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Huan Wang,1 Angela Chia-Chen Chen,2 Shaoping Wan,3 Hong Chen11West China School of Nursing and Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 2College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA; 3Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of ChinaBackground: HIV self-management is a lifetime and central task for people living with HIV/AIDS (PLWH). To date, there is little evidence to identify the related factors of self-management in PLWH from China.Purpose: This study aimed to investigate the status and related factors of self-management in PLWH from the Liangshan area of Sichuan Province, China.Patients and methods: A total of 322 PLWH were recruited from August to December 2017 in the study. Demographics characteristics and disease-related data were documented for each participant, social support was measured by the Medical Outcomes Study Social Support Survey (MOS-SSS-C), and self-management was evaluated by the HIV Self-Management Scale. Descriptive statistics analysis, independent Student’s t-test, one-way ANOVA, Spearman rank correlation, and multiple regression analysis were used to analyze the data.Results: The total score of HIV self-management was 38.26±7.17. Significant differences in self-management scores were found among the subgroups of different education level, marital status, nation, religion, resident place, occupation, infection route, symptom, research site, and household per capita monthly income. Self-management was positively significantly correlated with social support. Multiple regression analysis identified that nation, resident place, gender, marital status, and social support were the contributors of HIV self-management.Conclusion: The study demostrated that self-management in Yi Autonomous Prefecture was relatively low. The results indicate that the associated factors of self-management should be considered to develop effective intervention to improve the self-management of PLWH.Keywords: self-management, self-care, HIV, HIV/AIDS, China

DesignSingle Observational Case Report.SettingA 67-year-old male of Persian descent had a complex systemic and ocular history prior to a right penetrating keratoplasty (PK) reported here. The clinical diagnoses leading to the PK included Cogan's syndrome, chronic uveitis, secondary glaucoma, and corneal stromal scarring, presumed secondary to a corneal ulcer diagnosed on the second visit to our clinic. The specimen described here had been in place for 11 months and 17 days after the third failed Descemet stripping endothelial keratoplasty (DSEK). Visual acuities had ranged from 20/100 to 20/400 in both eyes. Visual acuity in the right eye just before surgery was 20/400. Intraocular pressures were 22 mmHg in both eyes with functioning Ahmed glaucoma shunts. The stromal cyst was not suspected preoperatively and no clinical imaging was performed.Study methodsHistopathology including serial sections and immunohistochemistry.ResultsHistologic study demonstrated a trans-stromal corneal epithelial cyst without goblet cells that extended through a 500 μm gap in the donor tissue surface and edge.ConclusionsThis large stromal cyst was an unusual complication of serial posterior lamellar keratoplasties and we postulate that multiple prior posterior lamellar grafts may have been a risk factor for this complication. Anterior segment imaging with either anterior segment optical coherence tomography or high-resolution ultrasound would likely have detected this stromal cyst.

Matrix stiffness potently regulates cellular behaviour in various biological contexts. In breast tumours, the presence of dense clusters of collagen fibrils indicates increased matrix stiffness and correlates with poor survival. It is unclear how mechanical inputs are transduced into transcriptional outputs to drive tumour progression. Here we report that TWIST1 is an essential mechanomediator that promotes epithelial-mesenchymal transition (EMT) in response to increasing matrix stiffness. High matrix stiffness promotes nuclear translocation of TWIST1 by releasing TWIST1 from its cytoplasmic binding partner G3BP2. Loss of G3BP2 leads to constitutive TWIST1 nuclear localization and synergizes with increasing matrix stiffness to induce EMT and promote tumour invasion and metastasis. In human breast tumours, collagen fibre alignment, a marker of increasing matrix stiffness, and reduced expression of G3BP2 together predict poor survival. Our findings reveal a TWIST1-G3BP2 mechanotransduction pathway that responds to biomechanical signals from the tumour microenvironment to drive EMT, invasion and metastasis.

We examined age, sex, and race/ethnicity differences in trajectories of depressive symptom from adolescence to early adulthood; we also tested whether socioeconomic status and acculturation were associated with the differences. The findings suggest that adolescents over age 15 had a higher level and faster decline in depressive symptoms than their younger counterparts; females had higher level and a faster decline in depressive symptoms than males. Chinese American females had the highest depressive symptoms sustained across 7 years; Chinese American males over age 15 had higher depressive symptoms than their White male counterparts. Neither socioeconomic status nor acculturation was significantly associated with the differences in the trajectories. Our findings suggest a need for greater attention to Chinese American adolescents' psychological well-being. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the linguistic and cultural equivalency of two Chinese-version instruments measuring sexual knowledge, attitudes, and behaviors among 10 bilingual and 2 monolingual Chinese immigrant youth aged 13-19 years. We used a rigorous design to translate, back-translate, and pilot test the instruments. Kappa coefficient, percentage agreement, and qualitative feedback from participants were used to examine reliability and validity of the instruments. Telephone interviews revealed that answer discrepancies in different language versions were due to external factors rather than lack of linguistic and cultural equivalency. This study offers preliminary evidence supporting the cultural and linguistic equivalence of two Chinese-version sexual scales.Copyright © 2010 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Summary Background: Scaphoid fractures are very common in wrist trauma, and scaphoid nonunions with avascular necrosis are frequent complications of a fractured scaphoid. The purpose of these two retrospective studies was to examine the clinical and x-ray results of treatments for acute scaphoid fracture and scaphoid nonunion. The surgical techniques of cannulated screw fixation and pedicled vascularised bone graft are described. Methods: From 2001-2004, 80 patients with scaphoid fractures were treated with 3.0 mm cannulated screws and 5.5 mm threaded washers in our hospitals. The average age was 35 years, and the average time from injury to surgery was 16.5 hours. Outcomes were assessed by x-ray and the modified Mayo wrist score system. During the 6-year period of 1998-2004, 72 patients with scaphoid nonunions were treated using pedicled vascularised bone graft (VBG)in our hospitals. The average age was 38.5 years, and the average time from injury to surgery was 9.5 months. Results: The union rate was 96.25% and satisfactory function rate was 93.75% in acute scaphoid fractures with an average follow-up of 3.5 years. The union rate (90.28%) and satisfactory function rate (81.94%) achieved in scaphoid nonunions were acceptable, with an average follow-up of 5 years. Conclusions: Our studies suggested that appropriate application of a cannulated screw and threaded washer was able to produce satisfactory results in scaphoid fracture, and that pedicled vascularised bone graft was effective for treating scaphoid nonunion. [ABSTRACT FROM AUTHOR]

Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building. [ABSTRACT FROM AUTHOR]

Background: Osteochondral grafts, used to treat chondral and osteochondral defects, require high insertional forces that may affect the viability of chondrocytes in the graft. The objectives of this study were to (1) measure the loading impact during insertion of osteochondral grafts, (2) evaluate the effect of insertional loading on chondrocyte viability, and (3) assess this effect on chondrocyte apoptosis and activation of caspase-3.Methods: The distal parts of twelve fresh femora from six adult human cadavers were harvested within seventy-two hours after the death of the donor. From each femur, four 15-mm-diameter cylindrical osteochondral grafts were isolated; two of these grafts (a total of twenty-four grafts in the study) were transplanted with standard impact insertion into recipient sockets in the other condyle of the ipsilateral femur. The other two grafts served as unloaded controls. Loads were measured during the insertion of ten of the twenty-four transplanted grafts. Full-thickness cartilage disks were then removed from the grafts, incubated for up to forty-eight hours, and analyzed for cell viability, TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling)-positive reactivity, and caspase-3 activation, each as a function of the depth from the articular surface.Results: The insertion of an osteochondral graft was characterized, on the average (and standard deviation), by 10 +/- 4 impacts, each generating 2.4 +/- 0.9 kN of load and 13.3 +/- 4.9 MPa of stress for a duration of 0.57 +/- 0.13 ms with a 0.62 +/- 0.25 N.s impulse. Impact insertion increased cell death in the superficial 500 mum to 21% at one hour (p < 0.001) and 47% at forty-eight hours (p < 0.001) and also increased cell death in deeper layers at forty-eight hours. Some cell death was due to apoptosis, as indicated by an increase in caspase-3 activation at eight hours (p < 0.01) and TUNEL-positive cells at forty-eight hours (p < 0.05) in the superficial 500 mum of impacted cartilage.Conclusions: Impact insertion of osteochondral grafts generates damaging loads that cause chondrocyte death, particularly in the superficial zone, mainly as a result of apoptosis mediated by the activation of caspases.Clinical Relevance: Chondrocyte death that occurs during impact insertion of osteochondral grafts may lead to compromised function. Understanding the mechanisms and consequences of such impact loading may provide insights into potential therapeutic interventions, or lead to changes in the insertion technique, to decrease the cell injury associated with impact loading. [ABSTRACT FROM AUTHOR]

Background: The primary objective of this study was to ascertain the risk factors associated with hardware complications following segmental mandibular reconstruction in head and neck cancer patients. Additionally, we sought to develop a nomogram model that enables accurate risk prediction., Methods: Patients who underwent segmental mandibulectomy with immediate free or local regional tissue transfer between January 2016 and December 2020 were reviewed. Hardware complications were defined. Patient demographics and perioperative parameters were analyzed., Results: A total of 510 patients were analyzed. Postoperative radiation therapy (OR = 2.296, 95% CI = 1.339-3.938, p = 0.003), postoperative wound infection (OR = 2.367, 95% CI = 1.472-3.806, p < 0.001), and debridement for flap-related complications (OR = 5.484, 95% CI = 3.269-9.199, p < 0.001) were identified as independent risk factors. The nomogram model demonstrated good discriminatory ability., Conclusion: This comprehensive analysis identified three independent risk factors, and the nomogram provides a valuable tool for predicting the risks. Further research is needed to validate these findings and explore preventive strategies., (© 2024 Wiley Periodicals LLC.)

Background: Underrepresentation of racial and ethnic groups in clinical trials can limit generalizability of research findings and equitable access to treatment. This study evaluates racial and ethnic representation of youth in US-based interventional trials on childhood type 1 diabetes (T1D)., Methods: This cross-sectional study examined interventional trials of T1D conducted in the US and registered on ClinicalTrials.gov. Trials were included if completed as of June 6, 2023, began between years 2010 and 2022, and exclusively enrolled youth ≤19 years old. We assessed representation of racial and ethnic groups in T1D trials, estimated using the enrollment-prevalence difference (EPD)., Results: A total of 106 trials were eligible for inclusion. Of those eligible, 62 (58 %) trials reported participant race or ethnicity and were included in the analyses. Significant disparities in enrollment were observed for American Indian/Alaska Native, Asian/Pacific Islander, Black, and Hispanic youth compared to their respective contribution to disease burden among youth in the US. Disparities in trial enrollment were greatest for Black (EPD, -10.2; 95 % confidence interval [CI], -14.4 to -7.9) and Hispanic (EPD, -7.7; 95 % CI, -12.6 to -4.8) youth. EPDs of trials conducted prior to year 2017 did not differ significantly from those conducted as of year 2017., Conclusions: Historically marginalized racial and ethnic youth were underrepresented in T1D trials. Strategies to improve recruitment of these populations are needed to reduce inequities in diabetes treatment and outcomes., Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Given the growing concerns regarding objective measures of clinical outcomes, attention has recently been devoted to the establishment of clinically significant outcome (CSO) thresholds for patient-reported functional scores after rotator cuff surgery., Purpose: To retrospectively compare patient-reported outcome (PRO) measures (PROMs) and radiographic data between patients who underwent arthroscopic superior capsular reconstruction (SCR) with and without long head of the biceps tendon (LHBT) augmentation., Study Design: Cohort study; Level of evidence, 3., Methods: A total of 43 patients receiving arthroscopic SCR between 2016 and 2020 were enrolled, including a biceps augmentation group (n = 27) and a nonaugmentation group (n = 16). Patients were asked an anchor question regarding their satisfaction and perception of improvements. PROMs of American Shoulder and Elbow Surgeons (ASES), Constant score, Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain scores and radiographic data including magnetic resonance imaging and plain radiographs were collected and compared between the 2 groups. Anchor questions in CSO analysis for deriving the minimal clinically importance difference (MCID), substantial clinical benefit (SCB), Patient Acceptable Symptom State (PASS), and maximal outcome improvement (MOI) values were applied ≥2 years postoperatively., Results: Based on satisfaction responses, 17 patients were classified as satisfied, 16 as unsatisfied, and 10 as fair. Additionally, 13 patients felt they were improved, 14 changed, and 16 unchanged. Intergroup comparison based on patients' satisfaction and perception of change or improvement exhibited significant differences in all 4 functional scores in favor of the satisfied and improved patients. However, there was no significant difference in the ΔVAS scores between the groups. CSO analyses showed no significant difference in percentage of patients achieving MCID, SCB, and PASS thresholds for the ΔASES, ΔConstant, and ΔSANE scores between patients undergoing arthroscopic SCR with or without LHBT augmentation. A significant difference was found in the percentage of patients achieving the MOI for ΔASES score with 70.4% in the augmented group and 37.5% in the nonaugmented group, respectively. The mean acromiohumeral distance (AHD) differed significantly between augmentation (8.1 ± 2.2 mm) and nonaugmentation (7 ± 1.9 mm) groups. The graft tear rate did not differ significantly., Conclusion: There was no significant difference in PROs and percentage of patients achieving MCID, SCB, and PASS between isolated and augmented SCR groups. A higher percentage of patients achieving MOI and slightly greater AHD were found in the augmented group. Further evaluation is required to determine if there is any long-term benefit to LHBT augmentation of SCR., Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2024.)

Objective: To estimate differences in facility-level outcomes between nursing homes which reached Institutional Special Needs Plan (I-SNP) maturity and those which never cared for I-SNP enrollees., Study Setting and Design: We used a difference-in-differences design to estimate the effect of I-SNP maturity, defined as having at least 33.75% of Medicare long-stayers in the nursing home enrolled in any I-SNP. Our main outcome was the hospitalization rate in each nursing home-year. Secondary outcomes included the share of residents with medication use, fall, urinary tract infection, catheter insertion, pressure ulcer, physical restraint use, increased need for help with activities of daily living (ADLs), and mortality., Data Sources and Analytic Sample: This repeated cross-sectional study used 100% Medicare claims, Minimum Data Set assessments, and publicly available Medicare Advantage (MA) plan characteristics data (2004-2021). We included all MA beneficiaries who resided in US nursing homes which reached I-SNP maturity and those without I-SNP enrollees., Principal Findings: We identified 2530 nursing homes which reached I-SNP maturity (treated) and 9830 nursing homes without I-SNP enrollees (untreated). There were some differences observed between these nursing homes, including shares of residents who were White (76.42% vs. 84.84%) and on Medicaid (66.94% vs. 55.45%). These nursing homes were also larger on average (141.76 beds vs. 87.56 beds). From the difference-in-differences model, nursing homes which reached I-SNP maturity experienced declines of 4.1 percentage points (pp) for hospitalizations, 1.0 pp for pressure ulcers, 1.3 pp for urinary tract infections (p < 0.001) alongside increases in the need for help with ADLs, use of antipsychotics, falls, and physical restraints., Conclusions: Nursing homes which reached I-SNP maturity experienced fewer hospitalizations and pressure ulcers but a decline in function and increase in other negative outcomes. I-SNPs may be a promising model to improve care for long-stay residents, but more research is needed to understand potential adverse consequences., (© 2024 Health Research and Educational Trust.)

Background: Leukotriene-receptor antagonists (LTRA) and inhaled corticosteroids (ICS) are common controller medications for asthma, but limited studies examine their comparative risks on neuropsychiatric adverse events (NAEs) in patients with asthma., Objective: To investigate the comparative risks of LTRA versus ICS on 7 distinct categories of NAEs in patients with asthma at a nationwide level., Methods: We conducted a nationwide cohort study during 2010-2021. Incident NAEs and their clinical subgroups (eg, psychotic disorders, anxiety disorders, movement disorders, behavioral and emotional disorders, mood disorders, sleep-related disorders, and personality disorders) were assessed. Cox proportional hazards regressions were used to quantify the comparative risks., Results: There were 1,249,897 patients with asthma aged 6 to 64 years. Incidence rates for NAEs were 25.10 per 1000 person-years among patients treated with LTRA and 23.46 per 1000 person-years among those treated with ICS. The incidence rate difference was 1.64 (95% confidence interval [CI]: 0.30-2.98) per 1000 person-years. Positive associations of NAEs and 3 clinical subgroups were found in patients treated with LTRA compared with ICS (hazard ratios [HR]: 1.06 [95% CI: 1.00-1.12] for NAEs; HR: 1.88 [95% CI: 1.24-2.84] for psychotic disorders; HR: 1.10 [95% CI: 1.01-1.20] for anxiety disorders; and HR: 1.27 [95% CI: 1.02-1.58] for behavioral and emotional disorders), but not for movement disorders, mood disorders, sleep-related disorders, and personality disorders., Conclusions: This nationwide cohort study identified heightened risks, ranging from 6% to 88%, of NAEs and 3 clinical subgroups in patients with asthma treated with LTRA compared with ICS. These findings underscore the necessity for clinicians to communicate with patients regarding potential neuropsychiatric harms when prescribing LTRA., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate a serious game-based intervention's feasibility, acceptability, and efficacy in encouraging coronavirus disease (COVID-19) vaccination among 11-14-year-olds in the United States and assess participant experiences. Materials and Methods: The study, grounded in social cognitive theory and health belief model, recruited and engaged 32 English-speaking parent-child dyads with unvaccinated youths via snowball sampling and social media outreach. These dyads were randomly assigned to either the COVID-19 serious game-based intervention group ( n = 16) or a usual care group ( n = 16). The study measured beliefs, self-efficacy, and intentions regarding vaccination using surveys before and after the intervention, with follow-up at 2 months to evaluate vaccine uptake. Semistructured interviews provided insights into the gaming experience and study process. Results: All 32 eligible parent-youth dyads (16 in each group) completed the study with full participation. Most participants were Black or African American fathers, making up 75% and 81.3% of the intervention and control groups, respectively. The intervention impacted vaccine uptake, with 75% of the intervention group vaccinating their children compared with 37.5% of the control group [χ 2 (1, n = 32) = 4.57, P = 0.033]. Key factors for vaccine uptake included parents' motivation and youths' perceived susceptibility, with correlations of r (30) = 0.66, P = 0.006, and r (30) = 0.55, P = 0.029, respectively. The intervention reshaped youth perceptions about self and community protection. Participants expressed overall satisfaction with both the intervention and the study process. Conclusions: The intervention was found to be feasible and acceptable, with potential for integration into youth vaccination strategies to support COVID-19 vaccine decision-making.

Institutional Special Needs Plans (I-SNPs) are a type of Medicare Advantage (MA) plan designed for long-term residents of nursing homes or those who live in the community but need a nursing home level of care. I-SNPs provide for on-site nurse practitioners in nursing homes to help improve primary care, care planning, and care coordination. Our study was the first to undertake a nationwide descriptive analysis of the I-SNP market. The share of long-stay nursing home residents enrolled in I-SNPs quadrupled from 2006 to 2021, from 2.2 percent to 8.8 percent. Despite this growth, nearly 70 percent of nursing homes did not have any residents enrolled in I-SNPs in 2021, and in more than 60 percent of US counties, there were no I-SNPs available. Nearly 94 percent of long-stay nursing home residents who were enrolled in I-SNPs in 2021 were eligible for both Medicare and Medicaid. More research is needed to understand why I-SNPs enter certain markets and why long-stay nursing home residents choose to enroll in them; to assess I-SNP enrollment barriers; and to compare hospital admission rates and quality outcomes among long-stay nursing home residents by I-SNP enrollment status. Increased understanding of I-SNPs could inform policies to address long-standing concerns about the quality of care in nursing homes.

Purpose: Elective genomic testing (EGT) is increasingly available clinically. Limited real-world evidence exists about attitudes and knowledge of EGT recipients., Methods: After web-based education, patients who enrolled in an EGT program at a rural nonprofit health care system completed a survey that assessed attitudes, knowledge, and risk perceptions., Results: From August 2020 to April 2022, 5920 patients completed the survey and received testing. Patients most frequently cited interest in learning their personal disease risks as their primary motivation. Patients most often expected results to guide medication management (74.0%), prevent future disease (70.4%), and provide information about risks to offspring (65.4%). Patients were "very concerned" most frequently about the privacy of genetic information (19.8%) and how well testing predicted disease risks (18.0%). On average, patients answered 6.7 of 11 knowledge items correctly (61.3%). They more often rated their risks for colon and breast cancers as lower rather than higher than the average person but more often rated their risk for a heart attack as higher rather than lower than the average person (all P < .001)., Conclusion: Patients pursued EGT because of the utility expectations but often misunderstood the test's capabilities., Competing Interests: Conflict of Interest Robert C. Green, Kurt D. Christensen, Emilie S. Zoltick, Madison R. Hickingbotham, Jessica L. LeBlanc, and Lauren N. Galbraith were supported by a research grant from Sanford Health. Madison R. Hickingbotham, Madison R. Hickingbotham, Ann Chen Wu, Lauren N. Galbraith, and Jessica L. LeBlanc have been funded by National Center for Advancing Translational Sciences (NCATS), National Heart, Lung, and Blood Institute (NHLBI), and National Institute of Child Health and Human Development (NICHD). Ann Chen Wu has received grants from NICHD, NHLBI, and GlaxoSmithKline. Catherine Hajek is an employee of Helix OpCo. Christine Y. Lu undertook contract work with Illumina Inc outside the submitted work and has received research grants and contracts from National Human Genome Research Institute (NHGRI), NIMH, NICHD, National Cancer Institute, and Centers for Disease Control and Prevention. Emilie S. Zoltick has been funded by NIMHD. Hadley Stevens Smith has been funded by NHGRI and NICHD, has consulted for Illumina, Inc and received compensation, and has received compensation from Elsevier and the Eastern Society of Pediatric Research. Kurt D. Christensen has received research grants from NHGRI, NCATS, NHLBI, and NICHD. Lauren N. Galbraith is an employee of Pfizer, Inc. Robert C. Green has received compensation for advising the following companies: AIA, Allelica, Atria, Fabric, Genome Web, Genomic Life, Verily, and VinBigData; is cofounder of Genome Medical and Nurture Genomics; and has received research grants from NCATS, NHLBI, the Danaher Foundation, the Southcentral Foundation, GRAIL, and Beaumont Health. All other authors declare no conflicts of interest., (Copyright © 2024 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: Intraoperative neurophysiological monitoring plays a pivotal role in modern neurosurgery, aiding in real-time assessment of eloquent neural structures to mitigate iatrogenic neural injury. This study represents the largest retrospective series to date in monitoring corticospinal tract integrity during intracranial surgery with transcranial motor-evoked potentials (TCMEPs), focusing on the influence of demographic factors, comorbidities, and preoperative motor deficits on the reliability of intraoperative neurophysiological monitoring. While the impact of patient-specific factors affecting TCMEP monitoring in spine surgery is well-documented, similar insights for intracranial surgery are lacking., Methods: A total of 420 craniotomy patients were retrospectively analyzed from electronic medical records from December 2017 to February 2023, excluding patients without preoperative Medical Research Council scores or medical histories. Using intrinsic hand muscles as a robust data set, 840 hand TCMEPs acquired during intracranial surgery were assessed. Demographic and clinical factors, including preoperative motor scores, were analyzed to identify associations with TCMEP acquisition and amplitude. Nonparametric statistics and multivariate regression analysis were employed., Results: TCMEPs were successfully acquired in 734 (87.7%) patient hands, even in the presence of preoperative motor deficits in 13.9% of total patient hands. Preoperative motor scores did not predict the ability to acquire baseline TCMEPs ( P = .6). Notably, older age ( P < .001) and hypertension ( P = .01) were independent predictors of lower TCMEP acquisition rates. Preoperative motor scores significantly influenced TCMEP amplitudes, with higher scores correlating with higher amplitudes (1771 [SD = 1550] eve vs 882 [SD = 856] μV, P < .0001). Older age ( P < .001) and chronic kidney disease ( P = .04) were also associated with reduced TCMEP amplitudes., Conclusion: Our investigation into TCMEPs during intracranial surgery demonstrated a notably high acquisition rate in hand muscles, irrespective of preoperative motor deficits. Preoperative motor scores reliably correlated with TCMEP amplitudes in a linear fashion while advanced age and renal disease emerged as independent predictors of lower TCMEP amplitudes., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Background: International students contribute significantly to both the economy and the intellectual and cultural landscape of host countries. Their interactions with domestic students foster personal, socioeconomic, and political development, promopting a broader understanding of diverse cultures and values. This highlights how crucial international education is for staying competitive globally. However, international students often face challenges such as poor mental health, linguistic and cultural barriers, acculturative stress, and limited health literacy. Therefore, supporting their academic success and well-being on college campuses is essential. This protocol aims to describe strategies used to evaluate the effect of interventions on international students' mental health and wellbeing and propose directions for future research based on the evidence., Methods: We will conduct an extensive search in several databases including CINAHL, PubMed, Web of Science, PsyInFO, ERIC, and Google Scholar with no date limits. Two reviewers will independently screen the literature and extract data. We will then conduct meta-analyses of the extracted data., Discussion: To the best of our knowledge, this study is the first systematic review with meta-analysis focusing on interventions to enhance mental health and wellbeing among international college students. This study will provide most updated empirical evidence on the effects of interventions aimed to improve international students' mental health and wellbeing. The findings from this study will summarize the importance of a range of interventions being available to international students who experience psychological distress and the effectiveness of each intervention. This study will also highlight the gap for researchers to focus on for future studies., Trial Registration: PROSPERO registration number: CRD42024528767., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

We predict a rich excitation spectrum of a binary dipolar supersolid in a linear crystal geometry, where the ground state consists of two partially immiscible components with alternating, interlocking domains. We identify three Goldstone branches, each with first-sound, second-sound, or spin-sound character. In analogy with a diatomic crystal, the resulting lattice has a two-domain primitive basis and we find that the crystal (first-sound-like) branch is split into optical and acoustic phonons. We also find a spin-Higgs branch that is associated with the supersolid modulation amplitude.

Background: Lower limb coronal alignment was thought to be a predictive factor for Unicompartmental Knee Arthroplasty (UKA) result. The tibial bony resection and implant position lead to joint line change postoperatively. Analysis was done to find out the correlation between these factors., Methods: From 2019 to 2021, 90 medial Oxford UKA were implanted by a single surgeon. Hip Knee Ankle Angle (HKAA), Lateral Distal Femoral Angle (LDFA), Medial Proximal Tibial Angle (MPTA), and intraoperative bony resection thickness were measured. The medial joint line change was calculated. The correlation between joint line change and alignment change was evaluated., Results: The mean tibial resection thickness was 4.3 mm. The mean tibial joint line was elevated by 2.3 mm, while the mean femoral joint line proximalized by 0.8 mm. HKAA changed from 8.4° varus preoperatively to 3.6° varus postoperatively. LDFA changed from 89.0° to 86.7°. MPTA changed from 85.6° to 86.6°. Preoperative HKAA showed a strong correlation with postoperative HKAA (p < 0.001), and preoperative MPTA showed a positive correlation with postoperative HKAA (p < 0.001). While preoperative LDFA had a negative correlation with postoperative HKAA (p < 0.001). The femoral joint line change and LDFA change had a significant correlation with HKAA change (p < 0.05)., Conclusion: The change of joint line had no correlation with postoperative HKAA in Oxford UKA. Preoperative HKAA strongly correlated with postoperative HKAA; while preoperative smaller LDFA and larger MPTA had a moderate correlation with postoperative HKAA. The femoral joint line change and LDFA change had a weak to moderate correlation with HKAA change., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Functional recovery following peripheral nerve injury worsens with increasing time of denervation before repair. Denervated muscle undergoes progressive atrophy that limits the extent to which motor endplates can be reinnervated. The aims of this study were to assess nerve injuries reconstructed at different time points and to identify various neural and muscle-based markers to predict functional outcome, including an in-depth look at the neuromuscular junction (NMJ)., Methods: Adult wild-type C57BL/6J mice underwent surgery on the sciatic nerve and were divided into 5 groups: (1) nerve cut and repaired, (2) acute (nerve cut and immediately repaired with a 1-cm autograft), (3) subacute (nerve grafted 2 weeks after injury), (4) delayed (nerve grafted 4 weeks after injury), (5) nerve cut and capped. Functional recovery was measured by treadmill and electrodiagnostic tests. Nerves were harvested for histologic evaluation, and leg muscles, for histologic evaluation and NMJ immunofluorescent staining of motor endplate innervation and terminal Schwann cells (tSCs)., Results: The delayed graft group performed worst in nearly all parameters. The subacute graft group shared more similarities with the acute group, especially the tSC response (subacute, 48%; acute, 51%) and motor endplate innervation pattern (subacute, 75%; acute, 72%). The only parameters to elucidate differences were muscle weight and motor endplate fragmentation. Traditional axon count failed to capture differences among the 3 groups., Conclusion: The tSC activity and NMJ innervation pattern can be used as predictive markers of functional recovery that capture differences among acute, subacute, and delayed nerve injuries., Clinical Relevance Statement: The tSC activity at the NMJ displayed by immunohistochemical methods can accurately reflect target muscle innervation over time. This can be used as a predictor of reinnervation when timing of nerve reconstruction is delayed, which can be a critically needed tool in clinical scenarios., (Copyright © 2023 by the American Society of Plastic Surgeons.)

Bladder cancer (BC) is a common malignancy and its most prevalent type is urothelial carcinoma, which accounts for ~90% of all cases of BC. The current treatment options for BC are limited, which necessitates the development of alternative treatment strategies. Hyperthermia (HT), as an adjuvant cancer therapy, is known to improve the efficacy of chemotherapy or radiotherapy. The present study aimed to investigate the anti‑tumor effects of HT on cell survival, invasiveness, chemoresistance and immune evasion in human BC cell lines (5637, T24 and UMUC3). Calcein AM staining was performed to analyze the cytotoxicity of natural killer (NK) cells against human BC cells following HT treatment. Cell migration and invasion affected by HT were analyzed using Transwell migration and invasion assays. It was found that HT inhibited the proliferation of BC cells by downregulating the phosphorylation of protein kinase B. Moreover, HT effectively enhanced the sensitivity of BC cells to the chemotherapy drug cisplatin (DDP) and reduced the chemoresistance of DDP‑resistant cells by downregulating the expression of cadherin‑11. It was further demonstrated that HT inhibited the migration and invasion of BC cells and enhanced the cytotoxic effects of NK cells. In summary, the antineoplastic effects of HT were mediated through three main mechanisms: Enhancement of the chemosensitivity of BC cells and mitigation of DDP‑induced chemoresistance, suppression of the invasive potential of BC cells and reinforcement of the anticancer response of NK cells. Thus, HT appears to be a promising adjunctive therapy for human BC.

Competing Interests: Financial/Nonfinancial Disclosures None declared

The United States Veterans Affairs (VA) Health Care System has a strong history of conducting impactful oncology randomized clinical trials (RCTs). We developed a phase II/III RCT to test the use of metastasis-directed therapy in Veterans with oligometastatic prostate cancer (OMPC)-the first VA RCT in OMPC that leverages novel imaging and advanced radiotherapy techniques. To accomplish this, we developed a clinical trial network to conduct the study. In this manuscript, we describe several challenges we encountered in study development/conduct and our strategies to address them, with the goal of helping investigators establish robust study networks to conduct clinical trials. In the study start-up, we encountered challenges in timely site activation, and leveraged project management to maximize efficiency. Additionally, there were several changes in the clinical paradigms in imaging and treatment that led to protocol amendments to ensure maximum equipoise, recruitment, and impact of the study. Specifically, we amended the trial to add de novo OMPC patients (from initially only recurrent OMPC) and expanded the study to allow up to 10 metastases (from initially five). Finally, in order to maintain local study team engagement, we developed initiatives to maximize collaboration and add value to the overall clinical program through study participation.

Phase control over cation exchange (CE) reactions has emerged as an important approach for the synthesis of nanomaterials (NMs), enabling precise determination of their reactivity and properties. Although factors such as crystal structure and morphology have been studied for the phase engineering of CE reactions in NMs, there remains a lack of systematic investigation to reveal the impact for the factors in heterogeneous materials. Herein, we report a molybdenum disulfide induced phase control method for synthesizing multidimensional Co 3 S 4 -MoS 2 heteronanostructures (HNs) via cation exchange. MoS 2 in parent Cu 1.94 S-MoS 2 HNs are proved to affect the thermodynamics and kinetics of CE reactions, and facilitate the formation of Co 3 S 4 -MoS 2 HNs with controlled phase. This MoS 2 induced phase control method can be extended to other parent HNs with multiple dimensions, which shows its diversity. Further, theoretical calculations demonstrate that Co 3 S 4 (111)/MoS 2 (001) exhibits a higher adhesion work, providing further evidence that MoS 2 enables phase control in the HNs CE reactions, inducing the generation of novel Co 3 S 4 -MoS 2 HNs. As a proof-of-concept application for crystal phase- and dimensionality-dependent of cobalt sulfide based HNs, the obtained Co 3 S 4 -MoS 2 heteronanoplates (HNPls) show remarkable performance in hydrogen evolution reactions (HER) under alkaline media. This synthetic methodology provides a unique design strategy to control the crystal structure and fills the gap in the study of heterogeneous materials on CE reaction over phase engineering that are otherwise inaccessible., (© 2024 Wiley-VCH GmbH.)

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) affects patients after recovering from acute coronavirus disease 2019 (COVID-19). This study investigates the impact of SARS-CoV-2 vaccination on PASC symptoms in children in Taiwan during the Omicron pandemic., Methods: We enrolled children under 18 years with PASC symptoms persisting for more than 4 weeks. Data collected included demographics, clinical information, vaccination status, and symptom persistence. We used logistic regression models to compare symptoms in the acute and post-COVID-19 phases and to assess the association between vaccination and these symptoms., Results: Among 500 PASC children, 292 (58.4%) were vaccinated, 282 (52.8%) were male, and the mean (SD) age was 7.6 (4.6) years. Vaccinated individuals exhibited higher odds of experiencing symptoms in the previous acute phase, such as cough (adjusted odds ratio [AOR] = 1.57; 95% confidence interval [CI]: 1.02-2.42), rhinorrhea/nasal congestion (AOR = 1.74; 95% CI: 1.13-2.67), sneezing (AOR = 1.68; 95% CI: 1.02-2.76), sputum production (AOR = 1.91; 95% CI: 1.15-3.19), headache/dizziness (AOR = 1.73; 95% CI: 1.04-2.87), and muscle soreness (AOR = 2.33; 95% CI: 1.13-4.80). In contrast, there were lower odds of experiencing abdominal pain (AOR = 0.49; 95% CI: 0.25-0.94) and diarrhea (AOR = 0.37; 95% CI: 0.17-0.78) in children who had received vaccination during the post-COVID-19 phase., Conclusions: This study revealed clinical features and vaccination effects in PASC children in Taiwan. Vaccination may reduce some gastrointestinal symptoms in the post-COVID-19 phase.

Multiple sclerosis (MS) is a chronic and debilitating neurological disease that results in inflammatory demyelination. While endogenous remyelination helps to recover function, this restorative process tends to become less efficient over time. Currently, intense efforts aimed at the mechanisms that promote remyelination are being considered promising therapeutic approaches. The M1 muscarinic acetylcholine receptor (M1R) was previously identified as a negative regulator of oligodendrocyte differentiation and myelination. Here, we validate M1R as a target for remyelination by characterizing expression in human and rodent oligodendroglial cells (including those in human MS tissue) using a highly selective M1R probe. As a breakthrough to conventional methodology, we conjugated a fluorophore to a highly M1R selective peptide (MT7) which targets the M1R in the subnanomolar range. This allows for exceptional detection of M1R protein expression in the human CNS. More importantly, we introduce PIPE-307, a brain-penetrant, small-molecule antagonist with favorable drug-like properties that selectively targets M1R. We evaluate PIPE-307 in a series of in vitro and in vivo studies to characterize potency and selectivity for M1R over M2-5R and confirm the sufficiency of blocking this receptor to promote differentiation and remyelination. Further, PIPE-307 displays significant efficacy in the mouse experimental autoimmune encephalomyelitis model of MS as evaluated by quantifying disability, histology, electron microscopy, and visual evoked potentials. Together, these findings support targeting M1R for remyelination and support further development of PIPE-307 for clinical studies., Competing Interests: Competing interests statement:M.M.P., K.I.L., K.J.S., G.C.E., A.R.B., J.R.R., J.M.B., C.S.B., A.C.C., and D.S.L. are current employees of Contineum Therapeutics and hold financial shares of Contineum Therapeutics. Contineum Therapeutics owns patent rights to PIPE-307.