bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of lipid extraction in the muscle tissue of the blue crab Callinectes sapidus Rathbun, 1896 (Decapoda: Brachyura: Portunidae) in the determination of δ13C and δ15N
Authors: Rosas-Luis Rigoberto , Cabanillas-Terán Nancy , Hernandez-Chavez Luis Ignacio
Published: June 2023

Stable isotope analysis of δ13C and δ15N has been used in the description of the trophic ecology in marine organisms. This approach has been applied to various taxa including crustaceans. Pre-treatment of samples before isotope quantification is suggested for tissues with high lipid content, because lipids can affect the isotope concentrations. We focused on the isotope analysis of tissues of the blue crab (Callinectes sapidusRathbun, 1896) because it is a significant prey item for intermediate and top predators. We aimed to assess the isotope values produced by two lipid extraction methods and compare these results with values of samples which were not lipid-extracted. Results evidenced a negative relationship between Δδ13C and the C:N ratios, the C:N ratios explaining 98% of the variation in the Δδ13C. Regarding the SEAc results, the δ13C values showed more negative values after the lipid extraction Bligh and Dryer method, which indicates that this method is accurate for pre-treatment of samples before isotope quantification. These results highlighted the importance of lipid extraction before quantifying isotopes and enforces the need of pre-treatment of samples.
Surrogate modeling of the fan plot of a rotor system considering composite blades using convolutional neural networks with image composition
Authors: Noh Hong-Kyun , Lim Jae Hyuk , Lee Seungchul , Kim Taejoo , Kim Deog-Kwan
Published: June 2023

This study proposes an image composition technique based on convolutional neural networks (CNNs) to construct a surrogate model for predicting fan plots of three-dimensional (3D) composite blades, which represent natural frequency lists at different rotational speeds. The proposed method composes critical 2D cross-section images to improve the accuracy of the model. Numerical examples with various compositions of cross-section images are presented to demonstrate the efficacy of the CNN model. Additionally, gradient-weighted class activation mapping analysis is used to reveal the relationship between the internal structure of the blade and the fan plots. The study shows that using multiple images in the image composition technique improves the accuracy of the model compared to using single or fewer images. Overall, the proposed method provides a promising approach for predicting fan plots of 3D composite blades using CNN models.
Sound of Quantitative Metres in Medieval Hebrew Poetry
Authors: Kleiner Boris
Published: June 2023

The conventional view of quantitative metres in medieval Hispano-Hebrew poetry confuses vowels and syllables. This is because it was syllable structure, rather than vowel typology, that produced the quantitative oppositions. Vocalic shewa was not a furtive but a regular short vowel; its syllable was light because it was not closed by a consonant. Heavy syllables were formed by closing consonants, replaceable by a long vowel, as in Arabic and other languages. Arabic metres could be used in Hebrew with no modification of their phonological basis. However, the quantitative prosody of Arabic poetry was the same as in Qurʾānic recitation, whereas its application to Hebrew contradicted the accentual prosody of the Bible. This appears to be the reason for the controversy surrounding the introduction of Arabic metrics into Hebrew poetry. Quantitative metres require only the focus on the articulatory structures to become audible. Musical durations and accents can corroborate the metre, but they can also be non-related without compromising metre perception.
Prevalence and Distribution of Known Associated Factors of Burnout among Military Personnel of Sri Lanka Army: A Descriptive Cross-Sectional Study
Authors: Jothipala Dharshitha , Semage Saveen , Balasuriya Aindralal
Published: June 2023

Introduction

Burnout is a psychological condition that has a detrimental effect on occupational and mental health. The military is a known community that is vulnerable to burnout. Burnout risk may have increased over the past 10 years due to the accumulation of recognized burnout correlates in the Sri Lankan military context. Sri Lanka Army is acknowledged as the country’s main defense force to combat any impending threat. Therefore, it is crucial to recognize and control mental health issues like burnout. This study aims to describe the prevalence and distribution of recognized factors associated with burnout among Sri Lankan Army soldiers.

Materials and Methods

A descriptive cross-sectional study was conducted among 1692 Army personnel to describe the known associated factor profile and prevalence of burnout. The multistage sampling method that contained random, cluster, and systematic sampling steps was used. Validated Maslach burnout inventory-General Survey (MBI-GS) Sinhala version, Coping Orientation to Problems Experienced Inventory (Brief-COPE), and a structured questionnaire on associated factors of burnout were included in a self-administered questionnaire. Sizes of each associated variable were calculated as frequency and percentage. Relevant central tendencies (mean or median) and distributions (confidence interval or interquartile range) of important variables were calculated. Crude and adjusted prevalence was calculated using validity properties obtained from prior criterion validity assessment.

Results

The response rate was 94% (n = 1490). The mean age was 30.7 (SD ± 6.23) years. The female participant percentage was 9.4% (n = 149). Half of participants (n = 813, 51.1%) were Lance corporals and Corporals. Nearly 80% (n = 1324, 83.2%) of study population gets less than Sri Lankan Rupees (SLR) 50,000 as final monthly salary, and three-fourth (n = 1187, 74.7%) did not have money savings. Faced difficulty because of resource deficiency (n = 1099, 69.1%), poor job control (n = 669, 42.1%), job ambiguity (n = 869, 55%), intention to leave (n = 842, 53%), and history of been absent (n = 298, 18.7%) were found to be much prevalent. The crude prevalence of probable burnout among military personnel of Sri Lanka Army was estimated to be 28% (95% CI, 23.13-32.87), and the adjusted prevalence of burnout was 23.2% (95% CI, 18.9-27.5).

Conclusion

High prevalence and high density of known associated factors of burnout would adversely influence the achievement of organizational goals of Sri Lanka Army. Early attention and proper action are strongly recommended.
Profile split of DIB 6196 in Sco OB2 association objects
Authors: Galazutdinov G A , Krełowski J
Published: June 2023

This paper describes the specific profile of the diffuse interstellar band (DIB) 6196 Å in objects belonging to the Sco OB2 association. The investigated feature is the narrowest known strong diffuse band. Reddened Sco OB2 association objects show slightly broadened and split (W-shaped) 6196 DIB profiles. The split cannot be explained by the presence of two (or more) clouds of different radial velocities along the line of sight because it is not observed in the much narrower identified atomic/molecular features. The observed DIB profile may (in some cases) be a composition of the band centre and its head of a still unknown molecule. Our estimation of the rotational temperature of C2 exhibits systematically higher values for objects with the observed split effect (Sco OB2 members). These split profiles are observed in both ζ and σ types of clouds, although in Sco OB2 objects only, suggesting that the phenomenon originates in some specific and currently unclear physical/chemical conditions inside the Sco OB2 association. It could be that a lower amount of small dust particles in Sco OB2 affects the flux of ultraviolet photons, providing a higher rotational temperature of DIB 6196 carriers, which is seen as a profile split.
Recruitment of transcription factor ETS1 to activated accessible regions promotes the transcriptional program of cilia genes
Authors: Zhang Donghui , Zhang Chong , Zhu Yanmei , Xie Haixia , Yue Caifeng , Li Mingfeng , Wei Wenlu , Peng Yu , Yin Guibin , Guo Yunmiao , Guan Yiting
Published: June 2023

Defects in cilia genes, which are critical for cilia formation and function, can cause complicated ciliopathy syndromes involving multiple organs and tissues; however, the underlying regulatory mechanisms of the networks of cilia genes in ciliopathies remain enigmatic. Herein, we have uncovered the genome-wide redistribution of accessible chromatin regions and extensive alterations of expression of cilia genes during Ellis–van Creveld syndrome (EVC) ciliopathy pathogenesis. Mechanistically, the distinct EVC ciliopathy-activated accessible regions (CAAs) are shown to positively regulate robust changes in flanking cilia genes, which are a key requirement for cilia transcription in response to developmental signals. Moreover, a single transcription factor, ETS1, can be recruited to CAAs, leading to prominent chromatin accessibility reconstruction in EVC ciliopathy patients. In zebrafish, the collapse of CAAs driven by ets1 suppression subsequently causes defective cilia proteins, resulting in body curvature and pericardial oedema. Our results depict a dynamic landscape of chromatin accessibility in EVC ciliopathy patients, and uncover an insightful role for ETS1 in controlling the global transcriptional program of cilia genes by reprogramming the widespread chromatin state.
Highly active CRISPR-adaptation proteins revealed by a robust enrichment technology
Authors: Yosef Ido , Mahata Tridib , Goren Moran G , Degany Or J , Ben-Shem Adam , Qimron Udi
Published: June 2023

Natural prokaryotic defense via the CRISPR–Cas system requires spacer integration into the CRISPR array in a process called adaptation. To search for adaptation proteins with enhanced capabilities, we established a robust perpetual DNA packaging and transfer (PeDPaT) system that uses a strain of T7 phage to package plasmids and transfer them without killing the host, and then uses a different strain of T7 phage to repeat the cycle. We used PeDPaT to identify better adaptation proteins—Cas1 and Cas2—by enriching mutants that provide higher adaptation efficiency. We identified two mutant Cas1 proteins that show up to 10-fold enhanced adaptation in vivo. In vitro, one mutant has higher integration and DNA binding activities, and another has a higher disintegration activity compared to the wild-type Cas1. Lastly, we showed that their specificity for selecting a protospacer adjacent motif is decreased. The PeDPaT technology may be used for many robust screens requiring efficient and effortless DNA transduction.
Updated protein domain annotation of the PARP protein family sheds new light on biological function
Authors: Suskiewicz Marcin J , Munnur Deeksha , Strømland Øyvind , Yang Ji-Chun , Easton Laura E , Chatrin Chatrin , Zhu Kang , Baretić Domagoj , Goffinont Stéphane , Schuller Marion , Wu Wing-Fung , Elkins Jonathan M , Ahel Dragana , Sanyal Sumana , Neuhaus David , Ahel Ivan
Published: June 2023

AlphaFold2 and related computational tools have greatly aided studies of structural biology through their ability to accurately predict protein structures. In the present work, we explored AF2 structural models of the 17 canonical members of the human PARP protein family and supplemented this analysis with new experiments and an overview of recent published data. PARP proteins are typically involved in the modification of proteins and nucleic acids through mono or poly(ADP-ribosyl)ation, but this function can be modulated by the presence of various auxiliary protein domains. Our analysis provides a comprehensive view of the structured domains and long intrinsically disordered regions within human PARPs, offering a revised basis for understanding the function of these proteins. Among other functional insights, the study provides a model of PARP1 domain dynamics in the DNA-free and DNA-bound states and enhances the connection between ADP-ribosylation and RNA biology and between ADP-ribosylation and ubiquitin-like modifications by predicting putative RNA-binding domains and E2-related RWD domains in certain PARPs. In line with the bioinformatic analysis, we demonstrate for the first time PARP14’s RNA-binding capability and RNA ADP-ribosylation activity in vitro. While our insights align with existing experimental data and are probably accurate, they need further validation through experiments.
DICER1 platform domain missense variants inhibit miRNA biogenesis and lead to tumor susceptibility
Authors: Pelletier Dylan , Chong Anne-Laure , Wu Mona , Witkowski Leora , Albert Sophie , Sabbaghian Nelly , Fabian Marc R , Foulkes William D
Published: June 2023

The endoribonuclease DICER1 plays an essential role in the microRNA (miRNA) biogenesis pathway, cleaving precursor miRNA (pre-miRNA) stem-loops to generate mature single-stranded miRNAs. Germline pathogenic variants (GPVs) in DICER1 result in DICER1 tumor predisposition syndrome (DTPS), a mainly childhood-onset tumor susceptibility disorder. Most DTPS-causing GPVs are nonsense or frameshifting, with tumor development requiring a second somatic missense hit that impairs the DICER1 RNase IIIb domain. Interestingly, germline DICER1 missense variants that cluster in the DICER1 Platform domain have been identified in some persons affected by tumors that also associate with DTPS. Here, we demonstrate that four of these Platform domain variants prevent DICER1 from producing mature miRNAs and as a result impair miRNA-mediated gene silencing. Importantly, we show that in contrast to canonical somatic missense variants that alter DICER1 cleavage activity, DICER1 proteins harboring these Platform variants fail to bind to pre-miRNA stem-loops. Taken together, this work sheds light upon a unique subset of GPVs causing DTPS and provides new insights into how alterations in the DICER1 Platform domain can impact miRNA biogenesis.
Watching the clock in glioblastoma
Authors: Chan Priscilla , Rich Jeremy N , Kay Steve A
Published: June 2023

Glioblastoma (GBM) is the most prevalent malignant primary brain tumor, accounting for 14.2% of all diagnosed tumors and 50.1% of all malignant tumors, and the median survival time is approximately 8 months irrespective of whether a patient receives treatment without significant improvement despite expansive research (Ostrom QT, Price M, Neff C, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2015–2019. Neurooncology. 2022; 24(suppl 5):v1–v95.). Recently, important roles for the circadian clock in GBM tumorigenesis have been reported. Positive regulators of circadian-controlled transcription, brain and muscle ARNT-like 1 (BMAL1), and circadian locomotor output cycles kaput (CLOCK), are highly expressed also in GBM and correlated with poor patient prognosis. BMAL1 and CLOCK promote the maintenance of GBM stem cells (GSCs) and the establishment of a pro-tumorigenic tumor microenvironment (TME), suggesting that targeting the core clock proteins may augment GBM treatment. Here, we review findings that highlight the critical role the circadian clock plays in GBM biology and the strategies by which the circadian clock can be leveraged for GBM treatment in the clinic moving forward.
Tufted Puffins exhibit low levels of genetic differentiation among breeding colonies in North America
Authors: Graham Brendan A , Hipfner J Mark , Rojek Nora A , Stephensen Shawn W , Burg Theresa M
Published: June 2023

Tufted Puffins (Fratercula cirrhata) are experiencing population declines in some parts of their distribution, making this a species of increased conservation interest. Genetic data will help to identify Tufted Puffin populations of conservation importance and provide an important tool for developing conservation management plans. This species is broadly distributed across the North Pacific Ocean but little is known about the extent of genetic variation and differentiation across their range. In this study, we examine mitochondrial DNA (mtDNA), 8 microsatellite loci and 1,260 single nucleotide polymorphisms (SNPs) to determine the extent of gene flow among 7 breeding colonies (Oregon to the western Aleutians) in the North American breeding range of the species and identify potential barriers to dispersal. Our results show that most breeding colonies form a single genetic cluster, and mtDNA data show substantial historical gene flow among populations. For the microsatellite dataset, all FST comparisons that include St. Lazaria, in southeast Alaska, except Oregon, which had a small sample size, were significant as were comparisons between Triangle Island and the two westernmost sampling sites of Buldir and Aiktak. For the SNP dataset, FST comparisons were low and nonsignificant, further suggesting that breeding colonies form a single panmictic population. Individuals were more closely related to individuals from the same colony, and we found a weak relationship between genetic and geographic distance. This suggests that dispersal among colonies is high, likely facilitated by an overlap in wintering ranges among colonies. The high connectivity among breeding colonies indicates that Tufted Puffins form a single conservation unit, although future genetic studies should incorporate a whole genome sequencing approach to assessing how functional genetic diversity varies across their distribution.
How welfare wins: Discursive institutionalism, the politics of the poor, and the expansion of social welfare in India during the early 21st century
Authors: Roy Indrajit
Published: June 2023

The worldwide explosion of social welfare has been described as the “quiet revolution” of our time. This paper analyses the expansion of social welfare in India during the early part of the 2000s. What explains this expansion of encompassing social welfare in India, following a history of disparate and fragmented social policies? The answer, I argue, lies in recognizing the importance of the “politics of the poor,” the ensemble of negotiations that encompass both electoral participation and contentious politics vis-à-vis the political institutions in India. The paper develops this argument by drawing together insights from discursive institutionalism, Indian politics, and the politics of welfare literature. Doing so enables me to examine the ways in which poor people’s political practices were interpreted by India’s parliamentarians to justify the legislation of India’s flagship social welfare program the National Rural Employment Guarantee Act. I analyze the discourses communicated through 78 parliamentary debates in English and Hindi to enact the law. I blend this analysis with process tracing of electoral behavior of India’s poor and the Maoist insurrection that exploded in the country’s poorest districts at the turn of the century.
Discontinuation rate of sulfasalazine, leflunomide and methotrexate due to adverse events in a real-life setting (NOR-DMARD)
Authors: Mielnik Pawel , Sexton Joseph , Fagerli Karen M , Bakland Gunnstein , Hu Yi , Kristianslund Eirik K , Hoff Mari , Wierød Ada , Kvien Tore K
Published: June 2023

Objectives

MTX, LEF and SSZ are conventional synthetic DMARDs (csDMARDs) with a well-established role in the treatment of RA. We aimed to estimate and compare the relative risks for adverse events (AEs) and the discontinuation of these drugs owing to AEs.

Methods

We included all 3339 patients from the NOR-DMARD study treated with MTX, LEF or SSZ in monotherapy. All reported AEs were compared between treatment groups using quasi-Poisson regression. In addition, drug retention rates were analysed using Kaplan–Meier estimates with Cox regression to control for possible confounders. We analysed drug retention rates and cumulative risk of discontinuation attributable to AEs using the Kaplan–Meier estimator. We assessed age, sex, baseline DAS in 28 joints with ESR (DAS28-ESR), seropositivity, prednisolone use, previous DMARD use, year of inclusion and co-morbidity as possible cofounders.

Results

We found that the discontinuation rate attributable to AEs was significantly higher for LEF and SSZ than for MTX. After the first year, it was 13.7% (95% CI 12.2, 15.2), 39.6% (95% CI 34.8, 44) and 43.4% (95% CI 38.2, 48.1) for MTX, SSZ and LEF, respectively. Similar results were found when adjusting for confounders. The overall AEs were comparable across the treatment groups. The AE profile was as expected for each drug.

Conclusion

Our work has shown a similar AE profile of csDMARDs to previous data. However, higher discontinuation rates for SSZ and LEF cannot be explained easily from AE profiles.
Evidence on Buprenorphine Dose Limits: A Review
Authors: Grande Lucinda A. , Cundiff Dave , Greenwald Mark K. , Murray MaryAnne , Wright Tricia E. , Martin Stephen A.
Published: June 2023

Objectives

As overdose deaths from fentanyl continue to increase, optimizing use of medications for opioid use disorder has become increasingly important. Buprenorphine is a highly effective medication for reducing the risk of overdose death, but only if a patient remains in treatment. Shared decision making between prescribers and patients is important to establish a dose that meets each patient’s treatment needs. However, patients frequently face a dose limit of 16 or 24 mg/d based on dosing guidelines on the Food and Drug Administration’s package label.

Methods

This review discusses patient-centered goals and clinical criteria for determining dose adequacy, reviews the history of buprenorphine dose regulation in the United States, examines pharmacological and clinical research results with buprenorphine doses up to 32 mg/d, and evaluates whether diversion concerns justify maintaining a low buprenorphine dose limit.

Results

Pharmacological and clinical research results consistently demonstrate buprenorphine’s dose-dependent benefits up to at least 32 mg/d, including reductions in withdrawal symptoms, craving, opioid reward, and illicit use while improving retention in care. Diverted buprenorphine is most often used to treat withdrawal symptoms and reduce illicit opioid use when legal access to it is limited.

Conclusions

In light of established research and profound harms from fentanyl, the Food and Drug Administration’s current recommendations on target dose and dose limit are outdated and causing harm. An update to the buprenorphine package label with recommended dosing up to 32 mg/d and elimination of the 16 mg/d target dose would improve treatment effectiveness and save lives.
Content Analysis of Feedback Journals for New Nurses From Preceptor Nurses Using Text Network Analysis
Authors: Ahn Shin Hye , Jeong Hye Won
Published: June 2023

This study aimed to identify keywords, core topic areas, and subthemes by analyzing feedback journals written by preceptor nurses to new nurses during the preceptorship period and to derive implications through word clustering. A total of 143 preceptor nurses' feedback journals for new nurses from March 2020 to January 2021 were converted into a database using Microsoft Office Excel. Text network analysis was performed using the NetMiner 4.4.3 program. After data preprocessing, simple frequency, degree centrality, closeness centrality, betweenness centrality, and community modularity were analyzed. In the feedback journals, the most central words were “study,” “medication,” “practice,” “nursing,” “method,” “need,” and “effort,” whereas frustration, “new nurses” had low centrality. Five subthemes were derived: (1) learning necessity to strengthen new nurses' competency, (2) independence of new nurses, (3) emphasis on accuracy in nursing skills, (4) difficulties in understanding the nursing tasks expected of new nurses, and (5) basic competency of new nurses. The results of this study highlighted the experiences of new nurses and allowed for an assessment of journal feedback content provided by preceptor nurses. As such, the study provides basic data to develop a standardized education and competency empowerment program for preceptor nurses.
Reconstruction of High-Tension Scalp Defects by the Twizzler Technique: A Retrospective Case Series
Authors: Riopelle Alexandria M. , Jeong Daehee , Boyd Alexandra Y. , Schanbacher Carl F.
Published: June 2023

BACKGROUND

Scalp wounds are difficult to close primarily because of the inelasticity of the galea, often requiring adjacent tissue transfer or grafting. It is still debated whether intraoperative tissue expansion can occur on the scalp.

OBJECTIVE

We report our experience with the Twizzler technique, a form of intraoperative tissue expansion and load cycling, to achieve primary closure of high-tension scalp wounds.

MATERIALS AND METHODS

In this case series, scalp defects repaired by the Twizzler were identified and those with minimum 3 month follow-up underwent assessment by physicians and patients.

RESULTS

All 50 scalp defects that could not be otherwise closed primarily were repaired successfully with the Twizzler. The average defect width was 2.0 cm (range 0.9–3.9 cm), the average physician aesthetic rating was 3.71 on a 5-point scale (very good; n = 25), and most patients rated the scars as “near normal skin” on the Patient and Observer Scar Assessment Scale 3.0 (n = 32).

CONCLUSION

Based on the findings of this case series, the Twizzler can be used to repair small and medium high-tension scalp defects after Mohs micrographic surgery. Intraoperative tissue expansion and creep deformation on the scalp is limited, but seemingly possible.
Safety of recent ophthalmic drugs and devices for wet macular degeneration
Authors: Timtim Elise , Weng Christina Y. , Finn Avni P.
Published: June 2023

Purpose of review

With frequent antivascular endothelial growth factors (VEGF) injections well established as the standard of care in neovascular age-related macular degeneration (nAMD), focus has now shifted towards decreasing treatment burden without compromising safety and efficacy. This review summarizes clinical stage and recently approved drugs and devices for nAMD, with an emphasis paid to safety concerns and their implications for product adoption.

Recent findings

Three strategies have emerged to decrease the treatment burden associated with the current standard of care: more durable intravitreal agents, sustained-release modalities and gene therapy. The appearance of biosimilars will further impact drug availability and cost. As patterns of adverse events emerge from clinical trial or postmarketing surveillance data, manufacturers have proactively responded by appointing independent review committees or issuing voluntary recalls. However, the example of one biosimilar approved outside of the USA and European Union demonstrates how early safety concerns, even when addressed by substantive data, can generate lingering uncertainty.

As the number of promising new treatments in nAMD continues to grow, so too does the amount of data that providers must sift through. The perception of safety surrounding first movers in each new therapeutic area is sure to affect adoption of that modality more broadly.
Outcomes of iStent Inject Versus Kahook Dual Blade Surgery in Glaucoma Patients Undergoing Cataract Surgery
Authors: Barkander Anna , Economou M A , Jóhannesson Gauti
Published: June 2023

Précis:

iStent Inject implantation (iStent) or Kahook Dual Blade goniotomy (KDB) in combination with phacoemulsification have a similar IOP-lowering effect in all stages of glaucoma, and medications are significantly reduced, especially after KDB.

Purpose:

To compare the 2-year efficacy and safety of iStent or KDB in combination with phacoemulsification in eyes with mild to advanced open angle glaucoma.

Methods:

A retrospective chart review of 153 patients that received iStent or KDB in combination with phacoemulsification at a single center between March 2019 and August 2020. The main outcome parameters at 2 years were: (1) intraocular pressure (IOP)-reduction ≥20%, with a postoperative IOP ≤18 mm Hg, and (2) a reduction of ≥1 medication. Results were stratified by glaucoma grade.

Results:

After 2 years, mean IOP was reduced from 20.3±6.1 to 14.2±4.1 mm Hg in the phaco-iStent group (P<0.001) and from 20.1±6.1 to 14.7±3.6 mm Hg in the phaco-KDB group (P<0.001). The mean number of medications was reduced from 3.0±0.9 to 2.6±1.1 in the Phaco-iStent group (P=0.001) and from 2.3±1.0 to 1.5±1.3 in the Phaco-KDB group (P<0.001). Success regarding IOP-reduction ≥20% with a postoperative IOP ≤18 mm Hg was met by 46% in the phaco-iStent group and by 51% in the phaco-KDB group. A reduction of ≥1 medication was met by 32% in the phaco-iStent group and by 53% in the phaco-KDB group (P=0.013). Eyes with mild to moderate and advanced glaucoma responded equally well to the success criteria.

Conclusions:

iStent and KDB, in combination with phacoemulsification, both lowered IOP effectively in all stages of glaucoma. More medications were reduced after KDB, suggesting that it may be a more effective procedure compared with iStent.
A Novel Report of Suspected Prostate Adenocarcinoma to Orbital Roof Meningioma Metastasis
Authors: Wilson Darcie S. , Mohammad Syed , Hussain Ahsen
Published: June 2023

: Tumor-to-meningioma metastasis (TTMM) is an uncommon phenomenon, in which a primary malignant tumor metastasizes to a recipient preexisting meningioma. Herein, the authors report a case of a 74-year-old man with a known history of metastatic prostate adenocarcinoma who with frontal headache and right orbital apex syndrome. Initial CT studies demonstrated a right orbital roof osseous lesion. Subsequent MRI was reported as characteristic of an intraosseous meningioma with intracranial and intraorbital extensions. A biopsy of the right orbital mass was obtained and returned a diagnosis of metastatic prostate cancer. The combination of imaging and pathologic findings suggested that the clinical scenario was overall most in keeping with a skull bone-based prostate adenocarcinoma metastasis infiltrating a preexisting meningioma. This is a rare case of TTMM in an orbit-based meningioma, presenting with an orbital apex syndrome.
Predicting chronic postsurgical pain: current evidence and a novel program to develop predictive biomarker signatures
Authors: Sluka Kathleen A. , Wager Tor D. , Sutherland Stephani P. , Labosky Patricia A. , Balach Tessa , Bayman Emine O. , Berardi Giovanni , Brummett Chad M. , Burns John , Buvanendran Asokumar , Caffo Brian , Calhoun Vince D. , Clauw Daniel , Chang Andrew , Coffey Christopher S. , Dailey Dana L. , Ecklund Dixie , Fiehn Oliver , Fisch Kathleen M. , Frey Law Laura A. , Harris Richard E. , Harte Steven E. , Howard Timothy D. , Jacobs Joshua , Jacobs Jon M. , Jepsen Kristen , Johnston Nicolas , Langefeld Carl D. , Laurent Louise C. , Lenzi Rebecca , Lindquist Martin A. , Lokshin Anna , Kahn Ari , McCarthy Robert J. , Olivier Michael , Porter Linda , Qian Wei-Jun , Sankar Cheryse A. , Satterlee John , Swensen Adam C. , Vance Carol G.T. , Waljee Jennifer , Wandner Laura D. , Williams David A. , Wixson Richard L. , Zhou Xiaohong Joe ,   the A2CPS Consortium
Published: June 2023

Chronic pain affects more than 50 million Americans. Treatments remain inadequate, in large part, because the pathophysiological mechanisms underlying the development of chronic pain remain poorly understood. Pain biomarkers could potentially identify and measure biological pathways and phenotypical expressions that are altered by pain, provide insight into biological treatment targets, and help identify at-risk patients who might benefit from early intervention. Biomarkers are used to diagnose, track, and treat other diseases, but no validated clinical biomarkers exist yet for chronic pain. To address this problem, the National Institutes of Health Common Fund launched the Acute to Chronic Pain Signatures (A2CPS) program to evaluate candidate biomarkers, develop them into biosignatures, and discover novel biomarkers for chronification of pain after surgery. This article discusses candidate biomarkers identified by A2CPS for evaluation, including genomic, proteomic, metabolomic, lipidomic, neuroimaging, psychophysical, psychological, and behavioral measures. Acute to Chronic Pain Signatures will provide the most comprehensive investigation of biomarkers for the transition to chronic postsurgical pain undertaken to date. Data and analytic resources generatedby A2CPS will be shared with the scientific community in hopes that other investigators will extract valuable insights beyond A2CPS's initial findings. This article will review the identified biomarkers and rationale for including them, the current state of the science on biomarkers of the transition from acute to chronic pain, gaps in the literature, and how A2CPS will address these gaps.
Learning pain from others: a systematic review and meta-analysis of studies on placebo hypoalgesia and nocebo hyperalgesia induced by observational learning
Authors: Meeuwis Stefanie H. , Wasylewski Mateusz T. , Bajcar Elżbieta A. , Bieniek Helena , Adamczyk Wacław M. , Honcharova Sofiia , Di Nardo Marianna , Mazzoni Giuliana , Bąbel Przemysław
Published: June 2023

Observing someone experience pain relief or exacerbation after an intervention may induce placebo hypoalgesia or nocebo hyperalgesia. Understanding the factors that contribute to these effects could help in the development of strategies for optimizing treatment of chronic pain conditions. We systematically reviewed and meta-analyzed the literature on placebo hypoalgesia and nocebo hyperalgesia induced by observational learning (OL). A systematic literature search was conducted in the databases PubMed, PsycINFO, Web of Science, ScienceDirect, PsycARTICLES, Scopus, and Academic Search Ultimate. Twenty-one studies were included in the systematic review, 17 of which were suitable for meta-analysis (18 experiments; n = 764 healthy individuals). The primary end point was the standardized mean difference (SMD) for pain following placebo cues associated during OL with low vs high pain. Observational learning had a small-to-medium effect on pain ratings (SMD 0.44; 95% confidence interval [CI] 0.21-0.68; P < 0.01) and a large effect on pain expectancy (SMD 1.11; 95% CI 0.49-2.04; P < 0.01). The type of observation (in-person vs videotaped) modulated the magnitude of placebo hypoalgesia/nocebo hyperalgesia (P < 0.01), whereas placebo type did not (P = 0.23). Finally, OL was more effective when observers' empathic concern (but no other empathy-related factors) was higher (r = 0.14; 95% CI 0.01-0.27; P = 0.03). Overall, the meta-analysis demonstrates that OL can shape placebo hypoalgesia and nocebo hyperalgesia. More research is needed to identify predictors of these effects and to study them in clinical populations. In the future, OL could be an important tool to help maximize placebo hypoalgesia in clinical settings.
Interpretation bias in endometriosis-related pain
Authors: Pickup Brydee , Sharpe Louise , Todd Jemma
Published: June 2023

Endometriosis-related pain has been predominantly medically managed, which has hindered understanding of psychological factors involved in these pain experiences. Models of chronic pain highlight the biased interpretation of ambiguous information as health threat related (interpretation bias) as an important process in the development and maintenance of chronic pain. Whether interpretation bias may also be similarly implicated in endometriosis-related pain is unclear. The current study aimed to address this gap in the literature by (1) comparing interpretation biases between a sample of participants with endometriosis and a control sample of participants without medical conditions and pain, (2) exploring relationships between interpretation bias and endometriosis-related pain outcomes, and (3) exploring whether interpretation bias moderated the relationship between endometriosis-related pain severity and pain interference. The endometriosis and healthy control samples comprised 873 and 197 participants, respectively. Participants completed online surveys assessing demographics, interpretation bias, and pain-related outcomes. Analyses revealed that interpretation bias was significantly stronger among individuals with endometriosis relative to controls, with a large effect size. Within the endometriosis sample, interpretation bias was significantly associated with increases in pain-related interference, however, interpretation bias was not associated with any other pain outcomes and did not moderate the relationship between pain severity and pain interference. This study is the first to evidence biased interpretation styles among individuals with endometriosis and to show this bias is associated with pain interference. Whether interpretation bias varies over time and whether this bias can be modified through scalable and accessible interventions to alleviate pain-related interference are avenues for future research.
Investigation of exacerbating factors for postpartum hair loss: a questionnaire-based cross-sectional study
Authors: Hirose Asuka , Terauchi Masakazu , Odai Tamami , Fudono Ayako , Tsurane Kotoi , Sekiguchi Masaki , Iwata Misako , Anzai Tatsuhiko , Takahashi Kunihiko , Miyasaka Naoyuki
Published: June 2023

Background:

Although postpartum hair loss is believed to be common, there is little reliable information.

Objective:

We sought to examine the factors that were associated with postpartum hair loss and to elucidate factors correlated with its pathogenesis.

Methods:

We carried out a questionnaire-based cross-sectional study. The study participants were women who delivered at 2 facilities and filled the questionnaire 10–18 months after delivery. The survey questionnaire included baseline characteristics, pregnancy details, delivery, childcare, and extent of postpartum hair loss. We divided participants into 2 groups according to the absence or presence of postpartum hair loss and performed logistic regression analyses.

Results:

A total of 331 (21.0%) responses were analyzed; among these 304 (91.8%) women had postpartum hair loss. The average time for the start, peak, and end of hair loss was 2.9, 5.1, and 8.1 months, respectively. Women with hair loss had an earlier time of delivery, a lower birth weight, a higher preterm labor rate, and longer-term breastfeeding. Logistical regression analyses revealed that longer-term breastfeeding and preterm labor were independent predictors of postpartum hair loss. The adjusted odds ratio for postpartum hair loss in women who ended breastfeeding 6–12 months postpartum versus those who ended it after 12 months or more was 5.96 (95% confidence interval [CI] [1.68, 21.09]) and 6.37 (95% CI [1.95, 20.76]) compared with those who stopped breastfeeding within 6 months postpartum.

Limitations:

Finer details such as pregnancy complications and delivery information may not be accurate since all results are based on questionnaire responses. There may be a sampling bias because women who suffer from postpartum hair loss may tend to participate more frequently.

Conclusion:

Over 90% of women experienced postpartum hair loss. Our data show that long-term breastfeeding and preterm labor correlate with postpartum hair loss.
Correlations between NLR, NHR, and clinicopathological characteristics, and prognosis of acute ischemic stroke
Authors: Zhu Feng , Ji Yan , Song Jiang-Hua , Huang Guo-Xiang , Zhang Yun-Feng
Published: June 2023

Neuroinflammation plays an essential role in the process of acute ischemic stroke (AIS) injury repair. The current study seeks to investigate the relationship between the neutrophil/lymphocyte ratio (NLR) and neutrophil/high-density lipoprotein cholesterol ratio (NHR) and AIS disease severity and short-term prognosis. As such, the primary aim of this study is to improve AIS diagnosis and treatment. A total of 136 patients with AIS at the Nantong Third People’s Hospital were retrospectively analyzed. The inclusion criteria comprised patients with ischemic stroke admitted to the hospital <24 hours after symptom onset. Baseline, clinical, and laboratory data were collected from all patients within 24 hours of admission. Univariate, multivariate and receiver operating characteristic curve analysis were performed to determine the relationship between NLR, NHR, AIS severity, and short-term prognosis. NLR (odds ratio [OR] = 1.448, 95% confidence interval [CI] 1.116–1.878, P = .005) and NHR (OR = 1.480, 95% CI 1.158–1.892, P = .002) were identified as independent risk factors for stroke severity. Additionally, the correlation between combined NLR and NHR and AIS severity achieved a sensitivity of 81.4% and specificity of 60.4% with a best cutoff value of 6.989. This outcome was superior to that of the single composite inflammatory index. Moreover, NLR (OR = 1.252, 95% CI 1.008–1.554, P = .042) was an independent risk factor for poor short-term prognosis in patients with AIS. When the optimal cutoff value was 2.605, the sensitivity of NLR correlation with the short-term prognosis of AIS was 82.2%, and the specificity was 59.3%. NLR combined with NHR exhibits a strong correlation with disease severity in AIS. Meanwhile, an elevated NLR in patients with AIS can predict a poor short-term prognosis.
Spontaneous rupture of an unscarred uterus during pregnancy: A rare but life-threatening emergency: Case series
Authors: Chen Yue , Cao Ying , She Jing-Yao , Chen Si , Wang Pei-Juan , Zeng Zheng , Liang Chun-Yun
Published: June 2023

Rationale:

In most cases, uterine rupture occurs during the third trimester of pregnancy or during labor. Even fewer reports have been published about the occurrence of this condition without a gynecologic history of any surgical procedure. Due to their scarcity and variable clinical presentation, early diagnosis of uterine rupture may be difficult, and if the diagnosis is not timely, the condition may be life-threatening.

Patient concerns:

Herein, 3 cases of uterine rupture from a single institution are described. Three patients are at different gestational weeks and all have no history of uterine surgery. They came to the hospital due to acute abdominal pain, which is characterized by severe and persistent pain in the abdomen, with no apparent vaginal bleeding.

Diagnoses:

All 3 patients were diagnosed with uterine rupture during the operation.

Interventions:

One patient underwent uterine repair surgery; while the other 2 underwent subtotal hysterectomy due to persistent bleeding and pathological examination after surgery confirmed placenta implantation.

Outcomes:

The patients recovered well after the operation, and no discomfort occurred in the follow-up.

Lessons:

Acute abdominal pain during pregnancy can pose both diagnostic and therapeutic challenges. It is important to consider the possibility of uterine rupture, even in cases where there is no history of prior uterine surgery. The key to the treatment of uterine rupture is to shorten the diagnosis time as much as possible, this potential complication should be carefully monitored for and promptly addressed to ensure the best possible outcomes for both the mother and the developing fetus.
eNOS polymorphisms on male infertility: An updated systematic review and meta-analysis
Authors: Teng Zhihai , Wang Hu , Guo Fengran , Han Zhenwei , Wang Yaxuan
Published: June 2023

Background:

This meta-analysis was performed to examine the association of 3 endothelial nitric oxide synthase (eNOS) gene polymorphisms with male infertility.

Methods:

The literature on the relation between the mutant of eNOS and male infertility before July 1, 2022, was conducted in Pubmed, Medline, and Web of Science. The search strategy is as follows: (eNOS OR ECNOS OR nitric oxide synthase 3 OR NOS3) AND (polymorphism OR mutation OR variation OR SNP OR genotype) AND (male infertility). Statistical analysis was performed with the web of MetaGenyo, Stata 12, trial sequential analysis 0.9Beta, and the web of GTEx.

Results:

Overall, 13 studies (26 case-controls) were included involving 6518 cases and 5461 controls for 3 polymorphisms (rs2070744, rs1799983, rs61722009) of eNOS. We found that eNOS rs2070744 was correlated with an increased risk of male infertility (C vs. T: odds ratio [OR], 1.48; 95% confidence interval [CI], [1.19–1.85]; CC vs. TT: OR, 2.59; 95% CI, [1.40–4.80]; CT vs. TT: OR, 1.17; 95% CI, [1.00–1.38]; CC vs. CT + TT: OR, 2.50; 95% CI, [1.35–4.62]; CC + CT vs. TT: OR, 1.41; 95% CI, [1.21–1.64]). And eNOS rs1799983 was correlated with an increased risk of male infertility (allele contrast T vs. G: OR, 1.41; 95% CI, [1.01–1.96]; P = .043; recessive model TT vs. TG + GG: OR, 2.00; 95% CI, [1.03–3.90]; P = .042). In the stratified analysis of rs61722009, we found Asians might be correlated with an increased risk of male infertility (4a vs. 4b: OR, 1.50; 95% CI, [0.94–2.38]; 4a4a vs. 4b4b: OR, 2.56; 95% CI, [0.70–9.38]; 4a4b vs. 4b4b: OR, 1.36; 95% CI, [0.87–2.13]; 4a4a vs. 4a4b + 4b4b: OR, 2.57; 95% CI, [0.91–7.30]; 4a4a + 4a4b vs. 4b4b: OR, 1.44; 95% CI, [0.87–2.40]).

Conclusion:

The eNOS rs2070744 polymorphism and rs1799983 are associated with the risk of male infertility, and rs61722009 might be a risk factor for Asians.
Effect of fetal lung maturation on the efficacy of acetaminophen for premature infants with patent ductus arteriosus
Authors: Bai Chunqiang , Meng Fanyue , Wu Haiying , Wu Wenying
Published: June 2023

The objective of this study was to evaluate the effect of maturing fetal lung on clinical efficacy of acetaminophen in the treatment of premature infants with patent ductus arteriosus (PDA). A total of 441 premature infants admitted to our hospital from May 2020 to May 2021 were recruited, including 152 premature infants receiving fetal lung maturation (13 cases of PDA closure with drug use and 2 cases failed) and 289 cases without maturing fetal lung (17 cases of PDA closure and 8 cases failed). Finally, a total of 30 cases were enrolled in this clinical trial. All infants were divided into groups A and B according to whether fetal lung maturation was adopted before delivery. In group A, 13 infants received fetal lung maturation, and 17 in group B did not undergo fetal lung maturation. Infants in both groups were orally given with acetaminophen. After 3-day treatment, the second course of treatment was given immediately if PDA was not closed. The PDA closure rate and patency rate of PDA at the end of 2 treatment courses were statistically compared between 2 groups. The feeding intolerance, upper gastrointestinal bleeding, renal failure, necrotizing enterocolitis, bronchopulmonary dysplasia, periventricular-intraventricular hemorrhage, the age at total enteral nutrition and the length of hospital stay were also compared between 2 groups. After the 1st and 2nd treatment courses, the PDA closure rate in group A was 84.61%, significantly higher than 52.94% in group B (P < .05), whereas there was no significant difference in the PDA patency rate between 2 groups (P > .05). No significant differences were observed regarding the feeding intolerance, renal failure, necrotizing enterocolitis, periventricular-intraventricular hemorrhage, bronchopulmonary dysplasia, the length of hospital stay and the age at total enteral nutrition between 2 groups (all P > .05). In addition, the incidence of upper gastrointestinal bleeding in group A was 7.69%, slightly lower than 5.88% in group B (P > .05). Compared with premature infants untreated with fetal lung maturation interventions before delivery, premature infants who receive fetal lung maturation interventions combined with acetaminophen for PDA are likely to obtain a higher PDA closure rate and a lower incidence rate of the upper gastrointestinal bleeding.