Tag: pubmed

J Oral Maxillofac Surg. 2023 Sep 9:S0278-2391(23)01092-3. doi: 10.1016/j.joms.2023.09.001. Online ahead of print.

ABSTRACT

BACKGROUND: Soccer is one of the most popular sports worldwide. However, it has risks of injury to craniomaxillofacial regions such as the head, neck, and mouth.

PURPOSE: The purpose of this study is to determine which demographic and injury characteristics among soccer players with craniomaxillofacial injuries are associated with increased hospitalizations.

STUDY DESIGN, SETTING, AND SAMPLE: This is a retrospective cohort study utilizing the National Electronic Injury Surveillance System. Subjects included in this study experienced an injury to a craniomaxillofacial area from soccer between January 1, 2003, and December 31, 2022.

PREDICTOR VARIABLE: The predictor variables included demographics (age, sex, race) and injury characteristics (craniomaxillofacial region, diagnosis).

MAIN OUTCOME VARIABLE: The primary outcome variable was injury severity defined as hospitalization outcome after injury (yes/no). The secondary outcome variable was the trends in the incidence of soccer craniomaxillofacial injuries over time (2003-2022).

COVARIATES: The covariates were the heterogenous set of predictor variables in this study.

ANALYSES: Descriptive statistics and univariate analyses were computed. Survey-weighted univariate and multivariate logistic regression were used to measure the association of demographic and injury variables with hospitalization outcome. Statistical significance was defined as P < .05.

RESULTS: The study sample included 26,642 subjects (national estimate, 799,393). The national incidence of craniomaxillofacial soccer injuries generally increased between 2003 and 2012 and decreased between 2016 and 2020. Subjects in the ≥30 age group had increased odds of hospitalization compared to those in the 10-19 age group (odds ratio [OR], 2.12; P < .001). Compared to females, males had significantly higher odds of hospitalization (OR, 1.53; P < .001). Head (OR, 8.42; P < .001) and neck (OR, 15.8; P < .001) injuries had increased odds of hospitalization compared to facial injuries. Relative to contusions/abrasions, subjects with fractures (OR, 94.7; P < .001), dental injuries (OR, 41.3; P < .001), and concussions (OR, 5.33; P = .017) were at significantly higher odds of hospitalization.

CONCLUSION AND RELEVANCE: Age, sex, craniomaxillofacial region, and diagnosis were significant predictors of hospitalization outcome after craniomaxillofacial soccer injury. Safer playing styles, use of mouthguards, and proper medical management may reduce future risks of craniomaxillofacial injury from soccer.

PMID:37743045 | DOI:10.1016/j.joms.2023.09.001

J Oral Maxillofac Surg. 2023 Sep 5:S0278-2391(23)01091-1. doi: 10.1016/j.joms.2023.08.226. Online ahead of print.

ABSTRACT

BACKGROUND: Facial aesthetics may be optimized based on a deeper understanding of soft tissue changes after orthognathic surgery.

PURPOSE: The purpose of the study was to delineate facial soft tissue changes after clockwise rotation (CWR) of the maxillomandibular complex (MMC) to correct mandibular prognathism using the surgery-first approach.

STUDY DESIGN, SETTING, SAMPLE: This prospective cohort study enrolled patients over 18 years of age with skeletal Class III malocclusion in the craniofacial center. The patients were excluded with previous history of craniofacial syndrome, orthognathic surgery trauma, infection at surgical sites, chin deviation (menton deviation ≥4 mm), 2 or more missing data points after surgery, or without informed consent. This study compared significant facial changes before (T0) and after orthodontic debonding (T1) in the CWR and control groups.

PREDICTOR VARIABLE: The patients were divided in accordance with maxillary occlusal plane change (OPC) after surgery into CWR (OPC >4°) and control (OPC ≤4°) groups.

MAIN OUTCOME VARIABLE: The primary outcome variable was frontal lip curvature (FLC: Right Cheilion-Stomion-Left Cheilion, degree) with or without upper lip curving upward at T1, where upper lip curving upward was considered more favorable.

COVARIATES: The covariates included age, sex, and various cephalometric measurements.

ANALYSES: The Mann-Whitney U test, paired, and independent t-test were implemented to compare the intragroup and intergroup differences. Statistical significance was indicated by P value <.05.

RESULTS: The study comprised 34 patients (21 women) in the control group and 37 (29 women) in the CWR group; their mean ages were 23.64 ± 4.38 and 24.21 ± 3.84 years, respectively (P value = .562). At T1, the CWR group had significant increased FLC (P value = .001), alar width (P value = .034), and lower vermilion height (P value = .018), and decreased lower lip length (P value = .004). The high FLC group had significant decreased upper lip projection (P value = .002) and increased NLA (P value = .013). The significant relationship between CWR and high FLC was supported by the χ² test (P value = .018) and multiple logistic regression (P value = .017).

CONCLUSION: Greater CWR of the MMC increased FLC and lower vermilion height and reduced lower lip length. High FLC resulting from the CWR of the MMC improved facial appearance by moving the upper lip curve upward.

PMID:37743044 | DOI:10.1016/j.joms.2023.08.226

J Oral Maxillofac Surg. 2023 Sep 9:S0278-2391(23)01090-X. doi: 10.1016/j.joms.2023.08.225. Online ahead of print.

ABSTRACT

BACKGROUND: Limited research exists regarding the incidence and variations of zygomaticomaxillary complex (ZMC) fracture patterns and their correlation with the mechanism of injury. Hence, further research is indicated.

PURPOSE: The purpose of this study was to analyze the different ZMC fracture patterns in relation to its etiology using computed tomography scans.

STUDY DESIGN, SETTING, SAMPLE: This retrospective cohort study was conducted at a single institution. The medical records of maxillofacial trauma patients from 2016 to 2020 were analyzed. Patients from any gender and all age groups with complete records diagnosed with isolated ZMC fractures were included in the study.

PREDICTOR VARIABLE: The etiology of trauma was the primary predictor variable. It was categorized as road traffic accidents (RTAs), falls, interpersonal violence, fall from height, sports injuries, etc. MAIN OUTCOME VARIABLES: The primary outcome variable was the ZMC fracture patterns observed and was defined as similar to or different from the classical fracture patterns. Any type of variation noted from the classical fracture lines was defined as the secondary outcome variable.

COVARIATES: Covariates included demographic variables such as age, gender, the type of vehicle involved, the type of RTA, side of fracture, associated orbital fractures, and number of ZMC points fractured.

ANALYSES: Descriptive and bivariate statistics were used to measure association between the predictor and outcome variables using multiple proportions χ² test. Statistical significance was defined at P value of <.05.

RESULTS: Out of the 232 scans assessed, a total of 163 cases were included in this study. A majority of the cases belonged to a range of 21 to 30 years and showed a male predilection. The most common mode of injury was found to be RTAs (88.3%). Most cases had fracture patterns different from the classical fracture patterns (65.64%). A statistically significant association was found between the types of ZMC fracture patterns and etiology of trauma (RTA P = <.0001, falls P = .0001, and interpersonal violence P = .0001). Five different variations in ZMC fracture patterns were found and had a statistically significant association with the classical fracture lines (P < .0001).

CONCLUSION AND RELEVANCE: The authors conclude that the variations in fracture patterns encountered today may be attributed to the mechanism of injury. With due consideration to the limitations of this study, the authors suggest that the treatment plan may require slight modification based on the variation of the fracture pattern. Additional intervention may also be indicated.

PMID:37743043 | DOI:10.1016/j.joms.2023.08.225

Cell Signal. 2023 Sep 22:110901. doi: 10.1016/j.cellsig.2023.110901. Online ahead of print.

ABSTRACT

Cancer cachexia is a systemic inflammation-driven syndrome, characterized by muscle atrophy and adipose tissue wasting, with progressive weight loss leading to serious impairment of physiological function. Extracellular vesicles (EVs) derived from cancer cells play a significant role in adipocyte lipolysis, yet the mechanism remain uneclucidated. In this study, EVs derived from Lewis lung carcinoma (LLC) cells were extracted and characterized. 3 T3-L1 and HIB1B adipocytes were cultured with conditioned medium or EVs from LLC, and LLC cells were used to establish a cancer cachexia mouse model. EVs derived from LLC cells were taken up by 3 T3-L1 and HIB1B adipocytes, and derived exosomal EIF5A protein-induced lipolysis of adipocytes. High level of EIF5A was expressed in EVs from LLC cells, exosomal EIF5A is linked to lipid metabolism. Elevated expression of EIF5A is associated with shorter overall survival in lung cancer patients. Western blots, glycerol release and Oil red O staining assays were used to evaluate lipolysis of adipocytes. The reduction of lipolysis in 3 T3-L1 and HIB1B adipocytes is achieved through silencing EIF5A or treating with pharmacologic inhibitor GC7 in vitro, and suppressing the expression of EIF5A in LLC cells by infected with shRNA or GC7 treatment partly alleviated white and brown adipose tissue lipolysis in vivo. Mechanistically, EIF5A directly binds with G protein-coupled bile acid receptor 1 (GPBAR1) mRNA to promote its translation and then activates cAMP response element binding protein (CREB) signaling pathway to induce lipolysis. This study demonstrates that exosomal EIF5A from LLC cells, with hypusinated EIF5A, has a lipolytic effect on adipocyte and adipose tissues in cancer cachexia model. Exosomal EIF5A could be involved in lipolysis and these findings indicate that a novel regulator and potential target for cachexia treatment.

PMID:37743008 | DOI:10.1016/j.cellsig.2023.110901

Am J Obstet Gynecol MFM. 2023 Sep 22:101168. doi: 10.1016/j.ajogmf.2023.101168. Online ahead of print.

ABSTRACT

BACKGROUND: Continuous support during labor has many benefits, including lower use of obstetrical interventions. However, implementation remains limited. Insights into birth outcomes as well as peripartum costs are essential to assess whether continuous care by a maternity care assistant is a potentially (cost) effective program to provide for all women.

OBJECTIVE: Continuous care during labor, provided by maternity care assistants, will reduce the use of epidural analgesia and peripartum costs due to a reduction in interventions.

STUDY DESIGN: A randomized controlled trial, comparing continuous support during labor (intervention group) to care-as-usual (control group) with pre-specified intention-to-treat and per-protocol analyses. The primary outcome was epidural analgesia use. Secondary outcomes were use of other analgesia, referrals from midwife- to obstetrician-led care, modes of birth, hospital stay, sense of control (evaluated with the Labor Agentry Scale), maternal and neonatal adverse outcomes and peripartum costs. Data were collected using questionnaires. Anticipating incomplete adherence to providing continuous care, both intention-to-treat and per-protocol analyses were planned. Peripartum costs were estimated using a healthcare perspective. Mean costs per woman and cost differences between the intervention and control group were calculated.

RESULTS: The population consisted of 1076 women with 54 exclusions and 30 discontinuations, leaving 992 women to be analyzed (515 continuous care and 477 care-as-usual). Intention-to-treat analyses showed statistically non-significant differences between the intervention and control group for epidural use (RR 0.88, 95%-CI 0.74 to 1.04, p=0.14) and peripartum costs (mean difference € 185.83, 95%-CI -€ 204.22 to € 624.54). Per-protocol analyses showed statistically significant decreases in epidural analgesia (RR 0.64, 95%-CI 0.48 to 0.84, p=0.001), other analgesia (RR 0.59, 95%-CI 0.37 to 0.94, p=0.02), cesarean sections (RR 0.53, 95%-CI 0.29 to 0.95, p=0.03) and increase in spontaneous vaginal births (RR 1.09, 95%-CI 1.01 to 1.18, p=0.001) in the intervention group, but difference in total peripartum costs remained statistically non-significant (mean difference € 246.55, 95%-CI -€ 539.14 to € 13.50).

CONCLUSION: If the provision of continuous care given by maternity care assistants during labor can be secured, continuous care leads to more vaginal births and less epidural use, pain medication and cesarean sections, while not leading to a difference in peripartum costs compared to care-as-usual.

PMID:37742999 | DOI:10.1016/j.ajogmf.2023.101168

Sci Total Environ. 2023 Sep 22:167288. doi: 10.1016/j.scitotenv.2023.167288. Online ahead of print.

ABSTRACT

Limited information is available regarding the pollution status of organophosphate esters (OPEs) in the environment of the Yellow River estuary. Here, n = 51 sediment samples were collected from the Yellow River estuary in 2021, and further analyzed by using the integrated target, suspect, and feature fragment-dependent nontarget OPE screening strategy developed in our laboratory. Among the 30 target OPEs, 19 were detectable in at least one of the analyzed samples, with total concentrations (Σ₁₉OPEs) ranging from of 41.4 to 1930 ng/g dry weight (dw). On the basis of an in-house suspect compound database, we further tentatively identified 11 suspect OPEs, and they were semi-quantified. Furthermore, four other interesting findings were observed and described as follows: 1) a statistically significant difference existed in the concentrations of OPEs in sediment samples between the lower reaches of the Yellow River (n = 5 samples), and the Yellow River estuary (n = 46 samples) (unpaired t-test, p < 0.001); 2) tris(2,4-di-tert-butylphenyl)phosphate (TDTBPP) exhibited the greatest concentrations (ranging from 30.7 to 1920 ng/g dw) among all OPEs detected in the sediment samples; 3) samples from the north of the Yellow River estuary had higher OPE concentrations than those from the south; and 4) a suspect screening strategy allowed us to identify a novel OPE structure (tert-butyl)phenyl (ethyne-oxidane) bis(2,4-di-tert-butylphenyl) phosphate (TPBDTP) that exhibited a highly positive correlation relationship with TDTBPP (r = 0.749; p < 0.001). Overall, this study provided evidence that OPEs (especially TDTBPP) were ubiquitous in the sediment environment of the Yellow River estuary; thus, we emphasize that continuous monitoring of OPE pollution should be conducted in this region.

PMID:37742975 | DOI:10.1016/j.scitotenv.2023.167288

Sci Total Environ. 2023 Sep 22:167293. doi: 10.1016/j.scitotenv.2023.167293. Online ahead of print.

ABSTRACT

Magnesium-functionalized Magnolia grandiflora Linn leaf-derived biochar (MBC) capable of efficiently reclaiming phosphorus from urine was synthesized by slow co-pyrolysis. Four adsorption kinetic and seven adsorption isotherm models were fitted to the batch adsorption and desorption experimental data, and it was found that pseudo-first-order kinetic model and multilayer model with saturation best described the phosphate-phosphorus (PO₄^3--P) adsorption process by MBC. MBC and phosphorus-saturated MBC (P-MBC) were found to offer outstanding phosphorus adsorption and slow release properties, respectively. Based on material characterization, statistical physics, adsorption energy distribution and statistical thermodynamics, a multi-ionic, inclined orientation, entropy-driven spontaneous endothermic process of MBC on PO₄^3--P was proposed, involving physicochemical interactions (porous filling, electrostatic attraction, ligand exchange and surface precipitation). Further, seed germination and early seedling growth experiments proved that P-MBC can be used as a slow-release fertilizer. Overall, MBC offers prospective applications as an efficient phosphorus adsorbent and then as a slow-release fertilizer.

PMID:37742963 | DOI:10.1016/j.scitotenv.2023.167293

Sci Total Environ. 2023 Sep 22:167265. doi: 10.1016/j.scitotenv.2023.167265. Online ahead of print.

ABSTRACT

Africa is vulnerable to the impacts of climate change, particularly in terms of its agriculture and crop production. The majority of climate models project a negative impact of future climate change on crop production, with maize being particularly vulnerable. However, the magnitude of this change remains uncertain. Therefore, it is important to reduce the uncertainties related to the anticipated changes to guide adaptation options. This study uses a combination of local and large-scale empirical orthogonal function (EOF) predictors as a novel approach to model the impacts of future climate change on crop yields in West, East and Central Africa. Here a cross-validated Bayesian model was developed using predictors derived from the regional climate model REMO for the period 1982-2100. On average, the combined local and large-scale EOF predictors explained around 28 % of maize yield variability from 1982 to 2016 of the entire study regions. Notably, climate predictors played a significant role in West Africa, explaining up to 51 % of the maize yield variability. Large-scale climate EOF predictors contributed most to the explained variance, reflecting the role of regional climate in future maize yield variability. Under a high-emissions scenario (RCP8.5), maize yield is projected to decrease over the entire study region by 20 % by the end of the century. However, a minor increase is projected in eastern Africa. This study highlights the importance of incorporating climate predictors at various scales into crop yield modeling. Furthermore, the findings will offer valuable guidance to decision-makers in shaping adaptation options.

PMID:37742952 | DOI:10.1016/j.scitotenv.2023.167265

Hum Pathol. 2023 Sep 22:S0046-8177(23)00189-2. doi: 10.1016/j.humpath.2023.09.004. Online ahead of print.

ABSTRACT

Lymphocyte-rich hepatocellular carcinoma (LR-HCC), a newly proposed subtype of HCC, is characterized with abundant lymphocyte infiltration in the tumor. LR-HCC has a relatively good prognosis and is quite rare (< 1% of all HCC). We examined LR-HCC clinicopathological and molecular characteristics by analyzing 451 surgically resected HCC cases without any prior treatment history at our hospital between 2012 and 2021. Clinicopathological features of LR-HCC and other HCCs (non-LR-HCC) were compared. Neoplastic and nonneoplastic hepatocytes from LR-HCC (n = 4) were collected with a laser microdissection system; RNA was extracted, followed by microarray analysis to examine lymphocytic infiltration-related molecular targets. Immunohistochemical staining of identified molecular target was performed in LR-HCC and non-LR-HCC. CD3, CD20, and CD8 immunostaining was also performed in LR-HCCs. There were 28 cases of LR-HCC (6%). No statistically significant differences were found in clinicopathological features, except for gross type, between LR-HCC and non-LR-HCC cases. The LR-HCC 5-year survival rate was > 90%. Microarray analysis revealed high CCL20 expression in LR-HCC cases; immunohistochemical study showed significantly higher CCL20 expression in LR-HCC (P < 0.01) than in non-LR-HCC. CCR6, the only CCL20 receptor, was observed in infiltrating lymphocytes and HCC cells in LR-HCC. There were significantly more CD3-positive cells than CD20-positive cells (P < 0.0001) in tumor-infiltrating lymphocytes, most of which were CD8-positive T cells. In conclusion, there were no significant differences in clinicopathological characteristics between LR-HCC and non-LR-HCC, except for gross and LR microscopic features. CCL20 expression in LR-HCC may contribute to infiltration of large numbers of CD8-positive lymphocytes.

PMID:37742944 | DOI:10.1016/j.humpath.2023.09.004

Hum Pathol. 2023 Sep 22:S0046-8177(23)00187-9. doi: 10.1016/j.humpath.2023.09.002. Online ahead of print.

ABSTRACT

Molecular research on large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC) has progressed significantly. However, there are still fewer molecular markers related to prognostic/therapeutic strategies for these conditions compared to those for adenocarcinoma. We therefore investigated the molecular characteristics of neuroendocrine carcinomas (NECs). We enrolled patients surgically diagnosed with NECs between 2011 and 2019, with complete follow-up records. All were analyzed using whole exome sequencing and p53/Rb immunohistochemistry (IHC). A total of 92 cases, comprising 45 pure SCLC, 15 combined SCLC, 27 pure LCNEC, and 5 combined LCNEC, were included. TP53 (78.3%) and RB1 (34.8%) were the most common molecular alterations, followed by KMT2D, LRP1B, FAT3, NCOR2, SPTA1, and NOTCH1. The mutation frequency for EGFR was 10.9%. Sixteen patients with LCNEC who had TP53/RB1 co-alterations were SCLC-like, while the remaining were NSCLC-like. There was no statistically significant difference between the groups regarding overall survival (OS; p=0.458) and progression-free survival (PFS; p=0.157). The frequency of the loss of Rb expression by IHC in SCLC-like LCNEC was 100%. Significant pathway alterations unique to SCLC included Notch and AMPK, while HIF-1 was enriched exclusively in LCNEC. NCOR2 mutation was linked to worse OS (p=0.029) and PFS (p=0.015), while wild-type SPTA1 was associated with poor PFS (p=0.018). IHC for Rb was reliable for predicting LCNEC molecular subtypes, indicating its clinical value. NCOR2 and SPTA1 alterations were identified as prognostic factors that may provide therapeutic targets for patients with NEC.

PMID:37742943 | DOI:10.1016/j.humpath.2023.09.002