0.05). Chronicity of the injury and older age correlated significantly to worse outcomes in both groups (p < 0.05).

Conclusions:

In patients with proximal hamstring ruptures with <3 cm of retraction, there was no difference in PRO scores between matched cohorts of operatively and non-operatively treated proximal hamstring avulsions
Poster 253: Anterior Cruciate Ligament Reconstruction in 118 Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 5 years Mean Follow Up
Authors: Song Bryant , Wasserburger Jory , Till Sara , Camp Christopher , Levy Bruce , Stuart Michael , Okoroha Kelechi , Krych Aaron , Marigi Erick
Published: July 2022

Objectives:Introduction:

Wrestling is a physically demanding sport with young athletes prone to anterior cruciate ligament (ACL) injuries. However, there is a paucity of data evaluating the results of ACL reconstruction (ACLR) in this cohort.

Purpose:

To assess patient-reported outcomes, reoperation rates, graft survival, and return to play (RTP) following ACLR in a large cohort of competitive wrestlers

Methods:

All competitive wrestlers (high school, collegiate, or professional) with a history of an ACLR at a single institution between 2000 and 2019 were retrospectively identified. Graft failure was defined as a re-tear determined by clinical or advanced imaging evaluation, and/or revision ACL reconstruction. All patients were contacted for determination of reinjury rates, current sport status, visual analog scale (VAS), International Knee Documentation Committee (IKDC) and Tegner activity scores.

Results:

118 knees in 114 wrestlers were included at a median follow-up time of 5.8 years (IQR: 3.6 – 10.3). The median age was 17 years (15 – 18) with 116 (98%) males. ACLR was most often performed with bone-patellar tendon-bone (BTB) autograft (n = 64; 54%) or hamstring tendon (HT) autograft (n = 43; 36%). At final follow-up, 80% of athletes were able to RTP at a median of 273 days (IQR: 203 – 379). Graft failure occurred in 17 (14%) patients at a median time of 1.4 years (IQR: 0.8 – 4.7) after the index ACLR. BTB autograft demonstrated a lower failure rate compared to HT autograft (8% vs. 21%; P = 0.044). Kaplan-Meier survivorship free from graft failure for the entire cohort was 95.3% at 1 year, 92.5% at 2 years, 89.8% at 5 years, 84.6 at 10 years, 77.6 at 20 years. BTB autograft was associated with better survival than HT autograft up to 15 years after the index ACLR (90.4% vs. 76.3%; P = 0.030).

Conclusions:

Return to competitive wrestling was observed in 80% of athletes after ACLR, with 14% of wrestlers experiencing graft failure. BTB autograft reconstruction may serve as a more durable graft for competitive wrestlers with lower rates of failure when compared to HT autograft even up to 15 years after surgery. [Table: see text][Figure: see text][Figure: see text][Figure: see text]
An Assessment of Cultural and Linguistic Competence in Public Health Preparation Programs
Authors: Luquis Raffy , Perez Miguel A. , Suarez Steve
Published: July 2022

Demographic estimates suggest that as the population continues to grow and age in the coming decades, the United States of America will continue to become a more diverse society. The increased diversification of the population makes it urgent for public health professionals, including health education specialists, to master the concepts of cultural and linguistic competence during their academic preparation to be more applied in their professional work. The purpose of this study was to investigate the incorporation of concepts of cultural and linguistic competence in the curriculum among accredited public health schools and programs and other health education and promotion programs to prepare public health education specialists. Point of contact at selected 2021 Council on Education for Public Health list of accredited Schools and Programs of Public Health and an online directory of Health Education and Promotion programs were surveyed. Descriptive statistics were calculated to examine the responses of the participants. While most of the programs reported including cultural competence content and skills in their curriculum, fewer reported inclusion of linguistic competence. Academic programs should prioritize incorporating cultural and linguistic competence in their curriculum not only because of accreditation requirements but because of the moral and professional imperatives presented by the changing demographic changes in the United States.
Immunomodulation and endothelial barrier protection mediate the association between oral imatinib and mortality in hospitalised COVID-19 patients
Authors: de Brabander Justin , Duijvelaar Erik , Schippers Job R. , Smeele Patrick J. , Peters-Sengers Hessel , Duitman Jan Willem , Aman Jurjan , Bogaard Harm Jan , van der Poll Tom , Bos Lieuwe D.J.
Published: July 2022

Background

Imatinib reduced 90-day mortality in hospitalised coronavirus disease 2019 (COVID-19) patients in a recent clinical trial, but the biological effects that cause improved clinical outcomes are unknown. We aimed to determine the biological changes elicited by imatinib in patients with COVID-19 and what baseline biological profile moderates the effect of imatinib.

Methods

We undertook a secondary analysis of a randomised, double-blind, placebo-controlled trial of oral imatinib in hospitalised, hypoxaemic COVID-19 patients. Mediating effects of changes in plasma concentration of 25 plasma host response biomarkers on the association between randomisation group and 90-day mortality were studied by combining linear mixed effect modelling and joint modelling. Moderation of baseline biomarker concentrations was evaluated by Cox regression modelling. We identified subphenotypes using Ward's method clustering and evaluated moderation of these subphenotypes using the aforementioned method.

Results

332 out of 385 participants had plasma samples available. Imatinib increased the concentration of surfactant protein D (SP-D), and decreased the concentration of interleukin-6, procalcitonin, angiopoietin (Ang)-2/Ang-1 ratio, E-selectin, tumour necrosis factor (TNF)-α, and TNF receptor I. The effect of imatinib on 90-day mortality was fully mediated by changes in these biomarkers. Cluster analysis revealed three host response subphenotypes. Mortality benefit of imatinib was only present in the subphenotype characterised by alveolar epithelial injury indicated by increased SP-D levels in the context of systemic inflammation and endothelial dysfunction (hazard ratio 0.30, 95% CI 0.10–0.92).

Conclusions

The effect of imatinib on mortality in hospitalised COVID-19 patients is mediated through modulation of innate immune responses and reversal of endothelial dysfunction, and possibly moderated by biological subphenotypes.
Detection of COPD in the SUMMIT Study lung cancer screening cohort using symptoms and spirometry
Authors: Tisi Sophie , Dickson Jennifer L. , Horst Carolyn , Quaife Samantha L. , Hall Helen , Verghese Priyam , Gyertson Kylie , Bowyer Vicky , Levermore Claire , Mullin Anne-Marie , Teague Jonathan , Farrelly Laura , Nair Arjun , Devaraj Anand , Hackshaw Allan ,   the SUMMIT Consortium, Hurst John R. , Janes Sam M.
Published: July 2022

Background

COPD is a major comorbidity in lung cancer screening (LCS) cohorts, with a high prevalence of undiagnosed COPD. Combining symptom assessment with spirometry in this setting may enable earlier diagnosis of clinically significant COPD and facilitate increased understanding of lung cancer risk in COPD. In this study, we wished to understand the prevalence, severity, clinical phenotype and lung cancer risk of individuals with symptomatic undiagnosed COPD in a LCS cohort.

Methods

16 010 current or former smokers aged 55–77 years attended a lung health check as part of the SUMMIT Study. A respiratory consultation and spirometry were performed alongside LCS eligibility assessment. Those with symptoms, no previous COPD diagnosis and airflow obstruction were labelled as undiagnosed COPD. Baseline low-dose computed tomography (LDCT) was performed in those at high risk of lung cancer (PLCOm2012score ≥1.3% and/or meeting USPSTF 2013 criteria).

Results

Nearly one in five (19.7%) met criteria for undiagnosed COPD. Compared with those previously diagnosed, those undiagnosed were more likely to be male (59.1%versus53.2%; p<0.001), currently smoking (54.9%versus47.6%; p<0.001) and from an ethnic minority group (p<0.001). Undiagnosed COPD was associated with less forced expiratory volume in 1 s impairment (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1 and 2: 85.3%versus68.4%; p<0.001) and lower symptom/exacerbation burden (GOLD A and B groups: 95.6%versus77.9%; p<0.001) than those with known COPD. Multivariate analysis demonstrated that airflow obstruction was an independent risk factor for lung cancer risk on baseline LDCT (adjusted OR 2.74, 95% CI 1.73–4.34; p<0.001), with a high risk seen in those with undiagnosed COPD (adjusted OR 2.79, 95% CI 1.67–4.64; p<0.001).

Conclusions

Targeted case-finding within LCS detects high rates of undiagnosed symptomatic COPD in those most at risk. Individuals with undiagnosed COPD are at high risk for lung cancer.
A pulmonologist's guide to perform and analyse cross-species single lung cell transcriptomics
Authors: Pennitz Peter , Kirsten Holger , Friedrich Vincent D. , Wyler Emanuel , Goekeri Cengiz , Obermayer Benedikt , Heinz Gitta A. , Mashreghi Mir-Farzin , Büttner Maren , Trimpert Jakob , Landthaler Markus , Suttorp Norbert , Hocke Andreas C. , Hippenstiel Stefan , Tönnies Mario , Scholz Markus , Kuebler Wolfgang M. , Witzenrath Martin , Hoenzke Katja , Nouailles Geraldine
Published: July 2022

Single-cell ribonucleic acid sequencing is becoming widely employed to study biological processes at a novel resolution depth. The ability to analyse transcriptomes of multiple heterogeneous cell types in parallel is especially valuable for cell-focused lung research where a variety of resident and recruited cells are essential for maintaining organ functionality. We compared the single-cell transcriptomes from publicly available and unpublished datasets of the lungs in six different species: human (Homo sapiens), African green monkey (Chlorocebus sabaeus), pig (Sus domesticus), hamster (Mesocricetus auratus), rat (Rattus norvegicus) and mouse (Mus musculus) by employing RNA velocity and intercellular communication based on ligand–receptor co-expression, among other techniques. Specifically, we demonstrated a workflow for interspecies data integration, applied a single unified gene nomenclature, performed cell-specific clustering and identified marker genes for each species. Overall, integrative approaches combining newly sequenced as well as publicly available datasets could help identify species-specific transcriptomic signatures in both healthy and diseased lung tissue and select appropriate models for future respiratory research.
Obstructive sleep apnoea-related respiratory events and desaturation severity are associated with the cardiac response
Authors: Hietakoste Salla , Karhu Tuomas , Sillanmäki Saara , Bailón Raquel , Penzel Thomas , Töyräs Juha , Leppänen Timo , Myllymaa Sami , Kainulainen Samu
Published: July 2022

Background

Obstructive sleep apnoea (OSA) causes, among other things, intermittent blood oxygen desaturations, increasing the sympathetic tone. Yet the effect of desaturations on heart rate variability (HRV), a simple and noninvasive method for assessing sympathovagal balance, has not been comprehensively studied. We aimed to study whether desaturation severity affects the immediate HRV.

Methods

We retrospectively analysed the electrocardiography signals in 5-min segments (n=39 132) recorded during clinical polysomnographies of 642 patients with suspected OSA. HRV parameters were calculated for each segment. The segments were pooled into severity groups based on the desaturation severity (i.e.the integrated area under the blood oxygen saturation curve) and the respiratory event rate within the segment. Covariate-adjusted regression analyses were performed to investigate possible confounding effects.

Results

With increasing respiratory event rate, the normalised high-frequency band power (HFNU) decreased from 0.517 to 0.364 (p<0.01), the normalised low-frequency band power (LFNU) increased from 0.483 to 0.636 (p<0.01) and the mean RR interval decreased from 915 to 869 ms (p<0.01). Similarly, with increasing desaturation severity, the HFNUdecreased from 0.499 to 0.364 (p<0.01), the LFNUincreased from 0.501 to 0.636 (p<0.01) and the mean RR interval decreased from 952 to 854 ms (p<0.01). Desaturation severity-related findings were confirmed by considering the confounding factors in the regression analyses.

Conclusion

The short-term HRV response differs based on the desaturation severity and the respiratory event rate in patients with suspected OSA. Therefore, a more detailed analysis of HRV and desaturation characteristics could enhance OSA severity estimation.
Artemisinin relieves osteoarthritis by activating mitochondrial autophagy through reducing TNFSF11 expression and inhibiting PI3K/AKT/mTOR signaling in cartilage
Authors: Li Jin , Jiang Mengqing , Yu Zhentang , Xiong Chenwei , Pan Jieen , Cai Zhenhai , Xu Nanwei , Zhou Xindie , Huang Yong , Yang Zhicheng
Published: July 2022

Osteoarthritis (OA) is a widespread chronic degenerative joint disease characterized by the degeneration of articular cartilage or inflamed joints. Our findings indicated that treatment with artemisinin (AT) downregulates the protein levels of MMP3, MMP13, and ADAMTS5, which are cartilage degradation-related proteins in OA, and inhibits the expression of inflammatory factors in interleukin-1β (IL-1β)-stimulated chondrocytes. However, the mechanism of the role of AT in OA remains unclear. Here, we performed gene sequencing and bioinformatics analysis in control, OA, and OA + AT groups to demonstrate that several mRNA candidates were enriched in the PI3K/AKT/mTOR signaling pathway, and TNFSF11 was significantly downregulated after AT treatment. TNFSF11 was downregulated in the OA + AT group, whereas it was upregulated in rat OA tissues and OA chondrocytes. Therefore, we confirmed that TNFSF11 was the target gene of AT. In addition, our study revealed that AT relieved cartilage degradation and defection by activating mitochondrial autophagy via inhibiting the PI3K/AKT/mTOR signaling pathway in IL-1β-induced chondrocytes. Furthermore, an OA model was established in rats with medial meniscus destabilization. Injecting AT into the knee joints of OA rat alleviated surgical resection-induced cartilage destruction. Thus, these findings revealed that AT relieves OA by activating mitochondrial autophagy by reducing TNFSF11 expression and inhibiting PI3K/AKT/mTOR signaling.
Homelessness and the use of Emergency Department as a source of healthcare: a systematic review
Authors: Vohra Neha , Paudyal Vibhu , Price Malcolm J.
Published: July 2022

Background

Persons experiencing homelessness (PEH) often use hospital Emergency Department (ED) as the only source of healthcare. The aim of this study was to undertake a systematic review to identify the prevalence, clinical reasons and outcomes in relation to ED visits by PEH.

Methods

A protocol-led (CRD42020189263) systematic review was conducted using search of MEDLINE, EMBASE, CINAHL and Google Scholar databases. Studies that reported either the prevalence of homelessness in the ED or clinical reasons for presentation to ED by PEH and published in English language were included. Definitions of homelessness used by study authors were accepted.

Results

From the screening of 1349 unique titles, a total of 36 studies were included. Wide variations in the prevalence and key cause of presentations were identified across the studies often linked to differences in country, study setting, disease classification and data collection methods. The proportion of ED visits contributed by PEH ranged from 0.41 to 19.6%. PEH made an average of 0.72 visits to 5.8 visits per person per year in the ED [rate ratio compared to non-homeless 1.63 to 18.75]. Up to a third and quarter of the visits were contributed by alcohol-related diagnoses and substance poisoning respectively. The percentage of PEH who died in the ED ranged from 0.1 to 0.5%.

Conclusions

Drug-, alcohol- and injury-related presentations dominate the ED visits by PEH. Wide variations in the data were observed in regard to attendance and treatment outcomes. There is a need for prevention actions in the community, integrated discharge and referral pathways between health, housing and social care to minimise frequent usage and improve attendance outcomes.
Duplex sequencing identifies genomic features that determine susceptibility to benzo(a)pyrene-induced in vivo mutations
Authors: LeBlanc Danielle P. M. , Meier Matthew , Lo Fang Yin , Schmidt Elizabeth , Valentine Charles , Williams Andrew , Salk Jesse J. , Yauk Carole L. , Marchetti Francesco
Published: July 2022

Exposure to environmental mutagens increases the risk of cancer and genetic disorders. We used Duplex Sequencing (DS), a high-accuracy error-corrected sequencing technology, to analyze mutation induction across twenty 2.4 kb intergenic and genic targets in the bone marrow of MutaMouse males exposed to benzo(a)pyrene (BaP), a widespread environmental pollutant. DS revealed a linear dose-related induction of mutations across all targets with low intra-group variability. Heterochromatic and intergenic regions exhibited the highest mutation frequencies (MF). C:G > A:T transversions at CCA, CCC and GCC trinucleotides were enriched in BaP-exposed mice consistent with the known etiology of BaP mutagenesis. However, GC-content had no effect on mutation susceptibility. A positive correlation was observed between DS and the “gold-standard” transgenic rodent gene mutation assay. Overall, we demonstrate that DS is a promising approach to study in vivo mutagenesis and yields critical insight into the genomic features governing mutation susceptibility, spectrum, and variability across the genome.
Characterization of a novel recombinant halophilic β-glucosidase of Trichoderma harzianum derived from Hainan mangrove
Authors: Sun Nan , Liu Xiaoxuan , Zhang Bingxi , Wang Xuemei , Na Wei , Tan Zhen , Li Xiaochun , Guan Qingfeng
Published: July 2022

Background

β-glucosidase is an important biomass-degrading enzyme and plays a vital role in generating renewable biofuels through enzymatic saccharification. In this study, we analyzed the transcriptome of Trichoderma harzianum HTASA derived from Hainan mangrove and identified a new gene encoding β-glucosidase Bgl3HB. And the biochemically characterization of β-glucosidase activity was performed.

Results

Bgl3HB showed substantial catalytic activity in the pH range of 3.0–5.0 and at temperatures of 40 ℃-60 ℃. The enzyme was found quite stable at 50 ℃ with a loss of only 33.4% relative activity after 240 min of heat exposure. In addition, all tested metal ions were found to promote the enzyme activity. The β-glucosidase activity of Bgl3HB was enhanced by 2.12-fold of its original activity in the presence of 5 M NaCl. Surprisingly, Bgl3HB also showed a remarkable ability to hydrolyze laminarin compared to other measured substrates. Enzyme efficiency was examined in the sugarcane bagasse saccharification processes, in which Bgl3HB with 5 M NaCl worked better supplementing Celluclast 1.5L than the commercial Novozyme 188 ascertained it as an admirably suited biocatalyst for the utilization of agricultural waste. In this work, this is the first report of a halophilic β-glucosidase from Trichoderma harzianum, and represents the β-glucosidase with the highest known NaCl activation concentration. And adding 5 M NaCl could enhance saccharification performance even better than commercial cellulase.

Conclusions

These results show that Bgl3HB has great promise as a highly stable and highly efficient cellulase with important future applications in the industrial production of biofuels.
Severe hypoxemia in a patient with right ventricular myocardial infarction and SARS-CoV-2 infection
Authors: Albuquerque Francisco , Lopes Pedro M. , Brízido Catarina , Strong Christopher , Andrade Maria João , de Araújo Gonçalves Pedro , Tralhão António
Published: July 2022

Background

Refractory hypoxemia after right ventricular myocardial infarction and concomitant SARS-CoV-2 infection represents an uncommon, yet particularly challenging clinical scenario. We report a challenging diagnostic case of refractory hypoxemia due to right-to-left shunt highlighting contemporary challenges and pitfalls in acute cardiovascular care associated with the current COVID-19 pandemic.

Case presentation

A 52-year-old patient admitted for inferior acute myocardial infarction developed rapidly worsening hypoxemia shortly after primary percutaneous coronary intervention. RT-PCR screening for SARS-CoV-2 was positive, even though the patient had no prior symptoms. A computed tomography pulmonary angiogram excluded pulmonary embolism and showed only mild interstitial pulmonary involvement of the virus. Transthoracic echocardiogram showed severe right ventricular dysfunction and significant right-to-left shunt at the atrial level after agitated saline injection. Progressive improvement of right ventricular function allowed weaning from supplementary oxygen support. Patient was latter discharged with marked symptomatic improvement.

Conclusion

Refractory hypoxemia after RV myocardial infarction should be carefully addressed, even in the setting of other more common and tempting diagnoses. After exclusion of usual etiologies, right-to-left shunting at the atrial level should always be suspected, as this may avoid unnecessary and sometimes harmful interventions.
Gastric carcinosarcoma with FGFR2 amplification under long-term control with pazopanib: a case report and literature review
Authors: Hayashi Hirokatsu , Makiyama Akitaka , Okumura Naoki , Yasufuku Itaru , Saigo Chiemi , Takeuchi Tamotsu , Miyazaki Tatsuhiko , Tanaka Yoshihiro , Matsuhashi Nobuhisa , Murase Katsutoshi , Takahashi Takao , Futamura Manabu , Yoshida Kazuhiro
Published: July 2022

Background

Gastric carcinosarcoma is most frequently diagnosed at an advanced stage when the tumor is generally large with invasion into other organs, lymph node metastasis, and distant metastasis. Standard chemotherapy has not been established, and surgery is the only curative treatment. Here, we present a case of postoperative recurrence of gastric carcinosarcoma under long-term tumor control with pazopanib.

Case presentation

A 77-year-old man was referred to our hospital because of nausea and vomiting. Computed tomography and upper gastrointestinal endoscopy revealed a type 1 tumor arising from the gastric antrum and extending into the duodenal bulb. He underwent distal gastrectomy (D2) with Roux-en-Y reconstruction. Histopathologically, the tumor had mixed adenocarcinoma and sarcoma components. According to the tumor–node–metastasis classification, the diagnosis was primary gastric carcinosarcoma pT1bN1M0 stage IB. Liver metastasis was detected 2 months after surgery; multiple lung metastases were detected 17 month after surgery. A genomic profiling test was performed using liver specimens as the patient became refractory to chemotherapy commonly used for gastric cancer, and the test revealedFGFR2amplification along withTP53R209*,AKT3N127D,NOTCH1A2036T, andPOLD1M161I. The patient was treated with pazopanib (800 mg/daily), and the tumor growth was controlled for 11 months.

Conclusions

We report a case of postoperative recurrence of gastric carcinosarcoma under long-term tumor control with pazopanib. This case suggested that pazopanib may be effective in treating gastric carcinosarcoma.
Total neoadjuvant therapy for locally advanced gastric cancer and esophagogastric junction adenocarcinoma: study protocol for a prospective, multicenter, single-arm, phase II clinical trial
Authors: Shi Jinming , Li Ning , Tang Yuan , Jiang Liming , Yang Lin , Wang Shulian , Song Yongwen , Liu Yueping , Fang Hui , Lu Ningning , Qi Shunan , Chen Bo , Li Ziyu , Liu Shixin , Wang Jun , Wang Wenling , Zhu Suyu , Yang Jialin , Li Yexiong , Zhao Dongbing , Jin Jing
Published: July 2022

Background

Gastric cancer ranks high in terms of morbidity and mortality worldwide. Multimodal therapy is therefore essential for locally advanced gastric cancer. Recent studies have demonstrated that both perioperative chemotherapy and neoadjuvant chemoradiotherapy can improve the prognosis of patients. However, the completion rate of chemotherapy after surgery remains low, which may affect survival. Thus, identifying the best way to combine radiotherapy, chemotherapy and surgery is important. The aim of this study was to explore the toxicity and efficacy of the total neoadjuvant therapy modality for locally advanced gastric cancer.

Methods

This study will be a prospective, multicenter, single-arm, phase II clinical trial. Patients diagnosed with locally advanced (stage cT3-4 and cN positive, AJCC 8th) gastric cancer and gastroesophageal junction adenocarcinoma will be enrolled. Patients will initially receive radiotherapy (95% planned target volume: 45 Gy/25 f) and concurrent chemotherapy (S-1: 40–60 mg twice a day) followed by six cycles of consolidated chemotherapy (SOX, consisting of S-1 and oxaliplatin) and surgery. The primary objective will assess pathological complete response; the secondary objectives will include toxicities assessing surgical complications, the tumor downstaging rate and the R0 resection rate.

Discussion

Investigation of total neoadjuvant therapy in gastric cancer is limited. The goal of this trial is to explore the efficacy and toxicity of total neoadjuvant therapy for locally advanced gastric cancer and gastroesophageal junction adenocarcinoma.

Trial registration: Clinicaltrials.gov (NCT04062058, August 20, 2019).
Association between c-type lectin-like receptor 2 and microsatellite instability in colorectal cancer: a cross-sectional study
Authors: Zhang Xin , Yuan Jia-rui , Wang Xin , Fu Shuang , Wang Rui-tao , Wang Guang-yu
Published: July 2022

Background

As a transmembrane protein, C-type lectin-like receptor 2 (CLEC-2) is mainly expressed on platelets and released into plasma after platelet activation. Activated platelets participate in the regulation of innate immune cells. Patients with different microsatellite statuses have distinct immune profiles. This study aimed to investigate the association of plasma CLEC-2 levels with microsatellite status among colorectal cancer (CRC) patients.

Methods

A cross-sectional analysis of 430 CRC patients from Harbin Medical University Cancer Hospital was conducted. CLEC-2 levels were measured with fasting venous blood samples drawn from each participant before any treatment. The microsatellite status was evaluated with DNA obtained from fresh frozen tumor tissue samples. The other clinical data were collected and recorded based on the medical system records.

Results

CLEC-2 levels were significantly higher among patients with high microsatellite instability phenotype than the stable microsatellite group, adjusting for other confounding variables.

Conclusions

The increased CLEC-2 is associated with the high microsatellite instability subtype of CRC.
Glycoprotein α-Subunit of Glucosidase II (GIIα) is a novel prognostic biomarker correlated with unfavorable outcome of urothelial carcinoma
Authors: Lin Qiongqiong , Pei Lu , Zhao Zhiguang , Zhuang Xiaoping , Qin Haide
Published: July 2022

Background

Urothelial carcinoma (UC) is among the most prevalent malignancies. The muscle-invasive bladder cancer (MIBC) shows an invasive feature and has poor prognosis, while the non-muscle invasive bladder cancer (NMIBC) shows a better prognosis as compared with the MIBC. However, a significant proportion (10%–30%) of NMIBC cases progress to MIBC. Identification of efficient biomarkers for the prediction of the course of UC remains challenging nowadays. Recently, there is an emerging study showed that post-translational modifications (PTMs) by glycosylation is an important process correlated with tumor angiogenesis, invasion and metastasis. Herein, we reported a data-driven discovery and experimental validation of GANAB, a key regulator of glycosylation, as a novel prognostic marker in UC.

Methods

In the present study, we conducted immunohistochemistry (IHC) assay to evaluate the correlation between the expression levels of GANAB protein and the prognosis of UC in our cohort of 107 samples using whole slide image (WSI) analysis. In vitro experiments using RNAi were also conducted to investigate the biological functions of GANAB in UC cell lines.

Results

We observed that positive GANAB protein expression was significantly correlated with poor prognosis of UC in our cohort, with p-value of 0.0017 in Log-rank test. Notably, tumor cells at the invasive front of the tumor margin showed stronger GANAB expression than the tumor cells inside the tumor body in UCs. We further validated that the elevated expression levels of GANAB were significantly correlated with high grade tumors (p-values of 1.72 × 10–10), advanced stages (6.47 × 10–6), and elevated in luminal molecular subtypes. Moreover, knocking-down GANAB using RNAi in UM-UC-3 and T24 cells inhibited cell proliferation and migration in vitro. Knockdown of GANAB resulted in cell cycle arrest at G1 phase. We demonstrated that GANAB mediated HIF1A and ATF6 transcriptional activation in the ER stress signaling, and regulated the gene expression of cell cycle-related transcriptional factors E2F7 and FOXM1.

Conclusions

The elevated expression of GANAB is a novel indicator of poorer prognosis of UC. Our data suggests that GANAB is not only a new and promising prognostic biomarker for UC, but also may provide important cues for the development of PTM-based therapeutics for UC treatment.
Impact on patient-provider relationship and documentation practices when mental health patients access their electronic health records online: a qualitative study among health professionals in an outpatient setting
Authors: Zanaboni Paolo , Kristiansen Eli , Lintvedt Ove , Wynn Rolf , Johansen Monika A. , Sørensen Tove , Fagerlund Asbjørn J.
Published: July 2022

Background

Patient accessible electronic health records (PAEHR) hold the potential to increase patient empowerment, especially for patients with complex, long-term or chronic conditions. However, evidence of its benefits for patients who undergo mental health treatment is unclear and inconsistent, and several concerns towards use of PAEHR emerged among health professionals. This study aimed at exploring the impact of PAEHR among mental health professionals in terms of patient-provider relationship, changes in the way of writing in the electronic health records and reasons for denying access to information.

Methods

In-depth qualitative interviews with health professionals working in two mental health outpatient clinics at Helgelandssykehuset in Northern Norway, one of the first hospitals in Norway to implement the PAEHR in 2015. The interviews were conducted by phone or videoconferencing, audio recorded and transcribed verbatim. Data were analyzed by a multidisciplinary research team using the Framework Method.

Results

A total of 16 in-depth qualitative interviews were conducted in April and May 2020. The PAEHR implemented in Norway was seen as a tool to increase transparency and improve the patient-provider relationship. The PAEHR was seen to have negative consequences only in limited situations, such as for patients with severe mental conditions, for child protective services when parents access their children’s journal, or for patients with abusive partners. The functionality to deny access to the journal was used rarely. A more common practice for making information not immediately available was to delay the final approval of the notes. The documentation practices changed over the years, but it was not clear to what extent the changes were attributable to the introduction of the PAEHR. Health professionals write their notes keeping in mind that patients might read them, and they try to avoid unclear language, information about third parties, and hypotheses that might create confusion.

Conclusions

The concerns voiced by mental health professionals regarding the impact of the PAEHR on the patient-provider relationship and practices to deny access to information were not supported by the results of this study. Future research should explore changes in documentation practices by analysing the content of the electronic health records.
What to target in cognitive behavioral treatment for gambling disorder—A qualitative study of clinically relevant behaviors
Authors: Molander Olof , Ramnerö Jonas , Bjureberg Johan , Berman Anne H.
Published: July 2022

Background

From a clinical perspective, knowledge of the psychological processes involved in maintaining gambling disorder has been lacking. This qualitative study formulated hypotheses on how gambling disorder is maintained by identifying clinically relevant behaviors at an individual level, as a means to guide the development of new cognitive behavioral interventions.

Methods

Six individuals from a treatment study, diagnosed with gambling disorder and with diverse symptom profiles of psychiatric comorbidity, were recruited. Participants were interviewed using an in-depth semi-structured functional interview and completed self-report measures assessing gambling behavior.

Results

Functional analysis was used as a theoretical framework for a thematic analysis, which yielded the following categories: 1) antecedents that may increase or decrease gambling; 2) experiences accompanying gambling; 3) control strategies; 4) consequences of gambling behavior; and 5) events terminating gambling behavior. Few differences were identified in relation to symptom profiles of psychiatric comorbidity, although some gamblers did not report experiencing abstinence when not being able to gamble.

Conclusions

Gambling is a secluded activity mainly triggered by access to money. Positive and negative emotions could be both antecedents and functions of gambling behavior. Avoidance-based strategies used to control gambling might result in a failure to learn to control gambling behavior. Anticipation, selective attention, and chasing could be important reinforcers, which should be addressed in new developments in cognitive behavioral treatment for gambling disorder.
The role of community factors in predicting depressive symptoms among Chinese workforce: a longitudinal study in rural and urban settings
Authors: Li Wanlian , Gao Guanghan , Sun Fei , Jiang Lin
Published: July 2022

Background

The dual urban–rural division system in China has led to distinguishes in economic development, medical services, and education as well as in mental health disparities. This study examined whether community factors (community cohesion, supportive network size, foreseeable community threat, and medical insurance coverage) predict the depressive symptoms of Chinese workers and how community factors may work differently in rural and urban settings.

Methods

This secondary data analysis was conducted using data from the 2014 and 2016 China Labor-force Dynamics Survey (CLDS). The sample of this study includes 9,140 workers (6,157 rural labors and 2,983 urban labors) who took part in both the 2014 and 2016 CLDS. This study discusses the relation between community factors and depressive symptoms of Chinese workers by correlation analysis and regression analysis. All analyses were conducted using SPSS 24.0.

Results

The results indicate that rural workers have higher levels of depressive symptoms than urban workers. Medical benefits coverage predicts depressive symptoms of rural workforces (B = -0.343, 95%CI = -0.695 ~ 0.009, p < . 10), and community supportive network size predicts depressive symptoms of urban workforces (B = -.539, 95%CI = -0.842 ~ 0.236, p < . 01).

Conclusions

Policymakers may address depressive symptoms of rural labor through improved coverage of medical benefits. In urban areas, efforts can be made to strengthen community supportive network for the urban labor force.