bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of periastron passage on the X-ray and optical properties of the Symbiotic System R Aquarii
Authors: Vasquez-Torres D A , Toalá J A , Sacchi A , Guerrero M A , Tejeda E , Karovska M , Jr R Montez
Published: November 2024

Multi-epoch Chandra and XMM–Newton observations of the symbiotic system R Aquarii (R Aqr) spanning 22 yr are analysed by means of a reflection model produced by an accretion disc. This methodology helps dissecting the contribution from different components in the X-ray spectra of R Aqr: the soft emission from the jet and extended emission, the heavily extinguished plasma component of the boundary layer and the reflection contribution, which naturally includes the 6.4 keV Fe fluorescent line. The evolution with time of the different components is studied for epochs between September 2000 and December 2022, and it is found that the fluxes of the boundary layer and that of the reflecting component increase as the stellar components in R Aqr approach periastron passage, a similar behaviour is exhibited by the shocked plasma produced by the precessing jet. Using publicly available optical and UV data we are able to study the evolution of the mass-accretion rate $\dot{M}_\mathrm{acc}$ and the wind accretion efficiency $\eta$ during periastron. These exhibit a small degree of variability with median values of $\dot{M}_\mathrm{acc}$=7.3$\times 10^{-10}$ M$_\odot$ yr$^{-1}$ and $\eta$=7$\times 10^{-3}$. We compare our estimations with predictions from a modified Bondi–Hoyle–Lyttleton accretion scenario.
Time-dependent metal ionization and the persistence of collisionally excited emission lines in the diffuse ionized gas of star-forming galaxies
Authors: McCallum Lewis , Wood Kenneth , Benjamin Robert , Krishnarao Dhanesh , Vandenbroucke Bert
Published: November 2024

We extend our time-dependent hydrogen ionization simulations of diffuse ionized gas to include metals important for collisional cooling and diagnostic emission lines. The combination of heating from supernovae and time-dependent collisional and photoionization from mid-plane OB stars produces emission line intensities (and emission line ratios) that follow the trends observed in the Milky Way and other edge-on galaxies. The long recombination times in low-density gas result in persistent large volumes of ions with high ionization potentials, such as O iii and Ne iii. In particular, the vertically extended layers of Ne iii in our time-dependent simulations result in [Ne iii] 15 $\mu$m/[Ne ii] 12 $\mu$m emission line ratios in agreement with observations of the edge-on galaxy NGC 891. Simulations adopting ionization equilibrium do not allow for the persistence of ions with high ionization states and therefore cannot reproduce the observed emission lines from low-density gas at high altitudes.
Rediscovering publicly available single-cell data with the DISCO platform
Authors: Li Mengwei , Ang Kok Siong , Teo Brian , Rom Uddamvathanak , Nguyen Minh N , Maurer-Stroh Sebastian , Chen Jinmiao
Published: November 2024

Single-cell RNA sequencing (scRNA-seq) has emerged as the key technique for studying transcriptomics at the single-cell level. In our previous work, we presented the DISCO database (https://www.immunesinglecell.org/) that integrates publicly available human scRNA-seq data. We now introduce an enhanced version of DISCO, which has expanded fourfold to include >100 million cells from >17 thousand samples. It provides uniformly realigned read count tables, curated metadata, integrated tissue and phenotype specific atlases, and harmonized cell type annotations. It also hosts a single-cell enhanced knowledgebase of cell type ontology and gene signatures relating to cell types and phenotypes. Lastly, it offers a suite of tools for data retrieval, integration, annotation, and mapping, allowing users to construct customized atlases and perform integrated analysis with their own data. These tools are also available in a standalone R package for offline analysis.
MDRepo—an open data warehouse for community-contributed molecular dynamics simulations of proteins
Authors: Roy Amitava , Ward Ethan , Choi Illyoung , Cosi Michele , Edgin Tony , Hughes Travis S , Islam Md Shafayet , Khan Asif M , Kolekar Aakash , Rayl Mariah , Robinson Isaac , Sarando Paul , Skidmore Edwin , Swetnam Tyson L , Wall Mariah , Xu Zhuoyun , Yung Michelle L , Merchant Nirav , Wheeler Travis J
Published: November 2024

Molecular Dynamics (MD) simulation of biomolecules provides important insights into conformational changes and dynamic behavior, revealing critical information about folding and interactions with other molecules. The collection of simulations stored in computers across the world holds immense potential to serve as training data for future Machine Learning models that will transform the prediction of structure, dynamics, drug interactions, and more. Ideally, there should exist an open access repository that enables scientists to submit and store their MD simulations of proteins and protein-drug interactions, and to find, retrieve, analyze, and visualize simulations produced by others. However, despite the ubiquity of MD simulation in structural biology, no such repository exists; as a result, simulations are instead stored in scattered locations without uniform metadata or access protocols. Here, we introduce MDRepo, a robust infrastructure that provides a relatively simple process for standardized community contribution of simulations, activates common downstream analyses on stored data, and enables search, retrieval, and visualization of contributed data. MDRepo is built on top of the open-source CyVerse research cyber-infrastructure, and is capable of storing petabytes of simulations, while providing high bandwidth upload and download capabilities and laying a foundation for cloud-based access to its stored data.
C9orf72 repeat expansion creates the unstable folate-sensitive fragile site FRA9A
Authors: Mirceta Mila , Schmidt Monika H M , Shum Natalie , Prasolava Tanya K , Meikle Bryanna , Lanni Stella , Mohiuddin Mohiuddin , McKeever Paul M , Zhang Ming , Liang Minggao , van der Werf Ilse , Scheers Stefaan , Dion Patrick A , Wang Peixiang , Wilson Michael D , Abell Theresa , Philips Elliot A , Sznajder Łukasz J , Swanson Maurice S , Mehkary Mustafa , Khan Mahreen , Yokoi Katsuyuki , Jung Christine , de Jong Pieter J , Freudenreich Catherine H , McGoldrick Philip , Yuen Ryan K C , Abrahão Agessandro , Keith Julia , Zinman Lorne , Robertson Janice , Rogaeva Ekaterina , Rouleau Guy A , Kooy R Frank , Pearson Christopher E
Published: November 2024

The hyper-unstable Chr9p21 locus, harbouring the interferon gene cluster, oncogenes and C9orf72, is linked to multiple diseases. C9orf72 (GGGGCC)n expansions (C9orf72Exp) are associated with incompletely penetrant amyotrophic lateral sclerosis, frontotemporal dementia and autoimmune disorders. C9orf72Exp patients display hyperactive cGAS-STING-linked interferon immune and DNA damage responses, but the source of immunostimulatory or damaged DNA is unknown. Here, we show C9orf72Exp in pre-symptomatic and amyotrophic lateral sclerosis-frontotemporal dementia patient cells and brains cause the folate-sensitive chromosomal fragile site, FRA9A. FRA9A centers on >33 kb of C9orf72 as highly compacted chromatin embedded in an 8.2 Mb fragility zone spanning 9p21, encompassing 46 genes, making FRA9A one of the largest fragile sites. C9orf72Exp cells show chromosomal instability, heightened global- and Chr9p-enriched sister-chromatid exchanges, truncated-Chr9s, acentric-Chr9s and Chr9-containing micronuclei, providing endogenous sources of damaged and immunostimulatory DNA. Cells from one C9orf72Exp patient contained a highly rearranged FRA9A-expressing Chr9 with Chr9-wide dysregulated gene expression. Somatic C9orf72Exp repeat instability and chromosomal fragility are sensitive to folate deficiency. Age-dependent repeat instability, chromosomal fragility and chromosomal instability can be transferred to CNS and peripheral tissues of transgenic C9orf72Exp mice, implicating C9orf72Exp as the source. Our results highlight unappreciated effects of C9orf72 expansions that trigger vitamin-sensitive chromosome fragility, adding structural variations to the disease-enriched 9p21 locus, and likely elsewhere.
MID1-COMPLEMENTING ACTIVITY regulates cell proliferation and development via Ca2+ signaling in Marchantia polymorpha
Authors: Iwano Megumi , Suetsugu Noriyuki , Nishihama Ryuichi , Ishida Sakiko , Horie Tomoaki , Costa Alex , Katsuno Tatsuya , Kimura Midori , Iida Kazuko , Iida Hidetoshi , Nagai Takeharu , Kohchi Takayuki
Published: November 2024

MID1-COMPLEMENTING ACTIVITY (MCA) is a land plant-specific, plasma membrane protein, and Ca2+ signaling component that responds to exogenous mechanical stimuli, such as touch, gravity, and hypotonic-osmotic stress, in various plant species. MCA is essential for cell proliferation and differentiation during growth and development in rice (Oryza sativa) and maize (Zea mays). However, the mechanism by which MCA mediates cell proliferation and differentiation via Ca2+ signaling remains unknown. Here, we address this question using the liverwort Marchantia polymorpha. We show that the M. polymorpha MCA ortholog, MpMCA, is highly expressed in actively dividing regions, such as apical notches in the thalli and developing gametangiophores, and that MpMCA is a plasma membrane protein. In vivo, Ca2+ imaging using a Ca2+ sensor (yellow cameleon) revealed that MpMCA is required for maintaining proper [Ca2+]cyt levels in the apical notch region, egg cells, and antheridium cells. Mpmca mutant plants showed severe cell proliferation and differentiation defects in the thalli, gametangiophores, and gametangia, resulting in abnormal development and unsuccessful fertilization. Furthermore, expression of the Arabidopsis MCA1 gene complemented most of the defects in the growth and development of the Mpmca mutant plants. Our findings indicate that MpMCA is an evolutionarily conserved Ca2+-signaling component that regulates cell proliferation and development across the life cycle of land plants.
A noetic account of explanation in mathematics
Authors: D’Alessandro William , Lehet Ellen
Published: November 2024

We defend a noetic account of intramathematical explanation. On this view, a piece of mathematics is explanatory just in case it produces understanding of an appropriate type. We motivate the view by presenting some appealing features of noeticism. We then discuss and criticize the most prominent extant version of noeticism, due to Inglis and Mejía Ramos, which identifies explanatory understanding with the possession of well-organized cognitive schemas. Finally, we present a novel noetic account. On our view, explanatory understanding arises from meeting specific explanatory objectives. We defend a cluster-concept account of explanatory objectives and identify four important subfamilies within the relevant network of resemblance relations. The resulting view is objectivist (in the sense that it takes explanatory success to be a matter of observer-independent fact), broader in scope than why-question-based accounts, compatible with empirical findings on experts’ explanatory judgments, and capable of generalizing (with appropriate provisos) to scientific explanation as a whole. It thus fulfills Friedman’s half-century-old demand for a general and objectivist theory, which accounts for the link between explanation and understanding.
Electoral Turnovers
Authors: Marx Benjamin , Pons Vincent , Rollet Vincent
Published: November 2024

In most national elections, voters face a key choice between continuity and change. Electoral turnovers occur when the incumbent candidate or party fails to win reelection. To understand how turnovers affect national outcomes, we study all presidential and parliamentary elections held globally between 1946 and 2018. We document the prevalence of turnovers over time and estimate their effects on economic performance, human development, and the quality of democracy. Using a close-elections regression discontinuity design across countries, we show that turnovers improve several measures of country performance. To explain these positive effects, we explore how electoral turnovers affect leader characteristics, shape policy decisions, reduce perceived corruption, and foster accountability.
Clinical course of paediatric-onset Behçet’s disease in young adulthood
Authors: Bozkurt Tugce , Yildiz Mehmet , Deniz Rabia , Yazici Ayten , Karabacak Murat , Karatas Hakan , Kutluğ-Ağaçkıran Seda , Gunalp Aybuke , Kilic Konte Elif , Şahin Sezgin , Koker Oya , Barut Kenan , Bes Cemal , Cefle Ayse , Ergun Tulin , Direskeneli Haner , Kasapçopur Özgür , Alibaz-Oner Fatma
Published: November 2024

Objectives

Although Behçet’s disease (BD) typically manifests in the second or third decade of life, initial symptoms may appear at a younger age. It may also take a longer time for the full disease phenotype to develop after the first symptom onset in paediatric patients. In this study, the objective was to assess the clinical course of paediatric-onset BD in young adult period.

Methods

The files of 112 patients diagnosed with BD before the age of 18, selected from five tertiary clinics, were retrospectively examined. Patients with a follow-up of less than 6 months were excluded.

Results

The study comprised 93 patients with paediatric-onset BD, of whom 64.5% (n = 60) were male. The median age of diagnosis was 15 years (13–17). Major organ involvement was present in 49 (52.5%) patients. The most commonly affected organ was the eye (29%). Sixty-eight patients (73.1%) had follow-up data in adulthood. Forty patients had only mucocutaneous manifestations in the paediatric period. During follow-up in adulthood, 15 (53.3% were male) had new major organ involvement, at a mean of 10.1 (s.d.: 7.9) years after diagnosis. Twenty-eight patients (41.1%) experienced major organ involvement during the paediatric period. In follow-up during adulthood, 12 (42.8%) developed new major organ involvement and/or relapse of the same organ. Eighteen (26.5%) of 68 paediatric-onset BD patients had new major organ involvement, and 9 (13.2%) had a relapse during follow-up in adulthood.

Conclusion

Our results showed that nearly one-third of paediatric BD patients have a new major organ involvement or a relapse in adulthood. Regular follow-up of paediatric BD patients in adulthood is essential for preventing long-term damage in this disease subset.
Dismantling labour markets from above: the case of wage policy in the European Union
Authors: Guidi Mattia , Guardiancich Igor
Published: November 2024

Are countries reforming their labour market constrained by external political or financial institutions? This article analyses the supranational pressures impacting wage policy in European member states. Theoretically, it takes inspiration from the literature on international financial markets to analyse the key phases of a nascent multi-level policy cycle, where the European Commission plays a pivotal role. Empirically, it distinguishes between wage policy prescriptions (CSR database, 2011–2019, complemented with EUR-Lex) and reform events (LabRef database, 2008–2019) granting more or less protection to workers. Methodologically, it employs mixed regression models with country and year random intercepts finding out that: (a) the Commission, when recommending wage policy, unambiguously prefers reforms reducing workers’ protection, thus displaying preferences aligned with those of international financial institutions; (b) through external conditionality, the pressures stemming from such biased approach exert a tangible impact on national policymaking, ultimately resulting in weakened labour market institutions and reduced well-being of workers.
Time–space control: explaining subnational variation in Thailand’s guestwork regimes
Authors: Palmgren Pei
Published: November 2024

How do states control labor migration? Furthering global trends, nation states increasingly seek to include foreigners in labor markets while excluding them from settling. Yet, dominant theories maintain a limited conception of migration control as primarily immigrant restriction, especially in the global North. Thailand offers a paradigmatic case for understanding labor migration control and the dual goal of inclusion–exclusion it entails. While migrants generally face rigid limits on their immigration status, the Thai state shows internal variation in how it manages their inclusion as workers: in some places, authorities more strictly regulate time limits of documents, while in others, they focus on control of boundaries around migrant spatial access. Drawing from ethnographic fieldwork in two sites, this article examines this regulatory variation to inform a more general understanding of guestwork control in global context. Comparing two subnational regimes, I show that the state must respond to multiple forces from above and below when controlling labor migration, requiring subnational regulatory differences, and fostering contrasting means of labor reproduction. Findings suggest that differential subnational incorporation into regional and global economies can shape differences in the time–space control of migrant workers and the conditions of noncitizenship that come with it.
The potency of the OHADA law in the African digital economy
Authors: Djieufack Roland
Published: November 2024

There are various technological developments or innovations that have (or will in the future) radically transform business transactions and the way in which people work, enter into contracts, and fulfil their contractual obligations. The principal focus of this article is to analyse the shortfall of the Organisation for the Harmonisation of Business Laws in Africa’s (OHADA) law, through its Uniform Act on General Commercial Law, in failing to embrace new technologies in a trending digital era when applying traditional contract laws rules to the buying and selling of goods. This is significant because the Uniform Act, as a tool for the regulation of cross-border sale of goods contracts, has been put to the test. Although the scope of the OHADA Uniform Act on General Commercial Law is not extensive to new technologies, this article probes the question as to whether the pulse of technology poses a challenge for the traditional 20th-century rules under OHADA. In other words, is the statute robust enough to reflect the modern digital world, or will it become outdated if it is not revamped or supplemented by other conventions to accommodate new technologies and ways of conducting business? This study uses an in-depth critical analysis of the provisions of the Uniform Act in order to ascertain its potency as it concludes that it is imperative in this modern digital age for such a statute to embody technological innovations for the efficient conduct of transnational businesses.
Photosynthesis Responses to the Infection with Plant Pathogens
Authors: Cheaib Alissar , Killiny Nabil
Published: November 2024

Photosynthesis, the remarkable process by which green plants synthesize nutrients using light energy, plays a crucial role in sustaining life on Earth. However, the effects of pathogens on photosynthesis are not widely understood. In general, a reduction of photosynthesis occurs upon the infection with pathogens. Two main scenarios are responsible for the reduction in photosynthetic capacity. In the first scenario, the pathogen attacks green aerial tissues, such as when caused by fungal and bacterial leaf spots and blights, which affect photosynthesis by destroying green leaf tissue or causing defoliation. This leads to a decrease in the photosynthetic area, ultimately reducing photosynthesis. Interestingly, even when the overall chlorophyll content of leaves is significantly reduced due to pathogen invasion, the remaining chlorophyll-containing leaf area may maintain or even enhance its photosynthetic efficiency. This compensatory mechanism helps mitigate the loss of photosynthetic area. However, the overall yield of the plant is still affected. The second scenario is a reduction in chlorophyll content due to chlorosis, which is characterized by yellowing of leaves. It is a common symptom of plant diseases. It refers to a reduction in the amount of chlorophyll per chloroplast rather than a decrease in chloroplast number. Diseases caused by viruses and phytoplasmas often exhibit chlorosis. While pathogens disrupt photosynthesis, plants exhibit significant adaptations to cope with these challenges. Understanding these interactions is essential for sustainable agriculture and ecosystem health. Thus, in this review, we discuss the effect of several pathogens on the photosynthesis processes and efficiency in detail.

[Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Double-stranded RNAs targeting Sphaerulina musiva silence DCL but not CYP51 in vitro, and fail to confer resistance to canker in transgenic poplar
Authors: Gordon Michael I. , Ma Cathleen , Busby Posy E. , Strauss Steven H. , LeBoldus Jared M.
Published: November 2024

Host-induced gene silencing (HIGS) is a common method for engineering plant protection against pathogens, although success requires double-stranded (dsRNA) uptake mechanisms that may not be present in all fungi. We explored HIGS in transgenic poplar to study and control Sphaerulina musiva, the cause of Septoria stem canker disease. HIGS transgenic poplars expressing dsRNA that targeted either or both S. musiva CYP51 and DCL were developed and screened for resistance to stem canker disease in two greenhouse inoculation trials. While differences in resistance between transgenic lines and wild-type controls were not detected, there was a correlation between greenhouse-expressed disease resistance and transgene expression among HIGS lines targeting S. musiva DCL. To evaluate the likelihood that HIGS or spray-induced gene silencing might be effective under some conditions, concurrent with greenhouse screening we studied: 1) S. musiva’s capacity for uptake of environmental dsRNA; 2) effects of in vitro silencing of CYP51 and DCL on fungal growth and target transcript abundance; and 3) persistence of dsRNA in culture. Uptake of fluorescently tagged dsRNA was not detected with confocal imaging. In dsRNA-treated cultures, fungal growth inhibition was not detected, and RNA was rapidly degraded. Of the five target transcripts tested after dsRNA treatment, only DCL1 had reduced expression. Knockdown of DCL1 along with the enhanced resistance among high-expressing HIGS events targeting DCL suggests some HIGS may have been observed. Further determination of the factors limiting dsRNA uptake by S. musiva are needed to determine if HIGS can be an effective technology for limiting stem canker.
Aspartame enhances the scavenging activity of mice to low‐dose Escherichia coli infection via strengthening macrophage phagocytosis caused by sweet taste receptor activation
Authors: Liu Yulin , Huang Yilin , Yang Wei , Hu Weiqing , Wu Zhizhongbin , Wu Tianyue , Pu Yu , Jiang Yunbin , Zhu Huifeng , Zhang Jifen , Cheng Fang , Feng Shan
Published: November 2024

Aspartame is the most common artificial sweetener and a famous sweet‐taste receptor agonist. Macrophages are essential in the antibacterial system to maintain the stability of the intestinal environment. Recently, the sweet taste receptor has been found in macrophages. However, the effects of aspartame on macrophage phagocytosis in the gastrointestinal tract are little known. The current study sought to assess the influence of aspartame intake on the scavenging activity of mice to low‐dose Escherichia coli infection and related mechanisms. Firstly, no inflammatory response or pathological injury was observed in the intestines of mice after oral administration of aspartame (25–100 mg/kg, i.g.) for 2 weeks. Subsequently, aspartame intake was found to enhance the scavenging activity of mice to low‐dose E. coli infection. Similarly, aspartame dose‐dependent strengthened the ability of RAW264.7 cells to phagocytose GFP‐E.coli J96. Further mechanism evaluation reflected that aspartame could enhance macrophage phagocytosis, migration, and rearrangement via PLCβ‐2/Ca2+/PKCβ/Rho A/ROCK1 pathway caused by sweet taste receptor activation. In conclusion, the present study, for the first time, demonstrated that aspartame could enhance the scavenging activity of mice to low‐dose E. coli infection via strengthening macrophage phagocytic function through activating sweet taste receptor. It is then suggested that aspartame may affect the antibacterial activity of human gastrointestinal macrophages, and further studies need to validate these effects.
Cardiac Implantable Electronic Devices in Cardiac Transplant Patients: A Comprehensive Review
Authors: Khan Shayan , Abdo Dana Badry Faried Khaled , Mushtaq Varda , Ahmed Najeeb , Bai Kajal , Neelam FNU , Malik Maria , Malik Jahanzeb
Published: November 2024

A fraction of patients (approximately 10%) undergoing heart transplantation require permanent pacemaker (PPM) implantation due to sinus node dysfunction or atrioventricular block, occurring either shortly after surgery or later. The incidence of PPM implantation has declined to less than 5% with the introduction of bicaval anastomosis transplantation surgery. Pacing dependency during follow-up varies among recipients. A smaller subset (1.5–3.4%) receives implantable cardioverter-defibrillators (ICDs), but data on their use in transplant recipients are limited, primarily from cohort studies and case series. Sudden cardiac death affects around 10% of transplant recipients, attributed to various nonarrhythmic factors such as acute rejection, late graft failure, and cardiac allograft vasculopathy-induced ischemia. This review offers a comprehensive analysis of the existing data concerning the role of PPMs and ICDs in this population, encompassing leadless PPMs, subcutaneous ICDs, unique considerations, and future directions.
Size Matters: A Comparative Study on Midday Fogging and Lens Settling in Patients With Keratoconus Wearing Mini-Scleral Lenses With Two Different Diameters
Authors: Bagatur Vurgun Elif , Akkaya Turhan Semra , Toker Ayşe Ebru
Published: November 2024

Purpose:

The objective of this study was to compare the changes in postlens fluid optical density, timing and quantity of lens settling, and the clinical performance between two different mini-scleral lenses.

Methods:

Seventeen eyes of 10 patients with keratoconus were fitted with a 15-mm mini-scleral lens (AirKone Scleral Lenses; Laboratoire LCS, Normandy, France), and 15 eyes of 10 patients with keratoconus were fitted with 16.5-mm mini-scleral lenses (Misa Lenses; Microlens Contactlens Technology, Arnhem, The Netherlands). The lens fit was evaluated with biomicroscopy and anterior segment optical coherence tomography (AS-OCT). At 0, 2, and 4 hrs, corneal clearances were measured with AS-OCT, and optical density measurements were made by Scheimpflug tomography. High-contrast visual acuity (HCVA) and contrast sensitivity (CS) were assessed at each time point. At the end of the 4th hour, participants' comfort, visual quality, and general satisfaction were evaluated with a 5-point Likert scale and 100-mm Visual Analog Scale (VAS) scale.

Results:

The mean age (24.4 ± 5.4 vs. 21.7 ± 4.5, P = 0.145) and best spectacle-corrected HCVA (0.36 ± 0.15 vs. 0.35 ± 0.20, P = 0.984) were similar in both groups. The mean Snellen HCVA significantly improved with dispensing both mini-scleral lenses and remained stable at 4 hrs in both groups. In comparison, CS significantly decreased at 4 hrs in both groups (P = 0.02). Both groups' optical density significantly increased over time (P = 0.003). In the 15-mm mini-scleral lens group, the settling amount was 62.2 ± 11.9 μm (62.6%) and 99.5 ± 14.2 μm (100%) at 2 and 4 hrs, respectively; in the 16.5-mm mini-scleral lens group, it was 46.4 ± 22.3 μm (56.4%) and 82.1 ± 37.3 μm (100%) at 2 and 4 hrs, respectively. More than 50% of settling occurred in the first 2 hrs in both groups. No significant difference was observed between the two groups with regard to visual acuity, CS, optical density, and total settling amount at 4 hrs (P > 0.05). Patient in the 15-mm mini-scleral lens group scored higher in comfort (4.65 ± 0.7 vs. 3.60 ± 0.9), visual quality (4.76 ± 0.4 vs. 3.73 ± 0.7), and overall satisfaction (95.7 ± 6.0 vs. 65.3 ± 20.3) (P < 0.0001).

Conclusion:

Patients reported a heightened level of contentment with the smaller-diameter lens; however, it is crucial to emphasize that both diameter scleral lenses showcase comparable clinical efficacy, midday fogging, and settling.
Musculoskeletal Sepsis in the Pediatric Intensive Care Unit
Authors: Hunter Sarah , Brown Elsie , Crawford Haemish , Selak Vanessa , Grant Cameron
Published: November 2024

Background:

Childhood bone and joint infection (BJI) ranges in severity, with the most unwell children requiring pediatric intensive care unit (PICU) support. We describe demographic and prehospital features of BJI cases associated with PICU admission and report treatment outcomes and costs for these cases.

Methods:

This study includes a retrospective cohort of children ≤15 years of age hospitalized with acute hematogenous osteomyelitis or septic arthritis in Auckland between 2018 and 2023. Cases admitted to PICU were compared to non-PICU hospitalized BJI cases. Direct medical hospitalization costs, treatment type and outcomes were described up to 1 year following discharge.

Results:

Of 563 BJI cases, 43 (8%) were admitted to PICU. PICU cases had shorter prehospital symptom duration (3.78 vs. 5.73 days, P = 0.0002). Sensitive Staphylococcus aureus was equally likely to cause disease in PICU and non-PICU cases (P = 0.86). Average hospitalization was longer (35.78 vs. 8.71 days, P ≤ 0.0001) for those admitted to PICU. Readmission and complication rates were both higher within the first year. Average cost per admission was $378,120 NZ dollars (±$796,891.64) for PICU cases versus $32,219 (±$201,797.33), P = 0.01 for cases not requiring PICU admission. In regression analysis, Māori ethnicity, previous history of infections and congenital conditions were statistically associated with PICU admission.

Conclusion:

In this study, children admitted to PICU with severe BJIs were more likely to have a history of congenital conditions or previous infections. Those of Māori ethnicity are overrepresented. Children treated in PICU have longer hospitalizations and experience more adverse outcomes at 1 year following discharge.
Evaluating the Impact of Moderate and Severe Varicella Infections on Danish Children Under 18 Years Old: A Comprehensive Analysis From 2015 to 2023
Authors: Egeskov-Cavling Amanda Marie , Johannesen Caroline Klint , Folke Fredrik , Fischer Thea K.
Published: November 2024

Background:

Varicella (chickenpox) caused by varicella-zoster virus (VZV) is a highly contagious pediatric disease. While it typically manifests as a mild disease, complications leading to hospitalization are not uncommon. Knowing the current disease burden, seasonality and risk groups is pivotal for evidence-based decisions on the introduction of a varicella vaccine.

Methods:

Using the Danish National Patient Register and medical helpline records from the Capital Region, we estimated the burden of VZV infections among children younger than 18 years in Denmark from 2015 to June 2023.

Results:

We identified 14,443 cases with annual incidence rates of 325/100,000 children for mild-to-moderate varicella cases (helpline calls), 35/100,000 for moderate-to-severe cases (outpatients) and 10/100,000 for severe cases (hospitalized). Mild cases were most prevalent in children 1–4 years old, while moderate-to-severe cases were most prevalent among infants <1 year old. Among hospitalized cases, 23.2% had underlying diseases and 47.3% experienced complications. In April 2022, rapid surge in all types of VZV cases occurred, where admissions surpassed the prepandemic level.

Conclusion:

This study documents that varicella is highly prevalent among Danish young children. Mild-to-moderately severe cases strain healthcare, causing increased helpline calls and posing a persistent hospitalization risk, especially for infants and children with underlying conditions.
Infantile Pasteurella multocida Meningitis: Case Report and Review of the Literature
Authors: Inglis Christian , Wen Sophie C. H. , Kapoor Vishal
Published: November 2024

Background:

Pasteurella multocida is a rare cause of deep-seated pediatric infections including osteomyelitis and meningitis. We report a case of P. multocida meningitis from Queensland, with a comprehensive review of literature.

Methods:

Three databases were searched for infants < 12 months of age with confirmed P. multocida meningitis. Mode of transmission, clinical and laboratory features, imaging, treatment and complications were reviewed. Logistic regression analysis was performed to evaluate predictors for outcomes including short-term neurologic complications, any long-term complications and mortality.

Results:

A total of 74 infants were included, with most cases occurring from indirect household animal contact (42/74; 61%). Bacteremia (38/74; 51%) and seizures (15/74, 20%) were common complications with mortality in 6 children (8%). Young infant age appeared to be the single most important risk factor for bacteremia.

Conclusions:

Infantile P. multocida meningitis although rare has potentially devastating complications. Younger infants are more likely to develop concomitant bacteremia. Household hand hygiene is imperative after trivial interactions with pets.
Clinical Characteristics and Outcomes of Cardiac Findings in Young Persons Following SARS-CoV-2 Infection
Authors: Jones Milissa U. , Richard Stephanie A. , Malloy Allison M. W. , Colombo Rhonda E. , May Joseph , Saunders David , Lindholm David A. , Ganesan Anuradha , Sablak Ceyda , Hickey Patrick W. , Dobson Craig P. , Pollett Simon D. , Flanagan Ryan ,   on behalf of the EPICC COVID-19 Cohort Study Group
Published: November 2024

We studied cardiac complications in young persons with severe acute respiratory syndrome coronavirus 2. In a prospective cohort of 127 Military Health System beneficiaries 0–22 years old, 3.1% had cardiac abnormalities, all resolved within 6 months. Our findings support guidelines against routine cardiac screening in mild COVID-19 cases without cardiac symptoms.
Challenges of Congenital HHV6 Infection Diagnosis and Treatment: Two Case Reports and Literature Review
Authors: Fernandes Andreia , Pereira Mafalda , Oliveira Íris , Novo Marta , Soares Marta , Ramalho Ana Raquel , Santos Vera , Vinagre Elsa , Lopo Silvia , Gaspar Luísa
Published: November 2024

Introduction:

Congenital human herpesvirus 6 (HHV6) infection occurs in 1% of the general population and may result from the transmission of an inherited chromosomally integrated HHV6 (iciHHV6) or transplacental infection. It is mostly asymptomatic.

Case reports:

Case 1: a 29th-week-old female preterm newborn, admitted to the neonatal intensive care unit, became clinically unstable and irritable on the 20th day of hospitalization. Cranial ultrasound, revealed a significant posthemorrhagic tetraventricular dilation, with signs of ventriculitis. Investigations revealed HHV6 positivity on cerebrospinal fluid polymerase chain reaction multiplex panel testing and HHV6-DNA high viral loads in plasma samples. Case 2: a female late preterm newborn was admitted to the neonatal intensive care unit due to early-onset sepsis. Investigations revealed group B streptococcus positive blood cultures and cerebrospinal fluid HHV6 positivity on polymerase chain reaction multiplex panel testing, with negative bacterial culture. After 3 days of adequate antibiotic treatment, she maintained persistent moaning, which motivated a cranial ultrasound, revealing mild brain edema. Clinical improvement was observed only after beginning antiviral treatment in both newborns. Due to the persistency of high viral loads in both cases, despite antiviral treatment and clinical improvement, an iciHHV6 was suspected and posteriorly confirmed.

Discussion/conclusion:

Congenital iciHHV6 infection diagnosis is challenging because the presence of an iciHHV6 results in persistently high viral loads, even in the absence of active infection. Only a few diagnostic techniques can confirm active replication; unfortunately, these are not available in most countries. The decision to initiate antiviral treatment should be based on clinical judgment. Better ways for the diagnosis of active infection are needed.
The Prevalence, Serogroup Distribution and Risk Factors of Meningococcal Carriage in Children, Adolescents and Young Adults in Turkey Meningo-Carr-TR Study PART 3: COVID-19 Pandemic Situation
Authors: Kizil Mahmut Can , Kara Yalcin , Karbuz Adem , Oz Fatma Nur , Ciftci Ergin , Kurugol Zafer , Iseri Nepesov Merve , Celebi Solmaz , Cetin Benhur Sirvan , Yilmaz Dilek , Dinleyici Meltem , Kizmaz Isancli Didem , Kilicaslan Onder , Ozdemir Halil , Inceli Belkis Hatice , Penezoglu Dondu Nilay , Dortkardesler Burce , Sezer Yamanel Rabia G. , Aksoy Fatma Dilsad , Tekin Can Sedanur , Agrali Eröz Nesli , Kaya Mucahit , Kilic Omer , Dinleyici Ener Cagri
Published: November 2024

Background:

The prevalence of meningococcal carriage and serogroup distribution is crucial for assessing the epidemiology of invasive meningococcal disease, forecasting outbreaks and formulating potential immunization strategies. Following the meningococcal carriage studies conducted in Turkey in 2016 and 2018, we planned to re-evaluate meningococcal carriage in children, adolescents and young adults during the COVID-19 pandemic period.

Methods:

In the MENINGO-CARR-3 study, we collected nasopharyngeal samples from 1585 participants 0–24 years of age, across 9 different centers in Turkey. We used polymerase chain reaction and serogroup distribution to determine how common it is for people to carry Neisseria meningitidis.

Results:

The overall meningococcal carriage rate was 8.5% (n = 134). The serogroup distribution was as follows: serogroup A, 6%; serogroup B, 30.6%; serogroup W, 12.7%; serogroup Y, 3.7%; serogroup X, 1.5% and nongroupable as 45.5%. The highest carriage rate was found in 15–17-year-old adolescents (24.1%, 17.9%, and 20.2%, respectively). The carriage rate was higher among participants who had a previous COVID-19 infection (P = 0.05; odds ratio: 1.95; 95% confidence interval: 1.11–3.44). The nasopharyngeal carriage rate was also higher than in the 2016 and 2018 studies (8.45% vs. 6.3% and 7.5%, respectively), and the most prevalent groupable serogroup was B during this study period, followed by serogroup W in 2016 and serogroup X in 2018.

Conclusions:

The present study found that meningococcal carriage was higher during the post-COVID-19 pandemic period, especially in adolescents and young adults. Severe acute respiratory syndrome coronavirus-2 virus itself and/or pandemic mitigation strategies may affect both meningococcal carriage and serogroup distribution. Serogroup distribution varies between years, and further immunization strategies, including adolescent immunization, may play a role in controlling invasive meningococcal disease.
Potential Impact of Rapid Molecular Microbiologic Diagnosis for Mechanically Ventilated Children in Intensive Care With Suspected Pneumonia
Authors: Silcock Robyn , Clifford Vanessa , Osowicki Joshua , Gelbart Ben
Published: November 2024

Background:

Lower respiratory tract infections (LRTIs) remain a leading cause of community-acquired and nosocomial infection in children and a common indication for antimicrobial use and intensive care admission. Determining the causative pathogen for LRTIs is difficult and traditional culture-based methods are labor- and time-intensive. Emerging molecular diagnostic tools may identify pathogens and detect antimicrobial resistance more quickly, to enable earlier targeted antimicrobial therapy.

Methods:

This is a single-center, prospective observational laboratory study evaluating the use of the Biofire FilmArray pneumonia panel (FA-PP) (BioFire Diagnostics, Salt Lake City, UT) for bronchoalveolar lavage specimens from mechanically ventilated children admitted with suspected or presumed pneumonia. We aimed to determine its feasibility and utility for identifying pathogens, antimicrobial resistance and its potential influence on antibiotic prescribing.

Results:

We analyzed 50 samples taken from 41 children with a median age of 6 months. Positive agreement between culture and FA-PP was 83% and negative agreement was 76%. Agreement between FA-PP (mecA/C or MREJ) and culture was high for methicillin-resistant Staphylococcus aureus. In 3 cases, extended-spectrum beta-lactamase-producing Gram-negative organisms were detected by culture and not FA-PP. Hypothetically, FA-PP results would have affected antimicrobial prescribing in approximately half the cases (24, 48%).

Conclusions:

FA-PP is a useful adjunct to traditional culture methods in mechanically ventilated children with LRTIs and may influence clinical decision-making regarding antibiotic escalation or stewardship.
Precipitate, preterm labor in acute organophosphate poisoning in pregnancy: a case report
Authors: Shah Rosy , Pokhrel Amrit , Shrestha Anil , Shrestha Saroj , Sah Amrita , Shah Raj
Published: November 2024

Introduction:

Acute organophosphorus poisoning (AOPP) during pregnancy is uncommon. When complicated by preterm labor, it presents therapeutic dilemmas due to the lack of established guidelines.

Case presentation:

The authors describe a case of a 19-year-old primigravida at 33 weeks of gestation with AOPP. During her treatment, she unexpectedly experienced preterm, precipitate labor, resulting in the delivery of a live, healthy baby.

Discussion:

Late-pregnancy exposure to organophosphates may trigger preterm labor through receptor hyperstimulation from excess acetylcholine, causing premature contractions. Atropine, progesterone, and magnesium sulfate may help manage these effects.

Conclusion:

This case underscores the importance of vigilance and frequent clinical examinations in patients with AOPP to identify subtle early signs of potential complications.
Is fascia lata a viable graft for MPFL reconstruction? An overview of surgical technique and scoping literature review
Authors: Zachariou Dimitrios , Karampinas Panagiotis , Varsamos Iordanis , Galanis Athanasios , Vavourakis Michail , Spyrou Ioannis , Sakellariou Evangelos , Patilas Christos , Tsalimas Georgios , Kaspiris Angelos , Vlamis John , Pneumaticos Spiros
Published: November 2024

Lateral patellar dislocation is irrefutably one of the most common knee injuries, while subsequent medial patellofemoral ligament (MPFL) damage requires proper orthopedic care. Treatment of these injuries is regularly associated with the need for MPFL reconstruction surgery. This operation, often in combination with other procedures, can result very fruitful in restoring knee kinematics. There is a considerable variety of options for the orthopedic surgeon to choose from regarding graft selection when performing MPFL reconstruction surgery, including the semitendinosus tendon, the gracilis, and others. Notwithstanding, utilizing the fascia lata as an autograft or allograft for MPFL reconstruction has emerged as a promising alternative. Perusing the existing literature, not any review paper could be found examining the efficacy of fascia lata as a MPFL reconstruction graft. As a result, a thorough search was conducted in various databases to investigate and explore the studies analyzing this type of MPFL reconstruction surgery. The number of papers scrutinizing this operation was exceedingly narrow. However, out of these studies, it can be concluded that opting for fascia lata grafts when executing MPFL reconstruction surgery features some considerable advantages, involving similar biomechanics to the native MPFL, no hamstrings damage and quicker rehabilitation among others. This paper accentuates the requirement for considering fascia lata as a viable graft option in MPFL reconstruction surgery and the necessity for more pertinent research in order to attain more reliable inferences.
Prognostic Significance of C-MYC and EGFR Overexpression in Gastrointestinal Stromal Tumors: An Immunohistochemical Study
Authors: Ben Rejeb Sarra , Aloui Dorra , Ayari Asma , Chouchen Adnen
Published: November 2024

Introduction:

In addition to mutations in KIT and PDGFRA, many other genetic alterations have been described in gastrointestinal stromal tumors (GISTs), including amplifications of C-MYC and EGFR, which are often associated with increased protein expression. The main of this study was to investigate the prognostic significance of C-MYC and EGFR expression in GISTs using immunohistochemistry (IHC).

Methods:

We collected all GIST cases over a 16-year period. These cases were tested using antibodies against C-MYC (Leica, clone EP121) and EGFR (Leica, clone 113). C-MYC staining was assessed using the H-score method for nuclear, cytoplasmic, and combined staining. For EGFR staining (either cytoplasmic or nuclear), the intensity was graded as follows: 0 (no staining), 1 (weak staining), 2 (moderate staining), and 3 (strong staining). The percentage of positive cells was evaluated using a semiquantitative approach. Statistical analysis was performed using SPSS24.

Results:

A total of 37 cases were included in our study. Nuclear expression of C-MYC was observed in 43% of the cases, with a high H-score in 43%. A statistically significant association was found between a high nuclear H-score for C-MYC and mitotic rate (P=0.046), as well as a high Ki-67 proliferation rate (P=0.046). However, no statistically significant associations were identified between the nuclear H-score of C-MYC and other clinical, pathologic, or survival data. Cytoplasmic expression of C-MYC was noted in 22% of cases, but no significant correlations were found with the clinicopathological data. EGFR staining was observed in 86% of cases, with a high score of 51%. EGFR expression was significantly associated with the mitotic index (P=0.012) and Ki-67 proliferation rate (P=0.046).

Conclusions:

Our findings suggest that both C-MYC and EGFR may be overexpressed and/or amplified in GISTs, indicating their potential prognostic role. This could also pave the way for therapeutic strategies targeting these proteins.
Pregnancy after amputation: A national survey of prosthetic and mobility outcomes in women with lived experience
Authors: Bateman Emma A. , Viana Ricardo , Sales Darda , Payne Michael W. C.
Published: November 2024

Background:

In pregnancy, women with limb loss or deficiency or lower extremity amputations (LEAs) may experience physiologic changes affecting mobility, prosthesis use, and/or pain. However, little is known about the pregnancy-related experiences of these women.

Objective:

The objective of this research was to characterize pregnancy-related experiences including complications, impact on prosthesis use, gait aid use, and mobility for women with LEAs.

Study Design:

A national, self-administered online survey. Data were analyzed using descriptive statistics. Thematic analyses were performed on open-ended questions. Participants were women with 1 or more LEA(s) who had been pregnant within the last 5 years and were recruited via social media, LEA clinics, and word of mouth.

Results:

Sixteen women from 4 Canadian provinces completed the survey describing 31 pregnancies. A total of 9 had acquired LEAs and 7 had congenital LEAs. All but 1 respondent had unilateral LEAs; most common level was transfemoral (38%). All wore a prosthesis daily and were K-level 4 ambulators. Five (31%) had to decrease or stop prosthesis use, and 6 (25%) required a gait aid or wheelchair during pregnancy. The most common pregnancy-associated complications were low back pain (64%), changes to limb size/prosthesis comfort (64%), reduced balance (44%), falls (38%), and postpartum depression (25%).

Conclusion:

This survey is the first to describe the many unique challenges women with LEAs may experience in pregnancy and highlights important information for women with LEAs, their health care providers, their rehabilitation team, and avenues for future research.