bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of stent compression in patients with non-thrombotic iliac vein lesions on iliac vein blood flow and related symptoms
Authors: Peng Minyong , Li Chao , Chen Jiangwei , Nie Chengli , Huang Wen
Published: August 2023

Objectives

To study outcomes in patients with non-thrombotic iliac vein lesions (NIVLs) treated by stents.

Methods

We performed a retrospective study that collected 109 patients from January 2016 to August 2020 diagnosed with symptomatic NIVLs. The patients underwent endovenous stenting using the Wallstents. Clinical severity was assessed using the venous clinical severity score and the Villalta scores. The patency was assessed using duplex ultrasound, while the diameters and the blood flow velocities (BFVs) in the proximal, middle, and distal stented segments were recorded simultaneously.

Results

A total of 128 stents were placed in 115 limbs (median age, 61 years), with a mean follow-up of 32 months. At 36 months, the Villalta scores went from 12.17 to 3.64 ( p < .001). The VCSS went from 9.41 to 3.31 ( p < .001). The mean diameters in the proximal, middle, and distal stented segments were 8.52 ± 2.15 mm, 10.13 ± 1.75 mm, and 10.17 ± 1.69 mm in the first month, while the mean BFVs were 31.17 ± 13.66 cm/s, 31.07 ± 11.90 cm/s, and 36.39 ± 18.41 cm/s, respectively. Repeated-measures analysis in 55 consecutive patients from 1 month to 3 years after procedure revealed a decrease of the stent diameter in the proximal stented segment ( p = .004); a stabilization of the stent diameter in the middle ( p = .43) or distal ( p = .45) stented segment; a steadiness of the BFVs in the proximal ( p = .40), middle ( p = .93), and distal ( p = .25) stented segments; and an improvement in the VCSS ( p = .03) and Villalta scores ( p = .006).

Conclusions

BFVs in stented segments remained steady and the symptoms in lower extremities improved after surgery, while stent compression was observed in the diameter of the proximal stented segment, with no impact on BFVs or symptoms.
A framework for design and usability testing of telerehabilitation system for adults with chronic diseases: A panoramic scoping review
Authors: Ghaben Suad J , Mat Ludin Arimi Fitri , Mohamad Ali Nazlena , Beng Gan Kok , Singh Devinder Kaur Ajit
Published: August 2023

Objective

This scoping review aimed to identify the design and usability testing of a telerehabilitation (TR) system, and its characteristics and functionalities that are best-suited for rehabilitating adults with chronic diseases.

Methods

Searches were conducted in PubMed, EBSCO, Web of Science, and Cochrane library for studies published between January 2017 and December 2022. We followed the Joanna Briggs Institute guidelines and the framework by Arksey and O’Malley. Screening was undertaken by two reviewers, and data extraction was undertaken by the first author. Then, the data were further reviewed and discussed thoroughly with the team members.

Results

A total of 31 results were identified, with the core criteria of developing and testing a telerehabilitation system, including a mobile app for cardiovascular diseases, cancer, diabetes, and chronic respiratory disorders. All developed systems resulted from multidisciplinary teams and employed mixed-methods research. We proposed the “input-process-output” framework that identified phases of both system design and usability testing. Through system design, we reported the use of user-centered design, iterative design, users’ needs and characteristics, theory underpinning development, and the expert panel in 64%, 75%, 86%, 82%, and 71% of the studies, respectively. We recorded the application of moderated usability testing, unmoderated testing (1), and unmoderated testing (2) in 74%, 63%, and 15% of the studies, respectively. The identified design and testing activities produced a matured system, a high-fidelity prototype, and a released system in 81.5%, 15%, and 3.5%, respectively.

Conclusion

This review provides a framework for TR system design and testing for a wide range of chronic diseases that require prolonged management through remote monitoring using a mobile app. The identified “input-process-output” framework highlights the inputs, design, development, and improvement as components of the system design. It also identifies the “moderated-unmoderated” model for conducting usability testing. This review illustrates characteristics and functionalities of the TR systems and healthcare professional roles.
Intersectional Discrimination: Gender and Caste
Authors: Ahmad Zahra
Published: August 2023

Patriarchy subordinates and subdues the fair sex on the basis of gender, a social and cultural construct to divide the two sexes (biological construct). The caste system is the hidden apartheid of ancient India which continues even in contemporary times. Apart from these, several other markers of identity like religion, class, economic position and geographical location also play an important role in discrimination. These interact with each other to give a unique experience of discrimination rather than a conglomeration of oppressions. The intersections of gender and caste in India echo issues of violence, coercion and infringement of basic human rights which can be explained through intersectionality theory. Cultural studies have facilitated the documentation of the petit narrative, thus bringing the subaltern to the mainstream. Literature thus portrays such marginalization, which sometimes challenges the status quo or at times negotiates its way around it. This article intends to analyse the English translations of Pawade’s Antahsphot (1981), Kamble’s Jina Amucha (1985), Sivakami’s Pazhaiyana Kazhithalum (1989) and Limbale’s Akkarmashi (1991) through the lens of intersectionality in the cultural milieu.
Impact of postnatal dexamethasone timing on preterm mortality and bronchopulmonary dysplasia: a propensity score analysis
Authors: Kwok T’ng Chang , Szatkowski Lisa , Sharkey Don
Published: August 2023

Background

Postnatal dexamethasone (PND) is used in high-risk preterm infants after the first week of life to facilitate extubation and prevent bronchopulmonary dysplasia (BPD) but the optimal treatment timing remains unclear. Our objective was to explore the association between the timing of PND commencement and mortality and respiratory outcomes.

Methods

This was a retrospective National Neonatal Research Database study of 84 440 premature infants born <32 weeks gestational age from 2010 to 2020 in England and Wales. Propensity score weighting analysis was used to explore the impact of PND commenced at three time-points (2–3 weeks (PND2/3), 4–5 weeks (PND4/5) and after 5 weeks (PND6+) chronological age) on the primary composite outcome of death before neonatal discharge and/or severe BPD (defined as respiratory pressure support at 36 weeks) alongside other secondary respiratory outcomes.

Results

3469 infants received PND. Compared with PND2/3, infants receiving PND6+were more likely to die and/or develop severe BPD (OR 1.68, 95% CI 1.28–2.21), extubate at later postmenstrual age (mean difference 3.1 weeks, 95% CI 2.9–3.4 weeks), potentially require respiratory support at discharge (OR 1.34, 95% CI 1.06–1.70) but had lower mortality before discharge (OR 0.38, 95% CI 0.29–0.51). PND4/5was not associated with severe BPD or discharge respiratory support.

Conclusions

PND treatment after 5 weeks of age was associated with worse respiratory outcomes although residual bias cannot be excluded. A definitive clinical trial to determine the optimal PND treatment window, based on early objective measures to identify high-risk infants, is needed.
Laboratory and free-living gait performance in adults with COPD and healthy controls
Authors: Buekers Joren , Megaritis Dimitrios , Koch Sarah , Alcock Lisa , Ammour Nadir , Becker Clemens , Bertuletti Stefano , Bonci Tecla , Brown Philip , Buckley Ellen , Buttery Sara C. , Caulfied Brian , Cereatti Andrea , Chynkiamis Nikolaos , Demeyer Heleen , Echevarria Carlos , Frei Anja , Hansen Clint , Hausdorff Jeffrey M. , Hopkinson Nicholas S. , Hume Emily , Kuederle Arne , Maetzler Walter , Mazzà Claudia , Micó-Amigo Encarna M. , Mueller Arne , Palmerini Luca , Salis Francesca , Scott Kirsty , Troosters Thierry , Vereijken Beatrix , Watz Henrik , Rochester Lynn , Del Din Silvia , Vogiatzis Ioannis , Garcia-Aymerich Judith
Published: August 2023

Background

Gait characteristics are important risk factors for falls, hospitalisations and mortality in older adults, but the impact of COPD on gait performance remains unclear. We aimed to identify differences in gait characteristics between adults with COPD and healthy age-matched controls during 1) laboratory tests that included complex movements and obstacles, 2) simulated daily-life activities (supervised) and 3) free-living daily-life activities (unsupervised).

Methods

This case–control study used a multi-sensor wearable system (INDIP) to obtain seven gait characteristics for each walking bout performed by adults with mild-to-severe COPD (n=17; forced expiratory volume in 1 s 57±19% predicted) and controls (n=20) during laboratory tests, and during simulated and free-living daily-life activities. Gait characteristics were compared between adults with COPD and healthy controls for all walking bouts combined, and for shorter (≤30 s) and longer (>30 s) walking bouts separately.

Results

Slower walking speed (−11 cm·s−1, 95% CI: −20 to −3) and lower cadence (−6.6 steps·min−1, 95% CI: −12.3 to −0.9) were recorded in adults with COPD compared to healthy controls during longer (>30 s) free-living walking bouts, but not during shorter (≤30 s) walking bouts in either laboratory or free-living settings. Double support duration and gait variability measures were generally comparable between the two groups.

Conclusion

Gait impairment of adults with mild-to-severe COPD mainly manifests during relatively long walking bouts (>30 s) in free-living conditions. Future research should determine the underlying mechanism(s) of this impairment to facilitate the development of interventions that can improve free-living gait performance in adults with COPD.
Oesophageal stasis is a risk factor for chronic lung allograft dysfunction and allograft failure in lung transplant recipients
Authors: Ramendra Rayoun , Fernández-Castillo Juan C. , Huszti Ella , Ghany Rasheed , Aversa Meghan , Havlin Jan , Riddell Peter , Chaparro Cecilia M. , Singer Lianne G. , Liu Louis , Keshavjee Shaf , Yeung Jonathan C. , Martinu Tereza
Published: August 2023

Background

Morbidity and mortality in lung transplant recipients are often triggered by recurrent aspiration events, potentiated by oesophageal and gastric disorders. Previous small studies have shown conflicting associations between oesophageal function and the development of chronic lung allograft dysfunction (CLAD). Herein, we sought to investigate the relationship between oesophageal motility disorders and long-term outcomes in a large retrospective cohort of lung transplant recipients.

Methods

All lung transplant recipients at the Toronto Lung Transplant Program from 2012 to 2018 with available oesophageal manometry testing within the first 7 months post-transplant were included in this study. Patients were categorised according to the Chicago Classification of oesophageal disorders (v3.0). Associations between oesophageal motility disorders with the development of CLAD and allograft failure (defined as death or re-transplantation) were assessed.

Results

Of 487 patients, 57 (12%) had oesophagogastric junction outflow obstruction (OGJOO) and 47 (10%) had a disorder of peristalsis (eight major, 39 minor). In a multivariable analysis, OGJOO was associated with an increased risk of CLAD (HR 1.71, 95% CI 1.15–2.55, p=0.008) and allograft failure (HR 1.69, 95% CI 1.13–2.53, p=0.01). Major disorders of peristalsis were associated with an increased risk of CLAD (HR 1.55, 95% CI 1.01–2.37, p=0.04) and allograft failure (HR 3.33, 95% CI 1.53–7.25, p=0.002). Minor disorders of peristalsis were not significantly associated with CLAD or allograft failure.

Conclusion

Lung transplant recipients with oesophageal stasis characterised by OGJOO or major disorders of peristalsis were at an increased risk of adverse long-term outcomes. These findings will help with risk stratification of lung transplant recipients and personalisation of treatment for aspiration prevention.
Computed tomography reveals hypertrophic remodelling of the diaphragm in cystic fibrosis but not in COPD
Authors: Ostadan Fatemeh , Donovan Adamo A. , Matouk Elias , David Francois Gabriel , Marchand Dylan , Reinhold Caroline , Nguyen Dao , Goldberg Peter , Benedetti Andrea , Smith Benjamin M. , Petrof Basil J.
Published: August 2023

Background

Computed tomography (CT) is increasingly used for assessing skeletal muscle characteristics. In cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD), reduced limb muscle mass predicts poor clinical outcomes. However, the degree to which quantity or quality of respiratory and nonrespiratory muscles is affected by these diseases remains controversial.

Methods

Thoracic CT images of 29 CF, 21 COPD and 20 normal spirometry control subjects were analysed to measure indices of muscle quantity (volume or cross-sectional area) and quality (radiodensity) in respiratory (diaphragm, abdominal) and nonrespiratory (pectoralis, lumbar paraspinal) muscles. Multivariable linear regression assessed relationships of CT measurements with body mass index (BMI), forced expiratory volume in 1 s (FEV1) % pred, inflammation and infection biomarkers, nutritional status and CF genotype.

Results

Diaphragm volume in CF was significantly higher than in COPD (by 154%) or controls (by 140%). Abdominal muscle area in CF was also greater than in COPD (by 130%). Nonrespiratory muscles in COPD had more low radiodensity muscle (marker of lipid content) compared to CF and controls. In CF but not COPD, higher BMI and FEV1% pred were independently associated with higher diaphragm and/or abdominal muscle quantity indices. Serum creatinine also predicted respiratory and nonrespiratory muscle quantity in CF, whereas other biomarkers including genotype correlated poorly with muscle CT parameters.

Conclusions

Our data suggest that the CF diaphragm undergoes hypertrophic remodelling, whereas in COPD the nonrespiratory muscles show altered muscle quality consistent with greater lipid content. Thoracic CT can thus identify distinctive respiratory and nonrespiratory muscle remodelling signatures associated with different chronic lung diseases.
α1-Antitrypsin deficiency associated with increased risk of heart failure
Authors: Winther Sine V. , Landt Eskild M. , Nordestgaard Børge G. , Seersholm Niels , Dahl Morten
Published: August 2023

Background

Individuals with α1-antitrypsin deficiency have increased elastase activity resulting in continuous degradation of elastin and early onset of COPD. Increased elastase activity may also affect elastic properties of the heart, which may impact risk of heart failure. We tested the hypothesis that α1-antitrypsin deficiency is associated with increased risk of heart failure in two large populations.

Methods

In a nationwide nested study of 2209 patients with α1-antitrypsin deficiency and 21 869 controls without α1-antitrypsin deficiency matched on age, sex and municipality, we recorded admissions and deaths due to heart failure during a median follow-up of 62 years. We also studied a population-based cohort of another 102 481 individuals from the Copenhagen General Population Study including 187 patients from the Danish α1-Antitrypsin Deficiency Registry, all with genetically confirmed α1-antitrypsin deficiency.

Results

Individuals withversuswithout α1-antitrypsin deficiency had increased risk of heart failure hospitalisation in the nationwide cohort (adjusted hazard ratio 2.64, 95% CI 2.25–3.10) and in the population-based cohort (1.77, 95% CI 1.14–2.74). Nationwide, these hazard ratios were highest in those without myocardial infarction (3.24, 95% CI 2.70–3.90), without aortic valve stenosis (2.80, 95% CI 2.38–3.29), without hypertension (3.44, 95% CI 2.81–4.22), without atrial fibrillation (3.33, 95% CI 2.75–4.04) and without any of these four diseases (6.00, 95% CI 4.60–7.82). Hazard ratios for heart failure-specific mortality in individuals withversuswithout α1-antitrypsin deficiency were 2.28 (95% CI 1.57–3.32) in the nationwide cohort and 3.35 (95% CI 1.04–10.74) in the population-based cohort.

Conclusion

Individuals with α1-antitrypsin deficiency have increased risk of heart failure hospitalisation and heart failure-specific mortality in the Danish population.
Effects of bepotastine, a nonsedating H1-antihistamine, for the treatment of persistent cough and allergic rhinitis: a randomised, double-blind, placebo-controlled trial
Authors: Lee Ji-Hyang , Oh Ji-Yoon , Kwon Hyouk-Soo , Kim Tae-Bum , Cho You Sook , Song Woo-Jung
Published: August 2023

Background

Empirical therapy with oral histamine-1 receptor antagonists (H1RAs) is often used for patients with suspected upper airway cough syndrome. No placebo-controlled trials with nonsedating H1RAs (nsH1RAs) have evaluated validated cough outcomes. The objective of the present study was to assess the effect of an nsH1RA, bepotastine, on cough outcomes in patients with allergic rhinitis and persistent cough.

Methods

A randomised, double-blind, placebo-controlled trial was conducted. Adult patients with persistent cough (>3 weeks in duration) and symptomatic allergic rhinitis were recruited and randomly assigned to receive either bepotastine or placebo at a 1:1 ratio. The primary outcome was cough-specific quality of life assessed using the Leicester Cough Questionnaire (LCQ). Secondary outcomes included cough severity visual analogue scale (VAS), throat VAS, Cough Hypersensitivity Questionnaire, Sinonasal Outcome Test-22 score and drug adverse events.

Results

Between October 2021 and September 2022, 50 participants (43 females; mean age 46.28 years; median cough duration 3 months) were assigned to either the bepotastine 10 mg twice daily or placebo group in a 1:1 ratio. After 2 weeks of treatment, both bepotastine and placebo groups showed significant improvements in the LCQ scores, but there was no significant difference in the magnitude of change between the groups (3.45±2.10versus3.04±2.94, p=0.576). Secondary outcomes were also comparable.

Conclusions

Despite the relatively small sample size, our study clearly demonstrated that a 2-week treatment with bepotastine did not provide therapeutic benefits for cough outcomes. These findings suggest against the use of nsH1RAs with the intention of improving cough outcomes, even in patients with persistent cough and allergic rhinitis.
Occult deterioration of an aortic annular abscess: how do we diagnose a pseudoaneurysm periaortic valve? A case report
Authors: Chen Tienan , Li Yinling , Qiao Shuai , Fu Huaying
Published: August 2023

Background

Infectious endocarditis (IE) is a disease caused by the colonization of toxic microorganisms on the endocardium of heart valves [1]. Although much progress has been made in the diagnosis and treatment of IE, its complications, such as annular abscesses [2], still have a high mortality rate. In this case, we describe a patient with infective endocarditis complicated by occult deteriorated aortic annular abscess.

Case presentation

A 44-year-old man was admitted due to weakness of his right limbs and unclear speech for 10 h. He had recurrent fevers for 1 month before admission. Transthoracic echocardiography showed a mix-echoic vegetation attached to the bicuspid aortic valve, moderate aortic regurgitation and a possible aortic annular abscess. Blood cultures were negative and empiric antibiotic therapy was begun. The patient did not have fever again and seem to be clinically improved. However, follow-up transesophageal echocardiography revealed a large periaortic abscess led to aortic sinus pseudoaneurysm. The patient underwent mechanical prosthetic valve replacement and annulus reconstruction successfully. Perivalvular abscess may be insidious deterioration in patients who seem to be clinically improved, which requires us to pay more attention.

Discussion

Occult deterioration of an aortic annular abscess is rare and more attention should be paid. Re-evaluation of echocardiography is required even if the patient’s symptoms improve.
Application of enhanced recovery after surgery following liver transplantation
Authors: Jin Boxun , Gu Yanmei , Xi Shuangmei , Liu Xin , Wu Xiulian , Li Guangming
Published: August 2023

Objective

To investigate the effect of an enhanced recovery after surgery (ERAS) programme following liver transplantation and to further clarify the safety and clinical application value of an ERAS programme.

Methods

A retrospective analysis of 250 patients who underwent liver transplant at Beijing You’an Hospital affiliated to Capital Medical University between March 2019 and December 2021 was conducted. According to different perioperative management methods, patients were divided into a control group (120 cases) and an ERAS group (130 cases). Postoperative safety indicators, efficacy indicators and economic indicators were compared between the two groups.

Results

There was no significant difference in the safety indicators between the two groups. The ERAS group showed significantly lower results compared with the control group in terms of ventilator-associated pneumonia, urinary tract infection, pressure injury of oral and nasal mucosa, postoperative pain score 5 days after surgery and the incidence of delirium, whereas the Barthel score 10 days after surgery was significantly higher. There was no significant difference between the two groups in skin pressure injury or the Subjective Global Assessment grade 10 days after surgery. The length of intensive care unit stay, the total length of stay after surgery and the 10-day medical expenses after surgery were significantly lower in the ERAS group than in the control group.

Conclusion

The application of an ERAS programme after liver transplantation can effectively promote the postoperative recovery of patients and reduce medical costs. Studies have shown that the ERAS programme has important application value in improving the postoperative quality of life and reducing the economic burden of patients after liver transplantation. This programme provides a new concept for related clinical improvement and application.
Nitrous oxide-induced polyneuropathy, pancytopenia and pulmonary embolism: a case report
Authors: Parein Guillaume , Bollens Benjamin
Published: August 2023

Background

Nitrous oxide is a medical and household gas that has seen its use drift to recreational purpose among the young population in recent years. Significant neurological, hematological and psychiatric side effects, generally related to an induced functional vitamin B12 deficiency, have been described separately in the literature.

Case report

A 22-year-old woman of North African origin experienced an exceptional combination of polyneuropathy, bilateral pulmonary embolism and severe pancytopenia related to vitamin B12 deficiency and hyperhomocysteinemia induced by recreational nitrous oxide use. After treatment with vitamin B12 supplementation and intensive rehabilitative management, the patient progressively regained the ability to walk and her biological parameters gradually returned to normal. The pathophysiological mechanisms related to a decrease in vitamin B12 activity are the reduction of products needed for synthesis of deoxyribonucleic acid, carbohydrate or fatty acids, and the increase of hyperhomocysteinemia. Other mechanisms involving a direct action of N2O are also suspected.

Conclusion

This case report brings elements to support our knowledge about pathological pathway, recovery and prognosis of recreational N2O abuse complications. The general and medical population should be aware to the serious consequences of this type of consumption.
Improving inappropriate radiology referrals: a template for imaging requests in Saudi Arabia
Authors: Albahiti Sarah , Khafaji Mawya , Jamjoom Lamia , Badeeb Arwa
Published: August 2023

Background

Imaging requests are the first line of communication between the referring physician and the radiology department. The information provided allows the imaging team to choose the optimal examination for the clinical question. There are no imaging referral guidelines in Saudi Arabia. The Radiological Society of Saudi Arabia (RSSA) and Arabsafe have surveyed to develop an imaging referral tool in Saudi Arabia. This study aims to determine the most critical clinical information that should be included in an imaging request form in Saudi Arabia.

Methodology

A questionnaire was sent to the RSSA members to rank —using the Likert scale— the importance of 8 pieces of clinical information to discern what must be included in the imaging request form.

Results

The response rate was 80% of the RSSA members, which included 75 respondents, mostly Radiology consultants and residents in training. Radiologists carried different specialties and came from 4 main provinces in the Kingdom. 90.6% of Radiologists ranked the clinical question with relevant details as very important. The contact information of the requesting clinician came next in the ranking, with 82.3% scoring it as very important. The “very important” scores were 64.9% for the past medical history, 67.3% for past surgical history, 49.2% for laboratory, 38.3% for risk factors, and 56.7% for prior radiological studies. The RSSA-Arabsafe imaging request template was proposed because of the respondents’ votes to include all eight points: a clear clinical question relevant to the requested exam, the contact information of the referring physician, relevant surgical history, relevant medical history, past radiological tests if any, patient demographics, and relevant laboratory tests.

Conclusions

The RSSA-Arabsafe template is the first tool to improving imaging referrals and hence patients’ safety and services in Radiology departments in Saudi Arabia. It is crucial for healthcare institutions to actively implement standardized imaging request forms, such as the proposed RSSA-Arabsafe template, to reduce inappropriate referrals, enhance communications and optimize resource utilization.
Bioautography, synergistic effect and HPTLC-MS and SEM analysis of antimicrobial and antioxidant compounds of inflorescence extract of Sphaeranthus indicus
Authors: Tandon Dhananjay , Gupta Ashwini Kumar
Published: August 2023

Background

Sphaeranthus indicus L. is a well-known medicinal plant in folk medicine. A variety of biological activities and chemical substances in this plant have been reported. The phytochemical content and activity may vary according to geographic location. This study aims to determine the geographical significance, the analysis of the synergistic effect of phytochemicals, the identification of active compounds, and the determination of the action mechanism of S. indicus inflorescence methanolic extract against Staphylococcus aureus and Klebsiella pneumonia.

Results

The bands with Rf values of 0.92 and 1.0 showed antimicrobial activity, while all bands showed antioxidant activity. The first fraction showed the highest antimicrobial activity, and the pool of the second fraction showed the highest antioxidant activity. The kinetics of the antioxidants differed among the fractions. Analysis of synergistic effects showed that several compounds were involved in the activities. The bands with Rf 0.45, 0.55, 0.68, 0.79, and 0.85 were active components of the extract. Leakage of cell contents was detected at 260 and 280 nm wavelengths. Six different proteins and one nucleic acid band were detected after electrophoresis. The SEM analysis showed that the phytochemicals caused severe membrane damage.

Conclusion

 The study revealed that the photochemical present in methanol extract of the inflorescence of S. indicus has a synergistic effect and acts on bacterial cell envelope. The five compounds were identified as active molecules belonging to the class of terpenoids. The result also signified the geographical area since thymol was identified for the first time in this plant at this location.

Graphical abstract
A LlMYB305-LlC3H18-LlWRKY33 module regulates thermotolerance in lily
Authors: Wu Ze , Liang Jiahui , Li Ting , Zhang Dehua , Teng Nianjun
Published: August 2023

The CCCH proteins play important roles in plant growth and development, hormone response, pathogen defense and abiotic stress tolerance. However, the knowledge of their roles in thermotolerance are scarce. Here, we identified a heat-inducible CCCH gene LlC3H18 from lily. LlC3H18 was localized in the cytoplasm and nucleus under normal conditions, while it translocated in the cytoplasmic foci and co-located with the markers of two messenger ribonucleoprotein (mRNP) granules, processing bodies (PBs) and stress granules (SGs) under heat stress conditions, and it also exhibited RNA-binding ability. In addition, LlC3H18 exhibited transactivation activity in both yeast and plant cells. In lily and Arabidopsis, overexpression of LlC3H18 damaged their thermotolerances, and silencing of LlC3H18 in lily also impaired its thermotolerance. Similarly, Arabidopsis atc3h18 mutant also showed decreased thermotolerance. These results indicated that the appropriate expression of C3H18 was crucial for establishing thermotolerance. Further analysis found that LlC3H18 directly bound to the promoter of LlWRKY33 and activated its expression. Besides, it was found that LlMYB305 acted as an upstream factor of LlC3H18 and activated its expression. In conclusion, we demonstrated that there may be a LlMYB305-LlC3H18-LlWRKY33 regulatory module in lily that is involved in the establishment of thermotolerance and finely regulates heat stress response.

Graphical Abstract
Caring for Our Patients With Opioid Use Disorder in the Perioperative Period: A Guide for the Anesthesiologist
Authors: Barreveld Antje M. , Mendelson Andrew , Deiling Brittany , Armstrong Catharina A. , Viscusi Eugene R. , Kohan Lynn R.
Published: August 2023

Opioid use disorder (OUD) is a rising public health crisis, impacting millions of individuals and families worldwide. Anesthesiologists can play a key role in improving morbidity and mortality around the time of surgery by informing perioperative teams and guiding evidence-based care and access to life-saving treatment for patients with active OUD or in recovery. This article serves as an educational resource for the anesthesiologist caring for patients with OUD and is the second in a series of articles published in Anesthesia & Analgesia on the anesthetic and analgesic management of patients with substance use disorders. The article is divided into 4 sections: (1) background to OUD, treatment principles, and the anesthesiologist; (2) perioperative considerations for patients prescribed medications for OUD (MOUD); (3) perioperative considerations for patients with active, untreated OUD; and (4) nonopioid and nonpharmacologic principles of multimodal perioperative pain management for patients with untreated, active OUD, or in recovery. The article concludes with a stepwise approach for the anesthesiologist to support OUD treatment and recovery. The anesthesiologist is an important leader of the perioperative team to promote these suggested best practices and help save lives.
Peculiarities of neoplasms appeared after total body irradiation and homeostasis parameters in rats
Authors: Snezhkova Elisaveta , Voronina Olena , Zadvornyi Taras , Todor Igor , Lukianova Natalia , Melnyk Victor , Sakhno Laryssa , Bardakhivska Kvitoslava , Chekhun Vasyl , Nikolaev Vladimir
Published: August 2023

Background: Tissue damage and disruption of metabolic processes as a result of total body irradiation (TBI) could lead to tumorigenesis.  

Methods:  Female rats (25 of 32) were X-irradiated with a 6-Gy dose. On month 12±1 animals   were sacrificed. The alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST),  amylase, lactate dehydrogenase (LDH), Ca 2+, creatinine, glucose, phosphorus, urea, uric acid, total protein, pO2, pCO2, pH, and blood cell count were evaluated in blood. Tumors were examinated histologically.

Results:  On 12±1 months after TBI, 76% of rats had visually detected tumors, histologically classified as benign fibro adenomas. Metabolic, hematological changes versus healthy control indicated disturbances in the homeostasis system. The blood lactate level was typically higher in animals with tumors than without. The ratio of tumor weight to lactate (or LDH) level in blood was 1±0.5 in the 63% of rats and histological analysis revealed the signs of biphasic hyperplasia of glandular lobes and connective tissue stroma, associated with secretory and proliferative activities in tumor. In animals with high values of this ratio (≥1.5) neoplasms were represented by fibrous and glandular tissues presenting a predominant stromal fibrous component, associated with the prevalence of high proliferation in tumor. While in 20% of tumor bearing rats with the low ratio (<0.5) predominated an epithelial structure with homogeneous basophilic content in the glandular lumens, suggesting the domination of secretory activity in tumor. 

Conclusions: TBI promoted the alterations of hematological and biochemical parameters of homeostasis in rats and provoked the appearance of benign tumors one year after. The ratio of tumor mass to lactate (or LDH) level in blood seems to be an informative indicator of the histological particularities of tumors, suggesting the prevalence of proliferative or secretory activity, or the balance between them.
BurkHostGEN: a study protocol for evaluating variations in the Burkholderia pseudomallei and host genomes associated with melioidosis infection
Authors: Angchagun Kesorn , Boonklang Phumrapee , Chomkatekaew Chalita , Pakdeerat Sukritpong , Wongsuwan Gumphol , Amornchai Premjit , Wuthiekanun Vanaporn , Panapipat Salwaluk , Ngernseng Thatsanun , Waithira Naomi , Walton Steve , Limmathurotsakul Direk , Surawong Anoree , Siriboon Suwatthiya , Chamnan Parinya , Chantratita Narisara , Dunachie Susie , Corander Jukka , Davenport Emma E. , Knight Julian , Parkhill Julian , Peacock Sharon J. , Thomson Nicholas R. , Day Nicholas P.J. , Chewapreecha Claire
Published: August 2023

Background: Melioidosis is a frequently fatal disease caused by an environmental bacterium Burkholderia pseudomallei. The disease is prevalent in northeast Thailand, particularly among rice field farmers who are at risk of bacterial exposure through contact with contaminated soil and water. However, not all exposure results in disease, and infection can have different infection outcomes. Our hypothesis is that the acquisition and outcomes of melioidosis may be influenced by genetic factors of the bacterium, the host, or a combination of both. To address this hypothesis, we aim to collect, sequence, and analyse genetic data from melioidosis patients and controls, along with isolates of B. pseudomallei obtained from patients. Additionally, we will study the metagenomics of the household water supply for both patients and controls, including the presence of B. pseudomallei.

Methods: BurkHostGEN is an ongoing observational study being conducted at Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand. Weare obtaining consent from 600 melioidosis patients and 700 controls, spanning both sexes, to collect 1 mL of blood for host DNA analysis, 3 mL of blood for RNA analysis, as well as 5 L of household water supply for metagenomic analysis. Additionally, we are isolating B. pseudomallei from the melioidosis patients to obtain bacterial DNA. This comprehensive approach will allow us to identify B. pseudomallei and their paired host genetic factors associated with disease acquisition and severity. Ethical approvals have been obtained for BurkHostGEN. Host and bacterial genetic data will be uploaded to European Genome-Phenome Archive (EGA) and European Nucleotide Archive (ENA), respectively.

Conclusions: BurkHostGEN holds the potential to discover bacterial and host genetic factors associated with melioidosis infection and severity of illness. It can also support various study designs, including biomarker validation, disease pathogenesis, and epidemiological analysis not only for melioidosis but also for other infectious diseases.
Classical Hodgkin lymphoma following follicular lymphoma: a case report
Authors: Kim Bomi
Published: August 2023

The simultaneous, composite, or sequential occurrence of follicular lymphoma (FL) and classical Hodgkin lymphoma (HL), both of which originate from germinal center B-cell, is rare. Questions have been raised with regard to the type of tests that pathologists should perform when observing the presence of a “large-cell lymphoma” following an FL and what are the most critical pathological points for diagnosis. Here, we present a case of a classical HL following an FL after administering rituximab-bendamustine (R-Benda) chemotherapy. Furthermore, we also summarized the literature and compared this case with other HLs that followed FLs. A 55-year-old woman was diagnosed with a grade 3A FL of the breast and axillary lymph node masses. She completed six R-Benda chemotherapy cycles for stage IV FL. Twenty-three months after the diagnosis, follow-up image studies showed an increase in the size and number of the lesions. Biopsies of the neck lymph node and liver were performed, and the diagnosis was classical HL. Sequential or composite FL and HL may sometimes develop from the same clone because they share the same genetic alterations, such as B-cell lymphoma (Bcl)-2 or Bcl-6 translocation. When a large-cell lymphoma is found after the treatment of FL, classical HL should be considered a pathological differential diagnosis, and histological, immunohistochemical, or molecular investigations must be considered during the diagnostic process.
Powojenny japoński pacyfizm jako narzędzie budowania dialogu międzykulturowego
Authors: Pletnia Maciej
Published: August 2023

POST-WAR JAPANESE PACIFISM AS A TOOL FOR BUILDING INTERCULTURAL DIALOGUE
The end of World War II marked the beginning of a long and complicated process of reconstructing a collective identity for the Japanese people, a process that largely continues to this day. The best example of this is the presence of contrasting attitudes toward the events of the war. This article highlights issues related to pacifist values and their relevance to the collective identity of contemporary Japanese. With the collapse of the previous identity at the end of World War II, pacifism has become one of the key values for contemporary Japanese. Using the concept of “core values” developed by Jerzy Smolicz, this article examines postwar pacifist movements from the mid-1950s through the 21st century.
Autonomic dysreflexia following spinal cord injury
Authors: Sarhan Firas , Sarhan Kenaan
Published: August 2023

Autonomic dysreflexia (AD) is one of the most common, yet most life-threatening, complication to occur following a spinal cord injury (SCI), at or above thoracic level six (T6). The main symptom of AD is a sudden and severe rise in blood pressure, which could cause death if untreated. Healthcare providers should be informed and familiar with the diagnosis and treatment of AD. It is important to note that most SCI patients, once discharged from rehabilitation hospitals, are managed at their own homes or a community rehabilitation setting, such as care, residential or nursing homes. Often, owing to the rapid onset and severity of the symptoms of AD, people with a SCI who develop AD are often admitted to the nearest local health facility, which may be staffed by healthcare professionals who have little or no knowledge or experience in managing AD. This article will offer very clear information regarding the causes, pathophysiology, symptoms and management of AD.
Critical calls: Circadian and seasonal periodicity in vocal activity in a breeding colony of Panamanian golden frogs (Atelopus zeteki)
Authors: Zigler Alan , Straw Stephanie , Tokuda Isao , Bronson Ellen , Riede Tobias
Published: August 2023

The Panamanian golden frog (Atelopus zeteki) is a critically endangered species and currently is believed to survive and reproduce only in human care. Panamanian golden frog males are considerably vocal which may be an important component in their successful reproduction, though little is currently known about their calls. To better understand the behavior and vocal patterns of this species and to improve breeding efforts in the assurance colony, we employed individual sound recording of male advertisement calls and acoustic monitoring of a breeding colony to investigate variation in the vocal behavior of Panamanian golden frogs. The goal was to capture variability within and among frogs as well as patterns of periodicity over time. First, the advertisement calls from individual male Panamanian golden frogs were recorded, and acoustic parameters were analyzed for individual differences. Results suggest that male advertisement calls demonstrate individual- and population specificity. Second, data collected through a year-long acoustic monitoring of the breeding colony were investigated for circadian and circannual periodicity. Male vocal activity revealed a circadian periodicity entrained by the daily light schedule. Seasonal periodicity was also found with highest vocal activities between December and March. The finding of a seasonal periodicity is worth noting given that the population had been bred for 20 years under constant environmental conditions. Finally, results suggest that vocal activity was responsive to daily animal care activity. Vocal activity decreased substantially when personnel entered the room and engaged in animal husbandry activities. The findings illustrate the usefulness of acoustic monitoring to provide insight into animal behavior in a zoo setting in a key breeding colony of endangered animals, and calling pattern observations may be utilized to modify husbandry practices to improve Panamanian golden frog breeding success and general care.
Bacterial community structure of Anopheles hyrcanus group, Anopheles nivipes, Anopheles philippinensis, and Anopheles vagus from a malaria-endemic area in Thailand
Authors: Boonroumkaew Patcharaporn , Rodpai Rutchanee , Saeung Atiporn , Aupalee Kittipat , Saingamsook Jassada , Poolphol Petchaboon , Sadaow Lakkhana , Sanpool Oranuch , Janwan Penchom , Thanchomnang Tongjit , Intapan Pewpan M. , Maleewong Wanchai
Published: August 2023

Bacterial content of mosquitoes has given rise to the development of innovative tools that influence and seek to control malaria transmission. This study identified the bacterial microbiota in field-collected female adults of the Anopheles hyrcanus group and three Anopheles species, Anopheles nivipes, Anopheles philippinensis, and Anopheles vagus, from an endemic area in the southeastern part of Ubon Ratchathani Province, northeastern Thailand, near the Lao PDR-Cambodia-Thailand border. A total of 17 DNA libraries were generated from pooled female Anopheles abdomen samples (10 abdomens/ sample). The mosquito microbiota was characterized through the analysis of DNA sequences from the V3−V4 regions of the 16S rRNA gene, and data were analyzed in QIIME2. A total of 3,442 bacterial ASVs were obtained, revealing differences in the microbiota both within the same species/group and between different species/group. Statistical difference in alpha diversity was observed between An. hyrcanus group and An. vagus and between An. nivipes and An. vagus, and beta diversity analyses showed that the bacterial community of An. vagus was the most dissimilar from other species. The most abundant bacteria belonged to the Proteobacteria phylum (48%-75%) in which Pseudomonas, Serratia, and Pantoea were predominant genera among four Anopheles species/group. However, the most significantly abundant genus observed in each Anopheles species/group was as follows: Staphylococcus in the An. hyrcanus group, Pantoea in the An. nivipes, Rosenbergiella in An. philippinensis, and Pseudomonas in An. vagus. Particularly, Pseudomonas sp. was highly abundant in all Anopheles species except An. nivipes. The present study provides the first study on the microbiota of four potential malaria vectors as a starting step towards understanding the role of the microbiota on mosquito biology and ultimately the development of potential tools for malaria control.
Prospective randomised unblinded comparison of sputum viscosity for three methods of saline nebulisation in mechanically ventilated patients: A pilot study protocol
Authors: Arnott Andrew , Hart Robert , McQueen Scott , Watson Malcolm , Sim Malcolm
Published: August 2023

Introduction

Heat and moisture exchanger (HME) filters are commonly used as passive circuit humidifiers during mechanical ventilation, however, are only ~80% efficient. As a result, patients that undergo mechanical ventilation in critical care with HME filter circuits will be exposed to partial airway humidification. This is associated with detrimental effects including increased secretion load which has been shown to be an independent predictor of failed extubation. Nebulised normal saline is commonly utilised to supplement circuit humidification in ventilated patients with high secretion loads, although there are no randomised control trials evaluating its use. Novel vibrating mesh nebulisers generate a fine aerosol resulting in deeper lung penetration, potentially offering a more effective means of nebulisation in comparison to jet nebulisers. The primary aim of this study is to compare the viscosity of respiratory secretions after treatment with nebulised normal saline administered via vibrating mesh nebuliser or jet nebuliser.

Methods and analysis

This randomised controlled trial is enrolling 60 mechanically ventilated adult critical care patients breathing on HME filter circuits with high secretion loads. Recruited patients will be randomised to receive nebulised saline via 3 modalities: 1) Continuous vibrating mesh nebuliser; 2) Intermittent vibrating mesh nebuliser or 3) Intermittent jet nebuliser. Over the 72-hr study period, the patients’ sputum viscosity (measured using a validated qualitative sputum assessment tool) and physiological parameters will be recorded by an unblinded assessor. A median reduction in secretion viscosity of ≥0.5 on the qualitative sputum assessment score will be deemed as a clinically significant improvement between treatment groups at analysis.

Discussion

At the conclusion of this trial, we will provisionally determine if nebulised normal saline administered via vibrating mesh nebulisation is superior to traditional jet nebulisation in terms of reduced respiratory secretion viscosity in intubated patients. Results from this pilot study will provide information to power a definitive clinical study.

Trial registration

ClinicalTrails.Gov Registry (NCT05635903).