bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-SAE autoantibody in dermatomyositis: original comparative study and review of the literature
Authors: Demortier Juliette , Vautier Mathieu , Chosidow Olivier , Gallay Laure , Bessis Didier , Berezne Alice , Cordel Nadège , Schmidt Jean , Smail Amar , Duffau Pierre , Jachiet Marie , Begon Edouard , Gottlieb Jeremy , Chasset François , Graveleau Julie , Marque Myriam , Cesbron Elise , Forestier Amandine , Josse Séverine , Kluger Nicolas , Beauchêne Caroline , Le Corre Yannick , Pagis Valentine , Rigolet Aude , Guillaume-Jugnot Perrine , Authier François-Jérôme , Guilain Nelly , Streichenberger Nathalie , Leonard-Louis Sarah , Boussouar Samia , Landon-Cardinal Océane , Benveniste Olivier , Allenbach Yves
Published: April 2023

Objective

Among specific autoantibodies in DM, the anti–small ubiquitin-like modifier activating enzyme (SAE) antibody is rare. We aim to describe the clinical characteristics, cancer prevalence, and muscle pathology of anti-SAE–positive DM.

Methods

Patients with a diagnosis of DM and sera positive for the anti-SAE antibody were recruited from 19 centres in this retrospective observational study. The available muscular biopsies were reviewed. We conducted a comparison with anti-SAE–negative DM and a review of the literature.

Results

Of the patients in the study (n = 49), 84% were women. Skin involvement was typical in 96% of patients, with 10% having calcinosis, 18% ulceration and 12% necrosis; 35% presented with a widespread skin rash. Muscular disease affected 84% of patients, with mild weakness [Medical Research Council (MRC) scale 4 (3, 5)], although 39% of patients had dysphagia. Muscular biopsies showed typical DM lesions. Interstitial lung disease was found in 21% of patients, mainly with organizing pneumonia pattern, and 26% of patients showed dyspnoea. Cancer-associated myositis was diagnosed in 16% of patients and was responsible for the majority of deaths, its prevalence being five times that of the general population. IVIG therapy was administered to 51% of the patients during the course of the disease. Comparison with anti-SAE–negative DM (n = 85) showed less and milder muscle weakness (P = 0.02 and P = 0.006, respectively), lower creatinine kinase levels (P < 0.0001) and less dyspnoea (P = 0.003).

Conclusion

Anti-SAE positive DM is a rare subgroup associated with typical skin features but a potentially diffuse rash, a mild myopathy. Interstitial lung disease defines an organizing pneumonia pattern. Cancer associated DM prevalence is five times that of the general population.

Trial registration

ClinicalTrials.gov, http://clinicaltrials.gov, NCT04637672.
Director Expertise and Corporate Sustainability
Authors: Iliev Peter , Roth Lukas
Published: April 2023

We show that US firms increase their sustainability performance when their directors acquire expertise through their exposure to sustainability reforms in foreign countries where they serve as directors. Our results suggest that a board that gains sustainability expertise increases a firm’s overall sustainability performance by 7.1%. The increase in sustainability comes both from improvements in environmental and social practices. Directors also consider the tradeoffs between sustainability improvements and firm characteristics, with boards having a stronger impact on sustainability in firms from clean industries and firms that face fewer operational and financial constraints.
The rise and fall of ordoliberalism
Authors: Hien Josef
Published: April 2023

Ordoliberalism has been accused of being the ideational blueprint for Germany’s fiscal stance during the Eurozone-crisis. While the literature that debates the influence of ordoliberalism on crisis politics is growing, there is a lack of studies tracing the ordoliberal influence within Germany. This study shows that ordoliberalism had very limited influence on the creation of German institutions and its economic knowledge regime. Where ordoliberalism can be found is in the bureaucracy. This influence will come to an end with the last ordoliberals retiring. The article reconstructs how the reorientation of German economics towards the global economics profession crowded out ordoliberalism. Ordoliberalism, publishing mostly in German and not being able to formalize its theory, could not keep up with modern German economics. This will also dry up the supply of ordoliberal staff for the bureaucracy. The article shows also that ordoliberalism lives on as part of the German conservative political tradition.
Elm tree defences against a specialist herbivore are moderately primed by an infestation in the previous season
Authors: Schott Johanna , Jantzen Friederike , Hilker Monika
Published: April 2023

The studies of the long-term effects of insect infestations on plant anti-herbivore defences tend to focus on feeding-induced damage. Infestations by an entire insect generation, including egg depositions as well as the feeding insects, are often neglected. Whilst there is increasing evidence that the presence of insect eggs can intensify plants’ anti-herbivore defences against hatching larvae in the short term, little is known about how insect infestations, including insect egg depositions, affect plant defences in the long term. We addressed this knowledge gap by investigating long-term effects of insect infestation on elm’s (Ulmus minor Mill. cv. ‘Dahlem’) defences against subsequent infestation. In greenhouse experiments, elms were exposed to elm leaf beetle (ELB, Xanthogaleruca luteola) infestation (adults, eggs and larvae). Thereafter, the trees cast their leaves under simulated winter conditions and were re-infested with ELB after the regrowth of their leaves under simulated summer conditions. Elm leaf beetles performed moderately worse on previously infested elms with respect to several developmental parameters. The concentrations of the phenylpropanoids kaempferol and quercetin, which are involved in egg-mediated, short-term effects on elm defences, were slightly higher in the ELB-challenged leaves of previously infested trees than in the challenged leaves of naïve trees. The expression of several genes involved in the phenylpropanoid pathway, jasmonic acid signalling, and DNA and histone modifications appeared to be affected by ELB infestation; however, prior infestation did not alter the expression intensities of these genes. The concentrations of several phytohormones were similarly affected in the currently challenged leaves of previously infested trees and naïve trees. Our study shows that prior infestation of elms by a specialised insect leads to moderately improved defences against subsequent infestation in the following growing season. Prior infestation adds a long-term effect to the short-term enhancer effect that plants show in response to egg depositions when defending against hatching larvae.
Minimum Wages around Birth and Child Health
Authors: Majid Muhammad Farhan , Behrman Jere R
Published: April 2023

This paper studies the effects of minimum wages in Indonesia around the time of birth on child height-for-age Z scores (HAZ) up to five years of age. Using variations in annual fluctuations in real minimum wages in different Indonesian provinces, it finds that children exposed to increases in minimum wages in their birth years have higher HAZ in the first five years of their lives. The estimated impacts are based on difference-in-differences models with biological-mother fixed effects and year-of-birth fixed effects and are robust to inclusion of multiple time-varying factors. The impacts are prominent particularly among male children.
Development of a PNA-LNA-LAMP Assay to Detect an SNP Associated with QoI Resistance in Erysiphe necator
Authors: Sharma Nancy , Neill Tara , Yang Hui-Ching , Oliver Charlotte L. , Mahaffee Walter F. , Naegele Rachel , Moyer Michelle M. , Miles Timothy D.
Published: April 2023

The repetitive use of quinone outside inhibitor fungicides (QoIs, strobilurins; Fungicide Resistance Action Committee [FRAC] 11) to manage grape powdery mildew has led to development of resistance in Erysiphe necator. While several point mutations in the mitochondrial cytochrome b gene are associated with resistance to QoI fungicides, the substitution of glycine to alanine at codon 143 (G143A) has been the only mutation observed in QoI-resistant field populations. Allele-specific detection methods such as digital droplet PCR and TaqMan probe-based assays can be used to detect the G143A mutation. In this study, a peptide nucleic acid-locked nucleic acid mediated loop-mediated isothermal amplification (PNA-LNA-LAMP) assay consisting of an A-143 reaction and a G-143 reaction, was designed for rapidly detecting QoI resistance in E. necator. The A-143 reaction amplifies the mutant A-143 allele faster than the wild-type G-143 allele, while the G-143 reaction amplifies the G-143 allele faster than the A-143 allele. Identification of resistant or sensitive E. necator samples was determined by which reaction had the shorter time to amplification. Sixteen single-spore QoI-resistant and -sensitive E. necator isolates were tested using both assays. Assay specificity in distinguishing the single nucleotide polymorphism (SNP) approached 100% when tested using purified DNA of QoI-sensitive and -resistant E. necator isolates. This diagnostic tool was sensitive to one-conidium equivalent of extracted DNA with an R2 value of 0.82 and 0.87 for the G-143 and A-143 reactions, respectively. This diagnostic approach was also evaluated against a TaqMan probe-based assay using 92 E. necator samples collected from vineyards. The PNA-LNA-LAMP assay detected QoI resistance in ≤30 min and showed 100% agreement with the TaqMan probe-based assay (≤1.5 h) for the QoI-sensitive and -resistant isolates. There was 73.3% agreement with the TaqMan probe-based assay when samples had mixed populations with both G-143 and A-143 alleles present. Validation of the PNA-LNA-LAMP assay was conducted in three different laboratories with different equipment. The results showed 94.4% accuracy in one laboratory and 100% accuracy in two other laboratories. The PNA-LNA-LAMP diagnostic tool was faster and required less expensive equipment relative to the previously developed TaqMan probe-based assay, making it accessible to a broader range of diagnostic laboratories for detection of QoI resistance in E. necator. This research demonstrates the utility of the PNA-LANA-LAMP for discriminating SNPs from field samples and its utility for point-of-care monitoring of plant pathogen genotypes.
Cerebrovascular Complications of COVID-19 on Venovenous Extracorporeal Membrane Oxygenation*
Authors: Zaaqoq Akram M. , Griffee Matthew J. , Kelly Thu-Lan , Fanning Jonathon P. , Heinsar Silver , Suen Jacky Y. , Mariani Silvia , Li Bassi Gianluigi , Jacobs Jeffrey P. , White Nicole , Fraser John F. , Lorusso Roberto , Peek Giles J. , Cho Sung-Min ,   COVID-19 Critical Care Consortium (COVID Critical)
Published: April 2023

OBJECTIVES:

Evidence of cerebrovascular complications in COVID-19 requiring venovenous extracorporeal membrane oxygenation (ECMO) is limited. Our study aims to characterize the prevalence and risk factors of stroke secondary to COVID-19 in patients on venovenous ECMO.

DESIGN:

We analyzed prospectively collected observational data, using univariable and multivariable survival modeling to identify risk factors for stroke. Cox proportional hazards and Fine-Gray models were used, with death and discharge treated as competing risks.

SETTING:

Three hundred eighty institutions in 53 countries in the COVID-19 Critical Care Consortium (COVID Critical) registry.

PATIENTS:

Adult COVID-19 patients who were supported by venovenous ECMO.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Five hundred ninety-five patients (median age [interquartile range], 51 yr [42–59 yr]; male: 70.8%) had venovenous ECMO support. Forty-three patients (7.2%) suffered strokes, 83.7% of which were hemorrhagic. In multivariable survival analysis, obesity (adjusted hazard ratio [aHR], 2.19; 95% CI, 1.05–4.59) and use of vasopressors before ECMO (aHR, 2.37; 95% CI, 1.08–5.22) were associated with an increased risk of stroke. Forty-eight-hour post-ECMO Paco
2–pre-ECMO Paco
2/pre-ECMO Paco
2 (relative ΔPaco
2) of negative 26% and 48-hour post-ECMO Pao
2–pre-ECMO Pao
2/pre-ECMO Pao
2 (relative ΔPao
2) of positive 24% at 48 hours of ECMO initiation were observed in stroke patients in comparison to relative ΔPaco
2 of negative 17% and relative ΔPao
2 of positive 7% in the nonstroke group. Patients with acute stroke had a 79% in-hospital mortality compared with 45% mortality for stroke-free patients.

CONCLUSIONS:

Our study highlights the association of obesity and pre-ECMO vasopressor use with the development of stroke in COVID-19 patients on venovenous ECMO. Also, the importance of relative decrease in Paco
2 and moderate hyperoxia within 48 hours after ECMO initiation were additional risk factors.
Efficacy and safety of LY01005 versus goserelin implant in Chinese patients with prostate cancer: A multicenter, randomized, open-label, phase III, non-inferiority trial
Authors: Gu Chengyuan , Wang Zengjun , Lin Tianxin , Liu Zhiyu , Han Weiqing , Zhang Xuhui , Liang Chao , Liu Hao , Yu Yang , Xu Zhenzhou , Liu Shuang , Wang Jingen , Jia Linghua , Yao Xin , Liao Wenfeng , Fu Cheng , Tan Zhaohui , He Guohua , Zhu Guoxi , Fan Rui , Yang Wenzeng , Chen Xin , Liu Zhizhong , Zhong Liqiang , Shi Benkang , Ding Degang , Chen Shubo , Wei Junli , Yao Xudong , Chen Ming , Lu Zhanpeng , Xie Qun , Hu Zhiquan , Wang Yinhuai , Guo Hongqian , Fan Tiwu , Liang Zhaozhao , Chen Peng , Wang Wei , Xu Tao , Li Chunsheng , Xing Jinchun , Liao Hong , He Dalin , Wu Zhibin , Yu Jiandi , Feng Zhongwen , Yang Mengxiang , Dou Qifeng , Zeng Quan , Li Yuanwei , Gou Xin , Zhou Guangchen , Wang Xiaofeng , Zhu Rujian , Zhang Zhonghua , Zhang Bo , Tan Wanlong , Qu Xueling , Sun Hongliang , Gan Tianyi , Ye Dingwei
Published: April 2023

Background:

LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.

Methods:

We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels.

Results:

On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9%, 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3%, 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0%vs. 1.4% [2/145]).

Conclusion:

LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile.

Trial registration:

ClinicalTrials.gov, NCT04563936.
Treatment Outcomes of Adjunct and Stand-alone Photodynamic Therapy in Patients With Extramammary Paget Disease: A Literature Review
Authors: Sachdeva Muskaan , Tai Felicia , Bargman Howard
Published: April 2023

BACKGROUND

Extramammary Paget disease (EMPD) is a rare malignant neoplasm arising from apocrine gland–bearing skin. The surgical management of EMPD is often coupled with noninvasive techniques including cryotherapy, ablative lasers, topical chemotherapies, and photodynamic therapy (PDT). The specificity and preservation of tissue that PDT with photosensitizers 5-aminolevulinic acid or 5-methyl aminolevulinate allows makes it a potential treatment of EMPD.

METHODS

The authors present a review of 13 studies, from 2002 to 2019, examining the reported efficacy of PDT alone and adjunctive PDT in EMPD treatment.

RESULTS

In the 52 patients with 56 lesions who received stand-alone PDT, 20 lesions (35.7%, n = 20/56) experienced complete resolution, 31 lesions (55.4%, n = 31/56) experienced partial resolution, 5 lesions (8.9%, n = 5/56) failed to demonstrate response to treatment, and 23 lesions (41.1%, n = 23/56) had recurrence. In the 56 patients with 66 lesions that received adjunctive PDT paired with surgery (n = 55/66), imiquimod (n = 4/66), holmium laser and surgery (n = 1/66), Mohs surgery (n = 2/66), and combined surgery, imiquimod, and 5-fluorouracil (n = 1/66), 34 lesions (51.5%) experienced complete resolution, 27 lesions (40.9%) experienced partial resolution, 5 lesions (7.6%) failed to demonstrate any response to treatment, and 16 lesions (24.2%) had EMPD recurrence.

CONCLUSION

Further studies with larger sample size are needed to consolidate these findings and inform clinical decisions.
Multidisciplinary team approach for treating recurrent gastrointestinal bleeding caused by a Dieulafoy lesion
Authors: Lezama Tamara , Phelan Liam , Parmar Jitesh , Karandikar Sharad
Published: April 2023

A Dieulafoy lesion is a histologically normal arteriole whose lumen diameter persists along the entire wall of its end organ. They are reported to account for 1% to 2% of all gastrointestinal bleeds. The etiology is largely unknown, with some reports of lesions in children suggesting a congenital origin (Ann R Coll Surg Engl 2010;92(7):548–554). Mortality rates are approximately 10% compared with the previous rate of 80%, and this is attributed to the vast advancement in endoscopic techniques. This case highlights the need for multidisciplinary team approach to the assessment and management of these patients and investigation with the breadth of modalities available. The potential for open operative intervention by emergency surgical teams needs to be identified early in cases where minimal access measures are unable to gain definitive control.
Reverse Expansion for Breast Reconstruction after Skin-sparing and Nipple-sparing Mastectomy: Our First 100 Cases
Authors: Fabiocchi Luca , Lucattelli Elena , Cattin Federico , Cipriani Federico , Dellachiesa Laura , Fogacci Tommaso , Frisoni Gianluca , Semprini Gloria , Samorani Domenico
Published: April 2023

Background:

Patients with breast cancer have experienced advancements both in oncological treatment and in aesthetics as a result of developments in reconstructive techniques. We aimed to present our experience with the reverse expansion technique, summarizing the results of our first 100 cases of reconstruction after skin-sparing mastectomy and nipple-sparing mastectomy.

Methods:

From January 2010 to September 2018, 253 breast reconstruction procedures were performed on 100 patients. The reverse expansion technique consists of autologous fat tissue transplantation requiring the combined use of a skin expander and of multiple lipofilling sessions. At the beginning of every session the breast expander was deflated by removing a saline volume similar to that of the fat to be injected.

Results:

Overall, 56 breast reconstructions after skin-sparing mastectomy and 44 after nipple-sparing mastectomy were performed. An average of 661.5 cm3 of fat per session was harvested and an average of 305.3 cm3 per breast was injected. The average number of sessions to achieve breast reconstruction was 2.53. Only four complications after 253 procedures (1.5%) were reported: one donor site hemorrhage due to genetic lack of coagulation factors, and three surgical site infections.

Conclusions:

Considering the large number of positive factors such as a fast postoperative recovery, an easy learning curve, a lack of need of a specialized surgical team, a natural look of the breast shape, and the soft consistency of the grafted tissue, we believe this technique could be the first choice for autologous reconstruction after skin-sparing mastectomy and nipple-sparing mastectomy.
Intramuscular Posterior Thigh Volumization: An Aesthetic and Harmonious Transition to the Gluteal Region (Hv-FAT)
Authors: Manzaneda Cipriani Raúl Martín , Babaitis Ricardo , Vega Héctor Duran , Viaro Mauricio , Flores Emmanuel , Adrianzen Gerardo A.
Published: April 2023

Background:

The gluteal region remains the preferred site for fat grafting. However, the transition from the gluteal region to the thighs has not been well studied. This study aimed to describe an echographic guidance hamstring volumization procedure (Hv-FAT) as a complement to body contouring surgery.

Methods:

Hv-FAT was performed in 19 patients from four countries (Peru, Argentina, Brazil, and Mexico) from May to June 2022 by four surgeons trained in soft-tissue ultrasound and in the aforementioned technique. All the patients met the following criteria: age older than 18 years and younger than 60 years; a body mass index of 30 kg/m² or less, and a surgical risk score of 2 or less, according to the Goldman index.

Results:

A total of four men and 15 women were included in this study, whose ages ranged from 22 to 58 years (mean: 36.37 years). After fat grafting, on average, the thickness of the right biceps femoris increased by 54.07%, maintaining 95.02% of this thickness one month postoperatively, whereas the thickness of the left biceps femoris increased by 46.57%, maintaining 94.86% of this thickness in the same postoperative period. In turn, the right semitendinosus muscle thickness increased by 181.90%, maintaining 97.42% of this thickness, whereas the left semitendinosus muscle increased by 111.90%, maintaining 95.29% of this thickness 1 month postoperatively (P < 0.0001).

Conclusion:

Hv-FAT is an effective and reproducible procedure for volumizing the biceps femoris and semitendinosus muscles, maintaining significant results one month postoperatively.
Introducing e-health technology to routine cataract care: patient perspectives on web-based eye test for postoperative telemonitoring
Authors: Claessens Janneau L.J. , Maats Emma P.E. , Iacob Maria E. , Wisse Robert P.L. , Jongsma Karin R.
Published: April 2023

Purpose:

To explore cataract patients' experiences with an e-health tool for self-assessing visual function (ie, a web-based eye test), and to formulate recommendations for its successful adoption in routine cataract care.

Setting:

Clinics in the Netherlands, Germany, and Austria.

Design:

Mixed-methods study.

Methods:

22 participants were included in this study; in-depth interviews were conducted with 12. Questionnaires and in-depth semi-structured interviews were conducted alongside a multicenter randomized controlled trial evaluating the validity, safety and cost-effectiveness of remote care after cataract surgery (Cataract Online Refraction Evaluation, a Randomized Controlled Trial). Results were analyzed thematically.

Results:

Participants reported positively about performing the web-based eye test at home. 4 overarching themes were identified in the interviews. First, participants were inventive in overcoming practical barriers encountered while conducting the test. Second, participants desired a clear presentation of test results and their meaning. Third, the ability to self-monitor visual function was appreciated. Fourth, most participants preferred to keep the option to contact their eyecare professional (ECP) postoperatively, especially when experiencing symptoms. Most would be satisfied with a phone consultation or an e-consult. Participants reported positive experiences with the web-based eye test. Barriers for successful adoption were identified, including insecurity about correctly performing the test, incomplete information on how to interpret test results, and a feeling that in-hospital assessments were superior to remote assessments.

Conclusions:

It is recommended to focus on building trust in remote eyecare delivery and that access to the ECP be retained when medically indicated or deemed necessary by the patient.
Early Postoperative Prosthesis After Transtibial Amputation: Step-By-Step Approach
Authors: Faldini Cesare , Mazzotti Antonio , Geraci Giuseppe , Zielli Simone Ottavio , Bonelli Simone , Panciera Alessandro
Published: April 2023

Introduction

Transtibial amputation represents a definitive treatment of several pathological conditions. Historically, immediate postoperative prosthetic protocols have been developed to improve recovery; however, concerns still limit their widespread application.

Materials and Methods

The aim of this article is to present a step-by-step approach to a revised, inexpensive, and easy technique that allows early postoperative prosthetic use and rehabilitation.

Results

The technique appears to provide optimal patient care levels at reasonable costs and could be applied also in low-resource settings.

Conclusions

Early ambulation allows to avoid postoperative complications (such as thromboembolism, pneumonia, etc.) and facilitates definitive prosthetic substitution and conservation of gait patterns as well as better psychological results.

Clinical Relevance

This technique can provide a solution for allowing early ambulation in persons with amputations, facilitating the postoperative management of these patients.
Psychometric Properties of the Patient Activation Measure in Family Caregivers of Patients With Chronic Illnesses
Authors: Lin Chin-Yen , Chung Misook L. , Schuman Donna L. , Biddle Martha J. , Mudd-Martin Gia , Miller Jennifer L. , Hammash Muna , Schooler Mary P. , Rayens Mary Kay , Feltner Frances J. , Moser Debra K.
Published: April 2023

Background

The Patient Activation Measure (PAM) is used clinically and in research to measure an individual’s knowledge, skills, and confidence related to their health management engagement. Despite the use of “patient” in the title, the instrument can be used in nonpatient populations. A group at high risk for low activation concerning their own health is family caregivers of patients with chronic illnesses. The psychometric properties of the PAM have not been established in family caregivers.

Objectives

This study aimed to examine the psychometric properties of the PAM 10-item version (PAM-10) in a sample of family caregivers of patients with chronic illnesses. Our focus was on family caregivers’ health activation of their own healthcare needs.

Methods

We evaluated the internal consistency reliability of the PAM-10 in a sample of 277 family caregivers. Item-total correlations and interitem correlations were used to assess item homogeneity. Construct validity of the PAM-10 was examined using exploratory factor analysis and testing hypotheses on known relationships.

Results

The PAM-10 demonstrated adequate internal consistency. Item-total correlation coefficients and interitem correlation coefficients were acceptable. Construct validity of the instrument was supported. Factor analysis yielded two factors that explained 62.3% of the variance in the model. Lower levels of depressive symptoms were significantly associated with better activation, providing evidence of construct validity. Caregivers with high activation levels were significantly more likely to engage in and adhere to self-care behaviors such as regular exercise, eating a healthy diet, and engaging in stress reduction strategies.

Discussion

This study demonstrated that the PAM-10 is a reliable and valid measure for family caregivers of patients with chronic illnesses to measure caregivers’ health activation of their own healthcare needs.
Communicating Nutrition, Food, and Health Information
Authors: Rowe Sylvia , Alexander Nick
Published: April 2023

In the several years since we last proposed in-depth analysis and guidance for health and nutrition communicators, in light of the evolving information environment, much has changed—mostly for the worse, for the more problematic. The communication landscape has become more challenging, public trust in health institutions seems to have experienced further shrinkage, and some of the old rules for disseminating consensus scientific information may need updating. In this article, we analyze recent events/conditions in the ongoing metamorphosis of the communication environment in the cyber age. Included are some observations from a 2022 National Academies of Sciences, Engineering, and Medicine workshop on best practices for nutrition communication, analysis of misinformation concerns, the effect of social media on information delivery, and some updated guidance for communicators.
Are Canadian orthopaedic surgeons and American orthopaedic surgeons on par? A Canadian practice survey of orthopaedic traumatologists
Authors: Doxey Stephen , Only Arthur J. , Milshteyn Michael , Cunningham Brian P. , Cannada Lisa K.
Published: April 2023

Objectives:

The purpose of this study was to obtain information on Canadian orthopaedic trauma surgeon practices and salary demographics. It was hypothesized that most of the practicing surgeons recognize specific practice aspects (compensation, call schedule, operating room availability, and provided support staff) as key factors in employment opportunity evaluation.

Design:

Cross-sectional survey study.

Setting:

Orthopaedic Trauma Association (OTA) practice surveys.

Participants:

All active Canadian members of the OTA were eligible to participate.

Main Outcome Measurement:

A 50-question survey was sent through email to OTA members assessing physician, practice, and compensation metrics of Canadian orthopaedic traumatologists.

Results:

Fifty-two of 113 Canadian OTA members participated giving a response rate of 46%. All surgeons worked in an academic practice, either for a university (83%) or community hospital (17%). Only 2% of surgeons have changed jobs in the last 5 years, and over 73% of surgeons maintain the same place of employment during their careers. Most had an available dedicated orthopaedic trauma operating room (73%). The majority indicated having residents (71%) and fellows (63%) as support staff. Many reported completing 300–500 cases per year (42%), which decreased during COVID-19 for 50% of surgeons. The most common reported compensation was between $400,000 and $600,000 US dollars (25%) with many working 4–6 call shifts a month (48%) and 51–70 hours a week (48%).

Conclusion:

This study demonstrated the varying practice and physician economic variables currently in Canada. The identification and continued surveillance of these employment variables will allow for transparency in job market evaluation by applicants.

Level of Evidence:

Level V.
“Prevention of postoperative complications by prepectoral versus subpectoral breast reconstruction: A systematic review and meta-analysis”
Authors: Kim Yo-Han , Yang Yun-Jung , Lee Dong-Won , Song Seung-Yong , Lew Dae-Hyun , Yang Eun-Jung
Published: April 2023

Background:

Implant-based breast reconstruction has evolved over time. However, the effects of prepectoral breast reconstruction (PBR) compared with those of subpectoral breast reconstruction (SBR) have not been clearly defined. Therefore, this study aimed to compare the occurrence of surgical complications between PBR and SBR to determine the procedure that is effective and relatively safe.

Methods:

PubMed, Cochrane Library, and EMBASE databases were searched for studies published until April 2021 comparing PBR and SBR postmastectomy. Two authors independently assessed the risk of bias. General information on the studies and surgical outcomes were extracted. Among 857 studies, 34 and 29 were included in the systematic review and meta-analysis, respectively. Subgroup analysis was performed to clearly compare the results of patients who underwent postmastectomy radiation therapy (PMRT).

Results:

Pooled results showed that prevention of capsular contracture (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.41–0.79) and infection control (OR 0.73, 95% CI 0.58–0.92) were better with PBR than with SBR. Rates of hematoma, implant loss, seroma, skin-flap necrosis, and wound dehiscence were not significantly different between PBR and SBR. PBR considerably improved postoperative pain, BREAST-Q score, and upper arm function compared with SBR. Among PMRT patients, the incidence rates of capsular contracture were significantly lower in the PBR group than in the SBR group (OR 0.14, 95% CI 0.05–0.35).

Conclusions:

The results showed that PBR had fewer postoperative complications than SBR. Our meta-analysis suggests that PBR could be employed as an alternative technique for breast reconstruction in appropriate patients.
“Needle micro-cores: can they pose an occlusive threat with non-particulate injections?”
Authors: Soares Danny J. , Bowhay Alexis , von Haven Haley N. , Ugarte Angela J. , Blevins Larry W. , Birusingh Rhea J. , Kechriotis Chris , Yi Christina H.
Published: April 2023

The incidence of vascular occlusion injuries has risen substantially due to the increasing popularity of cosmetic injectables. Among these occurrences, instances of soft tissue ischemic events following the injection of non-particulate solutions, such as botulinum, represent an enigmatic etiology that has yet to be fully understood. One hypothesized mechanism of injury underlying these events relates to the accidental capture and intravascular ejection of needle micro-cores, defined as submillimeter tissue fragments trapped by the beveled lumen of a needle during conventional injections. To test this hypothesis, we conducted a cytologic evaluation of dermal remnants incidentally captured by 31G tuberculin needles following repeated injections into post-rhytidectomy skin fragments. Our findings revealed the presence of dermal tissue micro-cores ranging from 100-275 μm in diameter with an overall micro-coring incidence of 0.7%. These findings confirm the ability of ultra-fine needles, commonly employed in botulinum injections, to produce tissue micro-cores that may serve as causative agents of vascular occlusion with non-particulate solutions. Awareness of this additional mechanism of injury may be of benefit in the early recognition and management of these rare occurrences.
177Lu-DOTATATE Theranostics
Authors: Peterson Avery B. , Wang Chang , Wong Ka Kit , Frey Kirk A. , Muzik Otto , Schipper Matthew J. , Dewaraja Yuni K.
Published: April 2023

Purpose

Pretreatment predictions of absorbed doses can be especially valuable for patient selection and dosimetry-guided individualization of radiopharmaceutical therapy. Our goal was to build regression models using pretherapy 68Ga-DOTATATE PET uptake data and other baseline clinical factors/biomarkers to predict renal absorbed dose delivered by 177Lu-DOTATATE peptide receptor radionuclide therapy (177Lu-PRRT) for neuroendocrine tumors. We explore the combination of biomarkers and 68Ga PET uptake metrics, hypothesizing that they will improve predictive power over univariable regression.

Patients and Methods

Pretherapy 68Ga-DOTATATE PET/CTs were analyzed for 25 patients (50 kidneys) who also underwent quantitative 177Lu SPECT/CT imaging at approximately 4, 24, 96, and 168 hours after cycle 1 of 177Lu-PRRT. Kidneys were contoured on the CT of the PET/CT and SPECT/CT using validated deep learning–based tools. Dosimetry was performed by coupling the multi–time point SPECT/CT images with an in-house Monte Carlo code. Pretherapy renal PET SUV metrics, activity concentration per injected activity (Bq/mL/MBq), and other baseline clinical factors/biomarkers were investigated as predictors of the 177Lu SPECT/CT-derived mean absorbed dose per injected activity to the kidneys using univariable and bivariable models. Leave-one-out cross-validation (LOOCV) was used to estimate model performance using root mean squared error and absolute percent error in predicted renal absorbed dose including mean absolute percent error (MAPE) and associated standard deviation (SD).

Results

The median therapy-delivered renal dose was 0.5 Gy/GBq (range, 0.2–1.0 Gy/GBq). In LOOCV of univariable models, PET uptake (Bq/mL/MBq) performs best with MAPE of 18.0% (SD = 13.3%), and estimated glomerular filtration rate (eGFR) gives an MAPE of 28.5% (SD = 19.2%). Bivariable regression with both PET uptake and eGFR gives LOOCV MAPE of 17.3% (SD = 11.8%), indicating minimal improvement over univariable models.

Conclusions

Pretherapy 68Ga-DOTATATE PET renal uptake can be used to predict post-177Lu-PRRT SPECT-derived mean absorbed dose to the kidneys with accuracy within 18%, on average. Compared with PET uptake alone, including eGFR in the same model to account for patient-specific kinetics did not improve predictive power. Following further validation of these preliminary findings in an independent cohort, predictions using renal PET uptake can be used in the clinic for patient selection and individualization of treatment before initiating the first cycle of PRRT.
A Case of Cavernous Hemangioma on the Lateral Wall of the Inferior Nasal Meatus
Authors: Yeon Eung Rok , Sim Soo Hyun , Park Ha Young , Park Seong Kook
Published: April 2023

Hemangiomas, which originate in the sinonasal area, are not common among the various types of tumors from the head and neck region. Mechanisms for the formation of the tumor are yet to be discovered, and a few factors such as trauma, infection, oncogene, and some hormones are considered to take a role in the occurrence and growth of the tumor. Hemangiomas are classified for their histologic features as cavernous, capillary, and mixed types. There are a few reported cases of cavernous hemangiomas of the maxillary sinus, ethmoid sinus, middle and inferior nasal turbinate, and nasal septum. However, a case of cavernous hemangioma from the inferior nasal meatus, on the lateral wall to be precise, has never been reported. The authors are the first to report a case of a 69-year-old female patient who had cavernous hemangioma which was originated from the lateral wall of the inferior nasal meatus and successfully managed.
Roseomonas fluvialis sp. nov., an aerobic bacteriochlorophyll a-containing freshwater bacterium isolated from river epilithic biofilm
Authors: Hirose Setsuko , Asano Tomomi , Hamada Moriyuki , Morohoshi Sho , Kunihiro Tadao , Hanada Satoshi
Published: April 2023

A strictly aerobic bacteriochlorophyll a-containing alphaproteobacterium, designated strain S08T, was isolated from a biofilm sampled at Tama River in Japan. The non-motile and rod-shaped cells formed pink-beige pigmented colonies on agar plates containing organic compounds and showed in vivo absorption maxima at 798 and 866 nm in the near-infrared region, typical for the presence of bacteriochlorophyll a. The new bacterial isolate is Gram-negative, oxidase-negative and catalase-positive. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain S08T was closely related to species in the genus

Roseomonas

. The closest phylogenetic relative of strain S08T was

Roseomonas lacus

TH-G33T (98.2 % sequence similarity). The major cellular fatty acids were C16 : 0, C18 : 1 2-OH and summed feature 8 (C18 : 1
 ω7c/C18 : 1
 ω6c). The predominant respiratory quinone was ubiquinone-9. The major polar lipids contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine and an aminolipid. The G+C content of the genomic DNA was 70.6 mol%. The average nucleotide identity and digital DNA–DNA hybridization values between strain S08T and the related

Roseomonas

type strains were all far lower than the cut-off value for the delineation of species. The results of polyphasic comparisons showed that strain S08T was clearly distinguishable from other members of the genus

Roseomonas

. Therefore, we propose a new species in the genus

Roseomonas

, namely, Roseomonas fluvialis sp. nov. The type strain is S08T (=DSM 111902T=NBRC 112025T).
SLC26A2-mediated sulfate metabolism is essential for the tooth development
Authors: Yoshida Y. , Inubushi T. , Yokoyama M. , Nag P. , Oka A. , Murotani T. , Kani R. , Shiraishi Y. , Kurosaka H. , Takahata Y. , Nishimura R. , Papagerakis P. , Yamashiro T.
Published: April 2023

The sulfate transporter gene SLC26A2 is responsible for diastrophic dysplasia, which represents skeletal dysplasia in humans. This highlights the importance of sulfate metabolism in skeletal formation. SLC26A2-related chondrodysplasia is also known to exhibit abnormalities in craniofacial and tooth development. Although the function of SLC26A2 in mammals has been investigated using genetic mouse models, the essential role of SLC26A2 during craniofacial and tooth development has not been elucidated.

In this study, we demonstrate the pivotal roles of SLC26A2-mediated sulfate metabolism during tooth development. Analysis ofSlc26a2expression reveals that it is predominantly expressed in dental tissues, including odontoblasts and ameloblasts, during tooth development.Slc26a2knockout mice (Slc26a2-KO-Δexon2) exhibit a retrognathic upper jaw, small upper incisors, and hypoplasia of upper molars. Additionally, upper incisors and molars inSlc26a2-KO-Δexon2mice display flattened odontoblasts and nuclei that lack intracellular polarity. In contrast, tooth phenotype is not remarkable in lower incisors and molars.

Furthermore, the expression of odontoblast differentiation markers,DsppandDmp1, is significantly decreased in the upper molars ofSlc26a2-deficient mice.Ex vivoorgan culture of tooth germs by implantation ofSlc26a2-deficient tooth germs under the kidney capsule reveals hypoplasia of the dentin matrix as well as tooth root shortening.In vitrostudies using human dental pulp stem cells (hDPSCs) show that the expression levels ofDsppandDmp1inshSlc26a2knockdown cells are significantly decreased compared to control cells.

Collectively, our data demonstrate that SLC26A2-mediated sulfate metabolism is essential for tooth development. This study may provide insight into the mechanisms underlying tooth abnormalities in patients with recessively inherited chondrodysplasias caused by mutations in the SLC26A2 gene.
Short time diffusive fluxes over membrane receptors yields the direction of a signaling source
Authors: Lindsay Alan E. , Bernoff Andrew. J. , Hernández Adrián Navarro
Published: April 2023

An essential ability of many cell types is to detect stimuli in the form of shallow chemical gradients. Such cues may indicate the direction that new growth should occur, or the location of a mate. Amplification of these faint signals is due to intra cellular mechanisms while the cue itself is generated by the noisy arrival of signaling molecules to surface bound membrane receptors. We employ a new hybrid numerical-asymptotic technique coupling matched asymptotic analysis and numerical inverse Laplace transform to rapidly and accurately solve the parabolic exterior problem describing the dynamic diffusive fluxes to receptors. We observe that equilibration occurs on long timescales, potentially limiting the usefulness of steady state quantities for localization at practical biological timescales. We demonstrate that directional information is encoded primarily in early arrivals to the receptors, while equilibrium quantities inform on source distance. We develop a new homogenization result showing that complex receptor configurations can be replaced by a uniform effective condition. In the extreme scenario where the cell adopts the angular direction of the first impact, we show this estimate to be surprisingly accurate.
Functioning human lung organoids model pulmonary tissue response from carbon nanomaterial exposures
Authors: Issa Rahaf , Lozano Neus , Kostarelos Kostas , Vranic Sandra
Published: April 2023

Human lung organoids (HLOs) are increasingly used to model development and infectious diseases, however their ability to recapitulate functional pulmonary tissue response to nanomaterial (NM) exposures has yet to be demonstrated. Here, we established a lung organoid exposure model that utilises microinjection to present NMs into the lumen of organoids. Our model assures efficient, reproducible and controllable exposure of the apical pulmonary epithelium, emulating real-life human exposure scenario. By comparing the impact of two well studied carbon-based NMs, graphene oxide sheets (GO) and multi-walled carbon nanotubes (MWCNT), we validated lung organoids as tools for predicting pulmonary NM-driven responses. In agreement with establishedin vivodata, we demonstrate that MWCNT, but not GO, elicit adverse effects on lung organoids, leading to a pro-fibrotic phenotype. Our findings reveal the capacity and suitability of HLOs for hazard assessment of NMs, aligned with the much sought-out 3Rs (animal research replacement, reduction, refinement) framework.
Deletion of arrestin-3 does not improve compulsive drug-seeking behavior in a longitudinal paradigm of oral morphine self-administration
Authors: Gooding Sarah Warren , Felth Lindsey , Foxall Randi , Rosa Zachary , Ireton Kyle , Sall Izabella , Gipoor Joshua , Gaur Anirudh , King Madeline , Dirks Noah , Whistler Cheryl A. , Whistler Jennifer L.
Published: April 2023

Opioid drugs are potent analgesics that mimic the endogenous opioid peptides, endorphins and enkephalins, by activating the µ-opioid receptor. Opioid use is limited by side effects, including significant risk of opioid use disorder. Improvement of the effect/side effect profile of opioid medications is a key pursuit of opioid research, yet there is no consensus on how to achieve this goal. One hypothesis is that the degree of arrestin-3 recruitment to the µ-opioid receptor impacts therapeutic utility. However, it is not clear whether increased or decreased interaction of the µ-opioid receptor with arrestin-3 would reduce compulsive drug-seeking. To examine this question, we utilized three genotypes of mice with varying abilities to recruit arrestin-3 to the µ-opioid receptor in response to morphine in a novel longitudinal operant self-administration model. We demonstrate that arrestin-3 knockout and wild type mice have highly variable drug-seeking behavior with few genotype differences. In contrast, in mice where the µ-opioid receptor strongly recruits arrestin-3, drug-seeking behavior is much less varied. We created a quantitative method to define compulsivity in drug-seeking and found that mice lacking arrestin-3 were more likely to meet the criteria for compulsivity whereas mice with enhanced arrestin-3 recruitment did not develop a compulsive phenotype. Our data suggest that opioids that engage both G protein and arrestin-3, recapitulating the endogenous signaling pattern, will reduce abuse liability.