bluuebunny/crossref_metadata_2025 huggingface dataset:
Unexpected oxidative cracking of diformyltricyclodecanes under catalyst-free and ultra-low temperature
Authors: Dun Linan , Yu Xinyu , Wang Han , Lin Pengmusen , Xiong Ziyao , Guo Xuqiang , Zhang Libo
Published: March 2023

The oxidative cracking of diformyltricyclodecanes (DFTD) to C6–C8 alkenes and alkenes were systematically studied in this work. A series of experiments was performed over a broad range of conditions (temperature: 40–60 °C; oxygen pressure: 0–1.0 Mpa; reaction time: 5–90 min, solvent selection) for exploring the reaction route and mechanism. Results show that the higher temperature and oxygen pressure, as well as tetrahydrofuran (THF) as solvent are of benefit to the generation of cracking products. In addition, the kinetics of this reaction was explored by the dynamic fitting. The obtained kinetics parameters demonstrate that the transformation of intermediate to cracking products possesses higher activation energy than to dicarboxyltricyclodecaneacids (DCTDA), showing that higher temperature is conducive to the generation of DFTD cracking products. This work firstly demonstrated that DFTD could be formed into C6-C8 alkenes containing the same as gasoline compound by the oxidative cracking, suggesting that the by-product of petroleum and coal could be transferred into fuels; this expanded the application of DCPD and will have significant and positive influence on the petroleum and coal chemical industry.
Crossed Product Equivalence of Quantum Automorphism Groups of Finite Dimensional C*-Algebras
Authors: Brannan Michael , Elzinga Floris , Harris Samuel J , Yamashita Makoto
Published: March 2023

We compare the algebras of the quantum automorphism group of finite-dimensional C$^\ast $-algebra $B$, which includes the quantum permutation group $S_N^+$, where $N = \dim B$. We show that matrix amplification and crossed products by trace-preserving actions by a finite Abelian group $\Gamma $ lead to isomorphic $\ast $-algebras. This allows us to transfer various properties such as inner unitarity, Connes embeddability, and strong $1$-boundedness between the various algebras associated with these quantum groups.
Putrescine Biosynthesis from Agmatine by Arginase (TtARG) in Thermus thermophilus
Authors: Kobayashi Teruyuki , Sakamoto Akihiko , Kashiwagi Keiko , Igarashi Kazuei , Takao Koichi , Uemura Takeshi , Moriya Toshiyuki , Oshima Tairo , Terui Yusuke
Published: March 2023

In the three domains of life, three biosynthetic pathways are known for putrescine. The first route is conversion of ornithine to putrescine by ornithine decarboxylase (ODC: SpeC), the second route is the conversion of arginine to agmatine by arginine decarboxylase (ADC: SpeA), followed by the conversion of agmatine to putrescine by agmatine ureohydrolase (AUH: SpeB), and the third route is the conversion of agmatine to N-carbamoylputrescine by agmatine deiminase (agmatine iminohydrolase, AIH), followed by the conversion of N-carbamoylputrescine to putrescine by N-carbamoylputrescine amidohydrolase (NCPAH). An extreme thermophile, Thermus thermophilus produces putrescine, although this bacterium lacks homologs for putrescine synthesizing pathways, such as ODC, AUH, AIH and NCPAH. To identify genes involved in putrescine biosynthesis in T. thermophilus, putrescine biosynthesis was examined by disruption of a predicted gene for agmatinase (agmatine ureohydrolase), or by using purified enzyme. It was found that arginase (TTHA1496) showed an agmatinase activity utilizing agmatine as a substrate. These results indicate that this bacterium can use arginase for putrescine biosynthesis. Arginase is a major contributor to putrescine biosynthesis under physiological conditions. The presence of an alternative pathway for converting agmatine into putrescine is functionally important for polyamine metabolism supporting survival at extreme environments.
Risk-reducing salpingo-oophorectomy for Japanese women with hereditary breast and ovarian cancer: a single-institution 10-year experience
Authors: Nagashima Minoru , Ishikawa Tetsuya , Asami Yuka , Hirose Yusuke , Shimada Kanae , Miyagami Satoshi , Mimura Takashi , Miyamoto Shingo , Onuki Mamiko , Morioka Miki , Izumi Mikiko , Yoshida Reiko , Yamochi Toshiko , Taruno Kanae , Nakamura Seigo , Sekizawa Akihiko , Matsumoto Koji
Published: March 2023

Background

For women diagnosed with hereditary breast and ovarian cancer, the clinical guidelines recommend risk-reducing salpingo-oophorectomy at age 35–40 years or after completion of childbearing. However, there is limited information regarding the current status of risk-reducing salpingo-oophorectomy in Japan.

Methods

To clarify factors influencing decision-making for risk-reducing salpingo-oophorectomy among Japanese women diagnosed with hereditary breast and ovarian cancer and their clinical outcomes, we analyzed the medical records of 157 Japanese women with germline BRCA pathogenic variants (BRCA1 n = 85, BRCA2 n = 71 and both n = 1) at our institution during 2011–21. Specimens obtained from risk-reducing salpingo-oophorectomy were histologically examined according to the sectioning and extensively examining the fimbriated end protocol.

Results

The risk-reducing salpingo-oophorectomy uptake rate was 42.7% (67/157). The median age at risk-reducing salpingo-oophorectomy was 47 years. Older age, married state and parity were significantly associated with risk-reducing salpingo-oophorectomy (P < 0.001, P = 0.002 and P = 0.04, respectively). History of breast cancer or family history of ovarian cancer did not reach statistical significance (P = 0.18 and P = 0.14, respectively). Multivariate analyses revealed that older age (≥45 years) and married state may be independent factors associated with risk-reducing salpingo-oophorectomy. Interestingly, the annual number of risk-reducing salpingo-oophorectomy peaked in 2016–17 and has increased again since 2020. The rate of occult cancers at risk-reducing salpingo-oophorectomy was 4.5% (3/67): ovarian cancer (n = 2) and serous tubal intraepithelial carcinoma (n = 1).

Conclusion

Age and marital status significantly affected decision-making for risk-reducing salpingo-oophorectomy. This is the first study to suggest possible effects of Angelina Jolie’s risk-reducing salpingo-oophorectomy in 2015 and the National Health Insurance introduced for risk-reducing salpingo-oophorectomy in 2020. The presence of occult cancers at risk-reducing salpingo-oophorectomy supports clinical guidelines recommending risk-reducing salpingo-oophorectomy at younger ages.
Survival and cause-specific mortality of coyotes in Wisconsin
Authors: Margenau Lydia L S , Russell Robin E , Hanrahan Alexander T , Roberts Nathan M , Price Tack Jennifer L , Storm Daniel J
Published: March 2023

Understanding the drivers of population dynamics informs management actions and assures the public that harvest activities are not detrimental to the long-term stability of wildlife populations. We examined the survival and cause-specific mortality of 66 adult coyotes (34 males, 32 females) using GPS radiotelemetry in southwestern Wisconsin during October 2016 to March 2020. We paired our study with a literature review of coyote survival and mortality across the United States and Canada, focusing on the geographical distribution of studies, demographic aspects of survival, and the level of exploitation by humans on coyote populations. In Wisconsin, annual survival did not differ between sexes or across years but did vary among seasons and social statuses. The relative risk for a coyote dying was higher during the winter compared to the summer. A transient coyote had a higher relative risk of mortality compared to a resident coyote. Mean annual survival probability (sexes combined) was higher for a year-long resident compared to a year-long transient. The predominant sources of known mortality (n = 37) were harvest (83.8%) and vehicle collisions (13.5%). For our literature review, we identified 56 studies estimating coyote survival or mortality from 1971 to 2021 spanning the geographic range of coyotes. We found no distinct temporal or regional patterns in survival probability or the proportion of human-induced mortality, although fewer studies originated from the northeast region of the United States. Additionally, we detected weak correlation between survival probability and proportion of human-induced mortality, suggesting coyote harvest may be compensatory. Although our findings indicate that the Wisconsin coyote population had relatively higher human-induced mortality than populations in other regions, these mortality rates appear to be sustainable for this population under current landscape and habitat conditions.
Sotrovimab Use in Young Pediatric Patients at High Risk of Progression to Severe COVID-19 Disease
Authors: White Elizabeth , Legg Amy , Bogart Alexandra , Graham Nicolette , Jebreen Faten , Clark Julia E
Published: March 2023

This retrospective analysis describes the administration of sotrovimab in 32 children (22 aged 12–16 years old; 10 aged 1–11 years old) who were at high risk of deterioration to severe COVID-19 disease. We provide dosing suggestions and demonstrate the feasibility of sotrovimab use in the younger pediatric population (<12 years old and <40 kg).
Real talk? The future of ChatGPT
Authors: Tarran Brian
Published: March 2023

One of the most impressive features of popular and controversial chatbot ChatGPT is its ability to sustain a conversation. Brian Tarran talks to Detlef Nauck, head of AI and data science research for BT’s Applied Research Division, about what this could mean for future developments.
Food poverty: a scale unimagined
Authors: Clarkson Dan
Published: March 2023

When Dan Clarkson volunteered to help at a UK food bank, he discovered how statistics and data analysis can help organisations assess need, plan for demand, and better understand the extent of food poverty
Editorial
Authors: Britten Anna
Published: March 2023

The Significance view on two divisive issues
Questions answered
Authors: Wan Alan
Published: March 2023

The president of the Hong Kong Statistical Society is also the head of a department with statistics as one of its core disciplines at the City University of Hong Kong
Lysergic acid diethylamide: In search of the wonder drug
Authors: Avram Mihai , Müller Felix , Borgwardt Stefan
Published: March 2023

Lysergic acid diethylamide (LSD) is a potent perception-altering chemical. Since the discovery of its effects almost eighty years ago, LSD has been revered and demonized. Before its ban in the late 1960s, LSD was used to model aspects of psychosis and treat distinct mental disorders such as alcohol addiction and anxiety. The new wave of research on psychedelics as potential treatments for mental disorders has revived interest in LSD. Recent clinical trials have demonstrated that LSD can be administered safely in a clinical context in healthy volunteers and various clinical groups. While research continues, small studies have identified potential therapeutic uses for LSD in tackling anxiety. LSD has a complex mechanism of action, affecting several neurotransmitter systems, but evidence indicates that its perception-altering effects are elicited via agonism at the 5-hydroxytryptamine 2A receptor (5-HT2A). Modern neuroimaging studies have revealed that LSD enhances signal diversity and complexity in the human brain. Functional magnetic resonance imaging (fMRI) studies have shown that LSD decreases the resting-state fMRI connectivity within several intrinsic brain networks while simultaneously increasing between-network connectivity, including aspects of thalamocortical connectivity. Recent evidence indicates that moderate to high doses of LSD have no long-lasting negative effects in healthy volunteers when administered in a clinical setting. Moreover, long-lasting positive outcomes have been reported for healthy volunteers. Whether LSD is a potential wonder drug to be used in treating various mental disorders is yet to be determined. Current studies are exploring putative therapeutic effects in several clinical populations, ranging from anxiety disorders and depression to cluster headaches.
The Answer Is Not Always a Medicine
Authors: Bernstein Carolyn
Published: March 2023

The chapter “The Answer is Not Always a Medicine” examines the complementary and integrative medicine approach to headache care. Studies from the National Center for Complementary and Integrative Health (NHCAM) have demonstrated that many patients are interested in non-drug therapies. Often, they will seek these treatments on their own, with little guidance or protection from non-evidenced treatments. Clinicians treating headache should be familiar with non-pharma options; these may be appropriate in addition to medication, or sometimes alone. Excellent resources exist for locating well-trained practitioners, and there is emerging evidenced-based data to support these therapies.
Looks Like a Stroke, Sounds Like a Stroke, But It’s a . . .
Authors: de Dhaem Olivia Begasse , Bernstein Carolyn
Published: March 2023

The chapter “Looks like a Stroke, Sounds like a Stroke, But It’s a . . .” presents a case of migraine with aura and discusses diagnosis, differential diagnosis, and management. The special considerations of migraine aura are discussed, such as cardiovascular risk factors, the use of estrogen-containing agents, and patent foramen ovale. This chapter discusses headaches that can mimic a stroke, discusses variants, when to be concerned and proper evaluation. There are important issues that are laid out and co-existing risk factors are reviewed as well. This chapter opens the differential for migraine variants and provides helpful details around evaluation and treatment concerns.
My Head Hurts Everyday
Authors: Gautreaux Jessica
Published: March 2023

The chapter “My Head Hurts Everyday” covers the diagnosis, evaluation, and management of new daily persistent headache (NDPH). NDPH is a rare primary headache disease, but it is important for clinicians to recognize. It is typified by a nonspecific headache which is continuous and unremitting from onset, the date of which most patients can recall with accuracy. Though the disease may have features that resemble other primary headache disorders such as migraine or tension-type headache, it appears to be a unique primary headache disease separate from these other well-recognized disorders. Unfortunately, NDPH has not been thoroughly studied at present, so little is understood about its pathogenesis and best treatment approaches, making it a notoriously refractory headache disorder.
Recurrent Thunderclap Headache
Authors: Mehla Sandhya
Published: March 2023

The book chapter “Recurrent Thunderclap Headache” discusses the work-up, differential diagnosis, and treatment of reversible cerebral vasoconstriction syndrome (RCVS). Thunderclap headache is an emergency which requires evaluation for subarachnoid hemorrhage (SAH) and intracranial aneurysm. In the absence of SAH and presence of triggers, especially when it is a recurrent thunderclap headache, diagnostic work-up for RCVS is warranted. Computed tomography angiogram (CTA) and magnetic resonance angiogram (MRA) are highly sensitive in detecting vasospasm. Common triggers for RCVS include vasoactive pharmacological agents, recreational drugs, postpartum state, and surgical manipulation. Standard of care includes withdrawing triggers, providing supportive care, and monitoring for complications with close follow-ups. Even though it is generally a benign condition with resolution of vasoconstriction in 3–6 months, severe complications like cerebral infarct, or intraparenchymal or convexal subarachnoid hemorrhage can occur. Nearly 50% of patients have residual post-RCVS headache, which commonly has migrainous features, and recurrence rate of RCVS is about 5%. Resumption of vasoactive substances after resolution of vasoconstriction is not recommended.
Basis for the discrimination of supercoil handedness during DNA cleavage by human and bacterial type II topoisomerases
Authors: Jian Jeffrey Y , McCarty Kevin D , Byl Jo Ann W , Guengerich F Peter , Neuman Keir C , Osheroff Neil
Published: March 2023

To perform double-stranded DNA passage, type II topoisomerases generate a covalent enzyme-cleaved DNA complex (i.e. cleavage complex). Although this complex is a requisite enzyme intermediate, it is also intrinsically dangerous to genomic stability. Consequently, cleavage complexes are the targets for several clinically relevant anticancer and antibacterial drugs. Human topoisomerase IIα and IIβ and bacterial gyrase maintain higher levels of cleavage complexes with negatively supercoiled over positively supercoiled DNA substrates. Conversely, bacterial topoisomerase IV is less able to distinguish DNA supercoil handedness. Despite the importance of supercoil geometry to the activities of type II topoisomerases, the basis for supercoil handedness recognition during DNA cleavage has not been characterized. Based on the results of benchtop and rapid-quench flow kinetics experiments, the forward rate of cleavage is the determining factor of how topoisomerase IIα/IIβ, gyrase and topoisomerase IV distinguish supercoil handedness in the absence or presence of anticancer/antibacterial drugs. In the presence of drugs, this ability can be enhanced by the formation of more stable cleavage complexes with negatively supercoiled DNA. Finally, rates of enzyme-mediated DNA ligation do not contribute to the recognition of DNA supercoil geometry during cleavage. Our results provide greater insight into how type II topoisomerases recognize their DNA substrates.
Making the Case for More Politicians: A Survey Experiment to Investigate Public Attitudes to an Expanded Welsh Parliament
Authors: Griffiths James D , Wyn Jones Richard , Poole Ed Gareth , Larner Jac M
Published: March 2023

In 2022, the Welsh Government announced plans to increase the size of the Welsh Parliament/Senedd Cymru, a culmination of two decades of elite-level argument over whether more members should parallel the institution’s growing suite of legislative and fiscal powers. While an expanded legislature may improve the Senedd’s capacity to scrutinise the executive, opposition has focused on increased costs that detract from core public spending. Using a novel survey experiment conducted in the 2021 Welsh Election Study, we assess public attitudes and find that support for expanding the Senedd is limited to those with a strong Welsh-only identity and pro-autonomy preferences. Although appeals to holding the executive to account do not broaden this base of support, a framing that the Senedd should be comparable in size to legislatures in Scotland and Northern Ireland does have a positive effect on voters with more median constitutional preferences.
The Chromite Crisis in the Evolution of Continental Magmas and the Initial High δ26Mg Reservoir
Authors: Xiao Yan , Yuan Meng , Su Ben-Xun , Chen Chen , Bai Yang , Ke Shan , Sun Yang , Robinson Paul T
Published: March 2023

Fractional crystallization of Fe–Ti oxides can induce detectable Mg isotopic changes during late-stage basalt differentiation. Because chromite and olivine are early crystallizing phases during basaltic melt differentiation, the effect of chromite crystallization on the fractionation of Mg isotopes during early-stage basalt differentiation is still poorly understood. Here, we examine the possibility of chromite induced Mg isotope fractionation with a Mg isotopic study of chromite–olivine pairs in dunites and chromitites collected from major types of basaltic intrusive rock suites formed by fractional crystallization in different tectonic settings. The chromite δ26Mg (= [(26Mg/24Mg)sample / (26Mg/24Mg)DSM3–1] × 1000) values range from −0.19‰ to 0.30‰ in the Luobusa ophiolite, −0.09‰ to 0.78‰ in the Kızıldağ ophiolite, −0.04 to 0.42‰ in the Gaositai Alaskan-type complex, similar to those previously reported from the Stillwater layered intrusion (−0.05 to 0.84‰; Bai et al., 2021). They are significantly higher than those of coexisting olivine (δ26Mg = −0.48 to −0.10‰). The Δ26MgChr-Ol (= δ26MgChr − δ26MgOl) values in the rock suites investigated here fall largely between equilibrium fractionation lines of spinel–olivine pairs and magnesioferrite–olivine pairs, indicating equilibrium Mg isotopic fractionation. Furthermore, the Δ26MgChr-Ol values increase with decreasing Cr content of chromite in the dunites and chromitites, showing that high 26Mg has a greater affinity to Al-rich chromite than Cr-rich chromite. Fractional crystallization of such isotopically high chromite is expected to progressively lower the Mg isotope values of the in the remaining magma. Furthermore, continental basaltic magmas typically experience early crystallization of olivine and Al-rich chromite. Their δ26Mg values correlate positively with MgO (FeO, Cr,) and CaO/Al2O3 ratios and negatively with total alkali contents (Na2O + K2O). This indicates that detectable Mg isotopic fractionation occurred in intra-continental basalt magmas, probably by fractional crystallization of olivine and chromite. The observed low-δ26Mg intra-continental basalts can be accurately modeled by olivine + chromite fractionation with fractionation factors (Δ26MgChr-Melt) of 0.20‰, 0.60‰, and 1.18‰ as observed in the chromitites investigated during this study. Therefore, the early-stage basaltic melt differentiation involving separation of olivine and chromite may induce resolvable Mg isotopic fractionation, and the δ26Mg values of continental basalts should be used with caution in petrogenetic studies.
The use of sodium-glucose cotransporter 2 inhibitors in heart failure with reduced or preserved ejection fraction: new guidelines hot off the press and directly into guidelines!
Authors: Clark Katherine A A
Published: March 2023

It is well known that the prevalence of heart failure (HF) is high and continues to grow. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, although initially developed as a therapy for type 2 diabetes, have been found to be beneficial in patients with HF, regardless of diabetic status. Given the clinical benefit demonstrated in recent large randomized clinical trials in those with HF, they have been rapidly incorporated into clinical practice and adopted by the national guidelines hot off the press. SGLT2 inhibitors are now recommended for patients with symptomatic HF, with any ejection fraction. These medications are generally very well tolerated by patients, and adverse effects include genital and soft tissue infections, euglycemic ketoacidosis, and volume depletion. SGLT2 inhibitors have now become a pillar of the pharmacologic treatment of HF, thus providers should be familiar with their use for not only those with type 2 diabetes, but also those with HF.
Hidden in the hills: phylogeny of the freshwater mussel genus Alasmidonta (Bivalvia: Unionidae) and description of a new species
Authors: Whelan Nathan V , Johnson Nathan A , Williams Ashantye’ S , Perkins Michael A , Beaver Caitlin E , Mays Jason W
Published: March 2023

Inaccurate taxonomy can lead to species in need of conservation being overlooked, which makes revisionary systematics crucially important for imperilled groups. The freshwater mussel genus Alasmidonta is one such group in need of study. Here, we take a multilocus phylogenetic approach to assess species-level taxonomy of Alasmidonta and test monophyly of this genus. Phylogenetic inference resulted in polyphyly of Alasmidonta. Lasmigona, which was included to test monophyly of Alasmidonta, was also polyphyletic. Species delimitation methods disagreed about whether Alasmidonta arcula, Alasmidonta triangulata and Alasmidonta undulata are distinct species, but all delimitation methods agreed that Alasmidonta harbours an undescribed species that would be considered Alasmidonta varicosa under current taxonomy. Given conflict among species delimitation methods and geographical separation, we maintain the current taxonomy for A. arcula and A. triangulata. The undescribed species is restricted to rivers of the Uwharrie Mountains region in North Carolina, USA that flow into the Pee Dee River from the east and can be distinguished morphologically from A. varciosa by higher and wider placed adductor mussels and a hooked pseudocardinal tooth. We offer insights into how supraspecific taxonomy of subtribe Alasmidontina might be resolved and formally describe the lineage from the Uwharrie Mountains region as Uwharrie elktoe, Alasmidonta uwharriensis sp. nov.
Dysplasia Epiphysealis Hemimelica in the Lower Extremity
Authors: LaBarge Matthew E. , Shirely Zachary , Rodgers Jennifer , Kuhn Andrew W. , Martus Jeffrey E. , Riccio Anthony I.
Published: March 2023

Background:

Because of the rarity of dysplasia epiphysealis hemimelica (DEH), little is known about the relationship between disease classification and clinical symptoms or patient outcomes. This studies therefore aims to characterize DEH of the lower extremity and correlate radiographic classification to presenting symptomatology and need for surgical intervention.

Methods:

A multi-center, retrospective review of all patients with DEH of the lower extremity over a 47-year period was conducted. Demographic data, presenting complaints, treatments, and symptoms at final follow-up were recorded. Radiographs were reviewed to classify lesions using the Universal Classification System for Osteochondromas (UCSO) and document the presence of solitary or multiple lesions within the involved joint. Correlative statistics were used to determine whether presenting complaints, lesion location or radiographic classification predicted the need for surgery or a pain-free outcome.

Results:

Twenty-eight patients met inclusion criteria with an average age at presentation of 7.8 years. The ankle was the most commonly affected joint with 20/28 patients (71%) having lesions of the talus, distal tibia, or distal fibula. Patients with chief complaints of pain were more likely to undergo surgery than those with complaints of a mass or deformity (P=0.03). Ankle lesions were more likely to be managed operatively than those of the hip or knee (P=0.018) and all 12 patients with talar lesions underwent surgery. Neither the number of lesions nor lesion classification was predictive of surgical intervention or a pain-free outcome after surgery. Patients presenting with pain were more likely to have a pain-free outcome (11/14 patients) after surgery (P=0.023) whereas all patients presenting with deformity who underwent surgery had pain at final follow-up.

Conclusions:

Although no single radiographic characteristic of DEH was predictive of surgical intervention or outcome, painful lesions of the ankle, and lesions of the talus were more likely to be managed operatively. Although surgery does not always result in a pain-free outcome, the operative management of painful lesions was more likely to provide a pain-free outcome than surgery for deformity or a mass.
Psilocybin facilitates fear extinction in mice by promoting hippocampal neuroplasticity
Authors: Du Yingjie , Li Yunfeng , Zhao Xiangting , Yao Yishan , Wang Bin , Zhang Liming , Wang Guyan
Published: March 2023

Background:

Posttraumatic stress disorder (PTSD) and depression are highly comorbid. Psilocybin exerts substantial therapeutic effects on depression by promoting neuroplasticity. Fear extinction is a key process in the mechanism of first-line exposure-based therapies for PTSD. We hypothesized that psilocybin would facilitate fear extinction by promoting hippocampal neuroplasticity.

Methods:

First, we assessed the effects of psilocybin on percentage of freezing time in an auditory cued fear conditioning (FC) and fear extinction paradigm in mice. Psilocybin was administered 30 min before extinction training. Fear extinction testing was performed on the first day; fear extinction retrieval and fear renewal were tested on the sixth and seventh days, respectively. Furthermore, we verified the effect of psilocybin on hippocampal neuroplasticity using Golgi staining for the dendritic complexity and spine density, Western blotting for the protein levels of brain derived neurotrophic factor (BDNF) and mechanistic target of rapamycin (mTOR), and immunofluorescence staining for the numbers of doublecortin (DCX)- and bromodeoxyuridine (BrdU)-positive cells.

Results:

A single dose of psilocybin (2.5 mg/kg, i.p.) reduced the increase in the percentage of freezing time induced by FC at 24 h, 6th day and 7th day after administration. In terms of structural neuroplasticity, psilocybin rescued the decrease in hippocampal dendritic complexity and spine density induced by FC; in terms of neuroplasticity related proteins, psilocybin rescued the decrease in the protein levels of hippocampal BDNF and mTOR induced by FC; in terms of neurogenesis, psilocybin rescued the decrease in the numbers of DCX- and BrdU-positive cells in the hippocampal dentate gyrus induced by FC.

Conclusions:

A single dose of psilocybin facilitated rapid and sustained fear extinction; this effect might be partially mediated by the promotion of hippocampal neuroplasticity. This study indicates that psilocybin may be a useful adjunct to exposure-based therapies for PTSD and other mental disorders characterized by failure of fear extinction.
Ultrathin Skin Grafting Versus Suction Blister Epidermal Grafting in the Treatment of Resistant Stable Vitiligo: A Self-Controlled Comparative Study
Authors: Ding Xiaolan , Sun Yifang , Wang Fang , Du Juan
Published: March 2023

BACKGROUND

Surgical therapies are effective methods to treat resistant stable vitiligo, with each method having advantages and disadvantages.

OBJECTIVE

This study aimed to compare the efficacy and safety of ultrathin skin grafting (UTSG) and suction blister epidermal grafting (SBEG) to treat stable vitiligo.

METHODS

A total of 15 patients with 45 vitiligo patches were recruited. Each vitiligo patch was divided in half; 1 half was treated by UTSG, whereas the other half was treated by SBEG. The patients were followed up monthly for 3 months to assess the repigmentation rate, relative melanin index (RMI), and relative erythema index (REI) at different timepoints.

RESULTS

Excellent repigmentation was observed in 97.8% of patches that underwent UTSG and 93.3% that underwent SBEG. The RMI and REI at 1, 2, and 3 months after the grafting procedure did not significantly differ between the 2 methods. At the recipient site, incomplete fall-off of the graft occurred in 4.4% of patches that underwent UTSG, whereas a “cobblestone appearance” was observed in 66.7% of patches that underwent SEBG. UTSG caused fewer complications at the donor site than SBEG.

CONCLUSION

Compared with SBEG, UTSG is faster and achieves better cosmetic outcomes at the recipient and donor sites.
Characterization of multi-DAA resistance using a novel hepatitis C virus genotype 3a infectious culture system
Authors: Fernandez-Antunez Carlota , Wang Kuan , Fahnøe Ulrik , Mikkelsen Lotte S. , Gottwein Judith M. , Bukh Jens , Ramirez Santseharay
Published: March 2023

Background and Aims:

The high HCV infection cure rates achieved with direct-acting antiviral (DAA) treatments could be compromised in the future by the emergence of antiviral resistance. Thus, it is essential to understand the viral determinants that influence DAA resistance, which is most prevalent in genotype 3. We aimed at studying how resistance to protease-, NS5A-, and NS5B-inhibitors influences the activities of glecaprevir/pibrentasvir, sofosbuvir/velpatasvir, and sofosbuvir/velpatasvir/voxilaprevir in cell culture, and how the HCV genome adapts to selective pressure by successive rounds of treatment failure.

Approach and Results:

A previously developed in vivo infectious cDNA clone of strain S52 (genotype 3a) was adapted to efficiently replicate and propagate in human hepatoma cells (Huh7.5) using 31 adaptive substitutions. DAA escape experiments resulted in the selection of S52 variants with decreased drug susceptibility (resistance), which was linked to the emergence of known resistance-associated substitutions (RASs). NS5A-inhibitor resistance was sufficient to promote treatment failure with double-DAA but not triple-DAA regimens. Enhanced viral fitness associated with the selection of sofosbuvir resistance accelerated escape from DAAs. After serial DAA treatment failure, HCV genetic evolution led to a complex genome-wide network of substitutions, some of which coevolved with known RASs.

Conclusions:

Baseline NS5A-RAS can compromise the efficacy of double-DAA pangenotypic regimens for HCV genotype 3, and enhanced viral fitness can accelerate treatment failure. Persistence of RASs after successive treatment failure is facilitated by the remarkable evolutionary capacity and plasticity of the HCV genome. Proof-of-concept for the potential development of multi-DAA resistance is shown.
Rhinovirus, When Is It More Than Just a Cold? Rhinovirus as a Cause of Organizing Pneumonia in Two Patients With Hematological Cancer
Authors: Vasiloudes Kritos P. , Greene John N.
Published: March 2023

Human rhinoviruses are pathogens that cause significant morbidity and economic strain from upper respiratory infections. Rhinovirus has also been associated with exacerbations of chronic lung disease. Less understood is the role of rhinovirus in organizing pneumonia (OP). Organizing pneumonia is a certain lung pattern of injury that occurs after injury to the pulmonary parenchyma, with infection being the most studied etiology. It typically presents with similar symptoms to pneumonia, and patients are often treated with antibiotics to lack of improvement. However, OP is more subacute in presentation, and the treatment, systemic glucocorticoids, differs from bacterial pneumonia. Recognition of rhinovirus as a significant pathogen in immunocompromised patients is important because it tends to cause more severe disease in this group. Here, we present a case series of 2 hematological malignancy patients with a long-standing rhinovirus infection and lung disease unresponsive to antibiotics, later found on biopsy to be OP.

Both patients survived the infection, and both patients had documented rhinovirus shedding for greater than 9 months. Both patients had lymphoma and were being actively treated with a monoclonal antibody that targeted cluster of differentiation 20. Both patients reported fever and dyspnea. Both patients had multiple superimposed bacterial infections, with both patients eventually developing Pseudomonas aeruginosa pneumonia. In the immunocompromised, rhinovirus may cause morbidity through a primary infection, a secondary bacterial infection, or OP. Novel treatment strategies and increased awareness are needed not only for rhinovirus-induced OP but also for rhinovirus as an important pathogen in immunocompromised patients.
Cannabis update: Anxiety disorders and post-traumatic stress disorder
Authors: Haycraft Amy L.
Published: March 2023

The development of anxiety disorders and post-traumatic stress disorder (PTSD) is complex. Both delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are of potential therapeutic use. Evidence suggests that cannabis has a beneficial effect on neural circuitry involved in fear regulation. In the United States, cannabis is considered either medical or recreational and can contain pure THC or CBD or any combination thereof. The numerous cannabis compounds of various administration routes, with variable pharmacokinetics, further affect the cannabis conundrum. Despite being federally unregulated, medical cannabis has received increased attention socially, and at present, 37 states, four territories, and the District of Columbia have legalized medical cannabis for use in specific health conditions. Patients are increasingly inquiring about cannabis, and clinicians must educate themselves with reliable cannabinoid information for patient education. In adults with anxiety disorders and PTSD, evidence supports a relatively safe profile for medical cannabis; however, conclusive scientific evidential support of its therapeutic properties is limited, resulting in a lack of standardization and Food and Drug Administration approval.
High positive rate after consecutive negative tests of SARS-CoV-2
Authors: Du Tingting , Wang Zhongliang
Published: March 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a global public health event since 2019. Real-time reverse transcription polymerase chain reaction (RT-PCR) assays of upper respiratory tract specimens were used as the most common method for confirmation of SARS-CoV-2. Patients diagnosed with coronavirus disease 2019 and hospitalized in Cancer Center of Wuhan Union Hospital were retrospectively enrolled. Epidemiological, clinical, and laboratory records were analyzed with highlights on the pattern of results of repeated RT-PCR tests. Nine hundred eighty-four patients admitted to hospital between February 13, 2020 to March 10, 2020 were enrolled. The median age was 62.0 years (interquartile range 49.0–68.0) and 44.5% was male. Three thousand-three hundred eleven specimens were collected for RT-PCR tests with a median of 3 tests (interquartile range 2.0–4.0) per patient. Three hundred sixty-two (36.8%) patients showed positive records from repeated RT-PCR tests. For the 362 confirmed patients, 147 cases received further RT-PCR tests after 2 consecutive negative records of SARS-CoV-2 and 38 (26%) of them obtained a positive result. Ten (23%) of 43 patients showed positive results after 3 consecutive negative tests and 4 (24%) of 17 patients were positive after 4 negative tests. Consecutive negative RT-PCR tests with respiratory specimens could not guarantee a viral clearance.
Imaging features of hyperacute intracerebral hemorrhage on multiple MRI sequences within 1 minute from onset during MRI examination: A case report
Authors: Bae Sang Bin , Kim Sanghyeon
Published: March 2023

Rationale:

Acute stroke requires accurate imaging to ensure appropriate treatment decisions and favorable clinical outcomes. Computed tomography has long been used as an exclusive imaging technique to assess intracerebral hemorrhage, owing to its rapid scanning time and widespread availability. Several recent studies have reported the reliable detection of hyperacute hemorrhage using magnetic resonance imaging (MRI).

Patient concerns:

An 88-year-old woman with a history of hypertension presented with mild, acute dysarthria. The National Institutes of Health Stroke Scale score was 1.

Diagnoses:

Non contrast head computed tomography revealed the absence of acute cerebral hemorrhage. The patient underwent magnetic resonance, revealed hyperacute intracerebral hemorrhage within a few minutes of its occurrence on multiple MRI sequences.

Interventions and outcomes:

In this patient, hemorrhage developed during MRI for acute ischemic stroke. Hemorrhage was initially misdiagnosed, and inappropriate treatment severely affected the patient’s health.

Lessons:

Clinicians in the Department of Neurological Emergency should be familiar with imaging findings of hyperacute hemorrhage on multiple MRI sequences.
Bilateral medial medullary infarction with intravenous thrombolytic therapy: A case report
Authors: Fan Mingyue , Gao Junshu , Li Na , Jin Wei , Liu Yang , Zhang Xueqian , Lv Peiyuan
Published: March 2023

Rationale:

Bilateral medial medullary infarction is a rare stroke subtype. To investigate its clinical manifestations, etiology, imaging features and thrombolytic effect, We here in reported a patient with acute ischemic stroke in the bilateral medial medullary and reviewed the related literatures.

Patients concern:

A 64-year-old female was taken to our hospital after 4.5 hours of dizziness in the morning, followed by somnolence and limb weakness. She gradually worsened into a rapidly progressive tetraparesis and slurred speech.

Diagnoses:

Diffusion weighted imaging exhibited a “heart appearance” sign in bilateral medial medulla oblongata, and high-resolution magnetic resonance imaging suggested the left vertebral artery-4 thromboembolism.

Interventions:

Timely intravenous thrombolysis was performed.

Outcome:

After intravenous thrombolysis, the patient’s symptoms did not worsen in a short time. Although the symptoms were aggravated in the later stage, they were alleviated after active treatment.

Lessons:

Diffusion weighted imaging can assist in the early diagnosis of bilateral medial medullary infarction, which will help in the decision to proceed with intravenous thrombolysis therapy. High-resolution magnetic resonance imaging should be improved as soon as possible, which can provide basis for the next intravascular interventional therapy.
Effectiveness of drug-coated balloon in acute myocardial infarction: A protocol for systematic review and meta-analysis
Authors: Yu Aili , Liu Hong , Yu Haiyan , Xiong Xue
Published: March 2023

Background:

The management of acute myocardial infarction (AMI) has improved dramatically over the past 3 decades and is evolving. Percutaneous coronary intervention is an alternative means of achieving coronary revascularization. Previous studies comparing the published literature on drug-coated balloon (DCB) and drug-eluting stents have drawn divergent conclusions. We perform a protocol for systematic review and meta-analysis to compare the efficacy and safety of DCB and drug-eluting stent in the management of AMI.

Methods:

This systematic review was registered in the PROSPERO network (registration number: CRD42023397266). We will follow the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocol to accomplish the systematic review protocol. A systematic search will be conducted in PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, Wanfang Database, and Weipu Database without any language restrictions from their inception to February 2022. The risk of bias will be assessed independently by 2 authors using parameters defined in the Cochrane Handbook for Systematic Reviews of Interventions criteria. Statistical analysis will be performed using the STATA13.0 software (IBM, USA).

Results:

The results of this systematic review and meta-analysis will be publicly available and published in a peer-reviewed journal.

Conclusion:

The results of the study will provide the evidence for the application of DCB in the treatment of AMI.
Multimorbidity, healthcare utilization, and quality of life for older patients undergoing surgery: A prospective study
Authors: Thanakiattiwibun Chayanan , Siriussawakul Arunotai , Virotjarumart Tithita , Maneeon Satanun , Tantai Narisa , Srinonprasert Varalak , Chaiwat Onuma , Sriswasdi Patcharee
Published: March 2023

Multimorbidity (≥2 chronic illnesses) is a worldwide healthcare challenge. Patients with multimorbidity have a reduced quality of life and higher mortality than healthy patients and use healthcare resources more intensively. This study investigated the prevalence of multimorbidity; examined the effects of multimorbidity on healthcare utilization; healthcare costs of multimorbidity; and compared the associations between the health-related quality of life (HRQoL) of older patients undergoing surgery and multimorbidity, the Charlson Comorbidity Index (CCI), the Simple Frailty Questionnaire (FRAIL), and the American Society of Anesthesiologists (ASA) physical status classifications. This prospective cohort study enrolled 360 patients aged > 65 years scheduled for surgery at a university hospital. Data were collected on their demographics, preoperative medical profiles, healthcare costs, and healthcare utilization (the quantification or description of the use of services, such as the number of preoperative visits, multiple-department consultations, surgery waiting time, and hospital length of stay). Preoperative-assessment data were collected via the CCI, FRAIL questionnaire, and ASA classification. HRQoL was derived using the EQ-5D-5L questionnaire. The 360 patients had a mean age of 73.9 ± 6.6 years, and 37.8% were men. Multimorbidity was found in 285 (79%) patients. The presence of multimorbidity had a significant effect on healthcare utilization (≥2 preoperative visits and consultations with ≥2 departments). However, there was no significant difference in healthcare costs between patients with and without multimorbidity. At the 3-month postoperative, patients without multimorbidity had significantly higher scores for HRQoL compared to those with multimorbidity (HRQoL = 1.00 vs 0.96; P < .007). While, patients with ASA Class > 2 had a significantly lower median HRQoL than patients with ASA Class ≤2 at postoperative day 5 (HRQoL = 0.76; P = .018), 1-month (HRQoL = 0.90; P = .001), and 3-months (HRQoL = 0.96; P < .001) postoperatively. Multimorbidity was associated with a significant increase in the healthcare utilization of the number of preoperative visits and a greater need for multiple-department consultations. In addition, multimorbidity resulted in a reduced HRQoL during hospital admission and 3-months postoperatively. In particular, the ASA classification > 2 apparently reduced postoperative HRQoL at day 5, 1-month, and 3-months lower than the ASA classification ≤2.
Extra-gastrointestinal stromal tumors (EGISTs): A case report for a mischief entity
Authors: El Charif Mohamad Hadi , Amro Sara , Boulos Fouad , Khalife Mohamad , Shamseddine Ali , Assi Hazem , Sbaity Eman
Published: March 2023

Background:

Extra-gastrointestinal stromal tumor is a rare subtype of soft tissue sarcomas with significantly variable presentation, management, and prognosis. This makes it crucial to report the different institutional experiences of encountering extra-gastrointestinal stromal tumors (EGIST).

Case presentation:

We report 3 cases of EGIST diagnosis at American University of Beirut Medical Center for 2 males and 1 female in the 5th, 6th, and 7th decades of life, respectively. For the first case, the tumor was initially suspected to be ovarian cancer, but biopsy revealed a diagnosis of EGIST, and the patient was started on neoadjuvant therapy. In the second case, the tumor was retro-gastric and prelim diagnosis was gastric cancer but again biopsy revealed an EGIST histopathology, and the patient underwent surgery and adjuvant treatment. For the third case, a previous history of testicular cancer prompted an initial suspicion of recurrence with metastasis but biopsy and immunohistochemistry staining revealed EGIST with related markers. The patient underwent treatment at a different institution in his home country.

Conclusion:

This report sheds light on the importance of keeping EGIST amongst any differential list for abdominal and pelvic tumors. It also shows that EGIST-focused studies are needed to assess the effectiveness of the different treatment modalities available when utilized specifically for EGIST. This would allow for better oncological outcomes and improved quality of life.