bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolutionary responses of energy metabolism, development, and reproduction to artificial selection for increasing heat tolerance inDrosophila subobscura
Authors: Mesas Andrés , Castañeda Luis E
Published: March 2023

Adaptation to warming conditions involves increased heat tolerance and metabolic changes to reduce maintenance costs and maximize biological functions close to fitness. Evidence shows that energy metabolism evolves in response to warming conditions, but we know little about how heat stress intensity determines the evolutionary responses of metabolism and life history traits. Here, we evaluated the evolutionary responses of energy metabolism and life-history traits to artificial selection for increasing heat tolerance in Drosophila subobscura, using 2 protocols to measure and select heat tolerance: slow and fast ramping protocols. We found that the increase in heat tolerance was associated with reduced activity of the enzymes involved in the glucose-6-phosphate branchpoint but no changes of the metabolic rate in selected lines. We also found that the evolution of increased heat tolerance increased the early fecundity in selected lines and increased the egg-to-adult viability only in the slow-ramping selected lines. This work shows heat tolerance can evolve under different thermal scenarios but with different evolutionary outcomes on associated traits depending on the heat stress intensity. Therefore, spatial and temporal variability of thermal stress intensity should be taken into account to understand and predict the adaptive response to ongoing and future climatic conditions.
Within-generation and transgenerational social plasticity interact during rapid adaptive evolution
Authors: Sturiale Samantha L , Bailey Nathan W
Published: March 2023

The effects of within-generation plasticity vs. transgenerational plasticity on trait expression are poorly understood, but important for evaluating plasticity’s evolutionary consequences. We tested how genetics, within-generation plasticity, and transgenerational plasticity jointly shape traits influencing rapid evolution in the field cricket Teleogryllus oceanicus. In Hawaiian populations attacked by acoustically orienting parasitoid flies, a protective, X-linked variant (“flatwing”) eliminates male acoustic sexual signals. Silent males rapidly spread to fixation, dramatically changing the acoustic environment. First, we found evidence supporting flatwing-associated pleiotropy in juveniles: pure-breeding flatwing males and females exhibit greater locomotion than those with normal-wing genotypes. Second, within-generation plasticity caused homozygous-flatwing females developing in silence, which mimics all-flatwing populations, to attain lower adult body condition and reproductive investment than those experimentally exposed to song. Third, maternal song exposure caused transgenerational plasticity in offspring, affecting adult, but not juvenile, size, condition, and reproductive investment. This contrasted with behavioral traits, which were only influenced by within-generation plasticity. Fourth, we matched and mismatched maternal and offspring social environments and found that transgenerational plasticity sometimes interacted with within-generation plasticity and sometimes opposed it. Our findings stress the importance of evaluating plasticity of different traits and stages across generations when evaluating its fitness consequences and role in adaptation.
Geographic variability of hybridization between red-breasted and red-naped sapsuckers
Authors: Natola Libby , Billerman Shawn M , Carling Matthew D , Seneviratne Sampath S , Irwin Darren
Published: March 2023

Hybrid zones reveal the strength of reproductive isolation between populations undergoing speciation and are a key tool in evolutionary biology research. Multiple replicate transects across the same hybrid zone offer insight into the dynamics of hybridization in different environments, clarifying the role of extrinsic forces on the speciation process. Red-breasted and red-naped sapsuckers (Sphyrapicus ruber and Sphyrapicus nuchalis) have a long zone of contact over approximately 1,600 km from central British Columbia, Canada to central California, USA. We used Genotyping-by-Sequencing data from three independent sapsucker hybrid zone transects to compare hybridization dynamics between these species under variable geoclimatic conditions. We generated geographic clines of the genomic data to compare hybrid zone widths and used random forests models and linear regression to assess the relationship between climate and sapsucker ancestry along each transect. Our results show variation in the directionality of backcrossing, often indicative of moving hybrid zones. We note variable cline widths among transects, indicating differences in selection maintaining hybrid zone dynamics. Furthermore, random forests models identified different variables in close association with sapsucker ancestry across each transect. These results indicate a lack of repeatability across replicate transects and a strong influence of the local environment on hybrid zone dynamics.
On the predictability of phenotypic divergence in geographic isolation
Authors: Freeman Benjamin G , Montgomery Graham A , Heavyside Julian , Moncrieff Andre E , Johnson Oscar , Winger Benjamin M
Published: March 2023

Do related populations that are separated by barriers predictably evolve differences from one another over time, or is such divergence idiosyncratic and unpredictable? We test these alternatives by investigating patterns of trait evolution for 54 sister pairs of Andean forest birds that live in similar environments on either side of the arid Marañón Gap, a strong dispersal barrier for humid montane species. We measured divergence in both sexual (song and plumage) and ecological (beak size and beak shape) traits. Sexual traits evolve in a clock-like fashion, with trait divergence positively correlated with genetic distance (r = 0.6–0.7). In contrast, divergence in ecological traits is uncorrelated or only loosely correlated with genetic distance (r = 0.0–0.3). Thus, for geographically isolated Andean montane forest birds that live in similar environments, divergence is predictable in sexual traits, but not for ecological traits. This means that sexual trait divergence occurs independently of adaptive ecological divergence within the mega-diverse tropical Andean avifauna. Last, we show that variation in genetic divergence across a biogeographic barrier is associated with traits that are proxies for species’ opportunities for dispersal (low elevation limit and elevational niche breadth), but not with traits that are proxies for species’ dispersal abilities (hand-wing index and foraging strata).
Environment rather than character displacement explains call evolution in glassfrogs
Authors: Mendoza-Henao Angela M , Zamudio Kelly R , Guayasamin Juan M , Escalona Moisés , Parra-Olea Gabriela
Published: March 2023

The acoustic adaptation hypothesis (AAH) and ecological character displacement (ECD) are two potential mechanisms shaping call evolution that can predict opposite trends for the differentiation of signals. Under AAH, signals evolve to minimize environmental degradation and maximize detection against background noise, predicting call homogenization in similar habitats due to environmental constraints on signals. In contrast, ECD predicts greater differences in call traits of closely related taxa in sympatry because of selection against acoustic interference. We used comparative phylogenetic analyses to test the strength of these two selective mechanisms on the evolution of advertisement calls in glassfrogs, a highly diverse family of neotropical anurans. We found that, overall, acoustic adaptation to the environment may outweigh effects of species interactions. As expected under the AAH, temporal call parameters are correlated with vegetation density, but spectral call parameters had an unexpected inverse correlation with vegetation density, as well as an unexpected correlation with temperature. We detected call convergence among co-occurring species and also across multiple populations from the same species in different glassfrogs communities. Our results indicate that call convergence is common in glassfrogs, likely due to habitat filtering, while character displacement is relatively rare, suggesting that costs of signal similarity among related species may not drive divergent selection in all systems.
The oxidative cost of competing for egg fertilization exceeds the cost of egg production
Authors: Lorenzi Maria Cristina , Robles-Guerrero Franco G , Costantini David
Published: March 2023

Measuring reproductive costs is crucial to understanding sexual conflict and its evolutionary outcomes. Sexual conflict is thought to originate from anisogamy—the size difference between male and female gametes; if sperm are tiny and not produced in vastly greater numbers than eggs, at any mating females’ gametic investment is larger than that of males. Testing this prediction has proven difficult, especially because males and females differ in many more traits than just gamete size. We overcame this difficulty by exposing simultaneously hermaphroditic polychaete worms Ophryotrocha diadema (two sexual functions in the same body) to two social conditions, pairs, and groups >2, where hermaphrodites invest either relatively more in the female function or relatively more in the male function, respectively. Then we measured four markers of cellular oxidative status, a physiological mediator of life-history strategies. Less female-biased hermaphrodites produced fewer eggs but, unexpectedly, had lower levels of antioxidant protection than more female-biased hermaphrodites, which produced more eggs. Male-biased hermaphrodites compete for mating as males (hermaphrodites in pairs do not) suggesting that in the short-term male competition might be costlier than egg production in terms of regulation of oxidative status. These results highlight the need of including behavioral traits, namely competition over egg fertilization, in the measures of reproductive costs.
Geography, ecology, and history synergistically shape across-range genetic variation in a calanoid copepod endemic to the north-eastern Oriental
Authors: Zhang Xiaoli , Huang Qi , Liu Ping , Sun Chenghe , Papa Rey Donne S , Sanoamuang Laorsri , Dumont Henri J , Han Bo-Ping
Published: March 2023

The center-periphery hypothesis (CPH) predicts that peripheral populations will have lower genetic variation than those at the center of a species’ distribution. However, ecological margins do not always coincide with geographical edges when topographies are diverse. Historical climate changes can also strongly affect genetic variation. Here, we examined genetic variation in Phyllodiaptomus tunguidus, a calanoid copepod endemic to the north-eastern Oriental. This species was predicted to exhibit a complex pattern of genetic variation across its range due to the diverse topographies and stable climate history of the north-eastern Oriental. To test this, we used geographic distance to the center of the distribution, current ecological suitability, and climate during the last glacial maximum as geographical, ecological, and historical factors, respectively, in our analyses. We measured genetic diversity and population differentiation using mitochondrial and nuclear markers. This showed that P. tunguidus had 3 refugia during the last glacial maximum (LGM). Such a pattern of multiple refugia complicates the determination of the center and periphery of spatial genetic diversity. Both regression models and redundancy analyses failed to support the CPH. Instead, they showed that geographical, ecological, and historical factors together shaped population genetic structure in this species. Ecological factors explained significantly more genetic variation than did geographical and historical factors—however, all three factors interacted significantly to affect the pattern of genetic variation. The results extend our understanding of the CPH and the extent to which it can explain genetic variation across populations.
Larval transcriptomes reflect the evolutionary history of plant–insect associations
Authors: de la Paz Celorio-Mancera Maria , Steward Rachel A , Pruisscher Peter , Smialowska Agata , Pires Braga Mariana , Janz Niklas , Wheat Christopher W , Nylin Sören
Published: March 2023

In this study, we investigated whether patterns of gene expression in larvae feeding on different plants can explain important aspects of the evolution of insect–plant associations, such as phylogenetic conservatism of host use and re-colonization of ancestral hosts that have been lost from the host repertoire. To this end, we performed a phylogenetically informed study comparing the transcriptomes of 4 nymphalid butterfly species in Polygonia and the closely related genus Nymphalis. Larvae were reared on Urtica dioica, Salix spp., and Ribes spp. Plant-specific gene expression was found to be similar across butterfly species, even in the case of host plants that are no longer used by two of the butterfly species. These results suggest that plant-specific transcriptomes can be robust over evolutionary time. We propose that adaptations to particular larval food plants can profitably be understood as an evolved set of modules of co-expressed genes, promoting conservatism in host use and facilitating re-colonization. Moreover, we speculate that the degree of overlap between plant-specific transcriptomes may correlate with the strength of trade-offs between plants as resources and hence to the probability of colonizing hosts and complete host shifts.
Phylogenetically controlled life history trait meta-analysis in cetaceans reveals unexpected negative brain size and longevity correlation
Authors: Groot Nikita E , Constantine Rochelle , Garland Ellen C , Carroll Emma L
Published: March 2023

The identification of patterns in trait evolution is essential to understand the interaction of evolutionary forces, and provides useful information for species management. Cetaceans are a phylogenetically well-resolved infraorder that exhibit distinct trait variation across behavioral, molecular, and life history dimensions, yet few researchers have applied a meta-analytic or comparative approach to these traits. To understand cetacean trait evolution, we used a phylogenetic generalized least squares approach to examine the cognitive buffer hypothesis (CBH). A large brain should buffer individuals against environmental challenges through increasing survival rates, and a longer lifespan should buffer individuals against the cost of extended development for larger brains according to the CBH, leading to an expected positive correlation between brain size and lifespan. In contrast to this expectation, previously observed in taxa including primates, we found a negative correlation between brain size and lifespan in cetaceans. This suggests cetaceans experience selective pressures different from most other mammals in these traits but may be more similar to some social mammalian carnivores that display alloparenting. We also provide a comprehensive dataset to explore additional aspects of trait evolution but which would greatly benefit from studies on behavioral ecology across cetaceans and increased focus on data deficient species.
Paternal condition affects offspring reproduction and life history in a sex-specific manner inDrosophila melanogaster
Authors: Zeender Valérian , Sbilordo Sonja H , Roy Jeannine , Lüpold Stefan
Published: March 2023

Nongenetic parental effects can contribute to the adaptation of species to changing environments by circumventing some of the limitations of genetic inheritance. A clearer understanding of the influence of nongenetic inheritance and its potentially sex-specific responses in daughters and sons is needed to better predict the evolutionary trajectories of species. However, whereas nongenetic maternal effects have long been recognized and widely studied, comparatively little is known about corresponding paternal effects. Here, by following 30 isogenic lines of Drosophila melanogaster across two generations, each reared under two dietary regimes in each generation, we tested how protein restriction during larval development of the fathers affects the fitness and health of their daughters and sons. We then quantified genetic and non-genetic paternal, and direct environmental, effects across multiple axes of offspring fitness. Daughters and sons responded differently to their father’s developmental history. While isolines differed in mean trait values, their specific responses to protein restriction generally varied little. The sex- and trait-specific responses to paternal effects emphasize the complexity of inter-generational parental effects, which raise important questions about their mode of transmission and adaptive value, including the potential for conflict between the sexes.
Synthetic microbial communities (SynComs) of the human gut: design, assembly, and applications
Authors: van Leeuwen Pim T , Brul Stanley , Zhang Jianbo , Wortel Meike T
Published: March 2023

The human gut harbors native microbial communities, forming a highly complex ecosystem. Synthetic microbial communities (SynComs) of the human gut are an assembly of microorganisms isolated from human mucosa or fecal samples. In recent decades, the ever-expanding culturing capacity and affordable sequencing, together with advanced computational modeling, started a ‘‘golden age’’ for harnessing the beneficial potential of SynComs to fight gastrointestinal disorders, such as infections and chronic inflammatory bowel diseases. As simplified and completely defined microbiota, SynComs offer a promising reductionist approach to understanding the multispecies and multikingdom interactions in the microbe–host-immune axis. However, there are still many challenges to overcome before we can precisely construct SynComs of designed function and efficacy that allow the translation of scientific findings to patients’ treatments. Here, we discussed the strategies used to design, assemble, and test a SynCom, and address the significant challenges, which are of microbiological, engineering, and translational nature, that stand in the way of using SynComs as live bacterial therapeutics.
Comparative analysis of 3 pollen sterilization methods for feeding bumble bees
Authors: Strange James P , Tripodi Amber D , Huntzinger Craig , Knoblett Joyce , Klinger Ellen , Herndon James D , Vuong Hoang Q , McFrederick Quinn S , Irwin Rebecca E , Evans Jay D , Giacomini Jonathan J , Ward Robert , Adler Lynn S
Published: March 2023

Pollen is an essential component of bee diets, and rearing bumble bees (Bombus spp.) for commercial use necessitates feeding pollen in mass quantities. This pollen is collected from honey bee (Apis mellifera L.) colonies because neither an artificial diet nor an economical, large-scale pollen collection process from flowers is available. The provenance of honey bee-collected pollen is often unknown, and in some cases has crossed international borders. Both deformed wing virus (DWV) and the fungal pathogen Ascosphaera apis (Claussen) Olive & Spiltoir (cause of chalkbrood disease); occur in honey bee-collected pollen, and infections have been observed in bumble bees. We used these pathogens as general surrogates for viruses and spore-forming fungal diseases to test the efficacy of 3 sterilization methods, and assessed whether treatment altered pollen quality for the bumble bee. Using honey bee-collected pollen spiked with known doses of DWV and A. apis, we compared gamma irradiation (GI), ozone fumigation (OZ), and ethylene oxide fumigation (EO) against an untreated positive control and a negative control. Following sterilization treatments, we tested A. apis spore viability, detected viral presence with PCR, and tested palatability to the bumble bee Bombus impatiens Cresson. We also measured bacterial growth from pollens treated with EO and GI. GI and EO outperformed OZ treatment in pathogen suppression. EO had the highest sterilizing properties under commercial conditions and retained palatability and supported bee development better than other treatments. These results suggest that EO sterilization reduces pathogen risks while retaining pollen quality as a food source for rearing bumble bees.
Genome manipulation by guide-directed Argonaute cleavage
Authors: Huang Shan , Wang Kaihang , Mayo Stephen L
Published: March 2023

Many prokaryotic argonautes (pAgos) mediate DNA interference by using small DNA guides to cleave target DNA. A recent study shows that CbAgo, a pAgo from Clostridium butyricum, induces DNA interference between homologous sequences and generates double-stranded breaks (DSBs) in target DNAs. This mechanism enables the host to defend against invading DNAs such as plasmids and viruses. However, whether such a CbAgo-mediated DNA cleavage is mutagenic remains unexplored. Here we demonstrate that CbAgo, directed by plasmid-encoded guide sequences, can cleave genome target sites and induce chromosome recombination between downstream homologous sequences in Escherichia coli. The recombination rate correlates well with pAgo DNA cleavage activity and the mechanistic study suggests the recombination involves DSBs and RecBCD processing. In RecA-deficient E. coli strain, guide-directed CbAgo cleavage on chromosomes severely impairs cell growth, which can be utilized as counter-selection to assist Lambda-Red recombineering. These findings demonstrate the guide-directed cleavage of pAgo on the host genome is mutagenic and can lead to different outcomes according to the function of the host DNA repair machinery. We anticipate this novel DNA-guided interference to be useful in broader genetic manipulation. Our study also provides an in vivo assay to characterize or engineer pAgo DNA cleavage activity.
Competing contextual processes rely on the infralimbic and prelimbic medial prefrontal cortices in the rat
Authors: George David N , Killcross Simon , Haddon Josephine E
Published: March 2023

Ambiguous relationships between events may be established using interference procedures such as latent inhibition, extinction or counterconditioning. Under these conditions, the retrieval of individual associations between a stimulus and outcome is affected by contextual cues. To examine the roles of the dorsal (prelimbic) and ventral (infralimbic) medial prefrontal cortex in the contextual modulation of such associations, we investigated the context specificity of latent inhibition. Male Lister hooded rats were pre-exposed to two separate stimuli, one in each of two distinct contexts. Both stimuli were then paired with the delivery of mild foot-shock in the same one of these contexts. Finally, the strength of the resultant conditioned emotional response (CER) to each stimulus was assessed in each context. For the sham-operated control rats, the CER was attenuated for each stimulus when it was tested in the context in which it had been pre-exposed. Rats who had received lesions to the infralimbic cortex showed this effect only in the conditioning context, whereas rats with lesions to the prelimbic cortex showed the effect only in the context in which conditioning had not taken place. These findings indicate that infralimbic and prelimbic cortices play distinct, and competing, roles in the contextual modulation of initial and later learning.
Fully adaptive Bayesian algorithm for data analysis: FABADA
Authors: Sánchez-Alarcón Pablo M , Ascasibar Yago
Published: March 2023

The discovery potential from astronomical and other data is limited by their noise. We introduce a novel non-parametric noise reduction technique based on Bayesian inference techniques, fully adaptive Bayesian algorithm for data analysis (FABADA) that automatically improves the signal-to-noise ratio of one- and two-dimensional data, such as astronomical images and spectra. The algorithm iteratively evaluates possible smoothed versions of the data, the smooth models, estimating the underlying signal that is statistically compatible with the noisy measurements. Iterations stop based on the evidence and the χ2 statistic of the last smooth model. We then compute the expected value of the signal as a weighted average of the whole set of smooth models. We explain the mathematical formalism and numerical implementation of the algorithm, and evaluate its performance in terms of the peak signal-to-noise ratio, the structural similarity index, and the time payload, using a battery of real astronomical observations. Our FABADA yields results that, without any parameter tuning, are comparable with standard image processing algorithms whose parameters have been optimized based on the true signal to be recovered, something that is impossible in a real application. On the other hand, state-of-the-art non-parametric methods, such as block-matching and three-dimensional filtering, offer slightly better performance at high signal-to-noise ratio, while our algorithm is significantly more accurate for extremely noisy data, a situation usually encountered in astronomy.
Treacherous waters: justifying the non-application of Saunders v Vautier to massively discretionary trusts
Authors: Bond Eliza , Sanderson Harry
Published: March 2023

Under the rule in Saunders v Vautier, a beneficiary may at any time call for the trust property to be transferred to them. An unresolved question is whether this rule can apply to “massively discretionary trusts”—trusts where the trustees’ discretions effectively displace or overwhelm a beneficiary’s interests. There has been conflicting authority on this issue: while decisions of superior courts in Guernsey and Jersey have held that the rule can apply, the balance of authority in English law favours the non-application of the rule. In In re GeraldMartinSmith [2021] EWHC 1272 (Comm) Foxton J made obiter comments on the point, indicating that Saunders v Vautier does not and should not apply to massively discretionary trusts. This note discusses the case, and endorses Foxton J’s conclusion. However, it also comments on some points of principle not considered in the decision, arguing that the concept of indefeasibility should be more central to the justification for this conclusion.
Contrasting stem water uptake and storage dynamics of water-saver and water-spender species during drought and recovery
Authors: Martín-Gómez Paula , Rodríguez-Robles Ulises , Ogée Jérôme , Wingate Lisa , Sancho-Knapik Domingo , Peguero-Pina José , dos Santos Silva José Victor , Gil-Pelegrín Eustaquio , Pemán Jesús , Ferrio Juan Pedro
Published: March 2023

Drought is projected to occur more frequently and intensely in the coming decades, and the extent to which it will affect forest functioning will depend on species-specific responses to water stress. Aiming to understand the hydraulic traits and water dynamics behind water-saver and water-spender strategies in response to drought and recovery, we conducted a pot experiment with two species with contrasting physiological strategies, Scots pine (Pinus sylvestris L.) and Portuguese oak (Quercus faginea L.). We applied two cycles of soil drying and recovery and irrigated with isotopically different water to track fast changes in soil and stem water pools, while continuously measuring physiological status and xylem water content from twigs. Our results provide evidence for a tight link between the leaf-level response and the water uptake and storage patterns in the stem. The water-saver strategy of pines prevented stem dehydration by rapidly closing stomata which limited their water uptake during the early stages of drought and recovery. Conversely, oaks showed a less conservative strategy, maintaining transpiration and physiological activity under dry soil conditions, and consequently becoming more dehydrated at the stem level. We interpreted this dehydration as the release of water from elastic storage tissues as no major loss of hydraulic conductance occurred for this species. After soil rewetting, pines recovered pre-drought leaf water potential rapidly, but it took longer to replace the water from conductive tissues (slower labeling speed). In contrast, water-spender oaks were able to quickly replace xylem water during recovery (fast labeling speed), but it took longer to refill stem storage tissues, and hence to recover pre-drought leaf water potential. These different patterns in sap flow rates, speed and duration of the labeling reflected a combination of water-use and storage traits, linked to the leaf-level strategies in response to drought and recovery.
Mobile health lifestyle intervention program leads to clinically significant loss of body weight in patients with NASH
Authors: Stine Jonathan G. , Rivas Gloriany , Hummer Breianna , Duarte-Rojo Andres , May Christine N , Geyer Nathaniel , Chinchilli Vernon M. , Conroy David E. , Mitchell Ellen Siobhan , McCallum Meaghan , Michealides Andreas , Schmitz Kathryn H.
Published: March 2023

Background & Aims:

Lifestyle intervention remains the foundation of clinical care for patients with NASH; however, most patients are unsuccessful in enacting sustained behavioral change. There remains a clear unmet need to develop lifestyle intervention programs to support weight loss. Mobile health (mHealth) programs offer promise to address this need, yet their efficacy remains unexplored.

Approach & Results:

We conducted a 16-week randomized controlled clinical trial involving adults with NASH. Patients were randomly assigned (1:1 ratio) to receive Noom Weight (NW), a mHealth lifestyle intervention program, or standard clinical care. The primary end point was a change in body weight. Secondary end points included feasibility (weekly app engagement), acceptability (>50% approached enrolled), and safety. Of 51 patients approached, 40 (78%) were randomly assigned (20 NW and 20 standard clinical care). NW significantly decreased body weight when compared to standard clinical care (-5.5 kg vs. -0.3 kg, p = 0.008; -5.4% vs. -0.4%, p = 0.004). More NW subjects achieved a clinically significant weight loss of ≥5% body weight (45% vs. 15%, p = 0.038). No adverse events occurred, and the majority (70%) of subjects in the NW arm met the feasibility criteria.

Conclusions:

This clinical trial demonstrated that NW is not only feasible, acceptable, and safe but also highly efficacious because this mHealth lifestyle intervention program led to significantly greater body weight loss than standard clinical care. Future large-scale studies are required to validate these findings with more representative samples and to determine if mHealth lifestyle intervention programs can lead to sustained, long-term weight loss in patients with NASH.
A paradigm for fostering patient-centered research in liver disease: The liver transplant patient-engagement program
Authors: Lieber Sarah R. , VanWagner Lisa B. , Noriega Ramirez Alvaro , Serper Marina , Singal Amit G. , Evon Donna M.
Published: March 2023

Background:

Many federal funding and regulatory agencies require patient engagement to conduct patient-centered research and drug development. We developed a liver transplantation patient-engagement program, which can serve as a model for bringing the patient perspective to digestive diseases research.

Methods:

Six liver transplantation patient-engagement program advisors completed training in patient engagement; participated in several virtual sessions; and completed postsession surveys.

Results:

Qualitative and quantitative results elucidated patient-centered liver transplantation study outcomes and barriers/facilitators to conducting clinical research. Group satisfaction was very high.

Conclusions:

The liver transplantation patient-engagement program model provides a paradigm for how to engage patients in the formative steps of patient-centered clinical research.
The impact of dietary and lifestyle interventions on blood pressure management in sub-Saharan Africa: a systematic review and metanalysis
Authors: Ilori Titilayo O. , Zhen Aileen , Velani Romie N. , Zhao Runqi , Echouffo-Tcheugui Justin , Anderson Cheryl A.M. , Waikar Sushrut S. , Kengne Andre P.
Published: March 2023

Objectives:

Current literature is lacking a comprehensive review of data on dietary interventions in blood pressure (BP) management in sub-Saharan African countries. We assessed the association of dietary and other lifestyle interventions with BP-lowering effects in populations within sub-Saharan Africa.

Methods:

We performed a systematic review and random-effects meta-analysis to determine the impact of dietary and lifestyle interventions on SBP and DBP in sub-Saharan Africa. We searched the MEDLINE, EMBASE, and Web of Science databases. We included intervention studies that were randomized and nonrandomized conducted in Africans residing in sub-Saharan Africa investigating diet and other lifestyle, physical activity, weight loss, tobacco, and alcohol cessation modifications. We determined the effect of diet and other lifestyle interventions on SBP and DBP. We expressed effect size as weighted mean difference and 95% confidence interval (CI).

Main results

: We identified six studies with a total of 1412 individuals, 38% males, mean age of 52.8 years (SD = 11.5). The weighted mean difference of dietary and other lifestyle interventions on SBP and DBP was −7.33 mmHg, (95% CI: −9.90 to −4.76, P < 0.001) and −2.98 mmHg, (95% CI: −4.28 to −1.69, P < 0.001), respectively. In the metaregression analyses, the duration of the interventions did not have any effect on changes in SBP and DBP.

Principal conclusion

: Dietary modifications showed a beneficial overall improvement in SBP and DBP in Africans. However, aside from low-salt interventions, studies on dietary potassium, healthy dietary patterns, and lifestyle modifications have not been investigated extensively in Africans and are in critical need. In addition, researchers will need to consider the settings (rural, urban, or semiurban) and the predominant existing dietary habits while designing studies on dietary interventions in sub-Saharan Africa.

PROSPERO registration

: CRD42020207923.
Inverse salt sensitivity in normotensive adults: role of demographic factors
Authors: Romberger Nathan T. , Stock Joseph M. , Patik Jordan C. , McMillan Ronald K. , Lennon Shannon L. , Edwards David G. , Farquhar William B.
Published: March 2023

Background:

Salt sensitivity and inverse salt sensitivity [ISS; a reduction in blood pressure (BP) on a high sodium diet] are each associated with increased incidence of hypertension. The purpose of this analysis was to determine the prevalence of ISS in normotensive adults and whether ISS is associated with any demographic characteristic(s).

Method:

Healthy normotensive, nonobese adults [n = 84; 43 women; age = 37 ± 13 years; baseline mean arterial pressure (MAP) = 89 ± 8 mmHg] participated in a controlled feeding study, consuming 7-day low-sodium (20 mmol sodium/day) and high-sodium (300 mmol sodium/day) diets. Twenty-four-hour ambulatory BP was assessed on the last day of each diet. ISS was defined as a reduction in 24-h MAP more than 5 mmHg, salt sensitivity as an increase in MAP more than 5 mmHg and salt resistance as a change in MAP between −5 and 5 mmHg from low sodium to high sodium.

Results:

Using this cutoff, 10.7% were ISS, 76.2% salt resistant, and 13.1% salt sensitive. Prevalence of ISS was similar between sexes and age groups (P > 0.05). However, ISS was more prevalent in those with normal BMI (15.8% ISS) compared with those with overweight BMI (0% ISS; P < 0.01). Interestingly, classification of participants using a salt sensitivity index (ΔMAP/Δ urinary sodium excretion) categorized 21.4% as ISS, 48.8% salt resistant, and 29.8% salt sensitive. Overall, we found that the prevalence of ISS was 10.7% (5 mmHg cutoff) or 21.4% (salt sensitivity index), and that ISS was associated with lower BMI.

Conclusion:

These results highlight the importance of future work to understand the mechanisms of ISS and to standardize salt sensitivity assessment.
Association of hydrochlorothiazide treatment compared with alternative diuretics with overall and skin cancer risk: a propensity-matched cohort study
Authors: Götzinger Felix , Wilke Thomas , Hardtstock Fänce , Krieger Julia , Maywald Ulf , Kunz Michael , Lauder Lucas , Schulz Martin , Mahfoud Felix , Böhm Michael
Published: March 2023

Introduction:

Hydrochlorothiazide (HCT) has been suggested to induce photosensitivity, thereby increasing the incidence of skin cancers. After a pharmacovigilance alert, HCT was frequently withdrawn or substituted by other diuretics. The aim of this study was to compare the association of exposure to HCT with cancer risk versus alternative diuretics.

Methods:

A retrospective cohort study was conducted based on data from the AOK PLUS, a large German statutory health insurance fund. Patients with HCT treatment were propensity score matching to patients using non-HCT diuretics. Incidence of cancer of any kind and, specifically, skin cancer was assessed in both groups. Time-to-incident cancer diagnosis was evaluated and compared between the groups.

Results:

A total of 199 708 patients were included in the final analysis (n = 76 855 in the HCT group; n = 122 853 in the non-HCT-diuretics group). After propensity score matching, 122 554 patients remained in the sample (n = 61 277 for both groups, of which >96% had hypertension, mean age 73 years, 61% female). HCT treatment was associated with a lower incidence of cancer of any kind compared with non-HCT diuretics (incidence rate ratio per 100 patient years 0.84 95% confidence interval: 0.82–0.87). HCT treatment was associated with a small albeit significantly higher incidence rate ratio of skin cancer (1.14 95% confidence interval: 1.06–1.24) with significant variances over time. Although numerically higher, the difference accounts to only 0.05 more skin cancer diagnoses in 100 patient-years.

Conclusion:

HCT treatment compared with alternative diuretics was associated with a lower all-cancer risk and a numerically small increased skin cancer risk in a large German population. Risk–benefit evaluation should be executed in patients with increased skin cancer risk and treatment with HCT. Furthermore, advice for skin protection is warranted in all patients taking thiazide or thiazide-like diuretics.
Neonatal Group B Streptococcal Infection in Australia: A Case–control Study
Authors: Yanni Marianne , Stark Michael , Francis Laura , Francis Joshua R. , McMillan Mark , Baird Rob , Heath Paul T. , Gordon Alex , Riccardione James , Wilson Angela , Lee Rebecca , Chooi Kathrina , Quinn Olivia-Paris , Marshall Helen S.
Published: March 2023

Background:

To determine maternal and neonatal risk factors for, and incidence of, neonatal early-onset group B streptococcus (EOGBS) and late-onset (LOGBS) infection in South Australia (SA) and the Northern Territory (NT).

Methods:

A case–control study with 2:1 matched controls to cases. The study included tertiary hospitals in South Australia and the Northern Territory, Australia. Retrospective data were collected from a 16-year epoch (2000–2015).

Results:

Of a total of 188 clinically suspected or confirmed cases, 139 were confirmed, of which 56.1% (n = 78) were EOGBS and 43.9% (n = 61) were LOGBS. The incidence of clinically suspected and confirmed cases of EOGBS was 0.26/1000 live births in SA and 0.73/1000 live births in the NT, and the incidence of confirmed cases was 0.19/1000 for SA and 0.36/1000 for the NT. The incidence of clinically suspected or confirmed LOGBS was 0.18/1000 live births in SA and 0.16/1000 for the NT. The majority of infants with GBS presented with sepsis, pneumonia, or meningitis. Developmental delay was the most commonly recorded long-term complication at 1 year old. Risk factors for EOGBS included maternal GBS carriage, previous fetal death, identifying as Aboriginal and/or Torres Strait Islander, and maternal fever in labor/chorioamnionitis.

Conclusions:

GBS remains a leading cause of neonatal morbidity and mortality. Adding previous fetal death to GBS screening guidelines would improve GBS prevention. The introduction of maternal GBS vaccination programs should be guided by country-specific disease epidemiology.
Colorectal cancer with testicular metastasis: A case report and literature review
Authors: Wu Jia-Ming , Zhang Ao , Dong Yu , Lin Si-Hong , Meng Jin-Cheng , Fang Can-Tu
Published: March 2023

Rationale:

Colorectal cancer is the second leading cause of cancer-related deaths in the world. About 50% of patients will have metastases during the course of the disease. The common sites of metastasis are the liver, lung, peritoneum, lymph, etc. Metastatic carcinoma to the testes is uncommon. We found a case of ascending colon cancer metastasized to the testis in the clinic.

Patient concerns:

We reported a 50-year-old male patient who was found to have testicular metastases >4 years after intestinal cancer surgery, and multiple metastases in the peritoneum and pelvis were found 1 week later.

Diagnoses:

After enhanced computed tomography and pathological biopsy, the patient was diagnosed with testicular metastasis of colon cancer.

Interventions:

Capecitabine combined with bevacizumab is currently undergoing palliative treatment.

Outcomes:

The patients died of tumor progression on June 28, 2021.

Lessons:

The testicular metastasis of colorectal cancer is a sign of peritoneum and multiple metastases. When the testicular metastasis occurs in colorectal cancer patients, it usually indicates that the patient has a poor prognosis.
Drug-induced liver injury in COVID-19 patients during hospitalization
Authors: Chen Ying , Shi Cai , Zhan Haiyan , Yang Boning , Liu Jun , Rong Peipei , Luo Yi , Yang Jian
Published: March 2023

Since coronavirus disease 2019 (COVID-19) outbreaks in December 2019 in Wuhan, almost no studies have systematically described drug-induced liver injury (DILI) in COVID-19 patients. This study aimed to assess the characteristics of liver test abnormality or liver injury in patients with COVID-19, and further to explore DILI in COVID-19 patients during hospitalization. It was a single-center retrospective analysis of confirmed severe acute respiratory syndrome coronavirus 2 infected patients in the hospital from January 2020 to March 2020. Univariate and multivariate logistic regression analysis were used to assess the risk factors associated with liver test abnormality or liver injury. At admission, 148 (48.8%, 148/303) patients had abnormal liver test results and 7 (2.4%, 7/303) had liver injury, while 195 (64.4%, 195/303) had abnormal liver test results and 17 (5.6%, 17/303) had liver injury during hospitalization. After excluding these patients with liver disease and liver function abnormalities or liver injury at admission, 15 (11.1%, 15/135) patients developed DILI during hospitalization. Further regression analysis indicated that methylprednisolone (odds ratio = 4.177, 95% confidence interval [1.106–15.771], P = .035), but not Chinese herbal medicine or other used drug, was associated with DILI in patients during hospitalization. Abnormal liver function results were in more than half of patients with COVID-19, and the incidence of DILI in COVID-19 patients was 11.1% during hospitalization. Liver test abnormality or liver injury in patients might be directly caused by the viral infection at admission, but the detrimental effects on liver injury mainly related to certain medications used during hospitalization, particularly methylprednisolone. Severe COVID-19 could increase the occurrence of liver injury (P = .007) during hospitalization, but not a risk factor of liver injury. However, Chinese herbal medicine was a protective factor for liver injury.
Pearls for practice from the 2022 joint task force drug allergy practice parameter
Authors: Wang Ziwei , Shaker Marcus , Hsu Blatman Karen
Published: March 2023

Purpose of review

To review updated recommendations in the 2022 Drug Allergy Practice Parameters for the evaluation and management of drug hypersensitivity reactions.

Recent findings

Adverse drug reactions have become increasingly prominent with the advent of new and emerging pharmacologic therapies. Hypersensitivity reactions encompass a significant proportion of adverse drug reactions and negatively impact both the individual patient and overall health system. Reactions are heterogeneous in presentation and may be immediate (onset of symptoms ≤6 h) or delayed (onset of symptoms >6 h to months) after drug exposure. The 2022 Drug Allergy Practice Parameter provides consensus-based statements for evaluation of hypersensitivity reactions to antibiotics, NSAIDs, cancer chemotherapies, immune checkpoint inhibitors, biologics, and excipients. In general, the guideline highlights the importance of patient history in elucidating the phenotype and severity of the index reaction. Drug challenge remains the gold standard for diagnosis and is increasingly favored over skin testing in patients with nonsevere, nonanaphylactic drug reaction histories.

The 2022 Drug Allergy Practice Parameter provides an updated framework for physicians to reference in clinical practice when managing patients with drug hypersensitivity reactions.
Long-Term Outcomes of Depression Treatment With Hypnotherapy or Cognitive Behavioral Therapy
Authors: Fuhr Kristina , Meisner Christoph , Batra Anil
Published: March 2023

In a recent randomized controlled trial of mild to moderate depression, hypnotherapy (HT) was noninferior to cognitive behavioral therapy (CBT) after 6 months of outpatient treatment. In the present article, we extended the results in a secondary analysis and investigated how HT compares with CBT 1) during the course of the self-rated depressive symptoms throughout the 12-month follow-ups, 2) with regard to the rates of full remission, and 3) for the time to remission after treatment. Of the 152 randomized patients with current depression, 136 were available for the follow-up analyses. The course of self-rated depressive symptoms during follow-ups was analyzed with linear mixed-effects models. Time to a full remission, defined as eight consecutive weeks without depression, was compared between groups in a survival analysis. The self-reported depressive symptoms could be maintained on a low symptom level during the 12-month follow-up for both HT and CBT. Overall, both treatments achieved comparably high long-term remission rates of 73% after a median of 30 weeks. Outpatient psychotherapy with HT achieved good long-term results mostly comparable to CBT.
A retrospective review of the rate of septic knee arthritis after retrograde femoral nailing for traumatic femoral fractures at a single academic institution
Authors: Bailey Ryan S. , Nwadike Benjamin A. , Revak Thomas
Published: March 2023

Background:

Retrograde intramedullary nailing of the femur is a popular treatment option for femoral shaft fractures. However, this requires accessing the intramedullary canal through the knee, posing a risk of intra-articular infection. The purpose of this study was to examine the rate of intra-articular infection of the knee after retrograde nailing of femoral shaft fractures.

Methods:

All patients who underwent retrograde intramedullary nailing for femoral shaft fractures between June 2004 and December 2017 at a level 1 trauma center were reviewed. Six months of follow-up or documented fracture union was required. Records were reviewed for documentation of septic arthritis of the ipsilateral knee during the follow-up period.

Results:

A total of 294 fractures, including 217 closed and 77 open injuries, were included. Eighteen had an associated ipsilateral traumatic arthrotomy; 188 cases had an associated ipsilateral lower extremity fracture. No cases of septic arthritis were identified.

Conclusion:

There were no cases of septic arthritis in 294 fractures treated with retrograde intramedullary nailing. Retrograde nailing appears safe for risk of postoperative septic arthritis of the knee even in the face of open fractures and traumatic wounds.