bluuebunny/crossref_metadata_2025 huggingface dataset:
How chromosomal inversions reorient the evolutionary process
Authors: Berdan Emma L. , Barton Nicholas H. , Butlin Roger , Charlesworth Brian , Faria Rui , Fragata Inês , Gilbert Kimberly J. , Jay Paul , Kapun Martin , Lotterhos Katie E. , Mérot Claire , Durmaz Mitchell Esra , Pascual Marta , Peichel Catherine L. , Rafajlović Marina , Westram Anja M. , Schaeffer Stephen W. , Johannesson Kerstin , Flatt Thomas
Published: November 2023

Inversions are structural mutations that reverse the sequence of a chromosome segment and reduce the effective rate of recombination in the heterozygous state. They play a major role in adaptation, as well as in other evolutionary processes such as speciation. Although inversions have been studied since the 1920s, they remain difficult to investigate because the reduced recombination conferred by them strengthens the effects of drift and hitchhiking, which in turn can obscure signatures of selection. Nonetheless, numerous inversions have been found to be under selection. Given recent advances in population genetic theory and empirical study, here we review how different mechanisms of selection affect the evolution of inversions. A key difference between inversions and other mutations, such as single nucleotide variants, is that the fitness of an inversion may be affected by a larger number of frequently interacting processes. This considerably complicates the analysis of the causes underlying the evolution of inversions. We discuss the extent to which these mechanisms can be disentangled, and by which approach.

Abstract

Inversions often play key roles in adaptation and speciation, but the processes that direct their evolution are obscured by the characteristic that makes them so unique (reduced recombination between arrangements). In this review, we examine how different mechanisms can impact inversion evolution, weaving together both theoretical and empirical studies. We emphasize that most patterns are overdetermined (i.e. can be caused by multiple processes), but we highlight new technologies that provide a path forward towards disentangling these mechanisms.
A digital approach to create a virtual implant preliminary cast for the fabrication of a splinted framework and custom open tray for multiple implants impression making: A dental technique
Authors: Yang Shengtao , Lin Pochun , Gu Yiping , Yue Li , Yuan Quan
Published: November 2023

A digital approach is described for fabricating a splinted framework and custom open tray for the impression of multiple implants based on a virtually created implant cast with the digital prediction of the future impression coping positions. In this technique, impression copings to be used in the definitive impression‐making process were digitally scanned and aligned to a preliminary cast using installed protective caps of screw‐retained abutments as references, which resulted in a virtual cast that offers information both about the impression coping positions and their surrounding tissues and could allow a splinted framework and custom open tray to be digitally designed and fabricated. Creation of a virtual cast through digital technologies eliminates the traditional manual splinted framework and custom tray fabrication procedures. Additionally, only one set of impression copings and analogs is needed in this technique, thereby reducing treatment time and cost. It also offers a splinted framework and custom open tray with consistent quality.
Is there a latitudinal diversity gradient for symbiotic microbes? A case study with sensitive partridge peas
Authors: Harrison Tia L. , Parshuram Zoe A. , Frederickson Megan E. , Stinchcombe John R.
Published: November 2023

Mutualism is thought to be more prevalent in the tropics than temperate zones and may therefore play an important role in generating and maintaining high species richness found at lower latitudes. However, results on the impact of mutualism on latitudinal diversity gradients are mixed, and few empirical studies sample both temperate and tropical regions. We investigated whether a latitudinal diversity gradient exists in the symbiotic microbial community associated with the legume Chamaecrista nictitans. We sampled bacteria DNA from nodules and the surrounding soil of plant roots across a latitudinal gradient (38.64–8.68 °N). Using 16S rRNA sequence data, we identified many non‐rhizobial species within C. nictitans nodules that cannot form nodules or fix nitrogen. Species richness increased towards lower latitudes in the non‐rhizobial portion of the nodule community but not in the rhizobial community. The microbe community in the soil did not effectively predict the non‐rhizobia community inside nodules, indicating that host selection is important for structuring non‐rhizobia communities in nodules. We next factorially manipulated the presence of three non‐rhizobia strains in greenhouse experiments and found that co‐inoculations of non‐rhizobia strains with rhizobia had a marginal effect on nodule number and no effect on plant growth. Our results suggest that these non‐rhizobia bacteria are likely commensals—species that benefit from associating with a host but are neutral for host fitness. Overall, our study suggests that temperate C. nictitans plants are more selective in their associations with the non‐rhizobia community, potentially due to differences in soil nitrogen across latitude.
Intra‐uterine programming of future fertility
Authors: Chavatte‐Palmer Pascale , Couturier‐Tarrade Anne , Rousseau‐Ralliard Delphine
Published: November 2023

The developmental origins of health and disease (DOHaD) shows that a relationship exists between parental environment at large, foeto‐placental development and the risk for the offspring to develop non‐transmittable disease(s) in adulthood. This concept has been validated in both humans and livestock. In mammals, after fertilization and time spent free in the maternal reproductive tract, the embryo develops a placenta that, in close relationship with maternal endometrium, is the organ responsible for exchanges between dam and foetus. Any modification of the maternal environment can lead to adaptive mechanisms affecting placental morphology, blood flow, foetal‐maternal exchanges (transporters) and/or endocrine function, ultimately modifying placental efficiency. Among deleterious environments, undernutrition, protein restriction, overnutrition, micronutrient deficiencies and food contaminants can be outlined. When placental adaptive capacities become insufficient, foetal growth and organ formation is no longer optimal, including foetal gonadal formation and maturation, which can affect subsequent offspring fertility. Since epigenetic mechanisms have been shown to be key to foetal programming, epigenetic modifications of the gametes may also occur, leading to inter‐generational effects. After briefly describing normal gonadal development in domestic species and inter‐species differences, this review highlights the current knowledge on intra‐uterine programming of offspring fertility with a focus on domestic animals and underlines the importance to assess transgenerational effects on offspring fertility at a time when new breeding systems are developed to face the current climate changes.
Characterization of the novel HLA‐C*16:98:02 allele by sequencing‐based typing
Authors: Blandin Lucie , Visentin Jonathan , Duclaut Marion , Lemal Richard , Rouzaire Paul
Published: November 2023

HLA‐C*16:98:02 differs from HLA‐C*16:98:01 by one nucleotide substitution in codon 132 in exon 3.
Characterization of the novel HLA‐B*39:06:09 allele by sequencing‐based typing
Authors: Blandin Lucie , Visentin Jonathan , Ralazamahaleo Mamy , Lemal Richard , Rouzaire Paul
Published: November 2023

HLA‐B*39:06:09 differs from HLA‐B*39:06:02:01 by one nucleotide substitution in codon 135 in exon 3.
Evaluation of an Unloading Concept for Knee Osteoarthritis: A Pilot Study in a Small Patient Group
Authors: Stoltze Jonas S. , Oliveira Anderson S. C. , Rasmussen John , Andersen Michael S.
Published: November 2023

Joint compressive forces have been identified as a risk factor for osteoarthritis disease progression. Therefore, unloader braces are a common treatment with the aim of relieving pain, but their effects are not clearly documented in the literature. A knee brace concept was tested with the aim of reducing joint loads and pain in knee osteoarthritis patients by applying an extension moment exclusively during the stance phase. The ideal effects were evaluated during gait based on musculoskeletal modeling of six patients, and experimental tests with a prototype brace were conducted on one patient. The effects were evaluated using electromyography measurements and musculoskeletal models to evaluate the muscle activation and knee compressive forces, respectively. The ideal brace simulations revealed a varying reduction of the first peak knee force between 3.5% and 33.8% across six patients whereas the second peak was unaffected. The prototype reduced the peak vasti muscle activation with 7.9% and musculoskeletal models showed a reduction of the first peak knee compressive force of up to 26.3%. However, the prototype brace increased the knee joint force impulse of up to 17.1% and no immediate pain reduction was observed. The reduction of the first peak knee compressive force, using a prototype on a single patient, indicates a promising effect from an applied knee extension moment for reducing knee joint loads during normal gait. However, further clinical experiments with this brace method are required to evaluate the long-term effects on both pain and disease progression in knee osteoarthritis patients.
A First Step Toward a Family of Morphed Human Body Models Enabling Prediction of Population Injury Outcomes
Authors: Larsson Karl-Johan , Östh Jonas , Iraeus Johan , Pipkorn Bengt
Published: November 2023

The injury risk in a vehicle crash can depend on occupant specific factors. Virtual crash testing using finite element human body models (HBMs) to represent occupant variability can enable the development of vehicles with improved safety for all occupants. In this study, it was investigated how many HBMs of different sizes that are needed to represent a population crash outcome through a metamodel. Rib fracture risk was used as an example occupant injury outcome. Morphed HBMs representing variability in sex, height, and weight within defined population ranges were used to calculate population variability in rib fracture risk in a frontal and a side crash. Two regression methods, regularized linear regression with second-order terms and Gaussian process regression (GPR), were used to metamodel rib fracture risk due to occupant variability. By studying metamodel predictive performance as a function of training data, it was found that constructing GPR metamodels using 25 individuals of each sex appears sufficient to model the population rib fracture risk outcome in a general crash scenario. Further, by utilizing the known outcomes in the two crashes, an optimization method selected individuals representative for population outcomes across both crash scenarios. The optimization results showed that 5–7 individuals of each sex were sufficient to create predictive GPR metamodels. The optimization method can be extended for more crashes and vehicles, which can be used to identify a family of HBMs that are generally representative of population injury outcomes in future work.
Comparison of Two Contact Detection Methods for Ground Reaction Forces and Moment Estimation During Sidestep Cuts, Runs, and Walks
Authors: Morin Pauline , Muller Antoine , Dumont Georges , Pontonnier Charles
Published: November 2023

Force platforms often limit the analysis of human movement to the laboratory. Promising methods for estimating ground reaction forces and moments (GRF&M) can overcome this limitation. The most effective family of methods consists of minimizing a cost, constrained by the subject's dynamic equilibrium, for distributing the force over the contact surface on the ground. The detection of contact surfaces over time is dependent on numerous parameters. This study proposes to evaluate two contact detection methods: the first based on foot kinematics and the second based on pressure sole data. Optimal parameters for these two methods were identified for walking, running, and sidestep cut tasks. The results show that a single threshold in position or velocity is sufficient to guarantee a good estimate. Using pressure sole data to detect contact improves the estimation of the position of the center of pressure (CoP). Both methods demonstrated a similar level of accuracy in estimating ground reaction forces.
Expression and engineering of PET-degrading enzymes from
Microbispora, Nonomuraea
, and
Micromonospora
Authors: Tiong Elaine , Koo Ying Sin , Bi Jiawu , Koduru Lokanand , Koh Winston , Lim Yee Hwee , Wong Fong Tian
Published: November 2023

Low recycling rates coupled with increased production have resulted in an alarming rapid accumulation of a widely used plastic material, polyethylene terephthalate (PET). With the buildup of plastics in our environment, there is an urgent need for more sustainable solutions to process them. Biological methods such as enzyme-catalyzed PET recycling or bioprocessing are potential solutions to this problem. Actinobacteria, known for producing enzymes involved in the degradation of complex organic molecules, are of particular interest due to their potential to produce enzymes that may assimilate plastics. This work expands on the discovery and characterization of new PET-degrading enzymes from the
Microbispora, Nonomuraea,
and
Micromonospora
genera. Within the
Micromonospora
genus, we analyzed enzymes from the polyesterase-lipase-cutinase family with ~60% similarity to leaf-branch compost cutinase (LCC), in which one of the enzymes was found to be capable of breaking down PET and bis(2-hydroxyethyl) terephthalate (BHET) at 45°C–50°C. Moreover, we were able to enhance the enzyme’s depolymerization rate through further engineering, resulting in a two-fold increase in activity.

IMPORTANCE

Mismanagement of PET plastic waste significantly threatens human and environmental health. Together with the relentless increase in plastic production, plastic pollution is an issue of rising concern. In response to this challenge, scientists are investigating eco-friendly approaches, such as bioprocessing and microbial factories, to sustainably manage the growing quantity of plastic waste in our ecosystem. Industrial applicability of enzymes capable of degrading PET is limited by numerous factors, including their scarcity in nature. The objective of this study is to enhance our understanding of this group of enzymes by identifying and characterizing novel enzymes that can facilitate the breakdown of PET waste. This data will expand the enzymatic repertoire and provide valuable insights into the prerequisites for successful PET degradation.
Phage Milagro: a platform for engineering a broad host range virulent phage for
Burkholderia
Authors: Yao Guichun , Le Tram , Korn Abby M. , Peterson Hannah N. , Liu Mei , Gonzalez Carlos F. , Gill Jason J.
Published: November 2023

The
Burkholderia cepacia
complex (Bcc) causes life-threatening respiratory tract infections in persons with cystic fibrosis (CF). In CF patients, end-stage pulmonary disease often requires lung transplantation, and pre-transplant colonization with antibiotic-resistant
Burkholderia
is predictive of poor post-transplant outcomes. To address this issue, phage therapy has been proposed as a treatment for these infections. However, the majority of characterized Bcc phages are temperate and are therefore difficult to use as therapeutics, and the few obligately lytic phages that have been isolated have limited host ranges. To overcome these limitations, we have produced a virulent, broad-host range derivative of the temperate
Burkholderia cenocepacia
phage Milagro. Phage Milagro is a 39.1-kb temperate myophage related to phage KL3 and the paradigm coliphage P2. This phage showed a phenotype of spontaneous autoplaquing on lawns of Milagro lysogens, and these autoplaques were found to be produced by virulent mutants of the parental phage Milagro. Mutations associated with virulence were identified as single base changes, insertions or deletions in the phage lysogeny control region that define potential operator sites required for lysogen maintenance. To improve phage host range, the C-terminal domain of the Milagro tail fiber was replaced with the receptor-binding domain of the broad-host range tailocin (high molecular weight bacteriocin) BceTMilo. A spontaneous virulent mutant of this engineered phage, designated Milagro
vir gp20:Milo
, exhibited an expanded host range over the parental phage and is able to infect multiple Bcc species including
B. cenocepacia
,
Burkholderia multivorans
,
Burkholderia gladioli, Burkholderia dolosa
, and
Burkholderia vietnamensis
.

IMPORTANCE

Burkholderia
infections are a significant concern in people with CF and other immunocompromising disorders, and are difficult to treat with conventional antibiotics due to their inherent drug resistance. Bacteriophages, or bacterial viruses, are now seen as a potential alternative therapy for these infections, but most of the naturally occurring phages are temperate and have narrow host ranges, which limit their utility as therapeutics. Here we describe the temperate
Burkholderia
phage Milagro and our efforts to engineer this phage into a potential therapeutic by expanding the phage host range and selecting for phage mutants that are strictly virulent. This approach may be used to generate new therapeutic agents for treating intractable infections in CF patients.
Smyd3 negatively regulates the anti-viral pathway by promoting TAK1 degradation in teleost fish
Authors: Qu Zhili , Sun Yuqin , Zhou Xuefeng , Yan Xiaolong , Xu Tianjun
Published: November 2023

Transforming growth factor beta kinase 1 (TAK1, also known as MAP3K7) has been identified as an adaptor protein in the NF-κB and IRF3 signaling pathways in teleost fishes, and it plays a crucial role in both inflammatory responses and anti-viral actions. SET and MYND domain protein 3 (Smyd3) belongs to the Smyd3 lysine methylase family and possess significant functions in the methylation process of diverse histone and non-histone targets. However, the exact role of Smyd3 in innate immune regulation has not yet been fully elucidated.
Siniperca chuatsi
rhabdovirus (SCRV) is a negative single-stranded RNA virus that has the potential to cause widespread fish diseases. In this study, we discovered that overexpression of Smyd3 facilitates the replication of SCRV, enabling the virus to evade detection of the immune system through Smyd3. Furthermore, we observed that Smyd3 promotes the degradation of TAK1 by inducing K48-linked ubiquitination of TAK1. As a result, Smyd3 exerts a negative regulatory effect on the TAK1-mediated NF-κB signaling pathway and the IRF3 signaling pathway. Thus, our findings demonstrate that Smyd3 plays a role in promoting the degradation of the TAK1 protein. Moreover, we discovered that the degradation of TAK1 by Smyd3 occurs independently of its methyltransferase activity. This study not only enhances our understanding of anti-viral immunity in fish but also offers a novel perspective for investigating anti-viral immunity in mammals.

IMPORTANCE

In this study, we have found that the existence of Smyd3 promoted the replication of SCRV. Additionally, we report that Smyd3 negatively regulates the NF-κB and IRF3 signaling pathway by facilitating the degradation of TAK1 in fish. Our findings suggest that Smyd3 interacts with TAK1. Further investigations have revealed that Smyd3 specifically mediates K48-linked ubiquitination of TAK1 and enhances TAK1 degradation, resulting in a significant inhibition of the NF-κB and IRF3 signaling pathway. These results not only contribute to the advancement of fish anti-viral immunity but also provide new evidence for understanding the mechanism of TAK1 in mammals.
LOX1- and PLP1-dependent transcriptional reprogramming is essential for injury-induced conidiophore development in a filamentous fungus
Authors: Camargo-Escalante Martín O. , Balcázar-López Edgar , Albores Méndez Exsal M. , Winkler Robert , Herrera-Estrella Alfredo
Published: November 2023

Fungi use oxylipins (oxidized lipids) as signaling molecules to induce asexual development. These molecules play an essential role in the response to wounding, exerting a protective effect against plant pathogens, and are part of the inflammatory process in animals. However, the physiological and molecular mechanisms triggered by oxylipins that lead to asexual development in fungi are not well understood. Using a genetic approach, mass spectrometry, and phenotypic analysis, we describe the functional role of a patatin-like phospholipase (
plp1
) and a unique lipoxygenase (
lox1
) in the response to injury in the model fungus
Trichoderma atroviride. lox1
and
plp1
are co-expressed and regulated by damage signaling and sensing components. Phenotypic analysis revealed an essential defect in the emergence of aerial hyphae in the
lox1
and
plp1
null mutant strains, blocking injury-induced conidiation. In addition, functional loss analysis demonstrated that both genes are essential for wound-associated linoleic acid-derived oxylipin 13-hydroxy-9Z,11E-octadecadienoic acid (13-HODE) production and the transcriptional reprogramming required for conidiation.
T. atroviride
requires LOX1 and PLP1 to induce transcription factors involved in asexual development such as
brlA
,
hox2
, and
azf1
homologs at the early stages of the response and at a later stage to activate lipid metabolism and the structural proteins involved in aerial mycelium emergence. Our study shows how the cooperative function of
lox1
and
plp1
, during the response to wounding, regulates the molecular and physiological processes of damaged-sensitized cells that lead to reproductive aerial mycelium development and consequently, ensure survival through asexual reproduction.

IMPORTANCE

In addition to being considered a biocontrol agent, the fungus
Trichoderma atroviride
is a relevant model for studying mechanisms of response to injury conserved in plants and animals that opens a new landscape in relation to regeneration and cell differentiation mechanisms. Here, we reveal the co-functionality of a lipoxygenase and a patatin-like phospholipase co-expressed in response to wounding in fungi. This pair of enzymes produces oxidized lipids that can function as signaling molecules or oxidative stress signals that, in ascomycetes, induce asexual development. Furthermore, we determined that both genes participate in the regulation of the synthesis of 13-HODE and the establishment of the physiological responses necessary for the formation of reproductive aerial mycelium ultimately leading to asexual development. Our results suggest an injury-induced pathway to produce oxylipins and uncovered physiological mechanisms regulated by LOX1 and PLP1 to induce conidiation, opening new hypotheses for the novo regeneration mechanisms of filamentous fungi.
Right atrial thrombus leading to pulmonary embolism in a patient with dermatomyositis and COVID-19 managed with FlowTriever device thrombectomy
Authors: Chirumamilla Yashitha , Edupuganti Srujan , Bachuwa Ghassan , Alkotob Luay
Published: November 2023

A woman in her late 40s presented with complaints of shortness of breath, right-sided pleuritic chest pain and diffuse myalgias. She was diagnosed with deep vein thrombosis (DVT) 3 weeks earlier and had been compliant with her oral anticoagulation therapy. Investigations revealed a pulmonary embolism (PE) involving the right distal pulmonary artery on a CT angiogram of the chest. She was also found to have an incidental SARS-CoV-2 (COVID-19) infection and an elevated creatine kinase value. Anticoagulation with intravenous heparin was initiated according to the DVT/PE protocol. The following morning, a medium-sized mobile mass was identified in her right atrium on performing a transthoracic echocardiogram. Due to concerns of embolisation of the mass which could result in obstruction, right ventricular strain and ultimately haemodynamic instability, a thrombectomy was performed using the FlowTriever device under transthoracic echocardiography guidance. The right atrial mass was successfully removed and the patient was transitioned to another oral anticoagulant agent. On discharge, a muscle biopsy was performed and aided in the diagnosis of dermatomyositis and the patient received intravenous Ig, steroids and methotrexate.
Atypical haemolytic uraemic syndrome in a postpartum patient
Authors: Hierholzer Ashton , Majdinasab Elleana , Young Madeline , Kauffman Robert P
Published: November 2023

A postpartum patient presented 1 week following uncomplicated pregnancy and elective repeat caesarean section with acute hypertension, severe anaemia and acute kidney injury. Her workup demonstrated microangiopathic anaemia, thrombocytopenia and liver enzyme elevations. Differential diagnoses included postpartum haemolysis-elevated liver enzyme-low platelet (HELLP) syndrome, haemolytic uraemic syndrome (HUS), and thrombotic thrombocytopenic purpura (TTP). She was treated initially with systemic corticosteroids, haemodialysis and plasmapheresis for presumed TTP while awaiting the results of ADAMSTS13 assay performed at an outside laboratory. When reported back as normal, the diagnosis of atypical HUS was established. Eculizumab was administered with rapid improvement of her condition.
‘More than likely the men come first. That’s just very frustrating’. A qualitative exploration of contextual factors affecting the implementation of injury prevention initiatives and the provision of effective injury management in elite-level women’s club football in Ireland
Authors: Horan Dan , Delahunt Eamonn , Roe Mark , Hägglund Martin , Blake Catherine , Kelly Seamus
Published: November 2023

Objectives

The aim of our study was to explore the contextual factors that affect the implementation of football injury prevention initiatives and the provision of effective injury management in the Irish Women’s National League (WNL).

Methods

We used a criterion-based purposive sampling approach to recruit coaches (n=7), players (n=17) and medical personnel (n=8) representing eight of the nine clubs in the WNL to participate in one-to-one semistructured interviews. Our study was located within an interpretivist, constructivist research paradigm. The interview data were analysed using reflexive thematic analysis.

Results

The participants identified academic and work pressures, financial challenges, conflict with college football, inadequate facilities and gender inequity as being barriers to the implementation of injury prevention initiatives and the provision of effective injury management. Financial constraints within clubs were perceived to limit the provision of medical care and strength and conditioning (S&C) support and this was deemed to be associated with a heightened risk of injuries.

Conclusion

Specific contextual factors were identified which curtail the implementation of injury prevention initiatives and the provision of effective injury management in elite-level women’s club football in Ireland. Gender inequity was identified as one of the factors impacting the availability of high-quality medical care, S&C support, as well as access to training and match facilities. Our results provide new insights that could be used to inform the design and implementation of injury prevention and management initiatives for women football players in Ireland.
Mapping nutrition within medical curricula in Australia and New Zealand: a cross-sectional content analysis
Authors: King Ryan E , Palermo Claire , Wilson Alyce N
Published: November 2023

Objective

To systematically map nutrition content in medical curricula across all 23 medical schools in Australia and New Zealand accredited by the Australian Medical Council (AMC).

Methods

A cross-sectional content analysis was conducted. Learning outcomes for 20 AMC-accredited medical curricula were extracted from online repositories and directly from universities in February to April 2021. Nutrition relevant learning outcomes or equivalent learning objectives/graduate attributes were identified. Nutrition learning outcomes were analysed according to Bloom’s revised taxonomy to determine whether outcomes met cognitive, psychomotor or affective domains and at what level.

Results

Of the total 23 AMC-accredited medical curricula, 20 medical schools had learning outcomes able to be sourced for analysis. A total of 186 nutrition learning outcomes were identified within 11 medical curricula. One medical school curriculum comprised 129 of 186 (69.4%) nutrition learning outcomes. The majority of outcomes (181, 97.3%) were in the cognitive domain of Bloom’s revised taxonomy, predominantly at level 3 ‘applying’ (90, 49.7%). The psychomotor domain contained five nutrition learning outcomes (5, 2.7%), while the affective domain contained none. New Zealand medical curricula (153, 82.3%) contained 4.6-fold more nutrition learning outcomes than Australian curricula (33, 17.7%). When comparing clinical and preclinical years across curricula, the proportion of learning outcomes in the psychomotor domain was 3.7-fold higher in clinical years (4.08%) versus preclinical years (1.15%).

Conclusion

There is wide variation across medical curricula regarding the number of nutrition learning outcomes. This may lead to varying competency of medical graduates to provide nutrition care in Australia and New Zealand.
Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome
Authors: McLatchie Rachel , Reed Matthew J , Freeman Nicola , Parker Richard A , Wilson Sarah , Goodacre Steve , Cowan Alicia , Boyle Jessica , Clarke Benjamin , Clarke Ellise
Published: November 2023

Background

The diagnosis of acute aortic syndrome (AAS) is commonly delayed or missed in the ED. We describe characteristics of ED attendances with symptoms potentially associated with AAS, diagnostic performance of clinical decision tools (CDTs) and physicians and yield of CT aorta angiogram (CTA).

Methods

This was a multicentre observational cohort study of adults attending 27 UK EDs between 26 September 2022 and 30 November 2022, with potential AAS symptoms: chest, back or abdominal pain, syncope or symptoms related to malperfusion. Patients were preferably identified prospectively, but retrospective recruitment was also permitted. Anonymised, routinely collected patient data including components of CDTs, was abstracted. Clinicians treating prospectively identified patients were asked to record their perceived likelihood of AAS, prior to any confirmatory testing. Reference standard was radiological or operative confirmation of AAS. 30-day electronic patient record follow-up evaluated whether a subsequent diagnosis of AAS had been made and mortality.

Results

5548 patients presented, with a median age of 55 years (IQR 37–72; n=5539). 14 (0.3%; n=5353) had confirmed AAS. 10/1046 (1.0%) patients in whom the ED clinician thought AAS was possible had AAS. 5/147 (3.4%) patients in whom AAS was considered the most likely diagnosis had AAS. 2/3319 (0.06%) patients in whom AAS was considered not possible did have AAS. 540 (10%; n=5446) patients underwent CT, of which 407 were CTA (7%). 30-day follow-up did not reveal any missed AAS diagnoses. AUROC (area under the receiver operating characteristic) curve for ED clinician AAS likelihood rating was 0.958 (95% CI 0.933 to 0.983, n=4006) and for individual CDTs were: Aortic Dissection Detection Risk Score (ADD-RS) 0.674 (95% CI 0.508 to 0.839, n=4989), AORTAs 0.689 (95% CI 0.527 to 0.852, n=5132), Canadian 0.818 (95% CI 0.686 to 0.951, n=5180) and Sheffield 0.628 (95% CI 0.467 to 0.788, n=5092).

Conclusion

Only 0.3% of patients presenting with potential AAS symptoms had AAS but 7% underwent CTA. CDTs incorporating clinician gestalt appear to be most promising, but further prospective work is needed, including evaluation of the role of D-dimer.

Trial registration number

NCT05582967;NCT05582967.
Injury-related emergency department use among people with intellectual and developmental disabilities insured by Medicaid from 2010 to 2016
Authors: Williams Jessica , Royer Julie , Lauer Emily , Kurth Noelle K , Horner-Johnson Willi , McDermott Suzanne , Levy Anna , Hall Jean P
Published: November 2023

Objectives

Data on non-fatal injuries and visits to the emergency department (ED) for injuries are not readily available. The objective of this paper is to describe injury-related ED visits for people with intellectual and developmental disabilities who are covered by the Medicaid insurance programme.

Methods

We aggregated 2010–2016 Medicaid claims data from eight states. Using these data, we identified individuals with intellectual and developmental disabilities and then determined an all-cause ED visit rate, ED visit due to injury rate and admission from ED due to injury rate. Data were stratified by sex and age group. Results were compared with national rates.

Results

Medicaid members with intellectual and developmental disabilities visited EDs at approximately 1.8 times the rate of the general population. The ED visit rate due to injury was approximately 1.5 times that observed in the population overall. When ED visits due to injury data were stratified by age and sex, the largest discrepancy was observed in women ages 45–64, who visited EDs due to injury at a rate 2.1 times that of women of the same age in the general population. The admission rate from ED due to injury increased over the study period most notably in the older age groups.

Conclusions

While rates and patterns of ED utilisation among Medicaid members with intellectual and developmental disabilities vary by age and gender, our findings suggest this group visits the ED due to injury at rates well above the general population.
Ethical navigation of biobanking establishment in Ukraine: learning from the experience of developing countries
Authors: Sulaieva Oksana N , Artamonova Oksana , Dudin Oleksandr , Semikov Rostyslav , Urakov Dmytro , Zakharash Yurii , Kacharian Arman , Strilka Vasyl , Mykhalchuk Ivan , Haidamak Oleksii , Serdyukova Olena , Kobyliak Nazarii
Published: November 2023

Building a biobank network in developing countries is essential to foster genomic research and precision medicine for patients’ benefit. However, there are serious barriers to establishing biobanks in low-income and middle-income countries (LMICs), including Ukraine. Here, we outline key barriers and essential milestones for the successful expansion of biobanks, genomic research and personalised medicine in Ukraine, drawing from the experience of other LMICs. A lack of legal and ethical governance in conjunction with limited awareness about biobanking and community distrust are the principal threats to establishing biobanks. The experiences of LMICs suggest that Ukraine urgently needs national guidelines covering ethical and legal aspects of biospecimen-related research. National guidelines must be consistent with international ethical recommendations for safeguarding participants’ rights, welfare and privacy. Additionally, efforts to educate and engage physicians and patient communities are essential for achieving biobanking goals and benefits for precision medicine and future patients.
Exploring the potential utility of AI large language models for medical ethics: an expert panel evaluation of GPT-4
Authors: Balas Michael , Wadden Jordan Joseph , Hébert Philip C , Mathison Eric , Warren Marika D , Seavilleklein Victoria , Wyzynski Daniel , Callahan Alison , Crawford Sean A , Arjmand Parnian , Ing Edsel B
Published: November 2023

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight ethical vignettes.

The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles.

This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings.
Observational study on occupational exposure of dairy farmers to formaldehyde
Authors: Janssen Esmée Rianne , Nielen Mirjam , Spithoven Jacobus Jochem Gerardus , van Werven Tine , Wouters Inge Maria
Published: November 2023

Objectives

To provide insights into exposure of Dutch dairy farmers to formaldehyde derived from formalin footbaths used for cows. Dutch safety norms are set at a limit of 0.122 ppm during an 8-hour time-weighted average (TWA) and 0.407 ppm for a 15-min TWA.

Methods

At 20 farms formaldehyde air concentrations were determined using stationary active air sampling with impingers next to the footbath and in the milking parlour during footbath usage. Formalin footbath concentrations were tested and meteorological conditions were collected using a climate monitor to assess associations with formaldehyde concentrations. A structured interview inquired on potential exposure routes and exposure duration.

Results

Formaldehyde concentrations next to the footbath ranged from <0.003 to 0.316 ppm, with seven measurements exceeding the 8-hour TWA threshold. None of the measurements exceeded the 15-min TWA threshold at either location. Formaldehyde air concentrations in the milking parlour were generally lower, yet at two farms exceeded the 8-hour TWA limit during sampling. Self-reported exposure time of the dairy farmers to the formalin footbath never exceeded 15 min. Although due to the small sample size, no significant associations between most predictor variables and formaldehyde levels in the air were found, the direction of effects were as expected.

Conclusions

The exposure of Dutch dairy farmers presumably falls within the established safety norms. Nonetheless, substantial levels of formaldehyde could be detected. This study further emphasises the importance of substitution of formalin in dairy practice and the relevance of informing dairy farmers on proper handling of formalin to reduce exposure.
Severe case of rhabdomyolysis following jellyfish envenomation in the Mediterranean Sea
Authors: Buscetta Giorgio , Rizzo Chiara , La Barbera Lidia , Camarda Federica , Federico Antonino , Garbo Benedetto Maria , Florena Ada Maria , Guggino Giuliana
Published: November 2023

Jellyfish envenomation is a common problem in coastal areas all over the world; usually symptoms are self-limited with no long-lasting complications. Despite that, some jellyfish species, mainly populating the Indian Ocean, are renown to be potentially lethal and in some cases may cause severe myopathy. We report the first case of rhabdomyolysis following a jellyfish sting in the Mediterranean Sea. A 17-year-old patient was admitted to the intensive care unit of our hospital in life-threatening conditions. He was dyspnoeic and dysphagic with pain and functional impairment of upper and lower limbs. The evidence of a red mark in his face and the clinical presentation, coupled with the diagnostic test performed, allowed the diagnosis of toxidrome from jellyfish venom. Treatment with hydration, ventilatory support and steroids led to a progressive improvement of patient conditions. Our case report stresses the importance of prompt identification and treatment of potential rhabdomyolysis determined by jellyfish and rises awareness on the presence of such venomous species in the Mediterranean Sea.
Engineering properties-based parameters used for moisture damage evaluation of asphalt mixtures: a review
Authors: Do Thanh Chung
Published: November 2023

Moisture-induced damage has been known as a major premature distresses in asphalt pavement. Numerous review papers have been made to provide the progression in study on moisture damage of asphalt pavement. However, mechanical properties of asphalt mixtures used as a parameter for moisture susceptibility evaluation were not reviewed in detail. To make the review of moisture-induced damage in asphalt pavement more comprehensive, this paper reviews research studies on moisture damage of asphalt pavement in view of mechanical properties as a parameter during the past 50 years. These parameters include tensile strength ratio (TSR), cohesion ratio (CR), dynamic modulus ratio (DMR), resilient modulus ratio (RMR), and shear strength ratio (SSR). TSR and CR are only relevant at bottom of asphalt concrete (AC), while SSR can be used to describe moisture damage at different AC depths. DMR and RMR are concentrated on the impact of moisture damage via performance characteristics of asphalt mixtures.
Review of climate change adaptation and mitigation implementation in Canada's forest ecosystems part II: successes and barriers to effective implementation
Authors: Antwi Effah Kwabena , Burkhardt Henrike , Boakye-Danquah John , Doucet Tyler , Abolina Evisa
Published: November 2023

With its northern location, the exposure and vulnerability of Canada's forest ecosystems to climate change impacts are all too glaring. While there is now an extensive body of literature describing expected climate change impacts and potential responses, studies characterizing the implementation of adaptation and mitigation practices in forest management remain rare in the Canadian forest sector. Using a systematic literature review, we examined reports on forest management practices implemented in response to climate change, specifically focusing on governance and institutional arrangements that either support or limit climate change adaptation and mitigation responses. Our literature sample size of 24 documents suggests that the body of literature reporting on adaptation and mitigation practices in forest management is scarce. Governments remain the dominant actors providing funding and leading the implementation and reporting of climate change adaptation practices, primarily in response to national or international climate change commitments. Forest practices such as enhanced silviculture, assisted migration, and nature-based solutions were the most frequently reported. However, given the scarcity of literature, it is difficult to conclude the scope of climate change adaptation practice uptake in Canada. Barriers such as lack of information/data, inter-jurisdictional knowledge transfer, policy conflicts, forest tenure models, technical capacity gaps, and economic barriers to adaptation need to be overcome to strengthen climate change response in forest management. Better coordination of reporting at the provincial and national levels and improved information flows between private sector organizations and governments are needed.
Cosmological singularities in $$f(T,\phi ) $$ gravity
Authors: Trivedi Oem , Khlopov Maxim , Said Jackson Levi , Nunes Rafael
Published: November 2023

The pursuit of understanding the mysteries surrounding dark energy has sparked significant interest within the field of cosmology. While conventional approaches, such as the cosmological constant, have been extensively explored, alternative theories incorporating scalar field-based models and modified gravity have emerged as intriguing avenues. Among these, teleparallel theories of gravity, specifically the $$f(T,\phi )$$

f
(
T
,
ϕ
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formulation, have gained prominence as a means to comprehend dark energy within the framework of teleparallelism. In this study, we investigate two well-studied models of teleparallel dark energy and examine the presence of cosmological singularities within these scenarios. Using the Goriely–Hyde procedure, we examine the dynamical systems governing the cosmological equations of these models. Our analysis reveals that both models exhibit Type IV singularities, but only for a limited range of initial conditions. These results could indicate a potential edge for teleparallel cosmological models over their other modified gravity counterparts, as the models we examine seem to be only allowing for weak singularities that too under non general conditions.
Quantum properties of classical Pearson random variables
Authors: Accardi Luigi , Ella Abdon Ebang , Ji Un Cig , Lu Yun Gang
Published: November 2023

This paper discusses the properties of the canonical quantum decomposition of the classical Pearson random variables. We show that this leads to the problem of representing the creation–annihilation–preservation (CAP) operators canonically associated to a real-valued random variable [Formula: see text] with all moments as (normally ordered) differential operators with polynomial coefficients — a problem already studied in the literature (see references in the introduction). We deduce a formula, for the polynomial coefficients in the representation of the CAP operators of [Formula: see text] as pseudo-differential operators, more explicit than the one existing in the literature. We give a new characterization of the Pearson distributions in terms of the Hermitianity of the associated Sturm–Liouville operators. In the second part of the paper, we introduce the notion of finite type random variable [Formula: see text] and characterize type-[Formula: see text] and type-[Formula: see text] real-valued random variables. We prove that a necessary condition for [Formula: see text] to be of finite type is the polynomial growth of the corresponding principal Jacobi sequence. This allows to single out three classes of random variables of infinite type and to prove that the Beta and the uniform distributions are of infinite type.
Out-of-Plane Stability Analysis of the Circular Box Arch with Sinusoidal Corrugated Webs
Authors: Xu Zijie , Yuan Bo , Wang Senping , Zheng Shiyu , Zhang Youhua , Yu Yang , Yi Lianjie
Published: November 2023

This paper presents an arch structure called the circular box arch with sinusoidal corrugated webs (CBASCW). This study investigates the out-of-plane elastic buckling behavior and elastoplastic stability capacity of the arch through a combined approach of theoretical derivation and finite element simulation. The section stiffness of the arch, including flexural stiffness, shear stiffness, and torsional stiffness, is achieved through theoretical derivation. Additionally, the elastic buckling load in both pure compression and pure bending states is derived. A simplified model is also introduced, which can conveniently simulate the internal force and deformation of the arch. The elastoplastic instability mechanism and failure mode are studied under various loading conditions, including uniform radial load, end bending moment, vertical load uniformly distributed in full-span, and vertical load uniformly distributed in half-span. Furthermore, the stability curves of the arch under conditions of pure compression and pure bending are graphed by incorporating stability coefficient and regularized slenderness ratio. According to the simulation results obtained from the simplified model and the analysis of stability curves, a design formula for stability capacity is proposed.