bluuebunny/crossref_metadata_2025 huggingface dataset:
Total Gynecomastia Removal with Layered Closure: A Study of 567 Cases
Authors: Caridi Robert C.
Published: April 2022

Background:

Conventional teaching dictates subtotal removal of gynecomastia tissue to ensure a cosmetically acceptable result. Modern-day concerns regarding gynecomastia treatment include continued “puffy nipples,” possible recurrence, and compromised aesthetic results resulting from incomplete tissue removal. The author practiced complete tissue removal with a layered closure technique to optimize the cosmetic result while addressing treatment complications.

Methods:

A single surgeon treated 567 patients using a standard four-step approach with complete tissue removal. A retrospective chart review was performed to assess complications and reason for surgical revision.

Results:

All revision procedures were for postoperative scar tissue accumulation. No revisions for complaints of contour depression, recurrence, or continued puffy nipples were noted. No necrosis of the nipple-areola complex or skin was noted.

Conclusions:

Complete removal of gynecomastia tissue was not only possible but also essential to achieve optimal cosmetic results. The layered closure technique is a useful adjunctive treatment after gynecomastia total tissue removal.
A Case of Orthognathic Surgery for Jaw Deformity in a Patient with Spinocerebellar Ataxia
Authors: Sato Marika , Kawase-Koga Yoko , Hamada Hayato , Chikazu Daichi
Published: April 2022

Spinocerebellar ataxia (SCA) is a progressive neurodegenerative disease that can cause various ataxia symptoms. Here we report a patient with spinocerebellar ataxia who underwent orthognathic surgery to correct a mandibular protrusion with facial asymmetry. A 33-year-old woman was admitted to our hospital for orthognathic surgery. She started preoperative orthodontic treatment after a diagnosis of mandibular protrusion with facial asymmetry. Two and a half years later, after completing preoperative orthodontic treatment, she returned to our hospital after being diagnosed with spinocerebellar ataxia. After discussing the risk of surgery with the anesthesiologist and neurologist, we elected to perform orthognathic surgery after the patient provided informed consent. Sagittal split ramus osteotomy and intraoral vertical ramus osteotomy were performed under general anesthesia, but no remarkable perioperative complications occurred. After a 3-year follow-up, the occlusion has remained stable, and no postoperative relapse occurred. Whether we should provide surgical treatment for SCA patients is controversial. However, when long-term predictions were considered, altering an occlusion could improve a patient’s quality of life in the present case.
Prepectoral Breast Reconstruction in Morbidly Obese Patients
Authors: Gabriel Allen , Storm-Dickerson Toni L. , Chan Vivian , Lord Rob , O’Rorke Erin , Maxwell G. Patrick
Published: April 2022

Background:

Prosthetic breast reconstruction via the subpectoral approach in morbidly obese patients (body mass index: ≥40 kg/m2) has been reported to be associated with an increased risk of perioperative complications and poor outcomes. Further, immediate reconstruction appears to carry a higher risk of poor outcomes than delayed reconstruction in this population. The impact of morbid obesity on outcomes after prepectoral breast reconstruction has not yet been evaluated, and such was the purpose of this study.

Methods:

This retrospective study included all consecutive patients with morbid obesity who underwent prepectoral expander/implant reconstruction between July 2009 and April 2020 in the first author’s practice. Patient records were reviewed, and data on demographics, comorbidities, radiotherapy use, type of mastectomy, mastectomy specimen weight, and postoperative complications following reconstruction were retrieved. Complications were stratified and compared by timing of reconstruction (immediate versus delayed).

Results:

Eighty-five breasts in 45 morbidly obese patients were reconstructed. Postoperative complications occurred in 11 breasts (12.9%) and included major skin necrosis (3.5%), seroma (4.7%), wound dehiscence (5.9%), and reconstructive failure (1.2%). Timing of reconstruction had little impact on postoperative complications other than major skin necrosis, which was significantly higher in the delayed group (11.1% versus 1.5%).

Conclusions:

Prosthetic breast reconstruction via the prepectoral approach can be successfully performed in morbidly obese patients, with outcomes approaching those seen in nonobese patients when performed by experienced surgeons. Patients with morbid obesity should not be denied this reconstructive approach because of their body mass index.
Functional connectivity and neurotransmitter impairments of the salience brain network in chronic low back pain patients: a combined resting-state functional magnetic resonance imaging and 1H-MRS study
Authors: Baumbach Philipp , Meißner Winfried , Reichenbach Jürgen R. , Gussew Alexander
Published: April 2022

Functional reorganisation of the salience network (SN) has been proposed as one of the key pathomechanisms associated with central nociceptive processing in the chronic pain state. Being associated with an altered functional connectivity within the SN, these processes have been hypothesized to result from a loss of inhibitory function leading to node hyperexcitability and spontaneous pain. Combined resting-state BOLD functional magnetic resonance imaging (MRI) and 1H-MR spectroscopy was applied to chronic back pain patients and healthy subjects to assess deviations from functional integrity (weighted closeness centrality [wCC], derived from resting-state functional MRI), oscillatory BOLD characteristics (spectral power), and neurotransmitter levels (GABA+, glutamate+glutamine) in 2 key SN nodes, anterior insular (aInsR) and anterior mid-cingulate cortices. In addition, examinations were repeated in chronic back pain patients after a 4-week interdisciplinary multimodal pain treatment and in healthy subjects after 4 weeks to explore longitudinal, treatment-mediated changes in target variables. The aInsR and, to a lesser extent, the anterior mid-cingulate of patients exhibited significantly reduced wCC accompanied by a spectral power shift from a lower to a higher frequency band, indicating a desynchronization of their neuronal activity within the SN, possibly because of increased spontaneous activations. Without revealing neurotransmitter differences, patients alone showed significant positive associations between local GABA+ levels and wCC in aInsR, suggesting a stronger dependence of node synchronization on the inhibitory tone in the chronic pain state. However, this needs to be explored in the future using magnetic resonance spectroscopy techniques that are more sensitive to detecting subtle neurotransmitter changes and also allow multifocal characterization of neurotransmitter tone.
Bone scan with technetium 99m-methyl diphosphonate, the missing link in the initial staging of muscle-invasive bladder carcinoma
Authors: Ghorbani Hamidreza , Soltani Salman , Zakavi Seyed Rasoul , Masoudifard Alireza , Aryan Reihaneh , Mottaghi Mahdi , Aryana Kamran , Aghaee Atena
Published: April 2022

Background

Accurate staging is crucial to determine the type of treatment for patients with bladder cancer (BCa), especially in high-risk cases. We aimed to assess the role of bone scan in the initial staging of muscle-invasive bladder carcinoma (MIBC).

Material and methods

Forty-five patients with MIBC were referred to our tertiary clinic to perform a technetium 99m-methyl diphosphonate (Tc99m-MDP) bone scan from January 2019 to March 2020. The patients underwent bone scintigraphy with pelvic SPECT/CT before radical cystectomy. Whole-body scanning was performed 4 hours after Tc99m-MDP injection in both anterior and posterior views. Since the most common bone involvement site in these patients is the pelvic bones and the spine, pelvic SPECT/CT was performed in all patients.

Results

Frequency of skeletal metastasis was 26.7%. Only 19% of the metastases were detected by previous pelvic CT/MRI images performed for routine staging. All the reported skeletal metastases by previous anatomical imaging methods were detected in the bone scan. There was no statistically significant correlation between bone metastasis and the patient’s age, lymph nodes metastasis (LNM), hydronephrosis, and muscle-invasive type. The mean serum calcium level was 8.7 ± 0.57 in patients with bone metastasis and 8.87 ± 0.99 in patients without bone metastasis, which was not statistically significant.

Conclusion

Bone scan has higher diagnostic performance than conventional imaging methods for detecting bone metastases. It changed the management plan in 8.8% of our patients, so we conclude that performing a whole-body bone scan in the initial staging of MIBC would be helpful.
Latent Profile/Class Analysis Identifying Differentiated Intervention Effects
Authors: Yang Qing , Zhao Amy , Lee Chiyoung , Wang Xiaofei , Vorderstrasse Allison , Wolever Ruth Q.
Published: April 2022

Background

The randomized clinical trial is generally considered the most rigorous study design for evaluating overall intervention effects. Because of patient heterogeneity, subgroup analysis is often used to identify differential intervention effects. In research of behavioral interventions, such subgroups often depend on a latent construct measured by multiple correlated observed variables.

Objectives

The purpose of this article was to illustrate latent class analysis/latent profile analysis as a helpful tool to characterize latent subgroups, conduct exploratory subgroup analysis, and identify potential differential intervention effects using clinical trial data.

Methods

After reviewing different approaches for subgroup analysis, latent class analysis/latent profile analysis was chosen to identify heterogeneous patient groups based on multiple correlated variables. This approach is superior in this specific scenario because of its ability to control Type I error, assess intersection of multiple moderators, and improve interpretability. We used a case study example to illustrate the process of identifying latent classes as potential moderators based on both clinical and perceived risk scores and then tested the differential effects of health coaching in improving health behavior for patients with elevated risk of developing coronary heart disease.

Results

We identified three classes based on one clinical risk score and four perceived risk measures for individuals with high risk of developing coronary heart disease. Compared to other classes we assessed, individuals in the class with low clinical risk and low perceived risk benefit most from health coaching to improve their physical activity levels.

Discussion

Latent class analysis/latent profile analysis offers a person-centered approach to identifying distinct patient profiles that can be used as moderators for subgroup analysis. This offers tremendous opportunity to identify differential intervention effects in behavioral research.
The CHARISMA Randomized Controlled Trial: A Relationship-Focused Counseling Intervention Integrated Within Oral PrEP Delivery for HIV Prevention Among Women in Johannesburg, South Africa
Authors: Montgomery Elizabeth T. , Roberts Sarah T. , Reddy Krishnaveni , Tolley Elizabeth E. , Hartmann Miriam , Mathebula Florence , Wagner L. Danielle , Lanham Michele , Wilcher Rose , Browne Erica N. , Baeten Jared M. , Palanee-Phillips Thesla
Published: April 2022

Background:

Consistent use of oral pre-exposure prophylaxis (PrEP) has been a challenge among women, particularly when in relationships with lack of partner support or intimate partner violence (IPV).

Methods:

We conducted a randomized controlled trial (RCT) of an empowerment counseling intervention called “CHARISMA” delivered to women within a PrEP demonstration project in Johannesburg, South Africa. The trial tested the effectiveness of CHARISMA to increase PrEP adherence; decrease social harms and IPV; and improve partnership dynamics (eg, communication, disclosure and support) compared with those who received the standard of care counselling support and referrals. Four hundred seven HIV-seronegative, nonpregnant women aged 18–45 years were enrolled for 6 months of PrEP use, with 203 randomized (1:1) to the intervention. All participants reporting IPV received counseling and referrals that followed the WHO five-step Listen, Inquire, Validate, Enhance Safety, and Support approach.

Results:

This RCT did not identify statistically significant differences between study arms for PrEP adherence or relationship dynamics, with the exception of an increase in PrEP disclosure among intervention arm women. In our study, we cannot determine whether the lack of detectable findings may have been because of lack of intervention effect, strength of standard of care services, low risk in the study population, or other factors.

Conclusions:

Addressing IPV and relationship dynamics remain important factors influencing HIV risk, and addressing these within the context of PrEP delivery is an important synergistic opportunity. CHARISMA was highly acceptable to participants, and further adaptation and testing of the intervention to other populations and settings will augment the evidence base.
Varying Utilization Rates but Superior Outcomes in Liver Transplantation From Hepatitis C−positive Donors in the United States: An Analysis of the OPTN/UNOS Database
Authors: Bekki Yuki , Crismale James F. , Myers Bryan , Schiano Thomas D. , Florman Sander
Published: April 2022

Background.

Liver transplantation (LT) from hepatitis C virus (HCV)−positive donors [antibody positive (Ab+) or nucleic acid test−positive (NAT+) donors] has been reported to achieve successful outcomes. However, donor and recipient selection has not been well-characterized.

Methods.

Data between 2015 and 2019 were obtained from the United Network for Organ Sharing database. The utilization rates and graft survival among 35 239 potential donors and 23 780 adult LT recipients were reviewed based on donor HCV Ab/NAT status.

Results.

The utilization of Ab+/NAT+ donors was significantly reduced compared with HCV-negative donors (66.4% versus 80.0%, P < 0.001) among donors aged between 40 and 69 y. Recipients of livers from HCV-positive donors had lower laboratory and allocation Model for End-stage Liver Disease scores (both P < 0.001). HCV-positive donors were younger (P < 0.001). Kaplan-Meyer survival curves demonstrated significantly superior 1-y graft survival in recipients of HCV-positive grafts compared with those from HCV-negative grafts (P = 0.004; 97.1% in Ab−/NAT+, 93.9% in Ab+/NAT−, and 93.7% in Ab+/NAT+ versus 91.8% in Ab−/NAT−). Multivariate analysis for 1-y graft survival identified donor age [hazard ratio (HR) = 1.01; 95% confidence interval (CI), 1.00-1.01] and laboratory Model for End-stage Liver Disease score (HR = 1.01; 95% CI, 1.00-1.01) as independent predictors but not donor HCV status: HR 0.77‚ 95% CI, 0.58-1.02 in Ab+/NAT−; HR 0.82‚ 95% CI, 0.66-1.03 in Ab+/NAT+; and HR 0.39‚ 95% CI, 0.10-1.55 in Ab−/NAT+.

Conclusions.

More widespread utilization of HCV-positive donors, especially Ab+/NAT+ donors of age 40–69 y, may expand the donor pool without impairing short-term outcomes after LT.
Phenology-based adjustments improve population estimates of Antarctic breeding seabirds: the case of Cape petrels in East Antarctica
Authors: Kliska Kimberley , Southwell Colin , Salton Marcus , Williams Richard , Emmerson Louise
Published: April 2022

To monitor and conserve a species, it is crucial to understand the size and distribution of populations. For seabirds, population surveys are usually conducted at peak breeding attendance. One of the largest populations of Cape petrels in East Antarctica is at the Vestfold Islands, where environmental and logistical constraints often prevent access to breeding sites at the optimal time for population surveys. In this study, we aim to quantify the contemporary and historical breeding population size of these Cape petrels by adjusting nest counts for variation in breeding phenology using photographs from remote cameras. We also compare spatial distribution between 1970s and 2017/2018. Our results show ground counts occurred outside peak breeding attendance, and adjusting for phenology changed the contemporary and historical population estimates. The Cape petrels showed local intra-island or adjacent-island changes in their distribution between the 1970s and 2017/2018 with no evidence of expanding or restricting their distribution or a significant change in their breeding population size. The results emphasize the importance of accounting for phenology in population counts, where populations are inaccessible at an optimal survey time. We discuss the applications of our research methodology for populations breeding in remote areas and as a baseline for assessing population change.
Regulation of dynamics and densities of whitefly
Bemisia tabaci
by agricultural landscapes in south China
Authors: Yang Shaowu , Dou Wenjun , Li Mingjiang , Li Xingxing , Jiang Zhengxiong , Chen Guohua , Zhang Xiaoming
Published: April 2022

Agricultural landscape patterns can affect the population dynamics of pest insects. We selected four landscapes (flower field, mountain, river and urban) based on principal components analysis in Yunnan Province, south China. Through systematic investigation carried out in tomato fields, we intended to clarify the population dynamics and densities of
Bemisia tabaci
under different landscape types. During the main activity period of
B. tabaci
, the population densities of
B. tabaci
nymphs in tomato fields in the river and the urban landscape types were the highest compared to the other landscape types; the population densities of female adults in tomato fields in the river landscape type were also the highest. While the population densities of
B. tabaci
nymphs and female adults in the flower landscape type, no more than five individuals (ind.) 100 cm
−2
leaf in both years, were the lowest. The density of
B. tabaci
nymphs in the middle position of tomato plants was higher than those in the other positions, while the density of adults in the upper position of tomato plants was higher, regardless of landscape types. Our findings showed that the population growth of
B. tabaci
can be easily controlled by the flower landscape type.
How the morning-afternoon cloudiness asymmetry affects the energy-maximizing azimuth direction of fixed-tilt monofacial solar panels
Authors: Takács Péter , Slíz-Balogh Judit , Horváth Ákos , Horváth Dániel , Jánosi Imre M. , Horváth Gábor
Published: April 2022

In the Northern Hemisphere, south is the conventional azimuth direction of fixed-tilt monofacial solar panels, because this orientation may maximize the received light energy. How does the morning-afternoon cloudiness asymmetry affect the energy-maximizing azimuth direction of such solar panels? Prompted by this question, we calculated the total light energy received by a fixed-tilt monofacial solar panel in a whole year, using the celestial motion of the Sun and the direct and diffuse radiation measured hourly throughout the year in three North American (Boone County, Tennessee, Georgia) and European (Italy, Hungary, Sweden) regions. Here we show that, depending on the tilt angle and the local cloudiness conditions, the energy-maximizing ideal azimuth of a solar panel more or less turns eastward from south, if afternoons are cloudier than mornings in a yearly average. In certain cases, the turn of the ideal azimuth of such solar panels may be worth taking into consideration, even though the maximum energy gain is not larger than 5% for nearly vertical panels. Specifically, when solar panels are fixed on vertical walls or oblique roofs with non-ideal tilt, the deviation of the energy-maximizing azimuth from the south can be incorporated in the design of buildings.
Cascading effects of pre-adult survival on sexual selection
Authors: Klug Hope , Langley Chelsea , Reyes Elijah
Published: April 2022

Sexual selection influences broad-scale patterns of biodiversity. While a large body of research has investigated the effect of mate competition on sexual selection, less work has examined how pre-adult life history influences sexual selection. We used a mathematical framework to explore the influence of pre-adult survival on sexual selection. Our model suggests that pre-adult male mortality will affect the strength of sexual selection when a fixed number of adult males have an advantageous mate-acquisition trait. When a fixed number of males have an advantageous mate-acquisition trait, sexual selection is expected to increase when pre-adult mortality is relatively low. By contrast, if a fixed proportion (rather than number) of adult males have a mate-acquisition trait, pre-adult male mortality is not expected to affect the strength of sexual selection. Further, if the advantageous mating trait affects pre-adult survival, natural and sexual selection can interact to influence the overall selection on the mating trait. Given that pre-adult mortality is often shaped by natural selection, our results highlight conditions under which natural selection can have cascading effects on sexual selection.
Ensemble-SINDy: Robust sparse model discovery in the low-data, high-noise limit, with active learning and control
Authors: Fasel U. , Kutz J. N. , Brunton B. W. , Brunton S. L.
Published: April 2022

Sparse model identification enables the discovery of nonlinear dynamical systems purely from data; however, this approach is sensitive to noise, especially in the low-data limit. In this work, we leverage the statistical approach of bootstrap aggregating (bagging) to robustify the sparse identification of the nonlinear dynamics (SINDy) algorithm. First, an ensemble of SINDy models is identified from subsets of limited and noisy data. The aggregate model statistics are then used to produce inclusion probabilities of the candidate functions, which enables uncertainty quantification and probabilistic forecasts. We apply this ensemble-SINDy (E-SINDy) algorithm to several synthetic and real-world datasets and demonstrate substantial improvements to the accuracy and robustness of model discovery from extremely noisy and limited data. For example, E-SINDy uncovers partial differential equations models from data with more than twice as much measurement noise as has been previously reported. Similarly, E-SINDy learns the Lotka Volterra dynamics from remarkably limited data of yearly lynx and hare pelts collected from 1900 to 1920. E-SINDy is computationally efficient, with similar scaling as standard SINDy. Finally, we show that ensemble statistics from E-SINDy can be exploited for active learning and improved model predictive control.
Highly coordinated nationwide massive travel restrictions are central to effective mitigation and control of COVID-19 outbreaks in China
Authors: Chen Xingru , Fu Feng
Published: April 2022

COVID-19, the disease caused by the novel coronavirus 2019, has caused grave woes across the globe since it was first reported in the epicentre of Wuhan, Hubei, China, in December 2019. The spread of COVID-19 in China has been successfully curtailed by massive travel restrictions that rendered more than 900 million people housebound for more than two months since the lockdown of Wuhan, and elsewhere, on 23 January 2020. Here, we assess the impact of China’s massive lockdowns and travel restrictions reflected by the changes in mobility patterns across and within provinces, before and during the lockdown period. We calibrate movement flow between provinces with an epidemiological compartment model to quantify the effectiveness of lockdowns and reductions in disease transmission. Our analysis demonstrates that the onset and phase of local community transmission in other provinces depends on the cumulative population outflow received from the epicentre Hubei. Moreover, we show that synchronous lockdowns and consequent reduced mobility lag a certain time to elicit an actual impact on suppressing the spread. Such highly coordinated nationwide lockdowns, applied via a top-down approach along with high levels of compliance from the bottom up, are central to mitigating and controlling
early-stage
outbreaks and averting a massive health crisis.
A fast pace-of-life is traded off against a high thermal performance
Authors: Tüzün Nedim , Stoks Robby
Published: April 2022

The integration of life-history, behavioural and physiological traits into a ‘pace-of-life syndrome’ is a powerful concept in understanding trait variation in nature. Yet, mechanisms maintaining variation in ‘pace-of-life’ are not well understood. We tested whether decreased thermal performance is an energetic cost of a faster pace-of-life. We characterized the pace-of-life of larvae of the damselflyIschnura elegansfrom high-latitude and low-latitude regions when reared at 20°C or 24°C in a common-garden experiment, and estimated thermal performance curves for a set of behavioural, physiological and performance traits. Our results confirm a faster pace-of-life (i.e. faster growth and metabolic rate, more active and bold behaviour) in the low-latitude and in warm-reared larvae, and reveal increased maximum performance,Rmax, but not thermal optimumTopt, in low-latitude larvae. Besides a clear pace-of-life syndrome integration at the individual level, larvae also aligned along a ‘cold–hot’ axis. Importantly, a faster pace-of-life correlated negatively with a high thermal performance (i.e. higherToptfor swimming speed, metabolic rate, activity and boldness), which was consistent across latitudes and rearing temperatures. This trade-off, potentially driven by the energetically costly maintenance of a fast pace-of-life, may be an alternative mechanism contributing to the maintenance of variation in pace-of-life within populations.
Body size and food–web interactions mediate species range shifts under warming
Authors: Tekwa E. W. , Watson James R. , Pinsky Malin L.
Published: April 2022

Species ranges are shifting in response to climate change, but most predictions disregard food–web interactions and, in particular, if and how such interactions change through time. Predator–prey interactions could speed up species range shifts through enemy release or create lags through biotic resistance. Here, we developed a spatially explicit model of interacting species, each with a thermal niche and embedded in a size-structured food–web across a temperature gradient that was then exposed to warming. We also created counterfactual single species models to contrast and highlight the effect of trophic interactions on range shifts. We found that dynamic trophic interactions hampered species range shifts across 450 simulated food–webs with up to 200 species each over 200 years of warming. All species experiencing dynamic trophic interactions shifted more slowly than single-species models would predict. In addition, the trailing edges of larger bodied species ranges shifted especially slowly because of ecological subsidies from small shifting prey. Trophic interactions also reduced the numbers of locally novel species, novel interactions and productive species, thus maintaining historical community compositions for longer. Current forecasts ignoring dynamic food–web interactions and allometry may overestimate species' tendency to track climate change.
Sex determination systems as the interface between male-killing bacteria and their hosts
Authors: Hornett Emily A. , Kageyama Daisuke , Hurst Gregory D. D.
Published: April 2022

Arthropods host a range of sex-ratio-distorting selfish elements, including diverse maternally inherited endosymbionts that solely kill infected males. Male-killing heritable microbes are common, reach high frequency, but until recently have been poorly understood in terms of the host–microbe interaction. Additionally, while male killing should generate strong selection for host resistance, evidence of this has been scant. The interface of the microbe with host sex determination is integral to the understanding of how death is sex limited and how hosts can evolve evasion of male killing. We first review current knowledge of the mechanisms diverse endosymbionts use to induce male-specific death. We then examine recent evidence that these agents do produce intense selection for host nuclear suppressor elements. We argue, from our understanding of male-killing mechanisms, that suppression will commonly involve evolution of the host sex determination pathways and that the host's response to male-killing microbes thus represents an unrecognized driver of the diversity of arthropod sex determination. Further work is required to identify the genes and mechanisms responsible for male-killing suppression, which will both determine the components of sex determination (or other) systems associated with suppressor evolution, and allow insight into the mechanism of male killing itself.
Spatial autocorrelation of local patch extinctions drives recovery dynamics in metacommunities
Authors: Saade Camille , Kéfi Sonia , Gougat-Barbera Claire , Rosenbaum Benjamin , Fronhofer Emanuel A.
Published: April 2022

Human activities put ecosystems under increasing pressure, often resulting in local extinctions. However, it is unclear how local extinctions affect regional processes, such as the distribution of diversity in space, especially if extinctions show spatial patterns, such as being clustered. Therefore, it is crucial to investigate extinctions and their consequences in a spatially explicit framework. Using highly controlled microcosm experiments and theoretical models, we ask here how the number and spatial autocorrelation of extinctions interactively affect metacommunity dynamics. We found that local patch extinctions increased local diversity (
α
-diversity) and inter-patch diversity (
β
-diversity) by delaying the exclusion of inferior competitors. Importantly, recolonization dynamics depended more strongly on the spatial distribution than on the number of patch extinctions: clustered local patch extinctions resulted in slower recovery, lower
α
-diversity and higher
β
-diversity. Our results highlight that the spatial distribution of perturbations should be taken into account when studying and managing spatially structured communities.
Genome-based, phenotypic and chemotaxonomic classification of Faecalibacterium strains: proposal of three novel species Faecalibacterium duncaniae sp. nov., Faecalibacterium hattorii sp. nov. and Faecalibacterium gallinarum sp. nov.
Authors: Sakamoto Mitsuo , Sakurai Naomi , Tanno Hiroki , Iino Takao , Ohkuma Moriya , Endo Akihito
Published: April 2022

Faecalibacterium prausnitzii

is one of the most important butyrate-producing bacteria in the human gut. Previous studies have suggested the presence of several phylogenetic groups, with differences at the species level, in the species, and a taxonomic re-evaluation is thus essential for further understanding of ecology of the important human symbiont. Here we examine the phenotypic, physiological, chemotaxonomic and phylogenomic characteristics of six

F. prausnitzii

strains (BCRC 81047T=ATCC 27768T, A2-165T=JCM 31915T, APC918/95b=JCM 39207, APC942/30−2=JCM 39208, APC924/119=JCM 39209 and APC922/41−1T=JCM 39210T) deposited in public culture collections with two reference strains of

Faecalibacterium butyricigenerans

JCM 39212T and

Faecalibacterium longum

JCM 39211T.

Faecalibacterium

sp. JCM 17207T isolated from caecum of broiler chicken was also included. Three strains of

F. prausnitzii

(BCRC 81047T, JCM 39207 and JCM 39209) shared more than 96.6 % average nucleotide identity (ANI) and 69.6 % digital DNA–DNA hybridization (dDDH) values, indicating that the three strains are members of the same species. On the other hand, the remaining three strains of

F. prausnitzii

(JCM 31915T, JCM 39208 and JCM 39210T) were clearly separated from the above three strains based on the ANI and dDDH values. Rather, JCM 39208 showed ANI and dDDH values over the cut-off values of species discrimination (>70 % dDDH and >95–96 % ANI) with

F. longum

JCM 39211T, whereas JCM 31915T, JCM 39210T and JCM 17207T did not share dDDH and ANI values over the currently accepted cut-off values with any of the tested strains, including among them. Furthermore, the cellular fatty acid patterns of these strains were slightly different from other

F. prausnitzii

strains. Based on the collected data,

F. prausnitzii

JCM 31915T,

F. prausnitzii

JCM 39210T and

Faecalibacterium

sp. JCM 17207T represent three novel species of the genus

Faecalibacterium

, for which the names Faecalibacterium duncaniae sp. nov. (type strain JCM 31915T=DSM 17677T=A2-165T), Faecalibacterium hattorii sp. nov. (type strain JCM 39210T=DSM 107841T=APC922/41-1T) and Faecalibacterium gallinarum sp. nov. (type strain JCM 17207T=DSM 23680T=ic1379T) are proposed.
Clonal spread of ArmA- and OXA-23-coproducing Acinetobacter baumannii International Clone 2 in Brazil during the first wave of the COVID-19 pandemic
Authors: Camargo Carlos Henrique , Yamada Amanda Yaeko , Nagamori Filipe Onishi , de Souza Andreia Rodrigues , Tiba-Casas Monique Ribeiro , de Moraes França Flavia Aparecida , Porto Maria Helena Trigueiro Nóbrega , de Lima Garzon Magda Lourdes , Higgins Paul , Madalosso Geraldine , de Assis Denise Brandão
Published: April 2022

Introduction. Carbapenem-resistant

Acinetobacter baumannii

(CRAB) is the primary pathogen causing hospital-acquired infections. The spread of CRAB is mainly driven by the dissemination of resistant clones, and in Latin America, International Clones IC-1 (also known as clonal complex CC1), IC-4 (CC15) and IC-5 (CC79) are the most prevalent.

Gap Statement. There are no documented outbreaks of CRAB International Clone 2 (IC-2) reported in Brazil.

Aim. To describe a large outbreak of CRAB caused by the uncommon IC-2 in a Brazilian COVID-19 hospital.

Methodology. From May 2020 to May 2021, 224 patients infected or colonized with CRAB were identified in a single hospital; 92 % of them were also infected with SARS-CoV-2. From these patients, 137 isolates were recovered and subjected to antimicrobial susceptibility testing, PCR analysis and molecular typing. Whole-genome sequencing and downstream analysis were carried out on a representative isolate (the first available isolate).

Results. In 76 % of the patients, a single OXA-23-producing CRAB IC-2 was identified. All the isolates were susceptible to polymyxin B, but highly resistant (>95 %) to aminoglycosides, fluoroquinolones and beta-lactams. Genomic analysis revealed that the representative isolate also carried the 16S rRNA Methylase ArmA, which was detected for the first time in this species in Brazil.

Conclusion. We report the rapid spread of an emerging CRAB clone responsible for causing a large outbreak in a hospital in Brazil, a country with predominance of other CRAB clones. Continuous and prospective surveillance is warranted to evaluate the impact of this clone in Brazilian hospital settings.
Targeted control of pneumolysin production by a mobile genetic element in Streptococcus pneumoniae
Authors: Stevens Emily J. , Morse Daniel J. , Bonini Dora , Duggan Seána , Brignoli Tarcisio , Recker Mario , Lees John A. , Croucher Nicholas J. , Bentley Stephen , Wilson Daniel J. , Earle Sarah G. , Dixon Robert , Nobbs Angela , Jenkinson Howard , van Opijnen Tim , Thibault Derek , Wilkinson Oliver J. , Dillingham Mark S. , Carlile Simon , McLoughlin Rachel M. , Massey Ruth C.
Published: April 2022

Streptococcus pneumoniae

is a major human pathogen that can cause severe invasive diseases such as pneumonia, septicaemia and meningitis. Young children are at a particularly high risk, with an estimated 3–4 million cases of severe disease and between 300 000 and 500 000 deaths attributable to pneumococcal disease each year. The haemolytic toxin pneumolysin (Ply) is a primary virulence factor for this bacterium, yet despite its key role in pathogenesis, immune evasion and transmission, the regulation of Ply production is not well defined. Using a genome-wide association approach, we identified a large number of potential affectors of Ply activity, including a gene acquired horizontally on the antibiotic resistance-conferring Integrative and Conjugative Element (ICE) ICESp23FST81. This gene encodes a novel modular protein, ZomB, which has an N-terminal UvrD-like helicase domain followed by two Cas4-like domains with potent ATP-dependent nuclease activity. We found the regulatory effect of ZomB to be specific for the ply operon, potentially mediated by its high affinity for the BOX repeats encoded therein. Using a murine model of pneumococcal colonization, we further demonstrate that a ZomB mutant strain colonizes both the upper respiratory tract and lungs at higher levels when compared to the wild-type strain. While the antibiotic resistance-conferring aspects of ICESp23FST81 are often credited with contributing to the success of the

S. pneumoniae

lineages that acquire it, its ability to control the expression of a major virulence factor implicated in bacterial transmission is also likely to have played an important role.
Racial/Ethnic Heterogeneity in Diet of Low-income Adult Women in the United States: Results from National Health and Nutrition Examination Surveys 2011-2018
Authors: Stephenson Briana Joy K. , Willett Walter C.
Published: April 2022

Background

Poor diet is a major risk factor of cardiovascular and chronic diseases, particularly for low-income women. However, the pathways by which race/ethnicity plays a role in this risk factor have not been fully explored.

Objective

This observational study aims to identify dietary consumption differences by race/ethnicity of US women living at or below the 130% poverty income level from 2011-2018.

Design

A total of 3005 adult women aged 20-80 years from the National Health and Nutrition Examination Survey (2011-2018) living at or below the 130% poverty-income level with at least one complete 24-hr dietary recall were classified into 5 self-identified racial/ethnic subgroups (Mexican, Other Hispanic, Non-Hispanic White, Non-Hispanic Black, Non-Hispanic Asian). Dietary consumption patterns were defined by 29 major food groups summarized from the Food Pattern Equivalents Database and derived via a robust profile clustering model which identifies foods that share consumption patterns across all low-income adult women, and foods that differ in consumption patterns based on race/ethnic subgroups.

Results

Legumes (protein and vegetable) were the most differentiating foods identified across all racial/ethnic subgroups and were primarily consumed by Mexican and Other Hispanic women. Non-Hispanic Asian women were most likely to favor a high consumption of prudent foods (fruits, vegetables, whole grains). Non-Hispanic White and Black women shared the most similarities in consumption patterns but differed in foods such as milk, poultry, and eggs.

Conclusions

Differences among consumption behaviors of low-income women were found along racial/ethnic lines. Efforts to improve nutritional health of low-income adult women should consider racial/ethnic differences in diet to appropriately focus interventions.

Disclaimers

N/A.

Sources of Support

Study supported in part by National Heart Lung and Blood Institute (NHLBI) grant R25 (HL105400) to Victor G. Davila-Roman and DC Rao.
Non-intuitive trends of fetal fraction development related to gestational age and fetal gender, and their practical implications for non-invasive prenatal testing
Authors: Forgacova Natalia , Gazdarica Juraj , Budis Jaroslav , Kucharik Marcel , Sekelska Martina , Szemes Tomas
Published: April 2022

Objective

Discovery of fetal cell-free DNA fragments in maternal blood revolutionized prenatal diagnostics. Although non-invasive prenatal testing (NIPT) is already a matured screening test with high specificity and sensitivity, the accurate estimation of the proportion of fetal fragments, called fetal fraction, is crucial to avoid false-negative results.

Methods

We collected 6999 samples from women undergoing NIPT testing with a single male fetus to demonstrate the influence of fetal fraction by the maternal and fetal characteristics.

Results

We show several fetal fraction discrepancies that contradict the generally presented conventional view. At first, the fetal fraction is not consistently rising with the maturity of the fetus due to a drop in 15 weeks of maturation. Secondly, the male samples have a lower fetal fraction than female fetuses, arguably due to the smaller gonosomal chromosomes. Finally, we discuss not only the possible reasons why this inconsistency exists but we also outline why these differences have not yet been identified and published.

Conclusion

We demonstrate two non-intuitive trends to better comprehend the fetal fraction development and more precise selection of patients with sufficient fetal fraction for accurate testing.

Bulleted statements

What is already known about this topic?

Non-invasive prenatal testing has become a well-known mature screening test, and the fetal fraction is studied in detail by research teams worldwide.

What does this study add?

Here we demonstrate two non-intuitive trends to better comprehend fetal fraction development that can further increase the sensitivity of routine testing by proper selection of blood sampling according to gestational age and fetus gender.
Plasma multi-omic and cardiac imaging network signatures predict poor long-term outcomes after acute myocardial infarction
Authors: Koh Hiromi W.L. , Pilbrow Anna , Tan Sock Hwee , Zhao Qing , Benke Peter I. , Burla Bo , Torta Federico , Pickering John W. , Troughton Richard , Pemberton Christopher , Soo Wern-Miin , Ling Lieng Hsi , Doughty Robert N. , Choi Hyungwon , Wenk Markus R. , Richards A. Mark , Chan Mark Y.
Published: April 2022

Background

Prognostic biomarkers for patients admitted for a myocardial infarction (MI) episode are of great interest for risk stratification and follow-up care after discharge. Multi-omics analysis is a standard approach for the discovery of diagnostic and prognostic biomarkers, but few studies have evaluated the prognostic potential of molecular markers in combination with echocardiographic imaging variables.

Methods

We measured the plasma proteome and lipidome in patients discharged from an acute MI and followed for secondary outcomes in New Zealand for a median time of 4.85 years (CDCS, N=741 for network inference, N=464 for predictive analysis) and in Singapore for a median time of 2.0 years (IMMACULATE, N=190 for validation). Using a network-based integrative analysis framework iOmicsPASS+, we mapped proteins, lipids, echocardiographic imaging variables and clinical biomarkers to a unified network and identified predictive subnetwork signatures of major adverse cardiac events (MACE) and heart failure hospitalization (HFH) in CDCS, with validation in IMMACULATE.

Results

Specific plasma proteins and lipids showed direct connections to cardiac imaging variables in the network. The gold standard biomarker, NT-proBNP, remained one of the best prognostic marker of MACE and HFH, but a number of plasma proteins involved in extracellular matrix organization, chemotaxis, inflammation, and apoptosis were also strong predictors of both outcomes. Hub proteins of subnetwork signatures were enriched in the heart, arteries, kidneys, liver and lungs. BMP10, CAPG, EFEMP1, FSTL3, RSPO4, and RELT were those directly connected to the echocardiographic variables and natriuretic peptides. In particular, EFEMP1 and FSTL3 in combination with diastolic function (E/e’) were strongly predictive of HFH in both CDCS (AUC 0.78, 95%CI 0.72-0.83) and IMMACULATE (AUC 0.72, 0.61-0.84).

Conclusions

Our integrative analysis revealed competing signatures beyond established biomarkers of post-MI HFH, comprised of plasma proteins correlated with impaired diastolic function after the primary MI episode.
Blood Draw Site and Analytic Device Influence Hemoglobin Measurements
Authors: Killilea David W. , Kuypers Frans A. , Larkin Sandra K. , Schultz Kathleen
Published: April 2022

Anemia is a continuing global public health concern and a priority for international action. The prevalence of anemia is estimated from the hemoglobin (Hb) levels within target populations, yet the procedures for measuring Hb are not standardized and different approaches may result in discrepancies. Several analytical variables have been proposed to influence Hb measurements, but it is difficult to understand the impact on specific variables from large population or field studies. Therefore, we designed a highly controlled protocol that minimized most technical parameters to specifically investigate the impact of blood draw site and analytic device on Hb measurements. A diverse cohort of sixty healthy adults each provided a sequential capillary and venous blood sample that were measured for Hb using an automated hematology analyzer (ADVIA-2120) and two point-of-care devices (HemoCue 201+ and HemoCue 301). Comparing blood draw sites, the mean Hb content was 0.32-0.47 g/dL (2-4%) higher in capillary compared to venous blood from the same donors. Comparing different Hb measuring instruments, the mean Hb content was 0.19-0.46 g/dL (1-4%) higher measured with HemoCue devices compared to ADVIA-2120 in both capillary and venous blood from the same donors. The maximum variance in measurement was also higher with HemoCue devices using blood from venous (5-6% CV) and capillary (21-25% CV) sites compared to ADVIA-2120 (0.6-2% CV). Other variables including blood collection tube manufacturer did not affect mean Hb content. These results demonstrate that even when most technical variables are minimized, the blood draw site and the analytical device can have a small but statistically significant effect on the mean and dispersion of Hb measurements. Even in this study, the few participants identified as mildly anemic using venous blood measured by ADVIA-2120 would not have been classified as anemic using their capillary blood samples or point-of-care analyzers. Thus, caution is warranted when comparing Hb values between studies having differences in blood draw site and Hb measuring device. Future anemia testing should maintain consistency in these analytical variables.
Lowered oxygen saturation and increased body temperature in acute COVID-19 largely predict chronic fatigue syndrome and affective symptoms due to LONG COVID: a precision nomothetic approach
Authors: Al-Hadrawi Dhurgham Shihab , Al-Rubaye Haneen Tahseen , Almulla Abbas F. , Al-Hakeim Hussein Kadhem , Maes Michael
Published: April 2022

Background

Long coronavirus disease 2019 (LC) is a chronic sequel of acute COVID-19. The exact pathophysiology of the affective, chronic fatigue and physiosomatic symptoms (labeled as “physio-affective phenome”) of LC has remained elusive.

Objective

The current study aims to delineate the effects of oxygen saturation (SpO2) and body temperature during the acute phase on the physio-affective phenome of LC.

Method

We recruited 120 LC patients and 36 controls. For all participants, we assessed the lowest SpO2 and peak body temperature during acute COVID-19, and the Hamilton Depression and Anxiety Rating Scale (HAMD/HAMA) and Fibro Fatigue (FF) scales 3 to 4 months later.

Results

Lowered SpO2 and increased body temperature during the acute phase and female sex predict 60.7% of the variance in the physio-affective phenome of LC. Using unsupervised learning techniques we were able to delineate a new endophenotype class, which comprises around 26.7% of the LC patients and is characterized by very low SpO2 and very high body temperature, and depression, anxiety, chronic fatigue, and autonomic and gastro-intestinal symptoms scores. Single latent vectors could be extracted from both biomarkers, depression, anxiety and FF symptoms or from both biomarkers, insomnia, chronic fatigue, gastro-intestinal and autonomic symptoms.

Conclusion

The newly constructed endophenotype class and pathway phenotypes indicate that the physio-affective phenome of LC is at least in part the consequence of the pathophysiology of acute COVID-19, namely the combined effects of lowered SpO2, increased body temperature and the associated immune-inflammatory processes and lung lesions.