bluuebunny/crossref_metadata_2025 huggingface dataset:
HOTAIR/miR-1277-5p/FBN2 signaling axis is involved in recurrent spontaneous abortion by regulating the growth, migration, and invasion of HTR-8/SVneo cells
Authors: Long Na , Sun Ru-liang , Lai Qing-hua , Lu Mei-yin , Li Xiao-hong , Chen Yan-na , Zhu Dong-yan
Published: February 2024

Objective

This study aimed to explore the specific pathways by which HOX transcript antisense intergenic RNA contributes to the pathogenesis of unexplained recurrent spontaneous abortion.

Methods

Real-time quantitative PCR was employed to assess the differential expression levels of HOX transcript antisense intergenic RNA in chorionic villi tissues from unexplained recurrent spontaneous abortion patients and women with voluntarily terminated pregnancies. HTR-8/SVneo served as a cellular model. Knockdown and overexpression of HOX transcript antisense intergenic RNA in the cells were achieved through siRNA transfection and pcDNA3.1 transfection, respectively. Cell viability, migration, and invasion were evaluated using cell counting kit-8, scratch, and Transwell assays, respectively. The interaction among the HOX transcript antisense intergenic RNA /miR-1277-5p/fibrillin 2 axis was predicted through bioinformatics analysis and confirmed through in vitro experiments. Furthermore, the regulatory effects of the HOX transcript antisense intergenic RNA /miR-1277-5p/fibrillin 2 signaling axis on cellular behaviors were validated in HTR-8/SVneo cells.

Results

We found that HOX transcript antisense intergenic RNA was downregulated in chorionic villi tissues from unexplained recurrent spontaneous abortion patients. Overexpression of HOX transcript antisense intergenic RNA significantly enhanced the viability, migration, and invasion of HTR-8/SVneo cells, while knockdown of HOX transcript antisense intergenic RNA had the opposite effects. We further confirmed the regulatory effect of the HOX transcript antisense intergenic RNA /miR-1277-5p/fibrillin 2 signaling axis in unexplained recurrent spontaneous abortion. Specifically, HOX transcript antisense intergenic RNA and fibrillin 2 were found to reduce the risk of unexplained recurrent spontaneous abortion by enhancing cell viability, migration, and invasion, whereas miR-1277-5p exerted the opposite effects.

Conclusion

HOX transcript antisense intergenic RNA promotes unexplained recurrent spontaneous abortion development by targeting inhibition of miR-1277-5p/fibrillin 2 axis.
A rank-based approach to evaluate a surrogate marker in a small sample setting
Authors: Parast Layla , Cai Tianxi , Tian Lu
Published: February 2024

In clinical studies of chronic diseases, the effectiveness of an intervention is often assessed using “high cost” outcomes that require long-term patient follow-up and/or are invasive to obtain. While much progress has been made in the development of statistical methods to identify surrogate markers, that is, measurements that could replace such costly outcomes, they are generally not applicable to studies with a small sample size. These methods either rely on nonparametric smoothing which requires a relatively large sample size or rely on strict model assumptions that are unlikely to hold in practice and empirically difficult to verify with a small sample size. In this paper, we develop a novel rank-based nonparametric approach to evaluate a surrogate marker in a small sample size setting. The method developed in this paper is motivated by a small study of children with nonalcoholic fatty liver disease (NAFLD), a diagnosis for a range of liver conditions in individuals without significant history of alcohol intake. Specifically, we examine whether change in alanine aminotransferase (ALT; measured in blood) is a surrogate marker for change in NAFLD activity score (obtained by biopsy) in a trial, which compared Vitamin E ($n=50$) versus placebo ($n=46$) among children with NAFLD.
Performance of an interstitial glucose monitoring device in patients with type 1 diabetes during haemodialysis
Authors: Cornet Sophie , Moranne Olivier , Jouret François , Parotte Marie Christine , Georges Benoit , Godon Eric , Cavalier Etienne , Radermecker Régis P , Delanaye Pierre
Published: February 2024

Background

The use of interstitial glucose monitoring devices such as flash glucose monitoring has been shown to be beneficial in patients with type 1 diabetes mellitus (T1DM). However, these devices have been little studied in patients with diabetes treated by chronic haemodialysis (HD).

Methods

The goal of this prospective, observational, multicentric study was to evaluate the analytical performance of the FreeStyle Libre 2 (FSL2) sensor in T1DM patients during HD sessions. During three HD sessions, interstitial fluid glucose (ISFG) concentrations given by the FSL2 were compared every 15 minutes with blood glucose (BG) concentrations obtained simultaneously. BG concentrations were measured by two different glucometers: the Accu-Chek Guide and StatStrip meters.

Results

Twelve HD patients were included, with a mean age of 54 ± 11 years and a mean diabetes duration of 36.5 ± 11.6 years. Dialysis vintage was 35 ± 22 months. A total of 565 pairs of ISFG/BG values were available for analysis. The mean absolute relative difference, defined as the mean of the absolute relative differences between the ISFG and BG measurements, was 17.4% and 20.9% when the ISFG was compared with the StatStrip meter or Accu-Chek Guide, respectively. Interstitial results tend to underestimate blood results, but all values were classified as having clinically acceptable error. The differences observed remained stable during the dialysis session and were not associated with the ultrafiltration rate.

Conclusion

Use of the FSL2 interstitial glucose monitoring device in HD patients with T1DM is clinically acceptable, even though the accuracy of the device is generally poorer than in studies including non-dialysis patients.
‘The imitation game’: a heart failure case report with a great diagnostic twist
Authors: Khan-Kheil Ayisha Mehtab , Demetriades Polyvios , Steeds Richard P , Moody William E
Published: February 2024

Background

Arrhythmogenic ventricular cardiomyopathy (AVC) is a hereditary cardiomyopathy that has been associated with mutations in genes encoding for components of the cardiac desmosome including desmoglein-2 (DSG-2).

Case summary

A 49-year-old male presented with decompensated heart failure and ventricular arrythmias. A cardiac magnetic resonance scan demonstrated a dilated left ventricle (LV) with severely impaired systolic function and extensive subepicardial late gadolinium enhancement in the lateral wall. An 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) scan identified myocardial uptake consistent with inflammation. Following treatment with steroids for presumed cardiac sarcoidosis, a repeat FDG-PET confirmed resolution of inflammation. A dilated cardiomyopathy/AVC gene panel, however, subsequently identified a pathogenic variant in the DSG-2 gene.

Discussion

We describe the case of a patient presenting with clinical and imaging features suggestive for cardiac sarcoidosis, however genetic testing established a diagnosis of DSG-2 associated AVC. DSG-2 mutations in AVC are associated with frequent LV involvement and heart failure. Active inflammation has been observed in other cardiomyopathies, specifically in desmoplakin cardiomyopathy which has a similar clinical course to DSG-2. To our knowledge, this is the first case of DSG-2 cardiomyopathy presenting in this manner. We encourage clinicians to have a high index of suspicion of inflammatory cardiomyopathies as a differential to myocarditis and cardiac sarcoidosis, when patients present with evidence of decompensated heart failure, arrhythmias, and active myocardial inflammation.
Tall stature and gigantism in adult patients with acromegaly
Authors: Bogusławska Anna , Godlewska Magdalena , Hubalewska-Dydejczyk Alicja , Korbonits Márta , Starzyk Jerzy , Gilis-Januszewska Aleksandra
Published: February 2024

Objectives

Increased height in patients with acromegaly could be a manifestation of growth hormone (GH) excess before epiphysis closure. The aim of this study was to evaluate the relationship between the height of adult patients with GH excess related to mid-parental height (MPH) and population mean and to find whether taller patients with acromegaly come from tall families.

Methods

This is a single-centre, observational study involving 135 consecutive patients with acromegaly diagnosed as adults and no family history of GH excess. We established three categories for height for patients with acromegaly: normal stature, tall stature (TS, height above the 97th percentile (1.88 standard deviations (SD)) to <3 SD for gender- and country-specific data or as a height which was greater than 1.5 SD but less than 2 SD above the MPH) and gigantism (height which was greater than 3 SD) above the gender- and country-specific mean or greater than 2 SD above MPH).

Results

Thirteen percent (17/135) of patients (53% females) met the criteria for gigantism, 10% (14/135) fulfilled the criteria for TS (57% females). Parents and adult siblings were not taller than the population mean.

Conclusion

In a group of 135 consecutive adult patients with acromegaly, 23% had increased height based on country-specific and MPH data: 13% presented with gigantism while 10% had TS. The frequency of gigantism and TS in patients diagnosed with GH excess as adults is not higher in males than in females. Patients with acromegaly come from normal-stature families.
Stability, survival, patient satisfaction, and cost-minimization of CAD/CAM versus conventional multistranded fixed retainers in orthodontic patients: a 2-year follow-up of a two-centre randomized controlled trial
Authors: Pullisaar Helen , Cattaneo Paolo M , Gera Arwa , Sankiewicz Monika , Bilińska Małgorzata , Vandevska-Radunovic Vaska , Cornelis Marie A
Published: February 2024

Background

CAD/CAM (computer-aided design/computer-aided manufacturing) fixed retainers (FRs) as an alternative to multistranded FRs to maintain orthodontic treatment outcome.

Objectives

The primary aim was to compare CAD/CAM versus conventional multistranded FRs in terms of stability until 2 years. Secondary outcomes were failure rates, patient satisfaction, and cost-minimization.

Trial design

2-arm parallel, two-centre randomized controlled trial.

Methods

Patients were randomized to CAD/CAM or conventional FRs in both arches, in a 1:1 ratio and blocks of four. Allocation concealment was secured by using sequentially numbered envelopes. Patients were blinded. FRs were bonded at the end of treatment, and patients were recalled after 12 and 24 months. First-time retainer failures were recorded and digital impressions were taken. Arch widths and lengths, as well as Little’s Irregularity Index (LII), were measured. Additionally, patients answered satisfaction questionnaires. Linear mixed models were applied for measurements and patient satisfaction. Survival analyses were estimated with Kaplan–Meier curves, along with Cox-regression modelling. Cost-minimization analysis was undertaken.

Results

One hundred and eighty-one patients were randomized (98 in Centre 1, and 83 in Centre 2): 90 in CAD/CAM and 91 in conventional group. One hundred and fifty three patients attended T24 follow-up. There were no significant differences in LII and arch dimensions between groups for failure-free patients. Within 24 months, 34% maxillary CAD/CAM FRs and 38% maxillary conventional FRs failed, along with 42% mandibular CAD/CAM FRs and 40% mandibular conventional FRs, with no significant difference in survival between groups (hazard ratios conventional to CAD/CAM: maxillary arch: 1.20 [P = 0.46], mandibular arch: 0.98 [P = 0.94]). There were no significant differences in patient satisfaction between groups. No harms were observed. Cost-minimization analysis showed that CAD/CAM FRs were slightly cheaper than conventional FRs.

Conclusions

There were no clinically significant differences in LII, arch widths, and lengths between CAD/CAM and conventional FRs after 24 months. There were no differences in failures and patient satisfaction between groups. CAD/CAM FRs were slightly cheaper than conventional FRs.

Trial registration

ClinicalTrials.gov NCT04389879.
Harmful types of gambling: changes and emerging trends in longitudinal helpline data
Authors: Marionneau Virve , Kristiansen Søren , Wall Håkan
Published: February 2024

Background

Gambling products differ in terms of their harm potential. Products are also constantly developing and changing. However, little research has addressed changes and trends in the types of gambling that are associated with harms. The current study explores trends in the gambling product categories identified as harmful in longitudinal helpline data from three Nordic countries.

Methods

We use data collected by national helplines in Denmark (StopSpillet), Finland (Peluuri) and Sweden (Stödlinjen) in their daily operations (N = 46 646). The data consist of information collected on gamblers and concerned significant others who have contacted these helplines between January 2019 and December 2022. We analyse which gambling products are mentioned as harmful by clients. The analysis uses linear regression with the interaction term (country) times time regressed over the outcome variable (proportion per month).

Results

The results show that an increased share of contacts concern online gambling. Online casino products have become the most harmful category across contexts. The share of reported harms from online betting and new emerging online forms is also increasing. The share of land-based products as a reported source of harms has decreased across 2019–22.

Conclusions

The results suggest that online gamlbing environments, and particularly online casino products, are associated with increasing harms to help-seekers. The harmfulness of different gambling products may not be stable, but change over time. Further harm prevention efforts are needed to address the online gambling field, including emerging formats.
Directional epistasis is common in morphological divergence
Authors: Bourg Salomé , Bolstad Geir H , Griffin Donald V , Pélabon Christophe , Hansen Thomas F
Published: February 2024

Epistasis is often portrayed as unimportant in evolution. While random patterns of epistasis may have limited effects on the response to selection, systematic directional epistasis can have substantial effects on evolutionary dynamics. Directional epistasis occurs when allele substitutions that change a trait also modify the effects of allele substitution at other loci in a systematic direction. In this case, trait evolution may induce correlated changes in allelic effects and additive genetic variance (evolvability) that modify further evolution. Although theory thus suggests a potentially important role for directional epistasis in evolution, we still lack empirical evidence about its prevalence and magnitude. Using a new framework to estimate systematic patterns of epistasis from line-crosses experiments, we quantify its effects on 197 size-related traits from diverging natural populations in 24 animal and 17 plant species. We show that directional epistasis is common and tends to become stronger with increasing morphological divergence. In animals, most traits displayed negative directionality toward larger size, suggesting that epistatic constraints reducing evolvability toward larger size. Dominance was also common but did not systematically alter the effects of epistasis.
Home Care Worker Continuity in Home-Based Long-Term Care: Associated Factors and Relationships With Client Health and Well-Being
Authors: Reckrey Jennifer M , Russell David , Fong Mei-Chia , Burgdorf Julia G , Franzosa Emily C , Travers Jasmine L , Ornstein Katherine A
Published: February 2024

Background and Objectives

Despite the importance of provider continuity across healthcare settings, continuity among home care workers who provide hands-on long-term care is understudied. This project describes home care worker continuity, identifies factors associated with increased continuity, and examines associations between continuity and client outcomes.

Research Design and Methods

We conducted a retrospective cohort study of clients receiving Medicaid-funded home-based long-term care (n = 3,864) using insurance plan and home care agency data from a large nonprofit organization. We estimated home care worker continuity for clients between 6-month clinical assessments using Bice–Boxerman scores. We then used generalized estimating equations to model associations between home care worker continuity and (1) client characteristics (e.g., cognitive impairment), and (2) client functional, health, and psychosocial outcomes.

Results

While home care worker continuity was lowest for clients receiving the most weekly care hours, a range of continuity existed across all levels of care need. Those who were male, older, Asian/Pacific Islander/Native American, cognitively impaired, and functionally impaired had lower continuity. Higher home care worker continuity was significantly associated (p < .05) with fewer falls, a higher likelihood of functional improvement/stabilization, and fewer depressive symptoms.

Discussion and Implications

The finding that home care worker continuity is associated with the health and well-being of home-based long-term care clients underscores the importance of building high-quality relationships in long-term care. Continued efforts are necessary to understand and advance home care worker continuity and to identify other aspects of the home care experience that benefit those receiving long-term care at home.
Reply to: Tuvikene et al. The inadequacies of estimating silver eel escapement by studying yellow eels caught in the coastal sea far away from the river mouth. A comment on Rohtla et al. (2021)
Authors: Rohtla Mehis , Saks Lauri , Eschbaum Redik , Vaino Väino , Verliin Aare , Kooijman Ellen , Vetemaa Markus
Published: February 2024

Restocking European eel (Anguilla anguilla) is generally considered as a conservation action, but its true conservation value remains unknown and is currently debated over. Estimation of the biomass of escaping silver eels is one way to partially measure the success of restocking. Tuvikene et al. in a comment to Rohtla et al. criticize the data that were used to reach the conclusion that eel conservation goals in a fully restocked eel management unit in Estonia are not being met. While acknowledging some potential and unavoidable sampling biases in our study that need to be addressed in the future, we stand by our general conclusions.
A short-term photovoltaic power interval forecasting method based on fuzzy granular computing and CNN-BiGRU
Authors: Shi Yan , Zhang Luxi , Wang Siteng , Li Wenjie , Tong Renjie
Published: February 2024

This paper presents a short-term PV power interval prediction method combining fuzzy information granulation and CNN-BiGRU model. First, historical data of PV power generation is processed using fuzzy information granulation to determine the interval range. Subsequently, a CNN-BiGRU model is constructed, where the CNN module extracts local features of the interval range and the BiGRU module captures temporal patterns. The interval range is then fed into the CNN-BiGRU model for training, which enables accurate prediction of short-term PV power generation intervals. Finally, the predicted power generation interval ranges are given. The experimental results show that this hybrid interval prediction method is first applied to the prediction of short-term PV power scenarios, which fully utilizes the advantages of information granularity to express the data intervals and CNN-BiGRU to learn the complex time series patterns, and realizes the accurate and reliable prediction of short-term PV power intervals. Compared with direct numerical prediction, the method provides an expression of prediction uncertainty, which provides an important reference for the operation decision of PV power plants.
A qualitative exploration of the barriers and enablers to supporting informal and familial carers within community pharmacies
Authors: Richardson Charlotte Lucy , Edwards Katherine , Lunny Judith , Lindsey Laura
Published: February 2024

Objectives

There are approximately 5.3 million informal carers in the United Kingdom, many of whom support family in their health despite being unpaid and often unsupported. Many visit pharmacies to collect medicines and look for advice. This work explores informal carer support within community pharmacies (CP).

Methods

Semi-structured video interviews exploring perspectives on the role of CP in supporting carers were conducted in autumn 2022. The study received institutional ethical approval. Interviews were audio-recorded, transcribed verbatim, and analysed using a reflexive thematic approach.

Key findings

In total 25 interviews were conducted with 13 carers and 12 pharmacy staff. Three themes were identified:

-What support do carers need through CP?—medicines management, navigating services, and carers health and wellbeing.

-Barriers to CP better supporting carers—relationships with CP, carer needs, identification as a ‘carer’.

-Enablers to CP better supporting carers—support is a team effort, and CP as a community ‘hub’.

Conclusions

There is a trusted relationships between carers and pharmacy staff which can contribute to establishing pharmacies as a safe space of support, this includes medicines-specific support and navigating services, but also carer health and wellbeing support. Pharmacy staff may need to reconsider approaches to identifying and supporting carers and not just treating them as an extension of supporting a patient. In making this support accessible, relationships with pharmacy staff are important, as well as embracing CP as a ‘community hub’, although pharmacy staff may need training and information to facilitate them in this role.
The Political Geography of Globalized Civil Wars: Networked Actors and Multi-Scalar Strategies in the Kurdish Conflict Assemblage
Authors: Adamson Fiona B
Published: February 2024

This article introduces and lays out a conflict assemblage framework for understanding the political geography of globalized civil wars. It suggests the utility of conceptualizing Turkey’s Kurdish conflict as an assemblage in which networked actors use multi-scalar strategies as part of their overall conflict strategy. Insurgent organizations such as the Kurdistan Workers’ Party (PKK) operate at various scales beyond the national—including local, regional, transnational, and global—and in so doing utilize political opportunities and mobilize resources that are embedded in different locales. In the Kurdish case, disparate sites such as Diyarbakir, Marseille, Istanbul, London, New York, and Kobane become tied together within a single conflict assemblage that transcends geographical boundaries. An assemblage approach to violent conflict is a form of ontological theorizing that highlights this spatial and political complexity. By treating violent conflicts as assemblages with their own symbolic boundaries, political dynamics, internal governance structures, and strategic logics, we gain a better understanding of the contours and dynamics of globalized civil wars.
Construction of an immune-related prognostic signature and lncRNA–miRNA–mRNA ceRNA network in acute myeloid leukemia
Authors: Qin Ling , Li Boya , Wang Shijie , Tang Yulai , Fahira Aamir , Kou Yanqi , Li Tong , Hu Zhigang , Huang Zunnan
Published: February 2024

The progression of acute myeloid leukemia (AML) is influenced by the immune microenvironment in the bone marrow and dysregulated intracellular competing endogenous RNA (ceRNA) networks. Our study utilized data from UCSC Xena, The Cancer Genome Atlas Program, the Gene Expression Omnibus, and the Immunology Database and Analysis Portal. Using Cox regression analysis, we identified an immune-related prognostic signature. Genomic analysis of prognostic messenger RNA (mRNA) was conducted through Gene Set Cancer Analysis (GSCA), and a prognostic ceRNA network was constructed using the Encyclopedia of RNA Interactomes. Correlations between signature mRNAs and immune cell infiltration, checkpoints, and drug sensitivity were assessed using R software, gene expression profiling interactive analysis (GEPIA), and CellMiner, respectively. Adhering to the ceRNA hypothesis, we established a potential long noncoding RNA (lncRNA)/microRNA (miRNA)/mRNA regulatory axis. Our findings pinpointed 9 immune-related prognostic mRNAs (KIR2DL1, CSRP1, APOBEC3G, CKLF, PLXNC1, PNOC, ANGPT1, IL1R2, and IL3RA). GSCA analysis revealed the impact of copy number variations and methylation on AML. The ceRNA network comprised 14 prognostic differentially expressed lncRNAs (DE-lncRNAs), 6 prognostic DE-miRNAs, and 3 prognostic immune-related DE-mRNAs. Correlation analyses linked these mRNAs’ expression to 22 immune cell types and 6 immune checkpoints, with potential sensitivity to 27 antitumor drugs. Finally, we identified a potential LINC00963/hsa-miR-431-5p/CSRP1 axis. This study offers innovative insights for AML diagnosis and treatment through a novel immune-related signature and ceRNA axis. Identified novel biomarkers, including 2 mRNAs (CKLF, PNOC), 1 miRNA (hsa-miR-323a-3p), and 10 lncRNAs (SNHG25, LINC01857, AL390728.6, AC127024.5, Z83843.1, AP002884.1, AC007038.1, AC112512, AC020659.1, AC005921.3) present promising candidates as potential targets for precision medicine, contributing to the ongoing advancements in the field.
Treatment status of psychiatric disorders and falls in the workplace among Japanese workers: a nationwide cross-sectional study
Authors: Yama Asumi , Nagata Tomohisa , Odagami Kiminori , Adi Nuri-Purwito , Nagata Masako , Mori Koji , W2S-Ohpm Study on behalf of the
Published: February 2024

Objectives: In Japan, the most common injury requiring sick leave is a fall in the workplace; therefore, it is very important to prevent falls. Most measures to prevent falls involve aspects of the workplace environment and safety. However, few measures consider the perspective of individual health. We investigated the relationship between psychiatric disorders and falls in the workplace and whether treatment status for a psychiatric disorder is associated with workplace falls.

Methods: We conducted a cross-sectional study among workers aged 20 years or older in Japan from February 28 to March 3, 2022. In total, the data of 27 693 participants were analyzed. We used a questionnaire to query participants’ status of treatment for any psychiatric disorder and whether they had experienced a fall in the workplace. The association between treatment for a psychiatric disorder and workplace falls was examined using logistic regression analysis.

Results: Compared with participants receiving appropriate treatment for a psychiatric disorder, the odds ratio (OR) of a workplace fall was significantly lower among participants who did not require treatment for a psychiatric disorder, at 0.56 (95% CI: 0.47-0.66; P < .001); the OR of a workplace fall was significantly higher among participants whose treatment for a psychiatric disorder was interrupted, at 1.47 (95% CI: 1.21-1.78; P < .001), after adjusting for age, sex, household income, number of workplace employees, sleeping hours, exercise habits, and psychological distress.

Conclusions: Our findings suggest that receiving appropriate treatment for psychiatric disorders may contribute to preventing falls in the workplace.
Cancer stem cell hypothesis 2.0 in glioblastoma: Where are we now and where are we going?
Authors: Sloan Anthony R , Silver Daniel J , Kint Sam , Gallo Marco , Lathia Justin D
Published: February 2024

Over the past 2 decades, the cancer stem cell (CSC) hypothesis has provided insight into many malignant tumors, including glioblastoma (GBM). Cancer stem cells have been identified in patient-derived tumors and in some mouse models, allowing for a deeper understanding of cellular and molecular mechanisms underlying GBM growth and therapeutic resistance. The CSC hypothesis has been the cornerstone of cellular heterogeneity, providing a conceptual and technical framework to explain this longstanding phenotype in GBM. This hypothesis has evolved to fit recent insights into how cellular plasticity drives tumor growth to suggest that CSCs do not represent a distinct population but rather a cellular state with substantial plasticity that can be achieved by non-CSCs under specific conditions. This has further been reinforced by advances in genomics, including single-cell approaches, that have used the CSC hypothesis to identify multiple putative CSC states with unique properties, including specific developmental and metabolic programs. In this review, we provide a historical perspective on the CSC hypothesis and its recent evolution, with a focus on key functional phenotypes, and provide an update on the definition for its use in future genomic studies.
Trunk Muscle Function and Core Stability in Women Who Had Muscle-Sparing Pedicled Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction
Authors: Liaw Lih-Jiun , Hsiao Shih-Fen , Hsu Ar-Tyan
Published: February 2024

Objective

The long-term effects of the unilateral muscle-sparing pedicled transverse rectus abdominis myocutaneous (TRAMmsp) flap procedure on trunk muscle performances and core stability were investigated in women with breast cancer.

Methods

Forty women (mean age = 42.6 years) who had received breast reconstruction with the unilateral TRAMmsp flap procedure no less than 6 months earlier (mean = 10.3 [standard deviation, SD = 4.9] months) (TRAM group) participated, and 30 women who were healthy and matched for age (mean age = 41.2 years) served as controls (control group). Their abdominal and back muscle strength was assessed using the curl-up and prone extension tests, respectively, and their static abdominal muscle endurance and back extensor endurance were assessed using the sit-up endurance test in the crook-lying position and the Biering-Sørensen test, respectively. Core stability strength was assessed using a 4-level limb-lowering test (abdominal muscle test), and core stability endurance was assessed while lying supine with both flexed legs 1 inch off the mat while keeping the pelvis in a neutral position with a pressure biofeedback unit.

Results

Compared with the control group, trunk muscles of the TRAM group were weaker, showing less endurance, as were their core stability strength and endurance. Static trunk muscle endurances and trunk flexion strength were associated with core stability in both groups.

Conclusions

Women exhibit trunk flexor and extensor weakness along with poor endurance and impaired core stability even after an average of 10 months from receiving the TRAMmsp flap procedure. Immobilization after surgery, with possible systemic inflammatory effects from surgery and chemotherapy, might have further contributed to the generalized weakness subsequent to the partial harvesting of the rectus abdominis.

Impact

Women after breast reconstruction with the TRAMmsp flap procedure show long-lasting deficits of strength and endurance in abdominal muscles, back extensors, and core stability. Proactive measures including early detection and evaluation of impairments as well as timely intervention targeting these clients are important to minimize the dysfunction and support their return to community participation.
Interleukin-6 trans-signalling regulates monocyte chemoattractant protein-1 production in immune-mediated necrotizing myopathy
Authors: Ma Xue , Gao Hua-Jie , Ge Hui-Zhen , Zhang Qing , Bu Bi-Tao
Published: February 2024

Objective

Immune-mediated necrotizing myopathy (IMNM) is pathologically characterized by diffuse myofibre necrosis and regeneration, myophagocytosis and a sparse inflammatory infiltrate. Monocyte chemoattractant protein-1 (MCP-1) is a key chemokine that regulates monocyte/macrophage infiltration into injured tissues. IL-6 signalling in the induction of MCP-1 expression has not been investigated in IMNM.

Methods

MCP-1 expression in muscle specimens was assessed using immunohistochemistry and Reverse transcription quantitative polymerase chain reaction (RT-qPCR). Levels of multiple serological cytokines were evaluated using the electrochemiluminescence-based immunoassays. Flow cytometry, RT-qPCR, enzyme-linked immunosorbent assay, western blot, dual-luciferase reporter assays and chromatin immunoprecipitation qPCR were performed to explore the effects of IL-6 signalling on MCP-1 production in human myoblasts.

Results

MCP-1 was scattered and was positively expressed within myofibres and a few inflammatory cells in the muscles of patients with IMNM. Sarcoplasmic MCP-1 expression significantly correlated with myonecrosis, myoregeneration and inflammatory infiltration. Serum MCP-1, IL-6 and the soluble form of the IL-6 receptor (sIL-6R) were elevated in patients with IMNM compared with controls. Serological MCP-1 levels were significantly associated with serum IL-6 expression and clinical disease severity in IMNM patients. The IL-6/sIL-6R complex induced MCP-1 expression via the signal transducer and activator of transcription 3 (STAT3) pathway in human myoblasts. Mechanistically, phospho-STAT3 was enriched in the MCP-1 promoter region and promoted the transcription.

Conclusion

IL-6 trans-signalling may contribute to the immunopathogenesis of IMNM by augmenting inflammation through regulation of MCP-1 expression in IMNM.
A Call to Action: How Social Work Programs Can Respond to Student Food Insecurity
Authors: Johnson Raenece , Beam Maria
Published: February 2024

The COVID-19 pandemic exacerbated student food insecurity on college campuses and exposed the vulnerability of institutions with no food emergency response. During the COVID-19 pandemic and for years to come, the need for social work to lead efforts on college campuses to address student food insecurity is even greater. The need will continue to be significant for social workers in higher education to support students with basic needs, including resources for food, housing, childcare, and transportation. As has been true after other pandemics and economic downturns, professionally trained social workers are critical to brokering resources for individuals in crisis. This article critically examines the role of social work education in addressing the issue of student food insecurity. Through a conceptual lens, it explores the many dimensions of this problem and highlights vital contributions that social work can make within a higher education setting to alleviate food insecurity, enhance student well-being, and promote equitable opportunities for academic success.
Interaction of Sweet Bran inclusion and corn processing method in beef finishing diets
Authors: McDermott Rebecca L , Troyer Braden C , Youngers Maggie E , Stock Rick A , Erickson Galen E , MacDonald Jim C
Published: February 2024

The study objective was to determine the effects of corn processing method and Sweet Bran (Cargill, Blair, NE) inclusion in beef finishing diets on performance and carcass characteristics. Four hundred and eighty crossbred yearling steers (363 ± 15 kg) were assigned to a 2 × 3 factorial arrangement of treatments, consisting of two corn processing methods, steam-flaked corn (SFC) or a high-moisture corn: dry-rolled corn blend (HMC: DRC), and three inclusions of Sweet Bran (0%, 20%, or 40% of diet dry matter). Data were analyzed using the MIXED procedure of SAS as a generalized block design with pen as the experimental unit and block as a fixed effect. Dry matter intake increased linearly as Sweet Bran increased in the diet, regardless of corn processing method (P < 0.01). A corn processing × Sweet Bran interaction (P < 0.01) was observed for feed efficiency (G:F), average daily gain (ADG), and hot carcass weight (HCW).

The G:F of steers fed SFC did not change with increasing Sweet Bran concentrations (P = 0.19) and the G:F of SFC-fed steers was 12.4% greater than those fed HMC:DRC without Sweet Bran, but was only 5.3% greater when Sweet Bran was included at 40% (P = 0.04). The ADG of steers increased linearly with increasing concentration of Sweet Bran in both SFC and HMC:DRC-based diets. However, the interaction occurred (P < 0.01) because ADG increased at a greater rate in HMC:DRC-based diets (1.93 to 2.21 kg/d for 0% and 40% Sweet Bran, respectively) compared to SFC-based diets (2.18 to 2.27 kg/d for 0% and 40% Sweet Bran, respectively;). Accordingly, while the ADG of steers fed SFC was 13% greater than steers fed HMC:DRC without Sweet Bran (P < 0.01), there was no difference in ADG due to corn processing method at 40% Sweet Bran (P = 0.30). In SFC-based diets, HCW tended to increase from 446 to 455 kg as Sweet Bran increased (P = 0.06). In HMC: DRC-based diets, HCW linearly increased from 421 to 449 kg (P < 0.01), resulting in similar HCW at 40% Sweet Bran (P = 0.28). These data suggest HMC:DRC-based diets are more competitive with SFC-based diets due to similar gains and more similar feed efficiencies when Sweet Bran is fed.
Antidote vs. unspecific hemostatic agents for the management of direct oral anticoagulant-related bleeding in trauma
Authors: Wienhold Jan , Rayatdoost Farahnaz , Schöchl Herbert , Grottke Oliver
Published: February 2024

Purpose of review

The advent of direct oral anticoagulants (DOACs) marks a significant milestone in anticoagulant treatment. However, DOACs can exacerbate bleeding, which is challenging for the treating clinician, especially when combined with traumatic injury.

Recent findings

In major bleeding associated with DOACs, rapid reversal of the anticoagulant effects is crucial. Recent observational and nonrandomized interventional trials have demonstrated the effectiveness of the specific antidotes andexanet alfa and idarucizumab as well as the unspecific prothrombin complex concentrates (PCCs) to counteract the anticoagulant effects of DOACs. The European Society of Anaesthesiology and Intensive Care guideline for severe perioperative bleeding and the European trauma guideline propose divergent recommendations for the use of andexanet alfa and PCC to obtain hemostasis in Factor Xa inhibitor-related bleeding. The conflicting recommendations are due to limited evidence from clinical studies and the potential increased risk of thromboembolic complications after the administration of andexanet. Regarding dabigatran-associated major bleeding, both guidelines recommend the specific reversal agent idarucizumab as first-line therapy.

Current guidelines recommend specific antidots and PCCs in DOAC-related major bleeding. Prospective randomized trials comparing specific vs. nonspecific hemostatic agents in the perioperative setting are needed to evaluate the effectiveness and safety of the hemostatic agents.
Thrombosis prophylaxis following trauma
Authors: Bösch Johannes , Bachler Mirjam , Fries Dietmar
Published: February 2024

Purpose of review

This review explores the persistent occurrence of venous thromboembolic events (VTE) in major trauma patients despite standard thrombosis prophylaxis with low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH). It investigates the inadequacies of standard pharmacologic prophylaxis and proposes alternative approaches not covered in current trauma guidelines.

Recent findings

Recent studies highlight the effectiveness of monitoring and adjusting subcutaneous LMWH doses based on anti-Xa levels for the purpose of reducing VTE in trauma patients. The need for dose adaptation arises due to factors like fluctuating organ function, varying antithrombin levels, interaction with plasma proteins, and altered bioavailability influenced by oedema or vasopressor use. Additionally, promising alternatives such as intravenous LMWH, UFH, and argatroban have shown success in intensive care settings.

The standard dosing of subcutaneous LMWH is often insufficient for effective thrombosis prophylaxis in trauma patients. A more personalised approach, adjusting doses based on specific effect levels like anti-Xa or choosing an alternative mode of anticoagulation, could reduce the risk of insufficient prophylaxis and subsequent VTE.
Developmental Anatomy of the Radial Bow in Pediatric Patients Using 3D Imaging
Authors: Nedder Victoria J. , Chen Kallie J. , May Catherine C. , Abzug Joshua M. , Liu Raymond W.
Published: February 2024

Background:

While radial bow shape is well characterized in adults, its development in children is not well understood. Previous studies on the radial bow use radiographs, thus, rotational positioning of the forearm could alter bowing measurements. This study used 3D imaging to better assess the pediatric radial bow.

Methods:

Computed tomography scans from the New Mexico Decedent Image Database were obtained for ages 2 to 16 (females) and 18 (males) (n=152). 3D models were generated using Slicer and Rhino software. Length of the entire radial bow (bicipital tuberosity to sigmoid notch), maximum radial bow, location of the maximum radial bow (bicipital tuberosity to the point of maximum bowing), and distal, middle, and proximal third radial bows were measured.

Results:

The length of the entire bow increased with age, with a strong correlation with age (r=0.90, P<0.01). The maximum bow increased with age, with a strong correlation with age (r=0.78, P<0.01). The maximum bow normalized to the length of the entire bow increased mildly with age, mean 0.059 ± 0.012 (r=0.24, P=0.0024), but seems to plateau around age 8. The location of the maximum bow increased with age (r=0.85, P<0.01). The normalized location of the maximum bow remained constant between ages, with a mean of 0.41 ± 0.10 (r=0.12, P=0.14). The normalized distal third bow mildly increased with age (r=0.34, P<0.01), the normalized middle third bow mildly increased with age (r=0.25, P<0.01), and the normalized proximal third bow remained constant between ages (r=0.096, P=0.24).

Conclusions:

Normalized values for maximum, distal third, and middle third radial bow increase with age, while normalized values for location and proximal third radial bow remain relatively constant, suggesting the proportional shape of the radius changes during development, although qualitatively plateaus after age 8.

Level of Evidence:

Retrospective comparative study, Level—III
Sociodemographic Factors are Associated with Care Delivery and Outcomes in Pediatric Severe Sepsis
Authors: Webb Lece V , Evans Jakob , Smith Veronica , Pettibone Elisabeth , Tofil Jarod , Hicks Jessica Floyd , Green Sherry , Nassel Ariann , Loberger Jeremy M
Published: February 2024

IMPORTANCE:

Sepsis is a leading cause of morbidity and mortality in the United States and disparate outcomes exist between racial/ethnic groups despite improvements in sepsis management. These observed differences are often related to social determinants of health (SDoH). Little is known about the role of SDoH on outcomes in pediatric sepsis.

OBJECTIVE:

This study examined the differences in care delivery and outcomes in children with severe sepsis based on race/ethnicity and neighborhood context (as measured by the social vulnerability index).

DESIGN, SETTING, AND PARTICIPANTS:

This retrospective, cross-sectional study was completed in a quaternary care children’s hospital. Patients 18 years old or younger who were admitted between May 1, 2018, and February 28, 2022, met the improving pediatric sepsis outcomes (IPSO) collaborative definition for severe sepsis. Composite measures of social vulnerability, care delivery, and clinical outcomes were stratified by race/ethnicity.

MAIN OUTCOMES AND MEASURES:

The primary outcome of interest was admission to the PICU. Secondary outcomes were sepsis recognition and early goal-directed therapy (EGDT).

RESULTS:

A total of 967 children met the criteria for IPSO-defined severe sepsis, of whom 53.4% were White/non-Hispanic. Nearly half of the cohort (48.7%) required PICU admission. There was no difference in illness severity at PICU admission by race (1.01 vs. 1.1, p = 0.18). Non-White race/Hispanic ethnicity was independently associated with PICU admission (odds ratio [OR] 1.35 [1.01–1.8], p = 0.04). Although social vulnerability was not independently associated with PICU admission (OR 0.95 [0.59–1.53], p = 0.83), non-White children were significantly more likely to reside in vulnerable neighborhoods (0.66 vs. 0.38, p < 0.001). Non-White race was associated with lower sepsis recognition (87.8% vs. 93.6%, p = 0.002) and less EGDT compliance (35.7% vs. 42.8%, p = 0.024).

CONCLUSIONS AND RELEVANCE:

Non-White race/ethnicity was independently associated with PICU admission. Differences in care delivery were also identified. Prospective studies are needed to further investigate these findings.
Tackling the resurgence of monkeypox in Africa: challenges and strategies for eradication
Authors: Abdul-Rahman Toufik , Ghosh Shankhaneel , Lawal Lukman , Bamigbade Gafar B. , Olanrewaju Omotayo F. , Amarachi Ogbonna R. , Aborode Abdullahi T. , Wireko Andrew A. , Faniyi Akinwale J. , Alao Uthman H.
Published: February 2024

Monkeypox is a zoonotic viral disease previously limited to isolated regions of Central Africa. The reasons for resurgence of the disease in Africa are multifaceted, including waning herd immunity acquired from smallpox vaccination, the evolution of the virus, disruption of health systems by the COVID-19 pandemic, and lack of adequate global funding for monkeypox research and intervention commodities in African countries. Policymakers should regulate the distribution of African rodents, and healthcare workers must be trained in monkeypox surveillance and case definition. The adoption of the mobile digital Surveillance Outbreak Response Management and Analysis System (SORMAS) is recommended to improve disease surveillance and outbreak management. African governments must collaborate with global leaders and pharmaceutical industries to develop and distribute monkeypox vaccines and specific therapeutics. These measures are crucial in preventing and managing monkeypox outbreaks.
Patterns of Craniomaxillofacial Trauma at an Urban Level I Trauma Center
Authors: Jagiella-Lodise Olivia , Stewart Christopher M. , Moriarty Hannah , Betarbet Udayan , Cheng Angela , Amin Dina
Published: February 2024

Background:

There is a paucity in the literature concerning craniomaxillofacial trauma (CMF) in the USA. Better recognition of these fracture patterns and their management clarifies how to best evaluate and treat them.

Methods:

A retrospective chart review was conducted of CMF trauma patients who required surgical intervention at a level I trauma center between 2015 and 2018. Descriptive statistics and univariate and bivariate analyses were conducted (α = 0.05).

Results:

A total of 1001 patients were included. Most patients were Black (n = 665; 66%) and/or male individuals (n = 813; 57%) with an average age of 37 years (range 15 -110). The most common etiologies were assault (n = 471; 44%), motor vehicle collision (n = 238; 22%), and fall (n = 117; 11%). The mechanism of injury was a determinant of fracture type (P = 0.045). The most common CMF injuries were mandibular fracture (n = 953; 95%), maxillary fracture (n = 815; 81%), and orbital fracture (n = 206; 21%). Male sex predicted panfacial fractures (P = 0.045). Black patients experienced more severe CMF trauma compared with other races (P < 0.001). ORIF was the most common treatment for mandibular (n = 481; 73%) and maxillary (n = 62; 66%) fractures.

Conclusions:

Etiology and patterns of CMF trauma differ globally, with assault and motor vehicle collisions being the leading causative factors in our patient population. Patient demographics are relatively consistent worldwide, with most injuries occurring in 30- to 40-year-old men. This study offers insight into at-risk populations and guidance on their management.