bluuebunny/crossref_metadata_2025 huggingface dataset:
Validity and Reliability of the Pieper-Zulkowski Pressure Ulcer Knowledge Test for Use in Turkey
Authors: Yeşil Mine , Toygar İsmail , Aslan Fatma Eti
Published: February 2024

OBJECTIVE

To assess the validity and reliability of the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) for use in Turkey.

METHODS

This methodological study was carried out at a state hospital from June to November 2022. The authors used the PZ-PUKT and nurse identification form for data collection. They assessed the validity and reliability of the PZ-PUKT for Turkish society by evaluating language validity, content validity index, exploratory factor analysis, confirmatory factor analysis, Cronbach α, Spearman-Brown Split-Half analysis, item-scale correlations, and test-retest correlations.

RESULTS

Item-level content validity indices ranged from .778 to 1.000 and the scale-level content validity index was .960. Factor loadings of the Turkish version of the PZ-PUKT ranged between .297 and .671. Cronbach α coefficients for the scale subsections were .838 for wounds, .851 for prevention, and .844 for staging; the Cronbach α coefficient was .936 for the total scale score.

CONCLUSIONS

The PZ-PUKT is valid and reliable for use with nurses in Turkey. The authors recommend using the Turkish version of the tool in education and research to assess nurses’ pressure injury knowledge.
The Impact of Malnutrition on Skin Integrity and Wound Healing
Authors: Demarest-Litchford Mary , Munoz Nancy , Strange Nancy , Casirati Amanda , Cereda Emanuele
Published: February 2024

Malnutrition is a global health issue that occurs in individuals across all weight categories and irrespective of healthcare resources. Researchers report that poor diet contributed to approximately 11 million deaths worldwide in 2017. Nutrition status is a modifiable risk factor in individuals at risk of or with impaired skin integrity. Incorporating best practices in identifying and treating malnutrition in a timely manner improves clinical outcomes. Valuable resources from the Malnutrition Quality Improvement Initiative for acute care patients and malnutrition quality improvement measures for post acute care residents are discussed, as well as sources for additional reimbursement.

GENERAL PURPOSE

To recognize valuable resources from the Malnutrition Quality Improvement Initiative for acute care patients and malnutrition quality improvement measures for postacute care residents.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:

1. Distinguish the prevalence of malnutrition among acute care patients.

2. Explain the assessment guidelines for identifying malnutrition.

3. Identify the resources available for measuring malnutrition quality improvement.
Operative Positioning and Intraoperative-Acquired Pressure Injury: A Retrospective Cohort Study
Authors: Xu Xin , Miao Miao , Shi Guirong , Zhang Peipei , Liu Ping , Zhao Bing , Jiang Liping
Published: February 2024

OBJECTIVE

To comprehensively assess the association between operative positioning with intraoperative-acquired pressure injury (IAPI) development.

METHODS

This retrospective cohort study included 455 patients who underwent surgery between October 2020 and January 2021. The authors grouped patients by operative positioning into the prone position and nonprone position groups. They used propensity-score matching at a 1:2 ratio to control for preoperative confounders, applied multiple logistic regression models to analyze the effects between positioning and IAPI, and assessed interactions of positioning and intraoperative factors on IAPI.

RESULTS

The final enrollment was 92 cases in the prone position group and 181 in the nonprone position group. Multivariable logistic analysis suggested that the prone position had a 2.92 times higher risk of IAPI than the nonprone position (odds ratio, 2.92; 95% CI, 1.13–7.57; P = .026). Subgroup analysis showed a significant multiplicative interaction between positioning and foam dressing on IAPI (P < .05), which was not observed in other intraoperative factors (P > .05).

CONCLUSIONS

This study provides evidence that prone operative positioning can increase IAPI risk. Patients in the prone position may particularly benefit from using dressings in Chinese populations. Further large-sample longitudinal studies are required to confirm these findings.
The Impact of COVID-19 on Rates of Pressure Injuries Among Hospitalized Patients across the US
Authors: Gomez-Rexrode Amalia E. , Lane Megan , Ashbaugh Kathryn , Kamdar Neil , Sears Erika D.
Published: February 2024

OBJECTIVE

To determine the impact of the COVID-19 pandemic on hospital-acquired pressure injury (HAPI) rates and composition of HAPI stages among hospitalized patients across the US.

METHODS

Using encounter-level data from a nationwide healthcare insurance claims database, the authors conducted a retrospective cohort study and an interrupted time-series analysis to determine HAPI rates among hospitalized patients within 90 days of admission before (January 2018 to February 2020) and after (March 2020 to December 2020) the onset of the COVID-19 pandemic. Of 3,418,438 adult patients assessed for inclusion in the study, 1,750,494 met the inclusion criteria. Outcomes measured included the presence of a HAPI within 90 days of admission and HAPI stage based on the International Classification of Diseases, 10th Revision diagnosis codes.

RESULTS

The authors identified HAPIs in 59,175 episodes of care, representing 59,019 unique patients and corresponding to an overall HAPI rate of 2.65%. Baseline characteristics did not vary significantly across the two time periods. Further, HAPI rates were consistent across the time periods analyzed with no significant differences in rates following the onset of the pandemic (P = .303). Composition of HAPI stages remained consistent across the pandemic (unspecified, stages 1–4, Ps = .62, .80, .22, .23, and .52, respectively) except for a significant decrease in unstageable/deep tissue pressure injuries (−0.088%, P = .0134).

CONCLUSIONS

Although hospital resources were strained at the peak of the COVID-19 pandemic, no differences were identified in HAPI rates among the study’s cohort of privately insured patients.
Casting, elastic intramedullary nailing or external fixation in pediatric tibial shaft fractures: which is the most appropriate treatment? A multicenter study
Authors: Marengo Lorenza , Enrietti Emilio , Piccinno Melissa , Ceroni Luca , Marre’ Brunenghi Giorgio , Boero Silvio , Colella Antonio , Dibello Daniela
Published: February 2024

The main objective of this study was to retrospectively evaluate and compare the outcomes and complications of displaced closed tibial fractures in children treated by CRC (closed reduction and casting), elastic stable intramedullary nailing (ESIN) or external fixation (EF). One hundred twenty-three consecutive children were treated for displaced closed tibia shaft fracture from July 2014 and January 2020 at two different institutions. Seventy-five of them met the inclusion criteria and were included in the study: 30 (40%) patients were treated with CRC, 33 (44%) with ESIN, and 12 with EF (16%). All clinical and radiographic outcomes and complications were registered and compared. The three groups did not differ with regard to gender, affected side, fracture site and associated fibula fracture. The age at the time of treatment in the CRC group was statistically lower than in ESIN and EF groups (8.43 ± 3.52 years vs. 10.39 ± 2.56 years vs. 11.08 ± 3.55 years, respectively). Immobilization time and time to partial and total weight bearing were significantly reduced in ESIN and EF groups compared to CRC group (P < 0.05). Overall, no statistically significant differences were found between the three groups regarding complication rate and clinical and radiographic outcomes between the three groups. However, in CRC group, 3 patients (10%) had secondary fracture displacement and underwent ESIN. Surgical treatment is not contraindicated in children with displaced tibia shaft fractures. EF and ESIN provide earlier mobilization and weight-bearing recovery than CRC. However, apart from that, nonoperative treatment was as efficacious as surgical treatment.
Safety and effectiveness of halo gravity traction combined with traditional growing rods in severe early-onset scoliosis with neurofibromatosis type 1
Authors: Liang Mingqian , Cao Jun , Zhang Xuejun , Guo Dong , Yao Ziming , Gao Rongxuan , Bai Yunsong
Published: February 2024

Neurofibromatosis type 1 (NF-1) scoliosis can be difficult to treat without early detection. Correcting deformities while considering long-term growth in early-onset scoliosis (EOS) treatment is important. This study was performed to establish the safety and effectiveness of halo gravity traction (HGT) with traditional growing rods (TGRs) in NF-1 EOS. We retrospectively reviewed a cohort of 15 children (7 boys and 8 girls; mean age, 5.61 years) diagnosed with NF-1 EOS from October 2016 to March 2021. All patients underwent HGT before growing rod implantation. The growing rods were lengthened every 9–12 months, with a follow-up of 2–7 years. Cobb angle, thoracic kyphosis (TK), trunk shift (TS), sagittal vertebral axis and T1–S1 height were measured before operation, after traction, after operation and at last follow-up. Complications were also recorded. Fifteen patients with NF-1 EOS were treated with an average traction weight of 10.00 kg. After 29.20 days of HGT, the Cobb angle improved from 99.10° to 62.60°, TK from 79.33° to 55.04°, TS from 31.05 to 17.71 mm, sagittal vertebral axis from 42.07 to 25.63 mm and T1–S1 height from 27.50 to 29.70 cm (P < 0.05 for all). Postoperatively, compared with post-traction, the Cobb angle was 52.40° (P = 0.002) and TK was 44.54° (P = 0.004). No complications occurred during traction. Growing rod dislocation occurred in one patient and growing rod breakage in one patient. HGT combined with TGRs was well-tolerated and effective for treating severe NF-1 EOS. It significantly corrected the Cobb angle and TK, restored trunk balance, and increased spinal height with few complications.
Lumbar Vertebral Body Tethering
Authors: Stein Alan A. , Samdani Amer F. , Schupper Alexander J. , Naseer Zan , Shah Ronit V. , Zeller Sabrina , Pahys Joshua M. , Samuel Solomon Praveen , Quinonez Alejandro , Hwang Steven W.
Published: February 2024

Study Design.

Retrospective cohort study.

Objective.

To evaluate the outcomes and reoperation rates in patients with adolescent idiopathic scoliosis undergoing lumbar anterior vertebral body tethering (AVBT).

Background.

AVBT is a viable option for growing children. The benefit of motion preservation must be balanced by a higher reoperation rate. A paucity of reports has addressed lumbar AVBT.

Materials and Methods.

A single-center retrospective study was conducted to identify all patients who underwent lumbar AVBT (lowest instrumented vertebra L3 or L4) with a minimum of 2 years of follow-up. Clinical and radiographic parameters, including complications and reoperations, were also collected. Statistical analysis was performed using the Student t test for qualitative variables.

Results.

From a data set of 551 patients, we identified 106 patients (89% female) who underwent a lumbar AVBT (33 lumbar only, 73 bilateral thoracic/lumbar) with a mean follow-up of 4.1 ± 1.6 years at which point 85% (90/106) had reached skeletal maturity. Preoperatively, these patients were skeletally immature (age: 12.8 ± 1.3 yr, Sanders: 3.3 ± 0.8, R = 0.6 ± 0.9) with a lumbar coronal curve angle of 49.6° ± 11.2° which corrected to 19.9° ± 11.2° (P < 0.0001) at most recent follow-up. At the latest follow-up, 76.4% (81/106) of the patients harbored a coronal curve angle of <30°. Twenty patients (18.9%) underwent 23 reoperations, with overcorrection being the most common (10/23, 43%). Broken tethers led to reoperation in 3 instances (3/23, 13%). Six patients in the cohort needed a posterior spinal fusion (6/106, 5.4%).

Conclusions.

Vertebral body tethering is a viable treatment option for skeletally immature patients with idiopathic scoliosis. This report is the largest to date for lumbar AVBT, highlighting that 84% of patients harbored a curve <35° at the latest follow-up but with an 18.9% reoperation rate.

Level of Evidence.

3.
Alterations in zonal distribution and plasma membrane localization of hepatocyte bile acid transporters in patients with NAFLD
Authors: Murphy William A. , Diehl Anna Mae , Loop Matthew Shane , Fu Dong , Guy Cynthia D. , Abdelmalek Manal F. , Karachaliou Georgia Sofia , Sjöstedt Noora , Neuhoff Sibylle , Honkakoski Paavo , Brouwer Kim L. R.
Published: February 2024

Background:

NAFLD is highly prevalent with limited treatment options. Bile acids (BAs) increase in the systemic circulation and liver during NAFLD progression. Changes in plasma membrane localization and zonal distribution of BA transporters can influence transport function and BA homeostasis. However, a thorough characterization of how NAFLD influences these factors is currently lacking. This study aimed to evaluate the impact of NAFLD and the accompanying histologic features on the functional capacity of key hepatocyte BA transporters across zonal regions in human liver biopsies.

Methods:

A novel machine learning image classification approach was used to quantify relative zonal abundance and plasma membrane localization of BA transporters (bile salt export pump [BSEP], sodium-taurocholate cotransporting polypeptide, organic anion transporting polypeptide [OATP] 1B1 and OATP1B3) in non-diseased (n = 10), NAFL (n = 9), and NASH (n = 11) liver biopsies. Based on these data, membrane-localized zonal abundance (MZA) measures were developed to estimate transporter functional capacity.

Results:

NAFLD diagnosis and histologic scoring were associated with changes in transporter membrane localization and zonation. Increased periportal BSEPMZA (mean proportional difference compared to non-diseased liver of 0.090) and decreased pericentral BSEPMZA (−0.065) were observed with NASH and also in biopsies with higher histologic scores. Compared to Non-diseased Liver, periportal OATP1B3MZA was increased in NAFL (0.041) and NASH (0.047). Grade 2 steatosis (mean proportional difference of 0.043 when compared to grade 0) and grade 1 lobular inflammation (0.043) were associated with increased periportal OATP1B3MZA.

Conclusions:

These findings provide novel mechanistic insight into specific transporter alterations that impact BA homeostasis in NAFLD. Changes in BSEPMZA likely contribute to altered BA disposition and pericentral microcholestasis previously reported in some patients with NAFLD. BSEPMZA assessment could inform future development and optimization of NASH-related pharmacotherapies.
Celastrol promotes apoptosis of breast cancer MDA-MB-231 cells by targeting HSDL2
Authors: Liu Li , Liu Yanqing , Zhang Shujie , Zhang Junzhe , Meng Yuqing , Liu Dandan , Gu Liwei , Zhang Ying , Xu Liting , Zhang Ziyue , Zhao Minghong , Wong Yinkwan , Wang Qixin , Zhu Yongping , Wang Jigang
Published: February 2024

Objective:

Celastrol is a pentacyclic triterpenoid extracted from the traditional Chinese medicinal herb, Tripterygium wilfordii. This study aimed to provide a scientific basis for the rational development and use of celastrol in breast cancer.

Methods:

A quantitative chemical biology approach was used to investigate the protein targets and molecular mechanisms of celastrol in breast cancer cells.

Results:

Low-concentration celastrol exerted an anti-tumor effect by directly binding to hydroxysteroid dehydrogenase-like 2 (HSDL2) and inhibiting its expression. Moreover, the expression of the pro-apoptotic protein, BaX, increased, the level of the anti-apoptotic protein, Bcl-2, decreased, and the rate of apoptosis increased. After the transfection of cells with si-HSDL2, the apoptosis rate was similar to that observed after the administration of celastrol. However, apoptosis was reversed by the overexpression of HSDL2. Furthermore, our MS (Mass Spectrometry) data indicated a relationship between HSDL2 and the MAPK signaling pathway. We also found that the expression of HSDL2 was directly related to the degree of ERK phosphorylation.

Conclusions:

Celastrol may promote apoptosis by suppressing the HSDL2/ MAPK/ERK signaling pathway.
Examining neoadjuvant treatment candidates in resectable pancreatic cancer based on tumor-vessel interactions and CA 19-9 levels: A retrospective cohort study
Authors: Jung Hye-Sol , Han Youngmin , Yun Won-Gun , Cho Young Jae , Lee Mirang , Lee Dong Ho , Kwon Wooil , Jang Jin-Young
Published: February 2024

Introduction:

The applicability of neoadjuvant treatment (NAT) for resectable pancreatic ductal adenocarcinoma (PDAC) has arisen, however, high-level evidence is lacking. This study aimed to explore patient subgroups with high-risk resectable PDAC for selecting candidates who may benefit from NAT.

Methods:

The 1,132 patients with resectable or borderline resectable PDAC who underwent surgery between 2007 and 2021 were retrospectively reviewed. Patients with resectable PDAC without contact of major vessels (R-no contact) (n=651), with contact of portal vein or superior mesenteric vein (PV/SMV) ≤180° (R-contact) (n=306), and borderline resectable PDAC without arterial involvement (BR-V) (n=175) were analyzed.

Results:

The mean age was 64.3 ± 9.8 years, and 647 patients (57.2%) were male. The median follow-up was 26 months in the entire cohort. Patients with resectable PDAC without vascular contact had the most improved overall survival (OS) (median; 31.5 months). OS did not significantly differ between NAT and upfront surgery in the entire resectable PDAC cohort. However, in R-contact group, NAT showed significantly improved OS compared to upfront surgery (33 vs. 23 months). Neoadjuvant FOLFIRINOX was showed a better OS than gemcitabine-based regimens in patients who underwent NAT (34 vs. 24 months). NAT was associated with a better survival in the patients with CA 19-9 level ≥150 U/mL, only when the tumor has PV/SMV contact in resectable disease (40 vs. 19 months, P = 0.001).

Conclusions:

NAT can be considered as an effective treatment in patients with resectable PDAC, particularly when the tumor is in contact with PV/SMV and CA 19-9 ≥150 U/mL.
Saw Palmetto Treatment for Prostatitis: A Systematic Review of the Literature
Authors: Punyala Ananth , Sze Christina , Winograd Joshua , Codelia-Anjum Alia , Morfin Montes de Oca Ernesto , Lee Maria , Bjohani Naeem , Elterman Dean , Zorn Kevin C. , Chughtai Bilal
Published: February 2024

Purpose:

This systematic review was conducted to determine the safety and efficacy of Serenoa repens extract (saw palmetto extract) in treating chronic prostatitis, as compared with existing treatment regimens and placebo.

Methods:

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic query was performed across multiple databases in December 2021 to identify relevant studies. The selection criteria focused on studies evaluating the treatment regimens, safety, and efficacy of saw palmetto in treating chronic prostatitis/chronic pelvic pain syndrome.

Results:

Of 259 references, 21 studies encompassing 1666 patients were selected. These studies included a range of trial types, with a mean follow-up period of approximately 6.975 months. Saw palmetto extract showed improved symptom relief compared with placebo, with mixed results when compared with alpha-blockers or 5-ARIs. Multimodal treatments, especially those including saw palmetto extract alongside antibiotics, displayed better efficacy in managing both Category II and Category III prostatitis.

Conclusion:

Saw palmetto extract provides symptom relief in patients with chronic prostatitis. Although monotherapy exhibited certain benefits over placebo, its best efficacy was observed when integrated into multimodal treatment regimens, particularly with antibiotics for Category II prostatitis. Future research may unveil specific adjuncts that enhance the therapeutic outcomes of regimens containing saw palmetto extract.
Evidence-based simulation: Fostering competency through structured and multisource feedback
Authors: Burt Leah , Fitz Sarah , Kiser Bob
Published: February 2024

Preclinical simulation is an evidence-based method for nurse practitioner (NP) students to improve clinical communication and disease management competency. During simulation, students may receive feedback from multiple sources, including standardized patients (SPs), faculty, peers, and themselves. Although evidence supports simulation with multisource feedback, its impact on clinical knowledge and communication has yet to be evaluated among NP students. We designed, implemented, and evaluated a preclinical simulation program with structured multisource feedback integrated into a disease management course within a Doctor of Nursing Practice curriculum. Differences in communication self-efficacy and disease management knowledge before and after participation, as well as perceptions of learning and importance of varying feedback sources, were evaluated using a single group pre–post mixed-methods design. On average, clinical communication self-efficacy was significantly higher, and disease management knowledge scores were significantly higher after participation. Learners rated feedback sources as important or very important and described varying feedback sources as complementary. Feedback from SPs, peers, learners themselves, and faculty was complementary and important to learning. This preclinical simulation program with purposeful integration of multisource feedback provides an evidence-based foundation for scaffolding multidomain competency development into curriculums to meet updated standards of advanced nursing education.
Antiphospholipid syndrome
Authors: Salinas Irene , Opton Laura
Published: February 2024

Antiphospholipid syndrome is an autoimmune disorder that's characterized by hypercoagulability and/or obstetric morbidity that nurses should understand to better treat their patients.
Nursing Skills Boot Camp
Authors: Matlack Patrick , Passero Lisa
Published: February 2024

The use of a nursing Boot Camp to provide didactic instruction and hands-on practice of common clinical skills is one component of a comprehensive transition-to-practice program required to empower the nursing workforce.
Self-care
Authors: Boswell Carol
Published: February 2024

It's become apparent that burnout and compassion fatigue are commonplace. We must consider new approaches to mitigate the negative effects in the workplace.
Predisposing Factors for Postoperative Complications in the Year Following Fronto-Orbital Advancement and Remodeling: A Single Institution Study of 267 Patients
Authors: Wietlisbach Larissa E. , Barrero Carlos E. , Villavisanis Dillan F. , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A.
Published: February 2024

Background:

Fronto-orbital advancement and remodeling (FOAR) is a common surgical approach used for craniosynostosis conferring functional and aesthetic benefit. There are few reports examining predisposing factors for postoperative complications within the first year after surgery. This study aimed to establish complication rates and identify risk factors for inferior outcomes in a large population of patients undergoing FOAR.

Methods:

All patients who underwent fronto-orbital advancement and remodeling from 2013-2022 at our institution were retrospectively studied. Perioperative and postoperative data were collected to yield outcomes analyses. Multivariable logistic regression with backwards selection was performed to identify predictors of postoperative complications.

Results:

267 patients underwent FOAR. The overall complication rate was 14.2%, most commonly delayed wound healing (7.4%), postoperative blood transfusion (5.8%), and infection requiring readmission (1.9%). Tense closure independently predicted delayed wound healing (p<0.001) and infection requiring readmission (p=0.03). Syndromic patients were more likely than non-syndromic children to have undergone prior craniofacial surgery (45.3% vs 23.8%, p=0.003). Syndromic status and prior craniofacial surgery were associated with increased risk of developing infection requiring readmission (p=0.012 and p=0.004, respectively). A greater proportion of malnourished patients experienced postoperative complications compared to patients without malnourishment (24.4% vs 12.1%, p=0.031), though there were no significant differences in individual postoperative outcomes.

Conclusions:

Identified risk factors for complications included syndromic status, tense closure, and prior craniofacial surgery. Most complications were managed nonoperatively. These factors may be considered in preoperative planning and when counseling patient families.
Cutaneous Metastasis of Ovarian Cancer on 68Ga-FAPI PET/CT
Authors: Ding Haoyuan , Li Dan , Chen Yue , He Wenfeng , Cai Liang
Published: February 2024

Ovarian cancer with cutaneous metastases is quite rare. We report the findings of cutaneous metastases from ovarian cancer on 68Ga-FAPI PET/CT imaging. A 53-year-old woman with cutaneous metastases from ovarian cancer was enrolled in 68Ga-FAPI PET/CT clinical trial. The images showed intense FAPI activity in the known cutaneous metastases.
Comparison of 18F-FAPI and 18F-FDG PET/CT in a Patient With Fibrous Dysplasia
Authors: Mu Xingyu , Li Zuguo , Qin Jie , Wang Zhenzhen , Fu Wei
Published: February 2024

A 16-year-old woman presented with an acute headache on the left side. A head CT scan revealed bone destruction in the skull. Subsequent 18F-FDG and 18F-FAPI PET/CT scans were performed within a week. The 18F-FDG PET/CT indicated mild uptake in the regions of bone destruction, whereas the 18F-FAPI PET/CT displayed significant tracer accumulation. The patient was ultimately diagnosed with fibrous dysplasia.
Eosinophilic Fasciitis Illustrated by 18F-FDG PET/CT
Authors: Fevrier Agathe , Dufour Pierre-Alban
Published: February 2024

Eosinophilic fasciitis is a rare sclerodermiform disease characterized by upper and lower limb edema. We present the case of a 71-year-old woman currently hospitalized for painful lower limb edema. Laboratory tests reveal moderate eosinophilia (0.8 g/L) and an inflammatory syndrome. Abdominopelvic ultrasound reveals no abnormalities. In light of the unexplained inflammatory syndrome, a 18F-FDG PET/CT scan currently shows intense hypermetabolism of the fasciae in the lower and upper limbs. Following an MRI, a biopsy is performed, and the anatomopathology currently confirms eosinophilic fasciitis.
FDG PET/CT in a Case of Isolated Gastric Metastasis From Pancreatic Ductal Adenocarcinoma
Authors: Ji Xia , Dong Aisheng , Wang Yang
Published: February 2024

Hematogenous gastric metastasis from pancreatic cancer is extremely rare. We describe FDG PET/CT findings in a case of isolated hematogenous gastric metastasis from pancreatic cancer with significantly elevated serum carbohydrate antigen 19-9 level. The gastric metastasis showed intense focal FDG uptake mimicking a primary tumor. The elevation of serum carbohydrate antigen 19-9 level may be useful as an aid in the differential diagnosis.
99mTc-HYNIC-FAPI-46 SPECT/CT Uptake in Lactating Breasts
Authors: Hadad Bentolhoda , Aryana Kamran , Kamali Hassan , Askari Emran
Published: February 2024

A 36-year-old woman with a history of medullary thyroid carcinoma was referred for 99mTc-HYNIC-FAPI-46 scan. Her calcitonin levels gradually increased after external beam radiation therapy, whereas her CEA levels were stable. A few suspicious tumoral lymphadenopathies were localized to the superior mediastinum. Interestingly, bilateral physiologic breast uptake was noticed, which was presumed to be due to lactation in the past 18 months. To our knowledge, physiologic breast uptake in 99mTc-HYNIC-FAPI imaging has not been previously reported.
Small Cell Neuroendocrine Carcinoma of the Prostate on 18F-DCFPyL and 18F-FDG PET/CT
Authors: Li Edward , Russon Andrew , Chen Jeffrey , Mansberg Victor , Mansberg Robert
Published: February 2024

A 51-year-old man with newly diagnosed small cell neuroendocrine carcinoma of the prostate was referred for a staging 18F-DCFPyL PET/CT, which showed a solitary metastasis in the left acetabulum. Subsequent 18F-FDG PET/CT showed intense uptake throughout the prostate as well as extensive avid pelvic and thoracic nodal disease and redemonstration of the left acetabular metastasis. Despite initial metabolic response to treatment, subsequent 18F-FDG PET 8 months later revealed significant progression of nodal disease above and below the diaphragm, as well as multiple new sites of metastases.
Diffuse Bone Uptake of 131I and Effect on Blood Counts in a Patient With Papillary Thyroid Carcinoma and Chronic Lymphocytic Leukemia
Authors: Latgé Adrien , Krim Mehdi , Vija Lavinia , Ysebaert Loïc , Zerdoud Slimane
Published: February 2024

A 57-year-old woman with history of chronic lymphocytic leukemia was referred to our center for adjuvant 131I therapy following complete thyroidectomy for differentiated thyroid cancer. Posttherapeutic scintigraphy revealed atypical diffuse osteomedullar uptake. A major drop in lymphocyte count was observed, from 117.7 g/L to 4.8 g/L 8 weeks after 131I therapy. Bone marrow uptake is presumed to be related to tracer sequestration in leukemic cells. White blood cell count normalization suggests a high sensitivity of leukemic cells to beta emission. This scintigraphic pattern may act as a pitfall for nuclear medicine physician.
Body Contouring Surgery after Bariatric Surgery Improves Long-term Health-related Quality of Life and Satisfaction with Appearance
Authors: Dalaei Farima , de Vries Claire E.E. , Poulsen Lotte , Möller Sören , Kaur Manraj N. , Dijkhorst Phillip J. , Thomsen Jørn Bo , Hoogbergen Maarten , Makarawung Dennis J.S. , Mink van der Molen Aebele B. , Repo Jussi P. , Paul Marek Adam , Busch Kay-Hendrik , Cogliandro Annalisa , Opyrchal Jakub , Rose Michael , Juhl Claus B. , Andries Alin M. , Printzlau Andreas , Støving René K. , Klassen Anne F. , Pusic Andrea L. , Sørensen Jens A.
Published: February 2024

Objective:

To examine health-related quality of life (HRQL) and satisfaction with appearance in patients who have undergone bariatric surgery (BS) with or without subsequent body contouring surgery (BCS) in relation to the general population normative for the BODY-Q.

Background:

The long-term impact of BS with or without BCS has not been established using rigorously developed and validated patient-reported outcome measures (PROM). The BODY-Q is a PROM developed to measure changes in HRQL and satisfaction with appearance in patients with BS and BCS.

Methods:

Prospective BODY-Q data were collected from six European countries (Denmark, Netherlands, Finland, Germany, Italy, and Poland) from June 2015 to February 2022 in a cohort of patients who underwent BS. Mixed effects regression models were used to analyze changes in HRQL and appearance over time between patients who did and did not receive BCS and to examine the impact of patient-level covariates on outcomes.

Results:

This study included 24,604 assessments from 5,620 patients. BS initially led to improved HRQL and appearance scores throughout the first post-bariatric year, followed by a gradual decrease. Patients who underwent subsequent BCS after BS experienced a sustained improvement in HRQL and appearance or remained relatively stable for up to 10-years postoperatively.

Conclusion:

Patients who underwent BCS maintained the improvement in HRQL and satisfaction with appearance in contrast to patients who only underwent BS, who reported a decline in scores 1-2 years postoperatively. Our results emphasize the pivotal role that BCS plays in the completion of the weight loss trajectory.
Optimizing Surgical Planning for Epilepsy Patients With Multimodal Neuroimaging and Neurophysiology Integration: A Case Study
Authors: Gong Ruxue , Bickel Stephan , Tostaeva Gelana , Lado Fred A. , Metha Ashesh D. , Kuzniecky Ruben I. , Bonilha Leonardo F. , Gleichgerrcht Ezequiel L.
Published: February 2024

Current preoperative evaluation of epilepsy can be challenging because of the lack of a comprehensive view of the network's dysfunctions. To demonstrate the utility of our multimodal neurophysiology and neuroimaging integration approach in the presurgical evaluation, we present a proof-of-concept for using this approach in a patient with nonlesional frontal lobe epilepsy who underwent two resective surgeries to achieve seizure control. We conducted a post-hoc investigation using four neuroimaging and neurophysiology modalities: diffusion tensor imaging, resting-state functional MRI, and stereoelectroencephalography at rest and during seizures. We computed region-of-interest-based connectivity for each modality and applied betweenness centrality to identify key network hubs across modalities. Our results revealed that despite seizure semiology and stereoelectroencephalography indicating dysfunction in the right orbitofrontal region, the maximum overlap on the hubs across modalities extended to right temporal areas. Notably, the right middle temporal lobe region served as an overlap hub across diffusion tensor imaging, resting-state functional MRI, and rest stereoelectroencephalography networks and was only included in the resected area in the second surgery, which led to long-term seizure control of this patient. Our findings demonstrated that transmodal hubs could help identify key areas related to epileptogenic network. Therefore, this case presents a promising perspective of using a multimodal approach to improve the presurgical evaluation of patients with epilepsy.
Multifocal tuberculosis revealed by a sternal swelling in an immunocompetent child
Authors: CHEHRASTANE GHIZLANE , Benaissa Elmostafa , Radi Abdelilah , EL Hassani Amal , Elouennass Mostafa
Published: February 2024

Tuberculosis (TB) is one of the most common pathogens of bacterial lung infections specially in underdevelopoed nations like morocco where the incidence of TB was 97 cases per 100,000 person in 2019. Thanks to its national TB prevention and control plan, Morocco was able to acheive a remarkable  progress in management of TB with 80% reduction in the total number patients diagnosed with TB between 1980 and 2018. The national plan also allowed to reach and maintain a therapeutic rate above 86% since 2002. extrapulmonary TB primarily affects the primary weight bearing joints and the spine. Sternal TB is a rare clinical condition accounting for 1% of all musculoskeletal TB cases. Due to its rarity and the lack of awareness of the clinicals presentations, The diagnosis of sternal TB can be quite complex. we describe the case of a 14 year old moroccan patient consulting in the military hospital mohammed V, Rabat with central chest pain for four months.  The pain was not associated to breathing, physical exercise or eating.  with a history of asthenia, fever, and  weight loss. A ct scan of the chest showed a destructive lesions of the sternum. thereafter, a chirurgical biopsy was performed  and enabled to confirm the microbiological diagnosis of tuberculosis thanks to the realization of the RT-PCR. The anti-tuberculosis therapy was given to the patient who had complete resolution of symptoms. This condition should be included in the differential diagnosis of chronic chest pain that mimics costochondritis particularly in patients from endemic areas.
High levels of multidrug-resistant isolates of genetically similar Salmonella 1,4, [5],12:I:- from Brazil between 1983 and 2020
Authors: Pereira Giovana do Nascimento , Seribelli Amanda Aparecida , Campioni Fábio , Gomes Carolina Nogueira , Tiba-Casas Monique Ribeiro , Medeiros Marta Inês Cazentini , Rodrigues Dália dos Prazeres , Falcão Juliana Pfrimer
Published: February 2024

Introduction.
Salmonella 1,4, [5],12:i:- strains with different antimicrobial resistance profiles have been associated with foodborne disease outbreaks in several countries. In Brazil, S. 1,4, [5],12:i:- was identified as one of the most prevalent serovars in São Paulo State during 2004–2020.

Gap Statement. However, few studies have characterized this serovar in Brazil.

Aim. This study aimed to determine the antimicrobial resistance profiles of S. 1,4, [5],12:i:- strains isolated from different sources in Southeast Brazil and compare their genetic diversity.

Methodology. We analysed 113 S. 1,4, [5],12:i:- strains isolated from humans (n=99), animals (n=7), food (n=5) and the environment (n=2) between 1983 and 2020. Susceptibility testing against 13 antimicrobials was performed using the disc diffusion method for all the strains. Plasmid resistance genes and mutations in the quinolone resistance-determining regions were identified in phenotypically fluoroquinolone-resistant strains. Molecular typing was performed using enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) for all strains and multilocus sequence typing (MLST) for 40 selected strains.

Results. Of the 113 strains, 54.87 % were resistant to at least one antimicrobial. The highest resistance rates were observed against ampicillin (51.33 %), nalidixic acid (39.82 %) and tetracycline (38.05 %). Additionally, 39 (34.51 %) strains were classified as multidrug-resistant (MDR). Nine fluoroquinolone-resistant strains exhibited the gyrA mutation (Ser96→Tyr96) and contained the qnrB gene. The 113 strains were grouped into two clusters using ERIC-PCR, and most of strains were present in one cluster, with a genetic similarity of ≥80 %. Finally, 40 strains were typed as ST19 using MLST.

Conclusion. The prevalence of MDR strains is alarming because antimicrobial treatment against these strains may lead to therapeutic failure. Furthermore, the ERIC-PCR and MLST results suggested that most strains belonged to one main cluster. Thus, a prevalent subtype of Salmonella 1,4, [5],12:i:- strains has probably been circulating among different sources in São Paulo, Brazil, over decades.
Combining computational biology and experimental knowledge to draw a structural profile of the active membrane-assembled NADPH oxidase complex
Authors: Aimeur Sana Zineb , Fas Burcu Aykac , Serfaty Xavier , Santuz Hubert , Sacquin-Mora Sophie , Bizouarn Tania , Taly Antoine , BACIOU LAURA
Published: February 2024

The phagocyte NADPH oxidase complex (NOX2) is activated by various intracellular stimuli, resulting in the generation of reactive oxygen species, which are responsible for many physiological processes, including innate immune defense. Structures of the cytochrome b558, membrane catalytic core of the complex, in their resting state have been solved experimentally. Unfortunately, very little is known about the structure of the active complex, as it involves the assembly of modular proteins and disordered regions, that have been shown to be essential to the function of the enzyme. Here, we modelled the supra-structure of the active complex using Alphafold2 and taking into account experimental data as well as conformational analyses by SRCD. AF2 ability to generate complexes enabled us to visualize ways in which subunits could assemble together, and revealed the implications of intrinsically disordered regions in protein-protein and membrane-protein interactions. Additional Molecular Dynamics simulations of the membrane embedded complex bring further insight regarding the system dynamics. Altogether, our work provides evidence for a model of the structure of the active complex where disordered regions can enable multi-subunit assembly.
Clonal analysis of fetal hematopoietic stem/progenitor cell subsets reveals how post-transplantation capabilities are distributed
Authors: Stonehouse Olivia , Biben Christine , Weber Tom S , Garnham Alexandra , Fennell Katie , Farley Alison , Terreaux Antoine , Alexander Warren , Dawson Mark , Naik Shalin , Taoudi Samir
Published: February 2024

It has been proposed that adult haematopoiesis is sustained by multipotent progenitor (MPP) clones that are specified during development. From an immunophenotypic perspective, it is known that hematopoietic stem cell (HSC) and MPPs are present in the fetal liver yet our understanding of how fetal MPPs functionally compare to those in the adult bone marrow is incomplete. Using acute-term transplantations, we found that at a population-level fetal immunophenotypic MPP classes exhibited similar lineage biases as adult cells, albeit with some difference in lymphoid output. Clonal assessment of fetal MPPs engraftment revealed that lineage biases largely resulted from differences in the pattern of single- or bi-lineage differentiation. Immunophenotypic long-term (LT)- and short-term (ST)-HSCs in the fetal liver were distinguished from MPPs according to propensity for clonal multi-lineage differentiation. We also discovered that a large cohort of long-term repopulating units (LT-RU) were within the immunophenotypic ST-HSC population, a significant portion of these were labelled using Flt3-cre. This finding has two implications: (1) use of the CD150+ LT-HSC immunophenotype alone will systematically underestimate the size and diversity of the fetal LT-RU pool; and, (2), given fetal LT-RUs with a ST-HSC immunophenotype have the functional attributes required to persist into adulthood.
Chloroplast Cell-Free Systems from Different Plant Species as a Rapid Prototyping Platform
Authors: Boehm Clemens V. , Inckemann Rene , Burgis Michael , Baumann Jessica , Brinkmann Cedric K. , Lipinska Katarzyna E. , Gilles Sara , Freudigmann Jonas , Seiler Vinca , Clark Lauren G. , Jewett Michael C. , Voll Lars M. , Niederholtmeyer Henrike
Published: February 2024

Climate change poses a significant threat to global agriculture, necessitating innovative solutions. Plant synthetic biology, particularly chloroplast engineering, holds promise as a viable approach to this challenge. Chloroplasts present a variety of advantageous traits for genetic engineering, but the development of genetic tools and genetic part characterization in these organelles is hindered by the lengthy timescales required to generate transplastomic organisms. To address these challenges, we have established a versatile protocol for generating chloroplast-based cell-free gene expression (CFE) systems derived from a diverse range of plant species, including wheat (monocot), spinach, and poplar trees (dicots). We show that these systems work with conventionally used T7 RNA polymerase, as well as the endogenous chloroplast polymerases, allowing for detailed characterization and prototyping of regulatory sequences at both transcription and translation levels. To demonstrate the platform for characterization of promoters and 5' and 3' untranslated regions (UTRs) in higher plant chloroplast gene expression, we analyze a collection of 23 5'UTRs, 10 3'UTRs, and 6 chloroplast promoters, assessed their expression in spinach and wheat extracts, and found consistency in expression patterns, suggesting cross-species compatibility. Looking forward, our chloroplast CFE systems open new avenues for plant synthetic biology, offering prototyping tools for both understanding gene expression and developing engineered plants, which could help meet the demands of a changing global climate.
Average correlation as an indicator for inseparability
Authors: Tschaffon Michael E. N. , Seiler Johannes
Published: February 2024

Inseparability of quantum states is one of the most crucial aspects of quantum physics, as it often provides the key ingredient for obtaining a quantum advantage. Quantifying inseparability is thus an important objective to better understand quantum physics and to improve quantum applications. So far, many measures for inseparability exist, however, most of them are based on abstract mathematical procedures and are not defined operationally which can easily be realized in an experiment. Recently we introduced average correlation [Tschaffon , ] as a reference frame independent indicator for nonclassicality in the Bell sense based on randomized measurements. It is defined as the average absolute value of the two-qubit correlation function and allows one to formulate a necessary and sufficient condition for the ability to violate the CHSH inequality. Experimentally it can be realized by randomized measurements which can approximate its value arbitrarily closely. This makes it independent of a shared reference frame between the two measuring parties, which can be useful in scenarios where it is impossible to find one. In this second article, we show that average correlation also serves as an indicator for inseparability by deriving a necessary and sufficient condition. From there, we prove the remaining open conjectures of the first article. Due to the operational definition of average correlation, it offers a first step toward finding a new operationally defined inseparability measure.

Published by the American Physical Society
2024
Nonequilibrium solvent response force: What happens if you push a Brownian particle
Authors: Koch Fabian , Erle Jona , Schilling Tanja
Published: February 2024

In this Letter we discuss how to add forces to the Langevin equation. We derive an exact generalized Langevin equation for the dynamics of one particle subject to an external force embedded in a system of many interacting particles. The external force may depend on time and/or on the phase-space coordinates of the system. We construct a projection operator such that the drift coefficient, the memory kernel, and the fluctuating force of the generalized Langevin equation are the same as for the system without external driving. We show that next to the external force another force term occurs that is caused by the nonequilibrium response of the solvent. The first contribution to the ensemble average of this force stems from third or higher order terms of the external force and from sixth or higher order terms of time. We also analyze the additional force term numerically for an exemplary system.

Published by the American Physical Society
2024
Nonlinear and Nonreciprocal Transport Effects in Untwinned Thin Films of Ferromagnetic Weyl Metal
SrRuO3
Authors: Kar Uddipta , Lu Elisha Cho-Hao , Singh Akhilesh Kr. , Reddy P. V. Sreenivasa , Han Youngjoon , Li Xinwei , Cheng Cheng-Tung , Yang Song , Lin Chun-Yen , Cheng I-Chun , Hsu Chia-Hung , Hsieh David , Lee Wei-Cheng , Guo Guang-Yu , Lee Wei-Li
Published: February 2024

The identification of distinct charge transport features, deriving from nontrivial bulk band and surface states, has been a challenging subject in the field of topological systems. In topological Dirac and Weyl semimetals, nontrivial conical bands with Fermi-arc surface states give rise to negative longitudinal magnetoresistance due to chiral anomaly effect and unusual thickness dependent quantum oscillation from Weyl-orbit effect, which were demonstrated recently in experiments. In this work, we report the experimental observations of large nonlinear and nonreciprocal transport effects for both longitudinal and transverse channels in an untwinned Weyl metal of SrRuO3 thin film grown on a SrTiO3 substrate. From rigorous measurements with bias current applied along various directions with respect to the crystalline principal axes, the magnitude of nonlinear Hall signals from the transverse channel exhibits a simple sinα dependence at low temperatures, where α is the angle between bias current direction and orthorhombic [001]o, reaching a maximum when current is along orthorhombic [11¯0]o. On the contrary, the magnitude of nonlinear and nonreciprocal signals in the longitudinal channel attains a maximum for bias current along [001]o, and it vanishes for bias current along [11¯0]o. The observed α-dependent nonlinear and nonreciprocal signals in longitudinal and transverse channels reveal a magnetic Weyl phase with an effective Berry curvature dipole along [11¯0]o from surface states, accompanied by 1D chiral edge modes along [001]o.

Published by the American Physical Society
2024