bluuebunny/crossref_metadata_2025 huggingface dataset:
A - 55 Pre- to Post-Season Reliability of Blink Reflex Parameters in Non-Concussed Athletes
Authors: Long C C , Dugan J E , Jo J , Williams K L , Zuckerman S L , Terry D P
Published: July 2024

Purpose

Examining quantitative parameters of the blink reflex may improve sport-related concussion (SRC) diagnosis and management because it may serve as an objective measure of injury severity and recovery. However, the psychometric properties of several FDA-cleared devices assessing the blink reflex are understudied. The current study compared blink reflex parameters pre- and post-season using the BlinkTBI EyeStatTM device to assess its reliability in non-concussed athletes.

Method

A cohort of high school athletes underwent pre- and post-season BlinkTBI EyeStatTM testing. Statistical analysis included Spearman correlations, Wilcoxon signed-rank tests, and interclass correlations for ten blink parameters. Multivariable linear regressions assessed the influence of contact (i.e., soccer, football) vs. non-contact sports (i.e., baseball, softball, basketball) on changes in blink parameters.

Results

Among 32 athletes with pre- and post-season testing (age: mean = 15.3, SD = 1.1; 53.1% female), 19 played non-contact and 21 played contact sports. Most parameters were not statistically different between pre- and post-season, except for delta 30 (W = 229.5, p = 0.015), time under threshold (W = 191.0, p = 0.003), and oscillations (W = 667.0, p < 0.001). Parameters exhibited moderate to excellent reliability (interclass correlations = 0.575–0.872, p-values = 0.001–0.004). Spearman’s rho values ranged from 0.435 to 0.828 (p-values = 001–0.005). Participation in contact vs. non-contact sports was not associated with changes in blink parameters (all p-values>0.05).

Conclusions

Preliminary evidence suggest stable blink parameters across a sports season in non-concussed athletes when measured by the BlinkTBI EyeStatTM device. Contact sport participation was not significantly associated with changes in blink parameters. The findings add to the psychometric evidence that the blink reflex can be reliably measured, warranting further study on its utility in concussion.
A - 56 Acute Psychological Symptom Profiles in High School Athletes Following Sport-Related Concussion
Authors: Jawid M Y , Williams K L , Jo J , Prosak O L , Amedy A , Anesi T J , Fitch R W , Terry D P , Zuckerman S L
Published: July 2024

Purpose

The current study (1) described the proportion of athletes with acute psychological symptoms, (2) identified predictors of higher initial psychological symptoms, and (3) determined whether psychological symptoms affect recovery post-sport-related concussion.

Method

A retrospective study of high-school athletes who sustained a sport-related concussion from 11/2017–04/2022 was performed. The main independent variable was psychological symptom cluster score, calculated by summing the four affective symptoms on the initial Post-Concussion Symptom Scale (PCSS). Psychological symptom ratio was defined as the ratio of the psychological symptom cluster score divided by the total initial PCSS score. The outcomes included time to return-to-learn (RTL), symptom resolution, and return-to-play (RTP).

Results

A total of 431 athletes (58.0% female, mean age = 16.2¬ ± 1.3 years) were included and 45% reported at least one psychological symptom. The mean psychological symptom cluster score was 4.2¬ ± 5.2 and the psychological symptom cluster ratio was 0.10¬ ± 0.11. Multivariable regression showed that female sex (B = 2.15, p < 0.001, 95%CI[0.91–3.39]), loss of consciousness (B = 1.91, p = 0.037, 95%CI[0.11–3.72]), retrograde/anterograde amnesia (B = 1.66, p = 0.026, 95%CI[0.20–3.11]), and psychological history (B = 2.96, p < 0.001, 95%CI[1.25–4.70]) predicted increased psychological symptom cluster score. Female sex (B = 0.03, p = 0.031, 95%CI[0.00–0.06]) and psychological history (B = 0.06, p = 0.002, 95%CI[0.02–0.10]) predicted increased psychological symptom ratio. Multivariable linear regression showed that both higher psychological symptom cluster score and ratio were associated with longer times to recovery.

Conclusions

Among the cohort, 45% reported at least one psychological symptom, most commonly irritability. Female sex, loss of consciousness, amnesia, and a psychological history were significantly associated with increased psychological symptom cluster scores. Higher psychological symptom cluster scores and ratios independently predicted longer recovery.
A - 57 Relationship between Exercise Participation and Cognitive/Emotional Symptom Endorsement in Older Former College Athletes
Authors: Shurtz L , Datoc A , Sanders G D , Bunt S C , Didehbani N , Schaffert J , LoBue C , Cullum C M
Published: July 2024

Purpose

Exercise participation has been associated with improved physical health, cognition, and psychological well-being as well as reduced risk for chronic illness and mortality. The effects of exercise participation in former athletes are less understood; this study investigated the relationship between current exercise participation and cognitive/emotional symptoms in former college athletes.

Method

Former college athletes aged 50–87 (N = 597, 44.2% female) completed the College Level Aging Athlete Study (CLEAATS) survey including the Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7), Cognitive Function Instrument (CFI), Telephone Interview for Cognitive Status-Modified (TICS-m), and self-reported weekly exercise involvement, classified as aerobic exercise (e.g., jogging/cycling), anaerobic exercise (e.g., weightlifting), and “other wellness activities”(e.g., yoga/meditation). Four multiple linear regression models investigated whether current exercise participation predicted mood and cognition, adjusting for demographic factors.

Results

Overall models for PHQ-8 [F(6,590) = 8.87, p < 0.001], GAD-7 [F(6,590) = 4.87, p < 0.001], CFI [F(6,590) = 3.45, p = 0.002], and TICS-m [F(6,590) = 15.99, p < 0.001] were significant. Individually, aerobic exercise was a significant predictor of PHQ-8 (b = −0.35, p < 0.001), GAD-7 (b = −0.18, p = 0.007), CFI (b = −0.12, p = 0.021), and TICS-m (b = 0.18, p = 0.022) scores, such that more exercise predicted lower emotional/cognitive difficulties. Engagement in “other wellness activities”was significantly associated with higher TICS-m (b = 0.18, p = 0.024) scores. Anaerobic exercise was not a significant predictor in any model.

Conclusions

Consistent with research in other populations, participation in aerobic exercise predicted better cognitive/emotional functioning in former college athletes. Involvement in other forms of exercise did not consistently predict greater functioning, though “other wellness activities”was associated with better objective cognition. Results emphasize the importance of recommending aerobic exercise for former athletes.
A - 58 Relationship between Cognitive Impairment Concern and Current Cognitive Functioning in Older Former College Athletes
Authors: Shurtz L , Bunt S C , Didehbani N , Schaffert J , LoBue C , Cullum C M
Published: July 2024

Purpose

Concerns regarding cognitive decline due to history of concussions/head injury are common among former athletes, especially as long-term effects of head injury have gained widespread media attention. Examining the association of these concerns with current cognitive functioning may prove beneficial for understanding the prominence of these concerns. This study investigated whether concerns for cognitive problems due to prior concussions/head injury might relate to current cognitive functioning in former college athletes.

Method

Former college athletes aged 50–87 (N = 597, 44.22% female) from the College Level Aging Athlete Study (CLEAATS) completed the Cognitive Function Instrument (CFI) and the Telephone Interview for Cognitive Status-Modified (TICS-m). Self-reported concern regarding contribution of history of concussions and/or head impacts to the development of “permanent memory or thinking problems”was measured on a 5-point Likert scale. Two multiple linear regressions investigated whether reported concern predicted subjective (CFI) and objective (TICS-m) cognitive functioning, with adjustment for age, gender, education, and mood/anxiety symptoms.

Results

Overall models CFI [F(6,590) = 69.78, R2 = 0.42, p < 0.001] and TICS-m [F(6,590) = 17.78, R2 = 0.15, p < 0.001] were significant. Level of concern for memory/thinking problems significantly predicted CFI scores (b = 0.68, p < 0.001) but not TICS-m scores, such that greater concern predicted higher CFI score.

Conclusions

Concern regarding cognitive problems due to history of concussion/head impacts may be associated with greater perceived cognitive symptoms among former college athletes, but this was unrelated to an objective measure of cognition. Further investigation is necessary to clarify the origin of these concerns, but these results underscore the importance of promoting accurate public information about long-term effects of concussion/head injury.
A - 59 MEG Power Changes in Non-concussed High School Football Players: Implications of Cumulative Head Impact Risk
Authors: Johnson C , Bell N M , Holcomb J , Bunt S , Urban J , Whitlow C , Stitzel J , Maldjian J A , Davenport E M
Published: July 2024

Purpose

The purpose of this study was to determine how cumulative repetitive head impacts (RHI) over a single season affects functional brain activity in high school football players that are clinically asymptomatic for concussion.

Method

Pre-season and post-season magnetoencephalography (275 channel CTF MEG) and MRI were acquired for 88 football participant seasons (mean age = 16.09 yrs, mean BMI = 26.32). Helmet-based accelerometer data was collected for each practice and game. Cumulative risk-weighted exposure from linear acceleration (RWELinear) was calculated for each subject. Standard processing and source localization of 8-minutes eyes-open-resting state MEG data was performed using Brainstorm2. Voxel-wise relative power spectral density (PSD) was calculated for the theta frequency band (5-7 Hz). After transformation to MNI space2, pre-season to post-season percent change in PSD (%theta) was calculated and spatial clusters significantly correlated with RWELinear were identified using SPM8 (a = 0.05 and false discovery correction to account for multiple corrections). Mean cluster values were extracted, and linear regression analysis performed in R 3.21 with covariates of BMI, age, and time between scans.

Results

After covariate adjustment, there was a significant positive correlation between RWELinear and %Δtheta PSD in the right postcentral gyrus and inferior parietal lobe (p = 9.342e-05, adj. R2 = 0.2092), with no other significant associations noted.

Conclusions

Changes in functional brain activity may be associated with RHI specifically in the right postcentral gyrus and inferior parietal lobe over a typical football season. Future research will include examining how these affected areas are associated with cognitive performance.
A novel murine model mimicking male genital Neisseria species infection using Neisseria musculi
Authors: Bryan Emily R , McRae Julia , Kumar Vishnu , Trim Logan K , Maidment Toby I , Tickner Jacob A D , Sweeney Emma L , Williams Elizabeth D , Whiley David M , Beagley Kenneth W
Published: July 2024

With ~78 million cases yearly, the sexually transmitted bacterium Neisseria gonorrhoeae is an urgent threat to global public health due to continued emergence of antimicrobial resistance. In the male reproductive tract, untreated infections may cause permanent damage, poor sperm quality, and subsequently subfertility. Currently, few animal models exist for N. gonorrhoeae infection, which has strict human tropism, and available models have limited translatability to human disease. The absence of appropriate models inhibits the development of vital new diagnostics and treatments. However, the discovery of Neisseria musculi, a mouse oral cavity bacterium, offers much promise. This bacterium has already been used to develop an oral Neisseria infection model, but the feasibility of establishing urogenital gonococcal models is unexplored.

We inoculated mice via the intrapenile route with N. musculi. We assessed bacterial burden throughout the male reproductive tract, the systemic and tissue-specific immune response 2-weeks postinfection, and the effect of infection on sperm health.

Neisseria musculi was found in penis (2/5) and vas deferens (3/5) tissues. Infection altered immune cell counts: CD19+ (spleen, lymph node, penis), F4/80+ (spleen, lymph node, epididymus), and Gr1+ (penis) compared with noninfected mice. This culminated in sperm from infected mice having poor viability, motility, and morphology. We hypothesize that in the absence of testis infection, infection and inflammation in other reproductive is sufficient to damage sperm quality. Many results herein are consistent with outcomes of gonorrhoea infection, indicating the potential of this model as a tool for enhancing the understanding of Neisseria infections of the human male reproductive tract.
The effectiveness of digital interventions for self-management of chronic pain in employment settings: a systematic review
Authors: Blake Holly , Chaplin Wendy J , Gupta Alisha
Published: July 2024

Introduction

Chronic pain affects over a quarter of the workforce with high economic burden for individuals, employers and healthcare services. Access to work-related advice for people with chronic pain is variable. This systematic review aims to explore the effectiveness of workplace-delivered digital interventions for the self-management of chronic pain.

Source of data

MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, JBI, Open Science Framework, Epistemonikos and Google Scholar. Articles published between January 2001 and December 2023 were included. Searches were conducted between October 2023 and December 2023.

Areas of agreement

Workplace-delivered digital interventions to support self-management of chronic pain at work may improve pain and health-related quality of life in vocationally active adults. Delivering interventions outside of clinical services, through the workplace setting, may help to reduce inequity in access to work-related advice for people with chronic pain, and ultimately reduce the burden on individuals, employers and healthcare services. Interventions include mobile apps and web-based programmes.

Areas of controversy

Studies were moderate-to-low quality. Most studies focused on exercise, few considered other aspects of pain self-management. Given the limited evidence in the current literature, consensus on best intervention format and delivery is lacking.

Growing points

More high-quality studies are needed given the heterogeneity in study design, interventions and outcome measures.

Areas timely for developing research

No interventions included advice on work-related adjustments or support. Few studies included work-related outcomes, despite the known impact of pain on work and work on health.
A homogeneous bioluminescent inhibition immunoassay to detect anti-interferon gamma antibodies
Authors: Bradhurst Peter , Stoyanov Alex , Nithichanon Arnone , Bundell Christine , Urriola Nicolás
Published: July 2024

Adult-onset immunodeficiency with antibodies to interferon-γ (AOID with AIGA) is a rare, acquired immunodeficiency causing susceptibility to disseminated non-tuberculous mycobacteria and other intracellular opportunistic infections. The diagnosis depends on demonstrating the presence of endogenous anti-interferon-γ antibodies (AIGA) that suppress Th1 cell-mediated immunity. Bioluminescent immunoassays are a newly emerging immunoassay format which utilize the action of bioluminescent enzymes on a substrate for specific analyte detection. In short, detecting antibodies are conjugated with a bioluminescent enzyme. The detecting antibodies bind the analyte of interest and produce light (luminescence) after addition of a substrate. The purpose of this study was to evaluate two newly developed bioluminescent immunoassays using Lumit® (Promega) technology as a diagnostic test for AOID with AIGA. Specific aims included the clinical validation of a new inhibition bioluminescent immunoassay technique to detect AIGA which block detection of interferon-γ (IFN-γ) in vitro and correlation of inhibition bioluminescent immunoassay results with AOID with AIGA disease status. Two bioluminescent inhibition immunoassays were developed. One which adapted an existing kit from Promega (Lumit® Human IFN-γ Immunoassay) and the other which was developed in house. Eighty-seven healthy controls and 48 patients with previously diagnosed AOID with AIGA were recruited and tested using these two methods. Results showed both bioluminescent inhibition immunoassays were able to clearly discriminate between AOID with AIGA patients and healthy controls. The mean inhibition percentage between patient groups correlated with disease activity. Both assays appeared to be more sensitive when compared to the existing inhibition ELISA.
TPRT: a trajectory publishing scheme for the Internet of Vehicles based on radix tree
Authors: Tian Junfeng , Zhu Qi , Shen Jia wei , Xu Tengfei
Published: July 2024

The location and trajectory information generated in the Internet of Vehicles (IoV) provides sufficient data support for road network planning. However, there is much sensitive information in these data, and publishing them directly will lead to serious privacy leakage risks. Therefore, this paper proposes a trajectory publishing scheme for the Internet of Vehicles based on radix tree (TPRT). Firstly, the trajectory data are divided into multiple location planes based on timestamps and processed using clustering and generalization. This approach addresses the issue of real-life trajectory data having almost no identical prefixes, making it more suitable for storage in radix tree. Then, the directed graph and the shortest path algorithm are utilized to synthesize a new trajectory dataset for publication. Subsequently, a radix tree structure that satisfies differential privacy is defined. In comparison to the research method employing a prefix tree, the radix tree not only captures the spatiotemporal characteristics of the trajectories but also reduces space consumption. Finally, a novel method of noise addition is proposed. In contrast to the traditional layer-by-layer noise addition approach, our method reduces the cost of noise addition and enhances data availability. Experimental results demonstrate that TPRT exhibits superior data availability compared to the baseline methods.
Security analysis of the MAP-T IPv6 transition technology
Authors: Al-Azzawi Ameen , Lencse Gábor
Published: July 2024

In this paper, we focus on one of the most prominent IPv6 transition technologies, namely Mapping of Address and Port using Translation (MAP-T), and we give attention to Mapping of Address and Port with Encapsulation (MAP-E) as well. We emphasize the uniqueness of MAP-T and MAP-E, and we discuss the differences between those two technologies, including their topology, functionality, and security vulnerabilities. We apply a threat modeling technique, Spoofing, Tampering, Repudiation, Information Disclosure, Denial of Service, and Elevation of Privilege (STRIDE), to assess potential vulnerabilities in the MAP-T infrastructure. Furthermore, we build a testbed for MAP-T using the open-source software, Jool, and we conduct testing on the translation process capabilities of Jool and its port allocation per subscriber. Finally, we present various attacking scenarios against the main routers of MAP-T, such as IP address spoofing, information disclosure, and source port exhaustion, and we propose mitigation methods for several attacks.
Rare case of fecaloma requiring endoscopic intervention in a 24-year-old female
Authors: Hooda Zamaan , Higgins Sabrina Clare , Pastore Dakota , Crisafulli Gregory , Canoles Haley , Alkomos Mina , Talishinskiy Toghrul , Amer Kamal , El-Sedfy Abraham
Published: July 2024

Fecalomas are a rare potential etiology for constipation experienced in children and the elderly. Large bowel obstructions due to fecalomas are preferably treated conservatively with laxatives and bowel rest. However, in the setting of severe corporostasis, more invasive procedures are required to prevent bowel ischemia and perforation. This case report describes a patient who presented to the emergency department with symptoms of large bowel obstruction and constipation, and she was found to have a fecaloma. Conservative interventions, including bowel rest and the administration of laxatives failed, prompting the need for more invasive therapies. During her admission, multiple flexible sigmoidoscopies were required to alleviate the obstruction. Ultimately, this case demonstrates an encounter of a patient with a sigmoid fecaloma from an unlikely demographic with few risk factors that required endoscopic intervention for treatment.
Mode of cell death in the penile cavernous tissue of type 1 diabetes mellitus rats
Authors: Li Jing , Jiang Qilan , Jiang Jun , Jiang Rui
Published: July 2024

Background

Diabetes mellitus commonly causes endothelial cell and smooth muscle cell death in penile cavernous tissue.

Aim

The study sought to study the mode of cell death in the penile cavernous tissue in type 1 diabetic rats.

Methods

A total of 36 Sprague Dawley rats 10 weeks of age were randomly divided into 2 groups: a normoglycemic group and type 1 diabetic group (intraperitoneal injection of Streptozotocin (STZ), 60 mg/kg). We randomly selected 6 rats from each group for tests at the end of 11, 14, and 18 weeks of age, respectively. All rats were able to eat and drink freely. The ratio of maximum intracavernous pressure to mean arterial pressure, concentration of serum testosterone, level of nitric oxide in the penile cavernosum, and expression of active caspase-1 (pyroptosis) and active caspase-3 (apoptosis) were determined.

Outcomes

At the end of weeks 4 and 8 of type 1 diabetes, the proportions of endothelial cells and smooth muscle cells undergoing apoptosis and pyroptosis in penile cavernous tissue are different.

Results

The ratio of maximum intracavernous pressure to mean arterial pressure and nitric oxide levels were significantly lower in the 4- and 8-week diabetic groups than in the normoglycemic group (P < .01). Penile endothelial cell pyroptosis (5.67 ± 0.81%), smooth muscle cell apoptosis (23.72 ± 0.48%), total cell pyroptosis (9.67 ± 0.73%), and total apoptosis (10.52 ± 1.45%) were significantly greater in the 4-week diabetic group than in the normoglycemic group (P < .01). The proportion of endothelial cell pyroptosis (24.4 ± 3.69%), endothelial cell apoptosis (22.13 ± 2.43%), total cell pyroptosis (14.75 ± 0.93%), and total apoptosis (14.82 ± 1.08%) in the penile tissues of the 8-week diabetic group were significantly greater than those in the normoglycemic group (P < .01).The 8-week survival proportions of diabetic endothelial cells (38.86 ± 8.85%) and smooth muscle cells (44.46 ± 2.94%) was significantly lower than the 4-week survival proportions of endothelial cells (93.17 ± 8.07%) and smooth muscle cells (75.12 ± 4.76%) (P < .05).

Clinical Translation

Inhibition of cell death by different methods at different stages may be the key to the treatment of type 1 diabetes–induced erectile dysfunction.

Strengths and Limitations

The effect of type 1 diabetes on other types of cell death in penile cavernous tissue needs further study.

Conclusion

The mode of death of endothelial cells in the cavernous tissue of the penis in the early stage in diabetic rats is dominated by pyroptosis, and the death of smooth muscle cells is dominated by apoptosis. Endothelial cell and smooth muscle cell death are not consistent at different stages of diabetes progression.
Early-onset and uncontrolled diabetes mellitus factors correlate with complications of Peyronie’s disease
Authors: Karakus Serkan , Unal Selman , Dai Daisy , Joseph Crystal , Du Comb William , Levy Jason A , Hawksworth Dorota , Burnett Arthur L
Published: July 2024

Background

Peyronie’s disease (PD) is a connective tissue disorder that affects the penis and is characterized by abnormal collagen structure in the penile tunica albuginea, resulting in plaque formation and penile deformity. PD’s overall prevalence is estimated at 3.2% to 8.9%, with rates as high as 20.3% among men with type 2 diabetes mellitus (DM). However, the characteristics of DM associated with PD complications remain unclear.

Aim

To explore clinical associations between DM characteristics and PD complications.

Methods

We conducted a retrospective analysis of patients with DM and PD who presented at our institution between 2007 and 2022. We examined patients’ clinical histories, DM- and PD-related clinical parameters, and complications. Penile deformities were assessed through physical examination, photographs, and penile Doppler ultrasound. Patients were categorized into subgroups based on age of DM onset: early (<45 years), average (45-65 years), and late (>65 years).

Outcomes

Outcomes included effects of DM characteristics on PD development, progression, and severity.

Results

In total, 197 patients were included in the evaluation. Early-onset diabetes and elevated hemoglobin A1c (HbA1c) levels exhibited significant correlations with the early development of PD (ρ = 0.66, P < .001, and ρ = –0.24, P < .001, respectively). Furthermore, having DM at an early age was associated with the occurrence of penile plaque (ρ = –0.18, P = .03), and there were no significant differences in plaque dimensions (ρ = –0.29, P = .053). A rise in HbA1c levels after the initial PD diagnosis displayed positive correlations with the formation of penile plaque (ρ = 0.22, P < .006).

Clinical Implications

These findings emphasize the need for comprehensive assessments and personalized treatment strategies for individuals with DM and PD. Enhanced management approaches can improve outcomes for those facing both challenges.

Strengths and Limitations

Limitations include the single-site retrospective design with potential selection bias, inaccuracies in medical record data, and challenges in controlling confounding variables.

Conclusions

This study highlights that early-onset diabetes and poor diabetes control, as indicated by a subsequent rise in HbA1c levels following PD diagnosis, are significantly correlated with the onset and severity of PD. Revealing the mechanisms behind these findings will help us develop better management strategies for individuals with DM and PD.
A low testosterone level impairs erectile function by increasing endocan expression in rat penile corpus cavernosum
Authors: Chen Zhaoguo , Jiang Jun , Jiang Rui
Published: July 2024

Background

The mechanism by which a state of low testosterone leads to erectile dysfunction (ED) has not been determined. Endocan is a novel marker of endothelial function. However, whether endocan is involved in the regulation of erectile function under low testosterone levels remains unclear.

Aim

In this study we sought to determine whether a low-testosterone state inhibits erectile function by regulating endocan expression in the endothelial cells of the rat penile corpus cavernosum.

Methods

Thirty-six male Sprague–Dawley rats aged 8 weeks were randomly assigned to 6 groups (n = 6 per group) as follows: (1) control, (2) castration, (3) castration + testosterone treatment (treated with 3 mg/kg testosterone propionate per 2 days), (4) control + transfection (4 weeks after castration, injected with lentiviral vector (1 × 108 transduction units/mL, 10 μL), (5) castration + transfection, or (6) castration + empty transfection. One week after the injection, we measured the maximal intracavernous pressure/mean arterial pressure (ICPmax/MAP), serum testosterone and nitric oxide (NO) levels, and the expression of endocan, phospho–endothelial NO synthase (p-eNOS), eNOS, phospho–protein kinase B (p-AKT), and AKT in the rat penile corpus cavernosum.

Outcomes

Under a low-androgen state, the expression of endocan in the rat penile corpus cavernosum was significantly increased, which inhibited the AKT/eNOS/NO signaling pathway and resulted in ED.

Results

In the castration group, the expression of endocan in the rat penile corpus cavernosum was significantly higher than that in the control group (P < .05). Additionally, the levels of p-AKT/AKT, p-eNOS/eNOS, and NO in the rat penile corpus cavernosum and ICPmax/MAP were significantly lower in the castration group than in the control group (P < .05). In the castration + transfection group compared with the castration group there was a significant decrease in the expression of endocan (P < .05) and an increase in the ratios of p-AKT/AKT, p-eNOS/eNOS, and ICPmax/MAP (P < .05) in the rat penile corpus cavernosum.

Clinical implications

Downregulating the expression of endocan in the penile corpus cavernosum may be a feasible approach for treating ED caused by hypoandrogenism.

Strengths and limitations

The results of this study indicte that endocan may affect NO levels and erectile function through multiple signaling pathways, but further experiments are needed to clarify the relationship between endocan and androgens.

Conclusion

A low-testosterone state inhibits the AKT/eNOS/NO signaling pathway by increasing the expression of endocan in the rat penile corpus cavernosum and impairing erectile function in rats. Decreasing the expression of endocan in the penile corpus cavernosum can improve erectile function in rats with low testosterone levels.
Association between genital gender-affirming surgery and psychiatric comorbidities in individuals with gender incongruence
Authors: Garoosi Kassra , Yoon YooJin , Hale Elijah , Kahan Riley , Kalia Nargis , Higuchi Ty , Mathes David , Hudish Tyler , Kaoutzanis Christodoulos
Published: July 2024

Background

Previous studies present mixed evidence on the relationship between psychiatric comorbidities and genital gender-affirming surgery (GGAS) in individuals with gender incongruence (GI).

Aim

This research aims to investigate the psychiatric comorbidity rates post-GGAS in the GI population—namely, depressive disorders, anxiety disorders, posttraumatic stress disorders, substance abuse disorder, and suicidality.

Methods

Based on the TriNetX health care database, an international database with >250 million patients, a cross-sectional study was executed comparing psychiatric comorbidity rates among cases of GI with and without GGAS. Individuals were matched for demographic and health-related variables, which included history of cardiovascular disease, diabetes, and obesity.

Outcomes

The main focus was to establish the rates and changes in psychiatric comorbidities following GGAS.

Results

Among individuals with GI, the study identified 4061 with GGAS and 100 097 without. At 1 year post-GGAS, there was a significant decrease in depression (odds ratio [OR], 0.748; 95% CI, 0.672-0.833; P < .0001), anxiety (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), substance use disorder (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), and suicidality (OR, 0.530; 95% CI, 0.425-0.661; P < .0001), and these reductions were maintained or improved on at 5 years, including posttraumatic stress disorder (OR, 0.831; 95% CI, 0.704-0.981; P = .028).

Clinical Implications

The findings indicate that GGAS may play a crucial role in diminishing psychiatric comorbidities among individuals with GI.

Strengths and Limitations

This is the largest known study to evaluate the effect of GGAS on psychiatric comorbidities in the GI population, offering robust evidence. The reliance on the precision of CPT and ICD-10 codes for data extraction poses a limitation due to potential coding inaccuracies.

Conclusion

The evidence suggests a significant association between GGAS and reduced psychiatric comorbidities in individuals with GI.
Archaea, bacteria and protists share a depth–decay relationship of community similarity in deep oceans
Authors: Wu Wenxue , Tang Wenqian , He Zhili , Wang Lei
Published: July 2024

Identifying the general patterns of biogeography is vital for a better understanding of biological communities over space. However, there is a lack of well-understood biogeographic patterns of microbial communities in pelagic ecosystems. In this study, we simultaneously investigated archaeal, bacterial and protist communities using metabarcoding in the deep Pacific Ocean. Our results showed that archaea, bacteria and protists shared a depth–decay relationship of community similarity, indicating a decrease in community similarity with increasing differences in water depth. Environmental factors were more important than water depth in shaping this relationship, indicating that the sinking process, compared to environmental conditions, might be relatively minor in driving community variations across water columns. Our study suggests that the depth–decay relationship should be primarily examined in field investigations to better interpret the vertical dynamics of marine microbial communities, and more efforts are required to determine the mechanism underlying this important relationship.
Vestibular Rehabilitation: Improving Symptomatic and Functional Outcomes of Persons With Vestibular Schwannoma: A Systematic Review
Authors: Yap Jayden , Palmer Gretta , Graving Kate , Stone Shona , Gane Elise M
Published: July 2024

Objective

Persons with vestibular schwannoma suffer from dizziness, imbalance, and decreased function leading to reduced quality of life. Other forms of peripheral vestibular hypofunction show improvements in these signs and symptoms with vestibular rehabilitation; however, the efficacy of this intervention for those with vestibular schwannoma is unknown. Therefore, the aim of this systematic review was to determine the effect of vestibular physical therapy on subjective and objective measures of vestibular symptoms and function in people with vestibular schwannoma.

Methods

Four electronic databases were searched: PubMed, CINAHL, EMBASE, and Cochrane. Included studies were experimental or observational in design and featured patients with vestibular schwannoma who had undergone vestibular physical therapy. Screening and quality assessment was completed independently by 2 researchers. Risk of bias was assessed with a tool appropriate for study design (eg, Cochrane Risk of Bias 2.0 tool for randomized trials). The Grading of Recommendations Assessment, Development and Evaluation approach was used to synthesize findings.

Results

Twenty-three studies were included. Overall, the effect of vestibular physical therapy for patients with vestibular schwannoma was uncertain. Outcomes of dizziness, static and dynamic balance, and vestibular function all showed very low certainty on the Grading of Recommendations Assessment, Development and Evaluation assessment. Multimodal physical therapist interventions consistent with clinical practice guidelines (eg, gaze stability, habituation, balance training, gait training) demonstrated potential for improvement in dizziness, balance, and vestibular function, respectively. Results were mostly insignificant when a single modality was used.

Conclusion

There may be benefit in multimodal vestibular physical therapy for people with vestibular schwannoma to improve symptoms and function. More high-quality studies specific to vestibular schwannoma prehabilitation and rehabilitation are needed to increase the certainty in the evidence.

Impact

Physical therapists are encouraged to use multimodal vestibular rehabilitation for vestibular schwannoma in clinical practice in line with clinical guidelines for peripheral vestibular hypofunction.
The FLuorometholone as Adjunctive MEdical Therapy for Trachomatous Trichiasis Surgery (FLAME) Trial: Study Design
Authors: Mohammed Ahlam Awad , Abashawl Aida , Dodson Sarity , Alemayehu Wondu , Gemechu Alemu , Mengesha Aemero Abateneh , Kumsa Dereje , Succar Tony , Chen Yineng , McWilliams Kathleen , Bunya Vatinee Y. , Maguire Maureen G. , Burton Matthew J. , Ying Gui-shuang , Kempen John H. ,   FLuorometholone as Adjunctive MEdical Therapy for Trachomatous Trichiasis Surgery (FLAME) Trial Research Group
Published: July 2024

Purpose

To report the design ofFLuorometholone asAdjunctiveMEdical Therapy for TT Surgery (FLAME) Trial.

Design

Parallel design, double-masked, placebo-controlled clinical trial with 1:1 randomization to fluorometholone 0.1% eyedrops twice daily or placebo twice daily for four weeks in eyes undergoing trachomatous trichiasis (TT) surgery; assessing the efficacy, safety, and cost-effectiveness of fluorometholone 0.1% in preventing recurrent postoperative trichiasis.

Methods

Up to 2500 eligible persons with trachomatous trichiasis (TT) undergoing lid rotation surgery will be enrolled in Jimma zone, Ethiopia. Participants, surgeons, study field staff, and study supervisors leading operational aspects of the trial are masked to treatment assignment. Randomization is stratified by surgeon, which simultaneously stratifies by the district. The study visits are at baseline/enrollment, at four-week post-enrollment, six months, and one year (study exit). The primary outcome is cumulative one-year postoperative TT (PTT) incidence, defined as: ≥1 lashes touching the globe, evidence of epilation, and/or repeat TT surgery. Secondary postoperative outcomes include number of trichiatic lashes, location thereof (touching the cornea or not), evidence of post-operative epilation, entropion, changes in corneal opacity, IOP elevation, need for cataract surgery, visual acuity change from baseline, eyelid contour abnormality, granuloma, eyelid closure defect, and occurrence of adverse events. Health economic analyses center on calculating the incremental cost per case of PTT avoided by fluorometholone treatment.

Conclusion

The FLAME Trial is designed to provide evidence of the efficacy, safety, and cost-effectiveness of adjunctive topical peri-/postoperative fluorometholone 0.1% therapy with trichiasis surgery, which is hypothesized to reduce the risk of recurrent trichiasis while being acceptably safe.

Trial Registration:ClinicalTrials.gov#NCT04149210
A qualitative study exploring Emergency Department Staff attitudes to COVID-19 research
Authors: Quinn Joanna , Ho Antonia , Blunsum Andrew , Lowe David J
Published: July 2024

Introduction

Research conducted in the Emergency Department (ED) is essential for improving patient care and advancing evidence-based practice. However, there are several challenges to research engagement in the ED, including lack of time, awareness of research opportunities, and concerns about the impact on clinical duties.

This study aimed to explore the attitudes and perceptions of ED staff involved in an enhanced syndromic surveillance of hospitalised severe acute respiratory illness (CHARISMA study) during the COVID-19 pandemic.

Methods

This qualitative study utilised semi-structured interviews with a mix of nursing and medical staff with a range of experience levels. Thematic analysis was then undertaken.

Results

9 respondents informed our four key themes: the value of research, the user experience of the study tools, clinician research engagement and improvement recommendations for future iterations of the study. Our findings reveal that ED staff value research and recognise its importance in improving patient care and evidence-based practice. However, they also face significant challenges in participating in research due to time constraints, lack of awareness of research opportunities, and concerns about the impact on clinical duties.

Conclusion

To address these challenges, we propose strategies to enhance research engagement in the ED, including providing more support from senior staff, more transparent communication about research studies, training on research methods and tools, and opportunities for feedback and input. Implementing these measures, we can enhance the environment for research in the ED, enabling wider staff contribution.

What is already known on this topic

Data collected in the Emergency Department by clinical and research teams was an important contribution to COVID research including multinational platform studies. However, little is known about the attitudes of front-line staff involved in this process. This study responds to a paucity of literature with regards to clinician attitudes towards being asked to participate in research during the COVID-19 pandemic in an acute setting.

What this study adds

This study provides the first published description of ED staff attitudes to their involvement in research during a global pandemic. It highlights the challenges that are posed by the unique pressures of the ED setting - namely activity and unpredictability, time pressure, and in some cases, a lack of resources.

How this study might affect research, practice or policy

This study reinforces the need, value and support of staff to conduct research in an ED setting. We hope that this study provides useful insight to researchers on potential pitfalls to beware when undertaking their own original research. We anticipate that many of our findings are highly generalisable to other ED and acute care settings and hope that this encourages further expansion of this area.
Monovalent XBB.1.5 COVID-19 vaccine effectiveness against hospitalisations and deaths during the Omicron BA.2.86/JN.1 period among older adults in seven European countries: A VEBIS-EHR Network Study
Authors: Nunes Baltazar , Humphreys James , Nicolay Nathalie , Braeye Toon , Van Evercooren Izaak , Hansen Christian Holm , Moustsen-Helms Ida Rask , Sacco Chiara , Fabiani Massimo , Castilla Jesús , Martínez-Baz Iván , Meijerink Hinta , Machado Ausenda , Soares Patricia , Ljung Rickard , Pihlström Nicklas , Nardone Anthony , Bacci Sabrina , Monge Susana
Published: July 2024

Background

Monovalent XBB.1.5 vaccine was administered among those aged ≥65 years in EU/EEA countries in autumn 2023; soon after SARS-Cov-2 BA.2.86/JN.1 lineages became dominant. We aimed to estimate XBB.1.5 vaccine effectiveness (VE) against COVID-19-related hospitalisations and deaths during a period of BA.2.86/JN.1 predominance using a European multi-country study.

Methods

We linked electronic health record data to create historical cohorts in Belgium, Denmark, Italy, Navarre (Spain), Norway, Portugal and Sweden. We included individuals aged ≥65 years eligible for the autumnal 2023 COVID-19 vaccine with at least a primary series. Follow-up started when ≥80% of country-specific sequenced viruses were BA.2.86/JN.1 lineages (4/12/23 to 08/01/24) and ended 25/02/2024. At study site level, we estimated the overall vaccine confounder-adjusted (for age, sex, country’s region, comorbidities and previous booster doses) hazard ratio (aHR) of COVID-19 hospitalisations and deaths between individuals with ≥14 days after vaccination and individuals unvaccinated in autumn 2023, as well as by time since vaccination and stratified by age groups. VE was estimated as (1-pooled aHR)x100 with a random effects model.

Results

XBB.1.5 VE against COVID-19 hospitalisations was 50% (95%CI: 45 to 55) and 41% (95%CI: 35 to 46) in 65-79-year-olds and in ≥80-year-olds respectively. VE against COVID19-related-death was 58% (95%CI: 42 to 69) and 48% (95%CI: 38 to 57), respectively, in both age groups. VE estimates against each respective outcome declined in all age group over time.

Conclusion

Monovalent XBB.1.5 vaccine had a moderate protective effect against severe COVID-19 likely caused by BA.2.86/JN.1 during the 2023/2024 winter, among persons aged ≥65.
MitoFit: Evaluation of a Mitochondrial Fitness Science Communication Intervention for Aging Adults
Authors: Maxwell Cathy A , Patel Maulik R , Boon Jeffrey T , Grubbs Brandon , Dietrich Mary S , Dunavan John , Knickerbocker Kelly
Published: July 2024

A key driver that leads to age-associated decline and chronic disease is mitochondrial dysfunction. Our prior work revealed strong community interest in the concept of mitochondrial fitness that led to development of a video based science communication intervention to prompt behavior change in adults aged 50+. Aim: To conduct formative and summative evaluations of MitoFit, an instructional, biologically based communication intervention aimed at improving physical activity (PA) in older adults, aged 50+. Methods: Phase 1 formative evaluation- Community-dwelling older adults (N=101), rated the acceptability, appropriateness and helpfulness of our MitoFit video series, titled, How to Slow Down Aging Through Mitochondrial Fitness. (4 out of five on a Likert-scale survey). Phase II summative evaluation- A subgroup of phase I participants (N=19) participated in a 1-month MitoFit intervention prototype to evaluate intervention and data collection feasibility (70% completion). Results: Phase I: Participants (mean age: 67.8 [SD 8.9]; 75% female) rated the MitoFit videos as acceptable (agree: 97%-100%), appropriate (agree: 100%) and helpful (agree: 95%-100%) to support adaptation and continued work on our novel approach. Phase II: Participants (mean age: 71.4 [SD 7.9]; 72% female) demonstrated MitoFit competencies (obtaining pulse, calculating maximum and zone 2 heart rate, demonstration of exercises). At one-month post-instruction, 13 participants (68.4%) had completed a self-initiated daily walking/exercise plan and submitted a daily activity log. Feasibility scores ranged from 89.4% to 94.7%. Fifteen participants (78.9%) stated an intention to continue the MitoFit intervention. Conclusion: MitoFit was enthusiastically embraced, and is a cost-effective, scalable, and efficacious intervention to advance with community-dwelling older adults.
Identification of a NovelSLC2A9Gene Association with LDL-C levels and Evaluation of Polygenic Scores in a Multi-Ancestry Genome Wide Association Study
Authors: Umlai Umm-Kulthum Ismail , Toor Salman M. , Al-Sarraj Yasser A. , Mohammed Shaban , Al Hail Moza S H , Ullah Ehsan , Kunji Khalid , El-Menyar Ayman , Gomaa Mohammed , Jayyousi Amin , Saad Mohamad , Qureshi Nadeem , Al Suwaidi Jassim M , Albagha Omar M E
Published: July 2024

The genetic determinants of low-density lipoprotein cholesterol (LDL-C) levels in blood have been predominantly explored in European populations and remain poorly understood in Middle Eastern populations. We investigated the genetic architecture of LDL-C variation in the Middle Eastern population of Qatar. Whole genome sequencing data of 13,701 individuals (discovery; n=5939, replication; n=7762) from the population-based Qatar Biobank (QBB) cohort was used to conduct a genome-wide association study (GWAS) on serum LDL-C levels. We replicated 168 previously reported loci from the largest LDL-C GWAS conducted by the Global Lipids Genetics Consortium (GLGC), with high correlation in allele frequencies (R2=0.77) and moderate correlation in effect sizes (Beta; R2=0.53). We also performed a multi-ancestry meta-analysis with the GLGC study using MR-MEGA (Meta-Regression of Multi-Ethnic Genetic Association). The multi-ancestry meta-analysis identified one novel LDL-C-associated locus; rs10939663 (SLC2A9; genomic control-correctedP=1.25×10−8). Lastly, we developed Qatari-specific polygenic score (PGS) panels from our discovery dataset and tested their performance in the replication dataset against PGS derived from other ancestries. The multi-ancestry derived PGS (PGS000889) performed best at predicting LDL-C levels, whilst the Qatari-derived PGS panels also showed comparable performance. Overall, we report one novel gene variant associated with LDL-C levels, which may be explored further to decipher its potential role in the etiopathogenesis of cardiovascular diseases. Our findings also highlight the importance of population-based genetics in developing PGS panels for clinical utilization.