bluuebunny/crossref_metadata_2025 huggingface dataset:
A Smaller Tibiotalar Sector is a Risk Factor for Recurrent Anterolateral Ankle Instability after Modified Broström-Gould Procedure
Authors: Zendeli Flamur , Pflueger Patrick , Viehoefer Arnd , Hodel Sandro , Farshad Mazda , Wirth Stephan H. , Weigelt Lizzy
Published: December 2024

Category:

Ankle; Sports

Introduction/Purpose:

Several demographical and clinical risk factors for recurrent ankle instability have been described. The main objective of this study was to investigate the potential influence of morphological characteristics of the ankle joint on the occurrence of recurrent instability and the functional outcomes following a modified Broström-Gould procedure for chronic lateral ankle instability.

Methods:

Fifty-eight ankles from 58 patients (28 males and 30 females) undergoing a modified Broström-Gould procedure for chronic lateral ankle instability between January 2014 and July 2021 were available for clinical and radiological evaluation. Based on the preoperative radiographs the following radiographic parameters were measured: talar width (TW), tibial anterior surface angle (TAS), talar height (TH), talar radius (TR), tibiotalar sector (TTS), ankle mortise angle (AMA). The history of recurrent ankle instability and the functional outcome using the Karlsson Score were assessed after a minimum follow-up of 2 years.

Results:

Recurrent ankle instability was reported in 14 patients (24%). The TTS was significantly lower in patients with recurrent ankle instability (69.8 degrees vs 79.3 degrees) (P < .00001). The multivariate logistic regression model confirmed the TTS as an independent risk factor for recurrent ankle instability (OR = 1.64) (P = .003). The receiver operating characteristic curve analysis revealed that patients with a TTS lower than 72 degrees (= low-TTS group) had an 82-fold increased risk for recurrent ankle instability (P = .001). The low-TTS group showed a significantly higher rate of recurrent instability (58% vs 8%; P = .0001) and a significantly lower Karlsson score (65 points vs 85 points; P < .00001).

Conclusion:

A smaller TTS was found to be an independent risk factor for recurrent ankle instability and led to poorer functional outcomes after a modified Broström-Gould procedure.
Ankle Fractures in the Complex Diabetic Patient. Minimally Invasive Surgery and Augmentation with Ring Fixation
Authors: Cuchacovich Natalio , Mena Javier , Diaz Nicolas , Bergeret Juan , Rivera Maximiliano , Fuentes Patricio , Bastias Gonzalo F.
Published: December 2024

Category:

Diabetes; Trauma

Introduction/Purpose:

Ankle fractures in complex diabetic patients (target organ damage, obesity, and HBA1C > 8 mg/dl) are associated with serious complications. Good results have been reported with MIS techniques in patients at risk of soft tissue complications and with the use of early containment frames in patients with diabetic neuroarthropathy. Our objective was to evaluate a novel, minimally invasive management protocol with augmentation using ring external fixation.

Methods:

Retrospective IRB approved study including 18 complicated diabetic patients with bi- or trimalleolar ankle fractures with a minimum follow-up of one year. Fibular intramedullary fixation was performedand percutaneous screws were used for the medial and posterior malleolar fractures. The stability of the construct was increased by using a ring external fixator. Demographic data, AOFAS scores, and Lower Extremity Functional Score (LEFS) functional scales were obtained, as well as a record of complications during the complete follow-up and visual analog scale (VAS).

Results:

The mean age and HBA1C were 56 years (R:37-73) and 9.8 ± 2.5 mg/dl. The external fixator time was 12.3 weeks (6-28) with complete healing in of 16/18 patients (89%) at 12.6 weeks (R:8-24). The average AOFAS was 79 (R:67-97), LEFS was 61.8% (R37.5-90). The mean postoperative VAS score was 4.4/10. The most frequent complication was superficial pin infections (38.8%) and there was one case of secondary Charcot Neuroarthropathy. No deep infections or wound dehiscence was observed.

Conclusion:

This minimally invasive fixation technique with augmentation is a safe alternative for complex diabetic patients with poor metabolic control and high HBA1C values. In our patients, we achieved high union rates according to what is reported in the literature, with a low incidence of major complications and acceptable functional results. Percutaneous fixation and ring augmentation
Are Intramedullary Implants Used for Midfoot Charcot Fit for Female Metatarsals?
Authors: Yammine Kaissar , Sayegh George E. , ElAlam Anthony , Jamaleddine Youssef , Mouawad Joseph , Assi Chahine
Published: December 2024

Category:

Midfoot/Forefoot; Basic Sciences/Biologics

Introduction/Purpose:

Radiological assessments of metatarsal biometrics have been documented in few studies and often lack direct clinical significance. The narrower diameter of female metatarsals could be an impediment for intramedullary implant suitability. This investigation examines the radiological morphometry of female metatarsals to assess the diameter fitness of intramedullary implants used for midfoot Charcot fusion.

Methods:

Foot roentgenograms of 143 female patients in the standing position were collected for radiological assessment. Initially, basic biometric parameters were determined at the level of the metatarsal neck. Cortical thickness was derived by subtracting the inner width from the outer width measurements. Following a hypothetical reaming, mean values of inner width, outer width, and cortical thickness were assessed for fitness estimation. Implant fitness was considered satisfactory if either a) the inner width was below the threshold of 6mm, and/or b) the cortical thickness was below the threshold of 2mm (1 mm on each side of the cortex). Additional examination was performed using the lower quartile values for further analysis.

Results:

The findings revealed that: a) the mean inner width of M5 was significantly greater compared to M2, M3 and M4 (p ˂ 0.00001), while no significant difference was observed among the median metatarsals, and b) M2 exhibited a significantly higher outer width than M3 and M4 (p ˂ 0.00001), with no difference observed with M5. According to the predefined threshold values, the estimated width fitness values (after hypothetical reaming) for accepting implant diameter were deemed inadequate for M2, M3 and M4, and the estimated cortical thickness values deemed inadequate for M3, M4 and M5.

Conclusion:

Our study indicates, for the first time, a discrepancy in the inner width of the lateral metatarsals at the neck level concerning commercially available Charcot-specific intramedullary implants for female patients. This mismatch suggests an increased vulnerability to cortex fractures at the metatarsal neck and potential implant migration. If a critical width is identified, utilizing smaller implant diameters or opting for a proximal insertion at the base of the metatarsals might present more suitable alternatives.
Understanding the risks of compound climate events and cascading risks
Authors: Ebi Kristie L
Published: December 2024

Increases in the frequency, intensity, and duration of extreme weather and climate events, such as heatwaves, droughts, fire weather, and flooding, are increasing the likelihood of compound and cascading events. The associated impacts are harming human health and well-being, ecosystems, livelihoods, and communities today, with larger impacts projected with additional climate change unless there are timely and significant investments in adaptation and mitigation. At this moment, risk management is not keeping pace with increasing risks. Investments in transdisciplinary research and implementation, accounting for barriers and capacities, is urgently needed.
Damage assessment and seismic response of steel buildings during the Kahramanmaraş, Turkey earthquakes of February 6, 2023
Authors: Tapia-Hernández Edgar , Geneş Mehmet Cemal , Gülkan Polat
Published: December 2024

On February 6, 2023, two earthquakes (Mw 7.8 and 7.5) occurred in Turkey. Notably, 10 provinces in Turkey and several others in Syria were subjected to severe ground shaking, resulting in a high number of casualties following the total and partial collapse of many reinforced concrete buildings. Although moderate damages in non-structural elements were identified in the very few steel buildings that existed, negligible structural damage was generally identified during field inspections. The notable exception was a 7-story steel building in Antakya that partially collapsed. The behavior of the building is examined in detail from the design project report and a previous study of real-time monitoring. Nonlinear analyses were carried out under the accelerograms recorded by the closest stations. The investigation aims to enrich the present knowledge of the structural performance of steel structures under extreme seismic demands.
Deletion of lymphotoxin-β receptor (LTβR) protects against acute kidney injury by PPARα pathway
Authors: Wang Zufeng , Cheng Yichun , Fan Jiahe , Luo Ran , Xu Gang , Ge Shuwang
Published: December 2024

Background

Recent data has shown a considerable advancement in understanding the role of lymphotoxin-β receptor (LTβR) in inflammation. However, the functions and underlying mechanisms of LTβR in acute kidney injury (AKI) remain largely unknown.

Methods

AKI was induced in mice by renal ischemia-reperfusion (I/R). HK-2 cells and primary renal tubular epithelial cells (RTECs) were subjected to hypoxia/reoxygenation (H/R) injury. The effects of LTβR depletion were examined in mice, as well as primary RTECs. Bone marrow chimeric mice was generated to determine whether the involvement of LTβR expression by parenchymal cells or bone marrow derived cells contributes to renal injury during AKI. RNA sequencing techniques were employed to investigate the mechanism via which LTβR signaling provides protection against I/R-induced AKI

Results

LTβR expression was downregulated both in vivo and in vitro models of AKI. Moreover, depletion of LTβR decreased renal damage and inflammation in I/R-induced AKI. We also found that LTβR deficient mice engrafted with wild type bone marrow had significantly less tubular damage, implying that LTβR in renal parenchymal cells may play dominant role in I/R-induced AKI. RNA sequencing indicated that the protective effect of LTβR deletion was associated with activation of PPARα signaling. Furthermore, upregulation of PPARα was observed upon depletion of LTβR. PPARα inhibitor, GW6471, aggravated the tubular damage and inflammation in LTβR−/− mice following I/R injury. Then we further demonstrated that LTβR depletion down-regulated non-canonical NF-κB and Bax/Bcl-2 apoptosis pathway through PPARα.

Conclusions

Our results suggested that the LTβR/PPARα axis may be a potential therapeutic target for the treatment of AKI.
IL-33/ST2 axis mediates diesel exhaust particles-induced mast cell activation
Authors: Cheng Wun-Hao , Zhuang Ting-Li , Lee Meng-Jung , Chou Chun-Liang , Chen Bing-Chang , Kuo Han-Pin , Weng Chih-Ming
Published: December 2024

Background

Mast cells are implicated in the pathogenesis and severity of asthma in children and adults. The release of proinflammatory mediators and cytokines from activated mast cells (MC) is associated with Type 2 (T2) cell-skewed inflammation.

Methods

We obtained the airway tissues of Balb/c mice with or without intra-tracheal diesel exhaust particles (DEP) instillation to measure the extent of tryptase+ MCs infiltration and interleukin (IL)-33 expression. Cultured human mast cells (HMC-1) were stimulated with DEP to determine the role of aryl hydrocarbon receptor (AhR) in mediating the synthesis and release of IL-33 and type-2 cytokines.

Results

In the control animals, most of the MC accumulated in the submucosal vessels without expression of IL-33. Intra-tracheal DEP installation increased the number of IL-33+ MC infiltrating in the epithelial and sub-epithelial areas of mice. Human MC exposed to DEP upregulated mRNA and protein expression of IL-33. These effects were abolished by knockdown of expression of the AhR or AhR nuclear translocator (ARNT) by small interfering (si)RNA transfection. DEP also activated nuclear factor-kappa B (NF-κB) to facilitate nuclear translocation of the AhR. DEP increased MC migration and induced the synthesis and release of IL-4, IL-5, and IL-13 in MCs, and these effects were abolished by anti-ST2 antibodies.

Conclusions

Airborne pollutants may activate MCs to produce IL-33 via the AhR/NF-κB pathway, leading to type 2 cytokines production and enhancing MC airway epithelium-shifted migration through the autocrine or paracrine IL-33/ST2 axis.
Benchmarks for low back pain in general practice in Flanders: electronic audit of INTEGO
Authors: Paridaens Rico , Vaes Bert , Van den Bulck Steve , Soetaert Justine
Published: December 2024

Background

Low back pain (LBP) is one of the most frequent reasons for encounter in general practice. Yet results from literature show adherence to clinical practice guidelines is low. Audit & feedback is a well-known strategy to improve adherence to guidelines. Benchmarking is an important step in the audit & feedback process. The objective of this study was to develop data-derived benchmarks for low back pain quality indicators.

Methods

Four electronic health record extractable quality indicators were selected from an existing indicator set developed by CEBAM, an independent, multidisciplinary and interuniversity medical scientific institute in Belgium. Data from 2021-2022 from INTEGO, a general practice morbidity registry, were used to calculate benchmarks for the four quality indicators. The Achievable Benchmark of Care methodology was used to create benchmarks based on the performance of the 10% best-performing practices.

Results

The following benchmarks were derived: 4.2% prescription for medical imaging, 12.7% prescription for opioids, 27.2% for prescription for non-steroidal anti-inflammatory drugs or acetaminophen, 37.7% prescription for physical therapy and 11.9% prescription for work absenteeism.

Conclusions

Benchmarks for four electronic health record-extractable quality indicators have been established. They can be used for an electronic audit & feedback tool in primary practice in Flanders or other quality improvement initiatives.
Hemolytic disease of the fetus and newborn and Rhesus alloimmunization in Latin American countries: a scoping review
Authors: Júnior Mário Dias Corrêa , Sosa Salvador Espino y , Fernandes Milene , do Carmo Lais , de Oliveira Renato Watanabe , Kanevsky Gabriela
Published: December 2024

Background

Hemolytic disease of the fetus and newborn (HDFN) is a condition due to maternal blood group antibodies targeting antigens in fetal red blood cells, with significant prenatal/perinatal morbidity and mortality. Severe HDFN cases are often associated with alloimmunization against Rhesus D (RhD) or Kell antigens. Information about HDFN epidemiology and treatment in Latin American countries is limited. This review aims to identify and synthesize the available evidence on the epidemiology and management of HDFN in this region.

Methods

In July 2023, EMBASE, PubMed, LILACS, and other databases were searched for articles reporting epidemiology, treatment, prenatal and perinatal outcomes, and patient journey of HDFN cases in Latin American countries. A snowball search of cross-references and gray literature complemented the initial search. Publications in English, Spanish, and Portuguese were reviewed. Data were extracted using a defined template and charted in tables.

Results

We reviewed five guidelines and 19 observational studies from Brazil, Chile, Mexico, Argentina, Colombia, Panamá, Paraguay, and Peru. HDFN due to Rh alloimmunization ranged from 0.5 to 5 per 1000 live births, and anti-D remains the most frequent alloantibody type for severe HDFN. The perinatal mortality rate of HDFN is approximately 1.3–1.6 per 100,000 live births, and fetal deaths can reach 30% among patients treated with intrauterine transfusions. Up to 47% of alloimmunized pregnancies were referred to reference centers only during the third trimester. About 60% of eligible pregnancies received anti-D IgG prophylaxis.

Conclusions

Although estimates in LATAM countries are scarce and lack standardized measures, we observed that the incidence, morbidity, and mortality of HDFN in this region are problematic. RhD alloimmunization was reported in approximately up to 70% of severe HDFN cases, despite anti D HDFN being largely preventable.
Establishment and characterization of a new intestinal-type ampullary carcinoma cell line, DPC-X3
Authors: Chai Changpeng , Miao Xin , Su Yuanhui , Yu Cheng , Tang Huan , Li Lu , Wang Zhengfeng , Yi Jianfeng , Ye Zhenzhen , Miao Long , Zhang Hui , Hu Zhao , Chen Luyang , Wu Keren , Li Ning , Wang Linpei , Zhou Wence , Xu Hao
Published: December 2024

Ampullary carcinoma (AC) of the intestinal type represents a distinct variant within the broader category of ampullary neoplasms. The scarcity of pertinent cellular models has constrained investigations centered on this particular malignancy. This research effectively generated a cell line (CL) of intestinal-type AC (DPC-X3). This newly developed CL has been continuously cultured for 1 year and has demonstrated stable passaging exceeding 60 generations. Morphologically, DPC-X3 exhibited characteristic attributes of an epithelial tumor. The cell proliferation rate of DPC-X3 exhibited a doubling interval of 79 h. Short tandem repeat (STR) analysis validated the high consistency between DPC-X3 and the patient’s primary tumor. Characteristically, DPC-X3 displayed sub diploid karyotypes, primarily featuring 44, XY inv (9), -18, -20, -22, and + mar. Under suspension culture conditions, DPC-X3 could efficiently form organoids, and DPC-X3 cells inoculated subcutaneously into NXG mice could form transplanted tumors. Drug susceptibility assays demonstrated that DPC-X3 resisted paclitaxel, oxaliplatin, 5-fluorouracil(5-FU), and gemcitabine. Immunohistochemical (IHC) evaluation revealed affirmative reactivity for CK7 and CK20 within DPC-X3 cells, while CDX2 exhibited no detectable expression. E-cadherin and Vimentin demonstrated positive immunoreactivity, whereas CEA and CA19-9 displayed faint positivity. The Ki-67 proliferation index was determined to be approximately 40%. DPC-X3 presents a valuable experimental platform for elucidating the pathogenesis of intestinal-type AC and can serve as a driver for drug development efforts.
Development and psychometric evaluation of an instrument measuring ambulance nurses’ adherence and attitudes to acute chest pain guidelines
Authors: Hansen Michael Ulrich , Zdravkovic Slobodan , Jakobsson Ulf , Vejzovic Vedrana , Axelsson Malin
Published: December 2024

Background

Effective prehospital care for acute chest pain critically relies on ambulance nurses’ adherence to clinical guidelines. However, current adherence is inadequate, with no instruments available to improve the situation. Therefore, this study aimed to develop and psychometrically evaluate an instrument measuring ambulance nurses’ adherence to and attitudes towards acute chest pain guidelines, and to adapt and test the Attitudes Regarding Practice Guidelines instrument for measuring general attitudes towards guidelines.

Methods

An instrument development design was used. A 49-item Adherence Instrument was initially developed for measuring adherence to and attitudes towards acute chest pain guidelines and the 18-item Attitudes Regarding Practice Guidelines instrument was translated into Swedish. Both instruments were validated through cognitive interviews and expert reviews. To ascertain its reliability, a test‒retest was conducted. The construct validity of the Adherence Instrument was assessed via principal component analysis on the basis of a polychoric correlation matrix.

Results

The developed Adherence Instrument was refined to 18 items and showed strong validity and reliability. Similarly, the Attitudes Regarding Practice Guidelines instrument, refined to 12 items, demonstrated strong validity and reliability. Principal component analysis of the Adherence Instrument identified five components: professional evidence-based practice, assessment of symptoms, confidence in skills, clinical autonomy, and guideline clarity and education. These components accounted for 64.5% of the total variance and demonstrated strong reliability, with an ordinal alpha of 0.84 for the entire scale.

Conclusion

The psychometric properties of the Adherence Instrument were satisfactory and will be useful in prehospital emergency care to measure attitudes and adherence towards acute chest pain guidelines.
Understanding the financial barriers to treatment among individuals with opioid use disorder: a focus group study
Authors: Anyanwu Precious , Olateju Olajumoke A. , Tata Vaishnavi , Varisco Tyler , Gilbert Lauren R. , Ogunsanya Motolani E. , Essien E. James , Johnson Michael L. , Thornton J. Douglas
Published: December 2024

Introduction

Despite the established effectiveness and relatively widespread availability of Medications for Opioid Use Disorder, individuals seeking treatment frequently encounter various structural and social barriers, including costs of treatment. This study aimed to understand the financial barriers that affect treatment continuation in individuals with opioid use disorder (OUD).

Methods

In this qualitative study, seven semi-structured in-depth focus group interviews were conducted among 28 participants in treatment for OUD. Basic demographic information were collected in a pre-focus group survey. Focus group interviews were conducted from December 2021 to February 2022. A moderator guide was used to facilitate the discussion. Transcripts were managed using ATLAS.ti© v7. Data collected from the focus groups underwent deductive thematic analysis.

Results

Data saturation was reached in 7 focus groups with a total of 28 participants (17 [60.7%] women; 27 [96.4%] white; 24 [85.7%] non-Hispanic). All three medications for OUD were represented (18 [64.3%] buprenorphine and naloxone, 5 [17.9%] methadone, 3 [10.7%] naltrexone, and 2 [7.1%] buprenorphine) and the time in treatment ranged from 1 month to over 36 months. Nearly all participants (27 [96.4%]) indicated a financial barrier that led to delayed treatment initiation and treatment retention. Two themes were identified from the focus group interviews: (1) OUD treatment-related financial burden- the direct and indirect cost associated with the treatment, and (2) psychosocial effects associated with the cost of OUD treatment -the mental, emotional, and social effects of the disease.

Conclusions

Most participants described the desire and need for resources to offset the unaffordable cost that inhibits treatment initiation and retention. Further work is required to help identify individuals susceptible to financial barriers that can lead to early discontinuation in treatment.
Do targeted intergovernmental fiscal transfers improve health outcomes? Evidence from Kenyan decentralization using the difference-in-differences technique
Authors: Thapa Bishnu Bahadur , Rahman Momotazur , Were Lawrence , Wamai Richard , Galárraga Omar
Published: December 2024

Background

As envisioned by the 2010 Constitution, Kenya implemented a devolved system of government in March 2013, setting up 47 counties and a corresponding number of local governments. These counties differed in their levels of development. While counties such as Nairobi and Kiambu led in social and economic indicators, others such as Turkana, Mandera and Wajir were at the bottom of the list. Keeping the between-country disparities and the need to remedy those disparities in mind, the national government used formula-based criteria to determine counties’ eligibility for the receipt of financial resources. On the basis of these criteria, counties were classified into marginalized and nonmarginalized counties. The marginalized counties were the 14 (of the 47) most socially and economically disadvantaged counties. These counties receive additional financial resources, which we call targeted intergovernmental fiscal transfers (i.e. fiscal transfers from the national government to county governments).

Methods

We used the difference-in-differences (DID) technique and fixed effects models to estimate the effects of these targeted intergovernmental fiscal transfers on human immunodeficiency virus (HIV) incidence and diarrhoea incidence.

Results

The results revealed that the counties receiving those transfers experienced a statistically significant decline in the incidence of diarrhoea but had no impact on the incidence of HIV. Our study fills a major gap in causal evidence linking intergovernmental fiscal transfers to health outcomes, especially in the context of low–middle-income countries in a newly decentralized setting.

Conclusions

Our results imply that targeted intergovernmental fiscal transfers may be effective at improving some subnational health outcomes, and therefore in reducing within-country health inequalities.
Eplerenone, a mineralocorticoid receptor inhibitor, reduces cirrhosis associated changes of hepatocyte glucose and lipid metabolism
Authors: Mohib Mohammad Mohabbulla , Rabe Sindy , Nolze Alexander , Rooney Michael , Ain Quratul , Zipprich Alexander , Gekle Michael , Schreier Barbara
Published: December 2024

Background

Recent studies suggest a contribution of intrahepatic mineralocorticoid receptor (MR) activation to the development of cirrhosis. As MR blockade abrogates the development of cirrhosis and hypoxia, common during the development of cirrhosis, can activate MR in hepatocytes. But, the impact of non-physiological hepatic MR activation is unknown. In this study, we investigate the impact of hypoxia-induced hepatocyte MR activation as a relevant factor in cirrhosis.

Methods

RNA sequencing followed by gene ontology term enrichment analysis was performed on liver samples from rats treated for 12 weeks with or without CCl4 and for the last four weeks with or without eplerenone (MR antagonist). We investigated if these changes can be mimicked by hypoxia in a human hepatocyte cell line (HepG2 cells) and in primary rat hepatocytes (pRH). In order to evaluate the functional cellular importance, hepatocyte lipid accumulation, glucose consumption, lactate production and mitochondrial function were analyzed.

Results

In cirrhotic liver tissue genes annotated to the GOterm “Monocarboxylic acid metabolic process” (PPARα, PDK4, AMACR, ABCC2, Lipin1) are downregulated. This effect is reversed by the MR antagonist eplerenone in vivo. The alterations are partially mimicked by hypoxia in rat and human hepatocytes in tissue culture. Furthermore, the reduction of mRNA and protein expression of PPARα, PDK4, AMACR, ABCC2 and Lipin1 during hypoxia is prevented by eplerenone in rat and human hepatocytes. Aldosterone, the endogenous MR agonist, did not affect the expression of those proteins in hepatocytes. As those proteins are key regulators of hepatocyte energy homeostasis, we analyzed if hypoxia affected glucose consumption, lactate production and lipid accumulation in HepG2 cells in a MR-mediated manner. All three parameters were affected by hypoxia and were partially normalized by eplerenone.

Conclusion

Our findings suggest that non-physiological MR activation plays a role in the dysregulation of glucose and lipid metabolism in hepatocytes. This leads to an increase in apoptosis, probably resulting in a proinflammatory micromilieu of the hepatic tissue. The enhanced deposition of extracellular matrix contributes to the development of cirrhosis. Therefore, MR antagonists may have therapeutic potential in the treatment of early stages of liver disease due to their direct action in the liver.
From controllers to cognition: the importance of selection factors on video game and gameplay mechanic-derived cognitive differences
Authors: Vo Tina T. , Pahlen Shandell , Zheng Anqing , Yu Sian , Lor Emery , Bowman Nicholas D. , Corley Robin P. , Friedman Naomi P. , Wadsworth Sally J. , Reynolds Chandra A.
Published: December 2024

Playing video games, especially games with action-based mechanics, is correlated with better cognitive performance, yet these performance advantages may originate from intrinsic factors such as earlier life cognitive differences. We investigated whether gaming-cognition associations in a sample past young adulthood remain robust after accounting for adolescent cognitive functioning. Using data from the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (CATSLife; N = 1241, Mage = 33.3, %, age range = 28–51, Female = 52.9%), we compared cognitive performance of adult recreational gamers (40.6%) to non-gamers (59.4%) and between different types of gamers. Measures included processing speed, spatial reasoning, and working memory cognitive tasks, gaming status, and gameplay type engagement. The majority of gamer participants reported exclusively playing puzzle/strategy/life simulation games (53.0%) or action type games (33.1%); a smaller proportion reported playing both types of games (10.3%). Overall, gamers significantly outperformed non-gamers across most cognitive tasks (Cohen’s d = 0.17–0.25), with limited evidence of a differential gameplay mechanic effect across tasks. Selection effects were evident whereby after adolescent IQ adjustment, gamer cognitive effects diminished by over 35% but persisted for spatial performance. Adolescent IQ predicted puzzle/strategy/life simulation preference but not action-type games, suggesting a selection effect. Our study replicates prior gaming findings and reveals that earlier life functioning contributes to adult gaming-cognition associations. Gamer-spatial associations are not fully attributable to intrinsic factors, and playing video games, regardless of a specific gameplay mechanic or genre, may represent a cognitively engaging lifestyle behavior that may benefit cognitive functioning, with implications for preserved cognition.
A systematic review of peer support interventions to improve psychosocial functioning among cancer survivors: can findings be translated to survivors with a rare cancer living rurally?
Authors: Hemming L. , Duijts S. F. A. , Zomerdijk N. , Cockburn C. , Yuen E. , Hardman R. , Van Vuuren J. , Farrugia T. , Wilson C. , Spelten E.
Published: December 2024

Background

This study aimed to (1) summarise research on the impact of peer support interventions aimed at improving psychosocial functioning among cancer survivors, and (2) identify key components for developing a support intervention for patients with a rare cancer living in rural, regional or remote areas.

Methods

A comprehensive search of EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library identified papers that examined peer support interventions: (i) for rare cancer patients, or (ii) for those living in rural, regional or remote locations, or (iii) that provided support online or via telehealth. After screening, data on study characteristics, intervention components and impact on psychosocial functioning were extracted. Quality assessment was conducted, and findings were synthesised narratively.

Results

A total of 23 unique studies were included, primarily exploring peer support for middle-aged females with a breast cancer diagnosis. Interventions were online or telephone-based, targeting a range of psychosocial outcomes with significant improvements found for coping abilities and loneliness. The most impactful interventions involved online, group formats facilitated by healthcare professionals. There were limited data on rare cancers and rural populations.

Conclusions

Few studies have explored peer support interventions for those diagnosed with a rare cancer living in rural, regional or remote areas. Evidence shows mixed impact on psychosocial functioning for cancer survivors, yet promising elements of peer support that can be translated to rare cancer patients living in rural, regional or remote areas.
Clinical differential factors in patients with hereditary transthyretin amyloidosis with Val142Ile and Ser43Asn mutations
Authors: Castellar-Leones Sandra Milena , Ruiz-Ospina Edicson , Diaz-Ruiz Jorge , Correa-Arrieta Cristian , Ruiz-Cortés Xiomara , Luzuriaga-Carpio Diana , Zambrano-Vera Dario , Cedeño-Quincha Jeanneth , Guerrero-Cepeda Luis , César-Chávez Daniel , Ortiz-Corredor Fernando
Published: December 2024

Background

Hereditary transthyretin amyloidosis (hATTR) is a rare autosomal dominant disease with high clinical variability, influenced by both genotype and the geographic origins of carriers. There is a limited understanding of the Val142Ile and Ser43Asn recognised mutations in Ecuador and Colombia. Therefore, the objective of this study is to describe the neurological and functional characteristics of patients with hATTR associated with the Val142Ile and Ser43Asn mutations, as well as to identify possible differentiating factors between the two mutations.

Methods

This cross-sectional, multicenter study included 35 hATTR patients from rehabilitation centers in Ecuador and Colombia. Patients had confirmed Val142Ile or Ser43Asn mutations. Neurological and functional assessments included the Neurological Impairment Scale, Norfolk Quality of Life-Diabetic Neuropathy (QOL-DN), Composite Autonomic Symptom Score-31, and various motor function tests as nine-hole peg test (NHP). Quantitative Sensory Testing (QST) evaluating small fiber function, while ultrasound measured the cross-sectional area (CSA) of peripheral nerves. Statistical analysis employed nonparametric tests and random forest classifiers, using SHAP values to identify differentiating variables.

Results

Val142Ile carriers showed lower performance in the right NHP test and greater sensitivity to cold pain in hand and leg. Ultrasound revealed increased CSA of the median nerve at the elbow and arm and the ulnar nerve at the arm in Val142Ile carriers compared to Ser43Asn carriers. The final random forest model identified the NHP test, Norfolk QOL-DN score, and CSA of the median and ulnar nerves as key discriminating variables.

Conclusion

This study identified significant neurophysiological and ultrasound markers differentiating Val142Ile and Ser43Asn mutations in hATTR-PN patients. Increased nerve CSA and specific motor and sensory impairments highlight the need for comprehensive evaluations to guide diagnosis and treatment.
Expanding the clinical spectrum of PPP3CA variants - alternative isoforms matter
Authors: Castiglioni Silvia , Pezzoli Laura , Pezzani Lidia , Lettieri Antonella , Di Fede Elisabetta , Cereda Anna , Ancona Silvia , Gallina Andrea , Colombo Elisa Adele , Parodi Chiara , Grazioli Paolo , Taci Esi , Milani Donatella , Iascone Maria , Massa Valentina , Gervasini Cristina
Published: December 2024

Background

the protein phosphatase 3 catalytic subunit alpha (PPP3CA) gene encodes for the alpha isoform of the calcineurin catalytic subunit, which controls the phosphorylation status of many targets. Currently, 23 pathogenic variants of PPP3CA are known, with clinical manifestations varying by mutation type and domain.

Results

through whole exome sequencing, we found two de novo variants in PPP3CA: a frameshift variant predicted leading to a truncated protein in Pt.1 and a splicing variant in Pt.2 associated with mild phenotype. PPP3CA is ubiquitously expressed with tissue-specificity of; namely, splicing isoform 1 prevailing over isoform 2 in the central nervous system. By analyzing isoform distribution in patient-derived cell lines, we highlight a skewed expression of both isoforms in Pt.1, whereas only isoform 2 shows a moderate reduction in Pt.2. In contrast, we did not observe significant abundance changes at the protein level. Cell lines derived from Pt.1 showed a reduced proliferation, associated with an increase in cell death and the upregulation of the unfolded protein response (UPR) pathway.

Conclusion

data suggest that an aberrant PPP3CA protein in Pt.1 could lead to UPR activation resulting in increased cell death. In Pt.2 an imbalance between the two main isoforms possibly explains the peculiar pathological manifestations, such as a moderate developmental delay.
Conventional versus task-based package organization for out-of-hospital emergency kits: an emergency medical services simulation study
Authors: Laxar Daniel , Grassmann Daniel , Reischmann Lena , Kaider Alexandra , Schadler Bertram , Huber Carmen , Krammel Mario , Hafner Christina
Published: December 2024

Background

Emergency Medical Service crews are equipped with comprehensive emergency kits for routine care and to provide life-saving interventions in severely ill patients. While guidelines on contents and packing strategies of emergency kits for specific tasks and specialized situations exist, data for the design of out-of-hospital emergency kits in a general urban population is lacking. It may be possible to transfer the promising results of modern in-hospital packing strategies such as task-based package organization (TPO) to an Emergency Medical Service setting.

Methods

Four types of emergency kit were used in this study: two novel backpack emergency kits were acquired for this study (one packed using a TPO approach (PAX bags) and the other a traditional non-TPO approach (inter-rescue)); the existing emergency kit; and a TPO-repack of the existing kit. We recruited 80 paramedics who each performed four different tasks in a simulated setting: preparation for endotracheal intubation; preparing an intravenous access and a crystalloid infusion; preparing intraosseous access with medication; and preparing for a forearm splint. Questionnaires were completed before starting, after each task, and at the end of each study session.

Results

There was no overall difference for the primary outcome of task completion between the novel TPO and novel non-TPO kit (p = 0.11). However, for selected tasks (forearm splint) completion time was significantly different between these kits. Overall, participants performed fastest when using the existing emergency kit. Participants frequently omitted items required for critical procedures, regardless of kit type.

Conclusion

TPO has been previously investigated in an in-hospital setting using participants with low exposure to medical emergencies, and with promising results. In our prehospital simulation setting with paramedics, equipment retrieval was neither faster nor more complete compared to non-TPO kits.
Veno-venous extracorporeal membrane oxygenation as a bridge in central airway obstruction: experience from a high-volume center
Authors: Luo Xiao-xiu , Li Jia-jia , Yang Fu-xun , Lei Yu , Zeng Fan , Lan Yun-ping , Pan Chun , Huang Xiao-bo , Liu Rong-an , Luo Jing-chao
Published: December 2024

Background

Perioperative airway management and oxygenation maintenance during central airway obstruction (CAO) treatment pose great challenges. While veno-venous extracorporeal membrane oxygenation (V-V ECMO) shows promise as a bridge therapy, optimal implementation and management strategies remain lacking. We present our experience with V-V ECMO in CAO management from a high-volume center.

Methods

We retrospectively analyzed 29 consecutive patients who received V-V ECMO support for CAO between 2015 and 2023. Patient demographics, clinical characteristics, ECMO cannulation and operation parameters, interventional procedures, complications, and outcomes were reviewed.

Results

Among patients with median airway diameter of 4.5 mm (IQR 2–5 mm), etiologies included primary tumors (n = 17), metastases (n = 7), and post-intubation/tracheostomy stenosis (n = 5). Treatment comprised bronchoscopic interventions (n = 9) and surgical procedures (thoracic = 15, head/neck = 5). Using predominantly femoral-jugular cannulation (n = 27), we implemented a minimal anticoagulation protocol (catheter flush with 5U/mL heparin only). All patients survived through 6-month follow-up with minimal ECMO-related complications.

Conclusion

The application of V-V ECMO with minimal anticoagulation demonstrates safety and efficacy as a bridging support in the therapeutic approach to CAO.
Signal regulatory protein α dynamically mediates macrophage polarization facilitated alleviation of ischemic diseases
Authors: Liu Haiyi , Yuan Yonghui , Johnson-Stephenson Takerra K. , Jing Chenyang , Zhang Mingchao , Huang Jun , Zen Ke , Li Limin , Zhu Dihan
Published: December 2024

Background

macrophage-targeting therapy of ischemic disease has made progress in clinic trial. However, the role and underlying mechanism of pro-inflammatory or anti-inflammatory polarized macrophages in modulating ischemic diseases remain incompletely understood.

Results

here we examine the effect of pro-inflammatory (LPS) and anti-inflammatory (IL-4) macrophage on ischemic diseases in a mouse ischemic hindlimb and heart model, and identify that signal regulatory protein α (Sirpα) modulates macrophage polarization induced angiogenesis via promoting phagocytosis or activating HIF1α nucleus relocation in macrophages, respectively. More importantly, the therapeutic effect of polarized macrophages is controlled by Sirpα in a time-dependent manner. Downregulation of macrophage Sirpα at the early-stage or upregulation of macrophage Sirpα at the late-stage of ischemic disease enhances the therapeutic effect. In contrast, increasing Sirpα at the early-stage or decreasing it at the late-stage leads to failure of inducing ischemic disease resilience. Mechanistically, we find that signal transducer and activator of transcription 3 and 6 (Stat3 and Stat6) mediate downregulation (pro-inflammatory polarization) or upregulation (anti-inflammatory polarization) of Sirpα, respectively.

Conclusion

Our results reveal that dynamic regulation of macrophage by Sirpα plays a critical role in alleviating ischemic diseases.
Baicalin alleviates intestinal inflammation and microbial disturbances by regulating Th17/Treg balance and enhancing Lactobacillus colonization in piglets
Authors: Zhang Shunfen , Luo Chengzeng , Li Kai , Wang Junhong , Wang Huixin , Zhong Ruqing , Chen Liang , Ma Qiugang , Zhang Hongfu
Published: December 2024

Background

Intestinal inflammation is a common and serious health problem in piglet production, especially enteritis caused by pathogenic Escherichia coli (E. coli). This condition often leads to high mortality, slow weight gain, and significant economic losses.

Results

In this study, we isolated an E. coli strain, SKLAN202302, from the colon of diarrheal piglets to create an intestinal inflammation model for evaluating the protective effects of baicalin. Piglets infected with E. coli exhibited significant reductions in body weight, feed intake, small intestine length, and ileal goblet cell count (P < 0.05), along with deteriorated ileal morphology. However, baicalin supplementation resulted in body weights, feed intake, and intestinal morphology similar to those of the control group. Notably, there was a significant increase in the colonization of Lactobacillus species, particularly Lactobacillus_reuteri, Lactobacillus_amylovorus, and Lactobacillus_johnii, compared to the E. coli group (P < 0.05). At the metabolic and transcriptional levels, E. coli infection increased inflammatory mediators, including eicosanoids (leukotriene F4, prostaglandin F1a, leukotriene E4, thromboxane B2, prostaglandin G2, and PGH2), monosaccharides, and TCA cycle intermediates (oxoglutaric acid, glutaric acid, adipic acid, citric acid, and isocitric acid) in the ileum. It also promoted the expression of genes related to autoimmune diseases and the Th17 differentiation signaling pathway (CTLA4, IFN-ALPHA-8, IL12RB2, TRAV3, TRAV16, FOS, and VEGFA), as well as inflammatory factors. Conversely, baicalin supplementation not only counteracted these effects but also enhanced the presence of metabolites such as phospholipids [including lysoPC (P-18:1(9Z)/0:0), PC (17:0/0:0), lysoPC (16:1(9Z)/0:0), PC (18:0/0:0), lysoPC (18:0/0:0), PA (10:0/i-16:0), and PA (10:0/8:0)] and amino acids. It also regulated genes within the IL-17 signaling pathway (IL4, CCL17, CXCL10, IFNG, and CXCL2), suggesting a mechanism by which baicalin mitigates E. coli-induced intestinal and microbial disturbances. Subsequent flow cytometry analysis showed that E. coli infection increased the numbers of CD3+ and Foxp3+ cells, decreased IL-17A+ cells, and reduced Th17/Treg ratios. Baicalin supplementation restored these parameters to control levels.

Conclusions

Baicalin supplementation effectively alleviates E. coli-induced intestinal inflammation and microbial disturbances in piglets by enhancing beneficial Lactobacillus colonization, counteracting inflammatory mediators, and regulating immune-related gene expression and the Th17/Treg balance. These findings highlight baicalin’s potential in alleviating intestinal inflammation.

Graphical abstract
Metabolic modelling uncovers the complex interplay between fungal probiotics, poultry microbiomes, and diet
Authors: Al-Nijir Montazar , Chuck Christopher J. , Bedford Michael R. , Henk Daniel A.
Published: December 2024

Background

The search for alternatives to antibiotic growth promoters in poultry production has increased interest in probiotics. However, the complexity of the interactions between probiotics, gut microbiome, and the host hinders the development of effective probiotic interventions. This study explores metabolic modelling to examine the possibility of designing informed probiotic interventions within poultry production.

Results

Genomic metabolic models of fungi were generated and simulated in the context of poultry gut microbial communities. The modelling approach correlated with short-chain fatty acid production, particularly in the caecum. Introducing fungi to poultry microbiomes resulted in strain-specific and diet-dependent effects on the gut microbiome. The impact of fungal probiotics on microbiome diversity and pathogen inhibition varied depending on the specific strain, resident microbiome composition, and host diet. This context-dependency highlights the need for tailored probiotic interventions that consider the unique characteristics of each poultry production environment.

Conclusions

This study demonstrates the potential of metabolic modelling to elucidate the complex interactions between probiotics, the gut microbiome, and diet in poultry. While the effects of specific fungal strains were found to be context-dependent, the approach itself provides a valuable tool for designing targeted probiotic interventions. By considering the specific characteristics of the host microbiome and dietary factors, this methodology could guide the deployment of effective probiotics in poultry production. However, the current work relies on computational predictions, and further in vivo validation studies are needed to confirm the efficacy of the identified probiotic candidates. Nonetheless, this study represents a significant step in using metabolic models to inform probiotic interventions in the poultry industry.