bluuebunny/crossref_metadata_2025 huggingface dataset:
EmAtlas: a comprehensive atlas for exploring spatiotemporal activation in mammalian embryogenesis
Authors: Zheng Lei , Liang Pengfei , Long Chunshen , Li Haicheng , Li Hanshuang , Liang Yuchao , He Xiang , Xi Qilemuge , Xing Yongqiang , Zuo Yongchun
Published: October 2022

The emerging importance of embryonic development research rapidly increases the volume for a professional resource related to multi-omics data. However, the lack of global embryogenesis repository and systematic analysis tools limits the preceding in stem cell research, human congenital diseases and assisted reproduction. Here, we developed the EmAtlas, which collects the most comprehensive multi-omics data and provides multi-scale tools to explore spatiotemporal activation during mammalian embryogenesis. EmAtlas contains data on multiple types of gene expression, chromatin accessibility, DNA methylation, nucleosome occupancy, histone modifications, and transcription factors, which displays the complete spatiotemporal landscape in mouse and human across several time points, involving gametogenesis, preimplantation, even fetus and neonate, and each tissue involves various cell types. To characterize signatures involved in the tissue, cell, genome, gene and protein levels during mammalian embryogenesis, analysis tools on these five scales were developed. Additionally, we proposed EmRanger to deliver extensive development-related biological background annotations. Users can utilize these tools to analyze, browse, visualize, and download data owing to the user-friendly interface. EmAtlas is freely accessible at http://bioinfor.imu.edu.cn/ematlas.
Artificial Intelligence and Phenomenological Ethnography
Authors: Banerji Ritwik
Published: October 2022

While phenomenological ethnography is primarily concerned with the structure of an individual subject’s experience of the sociocultural world, the contents of that experience itself remain a vital concern and problem for phenomenological ethnography given the several problems any ethnographer faces in trying to access what their subjects experience. This chapter describes an experimental methodology in which the ethnographer uses an artificially intelligent, improvising, musical social interactant to address this problem by staging encounters between performers active in free improvisation and these nonhuman virtual systems. Results of this method illustrate its efficacy as a novel means of understanding human social interaction as a distinct form of culture as experience.
Sport, Coaching, and Performance
Authors: Denison Jim , Avner Zoë
Published: October 2022

For any coach, a daily concern is always: What should I have the athletes I coach do in practice to achieve our performance objectives? While seemingly straightforward, what can make this question difficult for coaches to answer is the entangled multiplicity of forces and “knowledges” that shape coaches’ decision-making. As a result, what coaches have their athletes do in practice was more accurately described by Foucault, as “a series of discontinuous segments whose tactical function is neither uniform or stable … but can come into play in various strategies.” And it is the “effects” that these various strategies can have on athletes’ performance capabilities which are the focus of this chapter. More specifically, the chapter argues for the importance of coaches questioning many of their “normal” training practices in an effort to enhance their athletes’ performances.
Medical neglect: Working with children, youth, and families
Authors: Ward Michelle G K , Baird Burke
Published: October 2022

All children have a basic right to health care. When a child’s health care needs are not met, for any reason, health care providers (HCPs) must consider the barriers involved and the processes required to resolve the situation. Social, economic, or other barriers can prevent parents from accessing care for their child. Sometimes differing opinions, priorities, or values, between a child’s HCPs and parents come to impede the child receiving needed medical care. In some cases, caregiver failure to ensure needed care may be considered medical neglect. Specific skills and knowledge can help HCPs to prevent such situations from arising, and to work effectively with the family if they do. This statement offers an approach that HCPs can use to promote the best interests, well-being, and safety of children or youth at risk for medical neglect.
Interfacial cavitation
Authors: Henzel Thomas , Nijjer Japinder , Chockalingam S , Wahdat Hares , Crosby Alfred J , Yan Jing , Cohen Tal
Published: October 2022

Cavitation has long been recognized as a crucial predictor, or precursor, to the ultimate failure of various materials, ranging from ductile metals to soft and biological materials. Traditionally, cavitation in solids is defined as an unstable expansion of a void or a defect within a material. The critical applied load needed to trigger this instability -- the critical pressure -- is a lengthscale independent material property and has been predicted by numerous theoretical studies for a breadth of constitutive models. While these studies usually assume that cavitation initiates from defects in the bulk of an otherwise homogeneous medium, an alternative and potentially more ubiquitous scenario can occur if the defects are found at interfaces between two distinct media within the body. Such interfaces are becoming increasingly common in modern materials with the use of multimaterial composites and layer-by-layer additive manufacturing methods. However, a criterion to determine the threshold for interfacial failure, in analogy to the bulk cavitation limit, has yet to be reported. In this work, we fill this gap. Our theoretical model captures a lengthscale independent limit for interfacial cavitation, and is shown to agree with our observations at two distinct lengthscales, via two different experimental systems. To further understand the competition between the two cavitation modes (bulk versus interface), we expand our investigation beyond the elastic response to understand the ensuing unstable propagation of delamination at the interface. A phase diagram summarizes these results, showing regimes in which interfacial failure becomes the dominant mechanism.
Structured reflection increases intentions to reduce other people’s health risks during COVID-19
Authors: Ramos Jairo , Grant Marrissa D , Dickert Stephan , Eom Kimin , Flores Alex , Jiga-Boy Gabriela M , Kogut Tehila , Mayorga Marcus , Pedersen Eric J , Pereira Beatriz , Rubaltelli Enrico , Sherman David K , Slovic Paul , Västfjäll Daniel , Van Boven Leaf
Published: October 2022

People believe they should consider how their behavior might negatively impact other people, Yet their behavior often increases others’ health risks. This creates challenges for managing public health crises like the COVID-19 pandemic. We examined a procedure wherein people reflect on their personal criteria regarding how their behavior impacts others’ health risks. We expected structured reflection to increase people's intentions and decisions to reduce others’ health risks. Structured reflection increases attention to others’ health risks and the correspondence between people's personal criteria and behavioral intentions. In four experiments during COVID-19, people (N  = 12,995) reported their personal criteria about how much specific attributes, including the impact on others’ health risks, should influence their behavior. Compared with control conditions, people who engaged in structured reflection reported greater intentions to reduce business capacity (experiment 1) and avoid large social gatherings (experiments 2 and 3). They also donated more to provide vaccines to refugees (experiment 4). These effects emerged across seven countries that varied in collectivism and COVID-19 case rates (experiments 1 and 2). Structured reflection was distinct from instructions to carefully deliberate (experiment 3). Structured reflection increased the correlation between personal criteria and behavioral intentions (experiments 1 and 3). And structured reflection increased donations more among people who scored lower in cognitive reflection compared with those who scored higher in cognitive reflection (experiment 4). These findings suggest that structured reflection can effectively increase behaviors to reduce public health risks.
Engineering Pseudomonas aeruginosa arylsulfatase for hydrolysis of α-configured steroid sulfates
Authors: Stevenson Bradley J , Pranata Andy , McLeod Malcolm D
Published: October 2022

Steroid sulfate esters are important metabolites for anti-doping efforts in sports, pathology and research. Analysis of these metabolites is facilitated by hydrolysis using either acid or enzymatic catalysis. Although enzymatic hydrolysis is preferred for operating at neutral pH, no known enzyme is capable of hydrolyzing all steroid sulfate metabolites. Pseudomonas aeruginosa arylsulfatase (PaS) is ideal for the hydrolysis of β-configured steroid sulfates but like other known class I sulfatases it is inefficient at hydrolyzing α-configured steroid sulfates. We have used directed evolution with liquid chromatography mass spectrometry screening to find variants capable of hydrolyzing a α-configured steroid sulfate: etiocholanolone sulfate (ECS). After targeting two regions of PaS, four residues were identified and optimized to yield a final variant with a total of seven mutations (DRN-PaS) capable of hydrolyzing ECS ~80 times faster than the best PaS variant previously available. This DRN-PaS also shows improved activity for other α-configured steroid sulfates. Simultaneous mutagenesis was essential to obtain DRN-PaS due to complementarity between targeted residues.
Axisymmetric contact of two different power-law graded elastic bodies and an integral equation with two Weber–Schafheitlin kernels
Authors: Antipov Y A , Mkhitaryan S M
Published: October 2022

This article analyzes the axisymmetric contact problem of two elastic inhomogeneous bodies whose Young moduli are power functions of depth and the exponents are not necessarily the same. It is shown that the model problem is equivalent to an integral equation with respect to the pressure distribution whose kernel is a linear combination of two Weber–Schafheitlin integrals. The pressure is expanded in terms of the Jacobi polynomials, and the expansion coefficients are recovered by solving an infinite system of linear algebraic equations of the second kind. The coefficients of the system are represented through Mellin convolution integrals and computed explicitly. The Hertzian and Johnson–Kendall–Robertson adhesive models are employed to determine the contact radius, the displacement of distant points of the contacting bodies, the pressure distribution and the elastic normal displacement of surface points outside the contact circular zone. The effects of the exponents of the Young moduli and the surface energy density on the pressure distribution and the displacements are numerically analyzed.
Optimal Environmental Targeting in the Amazon Rainforest
Authors: Assunção Juliano , McMillan Robert , Murphy Joshua , Souza-Rodrigues Eduardo
Published: October 2022

This article sets out a data-driven approach for targeting environmental policies optimally in order to combat deforestation. We focus on the Amazon, the world’s most extensive rainforest, where Brazil’s federal government issued a “Priority List” of municipalities in 2008—a blacklist to be targeted with more intense environmental monitoring and enforcement. First, we estimate the causal impact of the Priority List on deforestation (along with other relevant treatment effects) using “changes-in-changes” due to Athey and Imbens (2006), finding that it reduced deforestation by 43$\%$ and cut emissions by almost 50 million tons of carbon. Second, we develop a novel framework for computing targeted optimal blacklists that draws on our treatment effect estimates, assigning municipalities to a counterfactual list that minimizes total deforestation subject to realistic resource constraints. We show that the ex post optimal list would result in carbon emissions over 10$\%$ lower than the actual list, amounting to savings of more than $ \$ $1.2 billion (34$\%$ of the total value of the Priority List), with emissions over 23$\%$ lower on average than a randomly selected list. The approach we propose is relevant both for assessing targeted counterfactual policies to reduce deforestation and for quantifying the impacts of policy targeting more generally.
iPSC-Derived Airway Epithelial Cells: Progress, Promise, and Challenges
Authors: Yu Fenggang , Liu Fei , Liang Xiaohua , Duan Linwei , Li Qiongqiong , Pan Ge , Ma Chengyao , Liu Minmin , Li Mingyue , Wang Peng , Zhao Xuening
Published: October 2022

Induced pluripotent stem cells (iPSCs) generated from somatic cell sources are pluripotent and capable of indefinite expansion in vitro. They provide an unlimited source of cells that can be differentiated into lung progenitor cells for potential clinical use in pulmonary regenerative medicine. This review gives a comprehensive overview of recent progress toward the use of iPSCs to generate proximal and distal airway epithelial cells and mix lung organoids. Furthermore, their potential applications and future challenges for the field are discussed, with a focus on the technological hurdles that must be cleared before stem cell therapeutics can be used for clinical treatment.
Molecular Characterization of Peronospora variabilis Isolates Infecting Chenopodium quinoa and Chenopodium album in Spain
Authors: Fondevilla Sara , Arias-Giraldo Luis F. , García-León Francisco Javier , Landa Blanca B.
Published: October 2022

Quinoa is an expanding crop in southern Spain. Downy mildew, caused by Peronospora variabilis, is the most important quinoa disease in Spain and worldwide. In Spain, this disease has also been observed on the weed Chenopodium album. The objectives of this study were to unravel the origin of the P. variabilis isolates currently infecting quinoa in southern Spain and to study their genetic diversity. We hypothesized that P. variabilis isolates infecting quinoa in Spain could have been introduced through the seeds of the quinoa varieties currently grown in the country or, alternatively, that these isolates are endemic isolates, originally infecting C. album, that jumped to quinoa. In order to test these hypotheses, we sequenced the internal transcribed spacer (ITS), cytochrome c oxidase subunit 1 (cox1), and cox2 regions of 33 P. variabilis isolates infecting C. quinoa and C. album in southern Spain and analyzed their phylogenetic relationship with isolates present in other countries infecting Chenopodium spp. cox1 gene sequences from all of the Spanish P. variabilis isolates were identical and exhibited nine single-nucleotide polymorphisms (SNPs) compared with a single P. variabilis cox1 sequence found at GenBank. Phylogenetic analyses based on the ITS ribosomal DNA region were not suitable to differentiate isolates according to their geographical origin or host. The cox2 sequences from P. variabilis Spanish isolates collected from C. quinoa and C. album were all identical and had a distinctive SNP in the last of four polymorphic sites that distinguished Spanish isolates from isolates from other countries. These results suggest that P. variabilis infecting quinoa in southern Spain could be native isolates that originally infected C. album.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Disentangling the signaling complexity of nerve growth factor receptors byCRISPR/Cas9
Authors: Testa Giovanna , Mainardi Marco , Vannini Eleonora , Pancrazi Laura , Cattaneo Antonino , Costa Mario
Published: October 2022

The binding of nerve growth factor (NGF) to the tropomyosin–related kinase A (TrkA) and p75NTRreceptors activates a large variety of pathways regulating critical processes as diverse as proliferation, differentiation, membrane potential, synaptic plasticity, and pain. To ascertain the details of TrkA‐p75NTRinteraction and cooperation, a plethora of experiments, mostly based on receptor overexpression or downregulation, have been performed. Among the heterogeneous cellular systems used for studying NGF signaling, the PC12 pheochromocytoma‐derived cell line is a widely used model. By means of CRISPR/Cas9 genome editing, we created PC12 cells lackingTrkA,p75NTR, or both. We found that TrkA‐null cells become unresponsive to NGF. Conversely, the absence of p75NTRenhances the phosphorylation of TrkA and its effectors. Using a patch‐clamp, we demonstrated that the individual activation of TrkA and p75NTRby NGF results in antagonizing effects on the membrane potential. These newly developed PC12 cell lines can be used to investigate the specific roles of TrkA and p75NTRin a genetically defined cellular model, thus providing a useful platform for future studies and further gene editing.
Chemoprophylactic Anticoagulation Following Lumbar Surgery Significantly Reduces Thromboembolic Events After Instrumented Fusions, Not Decompressions
Authors: Cloney Michael , Hopkins Benjamin , Dhillon Ekamjeet , El Tecle Najib , Koski Tyler R. , Dahdaleh Nader S.
Published: October 2022

Study Design:

Retrospective cohort

Objective.

To quantify any reduction in venous thromboembolic events (VTE) caused by chemoprophylaxis among lumbar surgery patients.

Summary of Background Data.

Chemoprophylactic anticoagulation (chemoprophylaxis) is used to prevent VTE after lumbar surgery. However, the treatment effect of chemoprophylaxis has not been reported among spine surgery patients, as conventional statistical methods preclude such inferences.

Methods.

1243 consecutive lumbar fusions and 1433 non-instrumented lumbar decompressions performed at our institution over a six-year period were identified, and clinical and demographic data were collected, including on VTE events within 30 days postoperatively. Instrumented lumbar fusions and non-instrumented lumbar surgeries were analyzed separately. Patients who were given chemoprophylaxis (treatment) and controls were matched according to known VTE risk factors, including age, body mass index, sex, diabetes, chronic kidney disease, history of VTE, estimated blood loss, length of surgery, transfusion, whether surgery was staged, and whether surgery used an anterior approach. K-nearest neighbor propensity score matching was performed, and the treatment effect of chemoprophylaxis was calculated.

Results.

Unadjusted, there was no difference in the rate of VTE between treatment and controls in either population. Baseline clinical and demographic characteristics differed significantly between treatment and control groups. 575 lumbar fusion patients and 435 non-instrumented lumbar decompression patients were successfully propensity score matched, yielding balanced models (Rubin’s B<25, 0.5<Rubin’s R<2.0) and >60% reduction in known bias for both populations. The treatment effect of chemoprophylaxis after lumbar fusion in our patient population was a reduction in VTE incidence from 9.4% to 4.2% (P<0.05), and propensity score adjusted regression confirmed a reduced odds of VTE with chemoprophylaxis (OR=0.37, P=0.035). The treatment effect was not significant for non-instrumented lumbar decompression patients.

Conclusion.

Among patients undergoing instrumented lumbar fusions, chemoprophylactic anticoagulation causes a significant reduction in VTE, but causes no significant reduction among patients undergoing non-instrumented lumbar decompression.
Impact of Health Literacy on Self-Reported Health Outcomes in Spine Patients
Authors: Lans Amanda , Bales John R. , Borkhetaria Pranati , Schwab Joseph H. , Verlaan Jorrit-Jan , Rossi Laura P. , Tobert Daniel G.
Published: October 2022

Study Design.

Cross-sectional survey study.

Objective.

The aim was to determine if health literacy level is associated with patient-reported outcomes and self-reported health status among patients presenting to an academic outpatient spine center.

Summary of Background Data.

Patient reports are critical to assessing symptom severity and treatment success in orthopedic spine patients. Patient-reported outcome measures (PROMs) are important instruments commonly used for this purpose. However, the influence of patient health literacy on PROMs has not yet been given much consideration in spine literature.

Materials and Methods.

Consecutive English-speaking patients over the age of 18 years and new to our clinic verbally completed the Newest Vital Sign health literacy assessment tool and a sociodemographic survey, including self-reported health status. In addition, seven Patient-Reported Outcomes Measurement Information System scores were extracted from patient records. Regression modeling was performed with PROMs considered as dependent variables, health literacy level as the primary predictor, and all other factors (age, sex, race, ethnicity, native English speaker, highest educational degree, grade-level reading, marital status, employment status, annual household income, and type of insurance) as covariates.

Results.

Among the 318 included patients, 33% had limited health literacy. Adjusted regression analysis demonstrated that patients with limited health literacy had worse PROM scores across all seven domains (Physical Function: P=0.028; Depression: P=0.035; Global Health—Physical: P=0.001; Global Health—Mental: P=0.007; Pain Interference: P=0.036; Pain Intensity: P=0.002; Anxiety: P=0.047). In addition, patients with limited health literacy reported worse self-reported health status (P<0.001).

Conclusions.

Spine patients with limited health literacy have worse baseline PROM scores confounders and report worse general health. Further investigations are necessary to elucidate if limited health literacy is a marker or the root cause of these disparities. Findings from this study urge the consideration of patient health literacy when interpreting PROMs as well as the implications for patient assessment and discussion of treatment options.
Neurological Safety of Endoscopic Transforaminal Lumbar Interbody Fusion: A Magnetic Resonance Neurography Study
Authors: Yang Xinyu , Wang Lianlei , Yang Qing , Su Junxiao , Qiu Cheng , Ibrahim Yakubu , Yuan Suomao , Tian Yonghao , Liu Xinyu
Published: October 2022

Objective.

A magnetic resonance neurography (MRN) study was conducted to assess the neurological safety of endoscopic transforaminal lumbar intervertebral fusion (endo-TLIF).

Materials and Methods.

A total of 56 healthy volunteers (29 men, 27 women; average age, 44 yr; age range, 21–60 yr) were included in the study. Coronal MRN images were collected from L2/L3 to L5/S1. The working triangle, modified working zone, and safest working zone areas, as well as the vertical and horizontal safe operation diameters, were measured. Linear regression analyses were conducted to explore the correlations between general characteristics (sex, age, height, body mass index) and the measured radiographic indicators.

Results.

MRN can effectively evaluate the operation zone of endo-TLIF. The safest working zone, modified working zone, and working triangle areas were largest at L4/L5 (92.4±23.4, 136±35.6, and 197±41.7 mm2, respectively) and smallest at L2/L3 (45.5±12.9, 68.1±19.5, and 92.6±24.4 mm2, respectively). The vertical safe operation diameter was large at L4/L5 and L2/L3 (5.34±0.8 and 5.42±0.9 mm, respectively) and smallest at L5/S1 (2.94±0.9 mm). The horizontal safe operation diameter was large at L4/L5 (7.28±1.2 mm) and smaller at L5/S1 and L2/L3 (4.28±1.0 and 4.77±0.8 mm, respectively).

Conclusions.

L4/L5 has the lowest risk of nerve injury, and may be the safest level for beginners initiating endo-TLIF in their practice. We recommend that coronal MRN is routinely performed before endo-TLIF to minimize the risk of neurological injury.
Safety and Accuracy of Freehand Pedicle Screw Placement and the Role of Intraoperative O-arm: A Single Institution Experience
Authors: Alomari Safwan , Lubelski Daniel , Lehner Kurt , Tang Anthony , Wolinsky Jean-Paul , Theodore Nicholas , Sciubba Daniel M. , Larry Lo Sheng-fu , Belzberg Allan , Weingart Jon , Witham Timothy , Gokaslan Ziya L. , Bydon Ali
Published: October 2022

Study Design:

Retrospective cohort study.

Objective:

To investigate the accuracy of pedicle screw placement by freehand technique and to compare revision surgery rates among three different imaging verification pathways.

Summary of Background Data:

Studies comparing different imaging modalities in freehand screw placement surgery are limited.

Methods:

A single-institution retrospective chart review identified adult patients who underwent freehand pedicle screw placement in the thoracic, lumbar or sacral levels. Patients were stratified into three cohorts based on the intraoperative imaging modality used to assess the accuracy of screw position: intraoperative X-Rays (cohort 1); intraoperative O-arm (cohort 2); or intraoperative CT-scan (cohort 3). Postoperative CT-scans were performed on all patients in cohorts 1 and 2. Postoperative CT-scan was not required in cohort 3. Screw accuracy was assessed using the Gertzbein-Robbins grading system.

Results:

9,179 pedicle screws were placed in the thoracic or lumbosacral spine in 1311 patients. 210 (2.3%) screws were identified as Gertzbein-Robbins grades C-E on intra/post-operative CT-scan, 137 thoracic screws , and 73 lumbar screws (P<0.001). 409 patients underwent placement of 2,754 screws followed by intraoperative X-Ray (cohort 1); 793 patients underwent placement of 5,587 screws followed by intraoperative O-arm (cohort 2); and 109 patients underwent placement of 838 screws followed by intraoperative CT-scan (cohort 3). Postoperative CT-scans identified 65 (2.4%) and 127 (2.3%) malpositioned screws in cohorts 1 and 2, respectively. 11 screws (0.12%) were significantly malpositioned and required a second operation for screw revision. 9 patients (0.69%) required revision operations: 8 of these patients were from cohort 1 and 1 patient was from cohort 2.

Conclusion:

When compared to intraoperative X-Ray, intraoperative O-arm verification decreased the revision surgery rate for malpositioned screws from 0.37% to 0.02%. In addition, our analysis suggests that the use of intraoperative O-arm can obviate the need for postoperative CT scans.
Emerging Treatment Approaches to Improve Outcomes in Patients with Heart Failure
Authors: Greenberg Barry H.
Published: October 2022

Heart failure (HF) is a major public health problem around the world. Although currently available therapies have improved outcomes, morbidity and mortality in patients with HF remain unacceptably high. Most guideline-recommended therapies for HF are indicated for patients with a reduced left ventricular ejection fraction (HFrEF). Until recently, treatment options that improved outcomes in patients with HF and preserved left ventricular ejection fraction or mildly reduced ejection fraction were limited. Over the past several years, however, several new drugs including angiotensin receptor neprilysin inhibitors (ARNIs), sodium glucose cotransporter 2 inhibitors (SGLT2 inhibitors), soluble guanylate cyclase stimulators, and a cardiac myotrope, omecamtiv mecarbil have all reported positive results in pivotal phase III clinical trials. Moreover, the results of these studies have provided evidence that both ARNIs and SGLT2 inhibitors can improve clinical outcomes in patients with HF across a broad spectrum of LVEF, not just in HFrEF. This article presents the rationale for the use of each of these 4 new classes of drugs, reviews the results from pivotal clinical trials showing their safety and efficacy, and provides a framework for how each drug has begun to be integrated into new HF management guidelines. Collectively, these new drugs provide hope for the millions of patients around the world who suffer from HF.
Disability-adjusted life years and the trends of the burden of colorectal cancer: a population-based study in Shanghai, China during 2002 to 2016
Authors: Zhong Wei , Chen Liping , Li Xiaopan , Chen Yichen , Zhang Yao , Guo Canjie , Shen Yufeng , Chen Huimin
Published: October 2022

Backgrounds:

Colorectal cancer (CRC) still ranks the top in morbidity and mortality of cancers worldwide, posing a huge threat and burden to the society. We aimed to determine the age-standardized incidence, mortality, and disability-adjusted life years (DALYs) of CRC and explore potential changes in the temporal trends of the CRC burden in Shanghai during 2002 to 2016.

Methods:

The cancer statistics and demographics were obtained from the Cancer Registry and the Statistics Bureau of Pudong New Area, respectively. Data from 2002 to 2016 were included and analyzed retrospectively. DALYs were calculated using DisMod and the age-standardized rates (ASRs) were obtained according to Segi world standard population. Joinpoint regression was used to measure the trends in CRC incidence and to estimate the annual percent change.

Results:

The increasing trend of CRC ASR incidence halted after 2014, coinciding with the introduction of the Shanghai CRC screening program. The ASRs of mortality and DALYs increased, at 0.42% (P < 0.05) and 4.07% (P < 0.001) per year, respectively, which were mainly driven by men and individuals aged above the CRC screening program target.

Conclusions:

The disease burden of CRC in Shanghai remains serious, especially among men, and individuals aged >74 years. The benefits of the screening program have been partially proven by the ASRs of CRC incidence, providing important insights into better and wider application of screening programs.
Pharmacodynamic Monitoring of Ciclosporin and Tacrolimus: Insights From Nuclear Factor of Activated T-Cell–Regulated Gene Expression in Healthy Volunteers
Authors: Djaelani Yoana Aurelia , Giese Thomas , Sommerer Claudia , Czock David
Published: October 2022

Background:

Although therapeutic drug monitoring of calcineurin inhibitor (CNI) concentrations is performed routinely in clinical practice, an identical concentration may lead to different effects in different patients. Although the quantification of nuclear factor of activated T-cell–regulated gene expression (NFAT-RGE) is a promising method for measuring individual CNI effects, CNI pharmacodynamics are as of yet incompletely understood.

Methods:

CNI concentrations and NFAT-RGEs were quantified in 24 healthy volunteers receiving either ciclosporin or tacrolimus in 2 clinical trials. NFAT-RGE was measured using quantitative reverse transcription polymerase chain reaction tests of whole-blood samples. Pharmacokinetics and pharmacodynamics were analyzed using compartmental modeling and simulation. In addition, NFAT-RGE data from renal transplant patients were analyzed.

Results:

The average NFAT-RGE during a dose interval was reduced to approximately 50% with ciclosporin, considering circadian changes. The different effect–time course with ciclosporin and tacrolimus could be explained by differences in potency (IC50 204 ± 41 versus 15.1 ± 3.2 mcg/L, P < 0.001) and pharmacokinetics. Residual NFAT-RGE at the time of maximum concentration (RGEtmax) of 15% when using ciclosporin and of 30% when using tacrolimus was associated with similar average NFAT-RGEs during a dose interval. Renal transplant patients had similar but slightly stronger effects compared with healthy volunteers.

Conclusions:

Ciclosporin and tacrolimus led to similar average suppression of NFAT-RGE in a dose interval, despite considerably different RGEtmax. Pharmacodynamic monitoring of average NFAT-RGE should be considered. When using NFAT-RGE at specific time points, the different effect–time courses and circadian changes of NFAT-RGEs should be considered.
Influence of Genetic Polymorphisms on the Pharmacokinetics of Trazodone Hydrochloride: A Scoping Review and Future Perspective
Authors: Meulman Jessica , Visacri Marília Berlofa , Moriel Patricia , Pincinato Eder de Carvalho
Published: October 2022

Background:

Trazodone hydrochloride is an antidepressant used in clinical practice. As a substrate of cytochrome P450 enzymes that is vulnerable to P-glycoprotein transport, several factors can alter its plasma concentration, and hence, dose adjustment may be required. The aim of this scoping review was to identify genetic polymorphisms that influence the pharmacokinetics of trazodone hydrochloride.

Methods:

A literature search was performed using PubMed, PubMed Central, BVS/BIREME, EBSCOhost, Web of Science, Embase, Cochrane Library, and Medline databases for studies published until August 2021. The search strategy was based on the following keywords: Trazodone OR “m-chlorophenyl piperazine” AND “Pharmacogenetics” OR “Genetics” OR “Cytochrome P-450 Enzyme System” OR “Polymorphism, Single Nucleotide” OR “Polymorphism, Genetic.”

Results:

The search retrieved 684 candidate articles; 307 duplicates were eliminated. In total, 377 articles were eligible for the first screen. However, only 4 met the eligibility criteria, and 12 polymorphisms in 5 different genes (CYP2D6, CYP1A2, CYP3A4, CYP3A5, and ABCB1). Notably, only C3435T ABCB1 influenced the pharmacokinetics of trazodone hydrochloride. Individuals with the T/T genotype had lower area under the curve, half-life, and maximum concentration values with a higher clearance rate.

Conclusions:

Polymorphisms in CYP450 do not seem to directly influence the pharmacokinetics of trazodone hydrochloride or its metabolites. By contrast, genetic polymorphisms in ABCB1 seem to have an important effect on the pharmacokinetics of trazodone hydrochloride by enhancing drug metabolism and elimination.
Microsurgical Complications after Finger Reimplantation Treated with Negative Pressure Wound Therapy: A Case Report
Authors: Quintero Jorge I. , Moreno-Serrano Constanza , Bermúdez Julio C. ,   Hand and Microsurgery Research Group
Published: October 2022

Venous congestion is the most critical complication following microsurgical finger replantation and can present within the first postoperative days or even in the immediate postoperative period. This is a case series of three patients who underwent digit replantation. The postoperative complication was venous congestion, and immediately, negative pressure wound therapy (NPWT) was applied to reduce the risk of failure. Three patients with a range of 35 years of age were included. One index finger, one thumb, and one ring finger were the fingers amputated; the surgical technique was described; our anticoagulant protocol was demonstrated; and finally, standardization of the NPWT was established. At the end of the therapy, all fingers survived. We concluded that NPWT is an excellent treatment option following the identification of venous congestion in digit replantation.
A Technical Guide for Sciatic Nerve Targeted Muscle Reinnervation in a Transfemoral Amputee
Authors: Lister Rachel C. , Tsui Jane M. , Naram Aparajit
Published: October 2022

Background:

There are approximately 2 million people living with the loss of a major limb in America. It is estimated that 95% of these will have some form of pain associated with their amputation. Phantom limb pain, related to symptomatic neuromas, contributes to amputation morbidity and can be difficult to treat. Studies have shown that targeted muscle reinnervation (TMR), by giving symptomatic neuromas “somewhere to go and something to do,” can be an effective therapy. However, a large proportion of surgeons still treat symptomatic neuromas by burying them in nearby tissue.

Methods:

We treated a patient with previous above-the-knee amputation, complicated by a symptomatic neuroma, with TMR. We identified and described nine steps to the procedure. Our description is accompanied by illustrative, intraoperative photographs and technical pearls.

Results:

This article provides a description of TMR technique involving a neuroma of the sciatic nerve and its branches, to treat an above-the-knee amputation, with the aim of making this approach more accessible. At 9-month follow-up, the patient had active firing of the recipient muscles with donor nerve stimulation indicating successful reinnervation. The patient continued to report stump pain, but with intermittent pain-free days.

Conclusions:

TMR has proven potential as a therapy for amputation-related, neuropathic pain. With this technical guide to TMR, surgeons should feel more comfortable adding this technique to their armamentarium, to be utilized either at the time of amputation or as a secondary measure.
To Do or Not to Do? Neurorrhaphy in Great Toe Pulp Flap Fingertip Reconstruction
Authors: Troisi Luigi , Stucchi Sara , Vizcay Macarena , Zanchetta Francesco , Baez Antonio , Parjardi Eugenio Eugenio
Published: October 2022

Background:

Since its inception, the great toe pulp (GTP) flap has represented a valid therapeutic choice in the reconstruction of defects of the hand. This study illustrates the clinical outcomes of GTP free flaps performed without nerve anastomosis‚ mainly for fingertip defect reconstruction.

Methods:

We performed a retrospective, monocentric cohort study. All patients included in this study presented with fingertip traumatic injury, with tendon or bone exposure; reconstruction with GTP flap, without nerve reconstruction, was performed by the first author (L.T.) from May 2019 to October 2021.

Results:

All 37 flaps survived completely. Due to COVID restrictions‚ we had to send the tests and PROMs to our patients; 28 of them replied. Cold intolerance was reported by 12 patients (moderate in two cases and mild in ten cases). No pain was complained about either in hand or donor site (Visual Analog Score 0, at rest and at movement). Complete range of motion was achieved in 22 of 28 patients. All flaps recovered protective sensitivity. In every section of the Michigan Hand Outcome Questionnaire, all patients expressed a high level of satisfaction based on the reconstruction’s function and aesthetics. Regarding the donor site morbidity, no patient complained about gait disturbance.

Conclusions:

This study showed that the GTP flap is the optimal choice for fingertip reconstruction, providing excellent functional and aesthetic results with durable and glabrous skin, satisfactory pulp contour, and sensory restoration. These results could be achieved with no need for nerve suture, especially in defects with no injuries proximal to the loss of substance.
Assault-related Orbital Trauma at an Urban Level I Trauma Center: Racial Segregation and Other Neighborhood-level Social Determinants
Authors: Mancera Norberto , Do D. Phuong , Griepentrog Gregory J. , Esmaili Neda
Published: October 2022

Purpose:

To report the demographics of assault-related orbital fractures over a 7-year period treated at a level I urban trauma center, as well as describe and analyze the variation in assault rates across different racial/ethnic neighborhoods for patients residing in Milwaukee County.

Methods:

A retrospective chart review was conducted for patients who sustained assault-related orbital fractures from January 1, 2013, through December 31, 2019, at the Froedtert & Medical College of Wisconsin, in Milwaukee, Wisconsin. A series of negative binomial regression models evaluating the association of neighborhood (i.e., US census tract) racial/ethnic composition, poverty, unemployment, percentage female head-of-household, and education level with neighborhood rate of orbital trauma was conducted.

Results:

A total of 410 adult patients with orbital fractures attributed to assault were identified during the seven-year period, of whom 326 (80%) resided in Milwaukee County. Among these patients, 242 (74%) were male, 260 (81%) were single, and 206 (63%) were non-Hispanic Black. Majority non-Hispanic Black, Hispanic, and Other-type minority neighborhoods have 5.30, 3.35, and 3.94 times higher incidence rates of orbital assault, respectively, compared with the majority of non-Hispanic White neighborhoods. The elevated incidence rates were significantly attenuated across all minority neighborhoods after accounting for neighborhood factors of poverty, unemployment, and low education level. Low education had the strongest association with the incidence of assault-related orbital fractures, followed by unemployment.

Conclusions:

Results indicate that minority neighborhoods suffer from compounded burdens of both social and economic disadvantage as well as violent assaults. Additional resources allocated to poor minority communities are needed.
Burden of pemphigus vulgaris with a particular focus on women: A review
Authors: Kianfar Nika , Dasdar Shayan , Mahmoudi Hamidreza , Daneshpazhooh Maryam
Published: October 2022

Pemphigus vulgaris is a chronic autoimmune mucocutaneous blistering disorder. Apart from the disease itself, other aspects of patients’ life, including psychological, social, and financial, can be affected. Women are particularly more disposed to the impact of the disease due to their physiological characteristics, the specific periods of pregnancy and lactation as well as their social and familial role. In this review, we summarized the burden of pemphigus vulgaris on various aspects of women’s lives. It is essential to understand these problems and provide appropriate support for patients with such a burdensome disease.
Comparing the outcomes of YAG laser anterior capsulotomies performed by an advanced nurse practitioner to ophthalmologists in the management of anterior capsular contraction syndrome
Authors: Moussa George , Ch'ng Soon Wai , Kalogeropoulos Dimitrios , Abdel-Karim Ziad , Panthagani Jesse , Andreatta Walter
Published: October 2022

Background:

Anterior capsular contraction syndrome (ACCS) describes the progressive fibrotic phimosis of the anterior capsular bag that usually occurs a few months after cataract surgery. YAG laser anterior capsulotomy (YAGAC) is the most common treatment option due to the low-risk profile of this intervention.

Purpose:

In this series, we evaluated the outcomes of an advanced nurse practitioner (ANP) in conducting this laser intervention, comparing the results with those of ophthalmologists.

Methodology:

Our study represents a single-centre, retrospective, continuous case series of 108 eyes that underwent YAGAC due to ACCS between January 2017 and July 2020 at the Birmingham and Midland Eye Centre, the second largest tertiary referral centre in the United Kingdom.

Results:

The groups treated by ANPs and ophthalmologists were similar in respect to age, gender, and laterality of the laser procedure. Eyes treated by ophthalmologists had significantly more ocular comorbidities (p < .001), the most common of which was glaucoma. Although the complication rate was higher in the ophthalmologist group, it did not reach statistical significance. However, there was a trend toward significance in the retreatment rate, with 8.6% (7/81) of eyes lasered by ophthalmologists requiring further YAGAC, and no repeat procedure was needed in the ANP group.

Conclusions:

YAGAC leads to good visual outcomes and a low complication rate in both ophthalmologist and ANP groups.

Implications:

Advanced nurse practitioners can deliver results that are comparable with those of experienced ophthalmologists.
Health care utilization in a nurse practitioner–led atrial fibrillation clinic
Authors: Meyer David B. , Larkins Michael C. , Taha Omar , Seiler Amber , Booth Sheryl , Hokanson Robert B. , Allred James
Published: October 2022

Background:

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is emerging in prevalence with an increasingly aging population. The complex nature of the disease and its association with significant morbidity and mortality has resulted in a call for a new integrative, multidisciplinary approach to AF management.

Purpose:

Determine if the use of a nurse practitioner (NP)–led AF clinic (NPAFC) can improve care for patients.

Methodology:

An NPAFC was designed to serve as an independent clinic for standardizing patient care and improving access to care. Baseline patient demographics, care pathway, and interventions were characterized in clinic. Primary outcomes were hospitalizations and emergency department (ER) visits, before and after clinic implementation.

Results:

Overall, 1,442 patients were enrolled in the AF clinic between January 2016 and June 2018. The mean age at the first AF clinic visit was 68.7 ± 12.6 years, 54% were male, and the mean body mass index was 31 ± 7 kg/m2. Among the patients, 45.2% had paroxysmal AF, 43.6% persistent AF, and 5.5% permanent AF. With an average of 3 ± 3 clinic visits per patient, the number of patients with ≥1 hospitalization decreased by 78% after clinic implementation. Similarly, the number of patients with ≥1 ER visit decreased by 79%, and 22.7% of patients avoided at least one ER visit.

Conclusions:

The number of patients with ≥1 hospitalization or ≥1ER visit decreased within two years after the implementation of an NPAFC.

Implications:

Implementation of an NP-led AF clinic in the United States may reduce hospitalizations and ER visits if implemented in an integrative model.
Consideration of the emergency nurse practitioner as a population within the APRN Consensus Model: A SWOT analysis
Authors: Wilbeck Jennifer , Schumann Lorna , Comer Amanda , Davis Wesley
Published: October 2022

After adoption of the 2008 Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation, evolution of the nurse practitioner (NP) role and emergency NP (ENP) specialty has outpaced regulatory standards. Lack of uniformity among regulators, health insurance providers, and employers in acknowledging the ENP specialty has created barriers to practice and access to care. This article serves to identify potential outcomes if the ENP specialty was transitioned to a population within the Consensus Model of Regulation. A strengths, weaknesses, opportunities, and threats (SWOT) analysis methodology was used to assess ENP specialty current state, specifically focusing on the licensure, accreditation, certification, and education model for APRN regulation. The data were collected from peer-reviewed literature, clinical subject-matter experts, and academic and advanced practice executive leaders. Variances in ENP licensure, recognition, and acknowledgment among State Boards of Nursing leave the ENP specialty in a precarious position. For each of the strengths and opportunities that could exist in recognizing the ENP at the population level of the Consensus Model, there are abundant weaknesses and threats. Although full acknowledgment of the ENP specialty is lacking, regulatory implications are highly variable, and employers' understanding of the APRN educational model is limited, our findings reveal that the ENP specialty is an evolving role that deserves regulatory legitimization. Although ideal placement for the ENP within the Consensus Model remains to be determined, challenges and opportunities exist with both specialty and population options.