bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulated analogues II: a new methodology for non-parametric matching of models to observations
Authors: Al-Belmpeisi Rami , Tuhtan Vito , Christensen Mikkel Bregning , Kuruwita Rajika , Haugbølle Troels
Published: September 2024

Star formation is a multiscale problem, and only global simulations that account for the connection from the molecular cloud-scale gas flow to the accreting protostar can reflect the observed complexity of protostellar systems. Star-forming regions are characterized by supersonic turbulence, and as a result, it is not possible to simultaneously design models that account for the larger environment and in detail reproduce observed stellar systems. Instead, the stellar inventories can be matched statistically, and the best matches found that approximate specific observations. Observationally, a combination of single-dish telescopes and interferometers are now able to resolve the nearest protostellar objects on all scales from the protostellar core to the inner $10\, \mathrm{au}$. We present a new non-parametric methodology which uses high-resolution simulations and post-processing methods to match simulations and observations using deep learning. Our goal is to perform a down-selection from large data sets of synthetic images to a ranked list of best-matching candidates with respect to the observation. This is particularly useful for binary and multiple stellar systems that form in turbulent environments. The objective is to accelerate the rate at which we can do such comparisons, remove biases from hand-picking matches, and contribute to identifying the underlying physical processes that drive the creation and evolution of observed protostellar systems.
ATH434, a promising iron-targeting compound for treating iron regulation disorders
Authors: Pall Ashley E , Bond Silas , Bailey Danielle K , Stoj Christopher S , Deschamps Isabel , Huggins Penny , Parsons Jack , Bradbury Margaret J , Kosman Daniel J , Stemmler Timothy L
Published: September 2024

Cytotoxic accumulation of loosely bound mitochondrial Fe2+ is a hallmark of Friedreich's Ataxia (FA), a rare and fatal neuromuscular disorder with limited therapeutic options. There are no clinically approved medications targeting excess Fe2+ associated with FA or the neurological disorders Parkinson's disease and Multiple System Atrophy. Traditional iron-chelating drugs clinically approved for systemic iron overload that target ferritin-stored Fe3+ for urinary excretion demonstrated limited efficacy in FA and exacerbated ataxia. Poor treatment outcomes reflect inadequate binding to excess toxic Fe2+ or exceptionally high affinities (i.e. ≤10−31) for non-pathologic Fe3+ that disrupts intrinsic iron homeostasis. To understand previous treatment failures and identify beneficial factors for Fe2+-targeted therapeutics, we compared traditional Fe3+ chelators deferiprone (DFP) and deferasirox (DFX) with additional iron-binding compounds including ATH434, DMOG, and IOX3. ATH434 and DFX had moderate Fe2+ binding affinities (Kd’s of 1–4  µM), similar to endogenous iron chaperones, while the remaining had weaker divalent metal interactions. These compounds had low/moderate affinities for Fe3+(0.46–9.59 µM) relative to DFX and DFP. While all compounds coordinated iron using molecular oxygen and/or nitrogen ligands, thermodynamic analyses suggest ATH434 completes Fe2+ coordination using H2O. ATH434 significantly stabilized bound Fe2+ from ligand-induced autooxidation, reducing reactive oxygen species (ROS) production, whereas DFP and DFX promoted production. The comparable affinity of ATH434 for Fe2+ and Fe3+ position it to sequester excess Fe2+ and facilitate drug-to-protein iron metal exchange, mimicking natural endogenous iron binding proteins, at a reduced risk of autooxidation-induced ROS generation or perturbation of cellular iron stores.
RPFdb v3.0: an enhanced repository for ribosome profiling data and related content
Authors: Wang Yan , Tang Yuewen , Xie Zhi , Wang Hongwei
Published: September 2024

RPFdb (http://www.rpfdb.org or http://sysbio.gzzoc.com/rpfdb/) is a comprehensive repository dedicated to hosting ribosome profiling (Ribo-seq) data and related content. Herein, we present RPFdb v3.0, a significant update featuring expanded data content and improved functionality. Key enhancements include (i) increased data coverage, now encompassing 5018 Ribo-seq datasets and 2343 matched RNA-seq datasets from 496 studies across 34 species; (ii) implementation of translation efficiency, combining Ribo-seq and RNA-seq data to provide gene-specific translation efficiency; (iii) addition of pausing score, facilitating the identification of condition-specific triplet amino acid motifs with enhanced ribosome enrichment; (iv) refinement of open reading frame (ORF) annotation, leveraging RibORF v2.0 for more sensitive detection of actively translated ORFs; (v) introduction of a resource hub, curating advances in translatome sequencing techniques and data analytics tools to support a panoramic overview of the field; and (vi) redesigned web interface, providing intuitive navigation with dedicated pages for streamlined data retrieval, comparison and visualization. These enhancements make RPFdb a more powerful and user-friendly resource for researchers in the field of translatomics. The database is freely accessible and regularly updated to ensure its continued relevance to the scientific community.
Optimized periphery-core interface increases fitness of the Bacillus subtilis glmS ribozyme
Authors: Yu Li-Eng D , White Elise N , Woodson Sarah A
Published: September 2024

Like other functional RNAs, ribozymes encode a conserved catalytic center supported by peripheral domains that vary among ribozyme sub-families. To understand how core-periphery interactions contribute to ribozyme fitness, we compared the cleavage kinetics of all single base substitutions at 152 sites across the Bacillus subtilis glmS ribozyme by high-throughput sequencing (k-seq). The in vitro activity map mirrored phylogenetic sequence conservation in glmS ribozymes, indicating that biological fitness reports all biochemically important positions. The k-seq results and folding assays showed that most deleterious mutations lower activity by impairing ribozyme self-assembly. All-atom molecular dynamics simulations of the complete ribozyme revealed how individual mutations in the core or the IL4 peripheral loop introduce a non-native tertiary interface that rewires the catalytic center, eliminating activity. We conclude that the need to avoid non-native helix packing powerfully constrains the evolution of tertiary structure motifs in RNA.
A multiscale analysis of factors influencing Setophaga striata (Blackpoll Warbler) occupancy and abundance during the nonbreeding season in eastern Colombia
Authors: Morales-Rozo Andrea , Bayly Nicholas J , Taylor Philip D , Hobson Keith A , Colorado Z Gabriel J , Gómez Juan Pablo
Published: September 2024

Setophaga striata (Blackpoll Warbler), one of the few boreal-breeding migratory birds that migrates to the Orinoco and Amazon regions, is experiencing steep population declines. However, knowledge of the species’ distribution and habitat use during the nonbreeding season is limited. Here, we explore how stationary nonbreeding season (December to April) occupancy probabilities vary across regional and landscape scales, and with vegetation structure for S. striata in eastern Colombia. By running single-species, single-season hierarchical occupancy models and N-mixture models, we evaluated how regional (annual precipitation, nonbreeding season precipitation, driest month, elevation, and net primary productivity), landscape (habitat type and % forest in the landscape), and vegetation structure variables influenced occupancy by S. striata. In the regional analysis, occupancy was positively influenced by stationary nonbreeding precipitation and net primary productivity, and was predicted to peak at elevations between 500 and 1,000 m. At the landscape scale, occupancy and abundance were higher in agroforestry systems (in order of magnitude: shade-grown cacao, citrus plantations and silvopastures) than in forested habitats. In relation to vegetation structure, occupancy was negatively correlated with a principal component containing shrub density, canopy height, and canopy cover. Within the Orinoco region, a spatial prediction based on our results supported high occupancy rates in moister areas along and close to the Andean foothills and where the Orinoco grasslands transition into Amazonian forests. Our results highlight the importance of landscapes containing agroforestry systems as stationary nonbreeding habitats for S. striata in Colombia’s Orinoco region and the importance of promoting agroforestry systems, like shade-grown cacao, in areas with higher nonbreeding season precipitation and net primary productivity values in order to increase habitat availability for the species.
Survey of non-thermal electrons around supermassive black holes through polarization flips
Authors: Tsunetoe Yuh , Kawashima Tomohisa , Ohsuga Ken , Mineshige Shin
Published: September 2024

Optically thick non-thermal synchrotron sources notably produce linear polarization vectors that are parallel to projected magnetic field lines on the observer’s screen, although they are perpendicular in well-known optically thin cases. To elucidate the complex relationship between the vectors and fields, and to investigate the energy and spatial distribution of non-thermal electrons through the images, we perform polarization radiative transfer calculations at submillimeter wavelengths. Here the calculations are based on semi-analytic force-free jet models with non-thermal electrons with a power-law energy distribution. In the calculated images, we find a $90{^\circ }$-flip of linear polarization vectors at the base of counter-side (receding) jet near a black hole, which occurs because of large optical depths for the synchrotron self-absorption effect. The $90{^\circ }$-flip of LP vectors is also seen on the photon ring at a high frequency, since the optical depth along the rays is large there due to the light bending effect. In addition, we see the flip of the sign of circular polarization components on the counter-jet and photon ring. Furthermore, we show that these polarization flips are synthesized with large values in the spectral index map, and also give rise to outstanding features in the Faraday Rotation Measure map. Since the conditions of flipping depend on the magnetic field strength and configuration and the energy distribution of electrons, we can expect that the polarization flips will provide us with observational evidence for the presence of non-thermal electrons around the black hole, and a clue to the magnetic driving mechanism of plasma jets.
The nuclear exosome subunit HEN2 acts independently of the core exosome to assist transcription in Arabidopsis
Authors: Bhat Susheel Sagar , Asgari Mishaneh , Mermet Sarah , Mishra Priyanka , Kindgren Peter
Published: September 2024

Regulation of gene expression is at the frontier of plant responses to various external stimuli including stress. RNA polymerase-based transcription and post-transcriptional degradation of RNA play vital roles in this regulation. Here, we show that HUA ENHANCER 2 (HEN2), a co-factor of the nuclear exosome complex, influences RNAPII transcription elongation in Arabidopsis (Arabidopsis thaliana) under cold conditions. Our results demonstrate that a hen2 mutant is cold sensitive and undergoes substantial transcriptional changes compared to wild type when exposed to cold conditions. We found an accumulation of 5′ fragments from a subset of genes (including C-repeat binding factors 1–3 [CBF1–3]) that do not carry over to their 3′ ends. In fact, hen2 mutants have lower levels of full-length mRNA for a subset of genes. This distinct 5′-end accumulation and 3′-end depletion was not observed in other NEXT complex members or core exosome mutants, highlighting HEN2's distinctive role. We further used RNAPII-associated nascent RNA to confirm that the transcriptional phenotype is a result of lower active transcription specifically at the 3′ end of these genes in a hen2 mutant. Taken together, our data point to the unique role of HEN2 in maintaining RNAPII transcription dynamics especially highlighted under cold stress.
Structure-based validation of recombinant light-harvesting complex II
Authors: Seki Soichiro , Miyata Tomoko , Norioka Naoko , Tanaka Hideaki , Kurisu Genji , Namba Keiichi , Fujii Ritsuko
Published: September 2024

Light-harvesting complex II (LHCII) captures sunlight and dissipates excess energy to drive photosynthesis. To elucidate this mechanism, the individual optical properties of pigments in the LHCII protein must be identified. In vitro reconstitution with apoproteins synthesized by Escherichia coli and pigment–lipid mixtures from natural sources is an effective approach; however, the local environment surrounding each pigment within reconstituted LHCII (rLHCII) has only been indirectly estimated using spectroscopic and biochemical methods. Here, we used cryo-electron microscopy to determine the 3D structure of the rLHCII trimer and found that rLHCII exhibited a structure that was virtually identical to that of native LHCII, with a few exceptions: some C-terminal amino acids were not visible, likely due to aggregation of the His-tags; a carotenoid at the V1 site was not visible; and at site 614 showed mixed occupancy by both chlorophyll a and b molecules. Our observations confirmed the applicability of the in vitro reconstitution technique.
Predictors of driving risk in patients with obstructive sleep apnea syndrome treated by continuous positive airway pressure: a French multicenter prospective cohort
Authors: Coelho Julien , Bailly Sébastien , Baillieul Sébastien , Sagaspe Patricia , McNicholas Walter T , Taillard Jacques , Micoulaud-Franchi Jean-Arthur , Sapène Marc , Grillet Yves , Tamisier Renaud , Pépin Jean-Louis , Philip Pierre
Published: September 2024

Study Objectives

To investigate the predictors of persistent driving risk related to sleepiness in patients with obstructive sleep apnea syndrome (OSAS) treated by continuous positive airway pressure (CPAP).

Methods

Longitudinal analysis of a prospective national database including 5308 patients with OSAS and an indication of CPAP. Near misses related to sleepiness, accidents related to sleepiness, and sleepiness at the wheel (SAW) were assessed before initiation and after ≥90 days of treatment. Multivariable associations with the cumulative incidence of near-misses and accidents under treatment were calculated using Cox models adjusted for age, sex, obesity, sleep duration, SAW, accidents/near-misses history, depressive symptoms, residual apnea–hypopnea index, and adherence to treatment.

Results

Residual SAW under treatment was associated with an eight-fold higher incidence of near-misses related to sleepiness (hazard ratios [HR] = 8.63 [6.08–12.2]) and five-fold higher incidence of accidents related to sleepiness (HR = 5.24 [2.81–9.78]). Adherence ≤4 h/night was also a significant predictor of persistent driving risk (HR = 1.74 [1.12–2.71] for near-misses and HR = 3.20 [1.37–7.49] for accidents).

Conclusions

Residual SAW and treatment adherence ≤4 h/night are easy-to-assess markers to detect persistent driving risk during the follow-up evaluations of patients under treatment. Health professionals, but also policymakers, should be aware of the crucial importance of systematically evaluating these elements during the follow-up evaluations of the patients with OSAS treated by CPAP to better evaluate their driving risk.
Emerging antibiotic resistance in Plesiomonasshigelloides: insights from surface waters in Southwest Nigeria
Authors: Adepoju Oluwarinu A , Adefisoye Jumoke M , Adesiyan Ibukun M
Published: September 2024

This study aimed to investigate the antibiotic resistance pattern, extended-spectrum β-lactamase (ESBL) production, and biofilm formation potential of Plesiomonas shigelloides in selected surface waters in southwestern Nigeria. Isolates were identified using the spread plate technique on inositol brilliant green bile agar and confirmed molecularly by polymerase chain reaction. Antibiotic susceptibility was determined using the Kirby–Bauer disc diffusion method, ESBL production by the double disc synergistic test, and biofilm formation by the test tube method. A total of 111 P. shigelloides isolates were identified and confirmed. Significant resistance rates were observed against cefuroxime (71%), cefotaxime (92%), and ceftazidime (92%), while high susceptibility was noted for ciprofloxacin (94%), gentamicin (96%), and chloramphenicol (100%). A higher prevalence of multiple drug resistant phenotypes was observed during the dry season, reaching 79% and 60% along sampled rivers. Biofilm-producing phenotypes exhibited robust homogeneous biofilm formation. In this study, P. shigelloides exhibited high resistance to critical antibiotics such as third-generation cephalosporins. However, isolates displayed susceptibility to ciprofloxacin, gentamicin, and chloramphenicol. The presence of ESBL phenotypes and strong biofilm formation emphasizes the potential threat of P. shigelloides as an emerging environmental pathogen, highlighting the importance of monitoring and understanding antibiotic resistance patterns for effective public health management strategies.
Molecular phylogenetic analyses reveal a radiation of freshwater Gammarus (Amphipoda: Gammaridae) in the northern Chihuahuan Desert
Authors: Cannizzaro Andrew G , Berg David J
Published: September 2024

Isolation of desert springs often leads to the evolution of unique biodiversity. We investigated the taxonomy and evolutionary relationships of members of the Gammarus pecos complex, an assemblage of narrowly endemic amphipod species in the Chihuahuan Desert of the USA. Morphological and molecular phylogenetic analyses, including newly obtained COI sequences from the now-extinct type population of Gammarus desperatus, reveal the presence of two undescribed species and lead to redescription of G. desperatus. Gammarus acerbatus sp. nov. is split from G. desperatus and Gammarus balmorhea sp. nov. is split from G. hyalelloides. Each of these species is endemic to a single spring system. Speciation in the Gammarus pecos complex was likely promoted by the lineage’s ties to marine/riverine systems and geological events during the Oligocene/Miocene. The additional diversity discovered within the complex highlights the effects of both habitat and evolutionary history on the processes of speciation at local and regional spatial scales. The entire complex of at least six species is imperilled due to the narrow ranges occupied by each species and human water-use that threatens the existence of their spring habitats.
A Quantitative PCR Assay for Specific Detection of Pseudomonas cannabina pv. alisalensis
Authors: Noh Enoch , Cedeno Cameron , Bull Carolee T. , Keinath Anthony P. , Wechter W. Patrick , Wang Hehe
Published: September 2024

Pseudomonas cannabina pv. alisalensis is a gram-negative bacterium that causes bacterial leaf blight in Brassica crops, an important disease that could bring severe damage to the host plants. The aim of this study was to develop a tool that can reliably and accurately quantify P. cannabina pv. alisalensis and distinguish it from other closely related bacterial pathogens. Two species and six pathovars of Pseudomonas were tested: three pathovars, P. syringae pv. coriandricola, P. syringae pv. philadelphi, and P. syringae strains from Vicia faba, were found or confirmed to be members of P. cannabina based on the multilocus sequence analysis and repetitive element sequence-based PCR results. The quantitative PCR (qPCR) assay was evaluated for specificity and examined for detection limit in pure bacterial cells and bacteria-spiked plant samples. The assay was applied in monitoring the quantities of the P. cannabina pv. alisalensis DNA over time in inoculated turnip green leaves. The newly developed qPCR assay detected the target DNA in P. cannabina pv. alisalensis suspension as low as 100 CFU/ml and did not detect any of the nontarget bacteria. The qPCR assay detected P. cannabina pv. alisalensis in all the inoculated samples at least 5 days before the symptoms became visible; bacterial quantity increased significantly in the first 3 days after inoculation but slowed down afterward. The new qPCR assay for P. cannabina pv. alisalensis detection will facilitate early detection and disease diagnosis, assist research to provide epidemiological insights for the pathogen, and guide implementation of strategies to manage disease and prevent its spread.
Control of Botrytis cinerea from Chilean Grapevines by Pydiflumetofen: Baseline and Carboxamide-Mutant Sensitivity
Authors: Esterio Marcela , Osorio-Navarro Claudio , Rubilar Mauricio , Copier Charleen , Azócar Madelaine , Estrada Verónica , Valdes Santiago , Gattini Fiorella , Scalliet Gabriel , Auger Jaime
Published: September 2024

The gray mold (Botrytis cinerea; Botrytis) is the main disease affecting grapevine production in Chile. Succinate dehydrogenase inhibitors belonging to the carboxamide fungicide family are a key tool for the control of Botrytis in grapevines from the Chilean Central Valley. This study aimed to determine the sensitivity of the Chilean Botrytis population to the new generation carboxamide pydiflumetofen. Conidial germination (CG) and germ-tube elongation (GTE) sensitivity assays were conducted on 200 single-spore isolates collected during the 2016 to 2017 season. The mean effective concentration that inhibited 50% (EC50) of CG in the Botrytis population was 0.0545 μg/ml, with mean values of 0.066 and 0.042 μg/ml for table and wine grapes, respectively. The mean EC50 value of GTE was 0.000245, 0.0003, and 0.0019 μg/ml for the total, table grape, and wine grape populations, respectively. The comparison between pydiflumetofen and fludioxonil, a highly efficient fungicide carrying a different mode of action, showed 87.5 and 97.5% of Botrytis control with an EC50 threshold of 0.1 μg/ml in table grape and wine grape populations, respectively. No cross-resistance between pydiflumetofen and fludioxonil was detected. For nine isolates with reduced pydiflumetofen sensitivity, we evaluated SdhB mutations using a qPCR-HRM diagnostic system. Two isolates carried the sdhBP225/H272R genotype, and two isolates carried the sdhBP225/H272Y genotype. Additional analysis of SdhB mutant isolates determined that pydiflumetofen controls wild-type as well as sdhBP225/H272R and sdhBP225H/H272 mutants. Pydiflumetofen does not control CG in the sdhBP225/H272Y mutant but is effective in the GTE control. Pydiflumetofen significantly controls Botrytis independently of the SdhB genotype in wounded berry assays. This condition resembles the berry cracking due to heavy rainfall right before harvest, as seen in recent years in the Chilean Central Valley. The findings demonstrate that pydiflumetofen effectively controls the grapevine Botrytis population, suggest a moderate risk of pydiflumetofen resistance, and highlight the significance of incorporating genetic data into the design of control programs.
UA influences the progression of breast cancer via the AhR/p27Kip1/cyclin E pathway
Authors: Wang Zhiying , Zhang Yuanqi , Huang Shengchao , Liao Zhihong , Huang Mingzhang , Lei Wei , Shui Xiaorong
Published: September 2024

Uric acid (UA) is the end product of purine metabolism. In recent years, UA has been found to be associated with the prognosis of clinical cancer patients. However, the intricate mechanisms by which UA affects the development and prognosis of tumor patients has not been well elucidated. In this study, we explored the role of UA in breast cancer, scrutinizing its impact on breast cancer cell function by treating two types of breast cancer cell lines with UA. The role of UA in the cell cycle and proliferation of tumors and the underlying mechanisms were further investigated. We found that the antioxidant effect of UA facilitated the scavenging of reactive oxygen species (ROS) in breast cancer, thereby reducing aryl hydrocarbon receptor (AhR) expression and affecting the breast cancer cell cycle, driving the proliferation of breast cancer cells through the AhR/p27Kip1/cyclin E1 pathway. Moreover, in breast cancer patients, the expression of AhR and its downstream genes may be closely associated with cancer progression in patients. Therefore, an increase in UA could promote the proliferation of breast cancer cells through the AhR/p27Kip1/cyclin E1 pathway axis.
Exploring How Housestaff Unions Impact the Program Director–Resident Educational Alliance
Authors: Krzyzaniak Sara M. , Sebok-Syer Stefanie S. , Akhtar Saadia , Gallahue Fiona
Published: September 2024

In 1999, the National Labor Relations Board determined that residents function as employees, thereby allowing them to freely unionize. From 2020 to 2023, housestaff (i.e., resident physicians and fellows) unions have significantly increased, and 8 physician training centers, representing nearly 4,000 housestaff, have unionized since March 2021. While unions provide residents with an important tool in effecting change in their workplace, their introduction into the educational milieu has the potential to alter the program director (PD)–resident relationship. In this article, the authors use the educational alliance framework to detail 3 factors required to support a quality educational relationship between a resident and their PD. They also elaborate on how the introduction of unions may impact the PD-resident relationship and explore the potential unintended consequences of unionization as it pertains to this relationship. The authors then use 2 social psychology theories, naïve realism and motivated reasoning, to describe common framing dynamics that lead to conflict during collective bargaining processes. They conclude by offering strategies that PDs may use to mitigate tensions that arise in contract negotiations, even without a direct seat at the table. Ultimately, PDs should anticipate continued growth of resident unions and prepare themselves and their programs for the tensions that may arise from this action. The PD role as a neutral third party ought to be preserved, which is possible if all parties set reasonable expectations for the changes in the PD’s role and responsibilities under a union. PDs should understand the 3 core aspects of the educational alliance and the importance of establishing credibility with their residents early on to build a strong foundation.
Determining Root Causes of Poor Academic Performance to Provide Wraparound Support for Preclerkship Medical Students
Authors: Coppola Kristen M. , Rashid Hanin , Terregino Carol A. , Lebeau Robert
Published: September 2024

Root Cause Analysis

Targeting support for lower performing medical students is a complex process due to the multiple contributing factorsthat derail academic success.1-4 Root cause analysis provides an approach for professionals in student affairs, academicsupport specialists, and teaching faculty to attribute academic difficulty to interrelated contributing causes.
Educational Podcasts: Effect of Content Delivery Timing on Knowledge Acquisition and Retention
Authors: Gottlieb Michael , Fung Cha-Chi , Haas Mary R.C. , Cooney Robert , King Andrew , Riddell Jeffrey
Published: September 2024

Purpose

This study examined whether the order of podcast content influenced knowledge acquisition and retention among emergency medicine (EM) resident physicians.

Method

This preplanned secondary analysis of 2 large, multicenter trials included a randomized, crossover trial conducted from November 2019 to June 2020 of 100 residents that compared driving and seated condition for two 30-minute podcasts and a randomized, crossover trial conducted from September 2022 to January 2023 of 95 EM residents that compared exercise with seated condition for the same two 30-minute podcasts. Each podcast contained 6 journal article reviews, with the segments recorded in forward or backward order. After completing each podcast, participants completed an initial 20-question test and a 40-question delayed recall test with separate questions. Segments were divided into 3 subgroups based on the order in which they were played (primacy group, recency group, and reference group) for assessment of primacy and recency effects. The mean scaled scores from the primacy and recency groups were compared with scores from the reference group.

Results

The study included 195 residents (390 podcasts), with 100 residents listening in the forward order and 95 residents the reverse order. No statistically significant difference was found in immediate recall scores between the primacy and reference groups (d = 0.094; 95% CI, −0.046 to 0.234) or the recency and reference groups (d = −0.041; 95% CI, −0.181 to 0.099) or in 30-day delayed recall score between the primacy and reference groups (d = −0.088; 95% CI, −0.232 to 0.056) or the recency and reference groups (d = −0.083; 95% CI, −0.227 to 0.060).

Conclusions

The order of podcast information did not significantly affect immediate knowledge acquisition or delayed knowledge retention. This finding can inform podcast creators and listeners regarding the order of content when using podcasts for learning.
Comparing clinical and patient-reported outcomes between robot-assisted and conventional unicompartmental knee arthroplasty
Authors: Strait Alexander V. , Lee Ji Won , Supra Rajesh , Jeong Suin , Tefera Eshetu A , Desale Sameer , McCormick Brian , Boucher Henry R.
Published: September 2024

Background:

Robot-assisted (RA) unicompartmental knee arthroplasty (UKA) has been associated with improved implant alignment and accuracy compared to conventional UKA; however, it is unclear if this translates to improved outcomes. The aim of this study was to compare short-term clinical and functional outcomes between RA and conventional UKA.

Methods:

A retrospective review of primary UKAs performed by a single surgeon from 2002 to 2021 was conducted using the institution’s electronic health records and outcomes database. Outcomes included 90-day complications, cumulative revisions, implant survivorship, and patient-reported outcome measures (PROMs). Oxford Knee Scores (OKS) and SF-12 physical and mental were compared using a mixed-effect regression model. A Kaplan-Meier curve was plotted to illustrate survivorship using revision as the endpoint.

Results:

A total of 397 cases were included (RA: n=85; conventional: n=312). The RA group had significantly more men (P<0.01) and a lower median BMI (P=0.02). Age and comorbidities were similar between groups (P>0.05). There was no difference in the rates of 90-day complications (RA: n=0, 0% vs. conventional: n=1, 0.9%, P=1). Significantly fewer cumulative revisions occurred in the RA group (RA: n=0, 0% vs. conventional: n=18, 5.8%; P=0.02). The median lengths of follow-up for RA and conventional UKA were 772 and 5,393 days, respectively. Both techniques showed within-group improvement in OKS and SF-12 physical through 2 yr (P<0.01). No between-group differences in PROMs occurred at any time point.

Conclusions:

Medial, fixed-bearing RA UKA shows no compromise in patient safety or outcomes when compared to conventional UKA through early-term follow-up.
Is Opioid Consumption Impacted by Study Participation? Maintenance of Fewer Opioid Refills With Reduced Prescription Quantity After Posterior Spinal Fusion in Adolescents With Idiopathic Scoliosis
Authors: Gong Davin , Yang Daniel Z. , Caird Michelle S. , Stepanovich Matthew , Whyte Noelle , Li Ying
Published: September 2024

Background:

Opioid overprescribing can lead to nonmedical opioid use. In a previous prospective study (STUDY), we showed that a standardized protocol involving preoperative education and reduced opioid prescription quantity decreased opioid use in idiopathic scoliosis patients following posterior spinal fusion (PSF). A potential limitation was the Hawthorne effect, where participant behavior changes due to observation. At STUDY conclusion, we continued the reduced opioid prescriptions but discontinued the formal preoperative education. This retrospective study (post-STUDY) assessed if opioid refill requests increased outside of a study setting.

Methods:

Post-STUDY included patients aged 10 to 17 years who underwent PSF for idiopathic scoliosis between January 2022 and December 2023 and were discharged with a prescription of ≤30 oxycodone doses. Patients were excluded if they had previous spine surgery or were discharged with an opioid other than oxycodone. Demographics, perioperative variables, and opioid refill requests were compared with the data from STUDY, in which patients were aware their opioid use would be tracked. Patient-reported outcomes were collected via Scoliosis Research Society-22r (SRS-22r) surveys.

Results:

The post-STUDY cohort included 67 patients (69% female). The average age at the time of PSF was 13.9 years (range, 11 to 17 y). The mean number of levels fused was slightly higher (10.9 vs. 10.0, P=0.04), and intraoperative estimated blood loss was lower (211 vs. 303 mL, P<0.01) compared with the STUDY cohort. Demographics, preoperative major curve magnitude, surgery duration, and length of hospital stay were similar. The percentage of patients who requested and received opioid refills between the post-STUDY and STUDY cohorts was also similar [6/67 (9%) vs. 3/49 (6%), P=0.30]. SRS-22r showed improvements in self-image, satisfaction, and mean total score from preoperative to postoperative.

Conclusions:

Reduced opioid prescriptions did not result in increased opioid refill requests in adolescents undergoing PSF for idiopathic scoliosis outside of a study setting. While formal preoperative discussions about postoperative pain control are important, other factors likely influence opioid use. Further research should explore characteristics that predispose patients to require higher amounts of postoperative opioids.

Level of Evidence:

Level III—therapeutic.
The Relationship Between Obesity and Lateral Condyle Fracture Healing: A Pilot Study
Authors: Smithey Jake , Debevec Cole , Jha Aaradhana , Gillon William , Dillon Tyler , Forrest Akeelein , Middleton Adam , Bhanat Eldrin , Nehete Priyanka , Melancon Drew P. , Spears Isaac J. , Leitch K. Kellie
Published: September 2024

Objective:

Childhood obesity is a growing public health concern in the United States. Obesity has been shown to lead to increased complications with regards to orthopaedic injuries, such as more severe fracture patterns, notably observed in injuries like lateral condyle fractures of the humerus. However, there is currently a gap in the literature regarding the relationship between obesity and the healing potential of these fractures. This study aims to determine whether obesity is associated with increased surgical time, wound/pin site infections, delayed union/nonunion, and time to union in pediatric patients with lateral condyle fractures of the humerus.

Methods:

A retrospective chart review was conducted at a level 1 trauma center on all patients 18 years or younger who sustained a lateral condyle fracture of the humerus. Patients were stratified into groups based on their body mass index-for-age percentile as defined by the Centers for Disease Control and Prevention; normal weight (<85%), overweight (85 to <95%), and obese (≥95%). Demographic data, Weiss classification, postoperative complications (infection, delayed union or nonunion, malunion, and need for repeat surgery), length of surgery, and time to union were recorded. Comparisons of categorical data were analyzed using χ2 tests. Analysis of variance was used to compare the means between weight cohorts for continuous data.

Results:

A total of 123 patients were analyzed. Sixty-six were categorized as normal weight, 20 were overweight, and 37 were obese. There were no significant differences between weight classes for any complications, including infection, delayed/nonunion, malunion, or repeat surgery. There was no correlation with fracture severity as defined by the Weiss classification of lateral condyle fractures in regards to weight cohort (P = 0.098). There was no significant difference in length of surgery (P = 0.393) or average time to union (P = 0.236) between the weight cohorts.

Conclusion:

In this study, population with higher pediatric obesity rates than the population average, there was no significant correlation between body mass index-for-age and each of the surgical complications reviewed, length of surgery, or time to union, indicating the healing potential of lateral condyle fractures in obese pediatric patients is no more compromised than that of their normal weight peers.

Level of Evidence:

Level III—a retrospective study.
Psoas Muscle Morphology
Authors: Emami Arash , Abdelmalek George , Davila Iciar , Changoor Stuart , Patel Neil , Coban Daniel , Sahai Nikhil , Sinha Kumar , Hwang Ki
Published: September 2024

Study Design.

Cross-sectional radioanatomic study.

Objective.

To introduce a classification system using magnetic resonance imaging to describe psoas morphology and examine the position of nearby neurovascular structures.

Background.

Oblique lumbar interbody fusion and lateral lumbar interbody fusion (LLIF) offer sagittal malignment correction and reduced morbidity. LLIF has a higher incidence of nerve injuries, whereas oblique lumbar interbody fusion has a higher incidence of vascular injuries.

Materials and Methods.

Measurements were completed on the left psoas at the inferior L4 endplate. Class A was designated if the ventral border of the psoas muscle was >2 mm anterior, class B if it was ≤ 2 mm anterior or posterior to the vertebral body, and class C if >2 mm posterior to the vertebral body ventral border. Modified oblique corridor, measured as the distance between two lines, one at the medial border of the psoas muscle and the other at the lateral border of the nearest vascular structure, and a preferred LLIF trajectory was projected onto an axial image of the left psoas. If the trajectory violated the posterior third of the psoas, it was considered a dangerous approach due to potential iatrogenic nerve injury.

Results.

One hundred patients' magnetic resonance imaging (class A: 44; class B: 27; class C: 29) were analyzed. The average modified oblique corridor was 7.49 mm. Modified oblique corridor varied among the 3 types of psoas morphologies (A: 8.99 mm vs. B: 8.10 mm vs. C: 4.66 mm, P = 0.040). LLIF trajectory intersected the “danger zone” in 34.1%, 3.7%, and 0.0% of patients, (P < 0.001), respectively.

Conclusion.

Class A psoas had the largest modified oblique corridor but the highest proportion of those with a dangerous LLIF trajectory. Class C psoas had the narrowest modified oblique corridor, but no dangerous LLIF trajectories were identified.
The role of wide local excision of a primary lesion in cutaneous malignant melanoma: a retrospective analysis of its usefulness in local and general control of disease
Authors: Nacchiero Eleonora , Giotta Massimo , Robusto Fabio , Metta Maria Elvira , Ronghi Valentina , Elia Rossella , Trerotoli Paolo , Maruccia Michele , Giudice Giuseppe
Published: September 2024

Currently, wide local excision is recommended after the primary excision of cutaneous melanomas. The definition of margins for wide local excision indicated by the guidelines has remained unchanged over the years, although the reported indications are derived from fairly dated studies in which melanomas tended to be thicker or in advanced stages at diagnosis. This study aimed to retrospectively evaluate the usefulness of wide local excision for local and general control of the disease and to identify patients who had benefited from the wide local excision procedure in terms of prognosis improvement. This retrospective observational study was conducted on patients who had undergone surgery for melanoma at a single institution. The primary endpoint was progression-free survival after wide local excision in patients with or without residual melanoma. The secondary endpoint was to evaluate which patients’ demographic features and melanoma histological data were associated with residual melanoma after wide local excision. In the univariate model, melanoma-positive wide local excision resulted in the worst progression-free survival; however, this association was not confirmed in the multivariate model. The results also showed that Breslow thickness was the only factor associated with an increased risk of metastasis to the wide local excision area. According to the receiver operating characteristic analysis, the optimum cutoff value of Breslow’s thickness to predict a tumor-positive wide local excision was 2.31 mm for males and 2.4 mm for females.
Perceived Stress and Health Outcomes Among Latinx and Non-Latinx White Adult People With HIV in East Harlem, New York: A Cross-Sectional Study
Authors: Slaughter Alexander W. , Stiver Jordan , Savin Micah , Oleas Denise S. , Lee Hyunjung , Summers Angela , Zhu Danqi , Cham Heining , Robinson-Papp Jessica , Mindt Monica Rivera
Published: September 2024

Stress and HIV disproportionately affect Latinx adults in the United States, contributing to numerous health inequities. Among people living with HIV (PLWH), increased stress is associated with decreased medication adherence, effectiveness, and higher rates of immunosuppression and comorbidities. Our study (N = 126) examined the relationship between perceived stress and HIV-related health among Latinx (n = 83) and non-Latinx White (n = 43) PLWH. Latinx PLWH reported better HIV-related health outcomes than non-Latinx White PLWH, despite higher viral load (all p's < .05). An interaction effect showed that higher perceived distress was associated with worse health outcomes and lower CD4+ T cell count only in Latinx PLWH (p's < .05). Our findings highlight the consequences of stress on HIV-related health. Notably, higher stress may be especially detrimental among Latinx PLWH, underscoring the need for more culturally tailored interventions in HIV-related care. Future research should include additional sociocultural factors and longitudinal assessment in a larger sample.
Eosinophilic gastrointestinal disorders and the role for the epithelium in pathogenesis and treatment
Authors: Rodríguez-López Eric M. , Hill David A.
Published: September 2024

Purpose of review

This review aims to provide an overview of the current understanding of eosinophilic gastrointestinal disorders (EGIDs) and the role of the epithelium in influencing disease pathogenesis to inform and devise future therapeutic strategies.

Recent findings

Changes in epithelial cell structure, functions, and integrity are observed in EGIDs. In eosinophilic esophagitis (EoE), the esophageal epithelium has been shown to play key roles in perpetuating the inflammatory response in EoE through the expression of pro-inflammatory cytokines and immunological cell-surface proteins. Similar mechanisms appear to exist in the other EGIDs, including eosinophilic gastritis (EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). Because of the increasing rarity of each non-EoE EGID, research focusing on how the epithelium is modulating disease in each lower gastrointestinal compartment is still in its rudimentary stages.

While there has been significant progress in understanding the role of the epithelium in EoE, further research is needed to obtain a better understanding of the mechanisms mediating epithelial-immune crosstalk in non-EoE EGIDs. Using EoE-epithelial cell research to inform future EGID investigations could lead to the development of new therapeutic interventions, such as targeted therapies to restore epithelial barrier function and reduce inflammation, to improve rare disease-patient quality of life.
Barriers to the Uptake of Tickborne Disease Prevention Measures: Connecticut, Maryland 2016-2017
Authors: Hansen AmberJean P. , Wilkinson Melanie M. , Niesobecki Sara , Rutz Heather , Meek James I. , Niccolai Linda , Hinckley Alison F. , Hook Sarah
Published: September 2024

Context

Public health programs promote numerous tickborne disease (TBD) prevention measures. However, measures are not frequently or consistently performed.

Objective

Describe barriers to consistent use of 4 commonly promoted TBD prevention measures.

Design

We conducted an online survey (n = 1883) evaluating behaviors regarding TBD prevention measures including conducting tick checks, applying insect repellents, showering/bathing, and applying chemical or natural pesticides to residential yards. Respondents could select reasons for never, rarely, or sometimes performing these measures. Descriptive analysis and logistic regression modeling evaluated associations between the 3 most cited barriers for each measure and select demographic variables.

Setting

The survey was administered to residents in high Lyme disease incidence counties of Connecticut and Maryland, 2016-2017.

Results

For tick checks (n = 800), the most cited barriers were forgetting (63%), not spending time in tick habitat (28%), and too much trouble (11%). For applying insect repellents (n = 1303), the most cited barriers were forgetting (38%), personal safety concerns (24%), and too much trouble (19%). For showering/bathing 2 hours after outdoor activity in tick habitat (n = 1080), the most cited barriers were being unaware of the prevention measure (51%), too much trouble (18%), and forgetting (18%). For applying chemical pesticides to yards (n = 1320), the most cited barriers were having environmental (45%), pet safety (31%), and personal safety concerns (28%). Lastly, for applying natural pesticides to yards (n = 1357), the most cited barriers were being unaware of natural pesticides (31%), having cost concerns (23%), and not being concerned about ticks on property (16%).

Conclusions

Forgetting, too much trouble, unawareness, and safety concerns were primary barriers to using several TBD prevention measures. Education regarding effectiveness, safety, and timing may increase uptake of certain measures. These challenges can be difficult to address, highlighting the need for passive TBD prevention measures, such as a Lyme disease vaccine.
Review of Local Homeless Mortality Efforts: A Call for Standardized Data and Reporting
Authors: Meehan Ashley A. , King Ben T. , Biggs Rachel , Boyer Alaina P. , Berner-Davis Lauryn , DiPietro Barbara
Published: September 2024

Context:

There are currently no national estimates of how many people die while unhoused in the US. Local jurisdictions have developed their own approaches for estimating homeless mortality.

Objective:

We aimed to examine these local approaches, document what is known about homeless mortality, and summarize local methodologies.

Design:

We reviewed 17 publicly available homeless mortality reports (ie, gray literature).

Setting:

Reports were sought from government, Health Care for the Homeless, coalition to end homelessness, and other advocacy and social service websites.

Main Outcome:

From each report, we extracted the number of homeless deaths, dates of observation, data source(s) used, determination of homeless status, manners and causes of death, and decedent demographics.

Results:

Data collection and reporting on homeless mortality varied greatly across reports. This variation limits aggregation across reports. Medical examiner data was the most used data source. Manner of death was the most consistently collected field, with accidental deaths reported as the most prevalent manner of homeless deaths. Not all reports listed specific causes of death, but those that did reported toxicity (eg, overdose) and cardiovascular causes as most prevalent. The most granular age category of most homeless decedents was 40 to 60 years. On average, 80% of decedents were of male sex. While over half of reports included race and ethnicity information, disparities could not be estimated without suitable denominators.

Conclusions:

Standardized data collection and reporting guidance is needed for homeless mortality. Health departments can work with local Health Care for the Homeless programs and Continuums of Care to establish data sharing processes. Matching vital statistics with homeless service utilization records may be one opportunity to improve these efforts. Until there is federal or national guidance on these standards, localities can consider adding housing or homelessness variables as optional or mandatory fields in electronic death reporting systems.