bluuebunny/crossref_metadata_2025 huggingface dataset:
A Portable Nucleic Acid Sensor Based on PCR for Simple, Rapid, and Sensitive Testing of Botrytis cinerea in Ginseng
Authors: Ren Bairu , Wang Yi , Chen Huijie , Diao Lei , Wang Jiaxin , Zhang Shuoyuan , Zhang Yongzhe , Zhang Meiping , Yin Rui , Wang Yanfang
Published: May 2023

Botrytis cinerea is a ubiquitous pathogen that can infect at least 200 dicotyledonous plant species including many agriculturally and economically important crops. In Ginseng, the fungus may cause ginseng gray mold disease, causing great economic losses in the ginseng industry. Therefore, the early detection of B. cinerea in the process of ginseng production is necessary for the disease prevention and control of the pathogen’s spread. In this study, a polymerase chain reaction-nucleic acid sensor (PCR-NAS) rapid detection technique was established, and it can be used for field detection of B. cinerea through antipollution design and portable integration. The present study showed that the sensitivity of PCR-NAS technology is 10 times higher than that of traditional PCR-electrophoresis, and there is no need for expensive detection equipment or professional technicians. The detection results of nucleic acid sensors can be read by the naked eye in under 3 min. Meanwhile, the technique has high specificity for the detection of B. cinerea. The testing of 50 field samples showed that the detection results of PCR-NAS were consistent with those of the real-time quantitative PCR (qPCR) method. The PCR-NAS technique established in this study can be used as a novel nucleic acid field detection technique, and it has a potential application in the field detection of B. cinerea to achieve early warning of the pathogen infection.
Does Skeletal Maturity Predict the Pattern of Tibial Tubercle Avulsion Fracture?
Authors: Yang Daniel , Kell David , Syed Akbar , Huang Kevin , Sarkar Sulagna , Goodbody Christine M. , Williams Brendan A.
Published: May 2023

Background:

Proximal tibial physeal development and closure is thought to relate to tibial tubercle avulsion fracture (TTAF) patterns. Prior work has yet to formally evaluate the relationship between skeletal maturity and fracture pattern.  Using 2 knee radiograph-derived skeletal maturity assessments [growth remaining percentage (GRP) and epiphyseal union stage], we examined their association with TTAF injury patterns using the Ogden and Pandya fracture classifications. We hypothesized that different TTAF injuries would occur during unique periods of skeletal development.

Methods:

Pediatric patients sustaining TTAFs treated at a single institution (2008–2022) were identified using diagnostic and procedural coding. Demographics and injury characteristics were collected. Radiographs were reviewed to assign epiphyseal union stage, Ogden and Pandya classifications and for measurements to calculate GRP. Univariate analyses examined the relationship between injury subgroups, patient demographics, and skeletal maturity assessments.

Results:

Inclusion criteria identified 173 patients with a mean age of 14.76 (SD: 1.78) and 2.95% (SD: 4.46%) of growth remaining. The majority of injuries were classified Ogden III/Pandya C. Most (54.9%) were the result of the axial loading mechanism. Ogden groups showed no significant differences across all patient characteristics studied including age and GRP. With the exception of Pandya A fractures, we did not identify a direct relationship between GRP, age, and Pandya groups. Epiphyseal union stage differed for Pandya A and D groups.

Conclusions:

A predictable pattern in TTAF characteristics across skeletal (GRP), epiphyseal union, or chronologic age was not identified in this study. Distal apophyseal avulsions (Ogden I/II and Pandya A/D) occurred across a broad chronologic and skeletal age range. No differences were identified in epiphyseal or posterior extension (Ogden III/IV and Pandya B/C) injuries. Although differences in age and GRP were identified among Pandya As, this is thought to be due to the degree of skeletal immaturity that is a prerequisite for differentiation from Pandya Ds.

Level of Evidence:

Level III—retrospective cohort study.
Developmentally-Trained Primary Care Clinicians: A Pipeline to Improved Access?
Authors: Roberts Mona Doss , Christiansen Audrey , O'Hagan Belinda , Jansen Emily , Augustyn Marilyn
Published: May 2023

Objective:

The purpose of this study is to decrease wait time and improve access to developmental-behavioral pediatric (DBP) evaluation in children 4 years of age and younger as part of a quality improvement (QI) initiative in an urban safety-net hospital.

Methods:

A primary care pediatrician received DBP minifellowship training 6 hours per week for 1 year to become a developmentally-trained primary care clinician (DT-PCC). DT-PCCs then conducted developmental evaluations that consisted of using a Childhood Autism Rating Scale and Brief Observation of Symptoms of Autism to evaluate children 4 years and younger referred within the practice. Baseline standard practice involved a 3-visit model: DBP advanced practice clinician (DBP-APC) intake visit, neurodevelopmental evaluation by a developmental-behavioral pediatrician (DBP), and feedback by a developmental-behavioral pediatrician. Two QI cycles were completed to streamline the referral and evaluation process.

Results:

Seventy patients with a mean age of 29.5 months were seen. The average days to initial developmental assessment decreased from 135.3 days to 67.9 days with a streamlined referral to the DT-PCC. Of the 43 patients who required further evaluation by a DBP, the average days to developmental assessment reduced from 290.1 to 120.4 days.

Conclusion:

Developmentally-trained primary care clinicians allowed for earlier access to developmental evaluations. Further research should explore how DT-PCCs can improve access to care and treatment for children with developmental delays.
The Peripheral Nerve Surgeon’s Role in the Management of Neuropathic Pain
Authors: Caragher Seamus P. , Khouri Kimberly S. , Raasveld Floris V. , Winograd Jonathan M. , Valerio Ian L. , Gfrerer Lisa , Eberlin Kyle R.
Published: May 2023

Neuropathic pain (NP) underlies significant morbidity and disability worldwide. Although pharmacologic and functional therapies attempt to address this issue, they remain incompletely effective for many patients. Peripheral nerve surgeons have a range of techniques for intervening on NP. The aim of this review is to enable practitioners to identify patients with NP who might benefit from surgical intervention. The workup for NP includes patient history and specific physical examination maneuvers, as well as imaging and diagnostic nerve blocks. Once diagnosed, there is a range of options surgeons can utilize based on specific causes of NP. These techniques include nerve decompression, nerve reconstruction, nerve ablative techniques, and implantable nerve-modulating devices. In addition, there is an emerging role for preoperative involvement of peripheral nerve surgeons for cases known to carry a high risk of inducing postoperative NP. Lastly, we describe the ongoing work that will enable surgeons to expand their armamentarium to better serve patients with NP.
Interventions of Postpartum Hemorrhage
Authors: Post Sara E. , Rood Kara M. , Kiefer Miranda K.
Published: May 2023

Postpartum hemorrhage is a common and potentially life-threatening obstetric complication, with successful management relying heavily on early identification of hemorrhage and prompt intervention. This article will review the management of postpartum hemorrhage, including initial steps, exam-specific interventions, medical therapy, minimally invasive, and surgical interventions.
Peroxisome proliferator-activated receptor γ activation ameliorates liver fibrosis—differential action of transcription factor EB and autophagy on hepatocytes and stellate cells
Authors: Yum Yunjin J. , Yoo Jin , Bang Kyuhoon , Jun Ji Eun , Jeong In-Kyung , Ahn Kyu Jeung , Chung Ho Yeon , Hwang You-Cheol
Published: May 2023

Background:

Peroxisome proliferator-activated receptor γ (PPARγ) activation suppresses HSC activation and liver fibrosis. Moreover, autophagy is implicated in hepatic lipid metabolism. Here, we determined whether PPARγ activation ameliorates HSC activation by downregulating transcription factor EB (TFEB)-mediated autophagy.

Methods and Results:

Atg7 or Tfeb knockdown in human HSC line LX-2 cells downregulated the expression of fibrogenic markers including α smooth muscle actin, glial fibrillary acidic protein, and collagen type 1. Conversely, Atg7 or Tfeb overexpression upregulated fibrogenic marker expression. Rosiglitazone (RGZ)-mediated PPARγ activation and/or overexpression in LX-2 cells and primary HSCs decreased autophagy, as indicated by LC3B conversion, total and nuclear-TFEB contents, mRFP-LC3 and BODIPY 493/503 colocalization, and GFP-LC3 and LysoTracker colocalization. RGZ treatment decreased liver fat content, liver enzyme levels, and fibrogenic marker expression in high-fat high-cholesterol diet-fed mice. Electron microscopy showed that RGZ treatment restored the high-fat high-cholesterol diet-mediated lipid droplet decrease and autophagic vesicle induction in primary HSCs and liver tissues. However, TFEB overexpression in LX-2 cells offset the aforementioned effects of RGZ on autophagic flux, lipid droplets, and fibrogenic marker expression.

Conclusions:

Activation of PPARγ with RGZ ameliorated liver fibrosis and downregulation of TFEB and autophagy in HSCs may be important for the antifibrotic effects of PPARγ activation.
Magnetic resonance elastography-based prediction model for hepatic decompensation in NAFLD: A multicenter cohort study
Authors: Kim Beom Kyung , Bergstrom Jaclyn , Loomba Rohan , Tamaki Nobuharu , Izumi Namiki , Nakajima Atsushi , Idilman Ramazan , Gumussoy Mesut , Oz Digdem K. , Erden Ayse , Truong Emily , Yang Ju Dong , Noureddin Mazen , Allen Alina M. , Loomba Rohit , Ajmera Veeral
Published: May 2023

Background and Aims:

Magnetic resonance elastography (MRE) is an accurate, continuous biomarker of liver fibrosis; however, the optimal combination with clinical factors to predict the risk of incident hepatic decompensation is unknown. Therefore, we aimed to develop and validate an MRE-based prediction model for hepatic decompensation for patients with NAFLD.

Approach and Results:

This international multicenter cohort study included participants with NAFLD undergoing MRE from 6 hospitals. A total of 1254 participants were randomly assigned as training (n = 627) and validation (n = 627) cohorts. The primary end point was hepatic decompensation, defined as the first occurrence of variceal hemorrhage, ascites, or HE. Covariates associated with hepatic decompensation on Cox-regression were combined with MRE to construct a risk prediction model in the training cohort and then tested in the validation cohort. The median (IQR) age and MRE values were 61 (18) years and 3.5 (2.5) kPa in the training cohort and 60 (20) years and 3.4 (2.5) kPa in the validation cohort, respectively. The MRE-based multivariable model that included age, MRE, albumin, aspartate aminotransferase, and platelets had excellent discrimination for the 3- and 5-year risk of hepatic decompensation (c-statistic 0.912 and 0.891, respectively) in the training cohort. The diagnostic accuracy remained consistent in the validation cohort with a c-statistic of 0.871 and 0.876 for hepatic decompensation at 3 and 5 years, respectively, and was superior to Fibrosis-4 in both cohorts (p < 0.05).

Conclusions:

An MRE-based prediction model allows for accurate prediction of hepatic decompensation and assists in the risk stratification of patients with NAFLD.
LONG-TERM MICROVASCULAR REMODELING AND CYSTIC CHANGES AFTER RETINAL DETACHMENT TREATED WITH SILICON OIL TAMPONADE
Authors: Pfister Nathalie , Dormegny Léa , Ballonzoli Laurent , Sauer Arnaud , Speeg-Schatz Claude , Bourcier Tristan , Gaucher David
Published: May 2023

Purpose:

To determine the long-term microvascular alterations associated with macular cystic changes after retinal detachment surgery with silicone oil tamponade.

Methods:

The results of two optical coherence tomography angiographies performed at 11 months and 38 months after silicone removal were retrospectively analyzed for 30 eyes. The data were compared between both measurements and between eyes with macular cysts (MC+) and without macular cysts (MC−). Two patterns of cysts were identified and compared: cysts exclusively involving the inner nuclear layer (INLc) and cysts present in all retinal layers.

Results:

At both end points, 20 eyes (67%) presented with macular cysts, 12 of them (40%) had INLc. At the first end point, vascular density of superficial capillary plexus was higher and superficial foveal avascular zone was smaller in MC+ eyes than in MC− eyes (P = 0.04 and P = 0.017, respectively). At the second end point, vascular density of superficial capillary plexus significantly decreased in MC+ eyes as compared with the first end point (P < 0.001) and superficial foveal avascular zone enlarged (P < 0.001). Macular central thickness decreased between follow-ups only in eyes with INLc (P < 0.01). The final best-corrected visual acuity was better in eyes with INLc than in eyes with cysts present in all retinal layers (P < 0.01). There was no difference between the final best-corrected visual acuity in eyes with INLc and MC− eyes.

Conclusion:

Macular cysts are a common finding long after silicon removal. Vascular remodeling seems characterized by an initial increase of the vascular density of superficial capillary plexus in eyes with cysts, which is followed by its progressive decrease. The INLc is the most common pattern of cysts. They are associated with a progressive decrease of the central macular thickness without visual impairment.
Transcription and secretion of interleukin-1β and HMGB1 in keratinocytes exposed to stimulations mimicking common inflammatory damage
Authors: Wei Xuecui , Chen Yujie , Long Fangyuan , Yu Shanshan , Xu Song , Chen Xu
Published: May 2023

Objective:

Interleukin-1β (IL-1β) and high-mobility group box 1 (HMGB1) are widely known damage-associated molecular patterns (DAMPs). However, their expression and secretion in different skin diseases, especially in inflammatory skin disorders, remain to be further elucidated. This study was performed to explore and compare the transcriptional and secretory levels of IL-1β and HMGB1 in keratinocytes under three types of stimulation: ultraviolet B (UVB) irradiation; co-stimulation by tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) (simulation of T helper 1 cell inflammatory challenge); and psoriasis-like stimulation by M5, a mixture of five proinflammatory cytokines.

Methods:

We used quantitative reverse-transcription polymerase chain reaction to determine the transcription levels of IL-1β and HMGB1. Western blotting and enzyme-linked immunosorbent assay were used to detect the secretion levels of IL-1β and HMGB1. The results were statistically analyzed by t test.

Results:

A rapid transcriptional and secretory response of IL-1β from keratinocytes occurred in all three types of stimulation mimicking common inflammatory environments (P < 0.05). Transcription of HMGB1 was inhibited in all three types of stimulation (P < 0.05), but secretion was increased after exposure to UVB irradiation and co-stimulation by TNF-α and IFN-γ (P < 0.05). We observed no change in the secretion level of HMGB1 after treatment with M5 (P = 0.196 > 0.05).

Conclusion:

IL-1β is a critical cytokine for the immunomodulatory functions of keratinocytes in inflammatory responses. In this study, keratinocytes restrained transcription of HMGB1 when the secretion of HMGB1 was induced in certain stimulations (e.g., by UVB exposure or stimulation by TNF-α and IFN-γ).
Prognostic role of minute ventilation/carbon dioxide production slope for perioperative morbidity and long-term survival in resectable patients with non-small-cell lung cancer: A prospective study using propensity score overlap weighting
Authors: Dun Yaoshan , Wu Shaoping , Cui Ni , Thomas Randal J. , Squires Ray W. , Olson Thomas P. , Sylvester Karl P. , Fu Siqian , Zhang Chunfang , Gao Yang , Du Yang , Xu Ning , Liu Suixin
Published: May 2023

Background:

The role of minute ventilation/carbon dioxide production (

/

CO2) slope, a ventilation efficiency marker, in predicting short- and long-term health outcomes for patients with non-small-cell lung cancer (NSCLC) undergoing lung resection has not been well investigated.

Material and Methods:

This prospective cohort study consecutively enrolled NSCLC patients who underwent a presurgical cardiopulmonary exercise test from November 2014 to December 2019. The association of

/

CO2 slope with relapse-free survival (RFS), overall survival (OS), and perioperative mortality was evaluated using the Cox proportional hazards and logistic models. Covariates were adjusted using propensity score overlap weighting. The optimal cut-off point of the

E/

CO2 slope was estimated using the Receiver Operating Characteristics curve. Internal validation was completed through bootstrap resampling.

Results:

A cohort of 895 patients (median age [interquartile range], 59 [13] years; 62.5% male) was followed for a median of 40 (range, 1-85) months. Throughout the study there were 247 relapses or deaths and 156 perioperative complications. The incidence rates per 1000 person-years for relapses or deaths were 108.8 and 79.6 among patients with high and low

E/

CO2 slope, respectively (weighted incidence rate difference per 1000 person-years, 29.21 [95% CI, 7.30 to 51.12]). A

E/

CO2 slope of ≥31 was associated with shorter RFS (hazard ratio for relapse or death, 1.38 [95% CI, 1.02 to 1.88], P=0.04) and poorer OS (hazard ratio for death, 1.69 [1.15 to 2.48], P=0.02) compared to a lower

/

CO2 slope. A high

E/

CO2 slope increased the risk of perioperative morbidity compared with a low

E/

CO2 slope (odds ratio, 2.32 [1.54 to 3.49], P<0.001).

Conclusions:

In patients with operable NSCLC, a high

E/

CO2 slope was significantly associated with elevated risks of poorer RFS and OS, and perioperative morbidity.
The Effect of Immediate Microsurgical Resection of Vestibular Schwannoma on Hearing Preservation
Authors: Moshtaghi Omid , Dixon Peter R. , Claussen Alexander D. , La Monte Olivia , Tadano Ashley , Gillette Dominique , Tawfik Kareem , Schwartz Marc S. , Friedman Rick A.
Published: May 2023

Objective

Evaluate for differences in postoperative hearing in patients who undergo immediate versus delayed hearing preservation microsurgical resection of vestibular schwannomas (VS).

Study Design

Retrospective single-institution cohort study spanning November 2017 to November 2021.

Setting

Single-institution tertiary care hospital.

Patients

Sporadic VS in patients with American Academy of Otolaryngology–Head and Neck Surgery hearing classification A or B, with tumor size less than or equal to 2 cm and undergoing hearing preservation microsurgical resection.

Interventions

Delayed surgical intervention defined by time from first diagnostic MRI to date of surgery being greater than 3 months

Main Outcome Measures

Preoperative and postoperative audiometric performance.

Results

In total, 193 patients met inclusion criteria. Within the cohort, 70 (36%) proceeded with surgery within 3 months of diagnostic MRI with a mean observation time of 62 days, whereas 123 (63%) underwent surgery after 3 months with a mean observation time of 301 days. There was no difference in preoperative hearing between the two groups with word recognition score 99% in early intervention group and 100% in delayed intervention group (p = 0.6). However, 64% of those who proceeded with immediate surgery had successful hearing preservation, compared to a 42% of those who had delayed intervention (p < 0.01). In a multivariable logistic regression accounting for preoperative word recognition score, tumor size, and age at diagnosis, the odds of hearing preservation were lower in those who delayed surgery compared to immediate surgery (odds ratio, 0.31; 95% confidence interval, 0.15–0.61).

Conclusions

Patients who underwent microsurgical resection within 3 months of diagnosis demonstrated a hearing preservation advantage compared to those who did not. Findings of this study highlight the counseling challenges associated with the timing of surgical treatment of VS in patients presenting with good preoperative hearing and small tumors.
Direct antiglobulin test-negative autoimmune hemolytic anemia associated with erythropoiesis stimulating agent resistance in a CKD patient with IgG4-related disease: A case report
Authors: Kitamura Koichi , Hayashi Koichi , Iwanami Keiichi , Kamesaki Toyomi , Suzuki Toshihiko
Published: May 2023

Rationale:

Direct antiglobulin test (DAT)-negative autoimmune hemolytic anemia (AIHA) is an important differential diagnosis for erythropoiesis-stimulating agents-resistant renal anemia with hemolysis.

Patient concerns:

An 82-year-old female with a past medical history of diabetes, end-stage kidney disease (estimated glomerular filtration rate: 6.9 mL/min/1.73 m2), post-transcatheter aortic valve implantation, and IgG4-related retroperitoneal fibrosis on prednisolone therapy was referred to our department for assessment of severe anemia. The patient underwent immunohematological testing for serological evaluation.

Diagnoses:

DAT-negative AIHA and IgG4-RD was established based on DAT-negative and immunohematological tests.

Interventions:

Glucocorticoid was administered to the patient.

Outcomes:

The patient’s condition including hemoglobin level was relieved.

Lessons:

In chronic kidney disease, AIHA may contribute to the development of severe anemia and erythropoiesis-stimulating agents-resistance, irrespective of the results of Coombs test. Reticulocytosis, undetectable haptoglobin and a fall in hemoglobinA1c despite sustained hyperglycemia may be a clue to the diagnosis of hemolysis.
Cognitive performance of Brazilian patients with favorable outcomes after severe traumatic brain injury: a prospective study
Authors: Vascouto Helena Dresch , Melo Hiago Murilo , Rodrigues de Oliveira Thais Maria Emília , Libório Schwarzbold Marcelo , Lin Katia , Dal Pizzol Felipe , Kupek Emil , Walz Roger
Published: May 2023

Objective

Investigate the cognitive performance of patients with favorable outcomes, determined by the Glasgow Outcome Scale (GOS) one year after hospital discharge due to severe traumatic brain injury (TBI).

Design

Prospective case-control study. From 163 consecutive adult patients with severe TBI included in the study, 73 patients had a favorable outcome (GOS 4 or 5) one year after hospital discharge and were eligible for the cognitive evaluation of which 28 completed the evaluations. The latter were compared with 44 healthy controls.

Results

The average loss of cognitive performance among participants with TBI varied between 13.35% and 43.49% compared to the control group. Between 21.4% and 32% of the patients performed below the 10th percentile on three language tests and two verbal memory tests, whereas 39% to 50% performed below this threshold on one language test and three memory tests. Longer hospital stay, older age, and lower education were the most important predictors of worse cognitive performance.

Conclusion

One year after a severe TBI, a significant proportion of Brazilian patients with the favorable outcome determined by GOS still showed significant cognitive impairment in verbal memory and language domains.
Residents' Perceptions of a Novel Virtual Livestream Cadaveric Teaching Series for Musculoskeletal Anatomy Education
Authors: Le Andy , Satkunam Lalith , Yu Jaime C.
Published: May 2023

Musculoskeletal anatomy education is essential to many healthcare providers, but has consistently been considered difficult for various reasons. Traditional methods have focused on in-person cadaveric teaching, which became inaccessible during the COVID-19 pandemic; therefore, new teaching methods were developed to address this gap in education. This project implemented novel virtual livestream musculoskeletal anatomy teaching methodology with cadaveric prosections and evaluated the efficacy of this modality compared to traditional in-person cadaveric teaching. A targeted musculoskeletal anatomy curriculum was developed and delivered via livestream to 12 Canadian physiatry residents. Upon completing the virtual curriculum, residents completed an anonymous survey assessing this new virtual livestream cadaveric methodology compared to prior experiences with traditional in-person anatomy teaching. The survey response rate was 92%. Most participants (73%) rated the virtual livestream sessions as better than traditional in-person teaching. Reasons included better visualization of cadaveric anatomy and easy discussion amongst the group. T-test analysis comparing both methods demonstrated the livestream method was equivalent or better across several domains. Virtual livestream teaching is a viable method for teaching the important subject of musculoskeletal anatomy. Educators should consider how to best integrate this approach into future anatomy curricula.
Efficacy of Extracorporeal Shockwave therapy on pain and function in Myofascial Pain Syndrome: A systematic review and meta-analysis of randomized clinical trials
Authors: Avendaño-López Carlos , Megía-García Álvaro , Beltran-Alacreu Hector , Serrano-Muñoz Diego , Arroyo-Fernández Rubén , Comino-Suárez Natalia , Avendaño-Coy Juan
Published: May 2023

Objective

To examine the effectiveness of ESWT in reducing pain, improving functionality, joint range of motion (ROM), quality of life, fatigue, and health status self-perception in people with MPS.

Methods

PubMed, the Cochrane Library, CINAHL, the Physiotherapy Evidence Database (PEDro), and SPORTDiscus were systematically searched for only randomized clinical trials published up to June 2, 2022. The main outcome variables were pain, as reported on the visual analog scale (VAS) and pressure pain threshold (PPT), and functionality. A quantitative analysis was conducted using the inverse variance method and the random effects model.

Results

Twenty-seven studies were included (n = 595 participants in the ESWT group). The effectiveness of ESWT for relieving pain was superior for the ESWT group compared to the control group on the VAS (MD = −1.7 cm; CI 95%: −2.2 to −1.1) and PPT (MD = 1.1 kg/cm2; CI 95%: 0.4 to 1.7) and functionality (SMD = −0.8; CI 95%: −1.6 to −0.04) with high heterogeneity. However, no differences were found between ESWT and other interventions as dry needling, exercises, infiltrations, and lasers interventions.

Conclusion

ESWT is effective in relieving pain and improving functionality in patients with MPS compared to control and ultrasound therapy.
Effect of Selective Serotonin Reuptake Inhibitors on Motor Recovery After Stroke: A Systematic Meta-analysis
Authors: Oh Ju Sun , Choo Yoo Jin , Chang Min Cheol
Published: May 2023

Objective

We conducted a meta-analysis to determine the effectiveness of SSRIs in improving motor outcomes after stroke. For accuracy, we only included studies in which SSRIs were administered to patients in the recovery phase after stroke (<6 months after stroke).

Design

Meta-analyses were conducted according to the tools used to measure motor function. We searched the SCOPUS, PubMed, Embase, and Cochrane Library databases for studies which compared motor recovery in patients who receive SSRI medication in the recovery phase after stroke with a control group that did not receive any SSRI.

Results

A total of 3,715 publications were assessed, and nine studies met the study criteria. The group which received SSRI showed improved Fugl-Meyer Motor Scale and Barthel index scores compared to the control group. However, there was no significant difference in the modified Rankin Scale scores between the SSRI and control groups. The incidence of adverse effects after the administration of SSRIs did not differ from that in the control group.

Conclusion

Our study showed that the use of SSRI in the recovery phase of stroke improved motor function without significant increase in side effects.
Accuracy of Ultrasound Imaging for Etiology of New-Onset Painless Jaundice
Authors: Rosen Sarah J. , Beier Matthew A. , Parikh Manish , Kim Sooah , Hindman Nicole
Published: May 2023

Purpose

Ultrasound (US) is considered a first-line study for painless jaundice. However, in our hospital system, patients with new-onset painless jaundice often have a contrast-enhanced computed tomography (CECT) or magnetic resonance cholangiopancreatography (MRCP) regardless of the sonographic findings. Thus, we investigated the accuracy of US for detection of biliary dilatation in patients with new-onset painless jaundice.

Methods

Our electronic medical record was searched from January 1, 2012, to January 1, 2020, for adult patients with new-onset painless jaundice. Presenting complaint/setting, laboratory values, imaging studies/findings, and final diagnoses were recorded. Patients with pain or known liver disease were excluded. A gastrointestinal physician reviewed the laboratory values/chart to classify the type of suspected obstruction. Two radiologists blindly re-reviewed the US scans, and κ between the radiologists was calculated. Fisher exact test and the 2-sample t test were used for statistical analysis.

Results

Three hundred sixty patients presented with jaundice (>3 mg/dL), of whom 68 met the inclusion criteria (no pain and no known liver disease). Laboratory values had an overall accuracy of 54%, but were accurate in 87.5% and 85% for obstructing stones/pancreaticobiliary cancer. Ultrasound demonstrated overall accuracy of 78%, but only 69% for pancreaticobiliary cancer and 12.5% for common bile duct stone. Seventy-five percent of the patients underwent follow-up CECT or MRCP regardless of presenting setting. In the emergency department or inpatient setting, 92% of the patients underwent CECT or MRCP regardless of US, and 81% had follow-up CECT or MRCP within 24 hours.

Conclusion

A US-first strategy in the setting of new-onset painless jaundice is accurate only 78% of the time. In practice, US was almost never a stand-alone imaging examination in patients presenting to the emergency department or inpatient setting with new-onset painless jaundice, no matter the suspected diagnosis based on clinical and laboratory grounds or on the US findings themselves. However, for milder elevations of unconjugated bilirubin (suspicious for Gilbert disease) in the outpatient setting, a US demonstrating lack of biliary dilatation was often a definitive study for exclusion of pathology.
What Is New in Stage 3 of the 2019 Revised Association Research Circulation Osseous Staging System of Osteonecrosis of the Femoral Head: A Relationship to Bone Resorption
Authors: Bae Jiwon , Lee Seul Ki , Kim Jiyoung , Kim Jee-Young , Kim Jun-Ho
Published: May 2023

Purpose

The aim of the study is to evaluate the stage 3 findings of the 2019 revision of the Association Research Circulation Osseous (ARCO) staging system for osteonecrosis of the femoral head between 3A and 3B and the relationship with bone resorption area.

Materials and Methods

We retrospectively enrolled 87 patients with ARCO stage 3 osteonecrosis of the femoral head, divided into stage 3A (n = 73) and 3B (n = 14). The revised stage 3 findings included subchondral fracture, fracture in necrotic portion, and flattening of the femoral head and were compared between stage 3A and 3B. The association between these findings and the causative features of bone resorption area was also evaluated.

Results

All stage 3 cases had subchondral fractures. In stage 3A, these fractures were generated by crescent sign (41.1%) and by fibrovascular reparative zone in 58.9%; however, in stage 3B, fibrovascular reparative zone generated 92.9% of these fractures and crescent sign only 7.1% with statistical significance (P = 0.034). Necrotic portion fracture was noted in 36.7% and femoral head flattening was observed in 14.9% of all stage 3. Necrotic portion fracture (92.9% vs 26.0%) and femoral head flattening (71.4% vs 4.1%) were observed more frequently in stage 3B than 3A (P < 0.001). Almost all subchondral fractures by fibrovascular reparative zone (96.4%) and necrotic portion fracture (96.9%), and all femoral head flattening was presented with bone resorption area with expanding areas.

Conclusions

The ARCO stage 3 descriptions reflect severity in this order: subchondral fracture, necrotic portion fracture, and femoral head flattening. More severe findings are usually associated with expanding bone resorption areas.
Robotic versus Laparoscopic Ventral Hernia Repair
Authors: Dhanani Naila H , Lyons Nicole B , Olavarria Oscar A , Bernardi Karla , Holihan Julie L , Shah Shinil K , Wilson Todd D , Loor Michele M , Kao Lillian S , Liang Mike K
Published: May 2023

Objective:

Report the two-year outcomes of a multi-center randomized controlled trial comparing robotic versus laparoscopic intraperitoneal onlay mesh ventral hernia repair.

Summary Background Data:

Ventral hernia repair is one of the most common operations performed by general surgeons. To our knowledge, no studies have been published to date comparing long-term outcomes of laparoscopic versus robotic ventral hernia repair.

Methods:

The trial was registered at clinicaltrials.gov (NCT03490266). Clinical outcomes included surgical site infection, surgical site occurrence, hernia occurrence, readmission, reoperation, and mortality.

Results:

175 consecutive patients were approached that were deemed eligible for elective minimally invasive ventral hernia repair. 124 were randomized and 101 completed follow-up at two years. Two-year follow-up was completed in fifty-four patients (83%) in the robotic arm and 47 patients (80%) in the laparoscopic arm. No differences were seen in surgical site infection or surgical site occurrence. Hernia recurrence occurred in two patients (4%) receiving robotic repair versus in six patients (13%) receiving laparoscopic repair (relative risk 0.3, 95% confidence interval 0.06 to 1.39; P=0.12). No patients (0%) required reoperation in the robotic arm whereas five patients (11%) underwent reoperation in the laparoscopic arm (P=0.019, relative risk not calculatable due to null outcome).

Conclusions:

Robotic ventral hernia repair demonstrated at least similar if not improved outcomes at two-years compared to laparoscopy. There is potential benefit with robotic repair, however additional multi-center trials and longer follow-up are needed to validate the hypothesis-generating findings of this study.
Functional insight and cell-specific expression of the adipokinetic hormone/corazonin-related peptide in the human disease vector mosquito,Aedes aegypti
Authors: Afifi Salwa , Wahedi Azizia , Paluzzi Jean-Paul
Published: May 2023

The adipokinetic hormone/corazonin-related peptide (ACP) is an insect neuropeptide structurally intermediate between corazonin (CRZ) and adipokinetic hormone (AKH). Unlike the AKH and CRZ signaling systems that are widely known for their roles in the mobilization of energy substrates and stress responses, respectively, the main role of ACP and its receptor (ACPR) remains unclear in most arthropods. The current study aimed to localize the distribution of ACP in the nervous system and provide insight into its physiological roles in the disease vector mosquito,Aedes aegypti. Immunohistochemical analysis and fluorescencein situhybridization localized the ACP peptide and transcript within a number of cells in the central nervous system, including two pairs of laterally positioned neurons in the protocerebrum of the brain and a few ventrally localized neurons within the pro- and mesothoracic regions of the fused thoracic ganglia. Further, extensive ACP-immunoreactive axonal projections with prominent blebs and varicosities were observed traversing the abdominal ganglia. Given the prominent enrichment ofACPRexpression within the abdominal ganglia of adultA. aegyptimosquitoes as determined previously, the current results indicate that ACP may function as a neurotransmitter and/or neuromodulator facilitating communication between the brain and posterior regions of the nervous system. In an effort to elucidate a functional role for ACP signaling, biochemical measurement of energy nutrients in female mosquitoes revealed a reduction in abdominal glycogen stores in response to ACP that matched the actions of AKH, but interestingly, a corresponding hypertrehalosaemic effect was only found in response to AKH since ACP did not influence circulating carbohydrate levels. Comparatively, both ACP and AKH led to a significant increase in haemolymph carbohydrate levels in male mosquitoes while both peptides had no influence on their glycogen stores. Neither ACP nor AKH influenced circulating or stored lipid levels in both male and female mosquitoes. Collectively, these results reveal ACP signaling in mosquitoes may have complex sex-specific actions, and future research should aim to expand knowledge on the role of this understudied neuropeptide.
Plastid anionic lipids are required for membrane development and protochlorophyllide synthesis in etioplasts
Authors: Yoshihara Akiko , Kobayashi Keiko , Nagata Noriko , Fujii Sho , Wada Hajime , Kobayashi Koichi
Published: May 2023

Dark-germinated angiosperms develop the chloroplast precursors called etioplasts in cotyledon cells. Etioplasts develop lattice membrane structures called prolamellar bodies (PLBs), where the chlorophyll intermediate protochlorophyllide (Pchlide) forms a ternary complex with NADPH and light-dependent NADPH-Pchlide oxidoreductase (LPOR). The lipid bilayers of etioplast membranes are mainly composed of galactolipids, which play important roles in membrane-associated processes in etioplasts. Although etioplast membranes also contain two anionic lipids, phosphatidylglycerol (PG) and sulfoquinovosyldiacylglycerol (SQDG), the roles of these anionic lipids are unknown. To reveal the importance of PG and SQDG for the development of etioplasts, we characterized etiolated Arabidopsis mutants deficient in the biosynthesis of PG and SQDG. A partial deficiency in PG biosynthesis loosened the lattice structure of PLBs and impaired the insertion of Mg2+into protoporphyrin IX, leading to a significant decrease in Pchlide content. Although a complete lack of SQDG biosynthesis did not notably affect both PLB formation and Pchlide biosynthesis, the lack of SQDG in addition to the partial deficiency of PG caused strong impairments of these processes. The results suggested that PG is required for PLB formation and Pchlide biosynthesis, whereas SQDG plays an auxiliary role in these processes. Notably, the PG deficiency and the lack of SQDG oppositely affected the dynamics of LPOR complexes after photoconversion, suggesting different involvements of PG and SQDG in the organization of LPOR complexes. Our data demonstrate pleiotropic roles of anionic lipids in etioplast development.
Explicit Ion Modeling Predicts Physicochemical Interactions for Chromatin Organization
Authors: Lin Xingcheng , Zhang Bin
Published: May 2023

Molecular mechanisms that dictate chromatin organizationin vivoare under active investigation, and the extent to which intrinsic interactions contribute to this process remains debatable. A central quantity for evaluating their contribution is the strength of nucleosome-nucleosome binding, which previous experiments have estimated to range from 2 to 14kBT. We introduce an explicit ion model to dramatically enhance the accuracy of residue-level coarse-grained modeling approaches across a wide range of ionic concentrations. This model allows forde novopredictions of chromatin organization and remains computationally efficient, enabling large-scale conformational sampling for free energy calculations. It reproduces the energetics of protein-DNA binding and unwinding of single nucleosomal DNA, and resolves the differential impact of mono and divalent ions on chromatin conformations. Moreover, we showed that the model can reconcile various experiments on quantifying nucleosomal interactions, providing an explanation for the large discrepancy between existing estimations. We predict the interaction strength at physiological conditions to be 9kBT, a value that is nonetheless sensitive to DNA linker length and the presence of linker histones. Our study strongly supports the contribution of physicochemical interactions to the phase behavior of chromatin aggregates and chromatin organization inside the nucleus.
Percutaneous coronary intervention with drug-eluting stent is associated with better survival than coronary artery bypass grafting in Taiwan dialysis patients
Authors: Pan Szu-Yu , Yang Ju-Yeh , Teng Nai-Chi , Chen Yun-Yi , Wang Shi-Heng , Lee Chien-Lin , Chen Kang-Lung , Chiu Yen-Ling , Hsu Shih-Ping , Peng Yu-Sen , Chen Yung-Ming , Lin Shuei-Liong , Chen Likwang
Published: May 2023

Rationale and Objective

To study the comparative effectiveness of percutaneous coronary intervention with drug-eluting stent and coronary artery bypass grafting in dialysis patients.

Study Design

Retrospective observational cohort study.

Setting and Participants

This population-based study identified dialysis patients hospitalized for coronary revascularization between January 1, 2009 and December 31, 2015 in Taiwan National Health Insurance Research Database.

Exposures

Percutaneous coronary intervention with drug-eluting stent versus coronary artery bypass grafting.

Outcomes

All-cause mortality, in-hospital mortality, and repeat revascularization.

Analytical Approach

Propensity scores were used to match patients. Cox proportional hazards models and logistic regression models were constructed to examine associations between revascularization strategies and mortality. Interval Cox models were fit to estimate time-varying hazards during different periods.

Results

A total of 1,840 propensity score-matched dialysis patients were analyzed. Coronary artery bypass grafting was associated with higher in-hospital mortality (coronary artery bypass grafting vs. percutaneous coronary intervention with drug-eluting stent, crude mortality rate 12.5% vs. 3.3%; adjusted odds ratio 5.22; 95% confidence interval [CI] 3.42-7.97; p < 0.001), and longer hospitalization duration (median [interquartile range], 20 [14-30] days vs. 3 [2-8] days, p < 0.001). After discharge, repeat revascularization, acute coronary syndrome, and repeat hospitalization all occurred more frequently in the percutaneous coronary intervention with drug-eluting stent group. Importantly, with a median follow-up of 2.8 years, coronary artery bypass grafting was significantly associated with a higher risk of all-cause overall mortality (adjusted hazard ratio 1.19, 95% CI 1.05-1.35, p < 0.01) in the multivariable Cox proportional hazard model. Sensitivity and subgroup analyses yielded consistent results.

Limitations

Observational study with mainly Asian ethnicity.

Conclusions

Percutaneous coronary intervention with drug-eluting stent may be associated with better survival than coronary artery bypass grafting in dialysis patients. Future studies are warranted to confirm this finding.
Model Parameter identification using 2D vs 3D experimental data: a comparative analysis
Authors: Cortesi Marilisa , Liu Dongli , Yee Christine , Marsh Deborah J. , Ford Caroline E.
Published: May 2023

Computational models are becoming an increasingly valuable tool in biomedical research. They enable the quantification of variables difficult to measure experimentally, an increase in the spatio-temporal resolution of the experiments and the testing of hypotheses.

Parameter estimation fromin-vitrodata, remains a challenge, due to the limited availability of experimental datasets acquired in directly comparable conditions. While the use of computational models to supplement laboratory results contributes to this issue, a more extensive analysis of the effect of incomplete or inaccurate data on the parameter optimization process and its results is warranted. To this end, we compared the results obtained from the samein-silicomodel of ovarian cancer cell growth and metastasis, calibrated with datasets acquired from two different experimental settings: a traditional 2D monolayer, and 3D cell culture models.

The differential behaviour of these models will inform the role and importance of experimental data in the calibration of computational models’ calibration. This work will also provide a set of general guidelines for the comparative testing and selection of experimental models and protocols to be used for parameter optimization in computational models

Author summary

Parameter identification is a key step in the development of a computational model, that is used to establish a connection between the simulated and experimental results and verify the accuracy of thein-silicoframework.

The selection of thein-vitrodata to be used in this phase is fundamental, but little attention has been paid to the role of the experimental model in this process. To bridge this gap we present a comparative analysis of the same computational model calibrated using experimental data acquired from cells cultured (i) in 2D monolayers, (ii) in 3D culture models and (iii) a combination of the two.

Data acquired in different experimental settings induce changes in the optimal parameter sets and the corresponding computational model’s behaviour. This translates in a varying degree of accuracy during the validation procedure, when the simulated data are compared to experimental measurements not used during the calibration step.

Overall, our work provides a workflow and a set of guidelines to select the most appropriate experimental setting for the calibration and validation of computational models.
A Recombinant Antibody For Tracking Murine Gammaherpesvirus 68 Uracil DNA Glycosylase Expression
Authors: Mu Yunxiang , Plummer Joshua B. , Zelazowska Monika A. , Paul Somnath , Dong Qiwen , Chen Zaowen , Krug Laurie T. , McBride Kevin M.
Published: May 2023

Antibodies are powerful tools to detect expressed proteins. However off-target recognition can confound their use. Therefore, careful characterization is needed to validate specificity in distinct applications. Here we report the sequence and characterization of a mouse recombinant antibody that specifically detects ORF46 of murine gammaherpesvirus 68 (MHV68). This ORF encodes the viral uracil DNA glycosylase (vUNG). The antibody does not recognize murine uracil DNA glycosylase and is useful in detecting vUNG expressed in virally infected cells. It can detect expressed vUNG in cells via immunostaining and microscopy or flow cytometry analysis. The antibody can detect vUNG from lysates of expressing cells via immunoblot under native conditions but not denaturing conditions. This suggests it recognizes a confirmational based epitope. Altogether this manuscript describes the utility of the anti-vUNG antibody and suitability for use in studies of MHV68 infected cells.