bluuebunny/crossref_metadata_2025 huggingface dataset:
The usefulness of platelet-rich plasma (PRP) as an adjuvant therapy for the treatment of vitiligo: a systematic review
Authors: Earlia N , Lestari W , Bulqiah M , Fajrina N , Maulana M N , Tasrif A Y
Published: July 2024

PRP (Platelet-Rich Plasma) has been widely used to treat dermatological diseases, one of which is vitiligo. There have been a number of published trials evaluating PRP combined therapy for vitiligo. However, evidence-based knowledge is insufficient for making sound decisions. This systematic review conducted to assess the evidence of therapeutic effect of PRP for vitiligo as an adjuvant therapy. All data sources were identified through electronic database searches on PubMed, Cochrane Library and Google Schoolar to find randomized controlled trials (RCT). The result of this review descriptively present with table. This study identified 13 studies that met inclusion criteria. Eight studies show the significant therapeutic effect of PRP for vitiligo. The combination therapy with PRP resulted in a significantly greater clinical improvement in re-pigmentation compared to monotherapy. PRP demonstrates efficacy and safety, making it a viable therapeutic option as an adjuvant or alternative treatment for vitiligo, owing to its healing and regenerative attributes.
Machine learning method for roughness prediction
Authors: Makhoul Bassem Y , Simas Filho Eduardo F , de Assis Thiago A
Published: July 2024

This work aims to employ machine-learning models, specifically neural networks, to predict the time evolution of the global surface roughness in a lattice model that represents a film growing on a d-dimensional substrate. We analyze the well-known ballistic deposition (BD) model for d=1, 2 since it presents strong corrections to the scaling, making it difficult to observe directly, via effective scaling exponents, its correspondence with the Kardar-Parisi-Zhang (KPZ) universality class. As an alternative to overcome this difficulty, we first intend to learn the time evolution of the global roughness for substrate sizes that are computationally viable to simulate. To test the learning, we apply two different methodologies for d = 1: the first one learns the Family-Vicsek scaling relation, and by doing the reverse transformation, we get the global roughness as a function of the time, and the second one learns the kinetic roughening directly from the time series data. For growth in d = 2 where applications arise and no exact KPZ scaling exponents are known, we apply the second methodology. However, we employ a more resilient learning model tailored for time series problems. Hence, the time required to generate the same amount of data, showing the evolution of global roughness, is reduced dramatically. Importantly, machine learning techniques capture the scaling corrections of the BD model, predicting an effective global roughness exponent, α, calculated from the learned data extracted from very large lateral sizes and times that cannot be simulated using lattice models. Our prediction is consistent with accurate estimates of the KPZ roughness exponent reported in the literature for d = 2.
Guideline summary: assessment, diagnosis, care and support for people with dementia and their carers [Scottish Intercollegiate Guidelines Network SIGN Guideline 168]
Authors: Burton Jennifer Kirsty , Soiza Roy L , Quinn Terence J ,   On behalf of the SIGN 168 guideline development group
Published: July 2024

The Scottish Intercollegiate Guidelines Network (SIGN) have recently published their guideline SIGN168 on ‘Assessment, Diagnosis, Care, and Support for People with Dementia and their Carers’. The guideline makes evidence-based recommendations for best practice in the assessment, care and support of adults living with dementia. Topics featured in this guideline are limited to those prioritised by stakeholders, especially people with lived and living experience, and those not well covered under pre-existing guidance. We summarise the guideline recommendations related to identification and diagnosis of dementia, investigative procedures, postdiagnostic support living with dementia, including non-pharmacological approaches for distressed behaviours, using technology to support people with dementia, grief and dementia and changing needs of people with dementia. The guideline content is summarised as officially published, with additional commentary in the final section.
Pathogenic heterozygous TRPM7 variants and hypomagnesemia with developmental delay
Authors: Bosman Willem , Butler Kameryn M , Chang Caitlin A , Ganapathi Mythily , Guzman Edwin , Latta Femke , Chung Wendy K , Claverie-Martin Felix , Davis Jessica M , Hoenderop Joost G J , de Baaij Jeroen H F
Published: July 2024

Background

Heterozygous variants in Transient receptor potential melastatin type 7 (TRPM7), encoding an essential and ubiquitously expressed cation channel, may cause hypomagnesemia, but current evidence is insufficient to draw definite conclusions and it is unclear whether any other phenotypes can occur.

Methods

Individuals with unexplained hypomagnesemia underwent whole-exome sequencing which identified TRPM7 variants. Pathogenicity of the identified variants was assessed by combining phenotypic, functional and in silico analyses.

Results

We report three new heterozygous missense variants in TRPM7 (p.Met1000Thr, p.Gly1046Arg, p.Leu1081Arg) in individuals with hypomagnesemia. Strikingly, autism spectrum disorder and developmental delay, mainly affecting speech and motor skills, was observed in all three individuals, while two out of three also presented with seizures. The three variants are predicted to be severely damaging by in silico prediction tools and structural modeling. Furthermore, these variants result in a clear loss-of-function of TRPM7-mediated magnesium uptake in vitro, while not affecting TRPM7 expression or insertion into the plasma membrane.

Conclusions

This study provides additional evidence for the association between heterozygous TRPM7 variants and hypomagnesemia and adds developmental delay to the phenotypic spectrum of TRPM7-related disorders. Considering that the TRPM7 gene is relatively tolerant to loss-of-function variants, future research should aim to unravel by what mechanisms specific heterozygous TRPM7 variants can cause disease.
Thrombus inside the channel of patent foramen ovale revealed by optical coherence tomography imaging in a patient with myocardial infarction
Authors: Wang Xing-ye , He Lu , Xie Xue-gang , Liu Xiao-qin , Zhang Yu-shun
Published: July 2024

Background

Myocardial infarction (MI) caused by patent foramen ovale (PFO)-based paradoxical embolism is rare, and there are few case reports in the literature.

Case summary

Here, we report a case of MI in which optical coherence tomography revealed in situ thrombi in the PFO channel.

Discussion

In addition to paradoxical embolism, in situ thrombus may also be one of the pathogenic mechanisms of PFO in patients with MI.
Reduction in the need for surgery and mortality after early administration of fibrinolytics following empyema drainage
Authors: Tamiya Hiroyuki , Jo Taisuke , Yokoyama Akira , Sakamoto Yukiyo , Mitani Akihisa , Tanaka Goh , Matsui Hiroki , Ishimaru Miho , Yasunaga Hideo , Nagase Takahide
Published: July 2024

OBJECTIVES

Although intrapleural administration of fibrinolytics is an important treatment option for the management of empyema, the addition of fibrinolytics failed to reduce the need for surgery and mortality in previous randomized controlled trials. This study aimed to investigate the effects of administrating fibrinolytics in the early phase (within 3 days of chest tube insertion) of empyema compared with late administration or no administration.

METHODS

We used the Japanese Diagnosis Procedure Combination Inpatient Database to identify patients aged ≥16 years who were hospitalized and underwent chest tube drainage for empyema. A 1:2 propensity score matching and stabilized inverse probability of treatment weighting were conducted.

RESULTS

Among the 16 265 eligible patients, 3082 and 13 183 patients were categorized into the early and control group, respectively. The proportion of patients who underwent surgery was significantly lower in the early fibrinolytics group than in the control group; the odds ratio (95% confidence interval) was 0.69 (0.54–0.88) in the propensity score matching (P = 0.003) and 0.64 (0.50–0.80) in the stabilized inverse probability of treatment weighting analysis (P < 0.001). All-cause 30-day in-hospital mortality, length of hospital stay, duration of chest tube drainage, and total hospitalization costs were also more favourable in the early fibrinolytics group.

CONCLUSIONS

The early administration of fibrinolytics may reduce the need for surgery and death in adult patients with empyema.
Artificial intelligence-enhanced patient evaluation: bridging art and science
Authors: Oikonomou Evangelos K , Khera Rohan
Published: July 2024

The advent of digital health and artificial intelligence (AI) has promised to revolutionize clinical care, but real-world patient evaluation has yet to witness transformative changes. As history taking and physical examination continue to rely on long-established practices, a growing pipeline of AI-enhanced digital tools may soon augment the traditional clinical encounter into a data-driven process. This article presents an evidence-backed vision of how promising AI applications may enhance traditional practices, streamlining tedious tasks while elevating diverse data sources, including AI-enabled stethoscopes, cameras, and wearable sensors, to platforms for personalized medicine and efficient care delivery. Through the lens of traditional patient evaluation, we illustrate how digital technologies may soon be interwoven into routine clinical workflows, introducing a novel paradigm of longitudinal monitoring. Finally, we provide a skeptic’s view on the practical, ethical, and regulatory challenges that limit the uptake of such technologies.
Recovering induced polarization effects from 1-D coupled inversion of transient electromagnetic data
Authors: Sharifi Fereydoun , Tezkan Bülent , Ibraheem Ismael M , Bergers Rainer , Yogeshwar Pritam
Published: July 2024

Induced polarization (IP) effects can significantly affect and superimpose the inductive earth response, leading to heavily distorted data and, if overlooked, false geological interpretation. In this paper, we implemented the Levenberg–Marquardt (LM) and very fast simulated annealing (VFSA) algorithms to recover IP effects from central loop transient electromagnetic (TEM) data. To incorporate the IP effect in the TEM response, we used the Cole–Cole parametrization, maximum phase angle (MPA), maximum imaginary conductivity (MIC) and Jeffrey transform of Cole–Cole parameters. The result of 1-D forward calculation and inversion of synthetic TEM data revealed that the Cole–Cole parametrization is more robust and reliable than MPA, MIC and Jeffrey transform, and that the synthetic data were well fitted and IP parameters well recovered using this model. However, the incorporation of the IP effect leads to a highly nonlinear and non-unique inverse problem which requires an accurate starting model, especially for LM inversion. To evaluate the performance of our algorithm using field data, we carried out a 1-D inversion of TEM data acquired along a profile that traverses a waste site located near Cologne, Germany. Furthermore, to obtain a priori information and validate the result of TEM data modelling, we conducted an electrical resistivity tomography (ERT) and time-domain IP (TDIP) survey along the TEM profile. A 2-D inversion was used to retrieve the Cole–Cole parameters as input for TEM interpretation. By including the IP information, the TEM field data can be explained quantitively, and a consistent and improved interpretation of the waste body is achieved.
“Do not inject our babies”: a social listening analysis of public opinion about authorizing pediatric COVID-19 vaccines
Authors: Golos Aleksandra M , Guntuku Sharath-Chandra , Buttenheim Alison M
Published: July 2024

Designing effective childhood vaccination counseling guidelines, public health campaigns, and school-entry mandates requires a nuanced understanding of the information ecology in which parents make vaccination decisions. However, evidence is lacking on how best to “catch the signal” about the public's attitudes, beliefs, and misperceptions. In this study, we characterize public sentiment and discourse about vaccinating children against SARS-CoV-2 with mRNA vaccines to identify prevalent concerns about the vaccine and to understand anti-vaccine rhetorical strategies. We applied computational topic modeling to 149 897 comments submitted to regulations.gov in October 2021 and February 2022 regarding the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee's emergency use authorization of the COVID-19 vaccines for children. We used a latent Dirichlet allocation topic modeling algorithm to generate topics and then used iterative thematic and discursive analysis to identify relevant domains, themes, and rhetorical strategies. Three domains emerged: (1) specific concerns about the COVID-19 vaccines; (2) foundational beliefs shaping vaccine attitudes; and (3) rhetorical strategies deployed in anti-vaccine arguments. Computational social listening approaches can contribute to misinformation surveillance and evidence-based guidelines for vaccine counseling and public health promotion campaigns.
From political priority to service delivery: complexities to real-life priority of abortion services in Ethiopia
Authors: McLean Emily , Miljeteig Ingrid , Blystad Astrid , Mirkuzie Alemnesh H , Haaland Marte E. S
Published: July 2024

Improving access to abortion services has been coined a high priority by the Ethiopian Federal Ministry of Health. Nevertheless, many women are still struggling to access abortion services. The dedicated commitment to expanding abortion services by central authorities and the difficulties in further improving access to the services make for an interesting case to explore the real-life complexities of health priority setting. This article thus explores what it means to make abortion services a priority by drawing on in-depth interviews with healthcare bureaucrats and key stakeholders working closely with abortion service policy and implementation. Data were collected from February to April 2022. Health bureaucrats from 9 of the 12 regional states in Ethiopia and the Federal Ministry of Health were interviewed in addition to key stakeholders from professional organizations and NGOs. The study found that political will and priority to abortion services by central authorities were not necessarily enough to ensure access to the service across the health sector. At the regional and local level, there were considerable challenges with a lack of funding, equipment and human resources for implementing and expanding access to abortion services. The inadequacy of indicators and reporting systems hindered accountability and made it difficult to give priority to abortion services among the series of health programmes and priorities that local health authorities had to implement. The situation was further challenged by the contested nature of the abortion issue itself, both in the general population, but also amongst health bureaucrats and hospital leaders. This study casts a light on the complex and entangled processes of turning national-level priorities into on-the-ground practice and highlights the real-life challenges of setting and implementing health priorities.
Mind the Gap: A Review of Disjunctions in Coastal Marine Species
Authors: Pagowski Veronica , Micheli Fiorenza
Published: July 2024

Synopsis

Many coastal marine species have discontinuous distributions or genetic breakpoints throughout their geographical ranges. These spatial and genetic disjunctions occur in species that span limited to broad dispersal potential. Thus, the mechanisms that underlie these disjunctions remain speculative or incompletely known, particularly on small spatial scales where long-term historical processes are unlikely to be the only mechanism contributing to disjunction. Rather, ecological or oceanographic factors may be important. To identify key drivers of coastal disjunctions, we reviewed publications investigating spatial and genetic disjunctions in coastal marine species and visually summarized where and why they are thought to occur. The most frequently cited mechanisms implicated in causing disjunctions include historical processes, oceanographic features, heterogeneous habitat, species introductions, and limited larval dispersal capacities. However, the relative importance of each of these processes varies depending on the spatial scales investigated. Furthermore, locations associated with disjunctions for a suite of species are typically associated with multiple processes that maintain these disjunctions. This study provides a non-exhaustive synthesis of disjunctions in coastal marine species by visualizing where they occur, exploring underlying mechanisms, and investigating biases in how the scientific community studies this phenomenon.
Trajectories of Serum Hepatitis B Surface antigen (HBsAg) During Treatment and Association With HBsAg Loss in Children With Hepatitis B e Antigen–Positive Chronic Hepatitis B: A Latent Class Trajectory Analysis
Authors: Yao Zhenzhen , Gu Yingping , Lai Xin , Yang Meng , Xu Yi , Luo Jiayou , Peng Songxu
Published: July 2024

Background

Changes in serum hepatitis B surface antigen (HBsAg) during treatment are associated with HBsAg loss. However, little is known about the trajectory patterns of HBsAg in early treatment and their relationship to subsequent HBsAg loss.

Methods

A retrospective study was conducted on 166 treatment-naive children with hepatitis B e antigen (HBeAg)–positive chronic hepatitis B (CHB). Latent class trajectory analysis was used to identify trajectory groups of serum HBsAg. Cox proportional hazards models were used to assess the association between HBsAg trajectory groups and HBsAg loss.

Results

The median follow-up time was 20.70 (interquartile range, 12.54–34.17) months, and HBsAg loss occurred in 70 (42.17%) of all study participants. Using latent class trajectory analysis, HBeAg-positive patients with CHB were classified into 3 trajectory groups: trajectory 1 (sustained stability, 24.70%), trajectory 2 (slow decline, 38.55%), and trajectory 3 (rapid decline, 36.75%), respectively. The risk of achieving HBsAg loss was higher in both trajectory 2 (hazard ratio, 3.65 [95% confidence interval, 1.70–7.83]) and trajectory 3 (7.27 [3.01–17.61]), respectively.

Conclusions

Serum HBsAg levels during early treatment can be classified into distinct trajectory groups, which may serve as an additional predictive indicator for HBsAg loss in HBeAg-positive children with CHB.
Large-scale single-virus genomics uncovers hidden diversity of river water viruses and diversified gene profiles
Authors: Nishikawa Yohei , Wagatsuma Ryota , Tsukada Yuko , Chia-ling Lin , Chijiiwa Rieka , Hosokawa Masahito , Takeyama Haruko
Published: July 2024

Environmental viruses (primarily bacteriophages) are widely recognized as playing an important role in ecosystem homeostasis through the infection of host cells. However, the majority of environmental viruses are still unknown as their mosaic structure and frequent mutations in their sequences hinder genome construction in current metagenomics. To enable the large-scale acquisition of environmental viral genomes, we developed a new single-viral genome sequencing platform with microfluidic-generated gel beads. Amplification of individual DNA viral genomes in mass-produced gel beads allows high-throughput genome sequencing compared to conventional single-virus genomics. The sequencing analysis of river water samples yielded 1431 diverse viral single-amplified genomes, whereas viral metagenomics recovered 100 viral metagenome-assembled genomes at the comparable sequence depth. The 99.5% of viral single-amplified genomes were determined novel at the species level, most of which could not be recovered by a metagenomic assembly. The large-scale acquisition of diverse viral genomes identified protein clusters commonly detected in different viral strains, allowing the gene transfer to be tracked. Moreover, comparative genomics within the same viral species revealed that the profiles of various methyltransferase subtypes were diverse, suggesting an enhanced escape from host bacterial internal defense mechanisms. Our use of gel bead-based single-virus genomics will contribute to exploring the nature of viruses by accelerating the accumulation of draft genomes of environmental DNA viruses.
The Effect of Enhanced Rehabilitation Program on Upper Limb Function in Patients Undergoing Abdominal Pedicle Flap Surgery
Authors: Chen Zhiyu , Huang Ling , Yu Ran , Zhou Yaqin , Tan Jianglin
Published: July 2024

To investigate the effect of an enhanced rehabilitation program on upper limb function in patients with abdominal pedicle flap surgery, we retrospectively analyzed 70 patients who received abdominal pedicled flap surgery between 2017 and 2022. Patients were categorized into the traditional rehabilitation group (rehabilitation initiated after the stage II pedicle dissection of the abdominal pedicle flap) and the enhanced rehabilitation group (rehabilitation initiated on the first day following the stage II abdominal pedicle flap surgery). All the patients received identical rehabilitation protocols. Passive Range of Motion (PROM), activities of daily living (ADL), Functional Independence Measure (FIM), and Manual Muscle Testing (MMT) were assessed at 5 days and 1 month following the stage II surgery. The main causes of injury were electrical burns in both groups. The hospital stay of patients in the enhanced group was significantly shorter than the traditional group. One month assessment indicated both groups showed significant improvements in the PROM of shoulder flexion, abduction, and elbow extension compared to the 5 days assessment. Notably, at 5 days assessment, the enhanced group had significantly higher PROM in shoulder abduction and elbow extension compared to the traditional group. Furthermore, the enhanced group continued to exhibit higher PROM in shoulder flexion and abduction than the traditional group at one month assessment. At one month assessment, a significant increase was observed in the ADL, FIM, and MMT of both groups compared to the 5 days. The study indicated the enhanced rehabilitation program immediately following the stage I surgery can effectively improve the PROM of the shoulder and elbow and reduce the length of hospital stay for patients.
Epistemic Injustice at the ICC?
Authors: Evans Hayley N , Hazim Mahir
Published: July 2024

This article empirically assesses the role third-party evidence has played in the Office of the Prosecutor’s (OTP) initiation of an investigation into the Afghanistan Situation at the International Criminal Court (ICC). After finding that most of the evidence upon which the OTP relied in its request to initiate an investigation is from third parties, this article classifies and ranks the categories of third party upon which the OTP relied. Critically analysing the OTP’s use of third-party sources, this article uncovers the way potential biases towards dominant languages, affluent locations and prestigious institutions influence the choice of which information to use as evidence, possibly evincing an epistemic injustice at the OTP. Heeding Naz Modirzadeh’s call to use Third World Approaches to International Law (TWAIL) to empower Global South states, this article concludes with recommendations to the OTP and third parties on how they can maximize their collaboration while avoiding capitulation to the politics of exclusion. In addition, the article’s findings reveal opportunities for stakeholders to enhance evidence collection and use by particular third-party categories in Afghanistan and in similar situations.
Reducing exposure levels of immersion washing workers to ortho-phthalaldehyde by improving exhaust systems
Authors: Yamamoto Shinobu , Hachiya Yuriko , Goto Motohide , Takeuchi Akito , Ishidao Toru , Hori Hajime , Miyauchi Hiroyuki
Published: July 2024

Objectives

The American Conference of Governmental Industrial Hygienists recommends a threshold limit value-ceiling (TLV-C) of 0.1 ppb for occupational exposure to ortho-phthalaldehyde (OPA) used in washing endoscope probes. To adhere to this extremely low exposure limit, this case study aimed to reduce OPA exposure concentrations of workers during immersion washing of an endoscope probe body. This was achieved by attaching a new duct and hood to the existing ceiling exhaust system.

Methods

The type of hood was determined by calculating and comparing the capture velocity obtained by assuming either an exterior or an enclosing hood. Additionally, the effect on improving the working environment was tested before and after the installation of the hood by measuring the OPA vapor concentration.

Results

The calculated capture velocities of the exterior and enclosing hoods were 0.05 m/s and 0.19 m/s, respectively. Considering the operability, the exterior hood was more appropriate; however, the calculated capture velocity indicated potential inadequacy in meeting the TLV-C requirement, leading to the adoption of the enclosing hood. The OPA vapor concentration in ceiling value measurements taken after the enclosing hood was fitted was reduced to 0.2 ppb, that is, 1/10 of the original concentration.

Conclusions

Although the environmental concentration after the improvement still exceeded the TLV-C of 0.1 ppb, this study’s findings indicate that even substances with extremely low occupational exposure limits can be managed with appropriate local exhaust ventilation.
Employing Constrained Nonnegative Matrix Factorization for Microstructure Segmentation
Authors: Chauniyal Ashish , Thome Pascal , Stricker Markus
Published: July 2024

Materials characterization using electron backscatter diffraction (EBSD) requires indexing the orientation of the measured region from Kikuchi patterns. The quality of Kikuchi patterns can degrade due to pattern overlaps arising from two or more orientations, in the presence of defects or grain boundaries. In this work, we employ constrained nonnegative matrix factorization to segment a microstructure with small grain misorientations, (<1∘), and predict the amount of pattern overlap. First, we implement the method on mixed simulated patterns—that replicates a pattern overlap scenario, and demonstrate the resolution limit of pattern mixing or factorization resolution using a weight metric. Subsequently, we segment a single-crystal dendritic microstructure and compare the results with high-resolution EBSD. By utilizing weight metrics across a low-angle grain boundary, we demonstrate how very small misorientations/low-angle grain boundaries can be resolved at a pixel level. Our approach constitutes a versatile and robust tool, complementing other fast indexing methods for microstructure characterization.
A catalogue of merging clusters of galaxies: cluster partners, merging subclusters, and post-collision clusters
Authors: Wen Z L , Han J L , Yuan Z S
Published: July 2024

Clusters of galaxies are merging during the formation of large-scale structures in the Universe. Based on optical survey data, we identify a large sample of pre-mergers of galaxy clusters and merging subclusters in rich clusters. We find 39 382 partners within a velocity difference of 1500 km s$^{-1}$ and a projected separation of 5 $r_{500}$ around 33 126 main clusters, where $r_{500}$ is the radius of the main cluster. Based on the galaxy distribution inside rich clusters with more than 30 member galaxy candidates, we identify subclusters by modelling the smoothed optical distribution with a two-component profile, and a coupling factor is obtained for merging subclusters in 7845 clusters. In addition, we find 3446 post-collision mergers according to the deviations of brightest cluster galaxies from other member galaxies, most of which have been partially validated by using the Chandra and XMM–Newton X-ray images. Two new bullet-like clusters have been identified by using the optical and X-ray images. The large samples of merging clusters of galaxies presented here are important databases for studying the hierarchical structure formation, cluster evolution, and the physics of intergalactic medium.
AstroSat observations of the dipping low-mass X-ray binary XB 1254−690
Authors: Navale Nilam R , Pawar Devraj , Rao A R , Misra Ranjeev , Chakraborty Sudip , Bhattacharyya Sudip , Bambole Vaishali A
Published: July 2024

XB 1254−690 is a neutron star low-mass X-ray binary with an orbital period of 3.88 h, and it exhibits energy-dependent intensity dips, thermonuclear bursts, and flares. We present the results of an analysis of a long observation of this source using the AstroSat satellite. The X-ray light curve gradually changed from a high-intensity flaring state to a low-intensity one with a few dips. The hardness–intensity diagram showed that the source is in a high-intensity banana state with a gradually changing flux. Based on this, we divide the observation into four flux levels for a flux-resolved spectral study. The X-ray spectra can be explained by a model consisting of absorption, thermal emission from the disc, and non-thermal emission from the corona. From our studies, we detect a correlation between the temperature of the thermal component and the flux and we examine the implications of our results for the accretion disc geometry of this source.
Applying the starquake model to study the formation of elastic mountains on spinning neutron stars
Authors: Gangwar Yashaswi , Jones David Ian
Published: July 2024

When a neutron star is spun-up or spun-down, the changing strains in its solid elastic crust can give rise to sudden fractures known as starquakes. Early interest in starquakes focused on their possible connection to pulsar glitches. While modern glitch models rely on pinned superfluid vorticity rather than crustal fracture, starquakes may nevertheless play a role in the glitch mechanism. Recently, there has been interest in the issue of starquakes resulting in non-axisymmetric shape changes, potentially linking the quake phenomenon to the building of neutron star mountains, which would then produce continuous gravitational waves. Motivated by this issue, we present a simple model that extends the energy minimization-based calculations, originally developed to model axisymmetric glitches, to also include non-axisymmetric shape changes. We show that the creation of a mountain in a quake necessarily requires a change in the axisymmetric shape too. We apply our model to the specific problem of the spin-up of an initially non-rotating star, and estimate the maximum mountain that can be built in such a process, subject only to the constraints of energy and angular momentum conservation.
Immune Reconstitution Inflammatory Syndrome Related to Antiretroviral Therapy Initiation in People With HIV and Mpox: An Observational Retrospective Study
Authors: Rodríguez-Aldama Juan Carlos , Pérez-Barragán Edgar , Hernández-Silva Graciela , Lezama-Mora Jezer Ivan , Olin-López Ana Karen , González-Flores Berenice , Cruz-Flores Raul Adrián , Crabtree-Ramírez Brenda
Published: July 2024

The study aims to compare the outcomes of initiating antiretroviral therapy early vs late in people with HIV and mpox. No worse outcomes were found associated with mpox-related immune reconstitution inflammatory syndrome among those who started antiretroviral treatment early, suggesting initiation as soon as possible.
Extensively Antibiotic-Resistant Bacterial Infections in Trauma Cases Managed at the Médecins Sans Frontières Tertiary Orthopaedic Center in Mosul, Iraq: A Case Series
Authors: Abdulrahman Ahmed Hisham , Hasheem Mahmood Humam , Hosam Aldin Sami Haitham , Natiq Taher Abdullah , Garcia-Vello Pilar , Ali Engy , Repetto Ernestina , Williams Anita , Gordillo Gomez Fabiola , Moussally Krystel
Published: July 2024

The Médecins Sans Frontières Tertiary Orthopaedic Care center in Mosul, Iraq, provides reconstructive surgery, microbiological analysis, integrated infection prevention and control, and antibiotic stewardship services. Between May 2018 and February 2020, we recorded soft tissue and/or bone infections caused by gram-negative extensively drug-resistant (XDR) bacteria in 4.9% (13/266) of the admitted patients. The XDR bacteria identified among 12 patients in this case series were extended-spectrum β-lactamase–producing Klebsiella pneumoniae (n = 5, 41.7%) with intermediate sensitivity or resistance to imipenem and/or meropenem, Acinetobacter spp (n = 3, 25.0%; 2 Acinetobacter baumannii strains) resistant to imipenem and/or meropenem, Pseudomonas aeruginosa (n = 2, 16.7%) resistant to imipenem and meropenem, and extended-spectrum β-lactamase–producing Proteus mirabilis (n = 2, 16.7%) resistant to meropenem. Most XDR isolates were sensitive only to colistin or polymyxin B, neither of which is available in Iraq. Therefore, the only treatment option was multiple rounds of surgical debridement and wound care. The infection was deemed cured before discharge in 7 patients (58.3%). Meanwhile, 4 patients (33.3%) were discharged with unhealed wounds, and outpatient follow-up was planned. One patient died in the intensive care unit of a referral hospital after developing septicemia postsurgery. XDR bacteria pose substantial health risks in Iraq. Thus, improving antimicrobial stewardship and accessibility to essential antibiotics is critical to address this issue.
Donor-Derived Bartonella quintana Infection in Solid Organ Transplantation: An Emerging Public Health Issue With Diagnostic Challenges
Authors: Boodman Carl , Garcia Oscar Fernandez , Kabbani Dima , Villalobos Armelle Perez Cortes , Beeson Amy , Marx Grace E , van Griensven Johan , Doucette Karen
Published: July 2024

Bartonella quintana is a louse-borne intracellular bacterium that remains a neglected cause of bacteremia, bacillary angiomatosis, and infective endocarditis among individuals experiencing poverty. In October 2023, Health Canada notified Canadian organ transplantation programs of an outbreak of donor-derived B quintana infection. From March to August 2023, 5 cases of donor-derived B quintana disease were acquired in Alberta, Canada, from 3 deceased donors who had experienced homelessness. Similar cases recently occurred in the United States. In this article, we discuss strategies to screen organ donors and monitor transplant recipients for B quintana infection using epidemiologic risk factors, physical examination signs, and laboratory diagnostic tests. We review the limitations of existing diagnostic tests for B quintana and describe how these problems may be magnified in the organ transplantation context.
Adolescent sleep patterns, genetic predisposition, and risk of multiple sclerosis
Authors: Johansson Eva , Olsson Tomas , Strid Pernilla , Kockum Ingrid , Alfredsson Lars , Hedström Anna Karin
Published: July 2024

Study Objectives

Shift work, insufficient sleep, and poor sleep quality at young age have been associated with increased risk of multiple sclerosis (MS). This study aimed to investigate the potential interaction between aspects of inadequate sleep (short sleep, phase shift, and poor sleep quality) during adolescence and HLA-DRB1*15:01 in relation to MS risk.

Methods

We used a Swedish population-based case–control study (1253 cases and 1766 controls). Participants with different sleep patterns during adolescence and HLA-DRB1*15:01 status were compared regarding MS risk by calculating odds ratios with 95% confidence intervals (CI) using logistic regression models. Additive interaction between aspects of inadequate sleep and HLA-DRB1*15:01 status was assessed by calculating the attributable proportion due to interaction (AP) with 95% CI.

Results

Short sleep duration (<7 hours/night) during adolescence acted synergistically with HLA-DRB1*15:01, increasing the risk of MS (AP 0.38, 95% CI: 0.01 to 0.75, p = .04). Similarly, subjective low sleep quality during adolescence interacted with HLA-DRB1*15:01 regarding risk of MS (AP 0.30, 95% CI: 0.06 to 0.56, p = .03), whereas phase shift did not significantly influence the risk of the disease, irrespective of HLA-DRB1*15:01 status.

Conclusions

Our findings underscore the importance of addressing inadequate sleep during adolescence, particularly in the context of the HLA-DRB1*15:01 allele, as it appears to amplify the risk of subsequently developing MS.
Expectation-Maximization enables Phylogenetic Dating under a Categorical Rate Model
Authors: Mai Uyen , Charvel Eduardo , Mirarab Siavash
Published: July 2024

Dating phylogenetic trees to obtain branch lengths in time units is essential for many downstream applications but has remained challenging. Dating requires inferring substitution rates that can change across the tree. While we can assume to have information about a small subset of nodes from the fossil record or sampling times (for fast-evolving organisms), inferring the ages of the other nodes essentially requires extrapolation and interpolation. Assuming a distribution of branch rates, we can formulate dating as a constrained maximum likelihood (ML) estimation problem. While ML dating methods exist, their accuracy degrades in the face of model misspecification, where the assumed parametric statistical distribution of branch rates vastly differs from the true distribution. Notably, most existing methods assume rigid, often unimodal, branch rate distributions. A second challenge is that the likelihood function involves an integral over the continuous domain of the rates, often leading to difficult non-convex optimization problems. To tackle both challenges, we propose a new method called Molecular Dating using Categorical-models (MD-Cat). MD-Cat uses a categorical model of rates inspired by non-parametric statistics and can approximate a large family of models by discretizing the rate distribution into k categories. Under this model, we can use the Expectation-Maximization algorithm to co-estimate rate categories and branch lengths in time units. Our model has fewer assumptions about the true distribution of branch rates than parametric models such as Gamma or LogNormal distribution. Our results on two simulated and real datasets of Angiosperms and HIV and a wide selection of rate distributions show that MD-Cat is often more accurate than the alternatives, especially on datasets with exponential or multimodal rate distributions.
Deconvoluting and derisking QRS complex widening to improve cardiac safety profile of novel plasmepsin X antimalarials
Authors: Delaunois Annie , Cardenas Alvaro , de Haro Teresa , Gerets Helga H J , Gryshkova Vitalina , Hebeisen Simon , Korlowski Chloé , Laleu Benoit , Lowe Martin A , Valentin Jean-Pierre
Published: July 2024

Quinoline-related antimalarial drugs have been associated with cardiotoxicity risk, in particular QT prolongation and QRS complex widening. In collaboration with Medicines for Malaria Venture, we discovered novel plasmepsin X (PMX) inhibitors for malaria treatment. The first lead compounds tested in anesthetized guinea pigs (GPs) induced profound QRS widening, although exhibiting weak inhibition of NaV1.5-mediated currents in standard patch clamp assays. To understand the mechanism(s) underlying QRS widening to identify further compounds devoid of such liability, we established a set of in vitro models including CaV1.2, NaV1.5 rate-dependence, and NaV1.8 patch clamp assays, human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM), and Langendorff-perfused isolated GP hearts. Six compounds were tested in all models including anesthetized GP, and 8 additional compounds were tested in vitro only. All compounds tested in anesthetized GP and isolated hearts showed a similar cardiovascular profile, consisting of QRS widening, bradycardia, negative inotropy, hypotension, and for some, QT prolongation. However, a left shift of the concentration–response curves was noted from in vitro to in vivo GP data. When comparing in vitro models, there was a good consistency between decrease in sodium spike amplitude in hiPSC-CM and QRS widening in isolated hearts. Patch clamp assay results showed that the QRS widening observed with PMX inhibitors is likely multifactorial, primarily due to NaV1.8 and NaV1.5 rate-dependent sodium blockade and/or calcium channel-mediated mechanisms. In conclusion, early de-risking of QRS widening using a set of different in vitro assays allowed to identify novel PMX inhibitors with improved cardiac safety profile.
Profitability of Foliar Fungicides in Double-Crop Soybean Under Low-Disease Environments
Authors: Barro Jhonatan P. , Del Ponte Emerson M. , Kelly Heather M. , Bissonnette Kaitlyn M. , Telenko Darcy E. P. , Ames Keith A. , Bradley Carl A.
Published: July 2024

Double-crop soybean production involves planting soybean ( Glycine max) directly following winter wheat ( Triticum aestivum) harvest. Frogeye leaf spot (FLS), caused by Cercospora sojina, is an important late-season foliar disease affecting soybean fields in the United States. In some instances, foliar fungicides have been used in double-crop soybean production with little to no FLS present, raising questions on the profitability of these applications. This study analyzed yield data from 25 fungicide trials across five states (Illinois, Indiana, Kentucky, Missouri, and Tennessee) conducted under low FLS pressure from 2008 to 2021 on double-crop soybean. Fungicide classes evaluated in the trials included quinone outside inhibitors (QoI), demethylation inhibitors (DMI), and methyl benzimidazole carbamates (MBC) applied alone and mixtures of chemistry classes that included DMI + succinate dehydrogenase inhibitor (SDHI), MBC + DMI, QoI + DMI, and QoI + DMI + SDHI. A network meta-analytic model estimated yield differences between fungicide-treated and nontreated plots, which ranged from −28 to 72 kg/ha among the fungicide treatments. Negative yield response values were estimated for the single fungicide classes MBC (−15.7 kg/ha) and QoI (−28.4 kg/ha). A yield difference as high as 72.8 kg/ha was estimated only for DMI + SDHI. Economic analyses indicated that, due to the lower yield responses, probabilities of breaking even were lower than 50% for all fungicide treatments, regardless of the fungicide cost or soybean sale price. Therefore, the low yield responses associated with foliar fungicides in low-disease environments linked to the higher risk of not offsetting the costs suggest that growers should consider disease risk prior to making the fungicide application.
Effect of Initial Inoculum on the Temporal and Spatial Dynamics of Wheat Blast Under Field Conditions in Bolivia
Authors: Góngora-Canul Carlos C. , Volkening Alexandria , Cuéllar Jorge , Calderón Lidia , Fernández-Campos Mariela , Lee Da Young , Salgado Jorge , Cruz-Sancan Andres , Cruz C. D.
Published: July 2024

Epidemiological studies to better understand wheat blast (WB) spatial and temporal patterns were conducted in three field environments in Bolivia between 2019 and 2020. The temporal dynamics of wheat leaf blast (WLB) and spike blast (WSB) were best described by the logistic model compared with the Gompertz and exponential models. The nonlinear logistic infection rates were higher under defined inoculation in experiments two and three than under undefined inoculation in experiment one, and they were also higher for WSB than for WLB. The onset of WLB began with a spatial clustering pattern according to autocorrelation analysis and Moran's index values, with higher severity and earlier onset for defined than for undefined inoculation until the last sampling time. The WSB onset did not start with a spatial clustering pattern; instead, it was detected later until the last sampling date across experiments, with higher severity and earlier onset for defined than for undefined inoculation. Maximum severity ( Kmax) was 1.0 for WSB and less than 1.0 for WLB. Aggregation of WLB and WSB was higher for defined than for undefined inoculation. The directionality of hotspot development was similar for both WLB and WSB, mainly occurring concentrically for defined inoculation. Our results show no evidence of synchronized development but suggest a temporal and spatial progression of disease symptoms on wheat leaves and spikes. Thus, we recommend that monitoring and management of WB should be considered during early growth stages of wheat planted in areas of high risk.
Parent Perspectives on Communication Quality in the Neonatal Intensive Care Unit
Authors: Guttmann Katherine F. , Raviv Gabriella N. , Fortney Christine A. , Ramirez Mildred , Smith Cardinale B.
Published: July 2024

Background:

Though prior literature has demonstrated that communication in the Neonatal Intensive Care Unit (NICU) needs to be improved, in-depth descriptions of parents’ views of NICU communication are lacking.

Purpose:

We sought (1) to explore parent perceptions of communication in the NICU and (2) to understand parents’ communication needs and preferences.

Methods:

We conducted in-depth semi-structured cognitive interviews utilizing concurrent probes with parents of 10 patients in our urban level IV Neonatal Intensive Care Unit over a period of 4 months (July 2021-October 2021). Interview questions were derived from the Quality of Communication scale. We conducted thematic analysis of interview transcripts modeled after work by Braun and Clarke.

Results:

Four overarching themes were identified: Strengths, Challenges, People, and Coping Strategies. Parents reported a range of communication quality in the NICU. Results revealed that the first 48 hours of NICU hospitalization represent a period of vulnerability and uncertainty for parents. Parents value clear yet hopeful communication about a baby’s clinical status and expected course.

Implications for Practice and Research:

We hope that the concrete findings from this study can both inform practice in the NICU now and influence practice guidelines to include such components as emphasis on the first 48 hours, desire for proactive information sharing, and the importance of including hope.