bluuebunny/crossref_metadata_2025 huggingface dataset:
MO349: Occurrence of Postoperative Acute Kidney Injury (AKI) in One Lung Ventilated Patients
Authors: Jovanovsi- Srceva Marija , Nikolov Igor , Nikolova Dushanka , Gavrilovska Aleksandra , Kuzmanovska Biljana , Gjorgjievski Nikola , Dzekova-Vidimliski Pavlina , Severova- Andreevska Galina , Rambabova- Bushljetik Irena , Kuzmanovski Igor , Jakupi Nexhati
Published: May 2022

BACKGROUND AND AIMS

During lung surgery, preoperative fluids are given in restrict manner. This is in correspondence with the fact that lungs produce polyphasic injury during surgery and increased levels of different inflammation, traumatic and stress markers, on one side and a lack of fluids that complicate the transfer of water and kidney function on the other side [1]. One lung ventilation additionally complicate ventilation/perfusion ratio in the lungs, has overall impact on the whole body and to novel knowledge it indirectly leads to kidneys hypoperfusion and injurie [2]. The aim of our study is to evaluate the level of postoperative acute kidney injurie (AKI) occurrence in patients who underwent OLV.

METHOD

In prospective study, 60 patients that underwent lung resection in OLV, BMI<30 m2 without hepatic or renal endocrine diseases, aged 45–65 at the University Clinic for thoracic surgery in Skopje were included. Patients who underwent prior haemotherapy or radiotherapy were exuded. In all patients, we evaluate the demographic, clinical, preoperative state, duration of OLV, operation data and fluid assessment. Primary, we evaluate the occurrence and staging of AKI according to KDGIO criteria [3, 4]. A total of 72 h postoperatively in all patients and post hoc, we corelate its occurrence to several factors.

RESULTS

On average, patients were 59.7 +5.9 SD years old. More males were operated (80%). Overall, AKI stage 1 occurred in total of 13.3% (8 patients), AKI stage 22 in 3.3% (2 patients) and AKI stage 3 in 1.6% (1 patient). OLV longer than 60 min was in 85% of the patients, and all stages AKI were after this time duration. Lobectomy was done in 65% of the patients, while pulmectomy in 18.3% and bilobectomy in 16.7%. In relation to type of surgery done most of the patients that had pneumectomy had AKI 1 (27.2%), and additionally, only in this analysed surgery group, AKI 3 occurred in 9%. In correspondence to the side operated, right side was operated in 57.7% of the patients, and most of the AKI occurred in the right-sided surgery. Most of the patients who developed AKI preoperatively had hypertension and other cardiovascular issues.

CONCLUSION

AKI occurs significantly after OLV, in relation to the type of surgery. Mainly when right-side surgery is done. However, more severe AKI occurs when pulmectomy is done. Fluid regiment, OLV longer than 60 min and some preoperative cardiovascular diseases may contribute to its occurrence.
MO353: Extracorporeal Blood Purification of Complications After Aortic Valve Replacement. Surgical Aortic Valve Replacement Compared With Transcatheter Aortic Valve Replacement
Authors: Kuanyshbek Aidyn , Bekishev Bolat , LI Tatyana , Jabayeva Nilufar , Vahrushev Ivan , Makhmutov Myrzabek , Tulegenov Shaimurat , Zagrebelnyy Alexandr
Published: May 2022

BACKGROUND AND AIMS

Complications after cardiac surgery have serious negative consequences, prolonging the average ICU stay days and costs. Prevention and treatment of complications after aortic valve replacement is a serious problem. According to numerous authors, the incidence of complications after aortic valve replacement varies from 10 to >60% of cases. Development of complications is associated with a higher hospital mortality rate, the risk of infection and a more complex course of the disease.

Advances in cardiac surgery have led to a reduction in the overall mortality associated with open-heart surgery; however, it can still exceed 40% among those patients who develop a postoperative complication and can reach 50% in patients requiring extracorporeal blood purification therapy. Impaired renal function or active infectious process has significant prognostic consequences, which are the cause of up to 40% of deaths.

The aim of this work is to structure or compare complications in immediate postoperative period after aortic valve replacement by the surgical and transcatheter method.

METHOD

Retrospective analysis of 267 medical records. All patients in study were after aortic valve replacement, hospitalized in JSC NSCC Nur-Sultan, Kazakhstan, from 1 January 2020 to 31 October 2021. A total of 127 patients SAVR, 137 patients TAVR. Of those, 3 patients were excluded from the study due to chronic haemodialysis.

Inclusion criteria: informed consent to participate in research. Age is>18 years old. Prosthetics of the aortic valve by the SAVR or TAVR methods. Treatment of postoperative complications by the extracorporeal blood purification methods.

Exclusion criteria: refusal to participate in research. Age is <18 years old. Chronic dialysis. Active bleeding.

The patients were divided into two groups: group 1—patients after aortic valve replacement by the TAVR method and group 2—patients after open surgery aortic valve—SAVR.

Indications for extracorporeal blood purification methods: acute kidney injury (AKI), acute liver injury, the systemic inflammatory response syndrome (SIRS) and cytokine storm.

RESULTS

Period from 2020 to 2021.

TAVR group—137 patients, male―65 (47.45%), female—72 (52.55%), the average age of patients was 69.2±11.16 years.

In the SAVR group, there were 127 patients, of which male 43 (33.9%) and female 84 (66.1%), the average age was 47.04 ± 13.67 years.

CONCLUSION

Complications and mortality rate are more common after open surgery SAVR than after TAVR. Extracorporeal blood purification methods are required after an open valve replacement. Extracorporeal blood purification methods are an effective way to treat complications such as AKI and SIRS after aortic valve replacement.
MO355: Recovering From a Renal Vascular Catastrophe
Authors: Francisco Diogo , Pimenta Gonçalo , Cristina Martins Ana , Ávila Gonçalo , Laranjinha Ivo , Gil Célia , Gonçalves Margarida , Ormonde Carolina , Estibeiro Hermínia , Póvoa Pedro , Gaspar Augusta
Published: May 2022

BACKGROUND AND AIMS

Bilateral acute renal artery thrombosis (BARAT) is a rare and catastrophic condition. This diagnosis is often delayed or unrecognized and the true incidence may be underestimated. To the best of our knowledge, only three cases are reported in literature—all treated conservatively. We present two cases of BARAT who recovered kidney function under conservative approach.

METHOD

Data was obtained from the electronical medical record.

RESULTS: Case 1:A 73-year-old male with no history of cardiac disease, hypertension or recent trauma was admitted with right flank pain and vomiting. He had severe hypertension (204/103 mmHg), anuria with acute kidney injury (AKI) and elevated lactate dehydrogenase (LDH). He started haemodialysis on admission. Renal computerized tomography (CT) angiogram showed bilateral arterial thrombosis—left renal artery was totally occluded and partial occlusion of the right renal artery with slight enhancement of the corresponding kidney (Fig. 1).

Vascular surgery posed no surgical indication and systemic anticoagulation with low molecular weight heparin (LMWH) was started. A thorough screening for occult neoplasm and hypercoagulable state causes was negative.

He was independent from dialysis 54 days after. Currently (6 months after), he is on stage 3b chronic kidney disease (CKD) with a serum creatinine (sCr) 2.19 mg/dL.

Case 2: A 65-year-old female was admitted with dyspnea associated with right lumbar pain, severe hypertension (230/140 mmHg), peripheral edema and pulmonary congestion. Her prior history included heavy smoking and atherosclerotic artery disease with placement of aortoiliac stent 20 years before. She had no history of atrial fibrillation.

She was admitted with de novo cardiac insufficiency with a mild reduction of left ventricular ejection fraction. After admission, she developed anuric AKI with refractory fluid overload and started dialysis.

CT angiogram showed a large aortic thrombus that occluded both renal arteries. The right principal renal artery was occluded but the kidney had partial reperfusion from an accessory artery (Fig. 2). The left renal artery was totally occluded. Vascular surgery posed no surgical indication and the patient started LMWH.

She was independent from haemodialysis 30 days after. She has currently a stage 4 CKD with sCr 3.2 mg/dL.

CONCLUSION

There are currently no guidelines on both the acute and long-term management of BARAT. The few reported cases of BARAT were all treated conservatively with systemic anticoagulation and had late but consistent kidney function recovery. This suggests that renal parenchyma could still be viable after BARAT. Could early revascularization therapies accelerate recovery and minimize irreversible damage?

In both cases, a cause was not found. Much is still unknown about the pathophysiology, and further research is warranted.
MO358: Analysis of Acute Kidney Injury Incidence in Patients After Left Ventricle Assist Device Implantation
Authors: Bekishev Bolat , Jabayeva Nilufar , Novikova Svetlana , Kuanyshbek Aidyn , LI Tatyana , Kaliyev Rymbay , Nurmykhametova Zhuldyz
Published: May 2022

BACKGROUND AND AIMS

Chronic heart failure (CHF) in the terminal stage is a crucial issue of medicine. Heart transplantation is still the best treatment option. Lack of donors, long waiting time make heart transplantation almost impossible. Implantation of left ventricular assist device—LVAD) in patients with CHF is a bridge to transplantation. Nevertheless, the LVAD implantation procedure is time-consuming, requires significant material costs, and leads to numerous complications in the postoperative period. Acute kidney injury (AKI) is one of the most common and dangerous complications. Issues of AKI in patients with LVAD should be carefully taught.

The aim of the study is to examine the incidence of postoperative renal failure after the implantation of LVAD and its relationship to outcomes. In addition, we want to share with our experience of AKI management in patients with LVAD.

METHOD

A retrospective analysis of 265 medical records of patients after surgical implantation of LVAD who were hospitalized to the National Research Cardiac Surgery Center, Nur-Sultan city, Kazakhstan. Period of hospitalization from 01.2015 to 10.2021 year. The Kidney Disease Improving Global Outcome (KDIGO) criteria were used to define AKI.

RESULTS

Total number of patients 265 after LVAD implantation. Male—85.66% and female—14.34%. Mean ICU stay of patient without severe AKI—7.17±5.47 days. Mean ICU stay of patient with severe AKI—11.82±7.47 days.

Patients with severe AKI and blood purification—59 patients (24.9%), male—61–92.4%, femal—-5–7.6%.

Total number of LVAD patients—265.

ICU Mortality rate of patients after LVAD implantation—11 patients (4.15%).

Severe AKI—59 patients (22.3%).

Recovery of AKI—47 patients (79.66%).

Transformation to terminal stage of chronic renal disease (CRD) with chronic dialysis—1 patient (1.69%).

ICU Mortality rate of patients with severe AKI—11 (18.64%).

CONCLUSION

AKI is a common complication in the immediate postoperative period after LVAD implantation. AKI negatively affects the outcome of the disease. The mortality rate of LVAD patients with renal insufficiency exceeds by 14% the mortality of patients with renal insufficiency.

Blood purification is the effective method of severe AKI therapy.
MO359: Acute Renal Failure in Covid-19 Patients in a Latin American Health Institution
Authors: Dulcey Luis , Theran Juan , Gonzalez Hernando , Quintero Aldahir , Aguas Melissa , Parales Rafael
Published: May 2022

BACKGROUND AND AIMS

Acute renal failure in hospitalized patients for COVID-19 occurs in 3%–28% and is a poor prognostic factor. The mechanisms of renal involvement are not completely clarified. However, it has been evaluated that the presentation of renal failure increases adverse outcomes.

METHOD

Prospective observational study of all the cases that were admitted for COVID-19 between January and December 2021. Clinical and analytical data of kidney complications in patients with COVID-19 were collected.

RESULTS

A total of 306 patients with a mean age of 70.2 years, 75.1% men and with previous chronic kidney disease in 29.7% were analyzed. A total of 50.8% had severe pneumonia or acute respiratory distress syndrome and 22.9% required admission to the ICU. Proteinuria was registered in 77.6% and hematuria in 67.6%. A total of 20.9% of the patients required renal replacement therapy. Renal failure was of prerenal etiology in 59.2%, acute tubular necrosis in the context of sepsis in 23.5%, glomerular in 8.1% and due to tubular toxicity in 9.2%. The median stay was 15 days, and 31.7% died. Patients who developed kidney failure during admission had higher C-reactive protein, LDH, and D-dimer values, more severe lung involvement, more need for ICU admission, and greater need for renal replacement therapy.

CONCLUSION

Hypovolemia and dehydration are common causes of acute kidney injury in COVID-19 patients. Those who develop renal complications have a worse pulmonary, renal and systemic prognosis profile. We point out that monitoring an individualized management of blood volume can be decisive in preventing worse outcomes.
Characterization of Salivary Progesterone in Female Smokers
Authors: Baker Nathaniel L , Ramakrishnan Viswanathan , Gray Kevin M , Carpenter Matthew J , McClure Erin A , Tomko Rachel L , Saladin Michael E
Published: May 2022

Introduction

Fluctuations in ovarian hormones have been associated with changes in cigarette smoking behavior, which can be measured through both serum or less invasive salivary procedures. The primary aim of this exploratory study is to characterize the progesterone profiles of salivary progesterone measurements and to compare that with the profiles estimated from a previously measured serum sample.

Aims and Methods

Nontreatment-seeking, cigarette smoking women (n = 82; ages 18–45 years) provided daily salivary hormone samples every morning for 14 consecutive days. Time-dependent random effects functions were used to approximate daily salivary progesterone (ng/mL) levels over the course of a standardized menstrual cycle. Serum measures of progesterone from a previous study of female cigarette smokers were examined for consistency with established profiles and compared with the salivary profile using the same methodology.

Results

The salivary model fit exhibits relative stability during the follicular phase and a clear unimodal peak during the luteal phase. Parameter estimates from the non-linear function show correspondence to serum data. Although the profiles estimated from salivary and serum data agree in functional form, we observed larger between-subject heterogeneity both in the follicular level and the peak luteal level in salivary measures.

Conclusions

The pattern of salivary and serum progesterone measured across the menstrual cycle is similar in form, which is noteworthy given that the saliva and serum samples were drawn from independent sample of female smokers. Inter- and intra-individual variation in salivary measures may be greater than in serum measures.

Implications

Measuring progesterone level variation across the menstrual cycle via saliva samples has several benefits relative to serum sampling methods in that they are easily obtained, noninvasive, and low-cost. Inter- and intra-individual variation in measurements may be greater than those in serum measurements. However, the functional form of the salivary progesterone profile is isomorphic to serum progesterone.
Initial Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load Is Associated With Disease Severity: A Retrospective Cohort Study
Authors: Souverein Dennis , van Stralen Karlijn , van Lelyveld Steven , van Gemeren Claudia , Haverkort Milly , Snijders Dominic , Soetekouw Robin , Kapteijns Erik , de Jong Evelien , Hermanides Gonneke , Aronson Sem , Herpers Bjorn , den Boer Jeroen , Wagemakers Alex , Euser Sjoerd
Published: May 2022

Background

We assessed the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and hospital admission, intensive care unit (ICU) admission, and in-hospital mortality.

Methods

All SARS-CoV-2–positive persons with a combined nasopharyngeal and oropharyngeal swab that was collected between 17 March 2020 and 31 March 2021 in public health testing facilities were included.

Results

From 20 207 SARS-CoV-2–positive persons, 310 (1.5%) were hospitalized within 30 days. High viral loads (crossing point [Cp] <25) were associated with an increased risk of hospitalization as compared to low viral loads (Cp >30), adjusted for age and sex (adjusted odds ratio [aOR], 1.57 [95% confidence interval {CI}, 1.11–2.26]). The same association was seen for ICU admission (aOR, 7.06 [95% CI, 2.15–43.57]). The median [interquartile range] Cp value of the 17 patients who died in hospital was significantly lower compared to the 226 survivors (22.7 [3.4] vs 25.0 [5.2]).

Conclusions

Higher initial SARS-CoV-2 viral load is associated with an increased risk of hospital admission, ICU admission, and in-hospital mortality. Our findings emphasize the added value of reporting SARS-CoV-2 viral load or cycle threshold/Cp values to identify persons who are at the highest risk of adverse outcomes such as hospital or ICU admission and who therefore may benefit from more intensive monitoring or early initiation of antiviral therapy.
Non-autonomous regulation of neurogenesis by extrinsic cues: aDrosophilaperspective
Authors: Nguyen Phuong-Khanh , Cheng Louise Y
Published: May 2022

The formation of a functional circuitry in the central nervous system (CNS) requires the correct number and subtypes of neural cells. In the developing brain, neural stem cells (NSCs) self-renew while giving rise to progenitors that in turn generate differentiated progeny. As such, the size and the diversity of cells that make up the functional CNS depend on the proliferative properties of NSCs. In the fruit fly Drosophila, where the process of neurogenesis has been extensively investigated, extrinsic factors such as the microenvironment of NSCs, nutrients, oxygen levels and systemic signals have been identified as regulators of NSC proliferation. Here, we review decades of work that explores how extrinsic signals non-autonomously regulate key NSC characteristics such as quiescence, proliferation and termination in the fly.
COVID-19 and the importance of effective risk communication with children
Authors: Abrams Elissa M , Shaker Marcus , Greenhawt Matthew
Published: May 2022

During the current COVID-19 pandemic, effective risk communication is essential to mitigate the mental health impact on children and their families. Effective risk communication involves being honest but yet reassuring, framing issues in an actionable way, and modeling realistically reassuring communication among adults. Health care providers may discuss with families principles of modeling good media consumption habits to mitigate misinformation on social media. In addition, health numeracy and health literacy need to be integrated into proper risk communication.
Les effets de la COVID-19 sur les intoxications à l’urgence pédiatrique
Authors: Zhang Evangeline W J , Davis Adrienne , Finkelstein Yaron , Rosenfield Daniel
Published: May 2022

Objectifs

Cette étude avait pour but de décrire l’impact de la pandémie sur les intoxications chez les enfants de moins de 18 ans s’étant présentés à un service d’urgence tertiaire pédiatrique du Canada.

Méthodologie

Nous avons utilisé les données de surveillance du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (SCHIRPT) pour identifier les enfants s’étant présentés à l’Hospital for Sick Children pour intoxication durant deux périodes: avant la pandémie (du 11 mars au 31 décembre 2018 et 2019) et durant la pandémie (du 11 mars au 31 décembre 2020). Les principaux paramètres d’évaluation étaient la variation par rapport au total des visites à l’urgence de la proportion des intoxications totales, des intoxications accidentelles, de l’usage de drogues récréatives et d’automutilation intentionnelle. Nous avons également examiné la variation entre avant et durant la pandémie de la proportion d’intoxications en fonction de l’âge, du sexe, du type de drogues et des exigences d’admission.

Résultats

La proportion par rapport au total des visites à l’urgence s’est significativement accrue pour ce qui est des intoxications totales (122,5 %), des intoxications accidentelles (127,8 %), de l’usage de drogues récréatives (160 %) et des intoxications intentionnelles (automutilation; 104,2 %). La proportion de tous les cas d’intoxication s’est aussi significativement accrue durant la pandémie pour ce qui est du cannabis (44,3 %), du vapotage (134,6 %), des autres drogues récréatives (54,5 %), de l’usage de plusieurs drogues (29,3 %) et des admissions pour intoxication (44,3 %).

Conclusion

Malgré une baisse généralisée des visites à l’urgence durant la pandémie, il y a eu une augmentation significative par rapport à avant la pandémie des présentations pour intoxication à notre salle d’urgence. Nos résultats permettront de mieux orienter la prestation des soins et les interventions de santé publique en matière d’intoxications pédiatriques.
Impact of SARS-CoV-2 pandemic on the mental and physical health of children enrolled in a paediatric weight management clinic
Authors: Nsamenang Sheri Agatha , Gutierrez Carline Anne , Manayathu Jones Jane , Jenkins Glenn , Tibelius Stephanie Anne , DiGravio Anna Maria , Chamas Basma , Ewusie Joycelyne Efua , Geddie Hannah , Punthakee Zubin , Samaan M Constantine , Wahi Gita , Morrison Katherine M
Published: May 2022

Background

Obesity is a global public health concern. Given the widespread disruption caused by the SARS-CoV-2 pandemic, it is important to evaluate its impact on children with chronic health conditions. This study examines the health of paediatric patients with obesity enrolled in a tertiary hospital weight management program, before and 1 year into the COVID-19 pandemic.

Methods

This is a retrospective chart review of patients aged 2 to 17 years enrolled in a paediatric weight management clinic. Mental health outcomes (i.e., new referrals to psychologist, social work, eating disorder program, incidence of dysregulated eating, suicidal ideation, and/or self-harm) and physical health (anthropometric measures) were compared before and 1 year into the pandemic.

Results

Among the 334 children seen in either period, there was an increase in referrals to psychologist (12.4% versus 26.5%; P=0.002) and the composite mental health outcome (17.2% versus 30.2%; P=0.005) during the pandemic compared with pre-pandemic. In a subset of children (n=30) with anthropometric measures in both periods, there was a lower rate of decline in BMIz score (–1.5 [2.00] versus –0.3 [0.73]/year; P=0.002) and an increase in adiposity (–0.8 [4.64] versus 2.7 [5.54]%/year; P=0.043) during the pandemic.

Discussion

The pandemic has impacted the mental and physical health of children with obesity engaged in a weight management clinic. While our study provides evidence of a negative impact on mental health outcomes and less improvement in anthropometric measures, future research when patients return to in-person care will enable further examination of our findings with additional objective measures.
A PLETHORA/PIN-FORMED/auxin network mediates prehaustorium formation in the parasitic plant Striga hermonthica
Authors: Xiao Ting Ting , Kirschner Gwendolyn K , Kountche Boubacar A , Jamil Muhammad , Savina Maria , Lube Vinicius , Mironova Victoria , al Babili Salim , Blilou Ikram
Published: May 2022

The parasitic plant Striga (Striga hermonthica) invades the host root through the formation of a haustorium and has detrimental impacts on cereal crops. The haustorium results from the prehaustorium, which is derived directly from the differentiation of the Striga radicle. The molecular mechanisms leading to radicle differentiation shortly after germination remain unclear. In this study, we determined the developmental programs that regulate terminal prehaustorium formation in S. hermonthica at cellular resolution. We showed that shortly after germination, cells in the root meristem undergo multiplanar divisions. During growth, the meristematic activity declines and associates with reduced expression of the stem cell regulator PLETHORA1 and the cell cycle genes CYCLINB1 and HISTONE H4. We also observed a basal localization of the PIN-FORMED (PIN) proteins and a decrease in auxin levels in the meristem. Using the structural layout of the root meristem and the polarity of outer-membrane PIN proteins, we constructed a mathematical model of auxin transport that explains the auxin distribution patterns observed during S. hermonthica root growth. Our results reveal a fundamental molecular and cellular framework governing the switch of S. hermonthica roots to form the invasive prehaustoria.
Synergistic antibacterial photocatalytic and photothermal properties over bowl-shaped TiO2 nanostructures on Ti-19Zr-10Nb-1Fe alloy
Authors: Wu Yan , Deng Zichao , Wang Xueying , Chen Aihua , Li Yan
Published: May 2022

As implant substitutes are increasingly applied to the clinic, the infection caused by implants has become one of the most common complications, and the modification of the antibacterial function of the implant can reduce such complications. In this work, a well-defined bowl-shaped nanostructure coating with photocatalytic and photothermal synergistic antibacterial properties was prepared on Ti-19Zr-10Nb-1Fe (TZNF) alloy. The coating is obtained by spin-coating and sintering TiO2 precursors templated from self-assembled microspheres of polystyrene-poly(4-vinylpyridine) (PS-P4VP) amphiphilic block polymer on TZNF alloy. PS-P4VP provides the bowl-shaped TiO2 nanostructures doped with C, N elements, reducing the band-gap of TiO2, which can absorb near-infrared (NIR) light to release reactive oxygen species and produce photothermal conversion. The bowl structure is expected to enhance the utilization of light via the reflection in the confined space. The bowl-shaped surface has 100% antibacterial rates after 30 min of NIR light irradiation. In addition to antibacterial properties, the bowl-shaped surface has better hydrophilicity and protein adsorption capacity. The amount of protein adsorbed on TZNF with the bowl-shaped structures was six times that of TZNF. Hence, the bowl-shaped nanostructure can promote the proliferation and adhesion of osteoblasts, the cell proliferation rate was increased by 10–30%.
Anatomical variation of the sacroiliac joint carries an increased risk for erosion and bone marrow oedema in axial spondyloarthritis
Authors: Ziegeler Katharina , Ulas Sevtap Tugce , Poddubnyy Denis , Proft Fabian , Rios Rodriguez Valeria , Rademacher Judith , Hermann Kay Geert A , Diekhoff Torsten
Published: May 2022

Objectives

To assess the impact of joint shape variations on inflammatory lesions on SI joint MRIs in patients with axial spondyloarthritis (axSpA).

Methods

A total of 1194 patients from four different prospective cohorts were evaluated, with 684 (57.3%) having sufficient imaging data for inclusion (379 axSpA, 305 controls). All images were evaluated for joint form, erosion, sclerosis, fat metaplasia and bone marrow oedema (BMO) by two independent readers. Logistic regression analyses were used to assess the association of joint form and lesions on imaging for axSpA patients and controls.

Results

Atypical joint forms were common in both axSpA (43.5% [154/354]) and control patients (44.2% [134/303]); both intra-articular variants and a crescent joint shape were significantly more common in axSpA patients (18.4% vs 11.6% and 11.0% vs 5.3.%, respectively; P < 0.001). The axSpA patients with intra-articular joint form variants had 2-fold higher odds of exhibiting erosions [odds ratio (OR) 2.09 (95% CI 1.18, 3.69)] and BMO [OR 1.79 (95% CI 1.13, 2.82)]; this association was not observed in controls. Accessory joints increased the odds for sclerosis in axSpA patients [OR 2.54 (95% CI 1.10, 5.84)] and for sclerosis [OR 17.91 (95% CI 6.92, 46.37)] and BMO [OR 2.05 (95% CI 1.03, 4.07)] in controls.

Conclusions

Joint form variations are associated with the presence of inflammatory lesions on SI joint MRIs of axSpA patients. This should be taken into consideration in future research on the interplay of mechanical strain and inflammation in axSpA.
Boosting working memory: uncovering the differential effects of tDCS and tACS
Authors: Senkowski Daniel , Sobirey Rabea , Haslacher David , Soekadar Surjo R
Published: May 2022

Working memory (WM) is essential for reasoning, decision-making, and problem solving. Recently, there has been an increasing effort in improving WM through noninvasive brain stimulation (NIBS), especially transcranial direct and alternating current stimulation (tDCS/tACS). Studies suggest that tDCS and tACS can modulate WM performance, but large variability in research approaches hinders the identification of optimal stimulation protocols and interpretation of study results. Moreover, it is unclear whether tDCS and tACS differentially affect WM. Here, we summarize and compare studies examining the effects of tDCS and tACS on WM performance in healthy adults. Following PRISMA-selection criteria, our systematic review resulted in 43 studies (29 tDCS, 11 tACS, 3 both) with a total of 1826 adult participants. For tDCS, only 4 out of 23 single-session studies reported effects on WM, while 7 out of 9 multi-session experiments showed positive effects on WM training. For tACS, 10 out of 14 studies demonstrated effects on WM, which were frequency dependent and robust for frontoparietal stimulation. Our review revealed no reliable effect of single-session tDCS on WM but moderate effects of multi-session tDCS and single-session tACS. We discuss the implications of these findings and future directions in the emerging research field of NIBS and WM.
Age-dependent modulation of oleoresin production in the stem of Sindora glabra
Authors: Yu Niu , Dong Mingliang , Yang Jinchang , Li Rongsheng
Published: May 2022

Plants produce specialized metabolites in various organs which serve important functions in defense and development. However, the molecular regulatory mechanisms of oleoresin production in stems from broadleaved tree species are not fully understood. To determine whether endogenous developmental cues play a role in the regulation of oleoresin biosynthesis in tree stems, anatomy, multi-omics and molecular experiments were utilized to investigate the change of secretory structures, chemical profiles and gene expression in different ontogenetic stages of Sindora glabra tree, which accumulates copious amount of sesquiterpene-rich oleoresin in stems. The size of secretory canals and the concentration of five sesquiterpenes in Sindora stems exhibited obvious increase with plant age, from 0.5- to 20-year-old plants. Moreover, α-copaene and β-copaene were found to be stem-specific sesquiterpenes. Metabolomic analysis revealed that salicylic acid highly accumulated in mature stems, but the content of triterpenes was greatly decreased. The expression of three repressors AUX/IAA, DELLA and JAZ involved in hormone signaling transduction pathways was significantly downregulated in stems of 10- and 20-year-old plants. Two key genes SgTPS3 and SgTPS5 were identified, whose expression was highly correlated with the accumulation patterns of specific sesquiterpenes and their enzymatic products were consistent with the chemical profiles in the stem. The promoters of three SgTPSs exhibiting high activity were isolated. Furthermore, we demonstrated that SgSPL15 directly interacts with SgTPS3 and SgTPS5 promoters and activates SgTPS5 expression but SgSPL15 inhibits SgTPS3 expression. In addition, SgSPL15 enhanced sesquiterpene levels by upregulating AtTPSs expression in Arabidopsis. These results suggested that sesquiterpene biosynthesis in S. glabra stem was dependent on the regulation of endogenous hormones as well as plant age, and SgSPL15 might act as a buffering factor to regulate sesquiterpene biosynthesis by targeting SgTPS genes.
Histopathology of the Shoot Apex of Sugarcane Colonized by Leifsonia xyli subsp. xyli
Authors: Marques João Paulo Rodrigues , Cia Mariana Cicarelli , Batista de Andrade Granato Adrielle , Muniz Larissa Fernanda , Appezzato-da-Glória Beatriz , Camargo Luis Eduardo Aranha
Published: May 2022

Colonization of the xylem of sugarcane by Leifsonia xyli subsp. xyli results in the occlusion of the vessels by a gum-like compound and compromises the elongation of the stalk leading to stunted plants. However, no study has been performed in the apical tissue where the elongation of the stalks initiates at the intercalary meristem (IM). Microscopic and histochemical analyses were performed in plants with lower and higher bacterial titers and revealed that in both cases L. xyli subsp. xyli is present in this tissue and colonizes the forming xylem vessels in a similar way as observed in developed internodes. In both cases, it was observed adhering to the secondary walls, but only in plants with higher titers were a mild degradation of the walls and a granular material filling the vessels observed. The mixed composition of lipids, proteins, and pectin indicates that the filling is not a bacterial extracellular polymeric substance. Plants with higher bacterial populations also presented lower starch content in the ground parenchyma at the node elements, possibly resulting from the reported downregulation of photosynthesis and increased accumulation of phenolics. Their second and third IMs presented fewer cells and reduced expression of genes related to the cell cycle and to the synthesis of ABA in the apical tissue. These results indicate that increased L. xyli subsp. xyli colonization affects the development of the IM, which ultimately would reduce the length of the internodes, resulting in the main symptom of the disease.
Young Women's Health Initiative
Authors: Sardana Aayushi , Ascencio Janice Krystal
Published: May 2022

OBJECTIVE:

A reflective conversation amongst the Jamaica Hospital Medical Center obstetrics and gynecology team regarding the misinformation we believed as young women resulted in a program focused on young women. The program was designed to provide young women with accurate information on their health and well-being. Equipped with this information, we believe that young women would be poised to make better decisions for their future.

PROJECT SUMMARY:

We discussed community engagement and outreach to target schools in the surrounding Jamaica Hospital Medical Center community. In the midst of the pandemic, when educational systems moved toward virtual and electronic platforms, the Jamaica Hospital Medical Center obstetrics and gynecology team established a virtual program to promote the health and wellness of young women in middle and high schools. To accomplish these objectives, the Jamaica Hospital Medical Center obstetrics and gynecology team created seven modules that cover the following topics: Module 1—an informational session that addresses female hygiene and other health-related topics for young women and girls. This session allowed the team to assess the knowledge of our cohort. Module 2—a tutorial on the anatomy of the female body to empower young women and girls to understand how their bodies work. Modules 3 and 4—two sessions focused on puberty and the associated changes young women and girls should expect. Module 5—a session focused on sexually transmitted infections and their long-term effects, both physically and emotionally. Module 6—a session focused on physical and mental health wellness (including topics that resonate with our cohort such as body image and eating disorders). Module 7—a session focused on breast health, specifically gauged to the needs of our cohort.

Each module required a commitment of at least 60 minutes, and, in some instances, a module had to be split into two sessions to ensure that the subject matter of that module was sufficiently covered. These modules were collaboratively developed from feedback provided by obstetricians in the community and educators at our target schools. The modules included interactive elements such as Poll Everywhere, videos, and diagrams that facilitated thoughtful and academic discussions.

OUTCOME:

We successfully implemented this pilot program in two classes (one middle school class and one high school class), with the curriculum adjusted to cater to its audience. We received overwhelmingly positive feedback from both the students and their educator liaisons.

RELEVANCE TO WOMEN’S HEALTH OR PHYSICIANS IN PRACTICE:

We recognize that this program is an important engagement tool to be shared with other communities to inform a wider audience of young women and girls.
Rating Spine Surgeons
Authors: Wanner John P. , Pennings Jacquelyn S. , Nian Hui , Sivaganesan Ahilan , Gupta Rishabh , Asher Anthony L. , Bydon Mohamad , Abtahi Amir , Zuckerman Scott L. , Devin Clinton , Archer Kristin R. , Stephens Byron F.
Published: May 2022

Study Design:

This was an observational study.

Objectives:

This study aims to determine the correlation between patient-reported outcomes (PROs) pulled from a national spine registry and physician ratings from physician review websites (PRWs).

Summary of Background Data:

PRWs are frequently utilized by patients to make health care decisions; however, many PRWs appear to incorporate subjective experiences unrelated to a surgeon’s clinical performance into ratings. As such, their utility as a health care decision-making tool remains unclear.

Materials and Methods:

This study evaluated 8834 patients from the Quality Outcomes Database (QOD) who underwent 1-level elective lumbar spine surgery. The lumbar module of QOD was queried to rank 124 surgeons using PROs (Oswestry Disability Index, EuroQOL, Numerical Rating Scale—back/leg pain, and patient satisfaction). The QOD PRO-ranking system was compared against PRWs including Healthgrades, Vitals, WebMD, and Google. The Spearman correlation coefficients, Kruskal-Wallis tests, and multiple linear regression models were used for statistical comparison. The primary outcome was the correlation between PRW scores and PROs.

Results:

Surgeon PRO-derived ranking showed high intercorrelational congruence with coefficients between the 3 PROs (Oswestry Disability Index, EuroQOL, Numerical Rating Scale back/leg) ranging between 0.70 and 0.88. Low correlations were observed between PRO-derived rankings and PRWs, ranging from 0.23 to 0.37. Healthgrades performed most similarly to PRO-derived rankings, correlating best with patient satisfaction, though the correlation was low (ρ=0.37).

Conclusions:

While PRWs are often used to evaluate surgeon competency, these results demonstrate they poorly correlate with a surgeon’s clinical ability measured by PROs. PRWs should be used with caution when making health care decisions by patients, payers, and administrators.

Level of Evidence:

Level III.
Influence of Preoperative Depressive Burden on Achieving a Minimal Clinically Important Difference Following Lumbar Decompression
Authors: Lynch Conor P. , Cha Elliot D.K. , Jenkins Nathaniel W. , Parrish James M. , Nolte Michael T. , Geoghegan Cara E. , Jadczak Caroline N. , Mohan Shruthi , Singh Kern
Published: May 2022

Study Design:

This was a retrospective cohort study.

Objective:

This study evaluates the association of preoperative mental health with the rate of achieving minimal clinically important difference (MCID) in patient-reported outcomes following lumbar decompression (LD).

Summary of Background Data:

Research is scarce regarding the influence of preoperative depression on the rate of achieving MCID for mental health, physical function, and pain among LD patients.

Methods:

A surgical registry was retrospectively reviewed for primary LD surgeries. Patients were grouped by depressive symptom severity according to the preoperative Patient Health Questionnaire 9 score. The association of Patient Health Questionnaire 9 subgroups with demographic and surgical variables was analyzed, and differences among subgroups were assessed. Achievement rates of MCID for physical function, pain, disability, and mental health were compared among groups at each time point using previously established MCID thresholds.

Results:

Of the 321 subjects, 69.8% were male, and 170 subjects had minimal preoperative depressive symptoms, 86 had moderate, and 65 had severe. Patients in moderate and severe groups demonstrated a significantly greater rate of MCID achievement for disability at 6 weeks and 3 months postoperatively. The severe group demonstrated a significantly higher rate of achieving MCID for mental health at the 1-year time point.

Conclusions:

Patients with any range of preoperative depressive symptom severity had a similar rate of achieving MCID for pain and physical function throughout 1 year following LD. The severe depressive symptom group had a higher rate of MCID achievement with disability at 6 weeks and with mental health at 1 year. This study demonstrates that patients with any preoperative depressive symptom severity have an indistinguishable ability to attain MCID by 1 year following LD.

Level of Evidence:

Level III.
A Pilot Study of Machine Learning–Based Algorithms to Assist Integrated Care for Older Community-Dwelling Adults
Authors: Ryu So Im , Lee Younghan , Jun Sohee , Paek Yunheung , Kim Hongsoo , Cho BeLong , Park Yeon-Hwan
Published: May 2022

As life expectancy increases, there is a growing consensus on the development of integrated care encompassing the health and daily activities of older adults. In recent years, although the demand for machine learning applications in healthcare has increased, only a few studies have implemented machine learning–based systems in integrated care for older adults owing to the complex needs of older adults and the coarseness of the available data. Our study aims to explore the possibility of implementing machine learning decision-support algorithms in the integrated care of older community-dwelling adults. Our experiment uses secondary data based on the community-based integrated service model. Such data were collected from 511 older adults through 162 assessment items in which tailored services were selected from 18 available services. We implemented four machine learning models: decision tree, random forest, K-nearest neighbors, and multilayer perceptron. The area under the receiver operating characteristic curve results of the four models were decision tree = 0.89, K-nearest neighbors = 0.88, random forest = 0.93, and multilayer perceptron = 0.88. The results suggest that machine learning–based decision-assisting algorithms can improve the quality of tailored services for integrated care with intensive involvement of face-to-face tasks by reducing the simple, repetitive tasks of care managers.
Photobiomodulation Therapy With Different Wavebands for Hair Loss: A Systematic Review and Meta-Analysis
Authors: Zhang Yuehou , Su Jianlong , Ma Kui , Fu Xiaobing , Zhang Cuiping
Published: May 2022

BACKGROUND

Photobiomodulation is a promising therapy for hair loss with negligible side effects. However, the reported effects of photobiomodulation therapy for hair loss are inconsistent.

OBJECTIVE

To assess the curative effect of photobiomodulation therapy for the treatment of hair loss.

METHODS

A systematic review of self-controlled studies and randomized controlled trials was conducted. ScienceDirect, PubMed, and Wiley Online Library were searched from the earliest date to May 30, 2021.

RESULTS

Thirty-six studies (966 patients) were included. Two to 4 meta-analyses with different indices were performed separately on 4 groups of studies to test the effectiveness of the following hair loss treatments: ultraviolet light for alopecia areata (AA), red light for androgenetic alopecia (AGA), infrared light for AA, and infrared light for AGA. All meta-analyses showed that treatments were superior to control (p < .05).

CONCLUSION

The meta-analyses strongly suggested that photobiomodulation therapies with ultraviolet and infrared light were effective for treating AA, and photobiomodulation therapies with red light and infrared light were effective for treating AGA.
Understanding Early Admission Processes: Implications for Physician Assistant Workforce Diversity and Healthcare Equity
Authors: Ackerman-Barger Kupiri , London Maya , Yi Amanda , Wilson Machelle , Fine Jeffrey , Kayingo Gerald
Published: May 2022

Purpose:

Increasing diversity in the physician assistant (PA) workforce has been identified as a key priority by national PA organizations and PA programs alike. This study aimed to understand why certain applicants did not progress in PA program admissions by exploring common reasons for nonprogression and identifying any demographic trends.

Methods:

We conducted a retrospective review of applicants over the last 5 consecutive admission cycles at the University of California Davis Physician Assistant program.

Results:

The most common reasons for denial, starting with the most prevalent, were low application score, bachelor's GPA <3.0, missing prerequisite(s), late application, and science GPA <2.7. Several associations between demographic groups and reasons for nonprogression were identified.

Conclusions:

The findings from a multicohort study might help programs consider these issues in their own programs and identify interventions to support underrepresented applicants.
Evaluation of Interprofessional Education on Effective Communication Between Pharmacy and Physician Assistant Students
Authors: Volino Lucio R. , Brust-Sisti Lindsay A. , Patel Sarah , Yeh Dipali , Liu Mei T. , Cogan-Drew Thea , Parrott J. Scott
Published: May 2022

Purpose

The purpose of this study was to assess the effect of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) on student self-perceived competencies and perceptions of interprofessional (IP) communication and teamwork in a clinical case review activity. TeamSTEPPS is an evidence-based curriculum that is used to enhance and support IP healthcare communication.

Methods

A repeated-measures, pretest/posttest study evaluated physician assistant students' and student pharmacists' perceptions of TeamSTEPPS. Students completed Performance Assessment for Communication and Teamwork (PACT) surveys, evaluating teamwork, knowledge, attitudes, and skills perceptions before and after a TeamSTEPPS lecture and associated activity with peer feedback.

Results

Overall, 87.4% (n = 429) completed pre- and post-PACT surveys. Apart from the Mutual Support domain (p = .898), all changes were significantly positive (p < .004), with the greatest improvements occurring in the Attitudes and Perceived Skills domains.

Conclusion

TeamSTEPPS IP education, application, and peer feedback improved students' perceptions of multiple domains, including effective communication. Using TeamSTEPPS tools in IP formats enabled the students to safely practice and collaborate in preparation for clinical practice.