bluuebunny/crossref_metadata_2025 huggingface dataset:
Home Nation First, but to What Degree?: Nationalism in Chinese Central Television’s Broadcasts of the 2018 Winter Olympics
Authors: Guo Sitong , Xu Qingru
Published: September 2021

The aim of this study was to analyze China Central Television’s (CCTV) broadcasts of the 2018 Winter Olympics and how their various narratives presented home and foreign athletes. The findings indicate that CCTV devoted more name mentions to home athletes even though their medal achievements were inferior to foreign athletes and that home athletes held at least 40% of the top 10 mentions in the three examined sports. In terms of word-by-word descriptors, broadcasters were more likely to attribute the success of Chinese athletes to subjective factors (e.g., concentration, composure, commitment, and intelligence) and to attribute the success of non-Chinese athletes to objective factors (e.g., experience). Moreover, the network tended to attribute the failure of Chinese athletes to strength, experience, and consonance and to attribute the failure of non-Chinese athletes to lack of athletic skill. Theoretical and practical implications are both discussed.
Psychopathy and Moral-Dilemma Judgment: An Analysis Using the Four-Factor Model of Psychopathy and the CNI Model of Moral Decision-Making
Authors: Luke Dillon M. , Neumann Craig S. , Gawronski Bertram
Published: September 2021

A major question in clinical and moral psychology concerns the nature of the commonly presumed association between psychopathy and moral judgment. In the current preregistered study ( N = 443), we aimed to address this question by examining the relation between psychopathy and responses to moral dilemmas pitting consequences for the greater good against adherence to moral norms. To provide more nuanced insights, we measured four distinct facets of psychopathy and used the CNI model to quantify sensitivity to consequences ( C), sensitivity to moral norms ( N), and general preference for inaction over action ( I) in responses to moral dilemmas. Psychopathy was associated with a weaker sensitivity to moral norms, which showed unique links to the interpersonal and affective facets of psychopathy. Psychopathy did not show reliable associations with either sensitivity to consequences or general preference for inaction over action. Implications of these findings for clinical and moral psychology are discussed.
Decreased Shoulder and Elbow Joint Loads During the Changeup Compared With the Fastball and Curveball in NCAA Division I Collegiate Softball Pitchers
Authors: Oliver Gretchen D. , Downs Talmage Jessica L. , Friesen Kenzie B. , Saper Michael G. , Dugas Jeffrey R.
Published: September 2021

Background:

Baseball leagues have implemented pitch count and pitch type restrictions based on biomechanical concepts associated with pitch type. Softball has not yet adopted these practices, although softball pitchers continue to pitch at a high volume and learn multiple pitches at a young age.

Purpose:

To examine shoulder and elbow kinetics between the fastball, curveball, and changeup, as well as to provide descriptive upper extremity pain data in National Collegiate Athletic Association (NCAA) softball pitchers.

Study Design:

Descriptive laboratory study.

Methods:

Study participants consisted of 27 female NCAA Division I softball pitchers (age, 20.2 ± 1.9 years; height, 175.7 ± 5.7 cm; weight, 83.6 ± 12.7 kg). The participants pitched 3 balls of each pitch type, and kinetic data were recorded. A one-way within-participants repeated-measures multivariate analysis of variance was used to determine significant differences in kinetics and pitch speed between pitch types.

Results:

Results revealed a statistically significant main effect for pitch type (Wilks λ = .087; F = 36.523; P < .001). Post hoc testing showed that the changeup produced less anterior elbow force compared with the fastball ( P < .001) and the curveball ( P = .012). In addition, the changeup produced less shoulder distraction force compared with the fastball ( P < .001) and the curveball ( P = .001). Additionally, there was a significant difference in pitch speed between all 3 pitch types ( P = .006). The curveball revealed no statistically significant kinetic differences compared with the fastball.

Conclusion:

The fastball and curveball placed similar stress on the upper extremity in collegiate softball pitchers. However, in comparison with the changeup, the fastball and curveball placed increased stress on the upper extremity. More research is needed to fully explain the differences seen between pitch type and injury risk.

Clinical Relevance:

Sports medicine professionals, coaches, and athletes should use the current study results to note these differences in shoulder distraction and elbow anterior forces between softball pitch types. The study results can be used as a reference and basis for future research investigating kinetic differences across varying pitch types.
Does Bone Regrow After Notchplasty in ACL Reconstruction? A Prospective Computed Tomography Study With 2-Year Follow-up
Authors: Kitridis Dimitrios , Tsifountoudis Ioannis , Georgiannos Dimitrios , Tsikopoulos Konstantinos , Givissis Panagiotis , Bisbinas Ilias
Published: September 2021

Background:

During notchplasty in anterior cruciate ligament (ACL) reconstruction, bone is excised from the lateral and roof area of the notch to widen the intercondylar space and avoid notch-graft impingement in extension. There are concerns that bone regrowth of the area will cause narrowing and increase the risk of complications.

Purpose:

To determine the possibility of late narrowing of the notch after notchplasty using computed tomography (CT) analysis.

Study Design:

Case series; Level of evidence, 4.

Methods:

Measurements were performed on CT scans (axial and sagittal planes with knee in extension) in patients who had undergone single-bundle anatomic ACL reconstruction using hamstring graft. Two axial image levels were used: at the anterior outlet and the anterior one-eighth level of the notch. The maximum notch height and width, the notch width at one-third and two-thirds of the preoperative notch midwidth height, the maximum condylar width, and the surface area of the lateral half of the notch were measured preoperatively and at 1 week and 2 years postoperatively.

Results:

Included were 20 consecutive patients (mean ± standard deviation age, 28 ± 7.3 years; follow-up, 24.2 ± 3.3 months). At the anterior notch outlet, the maximum notch width increased by 1.9 ± 1.7 mm at 1 week postoperatively and narrowed by 0.3 ± 1.1 mm at the final follow-up, while the maximum notch height increased by 1.7 ± 1.9 mm and narrowed by 0.8 ± 1.8 mm, respectively. At one-eighth of the roof length, the maximum notch width increased by 1.1 ± 1.7 mm at 1 week postoperatively and narrowed by 0.1 ± 1.1 mm at the final follow-up, and the maximum notch height increased by 1.2 ± 1.5 mm and narrowed by 0.5 ± 1.5 mm, respectively. All differences were statistically significant when comparing the pre- to the immediate postoperative measurements, and they were nonsignificant when comparing the immediate postoperative to the final follow-up measurements. The same applied for the ratio of maximum notch width to maximum condylar width, indicating no postoperative narrowing of the notch.

Conclusion:

Notch size-shape after a 2-mm notchplasty did not change significantly in stable knees during the first 2 years after anatomic ACL reconstruction. Surgeons should consider performing this adjuvant technique when there is notch-graft impingement during surgery.
Performance Outcomes After Surgical Repair of Achilles Tendon Rupture in the Women’s National Basketball Association
Authors: Hodgens Blake H. , Geller Joseph S. , Rizzo Michael G. , Munoz Julianne , Kaplan Jonathan , Aiyer Amiethab
Published: September 2021

Background:

Achilles tendon ruptures are devastating in elite athletes. There are currently no studies examining the effects of Achilles tendon rupture on performance outcomes in the Women’s National Basketball Association (WNBA).

Hypothesis:

Athletes in the WNBA who sustained an Achilles tendon rupture and underwent subsequent surgical repair will sustain declines in performance metrics when compared with their preinjury statistics and matched controls.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Seventeen WNBA players who sustained an Achilles tendon rupture from 2000 to 2019 were identified through publicly available injury reports and player profiles. Athlete information collected included age, body mass index, position, and service in the WNBA when the tear occurred. Statistics were collected for 1 season before and 2 seasons after the injury, and the player efficiency rating (PER) was calculated. Players were matched to uninjured controls by service in the WNBA, position, and performance statistics.

Results:

On average, players were 28 years of age at the time of Achilles tendon rupture, with a service time in the WNBA of 6.5 years. Four players never returned to play in the WNBA, while 7 players failed to play more than 1 season. Players who did return played significantly fewer minutes per game compared with preinjury in both postinjury seasons 1 and 2 (mean difference, –6.11 and –6.54 min/game, respectively; P < .01 for both) and had a significantly decreased PER in postinjury season 2 (mean difference, –2.53; P = .024). After returning to play, the injured players experienced significant decreases when compared with controls in field goals (–0.85 vs +0.20; P = .047), free throws (–1.04 vs +0.12; P < .01), steals (–0.48 vs +0.24; P = .018), and points scored (–2.89 vs +0.58; P = .014).

Conclusion:

WNBA players experienced significant decreases in performance metrics after Achilles tendon rupture compared with their preinjury levels and compared with uninjured controls. Overall, 23.5% of players failed to return to the WNBA, while 41.2% failed to play for more than 1 season.
The Effect of Infant Formulas With 4 or 8 g/L GOS/FOS on Growth, Gastrointestinal Symptoms, and Behavioral Patterns: A Prospective Cohort Study
Authors: Tonon Karina Merini , Tomé Thaís Moreno , Mosquera Elaine Martins Bento , Perina Natália Pratis , Lazarini Tamara
Published: September 2021

There is a lack of studies investigating the clinical benefits of prebiotic-supplemented infant formula. In this study, healthy infants that started, on medical recommendation, artificial feeding with one of 2 infant formulas containing 4 g/L of GOS/FOS (9:1) (IF4 group; n = 60) or 8 g/L of GOS/FOS (9:1) (IF8 group; n = 60) were followed for 30 days to the evaluation of growth and gastrointestinal symptoms. Exclusively breastfed infants (EBF; n = 60) were followed up as a reference. Both infant formulas supported adequate weight gain, however, IF4 formula promotes growth more similar to breastfed infants. There was no additional benefit of a dose higher than 4 g/L of GOS/FOS on gastrointestinal symptoms.
Gendered Patterns of Unmet Resource Need among Academic Researchers
Authors: Steffy Kody
Published: September 2021

An expansive body of literature has documented how academia acts as a gendered organization, characterized by disadvantage at multiple levels. Because of data limitations, we know surprisingly little about whether and how access to the resources needed to carry out high-quality research may be gendered. This study begins to fill this gap using a newly available survey of researchers in three disciplines across five European countries. Across a wide range of resources, findings point to marked gender disparities. Women are more likely than men to say that they do not have the resources they need to do their research well and that having them would make a big difference in their work. These findings are robust to controls including academic seniority, suggesting that structural sexism contributes to resource disparities in science. Even after overcoming obstacles en route to research positions in competitive fields, women in science remain systematically disadvantaged.
Seeing Through the FOG: A Classroom Exercise Illustrating the Challenges of Sharing Information as Facts, Opinions, and Guesses in Teams
Authors: Romney Alexander C. , Soderberg Andrew T. , Okhuysen Gerardo A.
Published: September 2021

Information sharing is a critical aspect of effective team functioning. However, it can be challenging to discern whether the information communicated is fact, opinion, or someone’s best guess (FOG) due to the varied understandings, assumptions, and interests team members bring to any collaboration. In this article, we introduce a role-play exercise that helps participants better understand the complexities associated with information sharing in teams and how to sort through the FOG associated with information exchanges. Drawing upon research on motivated information processing, this exercise simulates the challenges of information sharing and assists teachers in demonstrating strategies to overcome them.
A novel activating JAK1 mutation in chronic eosinophilic leukemia
Authors: Shomali William , Damnernsawad Alisa , Theparee Talent , Sampson David , Morrow Quinlan , Yang Fei , Fernandez-Pol Sebastian , Press Richard , Zehnder James , Tyner Jeffrey W. , Gotlib Jason
Published: September 2021

Hypereosinophilia (HE) has been defined as persistent eosinophilia >1.5 × 109/L; it is broadly divided into primary HE (clonal or neoplastic; HEN), secondary/reactive HE (HER), or HE of undetermined significance (HEUS) when no cause is identified. The use of myeloid next-generation sequencing (NGS) panels has led to the detection of several mutations in patients previously diagnosed with HEUS, reassigning some patients to the category of HEN, specifically the World Health Organization category of chronic eosinophilic leukemia, not otherwise specified (CEL, NOS). Here, we describe a novel somatic JAK1 pseudokinase domain mutation (R629_S632delinsSA) in a patient with HE that had initially been characterized as a variant of uncertain significance. We performed functional studies that demonstrated that this mutation results in growth factor independence of Ba/F3 cells in vitro and activation of the JAK-STAT pathway. These effects were abrogated by the JAK1/JAK2 inhibitor ruxolitinib. R629_S632delinsSA is the first known somatic mutation in JAK1 linked to a clonal eosinophilic neoplasm, and highlights the importance of the JAK-STAT pathway in eosinophil survival.
Restriction of HIV-1 infection in sickle cell trait
Authors: Kumari Namita , Nouraie Mehdi , Ahmad Asrar , Lassiter Hatajai , Khan Javed , Diaz Sharmin , Afangbedji Nowah , Wang Songping , Houston Patricia E. , Ammosova Tatiana , de Mulder Rougvie Miguel , Rana Sohail , Nixon Douglas F. , Anastos Kathryn , Lazar Jason , French Audrey L. , Gange Stephen , Adimora Adaora A. , Weitzmann M. Neale , Fischl Margaret , Kempf Mirjam-Colette , Kassaye Seble , Taylor James G. , Nekhai Sergei
Published: September 2021

Patients with sickle cell disease (SCD) have a lower risk for HIV-1 infection. We reported restriction of ex vivo HIV-1 infection in SCD peripheral blood mononuclear cells (PBMCs) that was due, in part, to the upregulation of antiviral, inflammatory, and hemolytic factors, including heme oxygenase-1 (HO-1). Here, we investigated whether individuals with sickle cell trait (SCT), who develop mild hemolysis, also restrict HIV-1 infection. Ex vivo infection of SCT PBMCs exhibited an approximately twofold reduction of HIV-1 replication and lower levels of HIV-1 reverse transcription products, 2-long terminal repeat circle, HIV-1 integration, and gag RNA expression. SCT PBMCs had higher HO-1 messenger RNA (mRNA) and protein levels and reduced ribonucleotide reductase 2 (RNR2) protein levels. HO-1 inhibition by tin porphyrin eliminated ex vivo HIV-1 restriction. Among Howard University clinic recruits, higher levels of HO-1 and RNR2 mRNA and lower HIV-1 env mRNA levels were found in SCT individuals living with HIV-1. To determine the population-level effect of SCT on HIV-1 prevalence, we assessed SCT among women living with HIV (WLH) in the WIHS (Women Interagency HIV-1 Study). Among WIHS African-American participants, the prevalence of SCT was lower among women with HIV compared with uninfected women (8.7% vs 14.2%; odds ratio, 0.57; 95% confidence interval, 0.36-0.92; P = .020). WIHS WLH with SCT had higher levels of CD4+/CD8+ ratios over 20 years of follow-up (P = .003) than matched WLH without SCT. Together, our findings suggest that HIV-1 restriction factors, including HO-1 and RNR2, might restrict HIV-1 infection among individuals with SCT and limit the pathogenicity of HIV.
Gata2 haploinsufficiency promotes proliferation and functional decline of hematopoietic stem cells with myeloid bias during aging
Authors: Abdelfattah Ali , Hughes-Davies Antonia , Clayfield Liam , Menendez-Gonzalez Juan Bautista , Almotiri Alhomidi , Alotaibi Badi , Tonks Alex , Rodrigues Neil P.
Published: September 2021

During aging, hematopoietic stem cell (HSC) function wanes with important biological and clinical implications for benign and malignant hematology, and other comorbidities, such as cardiovascular disease. However, the molecular mechanisms regulating HSC aging remain incompletely defined. GATA2 haploinsufficiency driven clinical syndromes initially result in primary immunodeficiencies and routinely evolve into hematologic malignancies on acquisition of further epigenetic mutations in both young and older patients. Using a conditional mouse model of Gata2 haploinsufficiency, we discover that during aging Gata2 promotes HSC proliferation, monocytosis, and loss of the common lymphoid progenitor. Aging of Gata2 haploinsufficient mice also offsets enhanced HSC apoptosis and decreased granulocyte-macrophage progenitor number normally observed in young Gata2 haploinsufficient mice. Transplantation of elderly Gata2 haploinsufficient HSCs impairs HSC function with evidence of myeloid bias. Our data demonstrate that Gata2 regulates HSC aging and suggest the mechanisms by which Gata2 mediated HSC aging has an impact on the evolution of malignancies in GATA2 haploinsufficiency syndromes.
Autologous and allogeneic hematopoietic cell transplantation for diffuse large B-cell lymphoma–type Richter syndrome
Authors: Herrera Alex F. , Ahn Kwang Woo , Litovich Carlos , Chen Yue , Assal Amer , Bashir Qaiser , Bayer Ruthee-Lu , Coleman Melanie , DeFilipp Zachariah , Farhadfar Nosha , Greenwood Matthew , Hahn Theresa , Horwitz Mitchell , Jacobson Caron , Jaglowski Samantha , Lachance Sylvie , Langston Amelia , Mattar Bassam , Maziarz Richard T. , McGuirk Joseph , Mian Mohammad A. H. , Nathan Sunita , Phillips Adrienne , Rakszawski Kevin , Sengeloev Henrik , Shenoy Shalini , Stuart Robert , Sauter Craig S. , Kharfan-Dabaja Mohamed A. , Hamadani Mehdi
Published: September 2021

Richter syndrome (RS) represents a transformation from chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) to aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL), which is associated with a dismal prognosis. Patients with DLBCL-RS have poor outcomes with DLBCL-directed therapy; thus, consolidation with hematopoietic cell transplantation (HCT) has been used, with durable remissions observed. Studies reporting HCT outcomes in patients with DLBCL-RS have been small, have not evaluated the prognostic impact of cytogenetic risk factors, and were conducted prior to the era of novel targeted therapy of CLL/SLL. We performed a Center for International Blood and Transplant Research registry study evaluating outcomes after autologous HCT (auto-HCT; n = 53) and allogeneic HCT (allo-HCT; n = 118) in patients with DLBCL-RS treated in the modern era. More auto-HCT recipients were in complete response (CR) at HCT relative to allo-HCT recipients (66% vs 34%), whereas a higher proportion of allo-HCT recipients had 17p deletion (33% vs 7%) and had previously received novel agents (39% vs 10%). In the auto-HCT cohort, the 3-year relapse incidence, progression-free survival (PFS), and overall survival (OS) were 37%, 48%, and 57%, respectively. Among allo-HCT recipients, the 3-year relapse incidence, PFS, and OS were 30%, 43%, and 52%, respectively. In the allo-HCT cohort, deeper response at HCT was associated with outcomes (3-year PFS/OS, 66%/77% CR vs 43%/57% partial response vs 5%/15% resistant; P < .0001 for both), whereas cytogenetic abnormalities and prior novel therapy did not impact outcomes. In our study, HCT resulted in durable remissions in therapy-sensitive patients with DLBCL-RS treated in the era of targeted CLL/SLL therapy, including patients with high-risk features.
CGRP outflow into jugular blood and cerebrospinal fluid and permeance for CGRP of rat dura mater
Authors: Risch Miriam , Vogler Birgit , Dux Mária , Messlinger Karl
Published: September 2021

Background

Calcitonin gene-related peptide (CGRP) is released from activated meningeal afferent fibres in the cranial dura mater, which likely accompanies severe headache attacks. Increased CGRP levels have been observed in different extracellular fluid compartments during primary headaches such as migraine but it is not entirely clear how CGRP is drained from the meninges.

Methods

We have used an in vivo preparation of the rat to examine after which time and at which concentration CGRP applied onto the exposed parietal dura mater appears in the jugular venous blood and the cerebrospinal fluid (CSF) collected from the cisterna magna. Recordings of meningeal (dural) and cortical (pial) blood flow were used to monitor the vasodilatory effect of CGRP. In a new ex vivo preparation we examined how much of a defined CGRP concentration applied to the arachnoidal side penetrates the dura. CGRP concentrations were determined with an approved enzyme immunoassay.

Results

CGRP levels in the jugular plasma in vivo were slightly elevated compared to baseline values 5-20 min after dural application of CGRP (10 μM), in the CSF a significant three-fold increase was seen after 35 min. Meningeal but not cortical blood flow showed significant increases. The spontaneous CGRP release from the dura mater ex vivo was above the applied low concentration of 1 pM. CGRP at 1 nM did only partly penetrate the dura.

Conclusions

We conclude that only a small fraction of CGRP applied onto the dura mater reaches the jugular blood and, in a delayed manner, also the CSF. The dura mater may constitute a barrier for CGRP and limits diffusion into the CSF of the subarachnoidal space, where the CGRP concentration is too low to cause vasodilatation.
Urethral meatus preserving ventral onlay augmentation urethroplasty for female urethral stricture: our technique with initial experience
Authors: Katiyar Varun Kumar , Sood Rajeev , Singla Anurag , Goel Hemant Kumar , Khattar Nikhil , Gunavanthe Varun
Published: September 2021

Background

Female urethral stricture (FUS) is an uncommon cause of lower urinary tract symptoms (LUTS) in women. Reconstructive techniques are being increasingly used for strictures resistant to the more conservative form of management. Most forms of reconstruction require cutting open of urethral meatus, thereby resulting in some loss of the meatus function. We hereby describe the technique of urethral meatus sparing ventral onlay mucosal graft augmentation urethroplasty with our initial experience.

Methods

We performed this procedure in 10 cases of FUS with normal meatus and prospectively studied the outcomes over a period of 6 months follow-up.

Results

There was 90 percent success rate with one recurrence. The mean Qmax increased from 7.2 to 19.5 ml/s, mean post-void residual urine (PVRU) decreased from 96.5 to 22.7 ml and the mean IPSS decreased from 26.1 to 5.7. There were no major complications noted and the patients demonstrated significant subjective and objective improvement of symptoms in the follow-up period.

Conclusion

The technique of meatus sparing ventral onlay augmentation graft urethroplasty is a promising approach with good outcomes, is reproducible and has minimal complication rate.
Education of the primary health care staff based on acceptance and commitment therapy is associated with reduced sick leave in a prospective controlled trial
Authors: Kadowaki Åsa , Alvunger Anna-Karin , Larsen Hanna Israelsson , Persdotter Anna , Zak Marta Stelmach , Johansson Peter , Nystrom Fredrik H.
Published: September 2021

Background

The use of cognitive behavioral therapy (CBT) to cope with mental distress and pain issues has helped many patients in primary health care in Sweden. However, the effects of CBT to reduce sick leave has not been equally convincing. Acceptance and Commitment Therapy (ACT) is an evolution of traditional CBT and we aimed to study if education based on ACT of the staff rather than the patients could reduce sick leave in primary health care.

Methods

This was a prospective trial in 6 primary health care centers in Kalmar (total amount of registered subjects of 28,930) in which the staff (physicians, nurses and therapists) received group-based education according to ACT during 2018 and 2019. The effects were compared with 5 similarly sized control health care centers in the neighboring Region of Jönköping in which no such education took place. The main aim was to study changes in sick leave in the 6 primary care centers of Kalmar and to keep track of more general trends by studying sick leave also in Jönköping, letting sick leave in the year 2017 to be the reference period for both areas.

Results

The staff at the health care centers in Kalmar reported to having attended a mean of 5.2 ± 2 educational ACT-sessions with psychiatrist Kadowaki in Kalmar. Sick leave for ICD-10 F43 (reaction to severe stress and related adjustment-disorders) was reduced from a mean value of 28.7 ± 9.1ongoing sick leaves/month in 2017 to 22.6 ± 7.0 sick leaves/month in 2018 (-21%, p = 0.033) and to 18.1 ± 10 sick leaves/month in 2019 (-37%, p = 0.038). The corresponding sick leave for any diagnosis (total sick leave) was reduced from 132 ± 39 sick leaves/month in 2017 to 118 ± 38 sick leaves/month in 2018 (-11%, p = 0.056) and to 102 ± 37 sick leaves/month in 2019 (-21%, p = 0.021). The corresponding sick leave comparisons in the control health centers did not show any significant changes (all p-values ≥ 0.24).

Conclusions

Total monthly mean sick leave was reduced 21% in the health care centers in Kalmar during the second year of the educational ACT intervention of the staff while it was unchanged in Jönköping. This suggests a significant effect to induce a reduction in long-term sick leave for patients in primary health care in which the staff received education according to ACT. The results of this trial could serve as a basis for a randomized trial in order to ascertain causality.

Trial registration

Pre-registration November 9, 2018 on ClinicalTrials.gov with number NCT03737019.
Expert consensus on the identification, diagnosis, and treatment of neurotrophic keratopathy
Authors: Dana Reza , Farid Marjan , Gupta Preeya K. , Hamrah Pedram , Karpecki Paul , McCabe Cathleen M. , Nijm Lisa , Pepose Jay S. , Pflugfelder Stephen , Rapuano Christopher J. , Saini Arvind , Gibbs Sarah N. , Broder Michael S.
Published: September 2021

Background

Neurotrophic keratopathy (NK) is a relatively uncommon, underdiagnosed degenerative corneal disease that is caused by damage to the ophthalmic branch of the trigeminal nerve by conditions such as herpes simplex or zoster keratitis, intracranial space-occupying lesions, diabetes, or neurosurgical procedures. Over time, epithelial breakdown, corneal ulceration, corneal melting (thinning), perforation, and loss of vision may occur. The best opportunity to reverse ocular surface damage is in the earliest stage of NK. However, patients typically experience few symptoms and diagnosis is often delayed. Increased awareness of the causes of NK, consensus on when and how to screen for NK, and recommendations for how to treat NK are needed.

Methods

An 11-member expert panel used a validated methodology (a RAND/UCLA modified Delphi panel) to develop consensus on when to screen for and how best to diagnose and treat NK. Clinicians reviewed literature on the diagnosis and management of NK then rated a detailed set of 735 scenarios. In 646 scenarios, panelists rated whether a test of corneal sensitivity was warranted; in 20 scenarios, they considered the adequacy of specific tests and examinations to diagnose and stage NK; and in 69 scenarios, they rated the appropriateness of treatments for NK. Panelist ratings were used to develop clinical recommendations.

Results

There was agreement on 94% of scenarios. Based on this consensus, we present distinct circumstances when we strongly recommend or may consider a test for corneal sensitivity. We also present recommendations on the diagnostic tests to be performed in patients in whom NK is suspected and treatment options for NK.

Conclusions

These expert recommendations should be validated with clinical data. The recommendations represent the consensus of experts, are informed by published literature and experience, and may improve outcomes by helping improve diagnosis and treatment of patients with NK.
Depression and its associated factors: perceived stress, social support, substance use and related sociodemographic risk factors in medical school residents in Nairobi, Kenya
Authors: Shah Sayed Shah Nur Hussein , Laving Ahmed , Okech-Helu Violet Caroline , Kumar Manasi
Published: September 2021

Background

Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya’s largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment.

Methods

We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression.

Results

Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = − 0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = − 2.19, p < 0.001).

Conclusions

Only 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization.
Mid-Term outcomes following fresh-frozen humeral head osteochondral allograft reconstruction for reverse Hill Sachs lesion: a case series
Authors: Marcheggiani Muccioli Giulio Maria , Rinaldi Vito Gaetano , Lullini Giada , Ritali Alice , Mosca Massimiliano , Romagnoli Matteo , Guerra Enrico , Zaffagnini Stefano
Published: September 2021

Background

Locked posterior glenohumeral dislocations with a reverse Hill-Sachs impaction fracture involving less than 30% of the humeral head are most frequently treated with lesser tuberosity transfer into the defect, whereas those involving more than 50% undergo humeral head arthroplasty. Reconstruction of the defect with segmental femoral osteochondral allografts has been proposed to treat patients between these two ranges, but the medium−/long-term outcomes of this joint-preserving procedure are controversial.

Methods

Between 2001 and 2018, 12 consecutive patients with a unilateral locked posterior shoulder dislocation and an impaction fracture from 30 to 50% (mean 31% ± 1.32) of the humeral head were treated with segmental reconstruction of the defect with fresh-frozen humeral head osteochondral allografts. Patients were assessed clinically, radiographically and with computed tomography (CT) at a medium follow-up of 66 ± 50.25 months (range, 24–225).

Results

All twelve shoulders presented a slight limitation in anterior elevation (average, 166.6° ± 22.76). The mean active external rotation with the shoulder at 90° of abduction was 82.5° ± 6.61, and that with the arm held in stable adduction was 79.16 ± 18.80. The mean abduction was 156.25° ± 25.09.

The mean Constant-Murley score (CS) was 82 ± 15.09 points (range, 40–97 points), and the mean ASES was 94 ± 8.49 points. The mean pre- and postoperatively Western Ontario Shoulder Instability index (WOSI) was 236.5 ± 227.9 and 11.20 ± 10.85, respectively.

Development of osteoarthrosis (OA) was minimal. The average allograft resorption rate was 4% ± 2.4. There were no cases of failure (reoperation for any reason) in this series.

Conclusion

Segmental humeral head reconstruction with humeral head fresh-frozen osteochondral allografts provides good to excellent clinical results with low-grade OA and low allograft resorption in patients with locked posterior shoulder dislocation.

Trial registration

ClinicalTrials.gov PRS, ClinicalTrials.gov ID: NCT04823455. Registered 29 March 2021 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AU8P&selectaction=Edit&uid=U0004J36&ts=12&cx=6cykp8

Level of evidence

Level IV, Case Series, Treatment Study.
Evaluation of intra-ovarian platelet-rich plasma administration on oocytes-dependent variables in patients with poor ovarian response: A retrospective study according to the POSEIDON criteria
Authors: Farimani Marzieh , Nazari Arash , Mohammadi Shahrzad , Anvari Aliabad Roghayeh
Published: September 2021

Background

Poor ovarian response (POR) is among the common findings in infertile women with no significant underlying condition. The aim of this study was to investigate the intra-ovarian potential of platelet-rich plasma (PRP) administration on oocytes-dependent variables in the POR women grouped according to the POSEIDON criteria.

Methods

This retrospective study was performed on POR women with no underlying condition who have undergone intra-ovarian PRP injection. As well as patients’ age, the number of total and MI, MII, and GV oocytes were extracted from the files. The laboratory variables including anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol were also gathered. In order to reduce any bias due to the possible differences in kits or devices, a single laboratory with the highest number of cases was selected and others were excluded from the study. Then, the included cases were grouped into four according to the POSEIDON criteria and analyzed for the mentioned variables by SPSS, version 25. The statistical significance level was set as P-value < 0.05.

Results

From 383 cases, a total number of 96 women were enrolled in this study. According to the POSEIDON criteria, group 4 (Age ≥ 35 years, AMH < 1.2 ng/mL) with the ratio of 56/96 (58.3%) had the highest prevalence among others. As the analyses showed, changes in the laboratory variables (LH, FSH, AMH, and estradiol) were not significant in almost all the groups following the intervention. Regarding the total oocytes number, PRP administration caused a significant increase in the total number in all the groups (all P < 0.05). Also, the number of MII oocytes was significantly increased following the treatment in all groups except for group 2 (Age ≥ 35 years, AMH ≥ 1.2 ng/mL; all P < 0.05). Of 96 cases, 14 (14.6%) got clinically pregnant following assisted reproductive techniques which this number were significantly differed among the groups (P = 0.002).

Conclusion

This study showed that PRP treatment was effective on total and MII oocyte numbers in the patients with POR, however, further studies are required.
Effects of a three-armed randomised controlled trial using self-monitoring of daily steps with and without counselling in prediabetes and type 2 diabetes—the Sophia Step Study
Authors: Rossen Jenny , Larsson Kristina , Hagströmer Maria , Yngve Agneta , Brismar Kerstin , Ainsworth Barbara , Åberg Linda , Johansson Unn-Britt
Published: September 2021

Background

This aimed to evaluate the effects of self-monitoring of daily steps with or without counselling support on HbA1c, other cardiometabolic risk factors and objectively measured physical activity (PA) during a 2-year intervention in a population with prediabetes or type 2 diabetes.

Methods

The Sophia Step Study was a three-armed parallel randomised controlled trial. Participants with prediabetes or type 2 diabetes were recruited in a primary care setting. Allocation (1:1:1) was made to a multi-component intervention (self-monitoring of steps with counselling support), a single-component intervention (self-monitoring of steps without counselling support) or standard care. Data were collected for primary outcome HbA1c at baseline and month 6, 12, 18 and 24. Physical activity was assessed as an intermediate outcome by accelerometer (ActiGraph GT1M) for 1 week at baseline and the 6-, 12-, 18- and 24-month follow-up visits. The intervention effects were evaluated by a robust linear mixed model.

Results

In total, 188 subjects (64, 59, 65 in each group) were included. The mean (SD) age was 64 (7.7) years, BMI was 30.0 (4.4) kg/m2 and HbA1c was 50 (11) mmol/mol, 21% had prediabetes and 40% were female. The dropout rate was 11% at 24 months. Effect size (CI) for the primary outcome (HbA1c) ranged from -1.3 (-4.8 to 2.2) to 1.1 (-2.4 to 4.6) mmol/mol for the multi-component vs control group and from 0.3 (-3.3 to 3.9) to 3.1 (-0.5 to 6.7) mmol/mol for the single-component vs control group. Effect size (CI) for moderate-to-vigorous physical activity ranged from 8.0 (0.4 to 15.7) to 11.1 (3.3 to 19.0) min/day for the multi-component vs control group and from 7.6 (-0.4 to 15.6) to 9.4 (1.4 to 17.4) min/day for the single-component group vs control group.

Conclusion

This 2-year intervention, including self-monitoring of steps with or without counselling, prevented a decrease in PA but did not provide evidence for improved metabolic control and cardiometabolic risk factors in a population with prediabetes or type 2 diabetes.

Trial registration

ClinicalTrials.gov, NCT02374788. Registered 2 March 2015—Retrospectively registered.
Prevalence and risk factors of metabolic associated fatty liver disease in the contemporary South China population
Authors: Fan Jiahua , Luo Shiyun , Ye Yongxin , Ju Jingmeng , Zhang Zhuoyu , Liu Ludi , Yang Jialu , Xia Min
Published: September 2021

Background

As a newly proposed diagnosis, data on the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is rare. We aimed to assess the prevalence and risk factors of MAFLD using new definition in the contemporary South China population.

Methods

In this population based, cross sectional study, a total of 5377 participants aged 30–79 years old were recruited from the South China between 2018 and 2019. MAFLD was diagnosed in subjects who have both hepatic steatosis and metabolic disorders according to the newly international expert consensus. The total prevalence of MAFLD and prevalence by sex and age was estimated. Demographic characteristics, history of disease, and lifestyle were recorded by participants on a questionnaire. Abdominal ultrasonography was performed and evaluated by experienced sonographers. Multivariable logistic regression was used to calculate the odds ratios (ORs) of MAFLD.

Results

Overall prevalence of MAFLD was 29.2% (95% confidence interval [CI] 28.0% to 30.5%). Prevalence was higher in women (31.7%) than in men (25.5%; p < 0.001 for sex difference) and in subjects aged 50 years or older (30.7%) than in those aged 30–49 years (19.8%; p < 0.001 for age difference). In participants diagnosed with MAFLD, the prevalence of overweight/obesity was up to 90.5%, type 2 diabetes (T2DM) and metabolic dysregulation were 25.0% and 62.2%, respectively. Risk factors for MAFLD included overweight/obesity (OR = 4.67; 95% CI, 3.76–5.83), T2DM (OR = 2.41, 95% CI, 1.68–3.47), hypertriglyceridemia (OR = 2.42, 95% CI, 2.03–2.87), high school education (OR = 1.50, 95% CI, 1.23–1.82), high income (OR = 1.22, 95% CI, 1.05–1.42). A lower risk of MAFLD was associated with high physical activity equivalent (OR = 0.71, 95% CI, 0.60–0.85). A U-shaped association of frequency of soups and ORs of MAFLD was found, the adjusted ORs (95% CI) of lower and higher frequency of soups were 1.58 (1.32–1.89) and 1.36 (1.13–1.63), respectively.

Conclusions

Our results showed a high prevalence of MAFLD in the general adult population in South China. Obesity has the greatest impact on MAFLD, physical activity and moderate consumption of soups might be the potential protective factors of MAFLD.
The budding yeast protein Chl1p is required for delaying progression through G1/S phase after DNA damage
Authors: Katheeja Muhseena N. , Das Shankar Prasad , Laha Suparna
Published: September 2021

Background

The budding yeast protein Chl1p is a nuclear protein required for sister-chromatid cohesion, transcriptional silencing, rDNA recombination, ageing and plays an instrumental role in chromatin remodeling. This helicase is known to preserve genome integrity and spindle length in S-phase. Here we show additional roles of Chl1p at G1/S phase of the cell cycle following DNA damage.

Results

G1 arrested cells when exposed to DNA damage are more sensitive and show bud emergence with faster kinetics in chl1 mutants compared to wild-type cells. Also, more damage to DNA is observed inchl1cells. The viability falls synergistically inrad24chl1cells. The regulation of Chl1p on budding kinetics in G1 phase falls in line with Rad9p/Chk1p and shows a synergistic effect with Rad24p/Rad53p.rad9chl1andchk1chl1shows similar bud emergence as the single mutantschl1,rad9andchk1.Whereasrad24chl1andrad53chl1shows faster bud emergence compared to the single mutantsrad24,rad53andchl1. In presence of MMS induced damage, synergistic with Rad24p indicates Chl1p’s role as a checkpoint at G1/S acting parallel to damage checkpoint pathway. The faster movement of DNA content through G1/S phase and difference in phosphorylation profile of Rad53p in wild type andchl1cells confirms the checkpoint defect inchl1mutant cells. Further, we have also confirmed that the checkpoint defect functions in parallel to the damage checkpoint pathway of Rad24p.

Conclusion

Chl1p shows Rad53p independent bud emergence and Rad53p dependent checkpoint activity in presence of damage. This confirms its requirement in two different pathways to maintain the G1/S arrest when cells are exposed to damaging agents. The bud emergence kinetics and DNA segregation were similar to wild type when given the same damage in nocodazole treatedchl1cells which establishes the absence of any role of Chl1p at the G2/M phase. The novelty of this paper lies in revealing the versatile role of Chl1p in checkpoints as well as repair towards regulating G1/S transition. Chl1p thus regulates the G1/S phase by affecting the G1 replication checkpoint pathway and shows an additive effect with Rad24p for Rad53p activation when damaging agents perturb the DNA. Apart from checkpoint activation, it also regulates the budding kinetics as a repair gene.
Multivalent electrostatic pi–cation interaction between synaptophysin and synapsin is responsible for the coacervation
Authors: Kim Goeun , Lee Sang-Eun , Jeong Seonyoung , Lee Jeongkun , Park Daehun , Chang Sunghoe
Published: September 2021

We recently showed that synaptophysin (Syph) and synapsin (Syn) can induce liquid–liquid phase separation (LLPS) to cluster small synaptic-like microvesicles in living cells which are highly reminiscent of SV cluster. However, as there is no physical interaction between them, the underlying mechanism for their coacervation remains unknown. Here, we showed that the coacervation between Syph and Syn is primarily governed by multivalent pi–cation electrostatic interactions among tyrosine residues of Syph C-terminal (Ct) and positively charged Syn. We found that Syph Ct is intrinsically disordered and it alone can form liquid droplets by interactions among themselves at high concentration in a crowding environment in vitro or when assisted by additional interactions by tagging with light-sensitive CRY2PHR or subunits of a multimeric protein in living cells. Syph Ct contains 10 repeated sequences, 9 of them start with tyrosine, and mutating 9 tyrosine to serine (9YS) completely abolished the phase separating property of Syph Ct, indicating tyrosine-mediated pi-interactions are critical. We further found that 9YS mutation failed to coacervate with Syn, and since 9YS retains Syph’s negative charge, the results indicate that pi–cation interactions rather than simple charge interactions are responsible for their coacervation. In addition to revealing the underlying mechanism of Syph and Syn coacervation, our results also raise the possibility that physiological regulation of pi–cation interactions between Syph and Syn during synaptic activity may contribute to the dynamics of synaptic vesicle clustering.
Small extracellular vesicle non-coding RNAs in pancreatic cancer: molecular mechanisms and clinical implications
Authors: Reese Moritz , Dhayat Sameer A.
Published: September 2021

Pancreatic cancer has the worst prognosis among common tumors which is attributed to its aggressive phenotype, diagnosis at advanced, inoperable stages, and resistance to systemic therapy. Non-coding RNAs (ncRNAs) such as microRNAs, long non-coding RNAs, and circular RNAs have been established as important regulators of gene expression and their deregulation has been implicated in multiple diseases and foremost cancer. In the tumor microenvironment, non-coding RNAs can be distributed among cancer cells, stromal cells, and immune cells via small extracellular vesicles (sEVs), thereby facilitating intercellular communication and influencing major cancer hallmarks such as angiogenesis, evasion of the immune system, and metastatic dissemination. Furthermore, sEV-ncRNAs have shown promising potential as liquid biopsies with diagnostic and prognostic significance. In this review, we summarize the role of sEVs as carriers of ncRNAs and underlying molecular mechanisms in pancreatic cancer. Moreover, we review the potential of sEV-ncRNAs as biomarkers and highlight the suitability of sEVs as delivery vehicles for ncRNA-based cancer therapy.