Whole exome sequencing identifies a novel variant causing cockayne syndrome type I in a consanguineous Pakistani family

BACKGROUND

Cockayne syndrome (CS) is a rare neurodegenerative disorder characterized by impaired neurological functions, cachectic dwarfism, microcephaly and photosensitivity. Complementation assays identify two groups of this disorder, CS type I (CSA) and CS type II (CSB), caused by mutations in ERCC8 and ERCC6, respectively.

OBJECTIVES

This study aimed to investigate the genetic basis of a consanguineous Pakistani family with three affected individuals presenting with typical clinical symptoms of CS.

METHODS

We employed whole exome sequencing of the proband and then Sanger sequenced all the family members to confirm its segregation in the family. Different bioinformatics tools were used to predict pathogenicity of this variant.

RESULTS

Variants were filtered according to the pedigree structure. We identified a novel homozygous variant (c.202A>T; p.Ile68Phe) in ERCC8 gene in the proband. The variant was found to segregate in the family.

CONCLUSIONS

These findings add to the genetic heterogeneity of ERCC8 and expands the mutation spectrum. Also, identification of this variant can facilitate prenatal diagnosis/genetic counselling set ups in Pakistan where this disease largely remains undiagnosed.

Introduction to Special Section: CSA Victimization in Incarcerated Populations

Research suggests that individuals involved in the criminal justice system have higher rates of childhood trauma, including experiences of child sexual abuse (CSA). Studies also suggest that childhood victimization has an impact on the success of mental health treatment for offenders which may contribute to recidivism rates. Accordingly, policymakers and correctional staff can be better informed in choosing appropriate assessments and intervention approaches when they understand the ways in which prior experiences of CSA impact individuals in correctional settings. This special section highlights four novel studies that advance the research examining CSA in incarcerated populations.

Neuromuscular ultrasound changes in unilateral symptomatic subacute lumbosacral radiculopathy: A prospective simple blinded cohort study

INTRODUCTION/AIMS

Lumbosacral radiculopathy (LR) is a common disorder. Neuromuscular ultrasound (NMU) is a rapidly evolving technique for the investigation of peripheral nerve and muscle disorders, but studies using NMU in LR are lacking. The aim of the present study was to investigate ultrasonographic neuromuscular changes distant from root compression in patients with subacute to chronic compressive LR with motor impairment.

METHODS

Patients with unilateral subacute to chronic L4, L5, or S1 radiculopathy with motor impairment and confirmed by magnetic resonance imaging were included. The sciatic and femoral nerve cross-sectional areas (CSA), the CSA of lower limb muscles, and muscle fasciculation detection rate were assessed using a pre-specified neuromuscular ultrasound evaluation with blinded side-to-side comparison.

RESULTS

Of the 18 included patients, 66% were male and the mean age was 51 years. Overall, 16.7% had L4, 55.5% L5, and 27.8% S1 radiculopathy, mostly due to disc herniation (83%). Sciatic nerve CSA of the symptomatic side was increased (61.4 mm2 vs. 51.3 mm2; p = .001), and the fasciculation detection rate was higher in the affected muscles (delta = 13%, p = .007) compared to unaffected ones. Muscle CSA in affected and nonaffected muscles was decreased on the symptomatic side.

DISCUSSION

NMU evaluation in patients with symptomatic subacute to chronic LR revealed sciatic nerve enlargement distant from nerve root compression and higher fasciculation rates. These structural findings on NMU might be due to an axonal repair mechanism and an inflammatory response with endoneurial edema induced by ongoing nerve damage and potentially reflect progressive axonal loss.

Stories of childhood sexual abuse (CSA) among older adults living with HIV (OALH) in South Carolina: a qualitative study

Childhood sexual abuse (CSA) devastatingly impacts an individual's behavioral, psychological, and social health. Childhood, a developmental stage directly influenced by the home or school environment, leaves a life-long imprint. Compared with the general population, CSA prevalence is doubled among people living with HIV. Thus, the study aimed to explore CSA circumstances among older adults living with HIV (OALH) in South Carolina (SC). We included 24 OALH aged 50 and above who reported CSA. The data were collected at an immunology center in SC. In-depth semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed using a thematic analysis approach. The iterative analytic process included a discussion of initial thoughts and key concepts, identification, and reconciliation of codes, and naming of emergent themes. Six themes emerged: known perpetrators, re-victimization, "nobody believed me", "cannot live like others", lack of CSA disclosure, and interconnections with other adverse childhood experiences (ACEs). CSA experiences and non-disclosure were found to be linked with shame, embarrassment, fear, and trust issues. Hence, trauma-focused interventions are required to resolve these issues and improve the quality of life of OALH with past trauma. Counseling or therapy programs should incorporate psychological and behavioral theoretical models to best target OALH who are CSA survivors.

MXSGD alleviates CsA-induced hypoimmunity lung injury by regulating microflora metabolism

Context

Ma Xing Shi Gan Decoction (MXSGD) is a traditional remedy for treating lung injuries that was developed by the Typhoid and Fever School of Pharmaceutical Biology. It has antitussive and expectorant effects, anti-inflammatory, antiviral, regulates the body's immunity, etc.

Aim

The aim of this study is to investigate whether MXSGD can ameliorate cyclosporine A (CsA)-induced hypoimmunity lung injury by regulating microflora metabolism. Methods: Establishment of a model for CsA-induced hypoimmunity lung injury. Using 16S rRNA high-throughput sequencing and LC-MS, the effects of MXSGD on gut flora and lung tissue microecology of mice with CsA-induced hypoimmunity were investigated.

Results

MXSGD was able to preserve lung tissue morphology and structure, reduce serum inflammatory marker expression and protect against CsA-induced lung tissue damage. Compared to the model, MXSGD increased beneficial gut bacteria: Eubacterium ventriosum group and Eubacterium nodatum group; decreased intestinal pathogens: Rikenellaceae RC9 intestinal group; reduced the abundance of Chryseobacterium and Acinetobacter, promoted the production of Lactobacillus and Streptococcus, and then promoted the lung flora to produce short-chain fatty acids. MXSGD was able to enhance the expression of serum metabolites such as Americine, 2-hydroxyhexadecanoylcarnitine, Emetine, All-trans-decaprenyl diphosphate, Biliverdin-IX-alpha, Hordatin A and N-demethyl mifepristone in the CsA-induced hypoimmunity lung injury model.

Conclusion

MXSGD can restore gut and lung microbiota diversity and serum metabolite changes to inhibit inflammation, ameliorate CsA-induced hypoimmunity lung injury.

Novel Approaches to Sleep Apnea in Heart Failure

Sleep apnea is a serious comorbid condition affecting patients with heart failure. Present in 50% to 75% of heart failure patients, it is often underrecognized, underdiagnosed, and undertreated. Patients with sleep apnea and heart failure are at increased risk of adverse cardiovascular events and sudden death. Treatment of sleep apnea has shown mixed results in reduction of adverse outcomes by sleep apnea type and intervention strategy. Evolving home-based technologies and device therapies present an exciting frontier for patients with sleep apnea and heart failure and an opportunity to improve outcomes. This article reviews novel approaches to sleep apnea in heart failure.

New insight into highly efficient CSA@g-C3 N4 for photocatalytic oxidation of benzyl alcohol and thioanisole: NAEDS as a promoter of photoactivity under blue LED irradiation

An open new perspective has been established toward synthesizing eco-friendly CSA@g-C3 N4 employing surface engineering. The carbon nitride modified through camphorsulfonic acid was designed and developed in a category of the new generation of photocatalysts for the oxidation of benzyl alcohol and thioanisole in the existence of a natural deep eutectic solvent (NADES). In comparison with pure g-C3 N4 , not only does CSA@g-C3 N4 exhibit an extraordinarily higher ability for harvesting visible light stemming from declining the recombination rate of electrons/holes dependent on PL results but it also reveals notable photocatalytic oxidation capability in the transformation of alcohols as well as thiols into relevant compounds. In addition, non-metal compound (CSA) incorporation would result in considerably diminishing the energy band gap value from 2.8 to 2.28 eV to escalate the visible-light absorption of g-C3 N4 . While the conventional consensus implies that inherent properties of photocatalysts bring on high photoactivity, this study indicates that deploying choline chloride-urea deep eutectic solvent as an external factor plays the role of photoactivity accelerator. Furthermore, readily recycling and reusability can be achieved for the photocatalytic setup of CSA@g-C3 N4 ascribed to its heterogeneous nature with no drop in the photoactivity.

Associations between radiographic parameters in the reverse shoulder arthroplasty and patient outcomes

Background

Various radiological parameters have been measured in the Reverse Shoulder Arthroplasty (RSA) and correlated to patient outcomes, to determine best baseplate position. Results remain unclear with respect to certain parameters such as inferior baseplate tilt. We have investigated our series of patients to clarify the relationship between radiological parameters and patient outcomes.

Methods

We conducted a UK based bi-centre retrospective review of 156 prostheses. Critical shoulder angle (CSA), RSA angle (RSAA), Overhang and Deltoid Lever Arm (DLA) were measured on preoperative and postoperative radiographs. Range of motion and Oxford Shoulder Score (OSS) (range 1-8 years) were obtained. We assessed for scapular notching at minimum 1 year follow up (n = 138).

Results

Decreased postoperative CSA and increased DLA were associated with higher OSSs (P = 0.001 and 0.019). Increased overhang and DLA were associated with increased flexion (P = 0.033 and 0.024 respectively). Multivariate analysis showed that CSA and DLA affected notching rate (P = 0.002 and 0.007).

Conclusions

Baseplate tilt in relation to the acromion (CSA) and DLA are the most predictive parameters for notching and OSS. We recommend considering a maximum CSA of 26 degrees to decrease notching rate and improve OSS. We recommend considering an Overhang of at least 6 mm to improve FF.

Adaptive servo-ventilation and mortality in patients with systolic heart failure and central sleep apnea: a single-center experience

BACKGROUND

Central sleep apnea (CSA) is associated with increased mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Treatment of CSA with a certain type of adaptive servo-ventilation (ASV) device that targets minute ventilation (ASVmv) was found to be harmful in these patients. A newer generation of ASV devices that target peak flow (ASVpf) is presumed to have different effects on ventilation and airway patency. We analyzed our registry of patients with HFrEF-CSA to examine the effect of exposure to ASV and role of each type of ASV device on mortality.

METHODS

This is a retrospective cohort study in patients with HFrEF and CSA who were treated with ASV devices between 2008 and 2015 at a single institution. Mortality data were collected through the institutional data honest broker. Usage data were obtained from vendors' and manufacturers' servers. Median follow-up was 64 months.

RESULTS

The registry included 90 patients with HFrEF-CSA who were prescribed ASV devices. Applying a 3-h-per-night usage cutoff, we found a survival advantage at 64 months for those who used the ASV device above the cutoff (n = 59; survival 76%) compared to those who did not (n = 31; survival 49%; hazard ratio 0.44; CI 95%, 0.20 to 0.97; P = 0.04). The majority (n = 77) of patients received ASVpf devices with automatically adjusting end-expiratory pressure (EPAP) and the remainder (n = 13) received ASVmv devices mostly with fixed EPAP (n = 12). There was a trend towards a negative correlation between ASVmv with fixed EPAP and survival.

CONCLUSION

In this population of patients with HFrEF and CSA, there was no evidence that usage of ASV devices was associated with increased mortality. However, there was evidence of differential effects of type of ASV technology on mortality.

Sexual exploitation of children: Barriers for boys in accessing social supports for victimization

BACKGROUND

The global evidence regarding sexual exploitation of children (SEC) is expanding, however, the majority of research continues to focus on girls. ECPAT International's Global Boys Initiative is a major contribution to broadening knowledge by exploring how sexual exploitation impacts boys specifically.

OBJECTIVE

This discussion paper explores data from the initiative to better understand how boys and children of all genders may be impacted by sexual exploitation.

PARTICIPANTS AND SETTING

During 2019-21, research was undertaken by ECPAT member organizations into the sexual exploitation of boys in 10 primarily low-and-middle income countries globally. The initiative also supported a global systematic scoping review of published and gray literature published in this issue (Moss et al., in press).

METHODS

Gender norms analysis of Initiative data identifies critical thematic issues impairing access to support services for victimized boys.

RESULTS

Most disconcerting is gender-based stigmatization from services that can compound children's trauma. Justice-based, rather than trauma-informed models of support predominate in responses for boys. Legal frameworks create barriers when binary gendered terminology defines sexual violence, thereby excluding anyone other than women and girls from protection.

CONCLUSIONS

Three solutions emerged to improve access to support for more children affected by sexual exploitation: (1) challenge problematic gender norms and consequent practices, such as gendered terminology in legislation, that create barriers for boys and gender-diverse children; (2) create psychologically, emotionally, and physically safe circumstances (i.e. trauma-informed care) for all children to know help-seeking is possible; and (3) undertake proactive support that specifically connects boys and gender-diverse children to therapeutic services like drop-in centers, night-time counseling, and emergency shelter.

Optimizing cyclosporine A dose post allogeneic hematopoietic stem cell transplantation in paediatric cancer patients

BACKGROUND/OBJECTIVES

Cyclosporine A (CSA) dosing has been complicated by considerable intra-patient and inter-patient variability in pharmacokinetics, which is affected by different factors. We aimed to assess the various factors that might affect the CSA dose and its plasma level.

PATIENTS AND METHODS

This retrospective study included paediatric cancer patients who underwent allogeneic hematopoietic stem cell transplant at the Children's Cancer Hospital Egypt 57357 from matched related donors with CSA as graft versus host disease prophylaxis. The CSA initial dose was 1.5 mg/kg IV Q12H. Then, it was titrated according to the level and drug toxicity. Cyclosporine A trough levels were assessed two to three times per week using the Emit 2000 cyclosporine-specific assay. Moreover, factors that may affect cyclosporine levels, such as age, sex, weight and the antifungal used, were analyzed to determine their effect on CSA plasma levels.

RESULTS

There were 119 patients included in the study. The median age was 10 years; and 43% of them used voriconazole as a prophylactic antifungal. The multivariate analysis revealed that female patients, those >9 years or on voriconazole reached the target level at low initial CSA doses. A higher probability (93%) of reaching the desired plasma level with doses 1.5 mg/kg IV Q12H was observed among patients >9 years, and on voriconazole. While those who were ≤9 years and not on voriconazole required doses >1.5 mg/kg IV Q12H, with an 89% probability of reaching the desired level.

CONCLUSION

This study suggests that the initial CSA dose should consider the patient's age and the antifungal used. Patients >9 years and/or on voriconazole may require lower initial CSA doses and could start with 1.5 mg/kg IV Q12H.

An electrical stimulation intervention protocol to prevent disuse atrophy and muscle strength decline: an experimental study in rat

BACKGROUND

Skeletal muscle is negatively impacted by conditions such as spaceflight or prolonged bed rest, resulting in a dramatic decline in muscle mass, maximum contractile force, and muscular endurance. Electrical stimulation (ES) is an essential tool in neurophysiotherapy and an effective means of preventing skeletal muscle atrophy and dysfunction. Historically, ES treatment protocols have used either low or high frequency electrical stimulation (LFES/HFES). However, our study tests the use of a combination of different frequencies in a single electrical stimulation intervention in order to determine a more effective protocol for improving both skeletal muscle strength and endurance.

METHODS

An adult male SD rat model of muscle atrophy was established through 4 weeks of tail suspension (TS). To investigate the effects of different frequency combinations, the experimental animals were treated with low (20 Hz) or high (100 Hz) frequency before TS for 6 weeks, and during TS for 4weeks. The maximum contraction force and fatigue resistance of skeletal muscle were then assessed before the animals were sacrificed. The muscle mass, fiber cross-sectional area (CSA), fiber type and related protein expression were examined and analyzed to gain insights into the mechanisms by which the ES intervention protocol used in this study regulates muscle strength and endurance.

RESULTS

After 4 weeks of unloading, the soleus muscle mass and fiber CSA decreased by 39% and 58% respectively, while the number of glycolytic muscle fibers increased by 21%. The gastrocnemius muscle fibers showed a 51% decrease in CSA, with a 44% decrease in single contractility and a 39% decrease in fatigue resistance. The number of glycolytic muscle fibers in the gastrocnemius also increased by 29%. However, the application of HFES either prior to or during unloading showed an improvement in muscle mass, fiber CSA, and oxidative muscle fibers. In the pre-unloading group, the soleus muscle mass increased by 62%, while the number of oxidative muscle fibers increased by 18%. In the during unloading group, the soleus muscle mass increased by 29% and the number of oxidative muscle fibers increased by 15%. In the gastrocnemius, the pre-unloading group showed a 38% increase in single contractile force and a 19% increase in fatigue resistance, while in the during unloading group, a 21% increase in single contractile force and a 29% increase in fatigue resistance was observed, along with a 37% and 26% increase in the number of oxidative muscle fibers, respectively. The combination of HFES before unloading and LFES during unloading resulted in a significant elevation of the soleus mass by 49% and CSA by 90%, with a 40% increase in the number of oxidative muscle fibers in the gastrocnemius. This combination also resulted in a 66% increase in single contractility and a 38% increase in fatigue resistance.

CONCLUSION

Our results indicated that using HFES before unloading can reduce the harmful effects of muscle unloading on the soleus and gastrocnemius muscles. Furthermore, we found that combining HFES before unloading with LFES during unloading was more effective in preventing muscle atrophy in the soleus and preserving the contractile function of the gastrocnemius muscle.

The Role of Second Step Child Protection Unit Online Teacher Training in Explaining Teacher and Student Outcomes: Multilevel SEM Analysis

Child sexual abuse (CSA) is a concern given its prevalence and harmful consequences such as depression, anxiety, substance misuse, and low academic performance, which pose great threats to children's sustainable development. In response, teachers must be empowered to play crucial roles in preventing CSA and intervening to avert CSA-related harm. We therefore explored the potential for online teacher training to improve teachers' preventive outcomes of CSA (awareness, commitment, and confidence in reporting) and student outcomes (CSA knowledge and ability to recognize, refuse, and report CSA). To assess the immediate effect of online teaching training, we analyzed pre-and post-test data from the implementation of the Second Step Child Protection Unit (CPU) on 131 teachers and 2,172 students using a multilevel structural equation modeling approach. We found a significant direct effect of online teacher training on improving teachers' preventive outcomes. Furthermore, we detected a significant indirect effect of online teacher training on children's preventive outcomes of CSA knowledge and ability to recognize, refuse, and report CSA via teachers' preventive outcomes of CSA awareness.

Cyclophosphamide with cyclosporine A for graft-versus-host disease prophylaxis in adult patients with acute myeloid leukemia undergoing allogeneic hematopoietic stem cell transplantation from human leucocyte antigen-matched donors

BACKGROUND

Graft-versus-host disease (GVHD) is one of the most severe complications in patients with acute myeloid leukemia (AML) who underwent allogenic hematopoietic stem cell transplantation (HSCT). This study addressed the effectiveness and safety outcomes of high dose post-transplant cyclophosphamide (PT-CY) followed by cyclosporine A (CSA) as a GVHD prophylaxis protocol.

PATIENTS AND METHODS

From January 2019 to March 2021, AML patients who underwent HSCT, and received high-dose PT-CY followed by CSA were prospectively recruited, assessed, and followed up for one-year post-transplantation (PT). The cumulative incidences of both acute GVHD (aGVHD) at 100 days PT, and chronic GVHD (cGVHD) at one-year PT were assessed.

RESULTS

This study included 52 patients. The cumulative incidence (95% CIs) of aGVHD was 2.3% (0.3 - 15.4%), while the cumulative incidence of cGVHD was 23.2% (12.2-41.5%). The cumulative incidence of relapse and non-relapse mortality were 15.6%, and 7.9%, respectively. The median duration to reach neutrophil and platelet engraftment was 17 and 13 days, respectively. The overall, progression-free, and GVHD-free/relapse-free survival rates (95% CIs) were 89.6% (76.6 - 95.6%), 77.7% (62.1-87.5%), and 58.2% (41.6 - 71.7%) respectively. The cumulative incidences of the main transplant-related complications were; neutropenic sepsis (48.3%), cytomegalovirus reactivation (21.7%), pneumonia (13.8%), hemorrhagic cystitis (17.8%), septic shock (4.9%), and CSA toxicity (48.9%).

CONCLUSION

PT-CY followed by CSA was associated with low cumulative incidences of both aGVHD and cGVHD without increase in either the relapse or transplant-related complications; so, considered as a promising protocol to be widely applied in the settings of HLA-matched donors.

Fusion-based strategy of CSA and mobile NIR for the quantification of free fatty acid in wheat varieties coupled with chemometrics

The use of sensor fusion, a novel method of combining artificial senses, has become increasingly popular in the assessment of food quality. This study employed a combination of the colorimetric sensor array (CSA) and mobile near-infrared (NIR) spectroscopy to predict free fatty acids in wheat flour. In conjunction with a partial least squares model, Low- and mid-level fusion strategies were used for quantification. Accordingly, performance of the built model was evaluated based on higher correlation coefficients between calibration and prediction (R_C and R_P), lower root mean square error of prediction (RMSEP), and a higher residual predictive deviation (RPD). The mid-level fusion coupled PLS model produced superior data fusion findings, with R_C = 0.8793, RMSECV = 7.91 mg/100 g, R_P = 0.8747, RMSEP = 6.99 mg/100 g, and RPD = 2.27. The findings of the study suggest that the NIR-CSA fusion approach could be effectively applied to the prediction of free fatty acids in wheat flour.

Determination of the relative orientation between 15N-1H dipolar coupling and 1H chemical shift anisotropy tensors under fast MAS solid-state NMR

In this work, we have proposed a proton-detected three-dimensional (3D) ¹⁵N-¹H dipolar coupling (DIP)/¹H chemical shift anisotropy (CSA)/¹H chemical shift (CS) correlation experiment to measure the relative orientation between the ¹⁵N-¹H dipolar coupling and the ¹H CSA tensors under fast magic angle spinning (MAS) solid-state NMR. In the 3D correlation experiment, the ¹⁵N-¹H dipolar coupling and ¹H CSA tensors are recoupled using our recently developed windowless C-symmetry-based C3₃¹-ROCSA (recoupling of chemical shift anisotropy) DIPSHIFT and C3₃¹-ROCSA pulse-based methods, respectively. The 2D ¹⁵N-¹H DIP/¹H CSA powder lineshapes extracted using the proposed 3D correlation method are shown to be sensitive to the sign and asymmetry of the ¹H CSA tensor, a feature that allows the determination of the relative orientation between the two correlating tensors with improved accuracy. The experimental method developed in this study is demonstrated on a powdered U-¹⁵N L-Histidine.HCl·H₂O sample.

Polysomnographic predictors of incident diabetes and pre-diabetes: an analysis of the DREAM study

STUDY OBJECTIVES

We sought to evaluate sleep measures that better predict incident diabetes and prediabetes in a large cohort of veterans.

METHODS

This secondary analysis included 650 patients without baseline diabetes from a multisite observational veterans' cohort. Participants underwent obstructive sleep apnea evaluation via laboratory-based polysomnography between 2000 and 2004 with follow-up through 2012. The primary outcomes were prediabetes and diabetes defined by fasting blood glucose, hemoglobin A1c, or use of glucose-lowering medication at study initiation. Exposure variables included respiratory event frequency, arousals, and oxygen desaturation. Cox models adjusted for body mass index, age, race, sex, change in body mass index, and continuous positive airway pressure device utilization.

RESULTS

The adjusted analysis revealed that time spent with oxygen saturation less than 90 [hazards ratio (HR) 1.009], confidence interval (CI) 1.001-1.017, P = .02), respiratory arousals (HR 1.009, CI 1.003-1.015, P < 0.01) and total arousals (HR 1.006 CI 1.001-1.011 P = .02) were associated with an increased incidence of diabetes. Increases in mean nocturnal oxygen saturation were associated with decreased incidence of diabetes (HR 0.914 CI 0.857-0.975, P < .01) and prediabetes (HR 0.914 CI 0.857-0.975, P < .01). No significant relationships were demonstrated for apnea-hypopnea index (AHI), measures related to central apnea, Cheyne-Stokes respiration, periodic limb movements, or Epworth Sleepiness Scale score.

CONCLUSIONS

There was no significant association of incident prediabetes or diabetes with AHI, the gold standard of sleep apnea severity. This study suggests that hypoxia may be a better predictor of glycemic outcomes than AHI in an obstructive sleep apnea population and may provide clues to the underlying mechanism(s) that link sleep-disordered breathing and its metabolic consequences.

CITATION

Wojeck BS, Inzucchi SE, Qin L, Yaggi HK. Polysomnographic predictors of incident diabetes and pre-diabetes: an analysis of the DREAM study. J Clin Sleep Med. 2023;19(4):703-710.

The lifetime prevalence of child sexual abuse assessed in young adults in Lithuania

OBJECTIVE

We examined the prevalence of different types of childhood sexual abuse (CSA) in Lithuania focusing on how these experiences were related to victim's age and relationship to the perpetrator.

METHODS

The participants came from a representative household survey of youth aged 18-29 and the sample consisted of 2000 participants (47.7 % women) with a mean age of 23.9 years (SD = 3.6). The ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R, Dunne et al., 2009) for young adults was used to investigate childhood exposure to CSA. Both current sociodemographic information and information on circumstances during childhood (e.g., number of siblings, family members with whom the participant lived between 7 and 12 year of age) were collected.

RESULTS

The prevalence of any CSA experience before the age of 18 was 15.9 %, with higher rates for women (13.5 % and 18.5 % for men and women, respectively). Being spoken to in a sexual way or sexual things being written about the person was the most prevalent form of CSA. In contrast, number of victims that reported sexual intercourse was much lower. The most common type of perpetrator was another young person. Intrafamilial CSA was rare with higher risk in step-relationships.

CONCLUSIONS

Our study provides representative prevalence estimates of the CSA in a region for which such estimates were not previously available. These Lithuanian estimates correspond well with previous literature. Importantly, the findings point to peers being an important perpetrator group in CSA cases. This and other findings can inform the planning of relevant policy measures and actions to both prevent CSA and investigate cases effectively.

Various Expressions of PIK3C2A and TXNIP Genes and Their Potential Role as Independent Risk Factors for Chronic Stable Angina and Acute Coronary Syndrome

BACKGROUND AND AIM

Genetic factors play a significant role in the onset and progression of coronary artery disease (CAD). PIK3C2A may contribute to the development of acute coronary syndrome (ACS) by affecting blood glucose levels and oxidative stress. The expression levels of TXNIP were significantly higher in patients with unstable angina pectoris. However, the situation is different in ACS. In the current study, we aim to investigate the role of PIK3C2A and TXNIP as independent risk factors for chronic stable angina (CSA) and ACS.

SUBJECTS AND METHODS

This study involved 215 subjects (60 patients with CSA, 55 patients with ACS, and 100 controls). All subjects were exposed for assaying gene expressions of PIK3C2A and TXNIP by quantitative real-time polymerase chain reaction.

RESULTS

It was found that TXNIP was upregulated, whereas PIK3C2A was downregulated in patients with CAD compared to the control group. PIK3C2A was significantly downregulated in patients with ACS compared to that in patients with CSA (p < 0.001), but TXNIP was not (p = 0.7). TXNIP was significantly upregulated in STEMI-ACS patients compared to CSA (p = 0.045) and NSTEMI ACS (p = 0.046), among non-diabetic (p = 0.023) smokers (p = 0.036) with hypertension (p = 0.005) and hypercholesterolemia (p = 0.001). ROC (receiver operating characteristic) curve analysis revealed that PIK3C2A (0.981; p < 0.001; 98.18) was the most sensitive mRNA for discriminating ACS from control, followed by TXNIP (0.775; p < 0.001; 70.91). However, for discriminating ACS from CSA combined mRNAs, (PIK3C2A + TXNIP) (0.893; p < 0.001; 98.18) and PIK3C2A (0.892; p < 0.001; 81.82) are promising biomarkers. On the other hand, the most sensitive mRNA for differentiating CSA from control is mRNAs (PIK3C2A + TXNIP) (0.963; p < 0.001; 95), then TXINP (81.3; p < 0.001; 93.33), and finally, PIK3C2A (0.782; p < 0.001; 81.67). In the multivariate regression model, PIK3C2A ((p = 0.002), 0.118 (0.031-0.445)) and smoking status ((p = 0.034); 0.151 (0.026-0.866)) were independent variables for ACS. Moreover, PIK3C2A ((p < 0.013); 0.706 (0.614-0.812)), Hb ((p = 0.013); 0.525 (0.317-0.871)), and total cholesterol ((p = 0.04); 0.865 (0.784-0.955)) were significantly (p < 0.05) and independently related to the prognosis of CSA. Furthermore, PIK3C2A ((p = 0.002), 0.923 (0.877-0.971)), TXNIP ((p = 0.001); 2.809 (1.558-5.064)) the body weight ((p = 0.033); 1.254 (1.018-1.544)) were independently associated with CSA.

CONCLUSIONS

Our study concluded that the dysregulated mRNA PIK3C2A and TXNIP gene expressions may be useful in diagnosis of CAD and prediction of ACS development.

Nondestructive Evaluation for Hydration and Setting Time of Gypsum Modified Calcium Sulfoaluminate Cement Paste

Calcium sulfoaluminate (CSA) cement is a promising solution for reducing CO₂ emissions. While previous studies have attempted to investigate the usefulness of CSA cement via various approaches, early age nondestructive evaluations for the setting and hydration of CSA cement mixtures have not been reported. In this study, we measured the ultrasonic pulse velocity and electrical resistivity of early age CSA cement paste. Six types of samples were prepared according to different water-to-solid ratios and different amounts of gypsum. In addition, various microstructural analyses were performed to understand CSA cement hydration with the obtained nondestructive parameters. Consequently, the effect of added gypsum in CSA cement paste was discussed in terms of ye'elimite dissolution and the precipitation of ettringite, and different pore distributions produced by added gypsum were discussed in terms of compressive strength. The 5% addition of gypsum in CSA cement paste enhanced the hydration evolution, such as ettringite, and it can induce the faster setting time up to 6 h and strength development during 24 h.

The predictive value of psoas and paraspinal muscle parameters measured on MRI for severe cage subsidence after standalone lateral lumbar interbody fusion

BACKGROUND CONTEXT

The effect of psoas and paraspinal muscle parameters on cage subsidence after minimally invasive techniques, such as standalone lateral lumbar interbody fusion (SA-LLIF), is unknown.

PURPOSE

This study aimed to determine whether the functional cross-sectional area (FCSA) of psoas and lumbar spine extensor muscles (multifidus and erector spinae), and psoas FCSA normalized to the vertebral body area (FCSA/VBA) differ among levels with severe cage subsidence after SA-LLIF when compared to levels without severe cage subsidence.

STUDY DESIGN

Retrospective single center cohort study.

PATIENT SAMPLE

Patients who underwent SA-LLIF between 2008 and 2020 for degenerative conditions using exclusively polyetheretherketone (PEEK) cages, had a lumbar magnetic resonance imaging (MRI) scan within 12 months, a lumbar computed tomography (CT) scan within 6 months prior to surgery, and a postoperative clinical and radiographic follow-up at a minimum of 6 months were included.

OUTCOME MEASURES

Severe cage subsidence.

METHODS

MRI measurements included psoas and combined multifidus and erector spinae (paraspinal) FCSA and FCSA/VBA at the L3-L5 pedicles. Following manual segmentation of muscles on axial T2-weighted images using ITK-SNAP (version 3.8.0), the FCSA was calculated using a custom written program on Matlab (version R2019a, The MathWorks, Inc.) that used an automated pixel intensity threshold method to differentiate between fat and muscle. Mean volumetric bone mineral density (vBMD) at L1/2 was measured by quantitative CT. The primary endpoint was severe cage subsidence per level according to the classification by Marchi et al. Multivariable logistic regression analysis was performed using generalized linear mixed models. All analyses were stratified by biological sex.

RESULTS

95 patients (45.3% female) with a total of 188 operated levels were included in the analysis. The patient population was 92.6% Caucasian with a median age at surgery of 65 years. Overall subsidence (Grades 0-III) was 49.5% (53/107 levels) in men versus 58.0% (47/81 levels) in women (p=.302), and severe subsidence (Grades II-III) was 22.4% (24/107 levels) in men versus 25.9% (21/81 levels) in women (p=.608). In men, median psoas FCSA and psoas FCSA/VBA at L3 and L4 were significantly greater in the severe subsidence group when compared to the non-severe subsidence group. No such difference was observed in women. Paraspinal muscle parameters did not differ significantly between non-severe and severe subsidence groups for both sexes. In the multivariable logistic regression analysis with adjustments for vBMD and cage length, psoas FCSA at L3 (OR 1.002; p=.020) and psoas FCSA/VBA at L3 (OR 8.655; p=.029) and L4 (OR 4.273; p=.043) were found to be independent risk factors for severe cage subsidence in men.

CONCLUSIONS

Our study demonstrated that greater psoas FCSA at L3 and psoas FCSA/VBA at L3 and L4 were independent risk factors for severe cage subsidence in men after SA-LLIF with PEEK cages. The higher compressive forces the psoas exerts on lumbar segments as a potential stabilizer might explain these findings. Additional pedicle screw fixation might be warranted in these patients to avoid severe cage subsidence.

"Not understanding but feeling guilty at the same time": The peritraumatic responses of CSA survivors from the Muslim Arab community in Israel

BACKGROUND

Studies on child sexual abuse (CSA) have greatly contributed to theoretical and empirical developments, advancing policy and practice. However, studies on CSA in closed societies are still scarce.

OBJECTIVE

The current study focuses on CSA in the Muslim Arab community in Israel while delving into the peritraumatic responses of survivors to CSA.

PARTICIPANTS AND SETTING

Twenty-eight Muslim Arab survivors of CSA provided written testimonies for an independent inquiry.

METHODS

The exploration of the Muslim Arab survivors' peritraumatic responses to CSA, according to their testimonies, was guided by an inductive thematic analysis and Braun and Clarke's (2006) six steps of analysis.

RESULTS

The results indicated that, as most of the abusive incidents were committed by an extended family member, the survivors experienced an inability to understand what had happened to them while simultaneously feeling guilt and self-blame. Furthermore, the survivors discussed feeling trapped by all of the systems and social expectations in their lives, leaving them feeling extremely lonely and with the understanding that seeking help and disclosing the abuse was not relevant for them.

CONCLUSION

The discussion addresses the developments in the research on peritraumatic responses that require further examination. This includes top-down processes that might explain survivors' peritraumatic responses, which are not merely instinctual. In addition, when perpetrators are family members, survivors are expected to stay in contact with them, which demands enormous resources and survival strategies from the survivors.

Child sexual abuse laws in India; failure of implementation - a case report

Child sexual abuse (CSA) is a worldwide problem with girls most affected even allowing for the possibility that boys are less likely to report it. In India there is strict anti-CSA legislation like the Protection of Children from Sexual Offences (POCSO) Act, but enforcement falls short due to poor socioeconomic conditions, low education levels, and insensitive actions and responses.

How education level influences internet security knowledge, behaviour, and attitude: a comparison among undergraduates, postgraduates and working graduates

During the pandemic, the prevailing online learning has brought tremendous benefits to the education field. However, it has also become a target for cybercriminals. Cybersecurity awareness (CSA) or Internet security awareness in the education sector turns out to be critical to mitigating cybersecurity risks. However, previous research indicated that using education level alone to judge CSA level received inconsistent results. This study postulated Social Educational Level (SEL) as a moderator with an extended Knowledge-Attitude-Behaviour model, used students' year level as a proxy for the impact of education level, and used work exposure for the influence of social education level, to compare CSA among undergraduates, postgraduates and working graduates. The participants in the study were divided into six groups, namely year 1 university students, year 2-3university students, final-year students, postgraduate students, young working graduates, and experienced working graduates. The Human Aspects of Information Security Questionnaire was used to conduct a large-scale survey. The multivariate regression model analysis showed significant differences among the knowledge, attitude and behaviour dimensions across groups with different conditions of year-level and work exposure. However, it was found that SEL played a more significant role than an individual's education level. The study suggested that a greater endeavour be committed to educating the public at large together with individuals, institutes, corporate and governments to improve the national CSA level.

Prevalence of Child Contact Sexual Abuse in the Spanish Region of Andalusia

The aim of this study was to analyze the prevalence and characteristics of child sexual abuse (CSA) in Andalusia, Spain's most populated region. A sample of 817 adults (281 male; M age = 34.7; SD = 13.86) completed the Child Sexual Abuse Experiences Questionnaire. Because the sample was unbalanced, we performed post-stratification by gender, resulting in 562 participants (50% male). Overall, 38.8% of the sample reported at least one type of contact abuse experience, with prevalence ranging from 22% for being fondled to 3.9% for being forced to perform a sexual act involving penetration. The first episode of CSA most commonly occurred between age 6 and 11 years, except for penetration. The majority of reported experiences were repeated and perpetrated by a male. More than half of the victims did not label their experience as sexual abuse, and this apparent lack of awareness about what constitutes abuse was particularly evident among male victims. The prevalence of CSA in Andalusia is higher than for Spain as a whole, highlighting the need to raise public awareness through prevention programs.

"Unless they bring it up, I won't go digging": Psychiatric nurses' experiences of developing therapeutic relationships with adult survivors of child sexual abuse

PURPOSE

The purpose of this study is to explore psychiatric nurses' experiences of developing therapeutic relationships with adult survivors of child sexual abuse (CSA).

DESIGN AND METHODS

A qualitative descriptive design was adopted. Semistructured interviews were conducted with six registered psychiatric nurses. Data were analyzed using reflexive thematic analysis.

FINDINGS

Although participants were able to develop therapeutic relationships with survivors and cited the importance of interpersonal skills, they felt uncomfortable discussing CSA.

PRACTICE IMPLICATIONS

Given the importance of developing trusting relationships, more support needs to be provided for nurses so they can build stronger alliances with survivors of CSA.

Recall of sexual abuse prevention education at school and home: Associations with sexual abuse experience, disclosure, protective parenting, and knowledge

BACKGROUND

Child sexual abuse (CSA) prevention is dominated by a focus on child education. However, evidence that this education reduces CSA risk is limited and mixed.

OBJECTIVE

We investigated whether participants' history of receiving school-based child sexual abuse prevention (CSAPP) was associated with experiencing CSA. Uniquely, we also investigated whether parent-led CSA education (PLSAE) and received protective parenting were associated with CSA. CSA knowledge was also considered.

METHODS

Australian university students (N = 1265, M_age = 22.8, SD = 7.7, Mo_age = 18, Md_age = 20, 75% female) reported their history of CSAPP and PLSAE, experience of CSA, disclosure of CSA, parenting, and CSA knowledge.

RESULTS

CSAPP attendance was reported by 29% of respondents, 72% reported PLSAE, and 24% reported CSA. PLSAE was significantly associated with lower risk of CSA, but was CSAPP attendance was not. PLSAE was significantly associated with higher levels of parental involvement/care and monitoring/supervision. In a multivariate logistic regression model, involvement/care and monitoring/supervision were associated with lower risk of CSA, but PLSAE was not. Neither CSAPP attendance nor PLSAE was associated with CSA disclosure or CSA knowledge.

CONCLUSIONS

These findings add to the small body of literature using reports of real-life experiences. Results call into question the over-reliance of child-education in CSA prevention and highlight the role of protective parenting. Building parenting capacity to include parenting practices is most likely to be effective for CSA prevention, such as monitoring and involvement, and should be included in CSA prevention efforts.

Fetal phonocardiogram signals denoising using improved complete ensemble (EMD) with adaptive noise and optimal thresholding of wavelet coefficients

Although fetal phonocardiogram (fPCG) signals have become a good indicator for discovered heart disease, they may be contaminated by various noises that reduce the signals quality and the final diagnosis decision. Moreover, the noise may cause the risk of the data to misunderstand the heart signal and to misinterpret it. The main objective of this paper is to effectively remove noise from the fPCG signal to make it clinically feasible. So, we proposed a novel noise reduction method based on Improved Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (ICEEMDAN), wavelet threshold and Crow Search Algorithm (CSA). This noise reduction method, named ICEEMDAN-DWT-CSA, has three major advantages. They were, (i) A better suppress of mode mixing and a minimized number of IMFs, (ii) A choice of wavelet corresponding to the study signal proven by the literature and (iii) Selection of the optimal threshold value. Firstly, the noisy fPCG signal is decomposed into Intrinsic Mode Functions (IMFs) by the (ICEEMDAN). Each noisy IMFs were decomposed by the Discrete Wavelet Transform (DWT). Then, the optimal threshold value using the (CSA) technique is selected and the thresholding function is carried out in the detail's coefficients. Secondly, each denoised (IMFs) is reconstructed by applying the Inverse Discrete Wavelet Transform (IDWT). Finally, all these denoised (IMFs) are combined to get the denoised fPCG signal. The performance of the proposed method has been evaluated by Signal to Noise Ratio (SNR), Mean Square Error (MSE) and the Correlation Coefficient (COR). The experiment gave a better result than some standard methods.

Effects of Oxygen Tension for Membrane Lipidome Remodeling of Cockayne Syndrome Cell Models

Oxygen is important for lipid metabolism, being involved in both enzymatic transformations and oxidative reactivity, and is particularly influent when genetic diseases impair the repair machinery of the cells, such as described for Cockayne syndrome (CS). We used two cellular models of transformed fibroblasts defective for CSA and CSB genes and their normal counterparts, grown for 24 h under various oxygen tensions (hyperoxic 21%, physioxic 5% and hypoxic 1%) to examine the fatty acid-based membrane remodeling by GC analysis of fatty acid methyl esters derived from membrane phospholipids. Overall, we first distinguished differences due to oxygen tensions: (a) hyperoxia induced a general boost of desaturase enzymatic activity in both normal and defective CSA and CSB cell lines, increasing monounsaturated fatty acids (MUFA), whereas polyunsaturated fatty acids (PUFA) did not undergo oxidative consumption; (b) hypoxia slowed down desaturase activities, mostly in CSA cell lines and defective CSB, causing saturated fatty acids (SFA) to increase, whereas PUFA levels diminished, suggesting their involvement in hypoxia-related signaling. CSB-deprived cells are the most sensitive to oxidation and CSA-deprived cells are the most sensitive to the radical-based formation of trans fatty acids (TFA). The results point to the need to finely differentiate biological targets connected to genetic impairments and, consequently, suggest the better definition of cell protection and treatments through accurate molecular profiling that includes membrane lipidomes.

Does isolated arthroscopic anterior acromioplasty modify critical shoulder angle?

INTRODUCTION

Critical shoulder angle (CSA)>35° correlates significantly with primary rotator cuff tear and re-tear after repair. Acromial axial orientation varies between individuals. The present study aimed to assess the impact of strictly anterior acromioplasty on CSA.

HYPOTHESIS

CSA is reduced by arthroscopic anterior acromioplasty.

MATERIAL AND METHODS

A single-center retrospective study included patients receiving isolated arthroscopic acromioplasty between January 2016 and December 2017. Exclusion criteria comprised history of surgery and fracture or dislocation of the shoulder. Pre- and post-operative AP shoulder radiographs were taken. The angle subtended by a line between the inferior and superior edges of the glenoid and a line between the inferior edge of the glenoid and the most lateral point on the acromion was measured.

RESULTS

One hundred and two patients were included: mean age, 50.5±10.1 years (range, 23-82 years). Mean CSA was 34.7±4.4° (range, 26-48°) preoperatively and 31.7±3.7° (range, 23-40°) postoperatively (p<0.001). In the group with CSA >35°, the decrease was significant: 34.4±3.2° (range, 28-40°) versus 38.9±2.8° (range, 36-48°) (p<0.001), with 64% CSA <35° after isolated anterior acromioplasty.

DISCUSSION

CSA was decreased by arthroscopic acromioplasty. However, in 36% of cases with preoperative CSA >35°, CSA was not normalized.

CONCLUSION

Anterior arthroscopic acromioplasty significantly reduced CSA in the overall population, and especially in case of high CSA.

LEVEL OF EVIDENCE

IV; retrospective study.

Ceragenins and Antimicrobial Peptides Kill Bacteria through Distinct Mechanisms

Ceragenins are a family of synthetic amphipathic molecules designed to mimic the properties of naturally occurring cationic antimicrobial peptides (CAMPs). Although ceragenins have potent antimicrobial activity, whether their mode of action is similar to that of CAMPs has remained elusive. Here, we reported the results of a comparative study of the bacterial responses to two well-studied CAMPs, LL37 and colistin, and two ceragenins with related structures, CSA13 and CSA131. Using transcriptomic and proteomic analyses, we found that Escherichia coli responded similarly to both CAMPs and ceragenins by inducing a Cpx envelope stress response. However, whereas E. coli exposed to CAMPs increased expression of genes involved in colanic acid biosynthesis, bacteria exposed to ceragenins specifically modulated functions related to phosphate transport, indicating distinct mechanisms of action between these two classes of molecules. Although traditional genetic approaches failed to identify genes that confer high-level resistance to ceragenins, using a Clustered Regularly Interspaced Short Palindromic Repeats interference (CRISPRi) approach we identified E. coli essential genes that when knocked down modify sensitivity to these molecules. Comparison of the essential gene-antibiotic interactions for each of the CAMPs and ceragenins identified both overlapping and distinct dependencies for their antimicrobial activities. Overall, this study indicated that, while some bacterial responses to ceragenins overlap those induced by naturally occurring CAMPs, these synthetic molecules target the bacterial envelope using a distinctive mode of action. IMPORTANCE The development of novel antibiotics is essential because the current arsenal of antimicrobials will soon be ineffective due to the widespread occurrence of antibiotic resistance. The development of naturally occurring cationic antimicrobial peptides (CAMPs) for therapeutics to combat antibiotic resistance has been hampered by high production costs and protease sensitivity, among other factors. The ceragenins are a family of synthetic CAMP mimics that kill a broad spectrum of bacterial species but are less expensive to produce, resistant to proteolytic degradation, and seemingly resistant to the development of high-level resistance. Determining how ceragenins function may identify new essential biological pathways of bacteria that are less prone to the development of resistance and will further our understanding of the design principles for maximizing the effects of synthetic CAMPs.

The Experience of Mothers from the Israeli Jewish Ultra-Orthodox Sector after Disclosure of Their Child's Sexual Abuse as Manifested in Drawings and Narratives

Child sexual abuse is present in all strata of Israeli society. However, there is scant research on the emotional experiences of non-abusing mothers after disclosure. In particular, no studies have examined the experiences of these mothers from the Jewish Ultra-Orthodox community in Israel. The current study analyzed the drawings and short narratives of 21 Israeli Ultra-Orthodox mothers to explore the effects of the disclosure of their child's sexual abuse. A phenomenological approach was used to analyze the drawings and yielded four different phenomena: (1) squiggles that represented distress, (2) the mother-child relationship, (3) pseudo-sweet houses, and (4) split drawings. The drawings were either colorful, sweet or shallow, or alternatively were in black and white. As confirmed by the narratives, these drawings primarily expressed the negative emotions of shock, sadness, distress, guilt, and failure as mothers. While some mothers reported breaking down and that pain had permeated their daily lives others coped by dissociating the painful experience, putting up a façade of normalcy, or splitting their lives into two parts corresponding to before and after the disclosure.

Vagus nerve ultrasound in transthyretin familial amyloid polyneuropathy: A pilot study

BACKGROUND AND PURPOSE

Autonomic dysfunction is common in transthyretin familial amyloid polyneuropathy (TTR-FAP). Because ultrasonography is a powerful tool to study peripheral neuropathy, vagus nerve (VN) ultrasonography was used in our study to investigate the possible changes of the dimension of VN in TTR-FAP.

METHODS

Eighteen patients with TTR-FAP and 17 age- and gender-matched individuals without any neuropathies were enrolled in a pilot study. The cross-sectional areas (CSAs) were measured bilaterally on transverse scans of vagus, median, and ulnar nerves. Clinical data were collected to explore the correlations with CSAs of VN.

RESULTS

The median CSAs of VN in TTR-FAP were 3.5 (2.0-6.0) mm² on the right side and 2.5 (1.0-6.0) mm² on the left side, compared with 2.0 (1.0-3.0) mm² and 1.0 (1.0-2.0) mm² for healthy controls (HCs). There was a significant difference between the two groups on both sides (p < .001). The mean VN CSAs were correlated positively with the course of disease (r = .7203, p = .0016)（not including the patient with the longest disease course), the Composite Autonomic Symptom Score 31 (r = .5252, p = .0252), the left ventricular posterior wall thickness (r = .5426, p = .0200), and the interventricular septum thickness (r = .5103, p = .0305). The cutoff values of right and left VN CSAs to identify TTR-FAP from HCs were 2.5 and 1.5 mm² and the areas under the curve were .9395 and .8856, with a high sensitivity (.889 and .889) and specificity (.941 and .765), respectively.

CONCLUSION

VN enlargement is prevalent among TTR-FAP patients. VN ultrasonography may be an important clinical tool for assessing the severity of autonomic dysfunction in TTR-FAP.

Polyaniline Synthesized by Different Dopants for Fluorene Detection via Photoluminescence Spectroscopy

The effects of different dopants on the synthesis, optical, electrical and thermal features of polyaniline were investigated. Polyaniline (PANI) doped with p-toluene sulfonic acid (PANI-PTSA), camphor sulphonic acid (PANI-CSA), acetic acid (PANI-acetic acid) and hydrochloric acid (PANI-HCl) was synthesized through the oxidative chemical polymerization of aniline under acidic conditions at ambient temperature. Fourier transform infrared light, X-ray diffraction, UV-visible spectroscopy, field emission scanning electron microscopy, photoluminescence spectroscopy and electrical analysis were used to define physical and structural features, bandgap values, electrical conductivity and type and degree of doping, respectively. Tauc calculation reveals the optical band gaps of PANI-PTSA, PANI-CSA, PANI-acetic acid and PANI-HCl at 3.1, 3.5, 3.6 and 3.9 eV, respectively. With the increase in dopant size, crystallinity is reduced, and interchain separations and d-spacing are strengthened. The estimated conductivity values of PANI-PTSA, PANI-CSA, PANI-acetic acid and PANI-HCl are 3.84 × 101, 2.92 × 101, 2.50 × 10-2, and 2.44 × 10-2 S·cm-1, respectively. Particularly, PANI-PTSA shows high PL intensity because of its orderly arranged benzenoid and quinoid units. Owing to its excellent synthesis, low bandgap, high photoluminescence intensity and high electrical features, PANI-PTSA is a suitable candidate to improve PANI properties and electron provider for fluorene-detecting sensors with a linear range of 0.001-10 μM and detection limit of 0.26 nM.

Morphometric Magnetic Resonance Imaging Evaluation of Cervical Spinal Canal and Cord in Normal Small-Breed Dogs

Cervical spinal disease is one of the most common neurological disorders in small-breed dogs. Magnetic resonance imaging (MRI) is a common test for dogs with cervical spinal diseases. However, there is no information on cervical spinal canal and cord using MRI in normal small-breed dogs. Therefore, this study aimed to perform analyses to establish morphologic MRI reference ranges of the cervical spinal canal and cord in normal small-breed dogs. Cervical MRI examinations were taken in 20 client-owned small dogs. The height, width, and cross-sectional area (CSA) of the spinal canal and cord were measured on sagittal and transverse T2-weighted images at each vertebral body level and each intervertebral disk level from C1-C2 to C7 (a total of 12 levels). The height ratio, the width ratio, and the CSA ratio were calculated. The height, width, and CSA of the spinal canal and cord increased as the dog's weight increased (p < 0.01), except for that at C1-C2. However, there was no correlation between the body weight and height ratio and the width ratio and CSA ratio at all levels, except for that at C1-C2. Also, there was a negative correlation between the body weight and CSA ratio at C1-C2. There were no statistical differences for the CSA of the spinal canal, the CSA of the spinal cord, and the CSA ratio between nearby levels, except for that at C1-C2. There was no statistical difference between measurements at each same level of the sagittal and transverse images. The results of this study may provide basic and morphometric information for diagnosing and researching cervical spinal diseases in small-breed dogs.

Neurovascular dysfunction and neuroinflammation in a Cockayne syndrome mouse model

Cockayne syndrome (CS) is a rare, autosomal genetic disorder characterized by premature aging-like features, such as cachectic dwarfism, retinal atrophy, and progressive neurodegeneration. The molecular defect in CS lies in genes associated with the transcription-coupled branch of the nucleotide excision DNA repair (NER) pathway, though it is not yet clear how DNA repair deficiency leads to the multiorgan dysfunction symptoms of CS. In this work, we used a mouse model of severe CS with complete loss of NER (Csa-/-/Xpa-/-), which recapitulates several CS-related phenotypes, resulting in premature death of these mice at approximately 20 weeks of age. Although this CS model exhibits a severe progeroid phenotype, we found no evidence of in vitro endothelial cell dysfunction, as assessed by measuring population doubling time, migration capacity, and ICAM-1 expression. Furthermore, aortas from CX mice did not exhibit early senescence nor reduced angiogenesis capacity. Despite these observations, CX mice presented blood brain barrier disruption and increased senescence of brain endothelial cells. This was accompanied by an upregulation of inflammatory markers in the brains of CX mice, such as ICAM-1, TNFα, p-p65, and glial cell activation. Inhibition of neovascularization did not exacerbate neither astro- nor microgliosis, suggesting that the pro-inflammatory phenotype is independent of the neurovascular dysfunction present in CX mice. These findings have implications for the etiology of this disease and could contribute to the study of novel therapeutic targets for treating Cockayne syndrome patients.

Determination of predisposing scapular anatomy with a statistical shape model-Part II: shoulder osteoarthritis

HYPOTHESIS AND BACKGROUND

Shoulder osteoarthritis can be divided into different glenoid types (A, B, C, and D) and subtypes. The aim of this study was to investigate if there is an association between the prearthropathy scapular anatomy, shoulder osteoarthritis, and different glenoid types and subtypes.

METHODS

Using principal components analysis, a statistical shape model (SSM) of the scapula was constructed from a data set of 110 computed tomographic (CT) scans. These subjects formed the control group. Next, CT scan images of 117 patients with osteoarthritis were classified according to the modified Walch classification. A complete 3-dimensional (3D) scapular bone model was created for every patient, and using the SSM, a reconstruction of their prearthropathy scapular anatomy was performed. Automated 3D measurements were performed in both the patient and control group to obtain glenoid version and inclination, critical shoulder angle (CSA), posterior acromial slope (PAS), lateral acromion angle, scapular offset, and the rotational alignment of the coracoacromial complex. These parameters were compared between controls, patients with osteoarthritis, and glenoid types and subtypes.

RESULTS

Mean version and inclination for the control group was 6° retroversion and 8° superior inclination (both SD 4°). The mean CSA, PAS, coracoid-posterior acromion angle, posterior acromion-scapular plane angle, and fulcrum axis ratio were 30° (SD 4°), 64° (SD 8°), 116° (SD 9°), 55° (SD 7°), and 46% (SD 4%), respectively. Patients with osteoarthritis had a significant lower CSA, posterior acromion-scapular plane angle, coracoid-posterior acromion angle, and fulcrum axis ratio (27°, 50°, 111°, and 44%, all P < .001). We found a significant difference between the control group and the respective glenoid types for the following parameters: mean CSA and coracoid-posterior acromion angle for A glenoids (27°, P = .001, and 111°, P = .007); mean version, CSA, PAS, coracoid-posterior acromion angle, posterior acromion-scapular plane angle, and fulcrum axis ratio for B glenoids (11°, 27°, 71°, 111°, 49°, and 43%, all P < .001); and mean version, CSA, and posterior acromion-scapular plane angle for D glenoids (2°, P = .002, 26°, P = .003, and 48°, P = .007).

DISCUSSION

There seems to be an association between prearthropathy scapular anatomy and shoulder osteoarthritis. A small lateral extension and less posterior rotation of the acromion is associated with shoulder osteoarthritis and is present in almost all types and subtypes of glenoid morphology. Furthermore, B and D glenoids are associated with, respectively, a more and less pronounced prearthropathy glenoid retroversion.

The Impact of Melatonin Supplementation and NLRP3 Inflammasome Deletion on Age-Accompanied Cardiac Damage

To investigate the role of NLRP3 inflammasome in cardiac aging, we evaluate here morphological and ultrastructural age-related changes of cardiac muscles fibers in wild-type and NLRP3-knockout mice, as well as studying the beneficial effect of melatonin therapy. The results clarified the beginning of the cardiac sarcopenia at the age of 12 months, with hypertrophy of cardiac myocytes, increased expression of β-MHC, appearance of small necrotic fibers, decline of cadiomyocyte number, destruction of mitochondrial cristae, appearance of small-sized residual bodies, and increased apoptotic nuclei ratio. These changes were progressed in the cardiac myocytes of 24 old mice, accompanied by excessive collagen deposition, higher expressions of IL-1α, IL-6, and TNFα, complete mitochondrial vacuolation and damage, myofibrils disorganization, multivesicular bodies formation, and nuclear fragmentation. Interestingly, cardiac myocytes of NLRP3^-/- mice showed less detectable age-related changes compared with WT mice. Oral melatonin therapy preserved the normal cardiomyocytes structure, restored cardiomyocytes number, and reduced β-MHC expression of cardiac hypertrophy. In addition, melatonin recovered mitochondrial architecture, reduced apoptosis and multivesicular bodies' formation, and decreased expressions of β-MHC, IL-1α, and IL-6. Fewer cardiac sarcopenic changes and highly remarkable protective effects of melatonin treatment detected in aged cardiomyocytes of NLRP3^-/- mice compared with aged WT animals, confirming implication of the NLRP3 inflammasome in cardiac aging. Thus, NLRP3 suppression and melatonin therapy may be therapeutic approaches for age-related cardiac sarcopenia.

Quantification of Cervical Cord Cross-Sectional Area: Which Acquisition, Vertebra Level, and Analysis Software? A Multicenter Repeatability Study on a Traveling Healthy Volunteer

Background: Considerable spinal cord (SC) atrophy occurs in multiple sclerosis (MS). While MRI-based techniques for SC cross-sectional area (CSA) quantification have improved over time, there is no common agreement on whether to measure at single vertebral levels or across larger regions and whether upper SC CSA can be reliably measured from brain images. Aim: To compare in a multicenter setting three CSA measurement methods in terms of repeatability at different anatomical levels. To analyze the agreement between measurements performed on the cervical cord and on brain MRI. Method: One healthy volunteer was scanned three times on the same day in six sites (three scanner vendors) using a 3T MRI protocol including sagittal 3D T1-weighted imaging of the brain (covering the upper cervical cord) and of the SC. Images were analyzed using two semiautomated methods [NeuroQLab (NQL) and the Active Surface Model (ASM)] and the fully automated Spinal Cord Toolbox (SCT) on different vertebral levels (C1-C2; C2/3) on SC and brain images and the entire cervical cord (C1-C7) on SC images only. Results: CSA estimates were significantly smaller using SCT compared to NQL and ASM (p < 0.001), regardless of the cord level. Inter-scanner repeatability was best in C1-C7: coefficients of variation for NQL, ASM, and SCT: 0.4, 0.6, and 1.0%, respectively. CSAs estimated in brain MRI were slightly lower than in SC MRI (all p ≤ 0.006 at the C1-C2 level). Despite protocol harmonization between the centers with regard to image resolution and use of high-contrast 3D T1-weighted sequences, the variability of CSA was partly scanner dependent probably due to differences in scanner geometry, coil design, and details of the MRI parameter settings. Conclusion: For CSA quantification, dedicated isotropic SC MRI should be acquired, which yielded best repeatability in the entire cervical cord. In the upper part of the cervical cord, use of brain MRI scans entailed only a minor loss of CSA repeatability compared to SC MRI. Due to systematic differences between scanners and the CSA quantification software, both should be kept constant within a study. The MRI dataset of this study is available publicly to test new analysis approaches.

Sleep-related breathing disorders associated with intrathecal baclofen therapy to treat patients with cerebral palsy: A cohort study and discussion

BACKGROUND

Patients with cerebral palsy and other static encephalopathies (CP) are known to be at increased risk of sleep-related breathing disorders (SRBD). Few studies have reviewed whether intrathecal baclofen (ITB) can contribute to SRBD.

OBJECTIVE

To assess the prevalence of SRBD in patients with CP receiving ITB by using nocturnal polysomnography (NPSG).

METHODS

We performed a retrospective chart review of patients receiving ITB who had NPSG at Children's Hospital Colorado (CHCO) and Seattle Children's Hospital (SCH) from 1995 to 2019. The Gross Motor Function Classification System (GMFCS) measured the severity of motor disability. Screening sleep questionnaires collected subjective data and NPSG provided objective data of SRBD.

RESULTS

All patients except one were GMFCS 4 or 5 with median age at ITB pump placement of 9.7 years. The screening questionnaire for SRBD detected one or more nighttime symptoms in > 82% of all patient groups. Pre-ITB criteria for a SRBD was met in 83% of patients at CHCO and 91% at SCH. Post-ITB prevalence remained similarly high.

CONCLUSIONS

NPSG identified a high prevalence of SRBD in these cohorts from CHCO and SCH. Our study showed neither improvement nor worsening of SRBD in patients receiving ITB.

Cyclophilin A Inhibits Human Respiratory Syncytial Virus (RSV) Replication by Binding to RSV-N through Its PPIase Activity

Human respiratory syncytial virus (hRSV) is the most common pathogen which causes acute lower respiratory infection (ALRI) in infants. Recently, virus-host interaction has become a hot spot of virus-related research, and it needs to be further elaborated for RSV infection. In this study, we found that RSV infection significantly increased the expression of cyclophilin A (cypA) in clinical patients, mice, and epithelial cells. Therefore, we evaluated the function of cypA in RSV replication and demonstrated that virus proliferation was accelerated in cypA knockdown host cells but restrained in cypA-overexpressing host cells. Furthermore, we proved that cypA limited RSV replication depending on its PPIase activity. Moreover, we performed liquid chromatography-mass spectrometry, and the results showed that cypA could interact with several viral proteins, such as RSV-N, RSV-P, and RSV-M2-1. Finally, the interaction between cypA and RSV-N was certified by coimmunoprecipitation and immunofluorescence. Those results provided strong evidence that cypA may play an inhibitory role in RSV replication through interaction with RSV-N via its PPIase activity.

IMPORTANCE RSV-N, packed in the viral genome to form the ribonucleoprotein (RNP) complex, which is recognized by the RSV RNA-dependent RNA polymerase (RdRp) complex to initiate viral replication and transcription, plays an indispensable role in the viral biosynthesis process. cypA, binding to RSV-N, may impair this function by weakening the interaction between RSV-N and RSV-P, thus leading to decreased viral production. Our research provides novel insight into cypA antiviral function, including binding to viral capsid protein to inhibit viral replication, which may be helpful for new antiviral drug exploration.

Child Sexual Abuse in Pakistan Schools: A Non-Systematic Narrative Literature Review

The current non-systematic narrative review of literature sought to explore the need for research into child sexual abuse (CSA) in Pakistan's schools. The limited literature that exists suggests that CSA is a pervasive problem in Pakistan as it is in neighboring India, and indeed, throughout the world. Government agencies and schools in Pakistan appear to be in their infancy in terms of recognizing and responding to CSA. High-profile media cases, however, have led to some promising child safety changes. The current narrative review identified the need for studies with methodological rigor to identify the nature and extent of children who have experienced CSA in Pakistan. Future studies also need to explore how best to conceptualize school-based abuse prevention in Pakistan. Recommendations are made for practice and research.

Immunofluorescence studies to dissect the impact of Cockayne syndrome A alterations on the protein interaction and cellular localization

Background

Cockayne syndrome (CS), which was discovered by Alfred Cockayne nearly 75 years ago, is a rare autosomal recessive disorder characterized by growth failure, neurological dysfunction, premature aging, and other clinical features including microcephaly, ophthalmologic abnormalities, dental caries, and cutaneous photosensitivity. These alterations are caused by mutations in the CSA or CSB genes, both of which are involved in transcription-coupled nucleotide excision repair (TC-NER), the sub-pathway of NER that rapidly removes UV-induced DNA lesions which block the progression of the transcription machinery in the transcribed strand of active genes. Several studies assumed that CSA and CSB genes can play additional roles outside TC-NER, due to the wide variations in type and severity of the CS phenotype and the lack of a clear relationship between genotype and phenotype. To address this issue, our lab generated isogenic cell lines expressing wild type as well as different versions of mutated CSA proteins, fused at the C-terminus with the Flag and HA epitope tags (CSA^Flag-HA). In unpublished data, the identity of the CSA-interacting proteins was determined by mass spectrometry. Among which three subunits (namely, CCT3, CCT8, and TCP1) of the TRiC/CCT complex appeared as novel interactors. TRiC is a chaperonin involved in the folding of newly synthesized or unfolded proteins. The aim of this study is directed to investigate by immunofluorescence analysis the impact of the selected CSA mutations on the subcellular localization of the CSA protein itself as well as on its novel interactors CCT3, CCT8, and TCP1.

Results

We showed that specific CSA mutations impair the proper cellular localization of the protein, but have no impact on the cellular distribution of the TRiC subunits or CSA/TRiC co-localization.

Conclusion

We suggested that the activity of the TRiC complex does not rely on the functionality of CSA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43141-021-00190-7.

WITHDRAWN: Does anterior arthroscopic acromioplasty modify critical shoulder angle?

This article has been withdrawn because we accidentally published the same article twice due to an error by the Managing editor/Elsevier. The correct version of the article has been published later in Orthop Traumatol Surg Res, 108 (2022) 103040, https://doi.org/10.1016/j.otsr.2021.103040. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal

Determination of pre-arthropathy scapular anatomy with a statistical shape model: part I-rotator cuff tear arthropathy

HYPOTHESIS AND BACKGROUND

Rotator cuff tear arthropathy (RCTA) is a pathology characterized by a massive rotator cuff tear combined with acromiohumeral and/or glenohumeral arthritis. The severity of RCTA can be staged according to the Hamada classification. Why RCTA develops in some patients is unknown. Furthermore, in RCTA patients, distinctly different articular damage patterns can develop on the glenoid side as categorized by the Sirveaux classification (glenoid erosion). The goal of this study was to determine whether an association exists between scapular anatomy and RCTA and different severity stages of RCTA, as well as the associated glenoid erosion types.

METHODS

A statistical shape model of the scapula was constructed from a data set of 110 computed tomography scans using principal component analysis. Sixty-six patients with degenerative rotator cuff pathology formed the control group. The computed tomography scan images of 89 patients with RCTA were included and grouped according to the Hamada and Sirveaux classifications. A complete 3-dimensional scapular bone model was created, and statistical shape model reconstruction was performed. Next, automated 3-dimensional measurements of glenoid version and inclination, scapular offset, the critical shoulder angle (CSA), the posterior acromial slope (PAS), and the lateral acromial angle (LAA) were performed. All measurements were then compared between controls and RCTA patients.

RESULTS

The control group had a median of 7° of retroversion (variance, 16°), 8° of superior inclination (variance, 19°), and 106 mm of scapular offset (variance, 58 mm). The median CSA, PAS, and LAA were 30° (variance, 14°), 65° (variance, 60°), and 90° (variance, 17°), respectively. In terms of inclination, version, scapular offset, and the PAS, we found no statistically significant differences between the RCTA and control groups. For RCTA patients, the median CSA and median LAA were 32° (P ≤ .01) and 86° (P ≤ .01), respectively. For all investigated parameters, we did not find any significant difference between the different stages of RCTA. Patients with type E3 erosion had a different pre-arthropathy anatomy with increased retroversion (12°, P = .006), an increased CSA (40°, P ≤ .001), and a reduced LAA (79°, P ≤ .001).

DISCUSSION

Our results seem to indicate that a 4° more inferiorly tilted and 2° more laterally extended acromion is associated with RCTA. RCTA patients in whom type E3 erosion develops have a distinct pre-arthropathy scapular anatomy with a more laterally extended and more inferiorly tilted acromion and a more retroverted glenoid in comparison with RCTA patients with no erosion. The pre-arthropathy scapular anatomy does not seem to differ between patients with different stages of RCTA.

Frequent recurrence of pregnancy-triggered congenital thrombotic thrombocytopenic purpura: A rare case report

Thrombotic thrombocytopenic purpura (TTP) in adults is rare thrombotic microangiopathy (TMA), which is closely related to the lack of specific proteases of von Willebrand factor (vWF) multimers. It is currently believed that both congenital TTP (cTTP) and acquired TTP (aTTP) can induce acute attack through pregnancy. We report a case of a 24-year-old woman who was diagnosed as TTP during early pregnancy. A novel mutation was detected: c.3667G>T (p.E1223*). She responded well to plasma therapy during pregnancy and had a child by cesarean section at 32 weeks. TTP is still recurrent in postpartum patients. The plasma transfusion was effective, but caused a severe transfusion reaction. Cyclosporine was administered with the consent of the patient. This case showed cyclosporine-A (CSA) had a positive effect on ADAMTS13 activity. At 11-months follow-up, the patient's blood cells and LDH status were stable and no symptom was seen. Our case suggests that the patient had an unreported genetic mutation that causes TTP, immune factors may be involved in the onset of cTTP during pregnancy, and the use of immunosuppressive agents is effective in preventing recurrence.

Sleep disorders in Prader-Willi syndrome, evidence from animal models and humans

Prader-Willi Syndrome (PWS) is a complex genetic disorder with multiple cognitive, behavioral and endocrine dysfunctions. Sleep alterations and sleep disorders such as Sleep-disordered breathing and Central disorders of hypersomnolence are frequently recognized (either isolated or in comorbidity). The aim of the review is to highlight the pathophysiology and the clinical features of sleep disorders in PWS, providing the basis for early diagnosis and management. We reviewed the genetic features of the syndrome and the possible relationship with sleep alterations in animal models, and we described sleep phenotypes, diagnostic tools and therapeutic approaches in humans. Moreover, we performed a meta-analysis of cerebrospinal fluid orexin levels in patients with PWS; significantly lower levels of orexin were detected in PWS with respect to control subjects (although significantly higher than the ones of narcoleptic patients). Sleep disorders in humans with PWS are multifaceted and are often the result of different mechanisms. Since hypothalamic dysfunction seems to partially influence metabolic, respiratory and sleep/wake characteristics of this syndrome, additional studies are required in this framework.

The Development and Validation of the Child Sexual Assault Victim Credibility Scale: An Instrument to Measure Laypersons' Perceptions of Victim Credibility

Child sexual assault is a global health issue, with extensive implications for legal, social, clinical, and health psychology. The perceived credibility of child victims is of considerable importance in terms of the successful prosecution of such cases. However, there has been considerable inconsistency within past research regarding how best to measure credibility, and to date, there exists no broadly accepted scale for the measurement of lay perceptions of credibility of child victims. The current study evaluates a proposed Child Sexual Assault Victim Credibility Scale (CSAVCS) and includes the results of both a pilot and scale validation study. A two-phase approach for instrument development was adopted. Thirty-six participants from the general community were involved in the pilot study (Phase I), comprising six males and 30 females. A further 210 participants (61 males and 149 females) were included in the scale validation sample (Phase II). Participants read a transcript of a child disclosing sexual abuse and rated their perceptions of the child's accuracy, believability, competency, reliability, and truthfulness. The scale's reliability and internal validity were successfully tested and modified in Phase I and subsequently validated and confirmed in Phase II. There was strong evidence of internal consistency, reliability, and content validity. Following model respecification, the final 23-item model was confirmed. The evaluation of the CSAVCS was a crucial first step and will be useful for future research exploring perceived credibility. Using a validated and reliable scale may serve to improve the consistency of measurement of credibility and to facilitate comparisons among studies.

The Effects of Low-Load Vs. High-Load Resistance Training on Muscle Fiber Hypertrophy: A Meta-Analysis

The aim of this meta-analysis was to explore the effects of low-load vs. high-load resistance training on type I and type II muscle fiber hypertrophy. Searches for studies were performed through ten databases. Studies were included if they: (a) compared the effects of low-load vs. high-load resistance training (performed to momentary muscular failure); and, (b) assessed muscle fiber hypertrophy. A random-effects meta-analysis was performed to analyze the data. Ten study groups were included in the analysis. In the meta-analysis for the effects of low-load vs. high-load resistance training on type I muscle fiber hypertrophy, there was no significant difference between the training conditions (standardized mean difference: 0.28; 95% confidence interval: –0.27, 0.82; p = 0.316; I² = 18%; 95% prediction interval: –0.71, 1.28). In the meta-analysis for the effects of low-load vs. high-load resistance training on type II muscle fiber hypertrophy, there was no significant difference between the training conditions (standardized mean difference: 0.30; 95% confidence interval: –0.05, 0.66; p = 0.089; I² = 0%; 95% prediction interval: –0.28, 0.88). In this meta-analysis, there were no significant differences between low-load and high-load resistance training on hypertrophy of type I or type II muscle fibers. The 95% confidence and prediction intervals were very wide, suggesting that the true effect in the population and the effect reported in a future study conducted on this topic could be in different directions and anywhere from trivial to very large. Therefore, there is a clear need for future research on this topic.