bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensive ecchymosis and retroperitoneal hemorrhage due to acquired hemophilia-A following influenza vaccination: A case report
Authors: Chin Chi Sheuan , Liang Shinn-Jye
Published: May 2024

Introduction:

Acquired hemophilia-A (AHA) is a rare but potentially life-threatening impaired coagulation disorder characterized by the development of autoantibodies against clotting factor VIII. Only a few case reports have been experienced with influenza vaccine-triggered AHA. Here, we report a case of severe hemorrhagic disorder due to AHA following influenza vaccine, which was successfully treated.

Patient concerns:

The patient presented to the emergency department because of several severe, progressively worsening bruises after receiving the influenza vaccination. Consequently, the patient required intubation due to nasal-oral bleeding, which compromised the airway, and retroperitoneal hemorrhage with shock also developed.

Diagnosis:

AHA was confirmed through a coagulation factor assay, including coagulation activity and antibody testing, which is possibly triggered by influenza vaccination.

Intervention:

Low-dose cyclophosphamide and hydrocortisone were prescribed until activated partial thromboplastin time showed normal levels. Coagulation factor VIIa was administered, and aggressive blood transfusion was carried out concurrently to address the blood loss.

Outcomes:

The upper airway bleeding subsided and bleeding tendencies had been corrected to normal. The patient was smoothly weaned from the ventilator and recovered from critical illness. She was then discharged on the 19th day.

Lessons:

The activated partial thromboplastin time mixing test can be performed immediately to establish the initial differential diagnosis and treatment plan for severe coagulopathy. AHA may be triggered by vaccination, with the hypothesis of activation of autoantibodies and molecular mimicry; this mechanism should be further studied.
A case report of thrombocytopenic COVID-19 and Miller–Fisher syndrome on a concurrent chronic immune neuropathy
Authors: Blackbourn Lisle , Hamid Umair , Tokala Janaki , Blume Gregory
Published: May 2024

Rationale:

Miller–Fisher syndrome (MFS) is a rare subtype of Guillain–Barre syndrome with classic features of ataxia, areflexia, and ophthalmoplegia that can be caused by a preceding infection including COVID-19. We present a current, asymptomatic thrombocytopenic COVID-19 infection as a cause of MFS in a 60-year-old male with a concurrent chronic immune neuropathy.

Patient concerns:

A 60-year-old male presenting with acute symptoms of MFS including ataxia, areflexia, and ophthalmoplegia on a chronic immune neuropathy for at least 1 year and concurrent asymptomatic COVID-19 positive infection.

Diagnosis:

MFS suspected secondary to a current thrombocytopenic COVID-19 infection.

Interventions:

Five days of intravenous immune globulin with continued monthly intravenous immune globulin as an outpatient, follow-up long-term in a neuromuscular clinic, electromyography as an outpatient, and continued physical therapy.

Outcomes:

The patient significantly improved after initial treatment.

Lessons:

The full effect of COVID-19 on the various Guillain–Barre syndrome subtypes is unknown, although it clearly can be a cause of the various variants including being caused by a current, asymptomatic infection.
Reversible acute heart failure induced by thyrotoxic cardiomyopathy: A case report
Authors: Shi Rui , Meng Wenyi , Yin Jinzhu , Xue Wen , Deng Yue
Published: May 2024

Rationale:

Thyrotoxic cardiomyopathy is a rare but severe complication of thyrotoxicosis, leading to episodes of acute heart failure. This case report highlights a rare presentation of thyrotoxic cardiomyopathy with low-output heart failure, emphasizing the importance of early diagnosis and comprehensive management. The report aims to increase awareness among clinicians about the potential reversibility of this condition and the effective strategies for managing such complex cases.

Patient concerns:

This patient presented with dyspnea and chest constriction, without any antecedent predisposing factors. Subsequently, the patient abruptly manifested symptoms indicative of acute heart failure during outpatient consultation. Electrocardiography revealed rapid atrial fibrillation with type A preexcitation syndrome, whereas cardiac ultrasonography demonstrated global cardiac enlargement with a diminished ejection fraction (EF).

Diagnoses:

After a comprehensive evaluation, the patient was diagnosed with thyrotoxic cardiomyopathy, acute heart failure, and atrial fibrillation with preexcitation syndrome.

Interventions:

Immediate interventions comprised diuretic administration, oxygen therapy, and antiarrhythmic agents, addressing acute heart failure concomitant with preexcitation syndrome. Following a fortnight of comprehensive therapeutic measures, the patient was discharged with a prescription for oral medications, notably methimazole.

Outcomes:

Following the intervention, the patient showed significant improvement with the resolution of heart failure symptoms and dyspnea, restoration of sinus rhythm, improved left ventricular ejection fraction (LVEF improved from 36% to 45%), and normalization of thyroid function. These outcomes underscore the efficacy of the intervention strategy and offer a hopeful prognosis for similar cases.

Lessons:

Thyrotoxicosis may cause cardiomyopathy in patients with heart failure that manifests as dilated cardiac chambers. Clinicians should carefully screen patients for this reversible condition. Diagnosis requires a comprehensive assessment of various tests, and the therapeutic goal is to restore normal thyroid function.
Evaluation of the relationship between dietary energy and protein intakes and anthropometric measurements in hemodialysis patients
Authors: Aygül Rojina Deniz , Mercanligil Seyit Mehmet , Bardak Demir Simge
Published: May 2024

This study evaluated the relationship between dietary energy, and protein (animal and plant based) intakes and anthropometric measurements in maintenance hemodialysis (MHD) patients. Individuals between the ages of 19 to 65 who received MHD treatment for more than 3 months from October 2021 to February 2022 in the state hospitals were included in the study. Body mass index (BMI) (kg/m2) was calculated for each patient, and anthropometric measurements including upper middle arm circumference, triceps skinfold thickness (TST) and hand grip strength (HGS) were carried out. 3-day food records and Subjective Global Assessment (SGA) were used to assess nutritional status of the patients. Of the 51 MHD patients included in the study, 33 (64.7%) were male and 18 (35.3%) were female. The mean age of the patients was 50.37 ± 11.55 years, and length of time on MHD was 39.49 ± 51.68 months. The mean energy intake of female and male MHD patients was 20.01 ± 6.94 and 17.26 ± 6.24 kcal/kg/d, respectively. The mean dietary protein intake of female and male MHD patients were 0.84 ± 0.35 and 0.78 ± 0.30 g/kg/d, respectively. Dry weight (P = .048), BMI (P = .020), TST (P = .013), and HGS (P = .026) of well-nourished and moderately malnourished female MHD patients according to SGA results were found to be lower than in male patients. While the majority of the patients receiving MHD treatment appeared to be well-nourished according to the SGA results, energy and protein intakes obtained from the food records were below the recommended daily dietary intake. These evaluations affected the anthropometric measurements including HGS, BMI, and TST. Therefore, there is a need for more comprehensive clinical studies in which anthropometric measurements, food consumption, biochemical findings and nutritional screening tools are used all together to evaluate nutritional status in MHD patients.
Structural characteristics, biomechanics and clinical significance of calcar femorale: A review
Authors: Zhou Xiaoyang , Jia Junjie , Lian Kai
Published: May 2024

The calcar femorale, first identified by Merkel in 1874, plays a pivotal role in the weight-bearing capacity of the proximal femur, and its structural integrity is crucial for the efficient distribution of mechanical loads. Originating at the vertical ridge where the pubofemoral ligament anchors, this bony prominence extends laterally behind the neutral axis from the medial to lateral aspects. Its presence is not merely an anatomical curiosity but significantly influences the biomechanics of the hip joint by providing additional strength and support against compressive forces encountered during activities such as walking or jumping. Despite its clear description in orthopedic texts, misconceptions persist about its exact function and importance. This article delves into the nuanced anatomy and biomechanical properties of the calcar femorale, offering a detailed literature-based examination that demonstrates its relevance in clinical practice. The review highlights how the robustness of the calcar femorale contributes to the prevention of femoral neck fractures as well as the stabilization of hip prostheses. Furthermore, the indispensable role of the calcar femorale in surgical outcomes is discussed, especially in the context of fracture repair and joint replacement, thus illustrating its enduring significance in contemporary medical applications.
Evaluating private hospital performance before and during COVID-19 in China
Authors: Wang Xiaowen , Xu Jian
Published: May 2024

The coronavirus disease 2019 (COVID-19) pandemic had a tremendous impact on the global medical system. The development of private hospitals is an important measure to deepen the reform of China’s medical and health system, and an important driving force to improve the effective supply of medical services. This study aims to compare the performance of China’s private hospitals before and during COVID-19 and determine the factors that affect hospital profitability between the 2 periods. Data are collected from 10 private listed hospitals from 2017 to 2022, and ratio analysis is used to measure hospital performance in 5 aspects, namely profitability, liquidity, leverage, activity (efficiency), and cost coverage. Multiple regression analysis is used to determine the influencing factors of hospital profitability. The results show a negative impact of COVID-19 on private hospital performance. Specifically, regardless of region, hospital profitability, liquidity, and cost coverage were reduced due to COVID-19, while hospital leverage was increased. COVID-19 had also an impact on hospital efficiency. In addition, before COVID-19, current ratio and cost coverage ratio were the determinants of hospital profitability, while only cost coverage ratio affected hospital profitability during the COVID-19 outbreak. We provide evidence that COVID-19 had an impact on China private hospitals, and the findings will aid private hospitals in improving their performance in the post-COVID-19 era.
Effects of effortful swallowing against kinesiology taping resistance on the swallowing function in patients with poststroke dysphagia: A randomized controlled trial
Authors: Kim Hwan-Hee , Park Ji-Su
Published: May 2024

Background:

A dysphagia rehabilitation method using kinesiology taping (KT) was recently introduced, and its potential for clinical efficacy was demonstrated by evaluating muscle activity and thickness. However, its effect on the swallowing function in patients with dysphagia remains unclear. This study aimed to investigate the effects of effortful swallowing against KT resistance on the swallowing function in patients with post stroke dysphagia.

Methods:

Thirty patients with poststroke dysphagia were recruited and randomly assigned to the experimental and placebo groups. In the experimental group, the KT was attached to the front of the neck (the hyoid bone between the sternum) with a tension of approximately 70% to 80%, and effortful swallowing was performed against the KT tension. In contrast, the placebo group performed effortful swallowing with KT applied at the same location without tension. The intervention was performed 30 times/day, 5 days/week for 6 weeks. The videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study were used to analyze oropharyngeal swallowing function.

Results:

The experimental group showed statistically significant improvements in the oral and pharyngeal phases of the VDS (P = .029 and .007, respectively) and PAS (P = .034) compared with the placebo group. Effect sizes were observed for the oral (0.3) and pharyngeal phases (0.5) of the VDS and PAS (1.1).

Conclusion:

This study demonstrated that effortful swallowing against resistance to KT is an effective therapeutic exercise for improving the swallowing function in patients with poststroke dysphagia.
Impact of COVID-19 pandemic on the circadian rhythm of cesarean section deliveries
Authors: Güneş Haci Yusuf , Keskin Mehmet Emin
Published: May 2024

Circadian rhythms synchronize all biological functions, enabling humans to foresee and respond better to periodic environmental changes. The coronavirus disease (COVID-19) lockdown regulations significantly changed the lighting conditions in pregnant women, leading to chronological disruption. This study aimed to investigate the impact of the COVID-19 on the circadian rhythm of cesarean deliveries. We investigated whether the circadian rhythm of cesarean section deliveries changed during the first year of the COVID-19 pandemic at a tertiary hospital in Van Province, eastern Turkey. We analyzed the distribution of birth times for 1476 cesarean deliveries performed between March 01, 2020 and January 20, 2021 (1st year of the COVID-19 pandemic) and compared this information with data from 1194 cesarean deliveries performed during a similar period in the previous year. The primary outcome was the change in the circadian rhythm of cesarean deliveries. Secondary outcomes included cesarean section (CS) delivery rates, indications for CS, 1st and 5th minutes Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration scores, and anesthesia technique use rates. Regarding the time distribution of CS deliveries in the first year of the COVID-19 pandemic, the maximum number of cesarean deliveries (n = 234, 16%) occurred between 14:00 and 16:00 (P = .112). Cesarean deliveries in pre-COVID-19 group were most frequently performed between 10:00 and 12:00, at a rate of 18% (n = 216) (P = .001). In both groups, the time point at which CS deliveries were the least performed was 04:00 to 06:00, and the rates were different (n = 35, 2% and n = 14, 1%, respectively) (P = .022). A 4-hour phase shift was detected at the peak of the birth time in the first year of the COVID-19 pandemic compared to the previous year. These results suggest that the circadian rhythm of cesarean deliveries is affected by the pandemic.
Antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Konda Raghunandan , Rajasekaran Arun , Rizk Dana V.
Published: May 2024

Purpose of review

This review focuses on latest developments in managing antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV), a systemic autoimmune condition characterized by inflammation and necrosis of small blood vessels due to circulating autoantibodies that target neutrophilic granules.

Recent findings

Our understanding of AAV pathogenesis has evolved in the past decades highlighting the central pathogenic roles of autoantibodies and complement activation. In parallel, the appreciation for glucocorticoid toxicity has led the research on crucial steroid-sparing therapeutic alternatives. Complement inhibitors (like avacopan) that have emerged are associated with better preservation of kidney function in AAV patients with severe kidney impairment. The role of plasma-exchange (PLEX) was revisited in updated guidelines that recommended its potential use in the context of diffuse alveolar hemorrhage associated hypoxia and severe kidney involvement, particularly with a serum creatinine level above 3.4 mg/dl. The ANCA Kidney Risk Score risk prediction and Glucocorticoid Toxicity Index score aid in identifying high-risk patients and individualizing management plans.

Kidney involvement in AAV requires prompt diagnosis and initiation of immunosuppression to prevent irreversible nephron loss. Newer therapeutic targets are on the horizon and offer hope for personalized treatment strategies.
Topical probiotics in wound care: a review of effects, mechanisms and applications
Authors: Yin Zhe , Qiu Yu , Han Yanting , Li Ka
Published: May 2024

The wound healing process depends on the wound microenvironment, influenced by factors like moisture, pH, bacteria, and immune activity. Current wound care strategies have drawbacks, necessitating safer non-drug-based methods. Recent research highlights the role of skin flora, particularly topical probiotics, in influencing the microenvironment and promoting wound healing. This article provides a comprehensive review of wound care research involving topical probiotics. It summarizes existing types of topical probiotics, their applications for various wound types, administration methods, and healing effects. The biological mechanisms promoting wound healing, such as immunomodulation, antibacterial properties, and growth factor release, are analyzed. Building on this, further exploration is conducted on the application challenges of topical probiotics in the field of wound care. Future prospects and trends are analyzed, and requirements and directions for relevant research design are proposed. This aims to provide valuable insights and guidance for future basic research and clinical practice in the realm of wound care.
The effect of medium-tension bandage and stump stocking on residual limb maturation in earthquake survivors
Authors: Ata Ayşe Merve , Borman Pınar , Bilir Emine Esra , Alemdaroğlu Ebru , Tezen Özge , Söyler Osman , Yaşar Evren
Published: May 2024

Background:

Residual limb maturation is a crucial stage in postamputation care.

Objective:

It was aimed to examine the effect of medium tension bandages and stump stockings on postamputation stump maturation in patients who underwent lower extremity amputations.

Study Design:

In this prospective observational study, patients who were earthquake survivors and had undergone emergency amputation of their lower extremities were included.

Methods:

Medium-tension elastic bandage or personalized stump stockings were used for stump maturation. Residual limb volume was measured once a week for 3 weeks.

Results:

The study included 23 patients and 29 amputated limbs. Because of the larger stump volume of transfemoral amputations and the higher number of these patients in the stocking group (p < 0.001), the stump volume differed across groups before and during the follow-up (p < 0.001). There was no difference in mean volumetric measurement between the bandage and stocking groups over time (p = 0.272). Although the group interaction was significant (p < 0.001), the group × time interaction was not (p = 0.306).

Conclusion:

Medium-tension bandages and stump stockings had a similar effect on postamputation stump maturation in patients with lower extremity amputations. So, depending on the patient's and physician's preferences, both procedures can be used for stump maturation.
Assessment of Hematopoietic Response to Total Body Irradiation in a Rat Experimental Model
Authors: Cyran Małgorzata , Stawarz Katarzyna , Chambily Lucile , Kusza Krzysztof , Siemionow Maria
Published: May 2024

Background

Exposure to high doses of total body irradiation (TBI) may lead to the development of acute radiation syndrome (ARS). This study was conducted to establish an experimental rat model of TBI to assess the impact of different doses of TBI on survival and the kinetics of changes within the hematopoietic system in ARS.

Materials and Methods

In this study, 132 Lewis rats irradiated with a 5Gy or 7Gy dose served as experimental models to induce ARS and to evaluate the hematopoietic response of the bone marrow (BM) compartment. Animals were divided into 22 experimental groups (n = 6/group): groups 1–11 irradiated with 5Gy dose and groups 12–22 irradiated with 7Gy dose. The effects of TBI on the hematopoietic response were assessed at 2, 4, 6, 8 hours and 5, 10, 20, 30, 40, 60 and 90 days following TBI. Signs of ARS were evaluated by analyzing blood samples through complete blood count in addition to the clinical assessment.

Results

Groups irradiated with 5Gy TBI showed 100% survival, whereas after 7Gy dose, 1.6% mortality rate was observed. Assessment of the complete blood count revealed that lymphocytes were the first to be affected, regardless of the dose used, whereas an “abortive rise” of granulocytes was noted for both TBI doses. None of the animals exhibited signs of severe anemia or thrombocytopenia. All animals irradiated with 5Gy dose regained initial values for all blood cell subpopulations by the end of observation period. Body weight loss was reported to be dose-dependent and was more pronounced in the 7Gy groups. However, at the study end point at 90 days, all animals regained or exceeded the initial weight values.

Conclusions

We have successfully established a rat experimental model of TBI. This study revealed a comparable hematopoietic response to the sublethal or potentially lethal doses of ionizing radiation. The experimental rat model of TBI may be used to assess different therapeutic approaches including BM-based cell therapies for long-term reconstitution of the hematopoietic and BM compartments allowing for comprehensive analysis of both the hematological and clinical symptoms associated with ARS.
Myoclonus: an update
Authors: Thomas Betsy , Frucht Steven J.
Published: May 2024

Purpose of review

Myoclonus, a common hyperkinetic movement disorder, can be disabling for patients. It is important to identify and classify myoclonus correctly to ensure appropriate workup and treatment. While the clinical history, examination, and process of classifying myoclonus remain largely unchanged, new causes and triggers for myoclonus are being elucidated, and new genetic causes have been found. Treatment can be challenging, though preliminary data about new options has been promising.

Recent findings

In this article, we will briefly outline the process of classifying and treating myoclonus. We will then discuss three specific scenarios where myoclonus has been identified: myoclonus associated with SARS-CoV-2 infections, spinal myoclonus following surgery or anesthesia of the spine, and auricular myoclonus. We will also discuss new genetic findings associated with myoclonus-dystonia, and promising results regarding the use of perampanel in treating myoclonus.

The process of describing unique scenarios associated with myoclonus has helped us build our understanding of the causes, genetic background, expected prognosis, and effective treatment of specific types of myoclonus. We hope that further studies on this topic will help tailor treatment.
Microbiota-dependent in vivo biotransformation, accumulation, and excretion of arsenic from arsenobetaine-rich diet
Authors: Mukherjee Mohana , Brandenburg Lisa , Dong Yuan , Pfister Stephanie , Sidler Anika , Mestrot Adrien , Capilla Teresa Chavez , Hapfelmeier Siegfried
Published: May 2024

Arsenic (As) is a naturally occurring metalloid that is ubiquitous in the environment. Various chemical forms of As, collectively referred to as 'As species', find their way into the food chain, impacting the health of millions globally. Many of these As species are products of bacterial enzymatic transformations in different environments. Yet, the in vivo gut microbial transformation of As and its consequences in the host, especially for less toxic As species like arsenobetaine (AB), remain elusive. Current regulatory assessments regard AB-rich foods, including various seafoods, as safe due to low toxicity and rapid unmodified urinary excretion of the ingested AB. This notion has been challenged by reports of AB metabolism by intestinal bacteria in vitro and by more recent evidence of in vivo AB metabolism in mice. However, these studies did not definitively establish the causal role of intestinal bacteria in AB transformation in vivo. To address this, we employed gnotobiology that allowed us to compare the biotransformation of As from a naturally AB-rich rodent diet in isogenic mice that were either completely germ-free, or colonized with gut microbiota of varying microbial diversity. Additionally, we examined the body distribution, accumulation, and clearance of the ingested As in these mice. Our results confirm the in vivo metabolism of AB in the intestine under chronic dietary exposure. The transformation of ingested As was found to be dependent on the presence/absence and complexity of the gut microbiota. Notably, specific toxic As species were absent under germ-free condition. Furthermore, gut microbial colonization was linked to increased As accumulation in the intestinal lumen as well as systemically, along with delayed clearance from the body. These findings emphasize the mammalian gut microbiota as a critical factor in evaluating the safety of AB-accumulating sea-foods.
ERK5 Signaling is Required for Type III IFN-mediated Mucosal Antiviral Responses
Authors: Bone Hannah , Natour Dalia S. , McFadden Matthew I. , Karp Andrew , Basu Anandita , Keller Andrea , Denz Parker , Collins Patrick L. , Mihaylova Maria M. , Yount Jacob S. , Forero Adriana
Published: May 2024

Type III interferons (IFNλ) are innate immune cytokines that limit viral replication and coordinate tissue repair through the induction of interferon stimulated genes (ISGs). This response must be tightly regulated to avoid excessive responses that result in the disruption of tissue barrier integrity or inefficient responses that allow for pathogen escape. Here we examine the contribution of Mitogen Activated Protein Kinase (MAPK) signaling on IFNλ-mediated antiviral activity. We find that extracellular-signal-regulated kinase 5 (ERK5), a poorly characterized member of the conventional MAPK family, potentiates the antiviral efficacy of IFNλ. Chemical inhibition and genetic targeting of ERK5 during IFNλ treatment of cells results in a decrease in ISG induction and impaired control of viral infections. This decrease in IFNλ antiviral efficacy in the absence of ERK5 kinase activity corresponded to lowered STAT1 phosphorylation, revealing a noncanonical role for ERK5 in STAT1 activation downstream of IFNλ. In contrast, type I IFN antiviral signaling is largely resistant to ERK5 modulation. Altogether, we identify ERK5 as a potentiator of STAT1 activation, ISG expression, and antiviral activity following type III IFN stimulation.

SIGNIFICANCE

Regulation of type III interferons (IFNλ) at mucosal barriers in response infection to mitigate viral replication and support barrier integrity. The specific mechanistic requirements for MAPK signaling to sustain IFNλ-mediated gene expression have remained elusive. Amongt the least characterized members of the MAPK family, the role of ERK5 in regulating host inflammatory responses has been hampered by off-target effects of kinase inhibitors. Here, we combine pharmacological and genetic approaches to specifically demonstrate that ERK5 promotes antiviral immunity in epithelial cells. Mechanistically, ERK5 enhances the activation of STAT1 in response to IFN stimulation to augment the transcription of IFN-stimulated genes. Our work demonstrates that therapeutic modulation of MAPK and IFN signaling pathway co-integration could distinguish between the protective and deleterious outcomes of IFN expression.

One-sentence summary

ERK5 potentiates IFN lambda responses.
National-scale acoustic monitoring of avian biodiversity and migration
Authors: Bick I. Avery , Bakkestuen Vegar , Cretois Benjamin , Hillier Ben , Kålås John A. , Pedersen Marius , Raja Kiran , Rosten Carolyn M. , Somveille Marius , Stokke Bård G. , Wiel Julia , Sethi Sarab S.
Published: May 2024

Billions of birds migrate annually, triggered by endogenous behaviors as well as ecoclimatic triggers, which are shifting with climate change. These dynamics play out over large spatiotemporal scales, making monitoring of phenology challenging with traditional biodiversity survey approaches. In this study, over a complete spring season, we collected 37,429 hours of audio from 28 networked sensors in forests across Norway. We used machine learning to automatically identify bird vocalizations, and with expert validation found we were able to classify 57 species (14 full migrants) with over 80% precision. We show that acoustic surveys can fill data gaps in traditional surveys and facilitate mapping of migratory waves across Norwegian forests. Our study demonstrates how acoustic monitoring can complement existing national-scale biodiversity datasets, delivering high quality data which can support the design and implementation of effective policy and conservation measures.
Grifola frondosa polysaccharide Ameliorates Inflammation and Insulin Resistance by Regulating Macrophage Polarization of liver in Type 2 diabetes mellitus Rats
Authors: Zou Pei , Li Xueyan , Wang Liping , She Ying , Xiao Chenyang , Peng Yang , Qian Xu , Luo Peng , Wei Shaofeng
Published: May 2024

Type 2 diabetes mellitus (T2DM) is a common metabolic disease characterized by a lack of insulin secretion, insulin resistance (IR), and hyperglycemia. Given its high prevalence and multifarious complications, diabetes is globally ranked as the third leading cause of mortality. It is critical to discover efficient medication substitutes in order to lessen the drawbacks and adverse effects of traditional diabetes medication therapy. Previous studies have shown that Grifola frondosa polysaccharide (GFP) have the positive effects in regulating blood glucose and insulin resistance, but the understanding of its regulatory mechanism is still limited. Therefore, this study aimed to investigate the effects of GFP on liver inflammation induced by a high-fat diet (HFD) combined with streptozotocin (STZ) in type 2 diabetic rats and to explore its possible mechanisms. The results showed that GFP intervention reduced weight loss and hyperglycemia symptoms, as well as lowered FINS, HOMA-IR, IPGTT-AUC, and IPITT-AUC to different degrees in T2DM rats. At the same time, after GFP intervention, the secretion level of inflammatory factors (TNF-α, IL-1β, MCP-1) was down-regulated and the secretion level of anti-inflammatory factor (IL-10) was up-regulated in the liver tissue of T2DM rats. Furthermore, GFP reduced macrophage infiltration in liver tissue, inhibited macrophage M1-type polarization, and promoted M2-type polarization. These results suggest that GFP intervention could attenuate the hepatic inflammatory response in T2DM rats; possible mechanisms for this effect include hepatic macrophage infiltration and M1/M2 polarization.

Summary statement

This study revealed the improvement effect of GFP on hepatic inflammation and insulin resistance in T2DM rats and to explore the possible key roles of hepatic macrophages and their potential mechanisms.
Prediction of etiology and prognosis based on hematoma location of spontaneous intracerebral hemorrhage
Authors: Liang Jingjing , Tan Weixiong , Xie Shijia , Zheng Lijuan , Li Chuyan , Yi Zhong , Li Jianrui , Zhou Changsheng , Zhiqiang Zhang , Zhou Zhen , Gong Ping , Chen Xingzhi , Zhang Longjiang , Chen Xiaoqing , Zhang Qirui , Lu Guangming
Published: May 2024

Background

The characteristics of the hemorrhagic location of spontaneous intracerebral hemorrhage (sICH) is pivotal for both identifying its etiology and prognosis. While empirical conclusions have been obtained in clinical practice, a comprehensive and quantitative modeling approach has yet to be thoroughly explored.

Methods

We employed lesion-symptom mapping to extract the location features of sICH. We registered patients’ non-contrast computed tomography image and hematoma masks with standard human brain templates to identify specific affected brain regions. Then, we generated hemorrhage probabilistic maps of different etiologies and prognoses. By integrating radiomics and clinical features into multiple logistic regression models, we developed and validated optimal etiological and prognostic models across three centers, comprising 1162 sICH patients.

Results

Hematomas of different etiology have unique spatial distributions. Location features robustly categorized the etiology sICH (mean area under the curve (AUC) = 0.825) across different datasets), yielding clear add on value in models (fusion model mean AUC = 0.915) compared to clinical features (mean AUC = 0.828). In the prognostic analysis, patients with more extensive hematoma had a worse prognosis, the location (mean AUC = 0.762) and radiomic features (mean AUC = 0.837) also providing reliable add on value effects (fusion model mean AUC = 0.873) compared to clinical features alone (mean AUC = 0.771).

Interpretation

Our results show that location features were more intrinsically robust, generalizable relative, strong interpretability to the complex modeling of radiomics, our approach demonstrated a novel interpretable, streamlined, comprehensive etiologic classification and prognostic prediction framework for sICH.
Screening for common mental disorders in caregivers of children with severe acute malnutrition in a nutritional rehabilitation centre using the WHO Self-Reporting Questionnaire-20
Authors: Mathur Radhika , Kamble Nisha , Pathan Saba , Lakhan Tejal , Shah Ayushi , Prabhu Sanjay , Bodhanwala Minnie
Published: May 2024

A high number of caregivers of children admitted for inpatient treatment of Severe Acute Malnutrition (SAM) at the Nutritional Rehabilitation Centre (NRC), experience psychological distress. It is essential for the caregiver, generally the mother, to feed, hold, comfort, and play with her child as much as possible to promote opportunities for early learning and faster recovery from SAM. Hence, identification of mental health issues among the caregivers is imperative. Using WHO Self-reporting questionnaire (SRQ) 20 score to screen for common mental disorders (CMD) of caregivers of children admitted with SAM. The primary caregiver was interviewed using WHO SRQ-20 scoring. Based on the questions answered YES, the total score was given. A total score of > 8 was considered as a positive screen. These positive-screened caregivers were forwarded to a psychologist. We also compared the CMD prevalence between caregivers of children with primary SAM versus those with secondary SAM. There were a total of 29.1% (n=60) of the caregivers who were screened positive for CMD. The category of CMD most prevalent on screening was somatic issues, followed by depression, anxiety, and cognitive symptoms. Caregivers of children with pre-existing co-morbidity were higher in number than those without one on a positive screen. Maternal mental health is widely neglected, especially in an NRC setting across the country. For mothers of children with severe wasting, underlying mental stressors are significant contributors to the child’s malnourished state. Through this study, we hope to incorporate maternal mental health screening in NRCs for better management of these cases.
Exploring Gender Bias in Cardiovascular Medical Education Through Clinical Simulation
Authors: Amghaiab Idris F. Ali , Venkatesan Archana , Tews Matthew C. , Kleinheksel A.J.
Published: May 2024

While it has been proven that women suffer disproportionately from cardiovascular disease-related deaths, the origins of this differential gender-based outcome remain unidentified. One possible cause is gender bias and associated discrepancies in how physicians assess the need for interventions in male versus female patients. This study aimed to identify early gender biases in cardiovascular care by assessing medical students’ management of a ruptured abdominal aortic aneurysm case presentation in male and female simulated patients. Clerkship students (n = 187) were randomly assigned to either a male or female patient with identical case presentations, simulated using high-fidelity mannequins. Minutes passed until point-of-care ultrasound (POCUS) usage served as a surrogate for diagnostic reasoning, while minutes passed until surgery consultation call served as a surrogate for successful intervention.

Two-way ANCOVA of time to surgery call and POCUS use showed no significant interaction between student and patient gender (p=0.819). Likewise, neither patient gender (p=0.210) nor student gender (p=0.653) had an impact on ultimate correct diagnosis. However, there appeared to be an association (p=0.010) between patient and student gender in the factorial ANOVA of POCUS use, F(1,183) = 6.862 effect size 0.36. While slight in-group bias was identified within the context of imaging, students predominantly called for the correct intervention regardless of their own or their patient’s gender. It is thus unlikely that medical students develop gender biases serious enough to impact clinical outcomes during clerkship-instead, these heuristics may be formed later in training.
Race and Ethnic Disparities in Catheter Ablation Utilization for Atrial Fibrillation: A Meta-analysis and Framework for Implementation Research
Authors: Nosair Waseem , Smith Jamal , Dolman Sarahfaye , Kolm Paul , Lee Sung , Tsimploulis Apostolos , Thomaides Athanasios , Strouse David , Weintraub William S.
Published: May 2024

Background

Race/ethnic disparities in catheter ablation utilization for atrial fibrillation (AF) have been reported in the literature, however the data have not been systematically reviewed.

Objectives

To perform a systematic review and meta-analysis of studies reporting on disparities in the utilization of catheter ablation (CA) and to explore possible root causes of disparities using a behavioral model of health service utilization.

Methods

We searched PubMed/MEDLINE, Web of Science and Embase for studies reporting on race/ethnic disparities in the utilization of CA for AF in the United States. A meta-analysis was performed on a subset of included articles using a random-effects model. Publication bias was assessed for race/ethnic groups pooled from 10 or more studies. We adapted a behavioral model of health service utilization to identify root causes of disparities.

Results

Our search identified 20 studies published between 2011 and 2023, representing 47,700,642 patients with AF of whom over 561,490 underwent CA. Compared to non-Hispanic White patients, racial minorities had a lower odds of utilization of catheter ablation: 0.68 (95%CI 0.58 – 0.77) for non-Hispanic black (NHB) patients, 0.72 (95%CI 0.65 – 0.79) for Hispanic/LatinX (HLx) patients, and 0.62 (95%CI 0.45 – 0.78) for Asian patients. Other race groups were excluded due to insufficient data. There was a moderate to high degree of between-study heterogeneity for each race/ethnicity group: HLx (I2= 58.2%), Asian (I2= 80.9%), and NHB (I2= 90.4%). Only NHB patients had sufficient data to generate a funnel plot which showed evidence of publication bias.

Conclusions

The high between-study heterogeneity reveals varying degrees of disparities across studies and settings. Further research adjusting for patient-provider preferences and factors, echocardiographic data and social determinants of health is needed to clarify root causes of disparities and to promote equitable adoption of this important therapy in AF care.
AtVPS13M1 is involved in lipid remodeling in low phosphate and is located at the mitochondria surface in plants
Authors: Leterme Sébastien , Albrieux Catherine , Brugière Sabine , Couté Yohann , Dellinger Julien , Gillet Benjamin , Hughes Sandrine , Castet Julie , Bernard Amélie , Scheuring David , Schilling Marion , Jouhet Juliette , Michaud Morgane
Published: May 2024

VPS13 are conserved lipid transporters with multiple subcellular localizations playing key roles in many fundamental cellular processes. While the localization and function of VPS13 have been extensively investigated in yeast and animals, little is known about their counterparts in plants, particularly regarding their role in stress response. In this study, we characterized AtVPS13M1, one of the four VPS13 paralogs of the flowering plantArabidopsis thaliana. We show that AtVPS13M1 binds and transports glycerolipids with a low specificityin vitro. AtVPS13M1 interferes with phospholipids degradation in response to phosphate starvation, a nutrient stress that triggers a massive remodeling of membrane lipids. AtVPS13M1 is mainly expressed in young dividing and vascular tissues. Finally, we show that AtVPS13M1 is mainly located at the surface of mitochondria in leaves. Overall, our work highlights the conserved role in lipid transport of VPS13 in plants, reveals their importance in nutrient stress response and opens important perspectives for the understanding of lipid remodeling mechanisms and for the characterization of this protein family in plants.
A novel mouse home cage lickometer system reveals sex- and housing-based influences on alcohol drinking
Authors: Petersen Nicholas , Adank Danielle N. , Quan Yizhen , Edwards Caitlyn M. , Taylor Anne , Winder Danny G. , Doyle Marie A.
Published: May 2024

Alcohol use disorder (AUD) is a significant global health issue. Despite historically higher rates among men, AUD prevalence and negative alcohol-related outcomes in women are rising. Loneliness in humans has been associated with increased alcohol use, and traditional rodent drinking models involve single housing, presenting challenges for studying social enrichment. We developed LIQ PARTI (Lick Instance Quantifier with Poly-Animal RFID Tracking Integration), an open-source tool to examine home cage continuous access two-bottle choice drinking behavior in a group-housed setting, investigating the influence of sex and social isolation on ethanol consumption and bout microstructure in C57Bl/6J mice. LIQ PARTI, based on our previously developed single-housed LIQ HD system, accurately tracks drinking behavior using capacitive-based sensors and RFID technology. Group-housed female mice exhibited higher ethanol preference than males, while males displayed a unique undulating pattern of ethanol preference linked to cage changes, suggesting a potential stress-related response. Chronic ethanol intake distinctly altered bout microstructure between male and female mice, highlighting sex and social environmental influences on drinking behavior. Social isolation with the LIQ HD system amplified fluid intake and ethanol preference in both sexes, accompanied by sex- and fluid-dependent changes in bout microstructure. However, these efects largely reversed upon resocialization, indicating the plasticity of these behaviors in response to social context. Utilizing a novel group-housed home cage lickometer device, our findings illustrate the critical interplay of sex and housing conditions in voluntary alcohol drinking behaviors in C57Bl/6J mice, facilitating nuanced insights into the potential contributions to AUD etiology.

Significance Statement

Loneliness has been associated with increased alcohol use, and traditional rodent drinking models involve single housing, presenting challenges for studying social enrichment. Here we developed LIQ PARTI (Lick Instance Quantifier with Poly-Animal RFID Tracking Integration), an open-source group-housed lickometer system to investigate how social housing, isolation, and sex influence alcohol consumption patterns in C57Bl/6J mice. LIQ PARTI accurately identifies mouse drinking events and uncovered significant housing- and fluid-dependent diferences in ethanol consumption and bout microstructure between male and female mice. Social isolation-induced changes to ethanol drinking behavior and microstructure were highly plastic, as resocialization generally reversed these changes. These findings expand on the complex interplay between sex, social isolation, and alcohol use.
CHiMP: Deep Learning Tools Trained on Protein Crystallisation Micrographs to Enable Automation of Experiments
Authors: King Oliver N. F. , Levik Karl E. , Sandy James , Basham Mark
Published: May 2024

A group of three deep learning tools, referred to collectively as CHiMP (Crystal Hits in My Plate) were created for analysis of micrographs of protein crystallisation experiments at the Diamond Light Source (DLS) synchrotron, UK. The first tool, a classification network, assigns images into categories relating to experimental outcomes. The other two tools are networks that perform both object detection and instance segmentation, resulting in masks of individual crystals in the first case, and masks of crystallisation droplets in addition to crystals in the second case, allowing positions and sizes of these entities to be recorded. Creation of these tools used transfer learning, where weights from a pre-trained deep learning network were used as a starting point and re-purposed by further training on a relatively small set of data. Two of the tools are now integrated at the VMXi macromolecular crystallography beamline at DLS where they absolve the need for any user input both for monitoring crystallisation experiments and for triggering in situ data collections. The third is being integrated into the XChem fragment-based drug discovery screening platform, also at DLS, to allow automatic targeting of acoustic compound dispensing into crystallisation droplets.
Strain concentration drives the anatomical distribution of injury in acute and chronic traumatic brain injury
Authors: Hirad Adnan A , Mix Doran , Venkataraman Arun , Meyers Steven P , Mahon Bradford Z.
Published: May 2024

Brain tissue injury caused by mild traumatic brain injury (mTBI) disproportionately concentrates in the midbrain, cerebellum, mesial temporal lobe, and the interface between cortex and white matter at sulcal depths. The bio-mechanical principles that explain why physical impacts to different parts of the skull translate to common foci of injury concentrated in specific brain structures are unknown. A general and longstanding idea, which has not to date been directly tested in humans, is that different brain regions are differentially susceptible to strain loading. We use Magnetic Resonance Elastography (MRE) in healthy participants to develop whole-brain bio-mechanical vulnerability maps that independently define which regions of the brain exhibit disproportionate strain concentration. We then validate those vulnerability maps in a prospective cohort of mTBI patients, using diffusion MRI data collected at three cross-sectional timepoints after injury: acute, sub-acute, chronic. We show that regions that exhibit high strain, measured with MRE, are also the sites of greatest injury, as measured with diffusion MR in mTBI patients. This was the case in acute, subacute, and chronic subgroups of the mTBI cohort. Follow-on analyses decomposed the biomechanical cause of increased strain by showing it is caused jointly by disproportionately higher levels of energy arriving to high-strain structures, as well as the inability of high-strain structures to effectively disperse that energy. These findings establish a causal mechanism that explains the anatomy of injury in mTBI based on in vivo rheological properties of the human brain.
Selective Functional Connectivity between Ocular Dominance Columns in the Primary Visual Cortex
Authors: Aganj Iman , Nasr Shahin
Published: May 2024

The primary visual cortex (V1) in humans and many animals is comprised of fine-scale neuronal ensembles that respond preferentially to the stimulation of one eye over the other, also known as the ocular dominance columns (ODCs). Despite its importance in shaping our perception, to date, the nature of the functional interactions between ODCs has remained poorly understood. In this work, we aimed to improve our understanding of the interaction mechanisms between fine-scale neuronal structures distributed within V1. To that end, we applied high-resolution functional MRI to study mechanisms of functional connectivity between ODCs. Using this technique, we quantified the level of functional connectivity between ODCs as a function of the ocular preference of ODCs, showing thatalikeODCs are functionally more connected compared tounalikeones. Through these experiments, we aspired to contribute to filling the gap in our knowledge of the functional connectivity of ODCs in humans as compared to animals.