bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective attenuation of Paraquat induced oxidative stress and Genotoxicity in testicular germ cells by vitamin E in Caprines
Authors: Rathee Vishavjeet , Bikal Prerna , Siwach Anshu , Bhardwaj Jitender Kumar
Published: September 2024

Toxicological empirical research suggests that excessive utilization of paraquat, an herbicide, shows detrimental consequences on mammalian reproductive toxicity. The current study aims to study it as a reproductive toxin on the caprine testicular cells at 4- and 6-hour exposure duration. Paraquat treatment decreased the cell viability percentage and induced histological architectural alterations such as disruption of germinal epithelium, vacuolization, and pyknotic nuclei in the testis. The differential EB/AO staining also revealed an increased incidence of apoptosis after paraquat treatment at both dosages, i.e. 10 mM and 100 mM. Paraquat also induces oxidative stress, as evident via increased Malondialdehyde levels (a byproduct of lipid peroxidation) and a decline in the antioxidant capacity (FRAP). However, co-administration of Vitamin E significantly reduced the paraquat-mediated decline in cell viability percentage, histological alterations, and apoptosis incidences and generated oxidative stress, indicating its antioxidative properties against paraquat exposure. This research concludes that Vitamin E co-administration considerably reduced the toxicity of paraquat elicited in testicles, suggesting that Vitamin E may have advantageous potential in preventing the male gonadotoxicity caused by paraquat use in agriculture.
MAD2L1 supports MYC-driven liver carcinogenesis in mice and predicts poor prognosis in human hepatocarcinoma
Authors: Lu Xinjun , Zhang Ya , Xue Jiahao , Evert Matthias , Calvisi Diego , Chen Xin , Wang Xue
Published: September 2024

Mitotic arrest-deficient 2 like 1 (MAD2L1) is a component of the mitotic spindle assembly checkpoint implicated in cancer cell proliferation and tumorigenesis. The functional role of MAD2L1 in hepatocellular carcinoma (HCC) has not been adequately investigated, especially in vivo. In the current manuscript, we sought to address the function of MAD2L1 in hepatocarcinogenesis. We found that MAD2L1 expression is upregulated in human HCCs, where its expression is associated with higher aggressive tumor grade, elevated proliferative activity, and poor prognosis. In human HCC cell lines, MAD2L1 knockdown led to decreased cell growth. Moreover, RNA-seq results demonstrated that MAD2L1 silencing induces the expression of genes associated with cell cycle, DNA replication, and various cancer-related pathways, supporting the critical role of MAD2L1 during HCC growth and differentiation. In a c-MYC-induced mouse HCC model, we revealed an increased expression of Mad2l1. Furthermore, Mad2l1 CRIPSR-mediated silencing prevented c-MYC-driven mouse liver development. Altogether, our study suggests that MAD2L1 plays a crucial role in hepatocarcinogenesis, and that its suppression could be a promising therapeutic strategy for treating human HCC.

MAD2L1 plays a critical role in liver cancer development, silencing MAD2L1 reduced cell growth in vitro and inhibited c-MYC-driven liver cancer development in vivo. MAD2L1 suppression might be a promising therapeutic approach for treating human liver cancer.
Promoting identification of obstructive sleep apnea among patients with psychiatric conditions
Authors: Smith Delaine , Toerber-Clark Jody
Published: September 2024

Obstructive sleep apnea (OSA) is prevalent but remains underdiagnosed and undertreated. Recognizing OSA in patients with psychiatric disorders can be challenging due to the conditions' overlapping symptoms. To aid primary care NPs in identifying OSA among patients with psychiatric disorders, this article examines overlapping symptoms and outlines diagnostic reasoning. It also provides an overview of the anatomy and neurotransmitters involved in OSA, as well as OSA-specific screening tools and risk stratification, to promote the condition's identification among this population.
Gender Differences in Clinical Performance Assessment of Internal Medicine Residents: A Longitudinal Analysis of the Influence of Faculty and Trainee Gender
Authors: Klein Robin , Julian Katherine A. , Koch Jennifer , Snyder Erin D. , Jassal Simerjot , Simon Wendy , Millard Alex , Uthlaut Brian , Burnett-Bowie Sherri-Ann M. , Ufere Nneka N. , Alba-Nguyen Sarah , Volerman Anna , Thompson Vanessa , Kumar Anshul , White B.A. , Park Yoon Soo , Palamara Kerri ,   for the Gender Equity in Medicine Workgroup
Published: September 2024

Purpose

Competency-based medical education relies on equitable assessment. This study examined the influence of faculty and trainee gender on assessments of internal medicine (IM) resident performance over time.

Method

A longitudinal analysis of clinical performance assessments from 7 U.S. IM residency programs (July 2014–June 2019) was conducted. Core competency scores (patient care [PC], medical knowledge [MK], practice-based learning and improvement [PBLI], systems-based practice [SBP], professionalism [PROF], and interpersonal and communication skills [ICS]) were standardized across programs. Cross-classified mixed-effects linear regression evaluated the relationship between gender and standardized competency scores within training programs, while adjusting for multiple variables including IM In Training Examination percentile rank.

Results

Data included 9,346 evaluations by 1,011 faculty (552 [55%] men, 459 [45%] women) for 664 residents (358 [54%] men, 306 [46%] women). Initially, women residents’ scores were significantly lower than men’s in PC (estimated difference [standard error], −0.097 [0.033]; P = .004), MK (−0.145 [0.034], P < .001), and PBLI (−0.090 [0.040], P = .022). PC, MK, PBLI, and SBP scores increased more over time for women residents than men (PC: 0.050 [0.015], P = .001; MK: 0.052 [0.015], P = .001; PBLI: 0.036 [0.018], P = .048; SBP: 0.036 [0.016], P = .027). PROF and ICS scores were comparable across gender. There was a significant interaction between faculty gender and postgraduate year (PGY) across all competencies but none between resident gender, faculty gender, and PGY, indicating that men and women faculty rated residents differently over time but were consistent in how they rated men and women residents.

Conclusions

Gender-based assessment differences were variable across competencies and time. Women residents had lower scores initially but greater gains in “hard skill” (MK, PC, and PBLI) than in “soft skill” (ICS and PROF) competencies, suggesting assessment inequities. Efforts to ensure equitable assessment are needed.
Doubly Marginalized: The Interplay of Racism and Disability in Outcomes for Minoritized People With Down Syndrome
Authors: Tewolde Salina , Scott Ashley , Higgins Alianna , Blake Jasmine , Michals Amy , Fox Matthew P. , Tripodis Yorghos , Rubenstein Eric
Published: September 2024

Background:

Intersectionality, or the multidimensional influence of social identity and systems of power, may drive increased morbidity and mortality for adults of color with Down syndrome. We documented racial and ethnic differences in death and hospitalizations among Medicaid-enrolled adults with Down syndrome and assessed the interaction of racial–ethnic group and Down syndrome.

Methods:

Our sample consisted of 119,325 adults with Down syndrome and >3.2 million adults without intellectual disability enrolled in Medicare at any point from 2011 to 2019. We calculated age-adjusted mortality and hospitalization rates by racial–ethnic group among those with Down syndrome. We examined the additive interaction between Down syndrome and racial and ethnic group on mortality and hospitalization rates.

Results:

Among those with Down syndrome, age-adjusted mortality rate did not differ between Black and White racial groups (rate ratio: 0.96, 95% confidence interval [CI] = 0.92, 1.01), while the mortality rate was lower for Pacific Islanders (0.80), Asian (0.71), Native (0.77), and mixed-race groups (0.50). Hospitalization rates were higher for all marginalized groups compared to the White group. When assessing the interaction between racial–ethnic group and Down syndrome, Black, Native Americans, and mixed-race groups exhibited a negative additive interaction for mortality rate, and all groups except Native Americans exhibited positive additive interaction for hospitalization.

Conclusions:

Increased hospitalization rates for adults with Down syndrome from marginalized racial and ethnic groups suggest worse health and healthcare. Similar mortality rates across racial and ethnic groups may result from an increased infant mortality rate in marginalized groups with Down syndrome, leading to reduced mortality among those surviving to adulthood.
User engagement with home blood pressure monitoring: a multinational cohort using real-world data collected with a connected device
Authors: Rech Jean-Simon , Postel-Vinay Nicolas , Vercamer Vincent , de Villèle Paul , Steichen Olivier
Published: September 2024

Objective:

Connected blood pressure (BP) monitors provide reliable data when used properly. Our objective was to analyse the engagement of real-world users with self-measurements.

Methods:

We included adult first-time users of a connected BP monitor from July 2019 to March 2021. They were categorized as persistent users if they continued to use the device between 311 and 400 days after inclusion. We defined a criterion to analyse the timing of self-measurements: at least 12 measurements performed within three consecutive days, at least once every 90 days. Persistent users were clustered by state sequence analysis according to the consistency of their BP monitor measurement timing with this criterion during 1 year of follow-up.

Results:

Among the 22 177 included users, 11 869 (54%) were persistent during the first year. Their use was consistent with the timing criterion 25% (median) of this time (first and third quartiles: 0%, 50%) and four patterns of use were identified by clustering: 5215 persistent users (44%) only performed occasional sparse measurements, 4054 (34%) complied at the start of follow-up up to eight cumulated months, 1113 (9%) complied at least once during later follow-up up to eight cumulated months, and the remaining 1487 (13%) complied nine or more cumulated months of follow-up.

Conclusion:

Although connected BP monitors can collect a high volume of data, the real-life timing of self-measurements is far from recommended schedules. We must promote the use of BP monitors as recommended by guidelines and/or learn to analyse more occasional and sparse measurements.
Factors Predicting Slow Visual Recovery Following Myopic Photorefractive Keratectomy
Authors: Safir Margarita , Ramon Dan , Kaiserman Igor , Sela Tzahi , Munzer Gur , Sorkin Nir , Mimouni Michael
Published: September 2024

Purpose:

To identify factors predicting slow visual recovery following photorefractive keratectomy (PRK).

Methods:

This retrospective study included consecutive patients who underwent PRK between January 2005 and December 2019 at Care Vision Laser Center, Tel Aviv, Israel. Myopic patients were divided into 2 groups according to whether they experienced normal recovery of visual acuity (within 60 days) or slow visual recovery (>60 days). Visual recovery was defined as achieving an efficacy index of 0.9 or greater. Efficacy index was calculated as postoperative uncorrected visual acuity/preoperative best corrected visual acuity. A comparison of baseline and intraoperative parameters was performed. Binary logistic regression was performed to identify potential predictors of slow visual recovery.

Results:

Overall, 4868 eyes were included. The mean age was 25.9 ± 7.7 years, and 53.9% were male. The slow visual recovery group (39.3%, n = 1911/4868) was older (P < 0.001) and had greater refractive astigmatism (P < 0.001) with a larger proportion of recent contact lens wearers (P = 0.002). The slow recovery group had larger optic zone treatments (P < 0.001), alcohol-assisted PRK (vs. transepithelial PRK) (P < 0.001), and greater maximum ablation depth (P < 0.001). In binary logistic regression, older age (P < 0.001), higher refractive astigmatism (P = 0.01), recent contact lens wear (P = 0.01), greater optic zone treatment (P = 0.001), and alcohol-assisted PRK (P < 0.001) remained significant predictors of slow visual recovery.

Conclusions:

Slow visual recovery was observed in ∼40% of patients following myopic PRK. Older age, greater refractive astigmatism, recent contact lens wear, greater optic zone treatment, and alcohol-assisted PRK were associated with slow visual recovery.
Optical Coherence Tomography Angiography Analysis of Peripapillary Choroidal Microvascular Density in Normal Tension Glaucoma and Primary Open Angle Glaucoma
Authors: Lin Yongdong , Wang Hongxi , Chen Shirong , Xiao Kailin , Liu Xujia , Xie Xiaolin , Zheng Xin , Tan Li , Ma Di
Published: September 2024

Précis:

Glaucoma patients had a reduction in the inner annulus peripapillary choroidal microvascular density (PCMD) that became worse as the glaucoma severity progressed, which might provide new evidence supporting the vascular theory.

Purpose:

To compare PCMD among normal tension glaucoma (NTG), primary open angle glaucoma (POAG), and healthy controls using optical coherence tomography (OCT) angiography (OCTA).

Materials and Methods:

The study included 40 POAG, 25 NTG, and 33 healthy controls. All subjects underwent OCT and OCTA testing. The inner annulus and outer annulus PCMD, as well as peripapillary vessel density (VD), were calculated. One-way analysis of variance was used to compare the vascular parameters of the 3 groups. Pearson correlation analysis or Spearman correlation test was used to evaluate the correlation between PCMD and glaucomatous severity factors. The spatial positional relationship between PCMD and corresponding peripapillary retinal nerve fiber layer (RNFL) thickness and visual field (VF) mean deviation (MD) was also assessed.

Results:

The average and 4 quadrants of the inner annulus PCMD and peripapillary VD in the 2 glaucomatous groups were significantly lower than in normal eyes (P<0.05). Strong correlations were found between inner annulus PCMD and VF MD, peripapillary VD, and RNFL in POAG patients. Similarly, the inner annulus PCMD in NTG patients was strongly correlated with peripapillary VD and RNFL (all r>0.5). Strong positional correlations were found between inner superior quadrantal PCMD and RNFL thickness in both POAG and NTG patients (r=0.566 and 0.731, respectively). Likewise, inner inferior quadrantal PCMD exhibited a strong correlation with RNFL thickness in POAG patients (r=0.608). Strong positional correlations were also found between inner superior PCMD and VF MD in both POAG and NTG patients (r=0.589 and 0.622, respectively). Inner inferior PCMD exhibited a moderate correlation with VF MD in both POAG and NTG patients (r=0.487 and 0.440, respectively).

Conclusion:

The study found that the inner annulus PCMD decreased to varying degrees in NTG and POAG patients. The inner annulus PCMD was closely related to the structural and visual function parameters of glaucoma in both NTG and POAG. Furthermore, inner PCMD demonstrated a spatial correlation with corresponding RNFL thickness and VF MD.
The rising cost of liver transplantation in the United States
Authors: Kaplan Alyson , Winters Adam , Klarman Sharon , Kriss Michael , Hughes Dempsey , Sharma Pratima , Asrani Sumeet , Hutchison Alan , Myoung Paul , Zaman Asad , Butler Laura , Pomposelli James , Gordon Fredric , Duarte-Rojo Andres , Devuni Deepika , Fortune Brett
Published: September 2024

Liver transplantation (LT) is the only curative treatment for end-stage liver disease and significantly improves patient outcomes. However, LT is resource-intensive and costly, with expenditures rising dramatically in recent years. Factors contributing to this increase in cost include expanded transplant criteria, utilization of marginal organs, and broader organ distribution, resulting in significant logistical expenses. Advanced technologies like organ perfusion devices, while promising better outcomes, further inflate costs due to their high price and market monopolization. Moreover, living donor liver transplant and utilization of donation after cardiac death organs introduce higher initial expenditures yet potential long-term savings. Despite rising costs, reimbursement has remained largely stagnant, putting financial strain on transplant programs, and threatening their sustainability. This review examines the multifaceted drivers of rising costs in LT, focusing on recent policy changes, the role of organ procurement organizations, and the impact of new technologies. We also propose comprehensive solutions at national, organ procurement organization, and local levels, including optimizing resource allocation, leveraging regional collaborations, and advocating for revised reimbursement models to curb escalating costs. Addressing these challenges is critical to ensuring the continued viability of LT programs and maintaining patient access to this life-saving intervention.
Glucagon-like peptide-1 agonists in cardiovascular diseases: a bibliometric analysis from inception to 2023
Authors: Mahapatro Abinash , Bozorgi Ali , Obulareddy Sri U.J. , Jain Shika M. , Reddy Korsapati Rohan , Kumar Aroon , Patel Kristina , Soltani Moghadam Saman , Arya Arash , Jameel Alotaibi Abdulhadi , Keivanlou Mohammad-Hossein , Hassanipour Soheil , Hasanpour Maryam , Amini-Salehi Ehsan
Published: September 2024

Background:

In recent years, glucagon-like peptide-1 (GLP-1) agonists have garnered increasing attention for their potential cardiovascular benefits beyond glycemic control in patients with diabetes. Understanding the research landscape surrounding GLP-1 agonists and cardiovascular diseases (CVDs) is crucial for informing clinical practice and guiding future research endeavors. This bibliometric analysis aimed to comprehensively assess the scholarly output and trends in this field, shedding light on the evolving landscape of GLP-1 agonists’ role in cardiovascular health.

Methods:

The publications concerning GLP-1 agonists in CVDs were gathered from the Web of Science Core Collection, and visualizations were created utilizing Excel 2019, Cite Space, and VOS viewer software.

Results and Conclusion:

Using bibliometric and visual methods, the research hotspots and trends regarding GLP-1 agonists in cardiovascular diseases were pinpointed. Additionally, a thriving interest in GLP-1 agonists research within cardiovascular medicine was observed, with a notable surge in publications from 2016 onwards. The analysis revealed that the United States and China are the leading contributors, accounting for over 50% of the total publications. The University of Copenhagen and the University of Toronto emerged as the most prolific institutions in this field. Co-citation analysis highlighted the influential role of landmark clinical trials, such as the LEADER, ELIXA, and EXSCEL. Keyword trend analysis identified the emergence of newer GLP-1 agonists, such as tirzepatide and semaglutide, as well as a growing focus on topics like ‘healthy obesity’ and chronic kidney disease. These findings suggest that the research landscape is evolving, with a focus on expanding the therapeutic applications of GLP-1 agonists beyond glycemic control. Overall, this bibliometric analysis provided insights into the current state and future directions of research on GLP-1 agonists and their impact on cardiovascular health, guiding future research endeavors, and informing clinical practice.
Comparing Men Who Have Sex With Men Only and Men Who Have Sex With Men and Women Visiting a Public Sexually Transmitted Infection Clinic
Authors: Reese Amanda C. , Ghanem Khalil , Gilliams Elizabeth , Hamill Matthew , Page Kathleen R. , Tuddenham Susan
Published: September 2024

Background

Men reporting same-sex behaviors are disproportionately impacted by sexually transmitted infections (STIs). Differences in clinical characteristics and STIs in men who have sex with men only (MSMO), with men and women (MSMW), and with women only (MSW) are not well described.

Methods

First visits to 2 Baltimore City STI clinics 2011–2016 from MSMO and MSMW compared with an age-matched random sample of MSW were analyzed. Acute STI (aSTI) included chlamydia, gonorrhea, nongonococcal urethritis, and primary or secondary syphilis. χ
2 Tests and logistic regression examined associations.

Results

Among N = 1226 MSMO, N = 491 MSMW, and N = 1717 MSW, most identified as Black/African American; mean age (29.8 years) was similar across groups. The percentages of MSMW, MSMO, and MSW who reported ≥2 partners in the last 6 months were 73.5%, 67.2%, and 60.3%, respectively. “Always” condom use was reported by 20.4%, 17.4%, and 14.1% of MSMW, MSMO, and MSW. Overall HIV prevalence was 13.8%. Among those tested, urogenital chlamydia prevalence rates were 21.7%, 8.3%, and 3.9% (P ≤ 0.01) in MSW, MSMW, and MSMO. Urogenital gonorrhea prevalence was 11.6%, 7.7%, and 8.3% in MSMW, MSW, and MSMO, respectively. Extragenital STI (range, 2.7%–21.9%), nongonococcal urethritis (25.2%), and primary or secondary syphilis (5.3%–5.7%) positivity was similar in MSMW and MSMO. Older age was inversely associated with STI diagnosis in MSW and MSMO only; consistent condom use was protective against aSTI in MSW (adjusted odds ratio, 0.60; P < 0.01) and MSMW (adjusted odds ratio, 0.54; P = 0.03) only.

Conclusions

Differences in behaviors and clinical characteristics associated with aSTI suggest that MSMO, MSMW, and MSW have diverse sexual health needs and may require tailored interventions to improve sexual health outcomes.
A Modification to the Assessment of Problem-Solving in Play to Enhance Its Utility: Evaluation of Validity, Responsiveness, and Reliability
Authors: Molinini Rebecca M. , Koziol Natalie A , Inamdar Ketaki , Rhee Claire , Salgaonkar Arya , Harbourne Regina T. , Hsu Lin-Ya , Westcott Mccoy Sarah , Lobo Michele A. , Bovaird James , Burnsed Jennifer , Spence Christine , Stevenson Richard , Dusing Stacey C.
Published: September 2024

Purpose:

This study investigated the psychometric properties of a 4-second interval scoring modification of the Assessment of Problem-Solving in Play (ie, Assessment of Problem-Solving in Play 4-second interval scoring [APSP-4]).

Methods:

A total of 95 children (3-48 months) with or at high risk for neuromotor delay were assessed with the APSP-4 and Bayley Scales of Infant and Toddler Development-III (Bayley). APSP-4 and Bayley cognitive raw scores were compared by age (construct validity) and over time (responsiveness). Twenty percent of videos were scored twice for intra- and interrater reliability.

Results:

The APSP-4 demonstrated excellent interrater (intraclass correlations [ICCs] ≥ 0.96) and intrarater (ICCs ≥ 0.99) reliability and performed similar to Bayley cognitive raw scores at different ages (rs > 0.5), and over time (r = 0.81). The motor delay had similar effects on APSP-4 and Bayley scores.

Conclusions:

Results support the validity and reliability evidence of the APSP-4 for use over time in tracking problem-solving skills in young children aged 3 to 48 months. Future research investigating clinical implementation of the APSP-4 is needed.
Challenges of patients with intrathecal baclofen pump therapy during COVID-19 pandemic in Saudi Arabia
Authors: Qureshi Ahmad Zaheer , Shacfe Hasan , Jameel Mohammed , Sami Waqas , Moukais Imad S. , Qannam Fares , Ortega Lady Lynn Salazar , Wani Tariq
Published: September 2024

Background:

This study was carried out to analyze the effects of the coronavirus disease 2019 (COVID-19) pandemic on patients with intrathecal baclofen (ITB) therapy.

Methods:

Patients who came for ITB refill during the COVID-19 pandemic between March 2020 and August 2020 were contacted, and a survey was conducted regarding challenges faced during the COVID-19 pandemic. Data obtained from the chart review included demographics, diagnoses, pump information, baclofen dose, and COVID triage. Information was collected regarding travel arrangements, appointments, and problems related to ITB therapy or travel. The survey included 12 multiple-choice questions related to travel, appointment scheduling, and difficulties faced during the travel restrictions.

Results:

The study included 19 patients with ITB (mean age: 38.1±14.4) from outside Riyadh city who came for ITB refill during the COVID-19 pandemic. The majority of the patients were males. Spinal cord injury with paraplegia was the most common diagnosis (52.6%). In total, 7 patients had either clinical (31.6%) or travel-related difficulties (15.8%). No patient had ITB withdrawal at the time of the clinic visit. Nearly half (47.4%) of the patients had to change their appointment for refill. The percentage of patients who used a car as a mode of travel pre-COVID was 42.1%, which increased to 78.9% during the pandemic. They traveled 747.4±356.6 km (7.4±3.7 h) to reach the hospital for refill. Patients needed 1–4 accompanied persons for assistance during travel, with the majority (68.4%) requiring 2 accompanied persons. Statistical analysis did not reveal any significant associations between clinical or travel difficulties and appointment changes.

Conclusions:

A pandemic or similar disaster can pose challenges to patients on ITB therapy living in areas with limited access to specialized care. In this study, none of the patients had serious complications or adverse outcomes; however, the main difficulties were attributed to travel. It is crucial to establish strategies at institutional, regional, or national levels to formulate guidelines for managing patients with ITB therapy during a pandemic.
Accuracy of Preoperative Imaging in Assessing the Positivity of the Deep Periosteal Margin in Dermatofibrosarcoma Protuberans of the Scalp
Authors: Cherukuri Sai , Zheng Eugene , Guerin Julie , Brewer Jerry , Mardini Samir , Gibreel Waleed
Published: September 2024

The locally aggressive nature and high recurrence rate of dermatofibrosarcoma protuberans (DFSP) make it challenging to manage, especially when present on the scalp, owing to its ability to invade the underlying periosteum, bone, dura, or brain. Preoperative imaging is used to plan resection, but the true correlation between periosteal or osseous changes on imaging and the presence of tumor within the periosteum is unclear. We present our institutional experience of managing DFSP of the scalp with emphasis on the imaging used. A retrospective review of 33 patients with DFSP of the scalp treated at a tertiary center was conducted. Data on demographics, tumor characteristics, preoperative imaging (magnetic resonance imaging or computed tomography), and surgical outcomes were analyzed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each imaging modality were calculated. Patients underwent surgical resection at a mean age of 37.11 years and had a median follow-up of 28.34 months. Preoperative imaging was available for 26 patients (CT only: 5, MRI only: 12, CT and MRI: 9). Calvarial abnormalities were seen in 3 patients. Treatment included Mohs surgery (66.7%) and wide local excision (33.3%). In 10 patients with positive periosteal margins, bone involvement was managed by burring (7) or craniectomy (3). The sensitivity and PPV of CT for periosteal margin positivity were 25% and 100%, and for MRI were 33% and 100%, respectively. The specificity and NPV were 100% and 50% for CT, and 100% and 66% for MRI. Preoperative CT and MRI have low sensitivity and NPV but high specificity and PPV in determining depth of involvement and are essential to guiding reconstruction in DFSP of the scalp.
2024 Guideline for Management of Wounds in Patients With Lower Extremity Arterial Disease
Authors: Bonham Phyllis A. , Droste Linda R. , González Arturo , Kelechi Teresa J. , Ratliff Catherine R.
Published: September 2024

This article is an executive summary of the Wound, Ostomy, and Continence Nurses Society’s (WOCN) 2024 Guideline for Management of Wounds in Patients With Lower Extremity Arterial Disease. It is part of the Society’s Clinical Practice Guideline Series. This article presents an overview of the systematic process used to update and develop the guideline. It also lists specific recommendations from the guideline for screening and diagnosis, assessment, management, and education of patients with wounds due to lower extremity arterial disease (LEAD). Suggestions for implementing recommendations from the guideline are also summarized. The guideline is a resource for WOC nurse specialists, other nurses, and health care professionals who work with adults who have/or are at risk of wounds due to LEAD. The complete guideline includes the evidence and references supporting the recommendations, and it is available from the WOCN Society’s Bookstore (www.wocn.org). Refer to the Supplemental Digital Content Appendix (available at: http://links.lww.com/JWOCN/A123) associated with this article for a complete reference list for the guideline.
Phytochemical profiles of honey bees (
Apis mellifera
) and their larvae differ from the composition of their pollen diet
Authors: Vidkjær Nanna Hjort , Laursen Bente B. , Kryger Per
Published: September 2024

Pollen and nectar consumed by honey bees contain plant secondary metabolites (PSMs) with vital roles in plant–insect interactions. While PSMs can be toxic to bees, they can also be health-promoting, e.g. by improving pesticide and pathogen tolerances. As xenobiotics, PSMs undergo post-ingestion chemical modifications that can affect their bioactivity and transmission to the brood. Despite the importance of understanding honey bee PSM metabolism and distribution for elucidating bioactivity mechanisms, these aspects remain largely unexplored. In this study, we used HPLC-MS/MS to profile 47 pollen PSMs in honey bees and larvae. Both adult bees and larvae had distinct PSM profiles that differed from their diet. This is likely due to post-ingestion metabolism and compound-dependent variations in PSM transmission to the brood via nurse bee jelly. Phenolic acids and flavonoid aglycones were most abundant in bees and larvae, whereas alkaloids, cyanogenic glycosides and diterpenoids had the lowest abundance despite being consumed in higher concentrations. This study documents larval exposure to a variety of PSMs for the first time, with concentrations increasing from early to late larval instars. Our findings provide novel insights into the post-ingestion fate of PSMs in honey bees, providing a foundation for further exploration of biotransformation pathways and PSM effects on honey bee health.
Synchrony within, synchrony without: establishing the link between interpersonal behavioural and brain-to-brain synchrony during role-play
Authors: Lim Mengyu , Carollo Alessandro , Bizzego Andrea , Chen Annabel S. H. , Esposito Gianluca
Published: September 2024

Interpersonal synchrony is a crucial construct in understanding social interactions, which has been used in clinical studies to measure the quality of the therapeutic alliance. However, there is a lack of studies investigating the correlation between synchrony expressed on different levels: behavioural and neurophysiological. Furthermore, there are no studies that examine how the implementation of psychodramatic role-playing techniques, when individuals adopt the persona of a different character, may influence intrinsic biobehavioural synchrony between two parties. The present study, therefore, aims to uncover the relationship between behavioural and brain-to-brain synchrony across different role-playing techniques and elucidate the impact of these synchronies on participants’ levels of anxiety and empathy. By using functional near-infrared imaging and behavioural coding in a dyadic role-playing paradigm (
n
= 41 dyads), the study found correlations between behavioural and brain-to-brain synchrony during naturalistic conversations, but not during role-play, implying a qualitative change in interpersonal synchrony when implementing role-playing techniques. Additionally, the study noted significant contributions of both behavioural and brain-to-brain synchrony as well as peripheral factors such as dyadic sex make-up and role immersion in predicting dyadic anxiety and empathy changes. Findings call for future studies to consider role-playing scenarios as a qualitatively different form of social interaction.
Food supplementing peregrine falcon (
Falco peregrinus tundrius
) nests increases reproductive success with no change in mean parental provisioning rate
Authors: McKinnon Rebekah A. , Hedlin Erik , Hawkshaw Kevin , Mathot Kimberley J.
Published: September 2024

Parents are expected to exhibit intermediate levels of investment in parental care that reflect the trade-off between current versus future reproduction. Providing parents with supplemental food may allow for increased care to the current brood (additive model), re-allocation of parental effort to other behaviours such as self-maintenance (substitution model), or may provide parents with a buffer against provisioning shortfalls (insurance model). We investigated the impact of parental food supplementation on provisioning behaviour and breeding success in Arctic-breeding peregrine falcons (
Falco peregrinus tundrius
) over five successive breeding seasons (2013−2017). We found that supplemental feeding had no impact on mean provisioning rates, yet resulted in increased nestling survival probability, increased nestling body mass and decreased variance in nestling body mass and provisioning rates. These results are consistent with parents adopting a hybrid of the additive and substitution models. We suggest that food supplementation enables increased investment in other forms of parental care (e.g. nest defence, brooding) without altering mean provisioning rates. The lack of observed effects on mean provisioning rates, coupled with increased survival and body mass of offspring, suggests a potential reallocation of parental effort. The findings contribute to understanding the responses of peregrine falcons to food supplementation, highlighting the need for future studies to explore broader environmental contexts and potential long-term effects on parental survival and future reproduction.
Sensing with shallow recurrent decoder networks
Authors: Williams Jan P. , Zahn Olivia , Kutz J. Nathan
Published: September 2024

Sensing is a universal task in science and engineering. Downstream tasks from sensing include inferring full-state estimates of a system (system identification), control decisions and forecasting. We propose a shallow recurrent decoder (SHRED) neural network structure for sensing, which incorporates (i) a recurrent neural network to learn a latent representation of the temporal dynamics of the sensors and (ii) a shallow decoder that learns a mapping between this latent representation and the high-dimensional state space. SHRED enables accurate reconstructions with far fewer sensors, outperforms existing techniques when more measurements are available and is more robust to random sensor placements. In the example cases explored, complex spatio-temporal dynamics are characterized by exceedingly limited sensors that can be randomly placed with minimal loss of performance.
Patterns of early post-disturbance reorganization in Central European forests
Authors: Seidl Rupert , Potterf Mária , Müller Jörg , Turner Monica G. , Rammer Werner
Published: September 2024

Disturbances catalyse change in forest ecosystems, and a climate-driven increase in disturbance activity could accelerate forest reorganization. Here, we studied post-disturbance forests after the biggest pulse of tree mortality in Central Europe in at least 170 years, caused by drought and bark beetle (Scolytinae) outbreaks in 2018–2020. Our objectives were to characterize the early state of tree regeneration after mortality, quantify patterns of reorganization relative to undisturbed reference conditions and assess how management and patch size affect forest reorganization after disturbance. We surveyed 1244 plots in 120 patches under managed (salvage-logged, often planted) and unmanaged (deadwood remaining on site, no planting) conditions in Germany. We found that regeneration density on disturbed sites was high (median 11 897 stems ha
−1
), resulting from a cohort of advance regeneration. Disturbances were strong drivers of change, with indications for resilience on only 36.3% of patches. Reassembly (i.e. a change in species composition) was the dominant pattern of reorganization (61.5%), and
Picea abies
forests changed most strongly. Post-disturbance management facilitated forest change, particularly promoting a change in species composition. The strength of reorganization increased with patch size. We conclude that the recent wave of tree mortality will likely accelerate forest change in Central Europe.
Inbreeding and high developmental temperatures affect cognition and boldness in guppies (
Poecilia reticulata
)
Authors: Vinogradov I. M. , Zang C. , Mahmud-Al-Hasan M. , Head M. L. , Jennions M. D.
Published: September 2024

Inbreeding impairs the cognitive abilities of humans, but its impact on cognition in other animals is poorly studied. For example, environmental stress (e.g. food limitation and extreme temperatures) often amplifies inbreeding depression in morphological traits, but whether cognition is similarly affected is unclear. We, therefore, tested if a higher temperature (30°C versus 26°C) during development exacerbates any difference in inhibitory control between inbred (
f
= 0.25) and outbred guppies (
Poecilia reticulata
). Inhibitory control is an aspect of cognition that is often measured in vertebrates using a detour test, in which animals have to navigate around a transparent barrier to reach a reward. We also tested if inbreeding and temperature affect ‘boldness’, which is a putative personality trait in guppies. Inbreeding lowered inhibitory control of guppies raised at the higher temperature but not those raised at the control temperature. Inbred fish were significantly less bold than outbred fish. In addition, males, but not females, raised at the higher temperature had significantly lower inhibitory control. There was no effect of temperature on the boldness of either sex. Our study is among the first to test if experimentally induced inbreeding impairs cognition in a non-domesticated vertebrate. We show that both inbreeding and higher temperatures during development can affect the behaviour and cognitive abilities of fish. These findings are noteworthy given the twin threats of rising global temperatures and more frequent inbreeding as habitat fragmentation reduces population sizes.
Association of Ventricular Arrhythmias with Lamotrigine: An Observational Cohort Study
Authors: Kim Sodam , Welch Landon , De Los Santos Bertha , Radwański Przemysław B. , Munger Mark A. , Kim Kibum
Published: September 2024

Background

Whether lamotrigine (LTG) is associated with ventricular tachycardia (VT) in bipolar disorder (BPD), partial seizures (PSZ) and generalized tonic-clonic seizures (GTSZ) with and without structural heart disease (SHD) remains controversial. A mechanistic rational for LTG-induced re-entrant cardiac arrhythmias has recently been elucidated, leading to a real-world comparative cohort observational study being warranted.

Methods

A retrospective observational comparative safety study was performed using a large healthcare claims database of adult participants analyzing the one-year cumulative VT. Analytic cohort included adult participants diagnosed with bipolar I disorder (BPD), partial seizures (PSZ) or generalized tonic-clonic seizures (GTSZ). Participants were free from supraventricular or ventricular arrhythmias during the 6-month baseline period before the index LTG or CTR date. Exposure to LTG versus commonly prescribed alternative agents were the control comparators (CTR). One-year cumulative ventricular tachycardia (VT) incidence was calculated separately for GTSZ, PSZ and BPD using Kaplan-Meier estimator, with participants being censored at last enrollment, treatment switching or discontinuation. The VT association hazard ratios (HR) for LTG versus CTR was adjusted for baseline characteristics.

Results

The analytic cohort included 153,852 LTG and 213,593 CTR for BPD, 10,275 LTG and 24,971 CTR for PSZ, and 5,860 LTG and 17,506 CTR for GTSZ. Baseline cardiovascular risk profiles were higher among CTR than LTG across the three sub-analytic cohorts. The 1-year VT cumulative incidence from LTG or CTR free from was 0.79% vs 0.68% in BPD, 0.76% vs 0.58% in PSZ, and 0.93% vs 0.40% in GTSZ cohorts, The adjusted HR [95% CI] estimates were 1.326 [1.122-1.568, p<0.01], 1.403 [0.920-2.138, p=0.11], and 1.180 [0.607-2.295, p=0.63].

Conclusions

In adult participants, LTG has a strong association to increase VT risk compared to commonly prescribed alternatives.

KEY POINTS

Question:Does lamotrigine investigated in a real-world database increase the risk of ventricular tachycardia in patients with epilepsy or bipolar disease?

Findings:The lamotrigine-ventricular tachycardia association was statistically significant in adult bipolar disease participants. Although limited statistical significance, the positive association is ubiquitous across epileptic conditions. Structural heart disease has a notable increased effect on the incidence on the onset of ventricular tachycardia.

Meaning:Caution should be exercised in the use of lamotrigine in adult bipolar disease patients to avoid ventricular tachycardia.
The effects of Autonomous Sensory Meridian Response (ASMR) on sleep quality improvement in adolescents
Authors: Wu Zuoda , He Chao , Zhao Kai
Published: September 2024

Background

In recent years, there has been a notable surge in sleep-related challenges among adolescents. The emergence of Autonomous Sensory Meridian Response (ASMR) content across various social media platforms has sparked interest in its potential to address these issues. This study explored the therapeutic impact of ASMR on sleep problems in high school students.

Methods

The study involved sixty participants, divided evenly into four groups: three intervention groups (A, B, C) and one control group. For five consecutive days, the intervention groups engaged in pre-sleep ASMR listening sessions lasting 10, 20, and 30 minutes, respectively. Sleep quality was evaluated using mobile application tools and the subjective Sleep Quality Scale.

Results

The analysis, performed utilizing repeated measures sphericity tests, revealed a significant correlation between ASMR intervention days and both objective sleep(P= 0.036) and effective sleep duration (P= 0.002). However, ASMR intervention did not significantly affect objective sleep efficiency or subjective sleep quality. These findings imply that ASMR interventions can significantly improve sleep issues in adolescents.

Conclusions

ASMR has been extensively promoted as a potential remedy for sleep enhancement, this study substantiates its effectiveness in tackling adolescent sleep concerns.
Sex-specific decline in prefrontal cortex mitochondrial bioenergetics in aging baboons correlates with walking speed
Authors: Adekunbi Daniel A. , Huber Hillary F. , Benavides Gloria A. , Tian Ran , Li Cun , Nathanielsz Peter W. , Zhang Jianhua , Darley-Usmar Victor , Cox Laura A. , Salmon Adam B.
Published: September 2024

Mitochondria play a crucial role in brain aging due to their involvement in bioenergetics, neuroinflammation and brain steroid synthesis. Mitochondrial dysfunction is linked to age-related neurodegenerative diseases, including Alzheimer’s disease and Parkinson’s disease. We investigated changes in the activities of the electron transport chain (ETC) complexes in normally aging baboon brains and determined how these changes relate to donor sex, morning cortisol levels, and walking speed. Using a novel approach, we assessed mitochondrial bioenergetics from frozen prefrontal cortex (PFC) tissues from a large cohort (60 individuals) of well-characterized aging baboons (6.6–22.8 years, approximately equivalent to 26.4–91.2 human years). Aging was associated with a decline in mitochondrial ETC complexes in the PFC, which was more pronounced when activities were normalized for citrate synthase activity, suggesting that the decline in respiration is predominantly driven by changes in the specific activity of individual complexes rather than changes in mitochondrial number. Moreover, when donor sex was used as a covariate, we found that mitochondrial respiration was preserved with age in females, whereas males showed significant loss of ETC activity with age. Males had higher activities of each individual ETC complex and greater lactate dehydrogenase activity relative to females. Circulating cortisol levels correlated only with complex II-linked respiration in males. We also observed a robust positive predictive relationship between walking speed and respiration linked to complexes I, III, and IV in males but not in females. This data reveals a previously unknown link between aging and bioenergetics across multiple tissues linking frailty and bioenergetic function. This study highlights a potential molecular mechanism for sexual dimorphism in brain resilience and suggests that in males changes in PFC bioenergetics contribute to reduced motor function with age.
No evidence for paternal age effects on sons or daughters, when accounting for paternal sperm storage
Authors: Sanghvi Krish , Gascoigne Samuel , Todorova Biliana , Vega-Trejo Regina , Pizzari Tommaso , Sepil Irem
Published: September 2024

The age at which a father reproduces is predicted to affect not only his own fertility but also the fitness of his offspring. Specifically, offspring born to old fathers are assumed to be of a lower quality than those conceived by young fathers. However, when fathers have low mating rates, paternal age might be confounded with the duration for which mature sperm are stored in fathers prior to ejaculation.

Studies that disentangle the confounding effects of paternal sperm storage duration from those of paternal age, on offspring, are lacking. We useDrosophila melanogasterto test the separate and interactive effects of paternal age and sperm storage duration (sexual rest) on the survival and lifetime reproduction of offspring.

As expected, old fathers produce fewer offspring than young fathers. But surprisingly, paternal age does not influence the survival or lifetime reproductive success of either sons or daughters. Instead, sons conceived by fathers with long durations of sexual rest have lower reproductive success than sons conceived by fathers with short durations of sexual rest.

We further discover that daughters of low reproductive quality selectively disappear with age, but sons do not, highlighting that demographic processes need to be accounted for when studying paternal age effects.

Overall, our study suggests that paternal age effects might not be as pervasive as previously assumed. We emphasize that a more nuanced understanding of the mechanisms causing paternal age effects is required, so that studies do not misattribute effects of paternal sperm storage to age.