bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic repair for internal hernia associated with colostomy: a case report
Authors: Shiratori Hiroshi , Onoda Takanobu , Takabayashi Naoki , Harada Chika , Imada Sae , Kita Yusuke , Kazama Shinsuke , Ishihara Yukio , Kobayashi Ryo , Hiramatsu Takeyuki
Published: May 2023

A 63-year-old woman was admitted with abdominal pain two months after laparoscopic abdominoperineal resection for rectal cancer. Computed tomography revealed dilated small intestine had passed through a defect between the lifted sigmoid colon and abdominal wall. She was diagnosed with small bowel obstruction without strangulation due to internal hernia and managed nonoperatively based on her wish. Recurrence of intestinal obstruction occurred for which curative surgery was performed laparoscopically. The herniated intestine was restored to the normal position, and the hernia orifice was closed using barbed suture, on laparoscopic management. Internal hernia is a rare complication after colostomy that requires surgical management. Although laparoscopic approach on re-operation is difficult, laparoscopic surgery may be suitable for patients with IHAC in terms of required less use of adhesiolysis.
The frontiers of medical negligence and diagnosis: an interview-based analysis
Authors: Mackley Annie , Liddell Kathleen , Skopek Jeffrey M , Le Gallez Isabelle , Fritz Zoë
Published: May 2023

While errors in medical diagnosis are common and often litigated, the different dimensions of diagnosis—formation, communication, recording—have received much less legal attention. When the process of diagnosis is differentiated in this way, new and contentious legal questions emerge that challenge the appropriateness of the Bolam/Bolitho standard. To explore these challenges, we interviewed 31 solicitors and barristers and asked them: (i) whether Montgomery should apply to information about alternative diagnoses; and (ii) whether the Bolam/Bolitho standard should be rejected in ‘pure diagnosis’ cases. Our qualitative analysis of the interviews sheds light not only on the two questions posed, but also on three cross-cutting themes. First, Bolam/Bolitho is criticised on two grounds that are often conflated: its paternalism for patients and its deference to medical professionals. Second, adopting different standards for different aspects of treatment and diagnosis may be justified in principle, but it can sometimes be difficult or not make sense in practice. Third, new conceptions of patients, doctors, and courts are being articulated in terms of rights or responsibilities over risks. In mapping these issues at the frontiers of medical negligence, this empirical study identifies potential pressure points for future legal developments.
The membership of stars, density profile, and mass segregation in open clusters using a new machine learning-based method
Authors: Noormohammadi M , Khakian Ghomi M , Haghi H
Published: May 2023

A combination of two unsupervised machine learning algorithms, DBSCAN: Density-Based Spatial Clustering of Applications with Noise, and GMM: Gaussian mixture models, are used to find members with a high probability of 12 open clusters, M38, NGC2099, Coma Ber, NGC752, M67, NGC2243, Alessi01, Bochum04, M34, M35, M41, and M48, based on Gaia DR3. These clusters have different ages, distances, and numbers of members which makes a suitable cover of these parameters situation to analyse this method. We have identified 752, 1725, 116, 269, 1422, 936, 43, 38, 743, 1114, 783, and 452, probable and possible members with a higher probability than 0.8 for M38, NGC2099, Coma Ber, NGC752, M67, NGC2243, Alessi01, Bochum04, M34, M35, M41, and M48, respectively. Moreover, we obtained the tidal radius, core radius, and clear evidence of mass segregation in 10 clusters. From an examination of the high-quality colour–magnitude data of the cluster, we obtained one white dwarf for each of NGC752, Coma Ber, and M67. In the young open cluster M38, we found all members inside the tidal radius however in the older clusters we found some members outside of the tidal radius, indicating that the young open clusters had not enough time to form clear tidal tails. It is seen that mass segregation occurs at a higher rate in older clusters than the younger ones.
Resolving the binary components of the outbursting protostar HBC 494 with ALMA
Authors: Nogueira Pedro Henrique , Zurlo Alice , Pérez Sebastián , González-Ruilova Camilo , Cieza Lucas A , Hales Antonio , Bhowmik Trisha , Ruíz-Rodríguez Dary A , Principe David A , Herczeg Gregory J , Williams Jonathan P , Cuadra Jorge , Montesinos Matías , Cuello Nicolás , Chavan Prachi , Casassus Simon , Zhu Zhaohuan , Goicovic Felipe G
Published: May 2023

Episodic accretion is a low-mass pre-main sequence phenomenon characterized by sudden outbursts of enhanced accretion. These objects are classified into two: protostars with elevated levels of accretion that lasts for decades or more, called FUors, and protostars with shorter and repetitive bursts, called EXors. HBC 494 is a FUor object embedded in the Orion Molecular Cloud. Earlier Atacama Large (sub-)Millimeter Array (ALMA) continuum observations showed an asymmetry in the disc at 0${_{.}^{\prime\prime}}$2 resolution. Here, we present follow-up observations at ∼0${_{.}^{\prime\prime}}$03, resolving the system into two components: HBC 494 N (primary) and HBC 494 S (secondary). No circumbinary disc was detected. Both discs are resolved with a projected separation of ∼0${_{.}^{\prime\prime}}$18 (75 au). Their projected dimensions are 84 ± 1.8 × 66.9 ± 1.5 mas for HBC 494 N and 64.6 ± 2.5 × 46.0 ± 1.9 mas for HBC 494 S. The discs are almost aligned and with similar inclinations. The observations show that the primary is ∼5 times brighter/more massive and ∼2 times bigger than the secondary. We notice that the northern component has a similar mass to the FUors, while the southern has to EXors. The HBC 494 discs show individual sizes that are smaller than single eruptive YSOs. In this work, we also report 12CO, 13CO, and C18O molecular line observations. At large scale, the 12CO emission shows bipolar outflows, while the 13CO and C18O maps show a rotating and infalling envelope around the system. At a smaller scale, the 12CO and 13CO moment zero maps show cavities within the continuum discs’ area, which may indicate continuum over-subtraction or slow-moving jets and chemical destruction along the line of sight.
The Proper Objects of Faith and Hope
Authors: Scott Michael
Published: May 2023

Can one have faith that something is the same as itself, or hope that a triangle has four sides? Accounts of the proper object of faith or of hope typically exclude modal cases, where the object of faith or hope is understood by the agent to be either necessary or impossible, on the basis of their intuitive implausibility or their incompatibility with beliefs that the agent has about the probability or possibility of the object of faith or hope. This paper argues that the noncognitive components of the psychology of these attitudes—evidential resistance in the case of faith and desire in the case of hope—provide a more plausible and economical explanation for restrictions on their proper objects.
On the Nature of Faith and Its Relation to Trust and Belief
Authors: Faulkner Paul
Published: May 2023

One can have faith in someone, believe in someone and trust someone, and these notions seem closely related. Any account of faith should then address its relation to trust and belief. Like trust, faith can similarly have propositional and relational forms. One can have faith that God is good and faith in God; one can trust that another will do something and trust them to do it. Starting from a comparison between these forms of faith and trust, this paper proposes a philosophical analysis of faith and its relation to trust and belief.
Rational Faith: How Faith Construed as Trust Does, and Does Not, Go Beyond Our Evidence
Authors: Dormandy Katherine
Published: May 2023

I argue that faith is a type of trust. It is also part of a relationship in which both parties are called on to be faithful, where faithfulness is a type of trustworthiness. What distinguishes faith relationships from trust relationships is that both parties value the faith relationship intrinsically. I discuss how faith on this account can, and cannot, be rational when it goes beyond a person’s evidence. It turns out that faith has the same rationality conditions as trust, differing from it only in the cases that fix our intuitions.
Faith as Trust
Authors: Simpson Thomas W
Published: May 2023

The Reformed theological tradition has maintained that faith consists in trust, with that trust involving belief of certain doctrinal propositions. This paper has two aims. First, it contributes towards rehabilitating this conception of faith. I start, accordingly, by setting out the Reformers’ basic case: faith consists in trust because faith is a response to the promises of God, by which the Christian receives God’s forgiveness and is united with God. This argument is independent of any commitment to nondoxasticism or doxasticism about faith. Second, it argues for a methodological commitment which the Reformers’ conception of faith-as-trust complies with, which I think is independently compelling, and which has significant implications for contemporary debates on faith: the kind of faith that matters is that which enables the individual to stand justified, or righteous, before God. Philosophical accounts of faith are unavoidably entangled with theological disputes about justification.
Chronic kidney disease is a key risk factor for aortic stenosis progression
Authors: Candellier Alexandre , Bohbot Yohann , Pasquet Agnes , Diouf Momar , Vermes Emmanuelle , Goffin Eric , Gun Mesut , Peugnet Fanny , Hénaut Lucie , Rusinaru Dan , Mentaverri Romuald , Kamel Saïd , Choukroun Gabriel , Vanoverschelde Jean-Louis , Tribouilloy Christophe
Published: May 2023

Background

Rapid progression of aortic stenosis (AS) has been observed in patients undergoing dialysis, but existing cross-sectional evidence is contradictory in non-dialysis-dependent chronic kidney disease (CKD). The present study sought to evaluate whether CKD is associated with the progression of AS over time in a large cohort of patients with AS.

Methods

We retrospectively studied all consecutive patients diagnosed with AS [peak aortic jet velocity (Vmax) ≥2.5 m/s] and left ventricular ejection fraction ≥50% in the echocardiography laboratories of two tertiary centers between 2000 and 2018. The estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2) was calculated from serum creatinine values. Patients were divided into five CKD stages according to the baseline eGFR. Annual rates of change in the aortic valve area (AVA) were determined by a linear mixed-effects model.

Results

Among the 647 patients included, 261 (40%) had CKD. After a median follow-up of 2.9 (interquartile range 1.8–4.8) years, the mean overall rate of change in AVA was –0.077 (95% confidence interval –0.082; –0.073) cm2/year. There was an inverse relationship between the progression rate and kidney function. The more severe the CKD stage, the greater the AVA narrowing (P < .001). By multivariable linear regression analysis, the eGFR was also negatively associated (P < .001) with AS progression. An eGFR strata below 45 mL/min/1.73 m2 was associated with higher odds of rapid progression of AS than normal kidney function. During the clinical follow-up, event-free survival (patients free of aortic valve replacement or death) decreased as CKD progressed. Rapid progression of AS in patients with kidney dysfunction was associated with worse outcomes.

Conclusions

Patients with CKD exhibit more rapid progression of AS over time and require close monitoring. The link between kidney dysfunction and rapid progression of AS is still unknown and requires further research.
Migration of silicone catheter into pleural space: a case report
Authors: Wong Chen-Yu , Yang Hsuan-Tzu , Hsin Chun-Hsien
Published: May 2023

Background: The totally implantable venous access port (TIVAP) is widely used for chemotherapy, transfusions and parenteral nutritional support. Dysfunction of TIVAP is not uncommon in clinical practice in cases of several etiologies. Herein, we report a rare case of TIVAP dysfunction due to a catheter that migrated into the pleural space. Case presentation: We present a case of a 70-year-old man of TIVAP dysfunction due to a rare catheter extra-vascular migration into the pleural space, diagnosed by computed tomography. We decided on observation without further utilization of the TIVAP and a shift to oral chemotherapy, after a discussion with patient and his primary care oncologist. Conclusion: Our case highlighted the importance of proper evaluation of TIVAP catheter location before its usage or replacement.
Autonomic neural regulation in mediating the brain–bone axis: mechanisms and implications for regeneration under psychological stress
Authors: Ma C , Zhang Y , Cao Y , Hu C -H , Zheng C -X , Jin Y , Sui B -D
Published: May 2023

Efficient regeneration of bone defects caused by disease or significant trauma is a major challenge in current medicine, which is particularly difficult yet significant under the emerging psychological stress in the modern society. Notably, the brain–bone axis has been proposed as a prominent new concept in recent years, among which autonomic nerves act as an essential and emerging skeletal pathophysiological factor related to psychological stress. Studies have established that sympathetic cues lead to impairment of bone homeostasis mainly through acting on mesenchymal stem cells (MSCs) and their derivatives with also affecting the hematopoietic stem cell (HSC)-lineage osteoclasts, and the autonomic neural regulation of stem cell lineages in bone is increasingly recognized to contribute to the bone degenerative disease, osteoporosis. This review summarizes the distribution characteristics of autonomic nerves in bone, introduces the regulatory effects and mechanisms of autonomic nerves on MSC and HSC lineages, and expounds the crucial role of autonomic neural regulation on bone physiology and pathology, which acts as a bridge between the brain and the bone. With the translational perspective, we further highlight the autonomic neural basis of psychological stress-induced bone loss and a series of pharmaceutical therapeutic strategies and implications toward bone regeneration. The summary of research progress in this field will add knowledge to the current landscape of inter-organ crosstalk and provide a medicinal basis for the achievement of clinical bone regeneration in the future.
The Major Features of Macroevolution
Authors: Henao-Diaz L Francisco , Pennell Matt
Published: May 2023

Evolutionary dynamics operating across deep time leave footprints in the shapes of phylogenetic trees. For the last several decades, researchers have used increasingly large and robust phylogenies to study the evolutionary history of individual clades and to investigate the causes of the glaring disparities in diversity among groups. Whereas typically not the focal point of individual clade-level studies, many researchers have remarked on recurrent patterns that have been observed across many different groups and at many different time scales. Whereas previous studies have documented various such regularities in topology and branch length distributions, they have typically focused on a single pattern and used a disparate collection (oftentimes, of quite variable reliability) of trees to assess it. Here we take advantage of modern megaphylogenies and unify previous disparate observations about the shapes embedded in the Tree of Life to create a catalog of the “major features of macroevolution.” By characterizing such a large swath of subtrees in a consistent way, we hope to provide a set of phenomena that process-based macroevolutionary models of diversification ought to seek to explain.
Autophagy inhibition mediated by intrauterinemiR‐1912‐3p/CTSDprogramming participated in the susceptibility to osteoarthritis induced by prenatal dexamethasone exposure in male adult offspring rats
Authors: Shi Huasong , Li Bin , Zhang Dingmei , Han Hui , He Hangyuan , Zhu Jiayong , Wang Hui , Chen Liaobin
Published: May 2023

Autophagy inhibition is known to be involved in the development of adult osteoarthritis. Dexamethasone, as a synthetic glucocorticoid, is widely used for premature delivery and related pregnancy diseases in clinics. We have previously shown that prenatal dexamethasone exposure (PDE) was associated with increased susceptibility to postnatal osteoarthritis in offspring. However, whether the occurrence of fetal‐originated adult osteoarthritis induced by PDE is related to autophagy remains unclear. In this study, we first found that PDE could increase the mRNA and protein expression of cartilage matrix‐degrading enzymes (MMP3, MMP13, and ADAMTS5) and decrease the cartilage matrix contents in adult offspring, and the in vitro results suggested that this might be related to the autophagy inhibition of chondrocytes. Further, we demonstrated a persistent autophagy inhibition with autolysosome accumulation, low expression of cathepsin D (CTSD), increased H3K9ac level, and expression of miR‐1912‐3p in the cartilage of PDE offspring from fetus to adulthood. In vitro experiments showed that dexamethasone inhibited autophagy flux and CTSD expression in fetal chondrocytes, while overexpression of CTSD could alleviate the inhibition of autophagic flux induced by dexamethasone. Finally, we confirmed that dexamethasone increased the H3K9ac level and expression of miR‐1912‐3p through activation of the glucocorticoid receptor (GR), resulting in the decreased expression of CTSD and inhibition of autophagy flux in fetal chondrocytes. In conclusion, intrauterine miR‐1912‐3p/CTSD programming‐mediated autophagy inhibition promoted the susceptibility to osteoarthritis in PDE adult offspring rats. This study provides new ideas for exploring early prevention and therapeutic targets in fetal‐originated osteoarthritis.
Broad and Asymmetric Lower Extremity Myotomes
Authors: Hashimoto Shuichi , Murohashi Takao , Yamada Shouto , Iesato Noriyuki , Ogon Izaya , Chiba Mitsumasa , Tsukamoto Arihiko , Hitrota Ryosuke , Yoshimoto Mitsunori
Published: May 2023

Study Design.

Retrospective review of prospectively collected data.

Objective.

This study aimed to accurately map the lower extremity muscles innervated by the lumbar spinal roots by directly stimulating the spinal roots during surgery.

Summary of Background Data.

Innervation of the spinal roots in the lower extremities has been estimated by clinical studies, anatomic studies, and animal experiments. However, there have been discrepancies between studies. Moreover, there are no studies that have studied the laterality of lower limb innervation.

Materials and Methods.

In 73 patients with lumbar degenerative disease, a total of 147 spinal roots were electrically stimulated and the electromyographic response was recorded at the vastus medialis (VM), gluteus medius (GM), tibialis anterior (TA), biceps femoris (BF), and gastrocnemius (GC). The asymmetry index (AI) was obtained using the following equation to represent the left-right asymmetry in the compound muscle action potential (CMAP) amplitude. Paired t tests were used to compare CMAP amplitudes on the right and left sides. Differences in the AI among the same spinal root groups were determined using one-way analysis of variance.

Results.

The frequency of CMAP elicitation in VM, GM, TA, BF, and GC were 100%, 75.0%, 50.0%, 83.3%, and 33.3% in L3 spinal root stimulation, 90.4%, 78.8%, 59.6%, 73.1%, and 59.6% in L4 spinal root stimulation, 32.2%, 78.0%, 93.2%, 69.5%, and 83.1% in L5 spinal root stimulation, and 40.0%, 100%, 80.0%, 70.0%, and 80.0% in S1 spinal root stimulation, respectively. The most frequent muscle with maximum amplitude of the CMAP in L3, L4, L5, and S1 spinal root stimulation was the VM, GM, TA, and GM, respectively. Unilateral innervation occurred at high rates in the TA in L4 root stimulation and the VM in L5 root stimulation in 37.5% and 42.3% of patients, respectively. Even in patients with bilateral innervation, a 20% to 38% AI of CMAP amplitude was observed.

Conclusions.

The spinal roots innervated a much larger range of muscles than what is indicated in general textbooks. Furthermore, a non-negligible number of patients showed asymmetric innervation of lower limb by the lumbar spinal roots.
Merkel Cell Hyperplasia Versus Intraepidermal Merkel Cell Carcinoma: A Comparative Study of 2 Cases
Authors: Valiga Alexander , Tababa Erin Jane , Chung Hye Jin , Cha Jisun
Published: May 2023

Intraepidermal Merkel cell hyperplasia and Merkel cell carcinoma represent 2 histologically similar-appearing diagnoses with significant differences regarding prognosis and management. We present 1 case of each diagnosis to highlight characteristic histopathologic and immunohistochemical features. Our case of Merkel cell hyperplasia was identified by its small intraepidermal nest of monomorphic cells without atypia or mitoses, which demonstrated cytoplasmic, rather than perinuclear dot, patterning on CK20 staining. This can be contrasted with our case of intraepidermal Merkel cell carcinoma, which, despite a lack of dermal extension, demonstrated large nests of pleomorphic cells with frequent mitoses and apoptoses. The diagnosis was further confirmed by immunohistochemistry because CK20 staining showed classic perinuclear dot patterning. By presenting both diagnoses in parallel, this comparison aims to underscore crucial histopathologic and immunohistochemical similarities and differences.
Gender-Affirming Vaginoplasty: A Comparison of Algorithms, Surgical Techniques and Management Practices across 17 High-volume Centers in North America and Europe
Authors: Coon Devin , Morrison Shane D. , Morris Martin P. , Keller Patrick , Bluebond-Langner Rachel , Bowers Marci , Brassard Pierre , Buncamper Marlon E. , Dugi Daniel , Ferrando Cecile , Gast Katherine M. , McGinn Christine , Meltzer Toby , Monstrey Stan , Özer Müjde , Poh Melissa , Satterwhite Thomas , Ting Jess , Zhao Lee , Kuzon William M. , Schechter Loren
Published: May 2023

Background:

Penile inversion vaginoplasty is the most common gender-affirming genital surgery performed around the world. Although individual centers have published their experiences, expert consensus is generally lacking.

Methods:

Semistructured interviews were performed with 17 experienced gender surgeons representing a diverse mix of specialties, experience, and countries regarding their patient selection, preoperative management, vaginoplasty techniques, complication management, and postoperative protocols.

Results:

There is significant consistency in practices across some aspects of vaginoplasty. However, key areas of clinical heterogeneity are also present and include use of extragenital tissue for vaginal canal/apex creation, creation of the clitoral hood and inner labia minora, elevation of the neoclitoral neurovascular bundle, and perioperative hormone management. Pathway length of stay is highly variable (1–9 days). Lastly, some surgeons are moving toward continuation or partial reduction of estrogen in the perioperative period instead of cessation.

Conclusions:

With a broad study of surgeon practices, and encompassing most of the high-volume vaginoplasty centers in Europe and North America, we found key areas of practice variation that represent areas of priority for future research to address. Further multi-institutional and prospective studies that incorporate patient-reported outcomes are necessary to further our understanding of these procedures.
Photoreceptor Damage in Terson Syndrome
Authors: Szeligowski Tomasz , Fu Dun J. , Fernandez-Ledo Noa , Birtel Johannes , Aslam Sher A. , Patel Chetan K. , Xue Kanmin , Charbel Issa Peter
Published: May 2023

Purpose:

To describe photoreceptor damage in patients with Terson syndrome as a potential cause for inconsistent clinical outcomes.

Methods:

Clinical evaluation and retinal imaging in six patients

Results:

Four patients were female and two male, with an average age of 46.8 years (SD 8.9). Four patients suffered aneurysmal subarachnoid haemorrhage, one vertebral artery dissection, and one superior sagittal sinus thrombosis. In 11 eyes, we observed a consistent pattern of outer retinal damage within the central macula affecting the ellipsoid zone and the outer nuclear layer, indicating photoreceptor damage. Areas of photoreceptor damage showed poor spatial correlation with intraocular haemorrhage, particularly sub-internal limiting membrane haemorrhage. The observed retinal abnormalities demonstrated incomplete recovery over long-term follow-up 3.5 to 8 years post-haemorrhage, irrespective of surgical or conservative treatment strategy, and had variable impact on the patients’ visual function.

Conclusion:

The observations suggest that photoreceptor damage in Terson syndrome likely represents a distinct manifestation of this condition, which could be caused by transient ischaemia resulting from disturbed choroidal perfusion secondary to acute rise in intracranial pressure.
Weight Status and Binge Drinking Among Male and Female Florida Firefighters
Authors: Kling Hannah E. , Koru-Sengul Tulay , Schaefer Solle Natasha , Louzado-Feliciano Paola , Lee David J. , Kobetz Erin N. , Caban-Martinez Alberto J.
Published: May 2023

Objective

The aim of the study is to examine the association between weight status and binge drinking among Florida firefighters.

Methods

Health survey data collected between 2015 and 2019 among Florida firefighters participating in the Annual Cancer Survey were analyzed for weight class (healthy, overweight, obese) and binge-drinking behaviors. Binary logistic regression models were fit and stratified by sex while controlling for sociodemographic and health characteristics.

Results

Among 4002 firefighter participants, 45.1% binge drink, 50.9% are overweight, and 31.3% are obese. Among male firefighters, being overweight (adjusted odds ratio = 1.34; 95% confidence interval = 1.10–1.64) or obese (1.29; 1.04–1.61) was significantly associated with binge drinking compared with healthy weight counterparts. In female firefighters, being obese (2.25; 1.21–4.22) was significantly associated with binge drinking but being overweight was not.

Conclusions

Being overweight or obese is selectively associated with binge drinking among male and female firefighters.
A new leadership frontier: Nurse practitioners and physician associates as inpatient medical directors
Authors: Patel Carla , Bruno Morgan , Rukundo Innocent , Dains Joyce , Martinez Ashley , Soliman Pamela
Published: May 2023

Nurse practitioners and physician associates (NPs and PAs) have become an integral part of health care delivery in every clinical setting. Both NPs and PAs possess the knowledge and skills to deliver quality care to patients that may otherwise go without. There is a push to have NPs and PAs work to the top of their licenses and take on leadership roles as they help reshape health care delivery in the United States. However, high-level leadership positions for this group of clinicians are not abundant, and no specific pathway has been established to develop these skills. The aim of this report is to share the early experience of a small group of NPs and PAs, given the opportunity to function as inpatient medical directors (IMD) and the qualities that make them ideal for this novel leadership role.
Alcohol-Induced Sudden Cardiac Death in a Teenager With PPA2 Gene Mutations
Authors: Graham Sydney , Peterson Diane C. , James Christine
Published: May 2023

The PPA2 gene encodes a mitochondrial pyrophosphatase protein. Mutations in the gene are inherited in an autosomal recessive fashion and, when mutated, function to induce mitochondrial ATP production failure resulting in increased stress on the heart and sudden cardiac death, especially when combined with alcohol. Herein, we describe a case of a 19-year-old female patient with a history of “alcohol intolerance” who was found unexpectedly deceased after consuming a minimal amount of alcohol. Histological examination of her heart revealed widespread fibrosis of the left ventricle and the interventricular septum. Other findings include hypertrophied myocytes, including some with pleomorphic nuclei. Genetic studies were performed on postmortem blood, revealing heterozygous PPA2 gene mutations, the pathogenic variant c.683C>T (p.Pro228Leu), and the other variant c.814C>T (p.His272Tyr), a novel variant of undetermined significance. We propose that the variant of undetermined significance is likely a pathogenic mutation due to the decedent's phenotype.
Camouflage of Postburn Scarring Alopecia Using Nanofat Grafting and Follicular Unit Hair Transplantation
Authors: Evin Nuh , Guray Evin Seyda
Published: May 2023

Background:

Postburn scarring alopecia on hair-bearing aesthetic subunits causes cosmetic disfiguring and psychological problems. Follicular unit extraction (FUE) hair transplantation is an effective technique for camouflaging postburn scarring alopecia. However, poorly vascularized and fibrotic scar tissue limits the viability of grafts. The mechanical and vascular characteristics of scar tissue can be improved by nanofat grafting. This study aimed to present the results of postburn scarring alopecia treatment using nanofat-assisted FUE hair transplantation.

Methods:

Eighteen patients who had postburn scarring alopecia in and around the beard were enrolled. Patients underwent single-session nanofat grafting and FUE hair transplantation at 6-month intervals. Twelve months after hair transplantation, the survival rate of transplanted follicular graft, scar improvement, and patient satisfaction were assessed by counting each transplanted follicle individually, using the Patient and Observer Scar Assessment Scale, and using a 5-point Likert satisfaction scale, respectively.

Results:

Nanofat grafting and hair transplantation were successfully performed without complication. All scars significantly improved in mature characteristics (P < 0.00001 for patients; P < 0.00001 for observers). The survival and density rates of transplanted follicular units ranged from 77.4% to 87.9% (mean, 83.2% ± 2.5%) and 10.7% to 19.6% (mean, 15.2% ± 2.46%), respectively. All patients reported significantly satisfying cosmetic results (P < 0.00001).

Conclusions:

Scarring alopecia is an inevitable and challenging late complication of deep burned hair-bearing units. Combining nanofat injection and FUE hair transplantation is among the most innovative and effective treatments for postburn scarring alopecia.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
The American Psychosomatic Society Antiracism Task Force: Implementation, Activities, and Lessons Learned
Authors: Mezuk Briana , Sin Nancy L. , Stanton Michael V. , Szabo Yvette Z. , Tomiyama A. Janet , White Kristi E.
Published: May 2023

The American Psychosomatic Society (APS) is an international professional society that aims to advance the scientific study of biological, behavioral, and social factors in health among educators, clinicians, and researchers. In pledging to be an antiracist organization in 2020, APS formed the Antiracism Task Force to identify different manifestations of systemic racism within the society and to make recommendations for building a more inclusive and equitable professional organization. The goal of this paper was to be maximally transparent to membership about our activities and lessons learned, as well as offer a case study to other organizations striving toward antiracism. We describe the inaugural year of activities of the APS Antiracism Task Force, which included proposing amendments to the society’s bylaws, collecting data on member attitudes toward diversity, and consulting on other member efforts to implement antiracism activities (e.g., increasing access to early career awards). In addition to reflecting on task force and society-specific factors that were facilitative in our first year, we describe future plans and potential challenges we may face as we support sustained commitment to APS’s antiracism efforts.
Financial Toxicity in Patients with Resected Lung Cancer
Authors: Deboever Nathaniel , Eisenberg Michael , Hofstetter Wayne L. , Mehran Reza J. , Rice David C. , Roth Jack , Sepesi Boris , Swisher Stephen G. , Vaporciyan Ara A. , Walsh Garrett L. , Antonoff Mara B. , Rajaram Ravi
Published: May 2023

Objectives:

We aimed to describe financial toxicity (FT) in patients with resected lung cancer and identify risk factors in this population.

Summary Background:

FT describes the financial burden associated with cancer care and its impact on the quality of survivorship. Few prior studies have examined FT in lung cancer patients.

Methods:

Patients who underwent lung cancer resection at our institution between January 1st 2016 and December 31st 2021 were surveyed to gather demographic information and evaluate FT using a validated questionnaire. A multivariable model was built to identify risk factors for FT.

Results:

1477 patients were contacted, of whom 463 responded (31.3%). Most patients were stage I (n=349, 75.4%) and lobectomy was performed often (n=290, 62.8%). There were 196 patients (42.3%) who experienced FT. Upon multivariable analyses, divorced marital status (Odds Ratio [OR]= 3.658, 95% confidence interval [CI]: 1.180-11.337), household income <$40,000 (OR=2.544, 95% CI: 1.003-6.455), credit score below 739 (OR=2.744, 95% CI 1.326-5.679), clinical stage > I (OR=2.053, 95% CI: 1.088-3.877), and change in work hours or work cessation (all P<0.05) were associated with FT. Coping mechanisms, such as decreased spending on food or clothing and increased use of savings or borrowing money, were more likely to be reported by patients experiencing FT than those who did not (P<0.001).

Conclusions:

Patients undergoing lung cancer resection often experienced significant financial stress with several identifiable risk factors. FT should be considered early in the care of these patients to alleviate detrimental coping mechanisms and enhance their quality of survivorship.
Multivariate mapping of ontogeny, taphonomy and phylogeny to reconstruct problematic fossil taxa
Authors: Reeves Jane C. , Sansom Robert S.
Published: May 2023

Exceptionally preserved fossils of soft-bodied organisms provide unique evidence of evolutionary history, but they are often contentious; different approaches frequently produce radically different reconstructions of taxa and their affinities. Conflict arises due to difficulties in disentangling the three non-independent factors that underlie all morphological variation within and between fossils: ontogeny, taphonomy and phylogeny. Comparative data from extant organisms can be extremely powerful in this context, but is often difficult to apply given the multi-dimensionality of anatomical variation. Here, we present a multivariate ordination method using discrete morphological character data from modern taxa at different ontogenetic and taphonomic stages (semaphoront and ‘semataphonts’). Analysing multiple axes of morphological variation simultaneously allows us to visualize character combinations that are likely to exist in fossil specimens at intersecting stages of growth and decay, and thus constrain interpretation of fossils. Application to early vertebrates finds variation in fossil specimens to be accounted for by all three axes: primarily decay inMayomyzon, ontogeny inPriscomyzonand phylogeny in ‘euphaneropoids’ andPalaeospondylus. Our demonstration of empirical multi-factorial variation underscores the power of multivariate approaches to fossil interpretation, especially non-biomineralized taxa. As such, this conceptual approach provides a new method for resolving enigmatic taxa throughout the fossil record.
Genotype-specific variation in seasonal body condition at a large-effect maturation locus
Authors: House Andrew H. , Debes Paul V. , Kurko Johanna , Erkinaro Jaakko , Primmer Craig R.
Published: May 2023

Organisms use resource allocation strategies to survive seasonal environmental changes and life-history stage transitions. Earlier studies found a transcription cofactor, vgll3,associating with maturation timing that inhibits adipogenesis in mice and affects body condition in juvenile salmon. Owing to a lack of temporal studies examining seasonality effects on phenotypes such asvgll3genotype, body condition, maturation and different life stages, we investigated the influence of different larval and juvenile temperatures,vgll3genotype and interactions with body condition and maturation rate. We reared Atlantic salmon for 2 years in four larval–juvenile phase temperature groups until the occurrence of mature males. We found no effect of larval temperature on the measured phenotypes or maturation rate. However, we observed an increased maturation rate in individuals of the warm juvenile temperature treatment and differences in body condition associated withvgll3genotype. Early maturation genotype individuals had a less variable body condition across seasons compared with late maturation genotype individuals. This result suggests avgll3influence on resource allocation strategies; possibly linked with the early maturation process, with early maturation genotype individuals having a higher maturation rate and a higher body condition in the spring.
Testudinimyces gracilis gen. nov, sp. nov. and Astrotestudinimyces divisus gen. nov, sp. nov., two novel, deep-branching anaerobic gut fungal genera from tortoise faeces
Authors: Pratt Carrie J. , Chandler Emily E. , Youssef Noha H. , Elshahed Mostafa S.
Published: May 2023

The anaerobic gut fungi (AGF, Neocallimastigomycota) represent a basal zoosporic phylum within the kingdom Fungi. Twenty genera are currently described, all of which were isolated from the digestive tracts of mammalian herbivores. Here, we report on the isolation and characterization of novel AGF taxa from faecal samples of tortoises. Twenty-nine fungal isolates were obtained from seven different tortoise species. Phylogenetic analysis using the D1/D2 region of the LSU rRNA gene, ribosomal internal transcribed spacer 1, and RNA polymerase II large subunit grouped all isolates into two distinct, deep-branching clades (clades T and B), with a high level of sequence divergence to their closest cultured relative (Khoyollomyces ramosus). Average amino acid identity values calculated using predicted peptides from the isolates’ transcriptomes ranged between 60.80–66.21  % (clade T), and 61.24–64.83  % (clade B) when compared to all other AGF taxa; values that are significantly below recently recommended thresholds for genus (85%) and family (75%) delineation in the Neocallimastigomycota. Both clades displayed a broader temperature growth range (20–45 °C, optimal 30 °C for clade T, and 30–42 °C, optimal 39 °C for clade B) compared to all other AGF taxa. Microscopic analysis demonstrated that strains from both clades produced filamentous hyphae, polycentric rhizoidal growth patterns, and monoflagellated zoospores. Isolates in clade T were characterized by the production of unbranched, predominantly narrow hyphae, and small zoospores, while isolates in clade B were characterized by the production of multiple sporangiophores and sporangia originating from a single central swelling resulting in large multi-sporangiated structures. Based on the unique phylogenetic positions, AAI values, and phenotypic characteristics, we propose to accommodate these isolates into two novel genera (Testudinimyces and Astrotestudinimyces), and species (T. gracilis and A. divisus) within the order Neocallimastigales. The type species are strains T130AT (T. gracilis) and B1.1T (A. divisus).
The Evidence of Cough Contagion in Human Beings
Authors: Wang Ziyou , Wang Huaiqing , Xia Zihan , Gao Dazhi
Published: May 2023

There is the evidence for cough contagion in human beings caused by empathy rather than physiology.Due to limited study on cough contagion,researchers have doubted whether cough was contagious from emtional contagion like yawn contagion.To deal with the doubts,we observed coughs from 34 adults in Ocean University of China in real time and recorded individual ‘s gender and local time.Then we developed a mathematical model to divide the cough process into several bouts and set a threshold for contagion to construct a response graph.With the graph,we first saw a strong effect of contagion for around 30 seconds no matter how long the bin(< 30s) was.Afterwards with mutiple measures,we extracted seven features(e.g.,duration) to describe the transmission chain and then found that there ‘s no time difference in cough contagion.Moreover,we also discovered tthe gender difference that males were more likely to be induced by triggers.Thus,cough contagion seems to be a normal phenomenon in human beings providing support to the experimental studies of empathy theory.
Mapping the daily rhythmic transcriptome in the diabetic retina
Authors: Silk Ryan P. , Winter Hanagh R. , -Benyahya Ouria Dkhissi , Evans-Molina Carmella , Stitt Alan W. , Tiwari Vijay K. , Simpson David A. , Beli Eleni
Published: May 2023

Retinal function shows marked changes from day to night. Yet, clinical diagnosis, treatments, and experimental sampling occur during the day, leaving a significant gap in our understanding of the pathobiology occurring at night. While there is evidence that diabetes disrupts the circadian system that optimizes our physiology to the environmental light/dark cycle, the impact of such disruption is not well understood. This study investigates whether diabetes affects the retina’s daily rhythm of gene expression to understand the pathobiology of diabetic retinopathy. Ins2Akita/Jmice, a model of type 1 diabetes, were kept under a standard 12h:12h light/dark cycle until four months of age. Non-diabetic littermates were used as controls. Bulk mRNA sequencing was conducted in retinas collected every 4 hours throughout the 24 hr light/dark cycle. Computational approaches were used to detect rhythmicity, predict acrophase, identify differential rhythmic patterns, analyze phase set enrichment, and predict upstream regulators. The retinal transcriptome exhibited a tightly regulated rhythmic expression with a clear 12-hr axis of transcriptional rush, peaking at midday and midnight. The functions of day-peaking genes were enriched for DNA repair, RNA splicing, and ribosomal protein synthesis, whereas night-peaking genes were enriched for metabolic processes and growth factor signaling. Although the 12-hr transcriptional axis is retained in the diabetic retina, it was phase advanced by approximately 1-3 hours with a wider distribution. Upstream regulator analysis for the genes that showed phase shifts identified oxygen sensing mechanisms and HIF1alpha as regulators, but not the circadian clock, which remained in phase to the light/dark cycle. We propose a model in which early in diabetes, the retina experiences a jet lag caused by the entrained circadian clock and its output being in one phase and metabolic pathways related to neuronal dysfunction and hypoxia driving advancement of gene expression to a different phase. Further studies are now required to evaluate the chronic implications of such internal jet lag for development of diabetic retinopathy.
IPEV: Identification of Prokaryotic and Eukaryotic Virus-derived sequences in virome using deep learning
Authors: Yin Hengchuang , Wu Shufang , Tan Jie , Guo Qian , Li Mo , Jiang Xiaoqing , Zhu Huaiqiu
Published: May 2023

Background

The virome obtained through virus-like particle enrichment contain a mixture of prokaryotic and eukaryotic virus-derived fragments. Accurate identification and classification of these elements are crucial for understanding their roles and functions in microbial communities. However, the rapid mutation rates of viral genomes pose challenges in developing high-performance tools for classification, potentially limiting downstream analyses.

Findings

We present IPEV, a novel method that combines trinucleotide pair relative distance and frequency with a 2D convolutional neural network for distinguishing prokaryotic and eukaryotic viruses in viromes. Cross-validation assessments of IPEV demonstrate its state-of-the-art precision, significantly improving the F1-score by approximately 22% on an independent test set compared to existing methods when query viruses share less than 30% sequence similarity with known viruses. Furthermore, IPEV outperforms other methods in terms of accuracy on most real virome samples when using sequence alignments as annotations. Notably, IPEV reduces runtime by 50 times compared to existing methods under the same computing configuration. We utilized IPEV to reanalyze longitudinal samples and found that the gut virome exhibits a higher degree of temporal stability than previously observed in persistent personal viromes, providing novel insights into the resilience of the gut virome in individuals.

Conclusions

IPEV is a high-performance, user-friendly tool that assists biologists in identifying and classifying prokaryotic and eukaryotic viruses within viromes. The tool is available athttps://github.com/basehc/IPEV.
Large differences in collateral blood vessel abundance among individuals arise from multiple genetic variants
Authors: Faber James E , Zhang Hua , Xenakis James G , Bell Timothy A , Hock Pablo , de Villena Fernando Pardo-Manuel , Ferris Martin T , Rzechorzek Wojciech
Published: May 2023

Collateral blood flow varies greatly among humans for reasons that remain unclear, resulting in significant differences in ischemic tissue damage. A similarly large variation has also been found in mice that is caused by genetic background-dependent differences in the extent of collateral formation, termed collaterogenesis—a unique angiogenic process that occurs during development and determines collateral number and diameter in the adult. Previous studies have identified several quantitative trait loci (QTL) linked to this variation. However, understanding has been hampered by the use of closely related inbred strains that do not model the wide genetic variation present in the “outbred” human population. The Collaborative Cross (CC) multiparent mouse genetic reference panel was developed to address this limitation. Herein we measured the number and average diameter of cerebral collaterals in 60 CC strains, their 8 founder strains, 8 F1 crosses of CC strains selected for abundant versus sparse collaterals, and 2 intercross populations created from the latter. Collateral number evidenced 47-fold variation among the 60 CC strains, with 14% having poor, 25% poor-to-intermediate, 47% intermediate-to-good, and 13% good collateral abundance, that was associated with large differences in post-stroke infarct volume. Genome-wide mapping demonstrated that collateral abundance is a highly polymorphic trait. Subsequent analysis identified: 6 novel QTL circumscribing 28 high-priority candidate genes harboring putative loss-of-function polymorphisms (SNPs) associated with low collateral number; 335 predicted-deleterious SNPs present in their human orthologs; and 32 genes associated with vascular development but lacking protein coding variants. This study provides a comprehensive set of candidate genes for future investigations aimed at identifying signaling proteins within the collaterogenesis pathway whose variants potentially underlie genetic-dependent collateral insufficiency in brain and other tissues.