bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating Complaint Analysis into Hospital Management: A Comparative Study of Surgical and Non-Surgical Complaints
Authors: Qin Jinling , Lu Bo , Li Xiaoyu , Sun Daofan , Liu Rongjun , Wu Yixiao , Fan Guoping
Published: August 2024

Aims/Background: In an era where patient-centred care is paramount, effectively managing and analyzing hospital complaints is crucial for improving service quality and patient satisfaction. This study examines hospital complaints to enhance management practices by differentiating between surgery-related and non-surgery-related grievances. By identifying patterns in complaint types and outcomes, we aim to inform targeted quality improvement strategies that address specific patient concerns and boost operational efficiency.

Methods: The study utilized data from an internal complaint management system over one year. Complaints were categorized as either surgery-related or non-surgery-related. Descriptive statistics and cross-tabulation analysis were employed to examine the data. The sample comprised 132 complaints, with 67 being surgery-related and 65 non-surgery-related.

Results: The analysis revealed that surgery-related complaints frequently involved issues with ‘Patient Communication’ and ‘Surgical Error’, while non-surgery-related complaints were primarily about the ‘Medical Treatment Process’. The Surgery Department received the highest number of complaints, indicating a critical area for intervention. Additionally, the correlation between complaint types and outcomes provided insights into potential areas for improvement.

Conclusion: The findings highlight the need for targeted communication training and procedural enhancements in surgical departments. Non-surgical departments should focus on improving treatment protocols and transparency. These strategies can reduce complaints and improve patient satisfaction. Future research should develop and test interventions based on these insights to further enhance healthcare quality.
TEN-YEAR SURVIVORSHIP OF HIP RESURFACING IN PATIENTS 30 YEARS OF AGE OR YOUNGER
Authors: Urbain A. , Putman S. , Migaud H. , Faure P-A , Girard J.
Published: August 2024

Hip resurfacing arthroplasty (HRA) is being offered as a viable alternative to total hip arthroplasty (THA). For very young patients (under 30 years old), THA achieves fair results but with high revision and complication rates. This retrospective study was designed to evaluate the results of HRA performed in patients under 30 years old with a long follow-up.

During the inclusion period (2007–2021), we collected in a single operator database, all HRA performed in patients under 30 with a minimum follow up of 2 years.

103 HRA in 93 patients (77 male / 16 females; a mean age at operation 27.7 years (18 to 29.9)) were included. The two mean preoperative diagnoses were osteoarthritis in 54 HRA (52.5%) and DDH or hip dislocation in 19.4% (20 cases). No patient was lost to follow-up and 3 patients (5 HRA) deceased. There were 2 revisions (one for femoral aseptic loosening and one infection recurrence (pediatric osteoarthritis)). No dislocation and adverse wear-related failures were found. At a mean follow-up of 10.4 years (2–17.4), mean UCLA activity and Oxford Hip score improved respectively from 5.4 (1 to 7) and 39.9 (25–55) pre-operatively to 7.9 (3 to 10) and 15.8 (12–34) post-operatively (p<0.001). Mean Harris hip score increased from 41.6 (22–63) to 91.8 (72–100) (p<0.001). There were no radiological cases exhibiting lysis while two cases displayed limited partial radiolucency around the femoral stem. Kaplan-Meier survival analysis, with the endpoint revision for any reason, showed a 10.8-year survival rate of 98% (95% expected with NICE guidelines).

This cohort of HRA performed under 30 is the longest follow-up ever reported in the literature. Despite a challenging cohort of patients, HRA exceeds the stricter NICE survivorship criteria. HRA remains an effective treatment with excellent functional outcomes and a very low rate of complications.
GAIT CHANGES FOLLOWING CERAMIC-ON-CERAMIC HIP RESURFACING ARTHROPLASTY: A PROSPECTIVE STUDY
Authors: Cobb J. , Maslivec A. , Clarke S. , Halewood C. , Wozencroft R.
Published: August 2024

A ceramic-on-ceramic hip resurfacing implant (cHRA) was developed and introduced in an MHRA-approved clinical investigation to provide a non metallic alternative hip resurfacing product. This study aimed to examine function and physical activity levels of patients with a cHRA implant using subjective and objective measures both before and 12 months following surgery in comparison with age and gender matched healthy controls.

Eighty-two unilateral cHRA patients consented to this study as part of a larger prospective, non-randomised, clinical investigation. In addition to their patient reported outcome measures (PROMs), self- reported measures of physical activity levels and gait analysis were undertaken both pre- operatively (1.5 weeks) and post operatively (52 weeks). This data was then compared to data from a group of 43 age gender and BMI matched group of healthy controls. Kinetics and kinematics were recorded using an instrumented treadmill and 3D Motion Capture. Statistical parametric mapping was used for analysis.

cHRA improved the median Harris Hip Score from 63 to 100, Oxford Hip score from 27 to 48 and the MET from 5.7 to 10.3. cHRA improved top walking speed (5.75km vs 7.27km/hr), achieved a more symmetrical ground reaction force profile, (Symmetry Index value: 10.6% vs 0.9%) and increased hip range of motion (ROM) (31.7° vs 45.9°). Postoperative data was not statistically distinguishable from the healthy controls in any domain.

This gait study sought to document the function of a novel ceramic hip resurfacing, using those features of gait commonly used to describe the shortcomings of hip arthroplasty. These features were captured before and 12 months following surgery. Preoperatively the gait patterns were typical for OA patients, while at 1 year postoperatively, this selected group of patients had gait patterns that were hard to distinguish from healthy controls despite an extended posterior approach. Applications for regulatory approval have been submitted.
SHORT-TERM OUTCOME OF A MODERN MONOBLOCK TITANIUM FLUTED TAPERED REVISION STEM FOR COMPLEX PRIMARY AND REVISION TOTAL HIP ARTHROPLASTY
Authors: McCalden R. W. , Vasarhelyi E. M. , Howard J. L. , Lanting B. A. , Naudie D. D. , MacDonald S. J.
Published: August 2024

For over a decade, modular titanium fluted tapered (TFT) stems have demonstrated excellent clinical success for femoral revision total hip arthroplasty (THA) surgery. The aim of this study was to report the short-term outcomes of a novel modern monoblock TFT stem used for revision and complex primary THA with a minimum of 2 years follow-up.

We identified 126 patients who received a single monoblock TFT stem - 26 patients for complex THA (failed fracture fixation) and 100 patients for revision THA. The reasons for revision THA included 40 for previous prosthetic joint infection (PJI), 42 for aseptic loosening, 9 for trunnionosis, 9 for periprosthetic fractures. The Paprosky grading for femoral bone loss at the time of surgery and the measured subsidence of femoral stems at 3 months follow-up were determined. We evaluated the number and indications for re-operations.

The mean time from surgery was 3.9 years (range 2.0 to 6.9 years). A paired t-test analysis showed significant improvement from pre-operative versus post-operative clinical outcome scores (p<0.001) for HHS (38.76 +/- 15.24vs. 83.42 +/- 15.38), WOMAC (45.6 ± 19.0 vs. 69.9 ± 21.3) and SF-12 Physical component (31.7 ± 8.1 vs. 37.8 ± 11.3) and SF-12 Mental component (48.2 ± 12.2 vs. 51.6 ± 12.5). The Paprosky grading for femoral bone loss was Grade 1 (3.9%), Grade 2 (35.7%), Grade 3A (47.6%), Grade 3B (11.1%) and Grade 4 (1.6%) cases. There were 18 re-operations (14.7%) with 13 for PJI (7 treated with implant retention, 6 treated with a two-staged revision), 4 for instability and one for acetabular aseptic loosening. There were no aseptic failures of the stem.

This novel modern monoblock TFT stem provided reliable femoral fixation and has increasingly supplanted the use of modular TFT stems for complex primary and revision surgery in our institution.
CEMENTLESS ACETABULAR CUP WITHOUT SCREW HOLES: A MINIMUM 20-YEAR FOLLOW-UP STUDY
Authors: Lau L. C. M. , Cheung M. H. , Ng F. Y. , Fu H. , Chan P. K. , Chiu P.
Published: August 2024

In total hip arthroplasty (THA), cementless cup without screw holes has the putative benefits of maximizing host bone contact and reducing osteolysis by eliminating channels to backside wear particles. However, supplemental trans-acetabular screws cannot be used.

74 hips in 60 patients receiving same model of cementless cup without screw holes (Depuy Duraloc 100 HA cup) from 6/1999 to 3/2003 were prospectively followed up. All patients were allowed to have immediate full weight bearing. Age at THA was 53 ± 13 (range 24–74) years. Osteonecrosis was the leading hip disease (45% of hips). Survivorship was assessed using revision of the cup as the end point. Radiological parameters, including lateral opening angle, vertical and horizontal migration distances of the cups were measured. Paired t-test was used to compare between the measurements in early postoperative period and at final follow up.

51 hips were assessed at minimum 20 years follow-up. The mean follow-up was 22.6 (range 21 – 25) years. All the cups were well fixed. There were two cup revisions. Conventional polyethylene (PE) was used in both hips; osteolysis occurred 17 and 18 years later. Both cups were well fixed but were revised, one due to cup mal-positioning, one due to need in upsizing the articulation. 14 other hips were revised but these cups were well fixed and not revised; 9 loosened stems (most were cemented Elite plus stems), 5 PE wear and osteolysis (all were conventional PE). At 20 years, the survivorship of cups was 96.1%. Changes in lateral opening angle, vertical and horizontal migration distances were 0.44±1.59°, 0.01±1.52mm and -0.32±1.47mm respectively, without statistical significance.

This study provided evidence of excellent long-term survivorship of cementless cup without screw holes. Immediate postoperative weight-bearing also did not lead to cup migration in the long-term.
WHAT IS THE IMPACT OF HIP DISLOCATION ON PATIENT QUALITY OF LIFE AFTER TOTAL HIP ARTHROPLASTY? HOW DO SPECIFIC IMPLANTS (LARGE HEADS, DUAL MOBILITY, OR CONSTRAINED LINERS) DEAL WITH THIS PROBLEM?
Authors: Hernigou P.
Published: August 2024

Dislocations have impact on quality of life, but it is difficult to quantify this impact for each patient. The Quality-of-Life Time Trade-Off assesses the percentage of a patient's remaining life that the patient would be willing to trade for perfect health [1]. This technique has been used for non-unions [2], but never proposed for dislocation.

154 patients (with 3 recurrent dislocations) undergoing revision were asked to choose between living with their associated dislocation risk or trading a portion of their life expectancy for a period of perfect health without dislocation, thus determining their Quality-of-Life score. This score may range from 0.1 (willing to trade nine years among 10) to 1.0 (unwilling to trade any years). Additionally, patients were assessed on their willingness to trade implant survival time for a reduced risk of dislocation, considering various implant options that might offer lower (but not necessary) survival time before revision than the theoretical best (for the surgeon) “standard” implant, thus determining a “Survival Implant Quality” score.

Patients diagnosed with 3 hip dislocations have a low health-related quality of life. The score of our “dislocation” cohort was average 0.77 with patients willing to trade average 23% of remaining lifespan for perfect health (range 48% to 12%). This score is below that (0.88) of illnesses type-I diabetes mellitus [3] and just higher than tibial non-union (0.68) score [2]. The mean “Survival Implant Quality” score of our recurrent dislocation cohort was 0.71 (range 0.59 to 0.78) which means that patients accept to trade average 3 years (range 2 to 4 years) among 10 theoretical years of survival of the implant.

Hip dislocation has a devastating impact that can be quantified for each patient when discussing revision and choice of implants for instability.

For references, please contact the author directly.
VIRTUAL IMPINGEMENT TESTS IN 113 PATIENTS UNDERGOING TOTAL HIP ARTHROPLASTY
Authors: Fu H. , Singh G. , H C. , Lam J. , Yan C. H. , Cheung A. , Chan P. K. , Chiu K. Y.
Published: August 2024

Hip precautions following total hip arthroplasty (THA) limits flexion, adduction and internal rotation, yet these precautions cause unnecessary psychological stress. This study aims to assess bony and implant impingement using virtual models from actual patient's bony morphology and spinopelvic parameters to deduce whether hip precautions are necessary with precise implant positioning in the Asian population.

Individualized sitting and standing sacral slope data of robotic THAs performed at two tertiary referral centers in Hong Kong was inputted into the simulation system based on patients’ pre-operative sitting and standing lumbar spine X-rays. Three-dimensional dynamic models were reconstructed using the Stryker Mako THA 4.0 software to assess bony and implant impingement both anteriorly and posteriorly, with default cup placement at 40° inclination and 20° anteversion. Femoral anteversion followed individual patient's native version. A 36mm hip ball was chosen for all cups equal or above 48mm and 32mm for those below. Anterior impingement was assessed by hip flexion and posterior impingement was assessed by hip extension.

113 patients were included. At neutral rotation and adduction, no patients had anterior implant impingement at hip flexion of 100°. 1.7% had impingement at 110°, 3.5% had impingement at 120°, 9.7% had impingement at 130°. With 20° of internal rotation and adduction, 0.8% had anterior implant impingement at hip flexion of 90°, 7.1% had impingement at 100° and 18.5% had impingement at 110°. With the hip externally rotated by 20°, 0.8% of patients had posterior implant impingement, and 8.8% bony impingement at 0° extension.

With enabling technology allowing accurate component positioning, hip precautions without limiting forward flexion in neutral position is safe given precise implant positioning and adequate osteophyte removal. Patients should only be cautioned about combined internal rotation, adduction with flexion.
COMPARISON OF PROMIS SCORES AFTER TOTAL HIP AND TOTAL ANKLE ARTHROPLASTY: A PROPENSITY SCORE-MATCHED STUDY
Authors: Holland C. T. , Leal J. , Easley M. E. , Nunley J. A. , Ryan S. P. , Bolognesi M. P. , Wellman S. S. , Jiranek W. A.
Published: August 2024

This study evaluates patient reported outcome measurement information system (PROMIS) scores after total hip arthroplasty (THA) and total ankle arthroplasty (TAA) in matched cohorts, while simultaneously evaluating implant survivorship and 90-day hospital utilization. It is hypothesized that while both procedures would yield similar PROMIS score improvements, THA would demonstrate superior mid-term implant survivorship.

Primary THA and TAA patients from 2015–2022 with minimum one-year follow-up were retrospectively reviewed. After applying exclusion criteria, 2,092 THAs and 478 TAAs were included for analysis. Demographics, pre- and post-operative patient reported outcome measures (PROMs), revision surgeries, ED visits, and re-admissions were collected. THA and TAA patients were then propensity score matched at 2:1 ratio for age, sex, race, BMI, ASA, and comorbidities, resulting in a final cohort of 844 THAs and 455 TAAs for comparison.

There were similar pre-operative PROMIS Pain Interference (PI) scores between THA and TAA, with both showing improvement at six weeks. However, THA patients exhibited lower PI scores at one year (53.0 versus 54.0; p=0.009). Pre-operative PROMIS Physical Function (PF) was worse in THA patients but showed greater improvement compared to TAA patients at both six weeks (p<0.001) and one year (p<0.001). Pre-operative PROMIS depression scores were similar and improved similarly in both groups. Joint-specific PROMs (HOOS for THA and FAAM for TAA) improved in both cohorts. THA demonstrated superior survivorship free of all-cause revision at five years compared to TAA (95% versus 77%; p<0.0001).

Patients undergoing THA or TAA experienced significant improvements in their general and joint-specific PROMs post-operatively. However, patients undergoing THA demonstrated higher PROMIS PI and PF scores at one-year when compared to TAA, as well as improved survivorship. Generic PRO instruments enable comparison of medical treatments in different anatomic sites to the patients overall health.
RETROSPECTIVE ANALYSIS OF PATIENT-REPORTED OUTCOME MEASURES IN A MATCHED COHORT OF INPATIENT AND DAY-SURGERY HIP ARTHROPLASTY PATIENTS
Authors: Waddell J.
Published: August 2024

Most hip replacements are performed in an in-patient setting; however, there has been a shift in recent years in Canada towards doing more on an outpatient basis. In 2021–2022, 15.6% of hip replacements were performed as day surgeries compared to 0.7% in 2018–2019. This analysis will assess patient reported outcome measures of patients who had inpatient versus outpatient hip replacement surgery between 2018 and 2021.

We analysed a retrospective sample of 4917 adult patients who had an elective primary unilateral hip replacement. Preoperative and three-month postoperative PROMs were completed - the Oxford Hip Score, EQD5L and patient satisfaction with the outcome were recorded. Patients who had an outpatient procedure were matched 1:1 with patients who are admitted to hospital for surgery based on age, sex and pre-COVID versus the COVID (March 15, 2020 as the start). Preoperative PROMs and Charlson Comorbidity Index were collected. T-tests and chi-square tests were used to assess the differences.

The inpatient group on average was older, female and had a lower preoperative PROMs score and more comorbidities than the outpatient group. With cohort matching the sample consisted of 1244 patients. The inpatient and outpatient groups have similar Oxford scores, postoperative EQ-5D-5L scores and the proportion satisfied with their surgical results. The Oxford postoperative score was slightly higher in the outpatient group compared to the inpatient group; however, this is not clinically significant.

We observed that outpatient protocols have no difference in patient satisfaction, self-reported functional outcomes and self-reported health-related quality of life three months after a hip replacement. Day surgery protocols represented potential solution to the challenges caused by the expected increase in demand for hip replacements. Our results demonstrated that patients do well clinically with day surgery procedures and there does not appear to be any detrimental effect on PROMs.
WEATHERING THE STORM: THE IMPACT OF TOTAL HIP ARTHROPLASTY ON WEATHER-RELATED PAIN
Authors: Tanzer M. , Laverdiere C. , Elmasry W. , Hart A.
Published: August 2024

It is not unusual for patients prior to their total hip arthroplasty (THA) to indicate that their symptoms worsen with certain meteorological conditions. However, the prevalence and evolution of weather-related pain (WRP) following THA remain poorly understood. The aim of this study was to investigate the prevalence of WRP both before and after primary THA, to assess the impact of THA on pre-existing WRP, and to identify potential risk factors associated with WRP.

An in-person survey was conducted on 442 primary THAs, in 327 consecutive patients at the time of their postoperative follow-up. Each patient was assessed using a questionnaire specifically designed to address weather-related joint pain before and after their THA. The clinical evaluation included patient-reported outcome scores (PROMS).

Preoperatively, 17% of THA hips experienced WRP, with 71% achieving complete resolution postoperatively (p < 0.001). In patients with WRP in multiple joints and their hip, the THA failed to alleviate the WRP in 31% of the cases. In addition, 8% of the THA patients developed de-novo WRP after surgery. Although the overall prevalence of WRP in hips post-THA was 12%, the prevalence was 29% in hips with WRP preoperatively and 31% in the hips of patients with WRP in multiple joints as well as their hip. WRP in other joints, the initial diagnosis, body mass index (BMI), and age were correlated with WRP following THA.

WRP is not uncommon prior to and after THA. Although THA can effectively alleviate WRP in specific patient populations, it does not universally eliminate preoperative WRP or prevent the emergence of new WRP after surgery.
Fluorescence separation based on the spatiotemporal Gaussian mixture model for dynamic fluorescence molecular tomography
Authors: Wu Yansong , Chen Zihao , Guo Hongbo , Li Jintao , Yi Huangjian , Yu Jingjing , He Xuelei , He Xiaowei
Published: August 2024

Dynamic fluorescence molecular tomography (DFMT) is a promising imaging method that can
furnish three-dimensional information regarding the absorption,
distribution, and excretion of fluorescent probes in organisms.
Achieving precise dynamic fluorescence images is the linchpin for
realizing high-resolution, high-sensitivity, and high-precision
tomography. Traditional preprocessing methods for dynamic fluorescence
images often face challenges due to the non-specificity of fluorescent
probes in living organisms, requiring complex imaging systems or
biological interventions. These methods can result in significant
processing errors, negatively impacting the imaging accuracy of DFMT.
In this study, we present, a novel, to the best of our knowledge,
strategy based on the spatiotemporal Gaussian mixture model (STGMM)
for the processing of dynamic fluorescence images. The STGMM is
primarily divided into four components: dataset construction, time
domain prior information, spatial Gaussian fitting with time prior,
and fluorescence separation. Numerical simulations and in vivo experimental results demonstrate that
our proposed method significantly enhances image processing speed and
accuracy compared to existing methods, especially when faced with
fluorescence interference from other organs. Our research contributes
to substantial reductions in time and processing complexity, providing
robust support for dynamic imaging applications.
Twisted-mode VECSEL with intracavity second harmonic generation
Authors: Mitten D. , Kaneda Y.
Published: August 2024

A vertical external cavity surface emitting laser (VECSEL) that uses intracavity second harmonic generation (SHG) and the twisted mode technique for power scaling was explored. The effects of the twisted mode technique are shown and discussed by examining the mode structure and spectrum of the fundamental mode. The maximum SHG output was 1 W at 458 nm while the fundamental was lasing in the TEM00 mode. We conclude that the twisted mode technique does not interfere with intracavity SHG and is a reasonable path for power scaling intracavity frequency doubled VECSELs.
Dynamic plasmonic structural color with deep sub-diffraction resolution based on borophene metasurfaces
Authors: Zhang Zhaojian , Du Te , Jiang Xinpeng , Chen Huan , Zhang Zhenfu , He Xin , Yu Yang , Yang Junbo
Published: August 2024

Structural colors have seen rapid development in recent years, yet two-dimensional (2D) materials have seldom taken center stage as pixel materials. In this study, we propose a novel approach utilizing the emerging 2D material borophene, wherein resulting metasurfaces can generate plasmonic structural colors with tunability and ultra-high resolution. Numerical investigations demonstrate that borophene metasurfaces support visible localized surface plasmon resonances at deep subwavelength scales under linear-polarized light excitation, thus enabling the realization of structural colors with an unparalleled resolution of up to 106 dots per inch (dpi)—an advancement of one order of magnitude over conventional counterparts. Furthermore, by modulating the electron density of borophene, these structural colors can be dynamically tuned across a broad spectrum. We highlight their high robustness against incident light angles and explore the influence of periodicity and polarization angle on color rendition. Finally, we present their potential applications in optical anti-counterfeiting, encryption, and switchable imaging methodologies. This work may promise future advancements in ultracompact, tunable, and lightweight display technologies.
Phase-only mask for superoscillatory enhanced resolution in confocal microscopy
Authors: Iglesias Ignacio , Filiu José Manuel
Published: August 2024

In this work, we present a simple phase mask that generates a superoscillatory spot suitable for confocal scanning microscopy enabling lateral sub-diffraction resolution. When considering linearly polarized light, the mask enhances the resolving power along the axis perpendicular to the polarization direction. The symmetry of the enhancement is recovered if the mask is combined with radial polarization.
Enhanced forward emission by a backside mirror design in micron-sized LEDs
Authors: Vögl Florian , Avramescu Adrian , Lex Andreas , Waag Andreas , Hetzl Martin , von Malm Norwin
Published: August 2024

Tiny InGaN micro-LEDs (μ-LEDs) play a pivotal role in emerging display technologies, particularly augmented reality (AR) applications. Achieving both high internal quantum efficiency (IQE) and efficient light extraction efficiency (LEE) is essential. While wet chemical etching can recover the IQE after dry etching, it alters the pixel shape, impacting optical properties and reducing the LEE. In this study, we overcome this issue by fabricating 1 μm thin-film-based μ-LED emitter arrays with a metallic backside mirror deposited on a patterned dielectric material around the μ-LED mesa. This concave mirror can be straightforwardly integrated into a thin-film LED process chain, and it redirects photons within the μ-LED structure, enhancing the LEE in the forward direction. Electro-optical measurements show a 2.1-fold improvement in light output within the ±15∘ emission cone compared to μ-LEDs with vertical sidewalls. These findings hold significant implications for μ-LED projection displays, where maximizing the overall efficiency and directionality is critical.
Repeated stress to the skin amplifies neutrophil infiltration in a keratin 17- and PKCα-dependent manner
Authors: Xu Yang , Cohen Erez , Johnson Craig N. , Parent Carole A. , Coulombe Pierre A.
Published: August 2024

Neutrophils are the first immune cells to reach inflamed sites and contribute to the pathogenesis of chronic inflammatory skin diseases. Yet, little is known about the pattern of neutrophil infiltration in inflamed skin in vivo and the mechanisms mediating their recruitment. Here, we provide insight into the dynamics of neutrophil infiltration in skin in response to acute or repeated inflammatory stress, highlighting a novel keratinocyte- and keratin 17 (K17)-dependent mechanism that regulates neutrophil recruitment to inflamed skin. We used the phorbol ester TPA and UVB, alone or in combination, to induce sterile inflammation in mouse skin. A single TPA treatment results in a neutrophil influx in the dermis that peaks at 12 h and resolves within 24 h. A subsequent TPA treatment or a UVB challenge, when applied 24 h but not 48 h later, accelerates, amplifies, and prolongs neutrophil infiltration. This transient amplification response (TAR) is mediated by local signals in inflamed skin, can be recapitulated in ex vivo culture, and involves the K17-dependent sustainment of protein kinase Cα (PKCα) activity and release of chemoattractants by stressed keratinocytes. K17 binds RACK1, a scaffold protein essential for PKCα activity. The N-terminal head domain of K17 is crucial for its association with RACK1 and regulation of PKCα activity. Analysis of RNAseq data reveals a signature consistent with TAR and PKCα activation in inflammatory skin diseases. These findings uncover a novel, keratin-dependent mechanism that amplifies neutrophil recruitment in skin under stress, with direct implications for inflammatory skin disorders.
Altered co-stimulatory and inhibitory receptors on monocyte subsets in patients with visceral leishmaniasis
Authors: Adem Emebet , Yizengaw Endalew , Mulaw Tadele , Nibret Endalkachew , Müller Ingrid , Takele Yegnasew , Kropf Pascale
Published: August 2024

Visceral leishmaniasis (VL) is a neglected tropical disease caused by parasites from the Leishmania (L.) donovani complex. VL is characterised by uncontrolled parasite replication in spleen, liver and bone marrow, and by an impaired immune response and high systemic levels of inflammation. Monocytes have been poorly characterised in VL patients. The aim of this study was to evaluate the expression levels of markers involved in the regulation of T cell responses on different subsets of monocytes from the blood of VL patients and healthy non-endemic controls (HNEC). Monocytes can broadly be divided into three subsets: classical, intermediate and non-classical monocytes. Our results show that the percentages of all three subsets stayed similar at the time of VL diagnosis (ToD) and at the end of anti-leishmanial treatment (EoT). We first looked at co-stimulatory receptors: the expression levels of CD40 were significantly increased on classical and intermediate, but not non-classical monocytes, at ToD as compared to EoT and HNEC. CD80 expression levels were also increased on intermediate monocytes at ToD as compared to EoT and HNEC, and on classical monocytes only as compared to HNEC. The levels of CD86 were similar at EoT and ToD and in HNEC on classical and intermediate monocytes, but significantly higher at EoT on non-classical monocytes. We also looked at an inhibitory molecule, PD-L1. Our results show that the expression levels of PD-L1 were significantly higher on all three monocyte subsets at ToD as compared to HNEC, and to EoT on classical and intermediate monocytes. These results show that monocytes from the blood of VL patients upregulate both co-stimulatory and inhibitory receptors and that their expression levels are restored at EoT.
Prevalence of dermal trypanosomes in suspected and confirmed cases of gambiense human African trypanosomiasis in Guinea
Authors: Soumah Alseny M’mah , Camara Mariame , Kaboré Justin Windingoudi , Sadissou Ibrahim , Ilboudo Hamidou , Travaillé Christelle , Camara Oumou , Tichit Magali , Kaboré Jacques , Boiro Salimatou , Crouzols Aline , Ngoune Jean Marc Tsagmo , Hardy David , Camara Aïssata , Jamonneau Vincent , MacLeod Annette , Bart Jean-Mathieu , Camara Mamadou , Bucheton Bruno , Rotureau Brice
Published: August 2024

The skin is an anatomical reservoir for African trypanosomes, yet the prevalence of extravascular parasite carriage in the population at risk of gambiense Human African Trypanosomiasis (gHAT) remains unclear. Here, we conducted a prospective observational cohort study in the HAT foci of Forecariah and Boffa, Republic of Guinea. Of the 18,916 subjects serologically screened for gHAT, 96 were enrolled into our study. At enrolment and follow-up visits, participants underwent a dermatological examination and had blood samples and superficial skin snip biopsies taken for examination by molecular and immuno-histological methods. In seropositive individuals, dermatological symptoms were significantly more frequent as compared to seronegative controls. Trypanosoma brucei DNA was detected in the blood of 67% of confirmed cases (22/33) and 9% of unconfirmed seropositive individuals (3/32). However, parasites were detected in the extravascular dermis of up to 71% of confirmed cases (25/35) and 41% of unconfirmed seropositive individuals (13/32) by PCR and/or immuno-histochemistry. Six to twelve months after treatment, trypanosome detection in the skin dropped to 17% of confirmed cases (5/30), whereas up to 25% of unconfirmed, hence untreated, seropositive individuals (4/16) were still found positive. Dermal trypanosomes were observed in subjects from both transmission foci, however, the occurrence of pruritus and the PCR positivity rates were significantly higher in unconfirmed seropositive individuals in Forecariah. The lower sensitivity of superficial skin snip biopsies appeared critical for detecting trypanosomes in the basal dermis. These results are discussed in the context of the planned elimination of gHAT.
Loneliness and the persistence of fear: Perceived social isolation reduces evaluative fear extinction
Authors: Hornstein Erica , Lazar Lee , Eisenberger Naomi
Published: August 2024

Loneliness has been linked to a host of harmful physical and mental health outcomes, detrimental effects that may stem from increases in threat-responding caused by altered fear learning in lonely individuals. In particular, the heightened threat-vigilance that is a hallmark of loneliness may augment the processes by which fear learning occurs, ultimately resulting in a greater number of perceived threatening cues in the environment. However, almost no research has examined how loneliness alters fear learning processes in humans. Here, we investigated the effect of loneliness on fear learning during an evaluative learning procedure in which participants (n = 782) were taught to associate fearful, positive, or neutral control stimuli with neutral images. Results showed that reduced extinction of evaluative fear associations occurred in high (vs. low) lonely individuals, but there was no difference in extinction of evaluative appetitive (also known as positive or reward) associations, suggesting this effect is specific to fear learning. In addition to shedding light on the link between loneliness and poor health, these results represent an important step forward in the growing understanding of the powerful impact of social bonds on fear learning processes.
Growth dynamics of Escherichia coli cells on a surface having AgNbO3 antimicrobial particles
Authors: Talebpour Cyrus , Fani Fereshteh , Salimnia Hossein , Ouellette Marc , Alamdari Houshang
Published: August 2024

The morphological dynamics of microbial cell proliferation on an antimicrobial surface at an early growth stage was studied with Escherichia coli on the surface of a gel supplied with AgNbO3 antimicrobial particles. We demonstrated an inhibitory surface concentration, analogous to minimum inhibitory concentration, beyond which the growth of colonies and formation of biofilm are inhibited. In contrast, at lower concentrations of particles, after a lag time the cells circumvent the antimicrobial activity of the particles and grow with a rate similar to the case in the absence of particles. The lag time depends on the surface concentration of the particles and amounts to 2 h at a concentration of ½ minimum inhibitory concentration. The applicability of these findings, in terms of estimating inhibitory surface concentration, was tested in the case of antimicrobial polymethyl methacrylate (PMMA) bone cement.
Regional characterization of meteorological and agricultural drought in Baluchistan province, Pakistan
Authors: Rafiq Muhammad , Cong Li Yue , Rahman Ghani , Sohail Khawar , Khan Kamil , Zahoor Aun , Gujjar Farrukh , Kwon Hyun-Han
Published: August 2024

Drought is a complex natural hazard that occurs when a region experiences a prolonged period of dry conditions, leading to water scarcity and negative impacts on the environment. This study analyzed the recurrence of drought and wet spells in Baluchistan province, Pakistan. Reconnaissance Drought Index (RDI), Standardized Precipitation Evapotranspiration Index (SPEI), and Vegetation Condition Index (VCI) were used to analyze droughts in Baluchistan during 1986–2021. Statistical analysis i.e. run theory, linear regression, and correlation coefficient were used to quantify the trend and relationship between meteorological (RDI, SPEI) and agricultural (VCI) droughts. The meteorological drought indices (1, 3, 6, and 12-month RDI and SPEI) identified severe to extreme drought spells during 1986, 1988, 1998, 2000–2002, 2004, 2006, 2010, 2018–2019, and 2021 in most meteorological stations (met-stations). The Lasbella met-station experienced the most frequent extreme to severe droughts according to both the 12-month RDI (8.82%) and SPEI (15.38%) indices. The Dalbandin met-station (8.34%) follows closely behind for RDI, while Khuzdar (5.88%) comes in second for the 12-month SPEI. VCI data showed that Baluchistan experienced severe to extreme drought in 2000, 2001, 2006, and 2010. The most severe drought occurred in 2000 and 2001, affecting 69% of the study region. A positive correlation was indicated between meteorological (RDI, SPEI) and agricultural drought index (VCI). The multivariate indices can provide valuable knowledge about drought episodes and preparedness to mitigate drought impacts.
An observational cohort study to investigate the impact of dolutegravir in pregnancy and its obesogenic effects on the metabolic health of women living with HIV and their children: Study protocol
Authors: Abrams Elaine J. , Jao Jennifer , Madlala Hlengiwe P. , Zerbe Allison , Catalano Patrick , Gerschenson Mariana , Goedecke Julia H. , Gomba Yolanda , Josefson Jami , Kurland Irwin J. , Legbedze Justine , McComsey Grace A. , Matyesini Sandisiwe , Mukonda Elton , Robinson Daniel , Myer Landon
Published: August 2024

Introduction

Dolutegravir (DTG)-based antiretroviral therapy is the World Health Organization’s preferred first-line regimen for all persons with HIV, including pregnant women. While DTG has been implicated as an obesogen associated with greater weight gain compared to other antiretrovirals, there is a paucity of data in pregnant women and their children. The Obesogenic oRigins of maternal and Child metabolic health Involving Dolutegravir (ORCHID) study is investigating associations between DTG, weight gain, and metabolic outcomes in the context of HIV.

Materials & methods

ORCHID is a prospective observational study taking place in Cape Town, South Africa (NCT 04991402). A total of 1920 pregnant women with and without HIV infection are being followed from ≤18 weeks gestational age to 24 months postpartum with their children. Participants attend eleven study visits: 3 antenatal, delivery, and 7 postnatal visits. Several embedded sub-studies address specific scientific aims. Primary outcome measurements in mothers include anthropometry, blood pressure, body composition, dysglycemia, insulin resistance (IR), and dyslipidemia. Other maternal measures include demographics, resting energy expenditure, viral load, physical activity, dietary intake, hepatic steatosis, and repository specimens. Sub-study measurements include markers of adipose inflammation, gut integrity, and satiety/hunger, subcutaneous adipose tissue morphology and mitochondrial function, and metabolomics. Primary outcome measurements in children include anthropometry, adipose tissue mass, dysglycemia, IR, and dyslipidemia. Other variables include fetal growth, birth outcomes, medical/breastfeeding history, caloric intake, neurodevelopment, and repository specimens. Sub-study measurements include metabolites/lipid subspecies in umbilical cord blood, as well as breast milk composition and DTG exposure.

Discussion

ORCHID will play a pivotal role in defining obesogenic mechanisms and clinical consequences of DTG use in pregnancy in women with HIV and their children. It will provide insights into metabolic disease risk reduction in the context of HIV/DTG, identify intervention targets, and inform public health approaches to diminish chronic metabolic co-morbidities for women and children.
Identification of microbial antigens in liver tissues involved in the pathogenesis of primary biliary cholangitis using 16S rRNA metagenome analysis
Authors: Katsumi Tomohiro , Sato Hidenori , Murakami Ryoko , Hanatani Takumi , Uchiyama Fumi , Suzuki Fumiya , Maki Keita , Hoshikawa Kyoko , Haga Hiroaki , Saito Takafumi , Ueno Yoshiyuki
Published: August 2024

Background

Multiple factors are involved in the pathogenesis of primary biliary cholangitis (PBC), a chronic cholestatic liver disease, characterized by intrahepatic cholangiopathy. In particular, studies have suggested that environmental factors such as the presence of granulomas in the portal vein region are important for the development of PBC. This study aimed to comprehensively analyze and identify foreign-derived antigens in PBC liver tissue to confirm their involvement in PBC pathogenesis.

Methods

Portal areas and hepatocyte regions were selectively dissected from formalin-fixed paraffin-embedded PBC liver tissue samples using the microlaser method, followed by total DNA extraction. We then validated whether the bacterial strains identified through 16S rRNA metagenomic analysis were detected in PBC liver tissues.

Results

The most frequently detected bacterial genera in the PBC liver tissue samples were Sphingomonas panacis, Providencia, and Cutibacterium. These bacterial genera were also detected in the other PBC samples. Validation for the detection of S. panacis, the most abundant genus, revealed polymerase chain reaction bands extracted from the portal areas of all samples. They were also more highly expressed than bands detected in the hepatocyte region.

Conclusion

S. panacis antigen was specifically detected in the portal areas of PBC liver tissues. The introduction of foreign-derived antigens into the liver as an environmental factor could be a possible mechanism for the development of PBC.
Use of tobacco during COVID-19: A qualitative study among medically underserved individuals
Authors: Klaiman Tamar , Farrell Nsenga , Sheu Dorothy , Belk Aerielle , Silvestri Jasmine , Kim Jannie , Coffman Ryan , Hart Joanna
Published: August 2024

The COVID-19 pandemic produced stress for people around the world. The perception that tobacco can be a coping tool for stress relief suggests that the conditions during the COVID-19 pandemic can provide insight into the relationship between stress and tobacco use patterns, particularly among those most at risk for severe COVID-19 disease. The goal was to identify the impacts of the COVID-19 pandemic on tobacco use and preparedness for smoking cessation among individuals who smoke and are older and medically underserved. We conducted in-depth interviews with 39 patients to learn about individuals’ smoking behavior during the COVID-19 pandemic. We used a modified grounded theory approach to code and analyze all qualitative data. We conducted thematic analysis to identify key factors associated with smoking behaviors during COVID-19. Our results indicated that increases in perceived stress and social isolation may have been associated with increased tobacco use during the COVID-19 pandemic. Pandemic-related social isolation contributed to increases in smoking, despite respondents being concerned about the severity of COVID-19. While many respondents felt that smoking relieved their stress from the pandemic, they appeared unaware of the stress-inducing properties of tobacco use. Our findings indicate that pandemic-related stress impacted smoking behavior among older, medically underserved smokers. Results may assist clinicians in addressing the role of tobacco use in response to highly stressful events. Smoking cessation strategies should consider the implications of stress on smoking behavior, including smoking relapse in response to highly stressful events–particularly for medically underserved populations.
Remote liver ischemic preconditioning protects against renal ischemia/reperfusion injury via phosphorylation of extracellular signal-regulated kinases 1 and 2 in mice
Authors: Wang Qifeng , Xiao Junshen , Wei Shichao , Yang Xi , Li Jiaxue , Zuo Yunxia , Hu Zhaoyang
Published: August 2024

Perioperative acute kidney injury (AKI), which is mainly mediated by renal ischemia‒reperfusion (I/R) injury, is commonly observed in clinical practice. However, effective measures for preventing and treating this perioperative complication are still lacking in the clinic. Thus, we designed this study to examine whether remote liver ischemic preconditioning (RLIPC) has a protective effect on damage caused by renal I/R injury. In a rodent model, 30 mice were divided into five groups to assess the effects of RLIPC and ERK1/2 inhibition on AKI. The groups included the sham-operated (sham), kidney ischemia and reperfusion (CON), remote liver ischemic preconditioning (RLIPC), CON with the ERK1/2 inhibitor U0126 (CON+U0126), and RLIPC with U0126 (RLIPC+U0126). RLIPC consisted of 4 liver ischemia cycles before renal ischemia. Renal function and injury were assessed through biochemical assays, histology, cell apoptosis and protein phosphorylation analysis. RLIPC significantly mitigated renal dysfunction, tissue damage, inflammation, and apoptosis caused by I/R, which was associated with ERK1/2 phosphorylation. Furthermore, ERK1/2 inhibition with U0126 negated the protective effects of RLIPC and exacerbated renal injury. To summarize, we demonstrated that RLIPC has a strong renoprotective effect on kidneys post I/R injury and that this effect may be mediated by phosphorylation of ERK1/2.
Spatial transcriptomics of fetal membrane—Decidual interface reveals unique contributions by cell types in term and preterm births
Authors: Richardson Lauren S. , Severino Mary Elise , Chauhan Rahul , Zhang Weibin , Kacerovsky Marian , Bhavnani Suresh K. , Menon Ramkumar
Published: August 2024

During pregnancy, two fetomaternal interfaces, the placenta–decidua basalis and the fetal membrane–decidua parietals, allow for fetal growth and maturation and fetal–maternal crosstalk, and protect the fetus from infectious and inflammatory signaling that could lead to adverse pregnancy outcomes. While the placenta has been studied extensively, the fetal membranes have been understudied, even though they play critical roles in pregnancy maintenance and the initiation of term or preterm parturition. Fetal membrane dysfunction has been associated with spontaneous preterm birth (PTB, < 37 weeks gestation) and preterm prelabor rupture of the membranes (PPROM), which is a disease of the fetal membranes. However, it is unknown how the individual layers of the fetal membrane decidual interface (the amnion epithelium [AEC], the amnion mesenchyme [AMC], the chorion [CTC], and the decidua [DEC]) contribute to these pregnancy outcomes. In this study, we used a single-cell transcriptomics approach to unravel the transcriptomics network at spatial levels to discern the contributions of each layer of the fetal membranes and the adjoining maternal decidua during the following conditions: scheduled caesarian section (term not in labor [TNIL]; n = 4), vaginal term in labor (TIL; n = 3), preterm labor with and without rupture of membranes (PPROM; n = 3; and PTB; n = 3). The data included 18,815 genes from 13 patients (including TIL, PTB, PPROM, and TNIL) expressed across the four layers. After quality control, there were 11,921 genes and 44 samples. The data were processed by two pipelines: one by hierarchical clustering the combined cases and the other to evaluate heterogeneity within the cases. Our visual analytical approach revealed spatially recognized differentially expressed genes that aligned with four gene clusters. Cluster 1 genes were present predominantly in DECs and Cluster 3 centered around CTC genes in all labor phenotypes. Cluster 2 genes were predominantly found in AECs in PPROM and PTB, while Cluster 4 contained AMC and CTC genes identified in term labor cases. We identified the top 10 differentially expressed genes and their connected pathways (kinase activation, NF-κB, inflammation, cytoskeletal remodeling, and hormone regulation) per cluster in each tissue layer. An in-depth understanding of the involvement of each system and cell layer may help provide targeted and tailored interventions to reduce the risk of PTB.