bluuebunny/crossref_metadata_2025 huggingface dataset:
Melanin Synthesis Pathway Interruption: CRISPR/Cas9-mediated Knockout of dopa decarboxylase (DDC) in Harmonia axyridis (Coleoptera: Coccinellidae)
Authors: Wu Meng-meng , Chen Xu , Xu Qing-xuan , Zang Lian-sheng , Wang Su , Li Ming , Xiao Da
Published: September 2022

CRISPR/Cas9 technology is a very powerful genome editing tool and has been used in many insect species for functional genomics studies through targeted gene mutagenesis. Here, we successfully established CRISPR/Cas9 research platform in Asian multi-colored ladybird beetle, Harmonia axyridis, an important natural enemy in biological control. In this study, one pivotal gene dopa decarboxylase (DDC) in melanin synthesis was targeted by CRISPR/Cas9 to generate mutants in H. axyridis by CRISPR/Cas9 technology. Our results showed that injection of single guide RNA of the DDC and Cas9 protein into preblastoderm eggs induced one insertion and four deletion (indels) mutant H. axyridis. Mutations of HaDDC gene generated 25% mutant rate with melanin missing phenotype in larva, pupa,l and adult stage. The predation ability of the fourth instar larvae has no significant difference between wild (control) and mutant H. axyridis (G0), while these mutant fourth instar larvae had longer developmental period than that of the wild type. Consequently, the total predation of the fourth instar larvae was significantly increased in H. axyridis mutants comparing with the wild type. These results indicated that the success of CRISPR/Cas9 gene editing in H. axyridis. The gene editing platform in H. axyridis would facilitate the gene function research and promote special strain of predatory ladybird beetle generation.
Vertical Distribution of Arthropod Interactions Within Turfgrass
Authors: Khan Fawad Z A , Joseph Shimat V
Published: September 2022

Arthropod predators are abundant in turfgrass systems, and they play an important role in managing pests. Understanding the vertical distribution of predation is critical to developing cultural strategies that enhance and conserve predatory services. However, little is known on how the predation is vertically distributed within the turfgrass canopy. Thus, the objective of this study was to determine the vertical distribution of predation within the turfgrass canopy. Clay models were used to emulate the general appearance of Noctuidae caterpillars, to estimate the predatory activity. The choice and no-choice experiments were conducted by placing clay models at 2.54, 5.08, and 7.62 cm from the thatch surface and denoted as lower, intermediate, and upper levels, respectively, within turfgrass canopy. The predator-mediated impressions, paired mark, scratch, deep cut mark, deep distortion, prick, dent, stacked surface impression, scooped mark, granulation, and U-shaped mark, were identified on clay models. The incidence and severity of impressions were significantly greater on clay models placed at the lower canopy level than on those placed at the intermediate and upper canopy levels in the choice and no-choice experiments (P < 0.05). Thus, predators are more likely to find their prey at the soil level. This information can be used to refine management strategies, such as mowing height and insecticide use for effectively managing soil-borne and foliar-feeding arthropod pests and beneficial arthropods.
SARS-CoV-2 Screening Testing in Schools: A Comparison of School- Vs. Home-Based Collection Methods
Authors: Chung Erin , Magedson Ariana , Emanuels Anne , Luiten Kyle , Pfau Brian , Truong Melissa , Chow Eric J , Hughes James P , Uyeki Timothy M , Englund Janet A , Nickerson Deborah A , Lockwood Christina M , Shendure Jay , Starita Lea M , Chu Helen Y
Published: September 2022

We implemented a voluntary SARS-CoV-2 screening testing study for kindergarten-2nd grade students in a Washington School district. Weekly SARS-CoV-2 testing participation was higher for students with staff-collected nasal swabs at school than for students with parent-collected swabs at home.
Presentation of Severe Diabetic Ketoacidosis in New-Onset Type One Diabetes Mellitus: The Importance of a Broad Differential in an Otherwise Healthy Population in the Operational Environment
Authors: Makhlouf Emily M
Published: September 2022

Diabetic ketoacidosis (DKA) is a serious disease entity that must be diagnosed quickly for urgent management in the intensive care unit. Keeping DKA in the differential diagnosis is important, especially in a forward deployed, resource-poor setting. The symptoms and signs of DKA are nonspecific, including fatigue, polydipsia, polyuria, weakness, weight loss, nausea, vomiting, and abdominal pain with tachycardia and tachypnea on exam. The testing capability to evaluate for DKA includes a glucometer, urine dipstick, and basal metabolic panel, all of which can be done in most forward deployed settings. The need for a high index of suspicion for DKA in patients with these symptoms is required due to the lack of life-saving insulin and intensive lab monitoring required. The downstream effects of DKA include diabetic coma and death. We present a case report of a 21-year-old otherwise healthy, active duty, male Marine who presents to the clinic with a chief complaint of 4 days of headache and 1 day of nausea with four episodes of non-bloody, non-bilious emesis along with epigastric abdominal pain. He returned to the clinic 2 days later with evidence of tachycardia and increased work of breathing, at which time there was a concern for a pulmonary embolus. By the time he was transferred to the emergency room, he was in severe DKA. The patient was treated in the intensive care unit and made a full recovery. He was processed for limited duty and medical board upon hospital discharge.
Water-maser survey towards off-plane O-rich AGBs around the orbital plane of the Sagittarius stellar stream
Authors: Wu Yuanwei , Zhang Bo , Li Jingjing , Zheng Xing-Wu
Published: September 2022

A 22 GHz water-maser survey was conducted towards 178 O-rich asymptotic giant branch (AGB) stars with the aim of identifying maser emission associated with the Sagittarius stellar stream. In this survey, maser emissions were detected in 21 targets, 20 of which were new detections. We studied the Galactic distributions of H2O- and SiO-maser-traced AGBs towards the Sgr orbital plane, and found an elongated structure towards the (l, b) ∼ (340°, 40°) direction. In order to verify its association with the Sagittarius tidal stream, we further studied the 3D motion of these sources, but found that, kinematically, these maser-traced AGBs are still Galactic disc sources rather than stream debris. In addition, we found a remarkable outward motion, ∼50 km s−1 away from the Galactic Centre of these maser-traced AGBs, but with no systermatic lag of rotational speed as reported in 2000 for solar-neighbourhood Miras.
Redshift in varying speed of light cosmology
Authors: Eaves R E
Published: September 2022

In standard cosmology, redshift is related to scale factor by z = a−1 − 1. Varying speed of light cosmologies have also applied this relationship, in which c does not explicitly appear, with the assumption that ℏ ∝ c. Measured redshift is not a comparison of an observed spectrum with the spectrum as it was emitted at a distant location, but a comparison with a reference spectrum generated more locally. This distinction suggests decomposition into two parts: (a) change during the flight of a photon and (b) difference in physics at the time of emission and at the time of observation of a photon associated with an electron transition between specific bound states of an atom. Based on atomic units consistent with data and a relativistic atomic model, redshift is given by z = β(θ)θa−1 − 1, where θ = c/c0, with c0 the present value of c, and β is a function of the atomic parameters describing the transition. The modified form appears to have a modest effect (a difference in scale factor <2 per cent) for redshifts that are not much greater than 10. However, the modification can have a major effect for an early universe with c significantly larger than the present. The simplified form z = θa−1 − 1, which results from a non-relativistic model, provides an approximation for redshift that is not transition-specific.
The PHEMU21 catalogue and astrometric results of the observations of the mutual occultations and eclipses of the Galilean satellites of Jupiter made in 2021
Authors: Emelyanov N , Arlot J-E , Anbazhagan P , André P , Bardecker J , Canaud G , Coliac J F , De Elias Cantalapiedra J , Ellington C K , Fernandez J M , Forbes M , Gazeas K , Gault D , George T , Gourdon F , Herald D , Huber D , Iglesias-Marzoa R , Izquierdo J , Jorba Lloveras R , Kerr S , Lasala A , Le Guen P , Leroy A , Lutz M , Maley P , Mannchen T , Mari J M , Maury A , Newman J , Palafouta S , Prieto Gallego J , Roger P , Röschli D , Selvakumar G , Serra V , Stuart P , Turchenko M , Vasundhara R , Velasco E
Published: September 2022

2021 was the year of Jupiter’s equinox, that is the Sun and the Earth passed through the equatorial plane of the planet and therefore the orbital planes of its main satellites. This occurrence made it possible to observe mutual occultations and eclipses between the satellites. Our former experience shows that observations of such events provide accurate astrometric data that can be used to obtain new information on the dynamics of the Galilean satellites. The observations are a series of photometric measurements of a satellite which are carried out through the organization of a world wide campaign of observations thus maximizing the number and the quality of the data obtained. This work focuses on processing the photometric observations of the mutual occultations and eclipses of the Galilean satellites of Jupiter made during the international campaign in 2021. The final goal is to derive new accurate astrometric data. We used an accurate photometric model of mutual events in conjunction with the accuracy of observation. We obtained and processed the 84 light curves obtained during the campaign. As compared with the current best ephemerides, the rms of ‘O–C’ residuals are equal to 49 and 48 mas in right ascension and declination, respectively.
Do Social Norms for Cigarette Smoking and Nicotine Vaping Product Use Predict Trying Nicotine Vaping Products and Attempts to Quit Cigarette Smoking Amongst Adult Smokers? Findings From the 2016–2020 International Tobacco Control Four Country Smoking and Vaping Surveys
Authors: Yong Hua-Hie , Chow Ruth , East Katherine , Thrasher James F , Hitchman Sara C , Borland Ron , Cummings K Michael , Fong Geoffrey T
Published: September 2022

Introduction

To examine whether perceived injunctive and descriptive social norms towards cigarette and nicotine vaping product (NVP) use predicted subsequent trying NVPs and attempts to quit cigarette smoking amongst current smokers and whether associations varied across countries.

Aims and Methods

Three waves of longitudinal cohort data from the International Tobacco Control Four Country Smoking and Vaping Survey were collected between 2016 and 2020 from 2290 adult smokers in Canada, Australia, England, and the United States who had never used NVPs at baseline (either wave 1 or wave 2) and followed up at the subsequent wave (wave 2 or wave 3, respectively) were analyzed using Generalized Estimating Equations.

Results

Of the injunctive and descriptive norm measures for smoking and NVP use, NVP initiation was only independently predicted by the injunctive interpersonal norm for NVP use, with perceived approval of NVP use by important others predicting higher odds of trying NVPs (AOR = 1.65, 95% CI = 1.20 to 2.27). This predictive effect was independent of baseline quit intention with no country variations found. By contrast, making cigarette smoking quit attempts were independently predicted by both injunctive and descriptive interpersonal norms with perceived disapproval of smoking by important others (AOR = 1.65, 95% CI = 1.38 to 1.99) and close friends using NVPs (AOR = 1.37, 95% CI = 1.04 to 1.79), both associated with higher odds of smoking quit attempts.

Conclusions

Adult smokers who perceive NVP use as normative, either because such behavior is socially approved or common within their close social networks, appear more inclined to try NVPs or make smoking quit attempts than smokers who do not.

Implications

Social norms can shape a person’s behavior and result in behavior change. This study shows that initiation of NVP use behavior among smokers can be reliably predicted by their perception of whether NVP use is acceptable to those important to them within their close social networks. Similarly, any attempts to stop cigarette smoking can be predicted by their perception of how acceptable cigarette smoking is among those who are important to them and whether any of their close friends use NVPs. Changing social norms towards cigarette smoking and NVP use could therefore be incorporated into smoking cessation interventions to help smokers to quit and/or switch to NVP use.
Replacement of dietary corn with corn bran plus condensed distillers solubles effects on feedlot growth performance and carcass trait responses of beef steers
Authors: Francis Forest L , Wilken Mallorie F , Smith Zachary K
Published: September 2022

Dry-corn milling biorefineries have the opportunity to install technology to fractionate corn prior to fermentation, which creates a product stream of fibrous bran that can be fed to cattle. The objective of this study was to determine the effects of replacing dietary corn with corn bran and condensed distillers solubles (CBCDS) or wet-corn gluten feed (WCGF) on growth performance, efficiency of dietary net energy (NE) utilization, and carcass characteristics in finishing steers. British × Continental steers (n = 240; initial body weight [BW] = 401 ± 43.2 kg) were assigned to the following dietary treatments in a randomized complete block design (RCBD): 1) a control finishing diet with no corn milling coproducts; 2) a finishing diet that contained CBCDS at 20% replacement of dietary corn; and 3) a finishing diet that contained WCGF at 20% replacement of dietary corn. Dietary corn (50:50 of dry-rolled corn and high-moisture corn) was included at 81.5% for control diet-fed steers and 61.5% for steers-fed CBCDS and WCGF. Steers were fed for 145.5 d until visually appraised to have 1.27 cm of rib fat (RF) and were harvested at a commercial abattoir where carcass data were collected. Data were analyzed as an RCBD with pen as the experimental unit, treatment as a fixed effect and block as a random effect. There were no significant differences (P ≥ 0.28) between treatments for final BW, average daily gain, dry matter intake, feed conversion efficiency, observed dietary NE for maintenance (NEm), and NE for gain (NEg), or observed-to-expected NEm and NEg. Additionally, no differences (P ≥ 0.16) were noted between treatments for hot carcass weight, ribeye area, RF, marbling score, kidney–pelvic–heart fat, estimated empty body fat (EBF), BW at 28% EBF (AFBW), and distribution of USDA Quality and Yield grades. Control steers tended (P = 0.10) to have the highest calculated yield grade followed by WCGF and CBCDS. Furthermore, WCGF steers tended (P = 0.08) to have the highest calculated retail yield followed by CBCDS and control steers. Replacement NEm and NEg values of corn coproducts were determined to be 2.14 and 1.42 for CBCDS and 2.09 and 1.37 for WCGF, respectively. Thus, CBCDS can be included in finishing steer diets at 20% replacement of corn without detriment to growth performance or carcass characteristics.
Prevalence and Clinical Significance of Psychiatric Comorbidities With Gambling Disorder in 12 Clinical Settings in Japan
Authors: Yamada Risa , Miyashita Kumi , Hashimoto Taka-Mitsu , Hironaka Naoyuki , Takada Kohji , Shigeta Masahiro , Miyata Hisatsugu
Published: September 2022

Objectives

This study investigated the occurrence rate of psychiatric disorders comorbid with gambling disorder, and their clinical significance in the severity of gambling disorder using a retrospective cross-sectional design.

Methods

The medical records of 359 patients (men/women, 326/33; median age, 37.0 years) with gambling disorder as the primary disorder from 12 treatment facilities specializing in addiction (9 clinics and 3 hospitals) in Japan were studied. We investigated patients' comorbid psychiatric disorders, demographic and clinical characteristics, and the severity of gambling disorder based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition.

Results

Of all patients, 58.3% had comorbidities (tobacco use disorder, 20.9%; alcohol use disorder, 13.9%; major depressive disorder, 13.1%; behavioral addictions, 13.1%; attention-deficit hyperactivity disorder, 6.1%; etc.). Statistical analysis indicated that as the number of comorbid psychiatric disorders increased, psychosocial problems also increased (e.g., proportion of adverse childhood experiences [P < 0.001], and history of suicide attempts [P = 0.009]). In the multivariable analysis, behavioral addictions (β = 0.666; t = 3.151) were significantly associated with gambling disorder severity. Specifically, individuals with gambling disorder comorbid with behavioral addictions including kleptomania, excessive buying, and excessive sex-related behavior may present more severe gambling problems than those without behavioral addictions.

Conclusions

Patients with gambling disorder should be carefully assessed for psychiatric comorbidities and interventions should reflect the individual diagnosis.
Scleroderma autoantibodies in guiding monitoring and treatment decisions
Authors: Shah Shivani , Denton Christopher P.
Published: September 2022

Purpose of review

One of the key clinical challenges of systemic sclerosis (SSc) is diversity in clinical presentation, organ involvement and disease progression. Antinuclear autoantibodies (ANA) are central to the diagnosis of SSc. ANA specificities associated with distinct clinical patterns of organ and skin involvement. Understanding of the molecular differences and pathogenesis of scleroderma has helped further inform clinical acumen. Here, we provide an update on ANA on clinical profiling, management and future direction of SSc.

Recent findings

There has been further development in delineating clinical patterns in ANA, genetic susceptibility and antigen triggers predisposing to ANA subtypes. Sub-group analysis of recent clinical trials shows differing treatment responses to novel therapeutics.

ANA subtyping is likely to be firmly embedded into future classification systems. Beyond informing current management and monitoring of scleroderma patients, ANA subsets have implication on future research and clinical trial design.
Low Transcondylar Fractures of the Distal Humerus: A Multicenter Cohort Study
Authors: Han Sung Bin , Kim Hyungsuk , Jeong Jinyoung , Kim Yang-Soo , Ji Jong-Hun , Lee Sang-Uk , Kong Chae-Gwan , Lee Hyo-Jin , Kim Jong-Ho , Song Hyun Seok
Published: September 2022

Objectives:

To determine the demographic characteristics and clinical and radiologic results of low transcondylar fractures and compare them with those of other types of distal humerus fractures using multicenter data and to suggest an optimal method for their treatment.

Design:

Retrospective cohort study.

Setting:

Tertiary-care university hospital.

Patients:

Between 2009 and 2019, 581 patients who underwent surgery for distal humerus fractures (OTA/AO classification A1 to C3) were enrolled at 7 university-affiliated hospitals.

Intervention:

Internal fixation of low transcondylar fractures.

Main Outcome Measures:

Demographic characteristics, including sex, age, mechanism of injury, fixation methods, and complications, were compared between low transcondylar (group A) and other distal humerus (group B) fractures. Clinical outcomes assessed included pain, stability, and range of motion. Radiographs obtained at the latest follow-up were assessed for union, delayed union, nonunion, and implant failure.

Results:

Mean age was 62.1 ± 19.1 (range, 20–95) years, and it was higher in group A (n = 100) than in group B (n = 376). Patients in group A were predominantly women. Low-energy trauma, such as that from a simple fall, was the most common cause of fracture in group A. Both column fixation, including parallel and orthogonal double plating, was performed more commonly in group A than in group B (87.4% vs. 66.4%, P < 0.001). The nonunion rate was higher in group A, but the difference was not significant. The incidence of ulnar nerve–related symptoms was higher in group A after surgery (6.3% vs. 2.0%, P = 0.003). No significant difference in clinical outcomes was found between the groups.

Conclusions:

Low transcondylar fractures occurred more frequently than other distal humerus fractures in older female patients and accounted for 21% of distal humerus fractures. The incidence of ulnar nerve–related symptoms was higher in patients with low transcondylar fractures after surgery. Clinical outcomes were not inferior in patients with low transcondylar fractures. The nonunion rate in patients with low transcondylar fractures treated with double plating was 3.6%.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Benefit of Addressing Malalignment in Revision Surgery for Proximal Junctional Kyphosis Following ASD Surgery
Authors: Passias Peter G. , Krol Oscar , Williamson Tyler K. , Lafage Virginie , Lafage Renaud , Smith Justin S. , Line Breton , Vira Shaleen , Lipa Shaina , Daniels Alan , Diebo Bassel , Schoenfeld Andrew , Gum Jeffrey , Kebaish Khaled , Park Paul , Mundis Gregory , Hostin Richard , Gupta Munish C. , Eastlack Robert , Anand Neel , Ames Christopher , Hart Robert , Burton Douglas , Schwab Frank J. , Shaffrey Christopher , Klineberg Eric , Bess Shay ,   International Spine Study Group
Published: September 2022

Study Design.

Retrospective cohort study.

Objective.

Understand the benefit of addressing malalignment in revision surgery for proximal junctional kyphosis (PJK).

Summary of Background Data.

PJK is a common cause of revision surgery for adult spinal deformity patients. During a revision, surgeons may elect to perform a proximal extension of the fusion, or also correct the source of the lumbopelvic mismatch.

Materials and Methods.

Recurrent PJK following revision surgery was the primary outcome. Revision surgical strategy was the primary predictor (proximal extension of fusion alone compared with combined sagittal correction and proximal extension). Multivariable logistic regression determined rates of recurrent PJK between the two surgical groups with lumbopelvic surgical correction assessed through improving ideal alignment in one or more alignment criteria [Global Alignment and Proportionality (GAP), Roussouly-type, and Sagittal Age-Adjusted Score (SAAS)].

Results.

A total of 151 patients underwent revision surgery for PJK. PJK occurred at a rate of 43.0%, and PJF at 12.6%. Patients proportioned in GAP postrevision had lower rates of recurrent PJK [23% vs. 42%; odds ratio (OR): 0.3, 95% confidence interval (CI): 0.1–0.8, P=0.024]. Following adjusted analysis, patients who were ideally aligned in one of three criteria (Matching in SAAS and/or Roussouly matched and/or achieved GAP proportionality) had lower rates of recurrent PJK (36% vs. 53%; OR: 0.4, 95% CI: 0.1–0.9, P=0.035) and recurrent PJF (OR: 0.1, 95% CI: 0.02–0.7, P=0.015). Patients ideally aligned in two of three criteria avoid any development of PJF (0% vs. 16%, P<0.001).

Conclusions.

Following revision surgery for PJK, patients with persistent poor sagittal alignment showed increased rates of recurrent PJK compared with patients who had abnormal lumbopelvic alignment corrected during the revision. These findings suggest addressing the root cause of surgical failure in addition to proximal extension of the fusion may be beneficial.
Staff Knowledge, Attitudes, and Beliefs About Child Sugar-Sweetened Beverage Intake and Acceptability of a Pediatric Clinic-Based Beverage Screener
Authors: Howell Bethany L. , Skelton Joseph A. , Jayaprakash Marionette S. , Lewis Kristina H.
Published: September 2022

Beverages are the leading source of sugar in children's diets and a modifiable risk factor for adverse health conditions. Electronic health record–based screeners could facilitate health systems' efforts to reduce child consumption of sugary beverages. Before implementing a sugar-sweetened beverage screener in the electronic health record within academic healthcare system, 228 pediatric and family medicine clinic staff completed an online educational training to familiarize them with the screener and its rationale. Pretraining and posttraining surveys were used to examine the association between staff knowledge of sugar-sweetened beverages and the acceptability of the screening workflow. Respondents displayed high levels of pretraining knowledge about health consequences of added sugar intake, but lower levels of pediatric beverage guideline knowledge. Knowledge improved from pretraining to posttraining surveys, with high acceptability of the screening process. Staff compliance with sugar-sweetened beverage screening was examined using electronic health record data. During the 6 months after screener implementation, 47% of eligible pediatric patients were screened, with some variation in compliance by age group and practice type. This study demonstrated that engaging nursing and frontline staff to screen pediatric patients for behavioral determinants of health is feasible. Ongoing outreach and refreshers may improve sustainability.
Neurothekeoma With PI3K w552*, ALK P1469S, SMO G461S, and ERBB3 L77M Genetic Alterations
Authors: Ortega Mahatma , Sparks Jessica , Nava Victor E. , Smith Shane D. B.
Published: September 2022

Neurothekeoma, a lesion of possible fibrohistiocytic origin, is a rare, benign, superficial soft tissue tumor, histologically subclassified in 3 types: myxoid, cellular, or mixed. It clinically presents as a solitary, pink to brown nodule, ranging from 0.3 to 2.0 cm. Four point mutations (PI3K w552*, ALK P1469S, SMO G461S, and ERBB3 L77M) were identified by next-generation sequencing of a neurothekeoma presenting in the left inner thigh of a 53-year-old man. We highlight novel genetic alterations (SMO G461S and ERBB3 L77M) and previously known mutations (PI3KCA w552* and ALK P1469S) that play a role in other pathogenic pathways, but to the best of our knowledge, these have not yet been reported in neurothekeoma.
Merkel Cell Carcinosarcoma With a Bland Sarcomatous Component
Authors: Ireland Amanda M. , Leecy Tamazin N. , Wood Benjamin A. , Mirzai Bob , Giardina Tindaro , Mesbah Ardakani Nima
Published: September 2022

Merkel cell carcinoma with a sarcomatous component is very rare, with only 12 cases reported in the literature, often with overtly malignant myoid differentiation. We report a case of metastatic Merkel cell carcinosarcoma presenting in a lymph node 6 months after a diagnosis of cutaneous Merkel cell carcinoma with conventional histologic features. The metastatic lesion showed a unique biphasic appearance with admixed populations of neuroendocrine epithelial cells and fascicles of mitotically active spindle cells with mild cytological atypia. In addition to the immunomorphological features, a common molecular profile between the epithelial and mesenchymal components further supported the notion of carcinosarcoma in this case. To the best of our knowledge, a bland sarcomatous component has not been previously described in Merkel cell carcinosarcoma, which can be easily overlooked as a reactive stromal reaction microscopically.
Feedback Interaction Between Apelin and Endoplasmic Reticulum Stress in the Rat Myocardium
Authors: Jin Sheng , Wang Yipu , Ma Liuchang , Zhang Jiaqi , Huang Panna , Zhang Haozhe , Liu Xinxia , Wu Yuming , Wang Xiaoning , Teng Xu
Published: September 2022

Apelin is an endogenous active peptide, playing a crucial role in regulating cardiovascular homeostasis. This study aimed to investigate the interaction between apelin and endoplasmic reticulum stress (ERS). Tunicamycin (Tm) and dithiothreitol (DTT) were used to induce ERS in the ex vivo cultured myocardium of rats. Myocardial injury was determined by the activities of lactate dehydrogenase and creatine kinase-MB in the culture medium. The protein levels of an ERS-associated molecule, apelin, and its receptor angiotensin domain type 1 receptor-associated proteins (APJ) in the myocardium were determined by western blot analysis. The level of apelin in the culture medium was determined by enzyme immunoassay. Administration of Tm and DTT triggered ERS activation and myocardial injury, and led to a decrease in protein levels of apelin and APJ, in a dose-dependent manner. Integrated stress response inhibitor, an inhibitor of eukaryotic initiation factor 2α phosphorylation that is commonly used to prevent activation of protein kinase R-like ER kinase cascades, blocked ERS-induced myocardial injury and reduction of apelin and APJ levels. The ameliorative effect of integrated stress response inhibitor was partially inhibited by [Ala]-apelin-13, an antagonist of APJ. Furthermore, apelin treatment inhibited activation of the 3 branches of ERS induced by Tm and DTT in a dose-dependent manner, thereby preventing Tm-induced or DTT-induced myocardial injury. The negative feedback regulation between ERS activation and apelin/APJ suppression might play a critical role in myocardial injury. Restoration of apelin/APJ signaling provides a potential target for the treatment and prevention of ERS-associated tissue injury and diseases.
Traumatic Brain Injury Classification Variability During the Afghanistan/Iraq Conflicts: Surveillance, Clinical, Research, and Policy Implications
Authors: Adams Rachel Sayko , Hoover Peter , Forster Jeri E. , Caban Jesus , Brenner Lisa A.
Published: September 2022

Objective:

Challenges associated with case ascertainment of traumatic brain injuries (TBIs) sustained during the Afghanistan/Iraq military operations have been widespread. This study was designed to examine how the prevalence and severity of TBI among military members who served during the conflicts were impacted when a more precise classification of TBI diagnosis codes was compared with the Department of Defense Standard Surveillance Case-Definition (DoD-Case-Definition).

Setting:

Identification of TBI diagnoses in the Department of Defense's Military Health System from October 7, 2001, until December 31, 2019.

Participants:

Military members with a TBI diagnosis on an encounter record during the study window.

Design:

Descriptive observational study to evaluate the prevalence and severity of TBI with regard to each code set (ie, the DoD-Case-Definition and the more precise set of TBI diagnosis codes). The frequencies of index TBI severity were compared over time and further evaluated against policy changes.

Main Measures:

The more precise TBI diagnosis code set excludes the following: (1) DoD-only extender codes, which are not used in other healthcare settings; and (2) nonprecise TBI codes, which include injuries that do not necessarily meet TBI diagnostic criteria.

Results:

When comparing the 2 TBI classifications, the DoD-Case-Definition captured a higher prevalence of TBIs; 38.5% were classified by the DoD-Case-Definition only (>164 000 military members). 73% of those identified by the DoD-Case-Definition only were diagnosed with nonprecise TBI codes only, with questionable specificity as to whether a TBI occurred.

Conclusion:

We encourage the field to reflect on decisions made pertaining to TBI case ascertainment during the height of the conflicts. Efforts focused on achieving consensus regarding TBI case ascertainment are recommended. Doing so will allow the field to be better prepared for future conflicts, and improve surveillance, screening, and diagnosis in noncombat settings, as well as our ability to understand the long-term effects of TBI.
Affluence and Contact Lens Prescribing
Authors: Efron Nathan , Morgan Philip B.
Published: September 2022

Objectives:

To assess the impact of national affluence on the extent of prescribing of various types of soft contact lenses.

Methods:

Using information derived from a large bank of contact lens prescribing data, the relationship between the percentage prescribing of daily disposable, toric, silicone hydrogel, and multifocal contact lenses versus the gross domestic product at purchasing parity per capita (GDP [PPP]) was determined for all countries in which contact lens prescribers returned survey forms relating to greater than 100 contact lens fits between 2017 and 2021, inclusive.

Results:

Data from 39 countries were analyzed, comprising 94,181 contact lens fits. The relationship between percentage contact lens prescribing versus GDP (PPP) was highly statistically significant for daily disposable lenses (r2=0.35, P<0.0001), marginally significant for toric lenses (r2=0.08, P=0.06), and not significant for silicone hydrogel lenses (r2=0.01, P=0.42) or multifocal lenses (r2=0.02, P=0.35).

Conclusions:

The rate of prescribing daily disposable contact lenses, and to a lesser extent toric lenses, is related to national affluence. The contact lens industry, practitioners, and governments/regulatory bodies should remain cognizant of this association and, where possible, reduce cost barriers to the purchase of such contact lens products so that they can be prescribed based on important clinical, refraction, and lifestyle considerations.
The one-year clinical course of back-related disability and the prognostic value of comorbidity among older adults with back pain in primary care
Authors: Vigdal Ørjan Nesse , Storheim Kjersti , Killingmo Rikke Munk , Småstuen Milada Cvancarova , Grotle Margreth
Published: September 2022

Back pain and comorbidity are common in older adults. Comorbidity is a promising prognostic factor for the clinical course of back-related disability, but confirmatory studies assessing its prognostic value are needed. Thus, the aims of this study were to describe the clinical course of back-related disability during 1-year follow-up in patients aged ≥55 years visiting primary care (general practitioner, physiotherapist, or chiropractor) with a new episode of back pain and assess the prognostic value of comorbidity on back-related disability during 1-year follow-up. A prospective cohort study was conducted, including 452 patients. The outcome measure was Roland–Morris Disability Questionnaire (RMDQ, range 0-24) measured at baseline and at 3-, 6-, and 12-month follow-up. The Self-Administered Comorbidity Questionnaire was used to assess comorbidity count (CC, range 0-15) and comorbidity burden (CB, range 0-45). The RMDQ scores improved from median (interquartile range) 9 (4-13) at baseline to 4 (1-9), 4 (0-9), and 3 (0-9) at 3, 6, and 12 months, respectively. Using linear mixed-effects models, we found that CC and CB were independently associated with RMDQ scores. A 1-point increase in CC was associated with an increase in RMDQ score of 0.76 points (95% confidence interval [0.48-1.04]) over the follow-up year, adjusted for known prognostic factors. A 1-point increase in CB was associated with an increased RMDQ score of 0.47 points (95% confidence interval [0.33-0.61]). In conclusion, the clinical course of back-related disability for older adults presenting in primary care was favorable, and increased comorbidity was an independent prognostic factor for increased disability levels.
Effects of nerve-sparing procedures on surgical margins after robot-assisted radical prostatectomy
Authors: Yang Ching-Wei , Wang Hsiao-Hsien , Hassouna Mohamed Fayez , Chand Manish , Huang William JS , Chung Hsiao-Jen
Published: September 2022

Background:

Nerve-sparing (NS) techniques could potentially increase positive surgical margins (PSM) after robot-assisted radical prostatectomy (RARP). Nevertheless, the available studies have revealed ambiguous results among distinct groups. This study purposed to clarify the details of NS techniques to accurately estimate their influence on margin status.

Methods:

We studied RARPs performed by one surgeon from 2010 to 2018. Surgical margins were evaluated by the laterality and levels of NS techniques in site-specific prostate lobes. The multivariable analysis evaluated the effects of nerve-sparing procedures, combined with other covariate factors, on margin status.

Results:

Overall, four hundred nineteen RARPs involving 838 prostate lobes were analyzed. Notably, 181 patients (43.4%) had pT2-stage, and 236 (56.6%) had pT3-stage cancer. The PSM rates for patients who underwent unilateral, bilateral, and non NS procedures were 30.3%, 28.8%, and 50%, respectively (p = 0.233) or in stratification by pT2 (p = 0.584) and pT3 (p = 0.116) stage. The posterolateral PSM rates among site-specific prostate lobes were 10.9%, 22.4%, and 18.9% for complete, partial, and non NS techniques, respectively (p = 0.001). The partial NS group revealed a significant increase in PSM rate compared with the complete NS (OR 2.187, 95% CI 1.19-4.03) and non NS (OR 2.237, 95% CI 1.01-4.93) groups in site-specific prostate lobes.

Conclusion:

Partial NS procedures have a potential risk of increasing the PSM rate than complete and non NS procedures do. Therefore, correct case selection is required before performing partial NS techniques.
Developing Action Plans Based on Machine Learning Analysis to Prevent Sick Leave in a Manufacturing Plant
Authors: Kurisu Ken , Song You Hwi , Yoshiuchi Kazuhiro
Published: September 2022

Objective

We aimed to develop action plans for employees' health promotion based on a machine learning model to predict sick leave at a Japanese manufacturing plant.

Methods

A random forest model was developed to predict sick leave. We developed plans for workers' health promotion based on variable importance and partial dependence plots.

Results

The model showed an area under the receiving operating characteristic curve of 0.882. The higher scores on the Brief Job Stress Questionnaire stress response, younger age, and certain departments were important predictors for sick leave due to mental disorders. We proposed plans to effectively use the Brief Job Stress Questionnaire and provide more support for younger workers and managers of high-risk departments.

Conclusions

We described a process of action plan development using a machine learning model, which may be beneficial for occupational health practitioners.
Underwater Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Superficial Non-ampullary Duodenal Epithelial Tumors ≤20 mm
Authors: Yin Zhikun , Li Ji , Yang Weilin , Huang Weifeng , Xu Dong , Lei Xiaoyi , Zhang Jinyan
Published: September 2022

Background:

Underwater endoscopic mucosal resection (UEMR) is increasingly applied in the treatment of superficial non-ampullary duodenal epithelial tumors (SNADETs). This meta-analysis aimed to assess the efficacy and safety of UEMR for SNADETs ≤20 mm in comparison with conventional endoscopic mucosal resection (CEMR).

Methods:

The following electronic databases were searched from 2012 until November 20, 2021: PubMed, Embase, Scopus, Web of Science databases, and Cochrane Library. The primary outcomes were the rates of en bloc resection and complete (R0) resection, and the secondary outcomes were procedure time, adverse events (delayed bleeding and delayed perforation), and recurrence rate.

Results:

A total of 6 studies with 679 lesions (331 underwent UEMR and 348 CEMR) were included in this study. The pooled analysis showed that UMER achieves a similar en bloc resection rate (87.6 vs. 89.9%; odds ratio [OR], 1.29; 95% confidence interval [CI], 0.45 to 3.73; P=0.64; I

2
=74%), a similar R0 resection rate (67.3 vs. 73.6%; OR, 1.11; 95% CI, 0.55 to 2.23; P=0.78; I

2
=59%), a shorter procedure time (min) (mean difference [MD], −4.05, 95% CI: −6.40 to −1.71; P=0.0007; I

2
=70%) compared with CEMR. There were no significant differences in the rates of delayed bleeding, delayed perforation, and recurrence (2.4 vs. 1.7%, 0 vs. 0.6%, 2.2 vs. 4.4%, respectively).

Conclusion:

This meta-analysis demonstrated that UEMR appears to be an effective and safe alternative to CEMR for SNADETs ≤20 mm.
Micro-RNA in obstructive sleep apnoea: biomarker of cardiovascular outcome?
Authors: Zapater Andrea , Barbé Ferran , Sánchez-de-la-Torre Manuel
Published: September 2022

Purpose of review

Obstructive sleep apnoea (OSA) is a global health problem with important cardiovascular consequences. Risk assessment tools are essential in OSA to identify patients at increased risk of cardiovascular disease and to achieve a cost-effective clinical management of the disease in the era of precision medicine. The objective is to provide an updated perspective on the role of microRNAs (miRNAs) in OSA as a biomarker of cardiovascular risk.

Recent findings

Specific miRNAs have already been associated with patients with OSA and specific cardiovascular diseases such as hypertension, myocardial infarction or endothelial dysfunction. Numerous studies have addressed the use of miRNAs to identify the cardiovascular risk associated with OSA, both in patients and in animals with in vivo hypoxia models. Thus, these studies identified profiles of differentially expressed miRNAs in patients with OSA. In addition, the in vitro studies suggest that therapies with miRNA inhibitors that could help reduce cardiovascular risk. Therefore, this review highlights the primary approaches of the potential of miRNAs as biomarkers at the prognostic, diagnostic and therapeutic strategy levels.

Given the heterogeneity of OSA and its cardiovascular consequences, miRNAs have emerged as powerful biomarkers that can help improve the clinical management of OSA and its cardiovascular risk.
Factors associated with quality of life in patients with benign prostatic hyperplasia, 2009–2016
Authors: Park Sewon , Lee Kyu-Sung , Choi Mankyu , Lee Munjae
Published: September 2022

This study analyzed the factors affecting the health-related quality of life of patients with benign prostatic hyperplasia (BPH) according to age. We also aimed to determine appropriate strategies to improve their quality of life. Data from the Korea Health Panel Survey (2009–2016) were used in this study. A total of 3806 patients with BPH were divided into 2 groups: younger adults (aged under 65 years) and older adults (aged over 65 years). In addition, a logistic regression analysis was conducted to identify factors affecting the quality of life of young and older patients with BPH. In younger adult patients with BPH, the higher the level of education, the higher the quality of life by a factor of 1.379, and the more intense the physical activity, the lower the quality of life by a factor of 0.791. Also, the longer the sitting time, the lower the quality of life by a factor of 0.765. In contrast, for older adult patients with BPH, the quality of life improved by factors of 1.601 and 2.921, respectively, for health insurance and higher income level. In addition, it was found that the quality of life decreased by a factor of 0.754 in patients who drink alcohol. In order to improve the quality of life of the middle-aged adult population with BPH, it is necessary to reduce sitting time through constant physical activity. Moreover, the cost of medical care should be reduced and the quality of life increased through reductions in surgical treatment, as the burden of medical expenses will degrade the quality of life for older adults.
Surgical excision of giant vulvar angiofibroma: A case report and a review of literature
Authors: Altal Omar F. , Rawashdeh Shireen , Al Sharie Sarah , Al Zu’bi Yazan O. , Al Sharie Ahmed H. , Daoud Majd N. , Alkhawaldeh Khaled M.
Published: September 2022

Rationale:

Cellular angiofibroma (CA) is a rare tumor of the soft tissue classified as a benign fibroblastic/myofibroblastic tumor. Considering this, the literature regarding CA mainly, but not exclusively, comprises single case reports and case series. Here, we report a case of giant CA of the vulva with comprehensive literature review.

Patient concerns:

We present a case of a massive vulvar CA arising in 53-year-old woman with no notable medical or surgical history. The mass has grown considerably over time, causing pain and difficult urination, defecation, and movement. The patient had normal regular menstrual cycle with no previous contraception use. Vaginal examination exposed a right-sided large tender vulvar mass with normal-looking vagina.

Diagnoses:

Pelvic magnetic resonance imaging with contrast revealed a large right vulvar heterogeneously enhancing soft tissue mass measuring 13.1 × 10.9 × 10.7 cm expending the left vulva, with internal and peripheral voids resembling feeding vessels. The mass was surgically removed, and subsequent histopathology showed skin-covered dermal-based lesion composed of fibroblast-like bland and spindle cell proliferation with thin-walled blood vessels of various sizes. Immunohistostaining of CD34 and smooth muscle antigen were both positive, while desmin was found to be negative. A diagnosis of vulvar angiofibroma was made based on the clinical scenario, imaging, and histopathology.

Interventions:

Mass vulvectomy was performed starting with a circumferential incision at the base of the mass and structural dissection to separate the mass from the vulvar wall. The incision was successfully closed, and subcuticular stitches were applied to the skin.

Outcomes:

The patient’s complaints were significantly relieved with no postoperative complications and the patient is being followed regularly in an outpatient setting.

Lessons:

Due to its extremely benign nature of CA, and the implausible ability of its recurrence, it was decided to surgically excise it. Despite its rarity, it can be readily identified at its earlier stages preventing the vexing and exasperating symptoms accompanied with increased size as mentioned.
Wide excision alone for elderly patients aged > 70 years old with soft tissue sarcomas
Authors: Aoki Yusuke , Tome Yasunori , Oshiro Hiromichi , Katsuki Ryo , Tamaki Tomoko , Wada Naoki , Karube Kennosuke , Nishida Kotaro
Published: September 2022

The purpose of the present study was to clarify clinical outcomes of elderly patients with soft tissue sarcoma who underwent surgery neither with neoadjuvant nor adjuvant chemotherapy. The median follow-up period was 46.3 (range 6.7–99.0) months. All patients underwent surgical resections. R0 margins were achieved in 24 cases (92.3%) and R1 margins in 2 cases (7.7%). The 1-, 2-, and 5-year sarcoma-specific survival (SSS) rates were 92.3%, 88.5%, and 83.8%, respectively. Multivariate analysis showed no significant risk factors for SSS. No significant relationship of histological grades and local recurrences (P = .56) or distant metastases (P = .54) was shown. In the current study, we observed a comparable survival ratio, despite no neoadjuvant or adjuvant chemotherapies performed. Tumor resections with adequate margins might, at least in part, have contributed to the decent survival ratio regardless of histological grade. Twenty-six consecutive patients aged ≥ 70 years, who underwent surgical resections of soft tissue sarcoma between January 2013 and December 2019, were included. SSS were analyzed by the Kaplan–Meier method, and the relationships between SSS and clinical parameters were evaluated by Cox proportional hazards analysis.