bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjudication of Procedural Safeguards for Vulnerable Asylum Seekers in Greece: Case Law and Systemic Non-Compliance
Authors: Mouzourakis Minos
Published: October 2023

Special procedural guarantees for vulnerable asylum seekers are a core part of refugee status determination standards. These safeguards are neither afforded, nor properly adjudicated in Greek asylum procedures, however. Drawing on recent case law, this article argues that Greek appeal bodies (the Appeals Committees) routinely rule that vulnerability is irrelevant to refugee status determination or that no procedural harm is sustained from the inappropriate channelling of vulnerable people into truncated procedures, in dereliction of European Union (EU) standards and domestic jurisprudence. Systemic non-compliance with the duty to grant special procedural safeguards is a policy choice, yet the European Commission, the institution responsible for EU law enforcement, refrains from enforcing these standards in Greece. The Commission’s enforcement deficit vis-à-vis the Greek asylum system is underpinned by its Task Force for Migration Management’s prioritization of ending overcrowding and speeding up decision making over procedural standards, as well as an uneasy balancing act between operational support and monitoring.
Changing Epidemiology and Outcome of Pediatric Thermal Burn Injury in South Western Nigeria
Authors: Olawoye Olayinka Adebanji , Isamah Chinsunum Peace , Ademola Samuel Adesina , Iyun Ayodele Olukayode , Michael Afieharo Igbibia , Aderibigbe Rotimi Opeyemi , Oluwatosin Odunayo Moronfoluwa
Published: October 2023

The pediatric age group has been noted to be particularly vulnerable to burn injuries. Burn is the fifth most common cause of childhood injuries. Nigeria has a very young population with a median age of 18.1 years. Scald is the most common form of burn injuries in this age group globally; however, previous reports from our institution found flame to be the most common form of burn in pediatric age. The most recent report from 13 years ago still maintained flame as the most common cause of pediatric burn injury. This study was carried out to determine the changes in epidemiology and outcome of pediatric thermal burn injury. This was a retrospective study carried out between January 2013 and December 2022. Data were analyzed using the statistical package for social sciences software version 23. The significance was set at a P-value of .05. Two hundred and sixty-five children presented with thermal burn with a male-to-female ratio of 1.3:1. 63.4% occurred in children 0-5 years. Scald (59.6%) was the most common cause of injury. Most flame injuries in females were due to liquified petroleum gas cookstove explosion, while petrol explosion was the most common cause in males (P ≤ .001). There is a yearly increase in burn depth (P = .009). Most inhalation injuries occurred in those aged 11–16 years (P = .006). Mortality rate was 10.2%, with total body surface area burned (P ≤ .001), burn depth (P ≤ .001), and inhalation injury (P ≤ .001) associated with increasing mortality. Scald is now the most common cause of thermal burn in our institution, with a remarkable reduction in mortality rate.
Rare malignant neoplasm of the esophagus: current status and future perspectives
Authors: Yoshinami Yuri , Nishimura Erica , Hosokai Taisuke , Yamamoto Shun , Matsuda Satoru , Nomura Motoo , Kawakubo Hirofumi , Kato Ken , Kitagawa Yuko
Published: October 2023

Esophageal cancer is common worldwide, including in Japan, and its major histological subtype is squamous cell carcinoma. However, there are some rare esophageal cancers, including neuroendocrine neoplasm, gastrointestinal stromal tumor, carcinosarcoma and malignant melanoma. The biological and clinical features of these cancers differ from those of esophageal squamous cell carcinoma. Therefore, different treatment strategies are needed for these cancers but are based on limited evidence. Neuroendocrine neoplasm is mainly divided into neuroendocrine tumor and neuroendocrine carcinoma by differentiation and the Ki-67 proliferation index or mitotic index. Epidemiologically, the majority of esophageal neuroendocrine neoplasms are neuroendocrine carcinoma. The treatment of neuroendocrine carcinoma is similar to that of small cell lung cancer, which has similar morphological and biological features. Gastrointestinal stromal tumor is known to be associated with alterations in the c-KIT and platelet-derived growth factor receptor genes and, if resectable, is treated in accordance with the modified Fletcher classification. Carcinosarcoma is generally resistant to both chemotherapy and radiotherapy and requires multimodal treatments such as surgery plus chemotherapy to achieve cure. Primary malignant melanoma is resistant to cytotoxic chemotherapy, but immune checkpoint inhibitors have recently demonstrated efficacy for malignant melanoma of the esophagus. This review focuses on the current status and future perspectives for rare cancer of the esophagus.
Snowshoe hare virus: discovery, distribution, vector and host associations, and medical significance
Authors: Walker Edward D , Yuill Thomas M
Published: October 2023

Snowshoe hare virus (SSHV), within the California serogroup of the genus Orthobunyavirus, family Peribunyaviridae, was first isolated from a snowshoe hare (Lepus americanus) in Montana, United States, in 1959. The virus, closely related to LaCrosse virus (LACV) and Chatanga virus (CHATV), occurs across Canada and the northern latitudes of the United States, primarily in the northern tier of states bordering Canada. Reports of SSHV in northern Europe and Asia are probably the closely related to CHATV, or the less closely related Tahyna virus. Vertebrate associations include snowshoe hares and ground squirrels, demonstrated by field isolation of virus from wild-caught animals, seroconversion of snowshoe hares, seroconversion of sentinel rabbits, isolation of virus from sentinel rabbits, and experimental infections demonstrating viremia. Isolations of virus from field populations of mosquitoes include primarily univoltine and boreal mosquitoes of the genus Aedes, Culiseta impatiens and Culiseta inornata; and, rarely, certain multivoltine floodwater Aedes species. Experimental transmission studies in mosquitoes show infection in and transmission by boreal Aedes and Culiseta inornata. Isolation of SSHV from larval Aedes on three occasions, and experimentation in Culiseta inornata, reveal transovarial transmission of the virus in mosquitoes. Serosurveys reveal exposure to SSHV in human and domestic animals, with rates of seropositivity commonly high in some settings in Alaska and Canada, but disease in humans or horses has rarely been reported, only in Canada.
Susac syndrome: a case report with initial presentation of incomplete bitemporal hemianopia
Authors: Gunaratnam Cadric , King Thomas , Moloney Thomas P , Boggild Mike , Goodwin Todd
Published: October 2023

Susac syndrome (SS) is a rare microangiopathy affecting the precapillary arterioles of the brain, inner ear, and retina. We present a novel case of SS, presenting as acute incomplete bitemporal field loss in addition to temporally spaced neurological and vestibulocochlear symptoms. A 39-year-old female was referred to the ophthalmology clinic with acute incomplete bitemporal hemianopia and worsening hemicrania. History revealed progressive hearing loss, subjective short-term memory impairment, and vertigo temporally spaced over the preceding 12 months. Magnetic resonance brain revealed multiple small colosal lesions and liner ‘spoke’ lesions. Fundus fluorescein angiography revealed multiple branch retinal artery occlusions in the right eye. Audiometry confirmed bilateral sensorineural hearing loss. Treatment included intravenous corticosteroids and rituximab. This case highlights the importance of early consideration and evaluation of SS in individuals presenting with atypical ocular disturbances, where no clear cause can be elicited, in order to limit the sequelae of disease.
A CRISPR/Cas9-based kinome screen identifies ErbB signaling as a new regulator of human naïve pluripotency and totipotency
Authors: Li Jiayu , Lin Xiwen , Xie Liangfu , Zhao Jingru , Han Chunsheng , Deng Hongkui , Xu Jun
Published: October 2023

Regulation of totipotency and naïve pluripotency is crucial for early human embryo development. However, the mechanisms of naïve pluripotency and totipotency regulation in humans, especially the signaling pathways involved in these processes, remain largely unknown. Here, using the conversion of human extended pluripotent stem cells (hEPSCs) to naïve pluripotent stem cells as a model, we performed a CRISPR/Cas9-based kinome knockout screen to analyze the effect of disrupting 763 kinases in regulating human naïve pluripotency. Further validation using small molecules revealed that the inhibition of ErbB family kinases promoted the transition of hEPSCs to human naïve pluripotent stem cells. More importantly, chemical inhibition of the ErbB family also promoted induction of totipotent signatures in human pluripotent cells under different culture conditions. Our findings provide new mechanistic insights into the regulation of naïve pluripotency and totipotency in humans.
Hydrodynamic simulations of the KT Eridani nova super-remnant
Authors: Healy-Kalesh M W , Darnley M J , Shara M M , Lanzetta K M , Garland J T , Gromoll S
Published: October 2023

A nova super-remnant (NSR) is an immense structure associated with a nova that forms when frequent and recurrent nova (RN) eruptions sweep up surrounding interstellar medium (ISM) into a high-density and distant shell. The prototypical NSR, measuring over 100 pc across, was discovered in 2014 around the annually erupting nova M 31N 2008-12a. Hydrodynamical simulations demonstrated that the creation of a dynamic NSR by repeated eruptions transporting large quantities of ISM is not only feasible but that these structures should exist around all novae, whether the white dwarf (WD) is increasing or decreasing in mass. But it is only the RN with the highest WD masses and accretion rates that should host observable NSRs. KT Eridani is, potentially, the eleventh RNe recorded in the Galaxy and is also surrounded by a recently unveiled H α shell tens of parsecs across, consistent with an NSR. Through modelling the nova ejecta from KT Eri, we demonstrate that such an observable NSR could form in approximately 50 000 yr, which fits with the proper motion history of the nova. We compute the expected H α emission from the KT Eri NSR and predict that the structure might be accessible to wide-field X-ray facilities.
Suppression of small-scale dynamo in time-irreversible turbulence
Authors: Kopyev A V , Il’yn A S , Sirota V A , Zybin K P
Published: October 2023

The conventional theory of small-scale magnetic field generation in a turbulent flow considers time-reversible random flows. However, real turbulent flows are known to be time irreversible: the presence of energy cascade is an intrinsic property of turbulence. We generalize the ‘standard’ model to account for the irreversibility. We show that even small time asymmetry leads to significant suppression of the dynamo effect at low magnetic Prandtl numbers, increases the generation threshold, and may even make generation impossible for any magnetic Reynolds number. We calculate the magnetic energy growth rate as a function of the parameters of the flow.
Ultra-processed food intake among South Asians in the United States: Specific vulnerabilities of a growing immigrant population group
Authors: Hussain Bridget Murphy , Juul Filippa , Deierlein Andrea L , Parekh Niyati
Published: October 2023

South Asians are among the fastest growing immigrant population groups in the United States. Their traditional diets are rich in minimally processed fruits, vegetables, grains, herbs, and spices. However, the proliferation of ultra-processed foods (highly processed, industrially manufactured formulations) around the globe may compromise the nutrition profile of South Asians, threatening to increase their risk of noncommunicable diseases. This commentary discusses the rise in ultra-processed food consumption among South Asians in the United States and hypothesizes that South Asians may be especially vulnerable to the effects of ultra-processed foods due to their unique cardiovascular disease risk profiles. Using these emerging data, we propose several strategies for preventing the overconsumption of ultra-processed foods among South Asian Americans. These include the implementation of policies to encourage the consumption of whole foods over ultra-processed foods and the development of culturally tailored interventions, which include promoting consumption of traditional diets, improving affordability of healthful, culturally appropriate foods, and cultivating healthier food environments for South Asians living in the United States.
Hepatitis C Treatment Uptake Following Dried Blood Spot Testing for Hepatitis C RNA in New South Wales, Australia: The NSW DBS Pilot Study
Authors: Conway Anna , Stevens Annabelle , Murray Carolyn , Prain Bianca , Power Cherie , McNulty Anna , Carrington Nigel , Lu Heng , Kingsland Melanie , McGrath Colette , Read Phillip , Starr Mitchell , Catlett Beth , Cunningham Philip , Grebely Jason
Published: October 2023

Background

Dried blood spot (DBS) testing for hepatitis C virus (HCV) RNA provides a sampling option that avoids venepuncture and can be carried out in a nonclinical setting. Large-scale evaluations are needed to understand how DBS testing can reduce HCV burden. This study estimated prevalence of, and factors associated with, HCV RNA and treatment initiation among people enrolled in a state-wide pilot of people testing in the NSW DBS Pilot in New South Wales, Australia.

Methods

People at risk of HIV/HCV could participate via (1) self-registration online with a DBS collection kit delivered and returned by conventional postal service; or (2) assisted DBS sample collection at a community site or prison. Logistic regression was used to identify factors associated with detectable HCV RNA and treatment initiation within 6 months of testing.

Results

Between September 2017 and December 2020, 5960 people were tested for HCV (76% men, 35% Aboriginal and/or Torres Strait Islander, 55% recently injected drugs): 21% online self-registration, 34% assisted registration in the community, 45% assisted registration in prison. Fifteen percent had detectable HCV RNA (878/5960). Overall, 44% (n = 386/878) of people with current HCV initiated treatment within 6 months (13% online self-registration, 27% assisted registration in the community, 61% assisted registration in prison). Testing in prison compared with the community (adjusted odds ratio [aOR], 4.28; 95% CI, 3.04–6.03) was associated with increased odds of treatment initiation. Being a woman compared with a man (aOR, 0.68; 95% CI, 0.47–0.97) was associated with reduced treatment initiation.

Conclusions

The NSW DBS Pilot demonstrates the feasibility of using DBS to promote HCV testing and treatment in community and prison settings.
In-Depth Quantification of Cell Division and Elongation Dynamics at the Tip of Growing Arabidopsis Roots Using 4D Microscopy, AI-Assisted Image Processing and Data Sonification
Authors: Goh Tatsuaki , Song Yu , Yonekura Takaaki , Obushi Noriyasu , Den Zeping , Imizu Katsutoshi , Tomizawa Yoko , Kondo Yohei , Miyashima Shunsuke , Iwamoto Yutaro , Inami Masahiko , Chen Yen-Wei , Nakajima Keiji
Published: October 2023

One of the fundamental questions in plant developmental biology is how cell proliferation and cell expansion coordinately determine organ growth and morphology. An amenable system to address this question is the Arabidopsis root tip, where cell proliferation and elongation occur in spatially separated domains, and cell morphologies can easily be observed using a confocal microscope. While past studies revealed numerous elements of root growth regulation including gene regulatory networks, hormone transport and signaling, cell mechanics and environmental perception, how cells divide and elongate under possible constraints from cell lineages and neighboring cell files has not been analyzed quantitatively. This is mainly due to the technical difficulties in capturing cell division and elongation dynamics at the tip of growing roots, as well as an extremely labor-intensive task of tracing the lineages of frequently dividing cells. Here, we developed a motion-tracking confocal microscope and an Artificial Intelligence (AI)-assisted image-processing pipeline that enables semi-automated quantification of cell division and elongation dynamics at the tip of vertically growing Arabidopsis roots. We also implemented a data sonification tool that facilitates human recognition of cell division synchrony. Using these tools, we revealed previously unnoted lineage-constrained dynamics of cell division and elongation, and their contribution to the root zonation boundaries.
Ablation of OCT4 function in cattle embryos by double electroporation of CRISPR-Cas for DNA and RNA targeting (CRISPR-DART)
Authors: Nix Jada L , Schettini Gustavo P , Speckhart Savannah L , Ealy Alan D , Biase Fernando H
Published: October 2023

CRISPR-Cas ribonucleoproteins are important tools for gene editing in pre-implantation embryos. However, the inefficient production of biallelic deletions in cattle zygotes has hindered mechanistic studies of gene function. In addition, the presence of maternal RNAs that support embryo development until embryonic genome activation may cause confounding phenotypes. Here, we aimed to improve the efficiency of biallelic deletions and deplete specific maternal RNAs in cattle zygotes using CRISPR-Cas editing technology. Two electroporation sessions with Cas9D10A ribonucleoproteins targeting exon 1 and the promoter of OCT4 produced biallelic deletions in 91% of the embryos tested. In most cases, the deletions were longer than 1000 nucleotides long. Electroporation of Cas13a ribonucleoproteins prevents the production of the corresponding proteins. We electroporated Cas9D10A ribonucleoproteins targeting exon 1, including the promoter region, of OCT4 in two sessions with inclusion of Cas13a ribonucleoproteins targeting OCT4 mRNAs in the second session to ablate OCT4 function in cattle embryos. A lack of OCT4 resulted in embryos arresting development prior to blastocyst formation at a greater proportion (13%) than controls (31.6%, P<0.001). The few embryos that developed past the morula stage did not form a normal inner cell mass. Transcriptome analysis of single blastocysts, confirmed to lack exon 1 and promoter region of OCT4, revealed a significant (FDR<0.1) reduction in transcript abundance of many genes functionally connected to stemness, including markers of pluripotency (CADHD1, DPPA4, GNL3, RRM2). The results confirm that OCT4 is key regulator of genes that modulate pluripotency and is required to form a functional blastocyst in cattle.
An organ-effective modulation for non-contrast chest computed tomography imaging: effect on image quality and thyroid exposure reduction
Authors: Li Qianling , Zhao Zicheng , Yang Chen , Zhu Fandong , Sun Chenweng , Zhao Zhenhua
Published: October 2023

We investigate the efficacy of organ-effective modulation (OEM) technique for thyroid dose reduction among various body habitus and its impact on image quality in chest non-contrast computed tomography (CT). We prospectively enrolled 64 patients who underwent non-contrast chest CT from January to May 2022. The skin-absorbed radiation dose over the thyroid (Dthyroid) was obtained using a thermoluminescence dosemeter. Signal-to-noise ratio and image noise was also quantitatively assessed. In subjective analyses, two radiologists independently evaluated images based on a 5-point scale. The OEM group showed a markedly decrease in Dthyroid when compared with the non-OEM group (p < 0.05). No significant difference was observed regarding the image noise (p < 0.05), except for the ventral air space. The subjective scores of two radiologists showed no significant differences between the non-OEM and OEM groups. OEM can effectively reduce the radiation exposure of thyroid without compromising on image quality in non-contrast chest CT.
Gene Transfer-Based Phylogenetics: Analytical Expressions and Additivity via Birth–Death Theory
Authors: Katriel Guy , Mahanaymi Udi , Brezner Shelly , Kezel Noor , Koutschan Christoph , Zeilberger Doron , Steel Mike , Snir Sagi
Published: October 2023

The genomic era has opened up vast opportunities in molecular systematics, one of which is deciphering the evolutionary history in fine detail. Under this mass of data, analyzing the point mutations of standard markers is often too crude and slow for fine-scale phylogenetics. Nevertheless, genome dynamics (GD) events provide alternative, often richer information. The synteny index (SI) between a pair of genomes combines gene order and gene content information, allowing the comparison of genomes of unequal gene content, together with order considerations of their common genes. Recently, genome dynamics has been modeled as a continuous-time Markov process, and gene distance in the genome as a birth–death–immigration process. Nevertheless, due to complexities arising in this setting, no precise and provably consistent estimators could be derived, resulting in heuristic solutions. Here, we extend this modeling approach by using techniques from birth–death theory to derive explicit expressions of the system’s probabilistic dynamics in the form of rational functions of the model parameters. This, in turn, allows us to infer analytically accurate distances between organisms based on their SI. Subsequently, we establish additivity of this estimated evolutionary distance (a desirable property yielding phylogenetic consistency). Applying the new measure in simulation studies shows that it provides accurate results in realistic settings and even under model extensions such as gene gain/loss or over a tree structure. In the real-data realm, we applied the new formulation to unique data structure that we constructed—the ordered orthology DB—based on a new version of the EggNOG database, to construct a tree with more than 4.5K taxa. To the best of our knowledge, this is the largest gene-order-based tree constructed and it overcomes shortcomings found in previous approaches. Constructing a GD-based tree allows to confirm and contrast findings based on other phylogenetic approaches, as we show.
Molecular mechanisms underlying mitochondrial damage, endoplasmic reticulum stress, and oxidative stress induced by environmental pollutants
Authors: Li Kang , Geng Yanpei , Lin Bencheng , Xi Zhuge
Published: October 2023

Mitochondria and endoplasmic reticulum (ER) are essential organelles playing pivotal roles in the regulation of cellular metabolism, energy production, and protein synthesis. In addition, these organelles are important targets susceptible to external stimuli, such as environmental pollutants. Exposure to environmental pollutants can cause the mitochondrial damage, endoplasmic reticulum stress (ERS), and oxidative stress, leading to cellular dysfunction and death. Therefore, understanding the toxic effects and molecular mechanisms of environmental pollution underlying these processes is crucial for developing effective strategies to mitigate the adverse effects of environmental pollutants on human health. In the present study, we summarized and reviewed the toxic effects and molecular mechanisms of mitochondrial damage, ERS, and oxidative stress caused by exposure to environmental pollutants as well as interactions inducing the cell apoptosis and the roles in exposure to environmental pollutants.
Revision of the darkling beetle genusEurynotus(Blaptinae: Platynotini) and new records of ovovivipary in Tenebrionidae
Authors: Lumen Ryan , Kamiński Marcin J
Published: October 2023

The taxonomic concepts and monophyly of the southern African genus Eurynotus and its subgeneric components (Biolus and Neosolenopistoma) are tested using cladistic analyses. Seventy morphological characters were scored and analysed using maximum parsimony and Bayesian inference for 26 Eurynotina species, including all Eurynotus. Comprehensive revision of Biolus and Eurynotus resulted in Neosolenopistoma becoming a junior synonym of the genus Biolus stat. nov. (elevated to generic rank), restoration of one species (B. asperipennis stat. res.), recognition of seven new combinations, and descriptions of two new species (Biolus brunoi sp. nov. and Eurynotus privisolum sp. nov.). Lectotypes are designated for previously described species from syntype material, and a key to species of Biolus and Eurynotus is provided. Three species were confirmed as ovoviviparous (two Biolus and one Eurynotus) bringing the number of recorded ovoviviparous Tenebrionidae to 14. Shortened ovipositors are discounted as requisite for ovovivipary based on elongate paraprocts in Biolus and Eurynotus. Principal component analyses were used to examine three lineages of ovoviviparous tenebrionids; however, no single set of climatic variables was correlated with ovovivipary. Southern African, Malagasy, and Guadeloupe lineages of ovoviviparous Tenebrionidae probably have additional and/or separate evolutionary origins and selection pressures to consider when examining this reproductive strategy.
The Self-Perceived E-Learning Environment Scale: Development and Psychometric Properties in a Nursing Students Samples
Authors: Dal Santo Letizia , Peña-Jimenez Marco , Canzan Federica , Saiani Luisa , Battistelli Adalgisa
Published: October 2023

AIM

E-learning is increasingly used in education, creating a learning environment that needs to be studied thoroughly for developing new learning opportunities.

BACKGROUND

Drawing from the community of inquiry framework, the present work provides the theoretical foundation and measurement validation of the Self-Perceived E-Learning Environment Scale (SEES). The SEES measures core aspects of the e-learning context: autonomous strategic planning, social interaction, and teacher feedback.

METHOD

Through two studies carried out in sample of nursing students, an exploratory (n = 302) and confirmatory (n = 245) factor analysis revealed a three-factor structure.

RESULT

The results provide empirical evidence of appropriate psychometric properties (i.e., reliability, validity).

CONCLUSION

The SEES can be used in a higher education context, particularly in nursing education programs. Theoretical, methodological, and practical implications for exploring the e-learning environment in nursing educational settings are discussed.
Feasibility and safety of percutaneous nephrolithotomy in the management of renal stones with emphysematous pyelonephritis following control of infection
Authors: Singh Anshuman , K.R. Surag , Choudhary Anupam , Reddy Suraj Jayadeva , Gali Kasi Viswanath , Shah Abhijit
Published: October 2023

Background

Management of renal calculi in the presence of emphysematous pyelonephritis (EPN) is challenging. The optimal management strategy for patients with EPN and renal calculi remains unclear. This study aimed to evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in the management of these patients and to provide insights into the postoperative outcomes and complications of PCNL according to the modified Clavien-Dindo classification.

Materials and methods

This retrospective study included patients with EPN and renal stones who underwent PCNL, after initial conservative management, between January 2012 and December 2021. Patient demographics, presenting symptoms, features of septicemia, preoperative drainage, postoperative complications, and outcomes were recorded. Postoperative complications were categorized according to the modified Clavien-Dindo classification.

Results

A total of 48 patients with EPN and renal calculi were included in this study. Percutaneous nephrolithotomy was performed 4–6 weeks later after obtaining a negative urine culture or under appropriate antibiotic coverage if the culture was unsterile. Of the total, 39 (81.25%) patients had postoperative complications, but only 9 (18.75%) patients had grade III or higher complications. Of these, 3 (6.25%) patients had grade IIIa complications, 3 (6.25%) had grade IIIb complications, 2 (4.1%) had grade IVa complications, and 1 (2.08%) had grade IVb complications and was admitted to the intensive care. No mortality was observed during the postoperative period.

Conclusions

Initial conservative management of EPN followed by PCNL after initial infection control is an effective strategy for managing these patients. Patients with higher EPN grades have a higher risk of major postoperative complications after PCNL for renal stones. Specifically, patients with an EPN class 3 or 4 had a higher risk of complications than those with an EPN class 2 or lower. Patients with EPN class 1 have a relatively uncomplicated postoperative course after PCNL.
Dynamic Prevalence of and Factors Associated With Fatigue Following Traumatic Brain Injury: A Systematic Review and Meta-analysis of Observational Studies
Authors: Liu I-Hsing , Lin Chia-Jou , Romadlon Debby Syahru , Lee Shu-Chun , Huang Hui-Chung , Chen Pin-Yuan , Chiu Hsiao-Yean
Published: October 2023

Objective:

To implement a systematic review and meta-analysis to comprehensively synthesize the prevalence of and factors associated with fatigue following traumatic brain injury (TBI).

Methods:

We systematically searched the PubMed, EMBASE, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, and ProQuest Dissertations and Theses A&I databases in all fields from their inception to March 31, 2021. We included observational studies investigating fatigue at specific time points following TBI or factors associated with post-TBI fatigue. All data were analyzed using a random-effects model.

Results:

This meta-analysis included 29 studies that involved 12 662 patients with TBI and estimated the prevalence of post-TBI fatigue (mean age = 41.09 years); the meta-analysis also included 23 studies that involved 6681 patients (mean age = 39.95 years) and investigated factors associated with post-TBI fatigue. In patients with mild-to-severe TBI, the fatigue prevalence rates at 2 weeks or less, 1 to 3 months, 6 months, 1 year, and 2 years or more after TBI were 52.2%, 34.6%, 36.0%, 36.1%, and 48.8%, respectively. Depression (r = 0.48), anxiety (r = 0.49), sleep disturbance (r = 0.57), and pain (r = 0.46) were significantly associated with post-TBI fatigue. No publication bias was identified among the studies, except for those assessing fatigue prevalence at 6 months after TBI.

Conclusion:

The pooled prevalence rates of post-TBI fatigue exhibited a U-shaped pattern, with the lowest prevalence rates occurring at 1 to 3 months after TBI. Depression, anxiety, sleep disturbance, and pain were associated with post-TBI fatigue. Younger patients and male patients were more likely to experience post-TBI fatigue. Our findings can assist healthcare providers with identifying appropriate and effective interventions targeting post-TBI fatigue at specific periods.
The Relationship of Health Literacy to Health Outcomes Among Individuals With Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study
Authors: Pappadis Monique R. , Sander Angelle M. , Juengst Shannon B. , Leon-Novelo Luis , Ngan Esther , Bell Kathleen R. , Corrigan John D. , Driver Simon , Dreer Laura E. , Lequerica Anthony H.
Published: October 2023

Objective:

To examine the associations between health literacy and health outcomes among individuals with traumatic brain injury (TBI) at least a year post-injury.

Setting:

Community following discharge from inpatient rehabilitation.

Participants:

A total of 205 individuals with complicated mild to severe TBI who completed a TBI Model Systems National Database follow-up interview and a web-based health literacy measure.

Design:

A multicenter, cross-sectional, observational study.

Main Measures:

The Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT), number of comorbid conditions (Medical and Mental Health Comorbidities Interview [MMHCI]), perceived physical and mental health (PROMIS Global Physical and Mental Health subscales), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7).

Results:

After controlling for sociodemographic, injury, cognition, and time post-injury, adequate health literacy was associated with higher odds of greater perceived physical health compared with participants with marginal/inadequate health literacy (odds ratio = 4.10; CI = 1.52-11.70]. Participants with inadequate/marginal health literacy had 3.50 times greater odds of depression (PHQ-9 ≥ 10) compared with those with adequate health literacy. Participants 45 years and older reported a greater number of MMHCI physical health conditions, but fewer MMHCI mental health conditions and GAD-7 anxiety symptoms compared with those who were younger. Non-Hispanic White participants and those with mild/moderate TBI were more likely to report a greater number of MMHCI mental health conditions compared with non-Hispanic Black participants or those with severe TBI. Greater time post-injury was associated with greater number of chronic physical and mental health conditions, and less odds of good-to-excellent perceived global mental health.

Conclusions:

Inadequate health literacy is associated with worse perceived physical health and greater depressive symptoms among adults with TBI. Greater efforts are needed to explore the mechanisms by which health literacy influences chronic disease management and mental health after TBI to improve postinjury health status and outcomes, particularly among those with limited health literacy skills.
Electrostimulation of the white matter of the posterior insula and medial operculum: perception of vibrations, heat, and pain
Authors: Mandonnet Valéry , Obaid Sami , Descoteaux Maxime , St-Onge Etienne , Devaux Bertrand , Levé Charlotte , Froelich Sébastien , Rheault François , Mandonnet Emmanuel
Published: October 2023

This study aimed to characterize the sensory responses observed when electrically stimulating the white matter surrounding the posterior insula and medial operculum (PIMO). We reviewed patients operated on under awake conditions for a glioma located in the temporoparietal junction. Patients' perceptions were retrieved from operative reports. Stimulation points were registered in the Montreal Neurological Institute template. A total of 12 stimulation points in 8 patients were analyzed. Painful sensations in the contralateral leg were reported (5 sites in 5 patients) when stimulating the white matter close to the parcel OP2/3 of the Glasser atlas. Pain had diverse qualities: burning, tingling, crushing, or electric shock. More laterally, in the white matter of OP1, pain and heat sensations in the upper part of the body were described (5 sites in 2 patients). Intermingled with these sites, vibration sensations were also reported (3 sites in 2 patients). Based on the tractograms of 44 subjects from the Human Connectome Project data set, we built a template of the pathways linking the thalamus to OP2/3 and OP1. Pain sites were located in the thalamo-OP2/3 and thalamo-OP1 tracts. Heat sites were located in the thalamo-OP1 tract. In the 227 awake surgeries performed for a tumor located outside of the PIMO region, no patients ever reported pain or heat sensations when stimulating the white matter. Thus, we propose that the thalamo-PIMO connections constitute the main cortical inputs for nociception and thermoception and emphasize that preserving these fibers is of utmost importance to prevent the postoperative onset of a debilitating insulo-opercular pain syndrome.
Targeted transcriptional upregulation of SENP1 by CRISPR activation enhances deSUMOylation pathways to elicit antinociception in the spinal nerve ligation model of neuropathic pain
Authors: Gomez Kimberly , Allen Heather N. , Duran Paz , Loya-Lopez Santiago , Calderon-Rivera Aida , Moutal Aubin , Tang Cheng , Nelson Tyler S. , Perez-Miller Samantha , Khanna Rajesh
Published: October 2023

The voltage-gated sodium channel NaV1.7 is an essential component of human pain signaling. Changes in NaV1.7 trafficking are considered critical in the development of neuropathic pain. SUMOylation of collapsin response mediator protein 2 (CRMP2) regulates the membrane trafficking and function of NaV1.7. Enhanced CRMP2 SUMOylation in neuropathic pain correlates with increased NaV1.7 activity. Pharmacological and genetic interventions that interfere with CRMP2 SUMOylation in rodents with neuropathic pain have been shown to reverse mechanical allodynia. Sentrin or SUMO-specific proteases (SENPs) are vital for balancing SUMOylation and deSUMOylation of substrates. Overexpression of SENP1 and/or SENP2 in CRMP2-expressing cells results in increased deSUMOylation and decreased membrane expression and currents of NaV1.7. Although SENP1 is present in the spinal cord and dorsal root ganglia, its role in regulating NaV1.7 function and pain is not known. We hypothesized that favoring SENP1 expression can enhance CRMP2 deSUMOylation to modulate NaV1.7 channels. In this study, we used a clustered regularly interspaced short palindromic repeats activation (CRISPRa) SENP1 lentivirus to overexpress SENP1 in dorsal root ganglia neurons. We found that SENP1 lentivirus reduced CRMP2 SUMOylation, NaV1.7–CRMP2 interaction, and NaV1.7 membrane expression. SENP1 overexpression decreased NaV1.7 currents through clathrin-mediated endocytosis, directly linked to CRMP2 deSUMOylation. Moreover, enhancing SENP1 expression did not affect the activity of TRPV1 channels or voltage-gated calcium and potassium channels. Intrathecal injection of CRISPRa SENP1 lentivirus reversed mechanical allodynia in male and female rats with spinal nerve injury. These results provide evidence that the pain-regulating effects of SENP1 overexpression involve, in part, the modulation of NaV1.7 channels through the indirect mechanism of CRMP2 deSUMOylation.
Psychosocial evaluation of living liver donors—State of current practices in the United States
Authors: Zimbrean Paula C. , Rubman Susan , Andacoglu Oya , Bakhai Darshit , Clifton Erin , Deng Yanhong , Doshi Mona , Emamaullee Juliet , Gan Geliang , Holmes Rachel , Jaber Lana , Jackson Whitney E. , Joyce Michael , Kalil Roberto , Kumar Vineeta , Laflen Jennie , Lentine Krista L. , Prashar Rohini , Winder Gerald S. , Yadav Anju , Liapakis AnnMarie
Published: October 2023

We surveyed living donor liver transplant programs in the United States to describe practices in the psychosocial evaluation of living donors focused on (1) composition of psychosocial team; (2) domains, workflow, and tools of the psychosocial assessment; (3) absolute and relative mental health-related contraindications to donation; and (4) postdonation psychosocial follow-up. We received 52 unique responses, representing 33 of 50 (66%) of active living donor liver transplant programs. Thirty-one (93.9%) provider teams included social workers, 22 (66.7%) psychiatrists, and 14 (42.4%) psychologists. Validated tools were rarely used, but domains assessed were consistent. Respondents rated active alcohol (93.8%), cocaine (96.8%), and opioid (96.8%) use disorder, as absolute contraindications to donation. Active suicidality (97%), self-injurious behavior (90.9%), eating disorders (87.9%), psychosis (84.8%), nonadherence (71.9%), and inability to cooperate with the evaluation team (78.1%) were absolute contraindications to donation. There were no statistically significant differences in absolute psychosocial contraindications to liver donation between geographical areas or between large and small programs. Programs conduct postdonation psychosocial follow-up (57.6%) or screening (39.4%), but routine follow-up of declined donors is rarely conducted (15.8%). Psychosocial evaluation of donor candidates is a multidisciplinary process. The structure of the psychosocial evaluation of donors is not uniform among programs though the domains assessed are consistent. Psychosocial contraindications to living liver donation vary among the transplant programs. Mental health follow-up of donor candidates is not standardized.
Point-of-care, goal-directed management of bleeding in trauma patients
Authors: Zipperle Johannes , Schmitt Felix C.F. , Schöchl Herbert
Published: October 2023

Purpose of review

The purpose of this review is to consider the clinical value of point-of-care (POC) testing in coagulopathic trauma patients with traumatic brain injury (TBI) and trauma-induced coagulopathy (TIC).

Recent findings

Patients suffering from severe TBI or TIC are at risk of developing pronounced haemostatic disorders. Standard coagulation tests (SCTs) are insufficient to reflect the complexity of these coagulopathies. Recent evidence has shown that viscoelastic tests (VETs) identify haemostatic disorders more rapidly and in more detail than SCTs. Moreover, VET results can guide coagulation therapy, allowing individualised treatment, which decreases transfusion requirements. However, the impact of VET on mortality remains uncertain. In contrast to VETs, the clinical impact of POC platelet function testing is still unproven.

POC SCTs are not able to characterise the complexity of trauma-associated coagulopathy. VETs provide a rapid estimation of underlying haemostatic disorders, thereby providing guidance for haemostatic therapy, which impacts allogenic blood transfusion requirements. The value of POC platelet function testing to identify platelet dysfunction and guide platelet transfusion is still uncertain.
Acupuncture or moxibustion adjuvant chemotherapy for advanced non-small cell lung cancer: Systematic review and network meta-analysis
Authors: Wang Shiheng , Mu Chaochao , Zhang Fengxia , Tang Hanqing , Ning Wanling
Published: October 2023

Background:

To compare the advantages and disadvantages of different acupuncture and moxibustion methods by network meta-analysis, in order to find out the best acupuncture and moxibustion adjuvant chemotherapy scheme of non-small cell lung cancer (NSCLC).

Methods:

Randomized controlled trials of acupuncture and moxibustion adjuvant chemotherapy in the treatment of NSCLC were searched in PubMed, Cochrane Library, Web of science, EMbase, China National Knowledge Infrastructure, Wanfang, VIP database and SinoMed. The retrieval time was up to December 03, 2022. ROB2 was used to evaluate publication bias, and Stata16 was used for network meta-analysis.

Results:

A total of 14 studies involving 921 patients were included. The results of network Meta-analysis showed that the effect of acupuncture combined with chemotherapy was better than that of chemotherapy (RR = 1.28, 95%CI (1.04,1.58), P < .0001). The effect of acupuncture combined with chemotherapy was better than that of chemotherapy in improving KPS score (MD = 9.01, 95%CI (3.35,14.67), P < .0001). The safety of acupuncture combined with chemotherapy (RR = 0.35, 95%CI (0.15,0.83), P < .0001) was better than that of chemotherapy.

Conclusion:

Acupuncture combined with chemotherapy has the best comprehensive effect.
Association between diabetes and venous thromboembolism: A systematic review and meta-analysis
Authors: Ding Chaowei , Guo Chang , Du Dan , Gong Xiaowei , Yuan Yadong
Published: October 2023

Background:

Diabetes mellitus (DM) plays a vital role in the development of cardiovascular disease. However, its association with venous thromboembolism (VTE) remains unclear, for the published study results are conflicting. We performed a meta-analysis of published cohort studies and case–control studies to assess the role of DM in the formation and prognosis of VTE.

Methods:

PubMed and EMBASE databases were searched for articles from the database’s establishment until September 15, 2022. Of the 15,754 publications retrieved, 50 studies were identified that met the selection criteria. The New castle-Ottawa Scale was used to evaluate the quality of the literature. Pooled odds ratios (ORs) and 95% confidence intervals were calculated using fixed- or random-effect models.

Results:

We combined OR using a random-effects or fixed-effects model: patients with DM had an increased risk of VTE (OR 1.27, 95% confidence interval [CI]: 1.15–1.41), which still showed a partial association in studies adjusted by confounding factors (OR 1.20, 95% CI: 1.07–1.35). DM was not significantly associated with VTE when analyzed in studies adjusted by body mass index (OR 1.04, 95% CI: 0.94–1.15). VTE patients with DM had a higher risk of short-term and long-term mortality than those without DM (OR 1.58 [95% CI: 1.26–1.99] for long-term mortality and OR 1.20 [95% CI: 1.19–1.21] for short-term mortality).

Conclusion:

There was no significant association between DM and VTE risk, and body mass index may be a significant confounding factor between DM and VTE risk. However, DM can still lead to an increased risk of long-term and short-term mortality in patients with VTE.
Uterine giant cell tumor of soft tissue: A case report
Authors: Jiang Yao , Chen Kaiyan , Yu Mengting , Qin Juan , Wang Juntao
Published: October 2023

Introduction:

Giant cell tumor of soft tissue (GCT-ST) is a rare primary soft tissue tumor. GCT-ST mainly occurs in the trunk and extremities. There is no standard treatment for GCT-ST. This paper reports a rare case of primary uterine GCT-ST.

Case presentation:

A 48-year-old female patient underwent a transabdominal subhysterectomy for uterine leiomyoma. Postoperative pathological examination showed GCT-ST with unclear tissue boundary (10.0 × 6.0 × 5.0 cm). A small amount of GCT-ST tissue could be seen on the local edge of the leiomyoma. Residual tumor tissue was found around the uterine cavity. The patient reported persistent lower abdominal distension pain 3 months after the operation. Pelvic and abdominal imaging showed a huge tumor and multiple pelvic and abdominal organ metastasis. No pulmonary metastasis was found. Exploratory surgery revealed widespread metastases in the abdominal and peritoneal cavities, involving both ovaries, right tubal serous membrane, appendix serous membrane, bladder, pelvic peritoneum, and abdominal wall incision. After surgery, the patient had 6 cycles of docetaxel and carboplatin but stopped treatments due to economic reasons. The patient died 3 months later because of multiple organs failure.

Conclusion:

GCT-ST is generally benign but has unpredictable behavior. A massive recurrence with wide invasion is possible after subtotal resection.
Dome impaction classification in acetabular fractures: Identifying atypical dome impactions with absence of the gull sign: A retrospective descriptive study
Authors: Kanezaki Shozo , Miyazaki Masashi , Sakamoto Tomonori , Hino Akihiro , Abe Tetsutaro , Sako Noriaki , Tsumura Hiroshi
Published: October 2023

We aimed to describe variations of dome impaction fractures and their characteristics using a new classification system, to explore the relationship between dome impaction and the gull sign. The present study was a retrospective descriptive study. All 104 cases of acetabular fracture that were treated in our institution from 2013 to 2022 were enrolled. Of these, 22 had dome impaction fractures. The primary outcome variable was to describe the variations and characteristics of dome impaction fractures. They were classified into 3 major subgroups based on reconstructed axial, coronal, and sagittal computed tomography findings: anteromedial, superomedial (SM), and posteromedial. The secondary outcome variable was to explore the relationship between dome impaction on computed tomography findings and the gull sign on plain radiographs. There were 4 cases of anteromedial (18.2%), 13 of SM (59.1%), and 5 of posteromedial (22.7%). There were 15 cases (68.2%) with the gull sign and 7 cases (31.8%) without the gull sign on plain radiographs. Twelve of fifteen cases (80.0%) with the gull sign had dome impaction fractures of the SM type. We found a variety of patterns of dome impaction fracture. Surgeons should be aware of atypical dome impactions not showing the gull sign.