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Metabolomic Profiling Reveals Distinct Pathways in Degenerated and Non-degenerated Rotator Cuff Tears: Implications for Pathogenesis and Treatment
No full textBackground Tissue metabolomics is a promising technology for evaluating in situ changes in disease pathogenesis. It addresses a significant knowledge gap in the study of both degenerated and non-degenerated supraspinatus (SSp) tendons. This study analyzed the metabolomic profiles associated with rotator cuff tears (RCTs).Purpose RCTs cause loss of function and shoulder pain, with the SSp muscle being the most frequently affected. Inflammation and complex metabolic changes may play roles in its etiology. Evaluation of the metabolomic differences between the degenerated and non-degenerated SSp tissues of RCT patients was aimed.Methods A cross-sectional study of 14 patients with RCTs, diagnosed through physical examination and magnetic resonance imaging, was conducted. Degenerate and non-degenerate SSp tissue debris were collected during arthroscopy. Untargeted metabolomic analysis of these samples was performed using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q-ToF-MS). Metabolic peaks were identified, matched, and normalized before further analysis. Partial least squares-discriminant analysis (PLS-DA), heatmap generation, unsupervised volcano plots, and fold-change analyses were conducted. A putative metabolite list was subsequently compiled to elucidate pathways of degeneration. These metabolites were matched with metabolic pathways using the RaMP-DB metabolite set library.Results The tyrosine metabolism (p=4.93 x10-4), ferroptosis (p=1.25 x10-3), steroidogenesis (p=9.89 x10-4), and cholesterol biosynthesis (p=3.05 x10-3) were altered in the degenerated RCTs.Conclusion These findings suggest that metabolomic alterations may be associated with the development of RCTs, with changes in tyrosine metabolism, ferroptosis, and lipid metabolism potentially contributing to muscle degeneration and inflammation. Identified disruptions in steroidogenesis provide new insights into the role of hormonal factors in RCT development. Understanding these metabolic pathways is clinically relevant in sports medicine, as it enables targeted therapies and personalized treatment strategies, ultimately enhancing recovery and improving outcomes for athletes
Seed morphology and its systematic implication in Noccaea s. l. (Brassicaceae)
No full textThe current research work was aimed to determine the macro-and micromorphological characters of seeds in Noccaea s.l. members and evaluate the potential phylogenetic utility of the seed coat character. Forty-two of the ca. 136 Noccaea s.l. species and one species of Thlaspi from 57 different accessions were investigated using light microscopy (LM) and scanning electron microscopy. Phylogenetic analysis was conducted by using internal transcribed spacer (ITS) DNA sequences obtained from NCBI. SEM studies revealed eight types (areolate, colliculate, ocellate, papillate, reticulate, ruminate, tuberculate and verrucate) of sculpture on the surface of the seeds and these types were found in species across different clades of the phylogenetic tree, indicating that the seed coat patterns of the examined specimens exhibit significant convergence. Our results revealed that the only synapomorphic characteristic for members of Noccaea s. l. is their non-ribbed seed surface, in contrast to the ribbed seed surface found in T. arvense. This research suggests that macro-and micromorphological characteristics of seeds are typically specific to individual species rather than to entire genera. Therefore, generic classifications based solely on seed characters may lead to inaccurate phylogenetic conclusions
Shortening antibiotic therapy duration for hospital-acquired bloodstream infections in critically ill patients: a causal inference model from the international EUROBACT-2 database
No full textIntroduction Hospital-acquired bloodstream infections (HA-BSIs) are severe and require antibiotic therapy. In non-complicated BSIs, shortened therapy reduces side effects without compromising efficacy. The impact of shortened antibiotic therapy in HA-BSI critically ill patients without indication of prolonged therapy requires further evaluation. Methods Using the international prospective EUROBACT-2 cohort, we compared shortened (7-10 days) versus long (14-21 days) treatment durations in ICU patients eligible for shortened therapy. Patients without antibiotic therapy within 3 days after HA-BSI occurrence or requiring prolonged therapy (due to infection source, microorganism, or clinical deterioration) were excluded. Treatment failure, defined as death, persistent infection, or subsequent infectious complications by Day 28, was assessed using an inverse-probability of treatment weighted (IPTW) logistic regression. Results Among 2600 patients, 550 were eligible for shortened treatment, 213 received short, and 337 received long treatment. The most common infection source was intravascular catheters (33%), most common microorganisms were Enterobacterales (39%). Patients with long treatment were more frequently infected with Staphylococcus aureus (11% vs. 5.6%, p = 0.025) or difficult-to-treat microorganisms (23% vs. 7%, p < 0.001), and received more commonly combination therapy (46% vs. 30%, p < 0.001). Short treatment was associated with reduced 28-day treatment failure (OR 0.64, 95% CI 0.44-0.93, p = 0.019), mainly due to reduction in subsequent infectious complications (OR 0.58, 95% CI 0.37-0.91, p = 0.018). Mortality (OR 0.92 [95% CI 0.59, 1.43], p = 0.7) and persistent infection rates (OR 0.47 [95% CI 0.17, 1.14], p = 0.12) were similar. Conclusions In selected ICU patients with HA-BSI, shortened antibiotic treatment might be considered. Eurobact2 was a prospective international cohort study, registered in ClinicalTrials.org (NCT03937245)
Polidocanol ablation in midventricular obstructive cardiomyopathy: novel approach and early outcomes.
No full textExperiences of final-year nursing students on simulation: a qualitative study
No full textSimulation is employed to facilitate instructional experiences in patient safety and nursing education for students. Through simulation, students endeavor to adapt to various scenarios and address associated challenges. The aim of the study was to examine final-year nursing students' experiences with scenario-based simulation. The Reporting Criteria for Consolidated Standards and Colaizzi's seven-step phenomenological data analysis method were employed. A qualitative study was conducted using a phenomenological research design. Content analysis conducted within the scope of simulation application yielded two main themes: 'Emotions, thoughts', and 'Challenges' related to simulation. It was ascertained that students underwent a spectrum of emotional and cognitive responses towards the simulation, encompassing both affirmative (enjoyable, realistic, educational, confidence-boosting) and adverse (stressful) dimensions. Concurrently, challenges related to treatment were noted, including the calculation of medication dosages for pediatric patients, the delivery of medication education to patients afflicted with dementia, and managing medication refusal exhibited by patients with bipolar disorder.The simulation with standardized patients administered to final-year nursing students prior to graduation can raise awareness of students' theoretical and practical deficiencies in clinical practice
SURİYELİ ANNELERDE EBEVEYN TÜKENMİŞLİĞİ, ÖZBAKIM ve MENTAL İYİLİK HALİ ARASINDAKİ İLİŞKİ
No full textPredicting the penetration rate of diamond core drilling of igneous rocks using P-wave velocity
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