bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypersensitivity-Related Genes HSR201 and HSR203J Are Regulated by Calmodulin-Binding Protein 60-Type Transcription Factors and Required for Pathogen Signal-Induced Salicylic Acid Synthesis
Authors: Takagi Kumiko , Tasaki Kosuke , Komori Hirotomo , Katou Shinpei
Published: June 2022

Salicylic acid (SA) plays a key role in plant resistance to pathogens. In Arabidopsis, the isochorismate synthase pathway mainly contributes to pathogen-induced SA synthesis, and the expression of SA synthesis genes is activated by two calmodulin (CaM)-binding protein 60 (CBP60)-type transcription factors, CBP60g and SARD1. In tobacco, the mechanisms underlying SA synthesis remain largely unknown. SA production is induced by wounding in tobacco plants in which the expression of two stress-related mitogen-activated protein kinases is suppressed. Using this phenomenon, we identified genes whose expression is associated with SA synthesis. One of the genes, NtCBP60g, showed 23% amino acid sequence identity with CBP60g. Transient overexpression of NtCBP60g as well as NtSARD1, a tobacco homolog of SARD1, induced SA accumulation in Nicotiana benthamiana leaves. NtCBP60g and NtSARD1 bound CaM, and CaM enhanced SA accumulation induced by NtCBP60g and NtSARD1. Conversely, mutations in NtCBP60g and NtSARD1 that abolished CaM binding reduced their ability to induce SA. Expression profiling and promoter analysis identified two hypersensitivity-related genes, HSR201 and HSR203J as the targets of NtCBP60g and NtSARD1. Virus-induced gene silencing of both NtCBP60g and NtSARD1 homologs compromised SA accumulation and the expression of HSR201 and HSR203J homologs, which were induced by a pathogen-derived elicitor in N. benthamiana leaves. Moreover, elicitor-induced SA accumulation was compromised by silencing of the HSR201 homolog and the HSR203J homolog. These results suggested that HSR201 and HSR203J are regulated by NtCBP60g and NtSARD1 and are required for elicitor-induced SA synthesis.
Dwarf and High Tillering1 represses rice tillering through mediating the splicing of D14 pre-mRNA
Authors: Liu Tianzhen , Zhang Xin , Zhang Huan , Cheng Zhijun , Liu Jun , Zhou Chunlei , Luo Sheng , Luo Weifeng , Li Shuai , Xing Xinxin , Chang Yanqi , Shi Cuilan , Ren Yulong , Zhu Shanshan , Lei Cailin , Guo Xiuping , Wang Jie , Zhao Zhichao , Wang Haiyang , Zhai Huqu , Lin Qibing , Wan Jianmin
Published: June 2022

Strigolactones (SLs) constitute a class of plant hormones that regulate many aspects of plant development, including repressing tillering in rice (Oryza sativa). However, how SL pathways are regulated is still poorly understood. Here, we describe a rice mutant dwarf and high tillering1 (dht1), which exhibits pleiotropic phenotypes (such as dwarfism and increased tiller numbers) similar to those of mutants defective in SL signaling. We show that DHT1 encodes a monocotyledon-specific hnRNP-like protein that acts as a previously unrecognized intron splicing factor for many precursor mRNAs (pre-mRNAs), including for the SL receptor gene D14. We find that the dht1 (DHT1I232F) mutant protein is impaired in its stability and RNA binding activity, causing defective splicing of D14 pre-mRNA and reduced D14 expression, and consequently leading to the SL signaling-defective phenotypes. Overall, our findings deepen our understanding of the functional diversification of hnRNP-like proteins and establish a connection between posttranscriptional splicing and SL signaling in the regulation of plant development.
Multi-omic analysis showsREVEILLEclock genes are involved in carbohydrate metabolism and proteasome function
Authors: Scandola Sabine , Mehta Devang , Li Qiaomu , Rodriguez Gallo Maria Camila , Castillo Brigo , Uhrig Richard Glen
Published: June 2022

Plants are able to sense changes in their light environments, such as the onset of day and night, as well as anticipate these changes in order to adapt and survive. Central to this ability is the plant circadian clock, a molecular circuit that precisely orchestrates plant cell processes over the course of a day. REVEILLE (RVE) proteins are recently discovered members of the plant circadian circuitry that activate the evening complex and PSEUDO-RESPONSE REGULATOR genes to maintain regular circadian oscillation. The RVE8 protein and its two homologs, RVE 4 and 6 in Arabidopsis (Arabidopsis thaliana), have been shown to limit the length of the circadian period, with rve 4 6 8 triple-knockout plants possessing an elongated period along with increased leaf surface area, biomass, cell size, and delayed flowering relative to wild-type Col-0 plants. Here, using a multi-omics approach consisting of phenomics, transcriptomics, proteomics, and metabolomics we draw new connections between RVE8-like proteins and a number of core plant cell processes. In particular, we reveal that loss of RVE8-like proteins results in altered carbohydrate, organic acid, and lipid metabolism, including a starch excess phenotype at dawn. We further demonstrate that rve 4 6 8 plants have lower levels of 20S proteasome subunits and possess significantly reduced proteasome activity, potentially explaining the increase in cell-size observed in RVE8-like mutants. Overall, this robust, multi-omic dataset provides substantial insight into the far-reaching impact RVE8-like proteins have on the diel plant cell environment.
Recent Advances in Neuroimaging Techniques to Assist Clinical Trials on Cell-Based Therapies in Neurodegenerative Diseases
Authors: Wilson Heather , de Natale Edoardo Rosario , Politis Marios
Published: June 2022

Neurodegenerative diseases, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD), are progressive disorders for which curative therapy is still lacking. Cell-based therapy aims at replacing dysfunctional cellular populations by repairing damaged tissue and by enriching the microenvironment of selective brain areas, and thus constitutes a promising disease-modifying treatment of neurodegenerative diseases. Scientific research has engineered a wide range of human-derived cellular populations to help overcome some of the logistical, safety, and ethical issues associated with this approach. Open-label studies and clinical trials in human participants have used neuroimaging techniques, such as positron emission tomography (PET) and magnetic resonance imaging (MRI), to assess the success of the transplantation, to evaluate the functional integration of the implanted tissue into the host environment and to understand the pathophysiological changes associated with the therapy. Neuroimaging has constituted an outcome measure of large, randomized clinical trials, and has given answers to clarify the pathophysiology underlying some of the complications linked with this therapy. Novel PET radiotracers and MRI sequences for the staging of neurodegenerative diseases and to study alterations at the molecular level significantly expands the translational potential of neuroimaging to assist pre-clinical and clinical research on cell-based therapy in these disorders. This concise review summarizes the current use of neuroimaging in human studies of cell-based replacement therapy and focuses on the future applications of PET and MRI techniques to evaluate the pathophysiology and treatment efficacy, as well as to aid patient selection and as an outcome measure to improve treatment success.
Normalization of maternal adiponectin in obese pregnant mice prevents programming of impaired glucose metabolism in adult offspring
Authors: Dumolt Jerad , Powell Theresa L. , Jansson Thomas , Rosario Fredrick J.
Published: June 2022

Infants born to obese mothers have a greater risk for childhood obesity and insulin resistance. However, the underlying biological mechanism remains elusive, which constitutes a significant roadblock for developing specific prevention strategies. Maternal adiponectin levels are lower in obese pregnant women, which is linked with increased placental nutrient transport and fetal overgrowth. We have previously reported that adiponectin supplementation to obese dams during the last four days of pregnancy prevented the development of obesity, glucose intolerance, muscle insulin resistance, and fatty liver in three months old offspring. In the present study, we tested the hypothesis that 6–9‐month‐old offspring of obese dams show glucose intolerance associated with muscle insulin resistance and mitochondrial dysfunction and that normalization of maternal adiponectin in obese pregnant mice prevents the development of this phenotype in the offspring. Male and female offspring of obese mice exhibited in vivo glucose intolerance and insulin resistance at 6 and 9 months of age. In gastrocnemius muscles ex vivo, male and female offspring of obese dams showed reduced phosphorylation of insulin receptor substrate 1Tyr‐608, AktThr‐308, and decreased Glut4 plasma membrane translocation upon insulin stimulation. These metabolic abnormalities in offspring born to obese mice were largely prevented by normalization of maternal adiponectin levels in late pregnancy. We provide evidence that low circulating maternal adiponectin is a critical mechanistic link between maternal obesity and the development of metabolic disease in offspring. Strategies aimed at improving maternal adiponectin levels may prevent long‐term metabolic dysfunction in offspring of obese mothers.
Academic Faculty Shadowing Their Graduate Nurses
Authors: Mau Kathleen A. , Kavanagh Joan , Burchill Christian N. , Siedlecki Sandra L.
Published: June 2022

AIM

The purpose of this study was to describe insights gained by academic nursing faculty after shadowing one of their new graduate nurses.

BACKGROUND

Shadowing experiences have been successfully used to orient students and new nurses to the role and reality of clinical practice. However, no studies were found on the experience of faculty shadowing a new graduate. This study addressed that gap.

METHOD

A case series design and methodology used both qualitative and quantitative data collection procedures. Qualitative data were derived from faculty during a debriefing session; quantitative data were obtained from a short survey completed by new graduates and faculty.

RESULTS

Faculty identified challenges faced by new graduates and opportunities to modify their nursing programs by addressing patient care delivery, time management, communication, and role ambiguity in more detail.

CONCLUSION

A shadowing experience for academic faculty leaders can help bridge the academic-practice gap and promote collaborative efforts to improve preparation for practice.
Factors Which May Contribute to the Success or Failure of the Use of Mother's Own Milk in a Level IV Neonatal Intensive Care Unit
Authors: D'Ambrosio Mary Ann , Gabrielski Lisbeth , Melara Diane , Pickett Kaci , Pan Zhaoxing , Neu Madalynn
Published: June 2022

Background:

Benefits of mother's own milk (MOM) for infants in neonatal intensive care units (NICUs) are well known. Many mothers provide for their infant's feedings during their entire hospitalization while others are unable. Knowledge is limited about which infant and maternal factors may contribute most to cessation of MOM feedings.

Purpose:

Study aims were to (1) identify which maternal and infant risk factors or combination of factors are associated with cessation of provision of MOM during hospitalization, (2) develop a lactation risk tool to identify neonatal intensive care unit infants at higher risk of not receiving MOM during hospitalization, and (3) identify when infants stop receiving MOM during hospitalization.

Methods:

A data set of 797 infants admitted into a level IV neonatal intensive care unit before 7 days of age, whose mothers chose to provide MOM, was created from analysis of data from the Children's Hospital Neonatal Database. Maternal and infant factors of 701 dyads who received MOM at discharge were compared with 87 dyads who discontinued use of MOM by discharge using χ2, t tests, and Wilcoxon rank tests. Logistic regression was used to build a risk-scoring model.

Results:

The probability of cessation of MOM increased significantly with the number of maternal–infant risk factors. A Risk Calculator was developed to identify dyads at higher risk for cessation of MOM by discharge.

Implications for Practice:

Identifying mothers at risk for cessation of MOM can enable the healthcare team to provide optimal lactation management and outcomes.

Implications for Research:

Although the Risk Calculator has potential to identify dyads at risk of early MOM cessation, further research is needed to validate these results.
Temporal and Directional Cue Effects on the Cocktail Party Problem for Patients With Listening Difficulties Without Clinical Hearing Loss
Authors: Kawase Tetsuaki , Teraoka Ryo , Obuchi Chie , Sakamoto Shuichi
Published: June 2022

Objectives:

To evaluate the listening difficulty in a cocktail party environment in the sound field in order to better demonstrate patients’ difficulties listening in noise, and to examine temporal and directional cue effects on the speech intelligibility in patients with listening difficulties in noise in comparison with control subjects.

Design:

This study examined and analyzed 16 control subjects without any complaints of listening difficulties and 16 patients who had visited the outpatient clinic of the Department of Otolaryngology-Head and Neck Surgery, Tohoku University Hospital, with complaints of listening difficulties, especially in background crowded conditions, despite having relatively good hearing on routine audiograms and speech audiometry. Using five loudspeakers located in front of the subject and at 30° and 60° to the left and right from the front, word intelligibility for the target voice (female talker) presented from one of the loudspeakers in random order with four distractor voices (male talker) was assessed under the following cue conditions: (1) “no additional temporal/directional cue (only talker sex as a cue)”; (2) “fixed temporal cue without directional cue” (white noise bursts [cue sounds] were presented from the five loudspeakers just before word presentation at 500-ms intervals); (3) “directional + variable temporal cues” [cue sounds were presented from the loudspeaker where the next target word would be presented with a variable inter-stimulus interval [ISI] of 500, 1000, 1500, or 2000 ms between the cue sound and word presentation); and (4) “directional + fixed temporal cues” (cue sounds were presented from the loudspeaker where the next target word would be presented with a fixed ISI of 500 ms).

Results:

The results indicated the following: (1) word intelligibility under distractors was significantly deteriorated in patients with listening difficulties compared with control subjects, although the clinical speech in noise test using the headphone system did not show any significant differences between the two groups; (2) word intelligibility under distractors for patients with listening difficulties was significantly improved with directional cues presented in advance; and (3) under most cue conditions, individual differences in word intelligibility among patients with listening difficulties were significantly correlated with their dichotic listening ability, which is one of the indicators used to assess auditory selective attention ability.

Conclusions:

The results of this study indicate the usefulness of the presentation of directional cues for speech comprehension in the cocktail party situation in patients with listening difficulties, as well as the importance of evaluating the degree of listening difficulties spatially in the cocktail party situation.
Renal oncocytoma: a challenging diagnosis
Authors: Mirkheshti Nooshin , Farrukh Naveed , Legesse Teklu , Rowe Steven P. , Gordetsky Jennifer , Hussain Arif
Published: June 2022

Purpose of review

The aim of the review is to provide an update on the current and evolving approaches to diagnosing the challenging clinical entity of renal oncocytoma.

Recent findings

Renal oncocytoma is being increasingly recognized among patients with renal masses, and it can be found in up to 50% of benign small renal masses (SRMs) less than 4 cm. Renal oncocytomas have benign clinical biology but distinguishing them from some of the other renal masses with more malignant potential can be challenging due to overlapping imaging, histologic, and immunophenotypic characteristics. Increasing integration of various imaging modalities, histologic characteristics, cytogenetics, and molecular and metabolic signatures is helping better define and characterize renal masses.

Evolving and complementary diagnostic approaches, including at the molecular level, are continuing to help refine the classification of renal tumors, with implications on their clinical behavior and ultimately clinical management.
Compliance with the smoke-free policy in hospitals in Spain: the patients’ perspective
Authors: Fu Marcela , Castellano Yolanda , Feliu Ariadna , Saura Judith , Estrada Joan , Galimany-Masclans Jordi , Moreno Carmen , Fernández Esteve , Martínez Cristina
Published: June 2022

Objective

To explore compliance with the smoke-free policy in hospitals in Catalonia, Spain, by exploring inpatients’ perceptions.

Methods

We conducted a cross-sectional study of a random sample of 1047 inpatients from 13 public hospitals. We collected data about: (a) type of information about the smoke-free policy provided by the hospital, (b) patients’ knowledge about the policy, (c) general appreciation of the compliance with the policy, and (d) specific appreciation of such compliance by noticing any sign of tobacco consumption. We described the data by several patients’ and hospitals’ characteristics and assessed their association with the perceived noncompliance using prevalence ratios (PR) and their 95% confidence intervals (CIs).

Results

Few patients were informed about the smoke-free policy (4.8% orally, 6.1% in writing, and 55.6% through sign postings). About 64% were aware of the regulation and 73.5% believed that it was properly obeyed. While 0.7% had never or rarely observed smoking indoors, 36.2% had seen someone smoking outdoors sometimes or many times. Signs of tobacco consumption were observed indoors and outdoors. Factors associated with the perception of noncompliance were: being less than 45 years old versus being more than 64 years old (adjusted PR, 2.33; 95% CI, 1.09–4.98) and currently smoking versus have never smoked (adjusted PR, 1.84; 95% CI, 1.02–3.34).

Conclusion

Compliance with the smoke-free policy in hospitals according to the patients’ view is notable, although several infringements were reported, mainly outdoors. The smoke-free policy in hospitals should be reinforced by prompting continuous awareness campaigns and the exemplary role of hospital workers.
Short-term association of PM2.5/PM10 on lung cancer mortality in Wuhai city, China (2015–2019): a time series analysis
Authors: Liu Ying , Liu Changhai , Song Yang , Zhao Jing , Gao Yumin , Zhao Lingyan , Cao Ning , Xu Danni , Li Hongwei , Li Hailing
Published: June 2022

Objective

The objective of this study was to evaluate the relationship between short-term fine particulate matter (PM2.5)/inhalable particulate matter (PM10) exposure and lung cancer mortality.

Method

From 2015 to 2019, data concerning air pollution, meteorology, and deaths were obtained in Wuhai, China. The association between PM2.5/PM10 and lung cancer mortality was investigated using time series analysis.

Result

According to the single-pollutant model, a 10 μg/m3 increase in PM2.5/PM10 was associated with an excess risk of 7.95% (95% CI, 2.22–13.95%), and 2.44% (95% CI, 0.32–4.62%), respectively (P < 0.05). PM2.5/PM10 had a stronger impact on men and the elderly (>65 years old). Particulate matter had a larger influence on lung cancer mortality during the warm season than the cold season. Furthermore, except for PM2.5 and PM10, the two-pollution model indicated that the other models were statistically significant. The study’s single and dual pollutant models were both relatively robust.

Conclusion

Short-term exposure to PM2.5/PM10 was correlated with a higher risk of lung cancer death in Wuhai, particularly among men and the elderly (>65 years old). Exposure to PM2.5/PM10 really does have a bigger effect on the population during the warm season. Moreover, it is essential that health administration departments should strengthen their regulatory mechanisms for particulate emissions and take the responsibility for safeguarding the vulnerable populations.
The Rural Perspective: Wisconsin Hospitals Share Workforce Solutions
Authors: Preston Jo Anne
Published: June 2022

The healthcare workforce crisis is daunting, and there are no quick fixes. However, intentional actions—taken one step at a time and skillfully led—can keep healthcare organizations moving forward to face the challenge. Six members of the Rural Wisconsin Health Cooperative, a 45-hospital collaborative network, are taking a strategic approach to meet the crisis head-on. This article shares their best ideas, along with supporting leadership tips, to address three questions:
How Healthcare Can Find Its Way Through the Workforce Crisis
Authors: Moreland Tresha D.
Published: June 2022

“Using a blindfold, I want you to find your way to the front door of the school building,” our elementary schoolteacher instructed. This was to teach us what it would be like to live without vision. We lined up on one side of the schoolyard and took turns when the teacher called our name. I watched as my fellow students, one by one, wandered about, never getting close to the school's front door. They eventually were guided along by other teachers. Then came my turn.

As I pulled the blindfold over my eyes, I noticed it was windy. I could hear the flag snap in the wind. Recalling that the flagpole was only a few feet away from the door, I followed the sound the flag made. As soon as I touched the flagpole, I turned and walked directly to the door, and excitedly grasped the handle. Our teacher approached me, astonished. “Tresha, how did you do it? How did you find the door so quickly?” he asked. “It was as if you could see.” I explained that I used my ears instead of my eyes. In effect, I reimagined my approach.

Today, healthcare leaders must reimagine their approach to navigating workforce shortages. Indeed, many methods used prior to the pandemic seem ineffective now. Relying on policymakers or education institutions and simply investing more money in the same solutions may not yield the desired turnaround. Increasing sign-on bonuses may entice potential candidates, but it cannot stem the tide of the Great Resignation.

I will describe three workforce practices that have rapidly become ineffective over the duration of the pandemic, then explore ways to rethink the practice and develop a new approach to navigating the workforce shortage.
Moving Past Business as Usual to Meet Future Hospital Staffing Needs
Authors: Stromstad Darlene
Published: June 2022

Workforce shortages, a dark reality for healthcare organizations even before the arrival of COVID-19, are being exacerbated by the persistent side effects of the pandemic. Burnout, more retirements, opposition to vaccination mandates, and intense competition from other industries are adding to the challenge. Those factors are keenly felt by hospitals and healthcare systems that are located beyond better-resourced major metropolitan areas. Many years will be required to resolve staffing shortfalls, and that work must begin now.

Mohawk Valley Health System (MVHS) is making some noteworthy responses to the healthcare workforce crisis in the Utica, New York, area. Employing a mix of deep appreciation for workers' personal and professional needs—backed by additional financial investment and development of a diverse talent pipeline— MVHS leadership is working to ensure that it will be able to safely deliver care to patients in its communities now and for years to come.
Comparison of 2 Methods of Debriefing for Learning of Interprofessional Handoff Skills
Authors: Ronnebaum Julie , Jie Chunfa , Salazar Kristina
Published: June 2022

Purpose:

Interprofessional (IP) handoff communication is imperative for patient safety in high-risk environments. Debriefing is an essential component of the learning process of this skill. Currently, one method of debriefing has not proven more effective than another. Therefore, the purpose of this study was to compare 2 forms of debriefing (face-to-face [F2F] debriefing vs computerized personal reflection) on learning and retention of IP handoff communication.

Methods:

Fifty-two (n = 52) third-year doctor of physical therapy students completed IP simulated experiences, followed by debriefing. Subjects were divided into 2 groups: (a) F2F debriefing (n = 26) and (b) computerized personal reflection (n = 26). Observed IP handoff communication behaviors were measured with an assessment tool.

Results:

Overall IP handoff skills improved from pre- to posttest scores (P < .05). The F2F debriefing demonstrated greater improvement in the delivery of communication and content skills (P < .05) than computerized personal reflection debriefing.

Conclusion:

The F2F debriefing should be included in the training of current and future physical therapists.
Immediate and Long-Term Effects of a Computerized Cognitive Rehabilitation Therapy on Cognitive Function in People Living with HIV in Iran: A Single-Blind Two-Arm Parallel Randomized Controlled Trial
Authors: Etesami Maede Sadat , Saboury Nadia , Mohraz Minoo , SeyedAlinaghi SeyedAhmad , Jones Deborah L. , Vance David E. , Habibi Asgarabad Mojtaba
Published: June 2022

Up to 50% of people with HIV (PWH) experience neurocognitive impairments (NCIs) that can interfere with everyday functioning and reduce quality of life. To address this problem, this study examined the immediate and long-term efficacy of computerized cognitive rehabilitation therapy (CCRT) on cognitive function in PWH in Tehran, Iran. Thirty PWH with NCI engaged in 24 biweekly 90-min CCRT sessions. A control group of 30 PWH and NCI received treatment-as-usual, but no CCRT. The cognitive rehabilitation protocol focused on attention, visual memory, nonverbal learning, and planning. Pretest, posttest, and follow-up cognitive measurements showed that the designed CCRT protocol was effective in improving performance in selected cognitive domains along with the global neurocognitive performance scores of PWH. These findings suggest that this CCRT protocol be considered as part of a treatment plan to address cognitive impairment for PWH. Implications for clinical practice and research are provided.
Outcomes With Direct and Indirect Thrombin Inhibition During Extracorporeal Membrane Oxygenation for COVID-19
Authors: Saeed Omar , Farooq Muhammad , Kuntzman Matthew , Patel Snehal R. , Stein Louis H. , Cavarocchi Nicholas , Silvestry Scott , Reyes Gil Morayma , Billett Henny H. , Jorde Ulrich P. , Goldstein Daniel J.
Published: June 2022

Anticoagulation during extracorporeal membrane oxygenation (ECMO) for Coronovirus Disease 2019 (COVID-19) can be performed by direct or indirect thrombin inhibitors but differences in outcomes with these agents are uncertain. A retrospective, multicenter study was conducted. All consecutive adult patients with COVID-19 placed on ECMO between March 1, 2020 and April 30, 2021 in participating centers, were included. Patients were divided in groups receiving either a direct thrombin inhibitor (DTI) or an indirect thrombin inhibitor such as unfractionated heparin (UFH). Overall, 455 patients with COVID-19 from 17 centers were placed on ECMO during the study period. Forty-four patients did not receive anticoagulation. Of the remaining 411 patients, DTI was used in 160 (39%) whereas 251 (61%) received UFH. At 90-days, in-hospital mortality was 50% (DTI) and 61% (UFH), adjusted hazard ratio: 0.81, 95% confidence interval (CI): 0.49–1.32. Deep vein thrombosis [adjusted odds ratio (aOR): 2.60, 95% CI: 0.90–6.65], ischemic (aOR: 1.58, 95% CI: 0.18–14.0), and hemorrhagic (aOR:1.22, 95% CI: 0.39–3.87) stroke were similar with DTI in comparison to UFH. Bleeding requiring transfusion was lower in patients receiving DTI (aOR: 0.40, 95% CI: 0.18–0.87). Anticoagulants that directly inhibit thrombin are associated with similar in-hospital mortality, stroke, and venous thrombosis and do not confer a higher risk of clinical bleeding in comparison to conventional heparin during ECMO for COVID-19.
Optimizing the Pulvertaft Weave Technique: A Comprehensive Systematic Review of Comparative Biomechanical Studies
Authors: Graham Emily M. , Oliver Jeremie , Hendrycks Russell , Mendenhall Shaun D.
Published: June 2022

Background:

The Pulvertaft weave continues as a staple technique for tendon coaptations. Many have proposed minor alterations to the original technique to improve its strength, although a lack of consensus exists. The authors’ aim was to explore how the number of weaves and suture characteristics contribute to the overall strength of the coaptation.

Methods:

A comprehensive electronic search was conducted using the PubMed, Cochrane Library, and Scopus databases. Criteria for inclusion consisted of cadaveric human or animal biomechanical studies evaluating ultimate failure load (in newtons) and the number of weaves, suture characteristics, tendon source, and number of coaptations. Weaves with minimum averages of 75 N were deemed successful, and those with greater than 120 N were considered high performing.

Results:

A total of 347 tendon coaptations from 15 studies met inclusion criteria. Average strength by number of weaves was 36.4 N (n = 52) for one weave, 54.2 N (n = 58) for two weaves, 115.9 N (n = 174) for three weaves, and 81.7 N (n = 63) for four weaves. Statistical differences were observed between one and two weaves (p < 0.0001); two and three weaves (p < 0.0001); three and four weaves (p < 0.003); and two and four weaves (p < 0.0001). High-performing tendon transfers used three weaves, 3-0 or 4-0 braided sutures, and figure-of-eight or mattress core sutures.

Conclusions:

Contrary to the current dogma of “the more the better,” the authors’ findings show that Pulvertaft weave strength is optimized when three weaves are used to combine donor and recipient tendons. Braided sutures with either figure-of-eight or mattress sutures were associated with the highest strength of repair.
Which Tendon Plasty Has the Best Outcome? A Comparison of Four Tendon Plasty Techniques in a Large Cohort of Patients with Symptomatic Trapeziometacarpal Osteoarthritis
Authors: Hoogendam Lisa , Bink Thijs , de Lange Jurriaan , Selles Ruud W. , Colaris Joost W. , Zuidam J. Michiel , Hovius Steven E. R. , van der Heijden Brigitte
Published: June 2022

Background:

Trapeziometacarpal osteoarthritis is commonly treated with a trapeziectomy combined with a form of tendon plasty. The type of tendon plasty used is based on the surgeon’s preference. The purpose of this observational study was to compare the outcomes of four different tendon plasties combined with trapeziectomy used to treat osteoarthritis of the trapeziometacarpal joint: the Weilby, Burton-Pellegrini, Zancolli, and anchovy plasty procedures.

Methods:

Patients treated with a trapeziectomy followed by a tendon plasty completed patient-reported outcome measures at baseline and 12 months postoperatively. The primary outcome was the Michigan Hand Outcomes Questionnaire pain subscale. Secondary outcomes were the minimal clinically important difference of Michigan Hand Outcomes Questionnaire pain scale score, Michigan Hand Outcomes Questionnaire hand function, satisfaction, and complication rate.

Results:

Seven hundred ninety-three patients underwent a trapeziectomy with a tendon plasty between November of 2013 and December of 2018. There was no difference in pain score after 12 months between the four tendon plasty techniques. Patients undergoing an anchovy plasty had a higher chance of reaching the minimal clinically important difference for Michigan Hand Outcomes Questionnaire pain score compared to the other techniques (OR, 2.3; 95 percent CI, 1.2 to 4.6). Overall, more than 80 percent of the patients were satisfied with the treatment outcome, independent of which technique was used. Complication rates of the different techniques were similar.

Conclusions:

Surgical treatment of osteoarthritis of the trapeziometacarpal joint reduced pain after 12 months, independent of which tendon plasty was used. Patients undergoing an anchovy plasty were more likely to experience a clinically relevant improvement in pain while having similar hand function, satisfaction, and complication rates. This suggests that anchovy plasty is the preferred tendon plasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Initial Experience with the PONTiS Tendon Repair System in Traumatic Upper Extremity Injuries
Authors: Maxwell Daniel W. , Desai Karan A. , Fang Robert C. , Cheng Angela , Payne Diane E. S.
Published: June 2022

Background:

Tendon injuries of the upper extremity remain a common surgical condition requiring prompt intervention. The authors review their initial experience with the PONTiS flexor tendon repair system, a knotless, multifilament, stainless steel crimp system.

Methods:

Consecutive patients undergoing repair by plastic and orthopedic surgeons with the PONTiS system were reviewed for the period from 2015 to 2017. Multivariate risk and Kaplan-Meier survival analyses were performed to assess risk factors associated with complications.

Results:

Eighty-one patients, with a mean follow-up of 75 days (range, 0 to 33 months), were identified. The most common demographics showed patients were right-handed (82.9 percent), male (71.4 percent), and laborers (35.7 percent) and sustained laceration injuries (77.1 percent) at zone 2 (27.2 percent). There were, on average, 3.7 tendon injuries per patient. Associated injuries included fractures (21.4 percent), arterial injuries (24.3 percent), and nerve injuries (61.4 percent). Thirteen patients (16.0 percent) developed complications, including adhesions/contracture (n = 4), rupture (n = 2), flap ischemia (n = 2), arterial thrombosis (n = 1), wound dehiscence (n = 1), tendon lag (n = 1), and erosion of the PONTiS system through soft-tissue grafts (n = 2). Multivariate analysis identified poor soft-tissue coverage (OR, 9.990; p = 0.043) and zone 2 involvement (OR, 7.936; p = 0.016) as risk factors, while epitendinous repairs (OR, 0.096; p = 0.010) were protective against complications.

Conclusions:

The PONTiS flexor tendon repair system is rapid, simple to deploy, and advantageous, especially in multiple traumatic tendon injuries. In comparison to traditional suture repair, it has a comparable overall complication profile but superior rupture and tenolysis rates. The authors advise using it with caution in cases with poor soft-tissue coverage to minimize risks of extrusion, and they strongly recommend the use of epitendinous sutures concurrently to limit complications.
Optic Nerve Atrophy in Syndromic Craniosynostosis
Authors: Fearon Jeffrey A. , Barrientos Stephan , Ditthakasem Kanlaya , Herbert Morley
Published: June 2022

Background:

Numerous children born with syndromic craniosynostosis will develop visual impairments. Based on the hypothesis that elevations in intracranial pressure might have greater impacts on vision than development, this review sought to ascertain the prevalence of optic nerve atrophy in syndromic craniosynostosis and to look for potential predictive factors.

Methods:

The authors conducted a retrospective chart review of all children with syndromic craniosynostosis treated at a single center.

Results:

Of 442 patients with syndromic craniosynostosis, complete ophthalmologic records were available for 253. Although no instances of optic nerve atrophy were noted among those with Saethre-Chotzen or Muenke syndromes, an overall 14.7 percent prevalence was noted among those with Apert (7.8 percent), Crouzon (27.9 percent), and Pfeiffer syndromes (23.1 percent), with initial diagnoses occurring at a mean age of 10 years. The presence of a Chiari malformation was found to significantly correlate with the subsequent diagnosis of optic nerve atrophy (OR, 3.544; p = 0.002); however, the timing of the first cranial vault procedure, presence of a ventriculoperitoneal shunt, degree of brachycephaly, number of vault expansions, and diagnosis of sleep apnea, did not show significant associations.

Conclusions:

A substantial percentage of children with Apert, Crouzon, and Pfeiffer syndromes were found to develop optic nerve atrophy, with a prevalence likely to trend higher with longer follow-up. Chiari malformations were the only significant potential predictor for optic nerve atrophy. With the goal of preventing visual losses, more frequent monitoring for raised intracranial pressure with ophthalmologic evaluations and magnetic resonance imaging measurements of optic nerve sheath diameters should be considered.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
The effect of strict lockdown on Omicron SARS-CoV-2 variant transmission in Shanghai
Authors: Yang Haibo , Nie Hao , Zhou Dewei , Wang Yujia , Zuo Wei
Published: June 2022

Background

Omicron, the current SARS-CoV-2 variant of concern, is much more contagious than other previous variants. Whether strict lockdown could effectively curb the transmission of Omicron is largely unknown.

Methods

In this retrospective study, we compared the strictness of government lockdown policies in Shanghai and some countries. Based on the daily Omicron case number from March 1st 2022 to April 30th 2022, the effective reproductive numbers in this Shanghai Omicron wave were calculated to confirm the impact of strict lockdown on Omicron transmission. Pearson correlation was conducted to illustrate the determining factor of strict lockdown outcomes in the 16 different districts of Shanghai.

Results

After very strict citywide lockdown since April 1st, the average daily effective reproductive number reduced significantly, indicating that strict lockdown could slow down the spreading of Omicron. Omicron control is more challenging in districts with higher population mobility and lockdown is more likely to decrease the number of asymptomatic carrier than the symptomatic cases.

Conclusions

The strict lockdown could curb the transmission of Omicron effectively, especially for the asymptomatic spread. And urban city with extensive personnel movement is suggested to adopt this lockdown strategy at early stage to maximally control the virus transmission.
Genome sequencing and transcriptome profiling in twins discordant for Mayer-Rokitansky-Küster-Hauser syndrome
Authors: Buchert Rebecca , Schenk Elisabeth , Hentrich Thomas , Weber Nico , Rall Katharina , Sturm Marc , Kohlbacher Oliver , Koch André , Rieß Olaf , Brucker Sara Y. , Schulze-Hentrich Julia M.
Published: June 2022

Objective

Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a rare congenital disease manifesting with aplasia or severe hypoplasia of uterine structures. Even though extensive studies have been performed, for the majority of cases the etiology remains unclear. In this study, we sought to identify genetic causes in discordant monozygotic (MZ) twins using genome sequencing of blood of both twins as well as uterine tissue of the affected twin. In addition, we profiled the endometrial transcriptome of affected twins to compare perturbations with those of sporadic MRKH cases.

Results

First, analyzing the data under the assumption that a variant solely identified in the affected twin or affected tissue could cause the phenotype, we identified a mosaic variant in ACTR3B with a high allele frequency in affected tissue, a low allele frequency in blood of the affected twin and almost absent in the blood of the unaffected twin. Since ACTR3B has not been reported for genitourinary anomalies before, clinical relevance of the variant needs to be clarified.

Second, examining the data for candidate genes previously implied in MRKH, we detected a pathogenic variant in GREB1L in one twin pair and their unaffected mother showing a reduced phenotypic penetrance. Furthermore, two variants of unknown clinical significance in PAX8 and WNT9B were identified. Analysis for copy number and structural variants revealed no discordant variants in the twins or variants in candidate genes or regions.

Third, we conducted transcriptome analysis of affected tissue and observed widespread perturbations largely similar to those in sporadic MRKH cases. These shared transcriptional changes were enriched for terms associated with estrogen and its receptors pointing at a key role of estrogen in MRKH pathology.

Conclusion

Our study on genome sequencing of blood and uterine tissue of discordant twins is the most extensive study performed on twins discordant for MRKH so far. Nevertheless, no clear pathogenic differences in the twins or between blood and tissue samples were detected. This points towards a more complex etiology of MRKH less dependent on genetic differences and more determined by epigenetic changes or environmental factors. Our transcriptome data showed a clear overlap with gene expression data of sporadic MRKH cases, indicating that the etiology for MRKH in discordant twins and sporadic cases is largely similar.
Language Models Learn Sentiment and Substance from 11,000 Psychoactive Experiences
Authors: Friedman Sam Freesun , Ballentine Galen
Published: June 2022

With novel hallucinogens poised to enter psychiatry, we lack a unified framework for quantifying which changes in consciousness are optimal for treatment. Using transformers (i.e. BERT) and 11,816 publicly-available drug testimonials, we first predicted 28-dimensions of sentiment across each narrative, validated with psychiatrist annotations. Secondly, BERT was trained to predict biochemical and demographic information from testimonials. Thirdly, canonical correlation analysis (CCA) linked 52 drugs’ receptor affinities with testimonial word usage, revealing 11 latent receptor-experience factors, mapped to a 3D cortical atlas. Together, these 3 machine learning methods elucidate a neurobiologically-informed, temporally-sensitive portrait of drug-induced subjective experiences. Different models’ results converged, revealing a pervasive distinction between lucid and mundane phenomena. MDMA was linked to “Love”, DMT and 5-MeO-DMT to “Mystical Experiences”, and other tryptamines to “Surprise”, “Curiosity” and “Realization”. Applying these models to real-time biofeedback, practitioners could harness them to guide the course of therapeutic sessions.
Clinical evaluation of the Multimapping technique for simultaneous myocardial T1and T2mapping
Authors: Jarkman Charlotta , Carlhäll Carl-Johan , Henningsson Markus
Published: June 2022

The Multimapping technique was recently proposed for simultaneous myocardial T1and T2mapping. In this study we evaluate its correlation with clinical reference mapping techniques in patients with a range of cardiovascular diseases (CVD), compare image quality and inter- and intra-observer repeatability. Multimapping consists of a ECG-triggered, 2D single-shot bSSFP readout with inversion recovery and T2preparation modules, acquired across 10 cardiac cycles. The sequence was implemented at 1.5T and compared to clinical reference mapping techniques, Modified Look-Locker inversion recovery (MOLLI) and T2prepared bSSFP with four echo times (T2bSSFP), and compared in 47 patients with CVD (of which 44 were analyzed). In diseased myocardial segments (defined as presence of late gadolinium enhancement) there was a high correlation between Multimapping and MOLLI for native myocardium T1(r2=0.73), ECV (r2=0.91) and blood T1(r2=0.88), and Multimapping and T2bSSFP for native myocardial T2(r2=0.80). In healthy myocardial segments a bias for native T1(Multimapping=1116±21 ms, MOLLI=1002±21,P<0.001), post-contrast T1(Multimapping=479±31 ms, MOLLI=426±27 ms, 0.001), ECV (Multimapping=21.5±1.9%, MOLLI=23.7±2.3%,P=0.001) and native T2(Multimapping=48.0±3.0 ms, T2bSSFP=53.9±3.5 ms,P<0.001) was observed. The image quality for Multimapping was scored as higher for all mapping techniques (native T1, post- contrast T1, ECV and T2bSSFP) compared to the clinical reference techniques. The inter- and intra- observer agreement was excellent (intraclass correlation coefficient, ICC>0.9) for most measurements, except for inter-observer repeatability of Multimapping native T1(ICC=0.87), post-contrast T1(ICC=0.73) and T2bSSFP native T2(ICC=0.88). Multimapping show high correlations with clinical reference mapping techniques for T1, T2and ECV in a diverse cohort of patients with different cardiovascular diseases. Multimapping enables simultaneous T1and T2mapping and can be performed in a short breath-hold, with image quality superior to that of the clinical reference techniques.
A proposed general variant classification framework using chronic pancreatitis as a disease model
Authors: Masson Emmanuelle , Zou Wen-Bin , Génin Emmanuelle , Cooper David N. , Gac Gerald Le , Fichou Yann , Pu Na , Rebours Vinciane , Férec Claude , Liao Zhuan , Chen Jian-Min
Published: June 2022

The widely used ACMG-AMP variant classification categories (pathogenic, likely pathogenic, uncertain significance, likely benign and benign) were specifically developed for variants in Mendelian disease genes, classifying variants discretely with respect to a simple causal versus benign dichotomy. A general variant classification framework taking into account the continuum of clinical phenotypes, the continuum of the variants’ genetic effects and the different pathological roles of the genes implicated, is however lacking. Herein, we used chronic pancreatitis (CP), which clinically manifests as hereditary, familial, idiopathic or alcoholic forms, as a disease model. Based upon cross-gene and cross-variant comparisons, we firstly assigned the four most studied CP genes (PRSS1, CFTR, SPINK1 and CTRC) to two distinct categories in terms of causality: CP-causing (PRSS1 and SPINK1) and CP-predisposing (CFTR and CTRC). We then employed two new classificatory categories, “predisposing” and “likely predisposing”, to replace ACMG-AMP’s “pathogenic” and “likely pathogenic” categories in CP-predisposing genes, thereby classifying all pathologically relevant variants in these genes as “predisposing”. In the case of CP-causing genes, the two new classificatory categories served to expand the five ACMG-AMP categories whilst two thresholds (allele frequency and functional) were introduced to discriminate pathogenic from predisposing variants. Our proposed five-category (predisposing, likely predisposing, uncertain significance, likely benign and benign) and seven-category (pathogenic, likely pathogenic, predisposing, likely predisposing, uncertain significance, likely benign and benign) frameworks (with respect to disease-predisposing and disease-causing genes, respectively) retain the backbone of the five ACMG-AMP categories while rendering them readily applicable to variant classification in other disease contexts.