bluuebunny/crossref_metadata_2025 huggingface dataset:
Differing effects of oral conjugated equine estrogen and transdermal estradiol on vitamin D metabolism in postmenopausal women: a 4-year longitudinal study
Authors: Santoro Anna Maria , Simpson Christine A. , Cong Elaine , Haas Andrea , Sullivan Rebecca R. , Parziale Stephen , Deng Yanhong , Insogna Karl L.
Published: August 2022

Objective

The aim of this study was to examine the effect of either conjugated equine estrogen or transdermal estradiol on vitamin D metabolism in postmenopausal women.

Methods

Twenty-five women from the Kronos Early Estrogen Prevention Study who were randomized to conjugated equine estrogen 0.45 mg/d and 20 women who were treated with transdermal estradiol 50 mg/d (patch replaced weekly) were analyzed in the present study. All participants received micronized progesterone for 12 days per month.

Results

There was no significant treatment effect on serum total 25-hydroxyvitamin D over 48 months in either study group, and there were no significant differences between treatment arms. In contrast, at 12 months, directly measured free 25-hydroxyvitamin D was significantly higher in the transdermal estradiol group than in the conjugated equine estrogen group. Directly measured free 25-hydroxyvitamin D subsequently increased significantly from 12 to 48 months in both treatment arms. Calculated free 25-hydroxyvitamin D was also significantly higher in the transdermal estradiol group at 36 months. Vitamin D–binding protein decreased significantly in both treatment groups from 12 to 48 months, but at 48 months, least square mean values were no different based on treatment assignment.

Conclusions

Directly measured free 25-hydroxyvitamin D levels, but not serum total 25-hydroxyvitamin D levels, are different within the first 12 months of estrogen replacement depending on the preparation. However, this difference is transient, in that there were no differences at 36 or 48 months. These findings suggest that there may be a short-term benefit to prescribing transdermal estradiol for women who are either vitamin D deficient or vitamin D insufficient.
Remote multimodality monitoring of maternal physiology from the first trimester to postpartum period: study results
Authors: Zielinska Agata P. , Mullins Edward , Magni Elena , Zamagni Giulia , Kleprlikova Hana , Adams Olive , Stampalija Tamara , Monasta Lorenzo , Lees Christoph
Published: August 2022

Objectives:

Current antenatal care largely relies on widely spaced appointments, hence only a fraction of the pregnancy period is subject to monitoring. Continuous monitoring of physiological parameters could represent a paradigm shift in obstetric care. Here, we analyse the data from daily home monitoring in pregnancy and consider the implications of this approach for tracking pregnancy health.

Methods:

Prospective feasibility study of continuous home monitoring of blood pressure, weight, heart rate, sleep and activity patterns from the first trimester to 6 weeks postpartum.

Results:

Fourteen out of 24 women completed the study (58%). Compared to early pregnancy [week 13, median heart rate (HR) 72/min, interquartile range (IQR) 12.8], heart rate increased by week 35 (HR 78/min, IQR 16.6; P = 0.041) and fell postpartum (HR 66/min, IQR 11.5, P = 0.021). Both systolic and diastolic blood pressure were lower at mid-gestation (week 20: SBP 103 mmHg, IQR 6.6; DPB 63 mmHg, IQR 5.3 P = 0.005 and P = 0.045, respectively) compared to early pregnancy (week 13, SBP 107 mmHg, IQR 12.4; DPB 67 mmHg, IQR 7.1). Weight increased during pregnancy between each time period analyzed, starting from week 15. Smartwatch recordings indicated that activity increased in the prepartum period, while deep sleep declined as pregnancy progressed.

Conclusion:

Home monitoring tracks individual physiological responses to pregnancy in high resolution that routine clinic visits cannot. Changes in the study protocol suggested by the study participants may improve compliance for future studies, which was particularly low in the postpartum period. Future work will investigate whether distinct adaptative patterns predate obstetric complications, or can predict long-term maternal cardiovascular health.
One year of isometric exercise training for blood pressure management in men: a prospective randomized controlled study
Authors: O’Driscoll Jamie M. , Edwards Jamie J. , Coleman Damian A. , Taylor Katrina A. , Sharma Rajan , Wiles Jonathan D.
Published: August 2022

Objective:

Isometric exercise training (IET) over 4–12 weeks is an effective antihypertensive intervention. However, blood pressure (BP) reductions are reversible if exercise is not maintained. No work to date has investigated the long-term effects of IET on resting BP.

Methods:

We randomized 24 unmedicated patients with high-normal BP to a 1-year wall squat IET intervention or nonintervention control group. Resting BP and various clinically important haemodynamic variables, including heart rate (HR), stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) were measured pre and post the 1-year study period.

Results:

One year of IET produced statistically significant reductions in resting systolic (-8.5 ± 5 mmHg, P < 0.001) and diastolic (-7.3 ± 5.8 mmHg, P < 0.001) BP compared with the control group. There was also a significant reduction in resting HR (-4.2 ± 3.7 b/min, P = 0.009) and a significant increase in SV (11.2 ± 2.8 ml, P = 0.012), with no significant change in CO (0.12 ± 2.8 l/min, P = 0.7). TPR significantly decreased following IET (-246 ± 88 dyne·s/cm5, P = 0.011). Adherence to the IET sessions was 77% across all participants (3x IET sessions per week), with no participant withdrawals.

Conclusion:

This novel study supports IET as an effective long-term strategy for the management of resting BP, producing clinically important, chronic BP adaptations in patients at risk of hypertension. Importantly, this work also demonstrates impressive long-term adherence rates, further supporting the implementation of IET as a means of effective BP management in clinical populations.
Comprehensive Analysis of circRNA-Associated-ceRNA Networks in Human Corneal Endothelial Dysfunction
Authors: Qiu Ji-ni , Shan Kun , Xiang Jun , Gu Jia-yu , Zhou Rong-mei , Zhang Xue-ling , Zhang Chao-ran , Xu Jian-jiang
Published: August 2022

Purpose:

Circular RNAs (circRNAs) are a novel class of endogenous noncoding RNAs that regulate gene expression through the competitive endogenous RNA (ceRNA) mechanism. CircRNA-associated-ceRNA networks are closely related to oxidative stress–related diseases. Oxidative stress–induced dysfunction of the corneal endothelium (CE) is a major pathological feature in many corneal diseases. This study was aimed to analyze circRNA-associated-ceRNA networks in oxidative stress–induced CE dysfunction.

Methods:

A CE dysfunction model was established using human corneal endothelial cells (HCECs) treated with H2O2 at a concentration of 250 μM for 4 hours at 37°C. High-throughput sequencing was conducted to determine the expression profiles of circRNA, miRNA, and mRNA. Bioinformatic analyses, including Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes analysis, were conducted to identify the potential biological modules and pathologic pathways of dysregulated circRNAs. CircRNA-associated-ceRNA networks were established based on the data of sequencing and bioinformatic analyses.

Results:

We obtained 108 differentially expressed circRNAs, including 77 upregulated and 31 downregulated circRNAs. GO analysis suggested that dysregulated circRNAs were mainly targeted to protein quality control for misfolded or incompletely synthesized proteins (biologic process), nuclear chromatin (cellular component), and ubiquitin protein ligase binding (molecular function). GO terms related to CE functions responding to oxidative stress were also identified. Kyoto Encyclopedia of Genes and Genomes pathway analysis indicated that dysregulated circRNAs were mostly enriched in the adherens junction pathway. Network analysis identified several potential therapeutic targets for CE dysfunction.

Conclusions:

CircRNAs are significantly dysregulated in HCECs under oxidative stress. The circRNA-associated-ceRNA networks are closely related to HCEC functions. Targeting these networks might provide novel therapies for CE dysfunction.
(Even Off-Label) Cochlear Implantation in Single-Sided Deafness and Asymmetric Hearing Loss Results in Measurable Objective and Subjective Benefit
Authors: Sydlowski Sarah A. , Farrokhian Nathan , Carrozza Marisa , Jamis Carmen , Woodson Erika
Published: August 2022

Objective

To quantify objective and subjective outcomes in cochlear implant (CI) recipients with asymmetric hearing loss, including single-sided deafness (SSD) whose candidacy was determined on an ear-specific basis when word recognition was 50% or less.

Study Design

Retrospective case review.

Setting

Tertiary referral center.

Background

The effectiveness of CI in cases of SSD and asymmetric hearing loss (AHL) has been described in terms of tinnitus suppression, improved speech recognition in quiet and noise, enhanced localization ability, and improved quality of life. However, CI is not yet routinely offered as a top option or standard of care for these individuals. Recent Food and Drug Administration (FDA) labeling limits aided word recognition in the ear to be implanted to only 5% in cases of AHL/SSD, which is significantly poorer than 40 to 50%, which is often referenced in cases of bilateral hearing loss. Anecdotal experience suggests that patients with much better preoperative word recognition than 5% can benefit from CI.

Methods

We conducted a retrospective chart review of all adult CI candidates, with one ear exhibiting consonant-nucleus-consonant (CNC) word recognition scores at least 50% and one ear not meeting CI candidacy (i.e., CNC word recognition >50%). Outcome variables of interest included word and sentence recognition and subjective handicap questionnaires (hearing, tinnitus, dizziness) and the Speech Spatial Qualities questionnaire.

Results

Statistically and clinically significant improvement in speech understanding (word, sentence, sentence in noise) was noted for both the SSD and AHL groups in the implanted ear. There were statistically and clinically significant subjective improvements noted for both groups on the Hearing Handicap Inventory, the Tinnitus Handicap Inventory, and the Speech Spatial Qualities questionnaire by 1 month after activation. There were no significant differences between the AHL and SSD groups on either objective or subjective measures of the implanted ear. Individual word understanding improved for the majority of recipients across both groups and is not dependent on meeting the FDA criteria of less than 5%.

Conclusions

Cochlear implantation is a viable option with measurable objective and perceived benefits for recipients with preoperative aided CNC word scores exceeding current FDA labeling. There is no significant difference between the AHL and SSD groups, suggesting that candidacy and outcome expectations should be set based on the ear to be implanted alone, without regard for the ability of the better hearing ear.
Surgical Reconsideration of Traumatic Facial Paralysis
Authors: Kim Jin , Lee Jeon Mi , Nam Sung-Il , Baek Moo Jin
Published: August 2022

Introduction

Despite the different pathophysiological mechanisms underlying Bell's palsy, in assessing severe traumatic facial paralysis, many surgeons rely on electrophysiological criteria to determine whether facial nerve exploration is warranted. To assess the value of preoperative electroneurography (ENoG) and the time of surgery, we analyzed data from three tertiary medical centers.

Materials and Methods

The records of 517 patients with a degenerative ratio (DR) greater than 80% on ENoG were collected, and two groups were defined: group A (90% DR ≤ ENoG) and group B (80% DR ≤ ENoG < 90% DR). The difference in effectiveness of surgery versus conservative treatment was analyzed based on the postoperative outcome determined by the House-Brackmann grading system. The independent-samples t test was used to compare surgery with conservative treatment for each day of surgical exploration.

Result

In groups A and B, the average recovery time from facial paralysis was better in patients who had undergone surgical exploration than in those who had been treated conservatively. In group A, the difference was significant only for patients who underwent surgery within 8 days. In group B, a significant difference was found for patients who underwent surgery within 16 days but also for surgery performed 20 and 30 days after the onset of facial paralysis.

Discussion

In the surgical treatment of facial paralysis, the criteria for trauma patients should be distinguished from those of patients with Bell's palsy. In traumatic facial paralysis, some axons are more vulnerable to external collapse, and the degree of Wallerian degeneration of the peripheral nervous system will vary depending on the type of injury. The results of this study will help to identify those patients with traumatic facial paralysis who should be treated surgically and when they should be treated.
Transtympanic Visualization of Cochlear Implant Placement With Optical Coherence Tomography: A Pilot Study
Authors: Wang Junzhe , Chawdhary Gaurav , Farrell Joshua , Yang Xiaojie , Farrell Matthew , MacDougall Dan , Trudel Mathieu , Shoman Nael , Morris David P. , Adamson Robert B. A.
Published: August 2022

Objective

This study aimed to evaluate the ability of transtympanic middle ear optical coherence tomography (ME-OCT) to assess placement of cochlear implants (CIs) in situ.

Patient

A 72-year-old man with bilateral progressive heredodegenerative sensorineural hearing loss due to work-related noise exposure received a CI with a slim modiolar electrode for his right ear 3 months before his scheduled checkup.

Intervention

A custom-built swept source ME-OCT system (λ
o = 1550 nm, ∆λ = 40 nm) designed for transtympanic middle ear imaging was used to capture a series of two- and three-dimensional images of the patient's CI in situ. Separately, transtympanic OCT two-dimensional video imaging and three-dimensional imaging were used to visualize insertion and removal of a CI with a slim modiolar electrode in a human cadaveric temporal bone through a posterior tympanotomy.

Main Outcome Measure

Images and video were analyzed qualitatively to determine the visibility of implant features under ME-OCT imaging and quantitatively to determine insertion depth of the CI.

Results

After implantation, the CI electrode could be readily visualized in the round window niche under transtympanic ME-OCT in both the patient and the temporal bone. In both cases, characteristic design features of the slim modiolar electrode allowed us to quantify the insertion depth from our images.

Conclusions

ME-OCT could potentially be used in a clinic as a noninvasive, nonionizing means to confirm implant placement. This study shows that features of the CI electrode visible under ME-OCT can be used to quantify insertion depth in the postoperative ear.
Preoperative neoadjuvant targeted therapy with lenvatinib for inoperable thyroid cancer
Authors: Iwasaki Hiroyuki , Toda Soji , Murayama Daisuke , Matsui Ai , Kadoya Mei
Published: August 2022

Rationale:

Neoadjuvant chemotherapy (NAC) with lenvatinib for inoperable thyroid cancer has not been established. We have previously reported a case of NAC in 2020. Here, we report 5 cases of thyroid cancer treated with NAC from 2019 to 2021, including 3 cases of inoperable differentiated thyroid cancer, 1 case of anaplastic thyroid cancer, and 1 case of concomitant differentiated thyroid cancer and anaplastic thyroid cancer.

Patient concerns and diagnosis:

Four patients were pathologically diagnosed with thyroid cancer by cytology or biopsy, and 1 patient was diagnosed with follicular neoplasm. These patients had pleural, laryngeal, and esophageal invasion, and radical surgery would have required an extended operation and increased surgical risks.

Interventions:

Five patients with thyroid cancer displaying invasion of adjacent organs who were inoperable were preoperatively treated with lenvatinib alone; they underwent surgery when the tumor stopped shrinking.

Outcomes:

The best response was achieved after 1.7 to 4.7 months (average 2.9 months) of lenvatinib treatment, and the dose was reduced due to the occurrence of adverse events. Surgery was successfully performed when the tumor stopped shrinking.

Conclusion:

The prognosis of patients with inoperable thyroid cancer is poor; however, patients can undergo surgery safely after NAC treatment with lenvatinib. We hope that NAC will be considered as a treatment option for advanced thyroid cancers and serve as a precedent for safe treatment. This can be a new treatment option to eliminate unresectable thyroid cancers.
Severe iron-deficiency anemia and candida esophagitis
Authors: Zaki Hany A. , Iftikhar Haris , Bashir Khalid , Taha Noheir Moustafa , Elmoheen Amr
Published: August 2022

Rationale:

Iron deficiency is the commonest cause of anemia globally. Oral candidiasis is a commonest fungal infection while esophageal candidiasis (EC) is the commonest cause of infectious esophagitis. There is limited literature on the association between EC and severe iron-deficiency anemia (IDA).

Patient concerns:

A 38-year-old woman who was previously healthy presented to our emergency facility with pain, swelling, and tenderness in both limbs. The patient appeared extremely pale with conjunctival pallor but no oral ulcers or scleral icterus.

Diagnosis:

A basic blood investigation showed that she had severe IDA (hemoglobin level 2.9 g/dL).

Interventions:

The emergency department management plan involved electrocardiography (ECG), chest radiography (CXR), blood investigations, occult stool analysis, and activation of the blood transfusion protocol. Extensive inpatient work up including further blood investigations, esophagogastroduodenoscopy (EGD), colonoscopy, pan-computed tomography (CT) was performed to determine the cause of IDA. Endoscopic diagnosis was candida esophagitis. Patient was started on fluconazole 200 mg for 14 days.

Outcomes:

The patient remained stable and pain-free while in hospital. She tolerated a full oral diet. She was discharged on oral iron tablets, esomeprazole, and fluconazole. She remained symptom-free. Her hemoglobin and liver function tests remained stable on follow-up.

Lessons:

This case shows that patients with severe IDA might have a higher level of susceptibility to EC or vice versa. This association may exist and needs further research.
Proteomic Identification and Clinicopathologic Characterization of Splenic Amyloidosis
Authors: Chiu April , Dasari Surendra , Kurtin Paul J. , Theis Jason D. , Vrana Julie A. , Rech Karen L. , Dao Linda N. , Howard Matthew T. , Dalland Joanna C. , McPhail Ellen D.
Published: August 2022

The spleen is a commonly encountered specimen in surgical pathology. However, little is known about the incidence, morphologic pattern, and clinical features of spleens involved by amyloidosis. We retrospectively identified 69 spleen amyloid cases typed using a proteomics-based method between 2008 and 2020. The frequency of amyloid types, clinicopathologic features, and distribution of amyloid deposits were assessed. Four amyloid types were detected: immunoglobulin light chain (AL) (N=30; 43.5%); leukocyte chemotactic factor 2 amyloidosis (ALECT2) (N=30; 43.5%); amyloid A (AA) (N=8; 11.6%); and fibrinogen alpha (AFib) (N=1; 1.4%). The splenic amyloid showed 5 distinct distribution patterns: (1) diffuse pattern, exhibited by most AL cases; (2) red pulp pattern, exhibited by most ALECT2 cases; (3) multinodular pattern, seen in subsets of AA and AL-kappa cases; (4) mass-forming pattern, seen in the AFib case; and (5) vascular only, seen in a subset of AA cases. Atraumatic splenic rupture was the most common reason for splenectomy in AL cases, while most ALECT2 spleens were removed incidentally during an unrelated abdominal surgery. Splenomegaly was significantly more common in AA spleens than in AL or ALECT2 spleens and was often the reason for splenectomy in this group. In conclusion, splenic amyloid may be underrecognized as it is often an incidental finding. Although, as expected, many of the spleens were involved by AL amyloidosis, ALECT2 emerged as another common spleen amyloid type. Although the spleen amyloid types exhibited characteristic distribution patterns, proteomics-based typing is warranted as some morphologic overlap still exists. Awareness of ALECT2 as a major spleen amyloid type is important for appropriate diagnostic workup and patient management.
Sinonasal Amoebiasis
Authors: McLean Anne C. , Bishop Justin A. , Guarner Jeannette , Montone Kathleen T. , Morris C. Paul , Sloan Philip , Rooper Lisa M.
Published: August 2022

While amoebic infection is widely known as a cause of gastroenteritis, keratitis, and meningoencephalitis, amoebae are challenging to recognize at unexpected sites. Despite multiple case reports of sinonasal amoebiasis, amoebic infection is not regularly considered in the differential diagnosis of sinonasal necroinflammatory disease. Here, we aim to characterize the pathologic features of sinonasal amoebiasis to facilitate better recognition. We identified sinonasal amoebiasis in 4 men, median age of 67 years (range: 37 to 71 y). All were immunocompromised, including 2 with chronic lymphocytic leukemia, 1 with human immunodeficiency virus, and 1 with human immunodeficiency virus and kidney transplant. Patients presented with nasal mucosal necrosis or polypoid masses, with facial ulceration in 1 patient and distant dermal nodules in another. Biopsies displayed extensive necrotic debris and inflammation. Although amoebic cysts were abundant in 3 cases, they were mistaken for yeast at frozen section in 1 case; 1 case showed only rare trophozoites that were not recognized on initial biopsy. Periodic acid Schiff and Grocott Methenamine Silver stains highlighted the organisms, and polymerase chain reaction confirmed Acanthamoeba species in 3 cases tested. 2 patients responded well to antiprotozoal medications, but 2 died of disease. Overall, sinonasal amoebiasis presents as a necroinflammatory process in patients immunocompromised for various reasons. Amoebae can mimic other organisms or be incredibly scarce, requiring active consideration to recognize amoebiasis and differentiate it from overlapping conditions like invasive fungal sinusitis, granulomatosis with polyangiitis, and natural killer/T-cell lymphoma. Because sinonasal amoebiasis is highly treatable when diagnosed promptly, pathologists play a critical role in the recognition of this rare necroinflammatory disease.
Facial Recognition Software Use on Surgically Altered Faces: A Systematic Review
Authors: Gupta Nikita , Hughes Samuel J. , Chirwa Robert , Cheng Qiang
Published: August 2022

Objective:

Facial recognition software (FRS) is becoming pervasive in society for commercial use, security systems, and entertainment. Alteration of the facial appearance with surgery poses a challenge to these algorithms, but several methods are being studied to overcome this issue. This study systematically reviews methods used in facial recognition of surgically altered faces.

Materials and Methods:

A systematic review was performed by searching PubMed and Institute of Electrical and Electronics Engineers (IEEE) databases to identify studies addressing FRS and surgery. On initial review, 178 manuscripts were identified relating to FRS and surgery and allowed division into multiple subgroups. The decision was made to focus on the recognition of surgically altered faces.

Results:

Eligible studies included those reports in English on FRS of surgically altered faces, and 39 papers were included. Surgical procedures range from affecting skin surface, such as skin peeling, to altering facial features, such as rhinoplasty, mentoplasty, malar augmentation, brow lift, facelift, orthognathic surgery, facial reanimation, and facial feminization. Methods were classified into appearance-based, feature-based, and texture-based. Descriptive versus experimental protocols were characterized by different reporting outcomes and controls. Accuracy ranged from 19.1% to 85.35% using various analysis methods.

Conclusions:

Knowledge of available limitations and advantages can aid in counseling patients regarding personal technology use, security, and quell fears about surgery to evade authorities. Surgical knowledge can be utilized to improve FRS algorithms for postsurgical recognition.
Closure of a Large Scalp Defect Using External Tissue Expansion
Authors: Shikara Meryam , Waghmarae Suneet , Vakharia Kalpesh T.
Published: August 2022

The limited laxity of the scalp and hair-bearing nature makes it difficult to optimally repair. Primary closure is limited to small defects, while healing by secondary intention requires underlying periosteum. Furthermore, the use of free flaps and skin grafting can lead to unfavorable cosmetic outcomes. This report describes a patient with a large parietal scalp dermatofibrosarcoma protuberans. Multiple resections resulted in a large scalp defect with exposed calvarium. Integra was placed over the exposed calvarium after each debridement and Negative Pressure Wound Therapy (NPWT) was applied. After granulation tissue formed, 2 DermaClose continuous external tissue expansion systems were installed. Following the application and tightening of the external tissue expanders, the wound was reduced in size, facilitating primary closure of the opposing edges. This process allowed for a large area to be covered with hair-bearing scalp with good cosmetic results.
Brugada Syndrome Unmasked by Cellulitis of the Face
Authors: Kim Han Koo , Kang Seung Hyun , Kim Woo Seob , Kang Shin Hyuk , Bae Tae Hui
Published: August 2022

A 35-year-old male patient with no specific history visited an emergency medical center with a chief complaint of facial swelling accompanied by fever (38.3°C). Contrast-enhanced facial computed tomography confirmed diffuse soft tissue swelling and facial infiltration of inflammation. Additional laboratory findings revealed elevated white blood cell count and C-reactive protein level. The patient also complained of chest pain; therefore, electrocardiography was performed, which confirmed a curved pattern-like ST-segment elevation (≥2 mm) of V2 without elevated cardiac enzyme levels. Based on various test results, the patient was diagnosed with Brugada syndrome. He was administered intravenous empirical antibiotics and intravenous ibuprofen as an antipyretic for the treatment of facial cellulitis and Brugada syndrome. After the resolution of the symptoms, his body temperature normalized. A subsequent electrocardiogram confirmed a normal sinus rhythm pattern. This case report shows that Brugada syndrome, a rare but life-threatening disease, can be unmasked by facial cellulitis. Because antipyretics can immediately reduce the critical rate of sudden cardiac death, Brugada syndrome should be differentially diagnosed, with an evaluation of facial cellulitis, to prevent sudden cardiac death.
Living Donor Intestinal Transplantation
Authors: Wu Guosheng , Liu Chaoxu , Zhou Xile , Zhao Long , Zhang Weitong , Wang Mian , Zhao Qingchuan , Liang Tingbo
Published: August 2022

Objective:

To examine outcomes of living-donor intestinal transplant (LDITx) recipients.

Background:

LDITx is not routinely performed because of surgical risks to the donor and the potential inferior physiologic performance of the segmental graft. However, data on the effectiveness of LDITx are scarce.

Design:

This retrospective cohort study included patients undergoing LDITx between May 1999 and December 2021 in intestinal transplant programs in 2 university-affiliated hospitals in China.

Results:

Actuarial survival rates were 80%, 72.7%, 66.7% for patient and 72.4%, 63.6%, 60% for graft at 1, 3, and 5 years, respectively. Recipients with >3/6 HLA-matched grafts had superior patient and graft survival rates than those with ≤3/6 HLA-matched grafts (P<0.05). There were 12 deaths among the recipients, with infection being the leading cause (41.7%), followed by rejection (33.3%), surgical complications (16.7%), and others (8.3%). There were 16 graft losses among the recipients, with acute cellular rejection being the predominant cause (37.5%), followed by infection (25%), technical failure (12.5%), chronic rejection (12.5%), and others (12.5%). With an average follow-up of 3.7 (range, 0.6–23) years, the rates of acute and chronic rejection were 35% and 5%, and the rate of cytomegalovirus disease and post-transplant lymphoproliferative disease were 5% and 2.5%, respectively. Of the 40 patients, 28 (70%) are currently alive and have achieved enteral autonomy.

Conclusions:

LDITx is a valuable treatment option for patients with end-stage intestinal failure. Improved immunosuppression, better HLA matching, and shorter cold ischemia times were associated with reduced rates of rejection, viral-mediated infection and improved graft survival.
FAIR data pipeline: provenance-driven data management for traceable scientific workflows
Authors: Mitchell Sonia Natalie , Lahiff Andrew , Cummings Nathan , Hollocombe Jonathan , Boskamp Bram , Field Ryan , Reddyhoff Dennis , Zarebski Kristian , Wilson Antony , Viola Bruno , Burke Martin , Archibald Blair , Bessell Paul , Blackwell Richard , Boden Lisa A. , Brett Alys , Brett Sam , Dundas Ruth , Enright Jessica , Gonzalez-Beltran Alejandra N. , Harris Claire , Hinder Ian , David Hughes Christopher , Knight Martin , Mano Vino , McMonagle Ciaran , Mellor Dominic , Mohr Sibylle , Marion Glenn , Matthews Louise , McKendrick Iain J. , Mark Pooley Christopher , Porphyre Thibaud , Reeves Aaron , Townsend Edward , Turner Robert , Walton Jeremy , Reeve Richard
Published: August 2022

Modern epidemiological analyses to understand and combat the spread of disease depend critically on access to, and use of, data. Rapidly evolving data, such as data streams changing during a disease outbreak, are particularly challenging. Data management is further complicated by data being imprecisely identified when used. Public trust in policy decisions resulting from such analyses is easily damaged and is often low, with cynicism arising where claims of ‘following the science’ are made without accompanying evidence. Tracing the provenance of such decisions back through open software to primary data would clarify this evidence, enhancing the transparency of the decision-making process. Here, we demonstrate a Findable, Accessible, Interoperable and Reusable (FAIR) data pipeline. Although developed during the COVID-19 pandemic, it allows easy annotation of any data as they are consumed by analyses, or conversely traces the provenance of scientific outputs back through the analytical or modelling source code to primary data. Such a tool provides a mechanism for the public, and fellow scientists, to better assess scientific evidence by inspecting its provenance, while allowing scientists to support policymakers in openly justifying their decisions. We believe that such tools should be promoted for use across all areas of policy-facing research.

This article is part of the theme issue ‘Technical challenges of modelling real-life epidemics and examples of overcoming these’.
Tracking the national and regional COVID-19 epidemic status in the UK using weighted principal component analysis
Authors: Swallow Ben , Xiang Wen , Panovska-Griffiths Jasmina
Published: August 2022

One of the difficulties in monitoring an ongoing pandemic is deciding on the metric that best describes its status when multiple intercorrelated measurements are available. Having a single measure, such as the effective reproduction number

R

, has been a simple and useful metric for tracking the epidemic and for imposing policy interventions to curb the increase when

R
>
1

. While

R

is easy to interpret in a fully susceptible population, it is more difficult to interpret for a population with heterogeneous prior immunity, e.g. from vaccination and prior infection. We propose an additional metric for tracking the UK epidemic that can capture the different spatial scales. These are the principal scores from a weighted principal component analysis. In this paper, we have used the methodology across the four UK nations and across the first two epidemic waves (January 2020–March 2021) to show that first principal score across nations and epidemic waves is a representative indicator of the state of the pandemic and is correlated with the trend in R. Hospitalizations are shown to be consistently representative; however, the precise dominant indicator, i.e. the principal loading(s) of the analysis, can vary geographically and across epidemic waves.

This article is part of the theme issue ‘Technical challenges of modelling real-life epidemics and examples of overcoming these’.
Reformulating the susceptible–infectious–removed model in terms of the number of detected cases: well-posedness of the observational model
Authors: Campillo-Funollet Eduard , Wragg Hayley , Van Yperen James , Duong Duc-Lam , Madzvamuse Anotida
Published: August 2022

Compartmental models are popular in the mathematics of epidemiology for their simplicity and wide range of applications. Although they are typically solved as initial value problems for a system of ordinary differential equations, the observed data are typically akin to a boundary value-type problem: we observe some of the dependent variables at given times, but we do not know the initial conditions. In this paper, we reformulate the classical susceptible–infectious–recovered system in terms of the number of detected positive infected cases at different times to yield what we term the observational model. We then prove the existence and uniqueness of a solution to the boundary value problem associated with the observational model and present a numerical algorithm to approximate the solution.

This article is part of the theme issue ‘Technical challenges of modelling real-life epidemics and examples of overcoming these’.
Statistical and agent-based modelling of the transmissibility of different SARS-CoV-2 variants in England and impact of different interventions
Authors: Panovska-Griffiths J. , Swallow B. , Hinch R. , Cohen J. , Rosenfeld K. , Stuart R. M. , Ferretti L. , Di Lauro F. , Wymant C. , Izzo A. , Waites W. , Viner R. , Bonell C. , Fraser C. , Klein D. , Kerr C. C. ,   The COVID-19 Genomics UK (COG-UK) Consortium
Published: August 2022

The English SARS-CoV-2 epidemic has been affected by the emergence of new viral variants such as B.1.177, Alpha and Delta, and changing restrictions. We used statistical models and the agent-based model Covasim, in June 2021, to estimate B.1.177 to be 20% more transmissible than the wild type, Alpha to be 50–80% more transmissible than B.1.177 and Delta to be 65–90% more transmissible than Alpha. Using these estimates in Covasim (calibrated 1 September 2020 to 20 June 2021), in June 2021, we found that due to the high transmissibility of Delta, resurgence in infections driven by the Delta variant would not be prevented, but would be strongly reduced by delaying the relaxation of restrictions by one month and with continued vaccination.

This article is part of the theme issue ‘Technical challenges of modelling real-life epidemics and examples of overcoming these’.
Synergistic antimicrobial effect of ascorbic acid and nicotinamide with rifampicin and vancomycin against SCCmec type IV Methicillin-Resistant Staphylococcus aureus (MRSA)
Authors: AlSaleh Abdullah , Shahid Mohammed , Farid Eman , Kamal Nermin , Bindayna Khalid
Published: August 2022

Background MRSA is a pathogenic bacteria involved in a wide spectrum of human diseases. Many virulence factors promote this widespread propagation. One important factor is acquiring antibiotic resistance genes which leads to a reduction in availability and efficacy of therapy options. Recently, research suggests antioxidants remarkable antimicrobial effect against superbugs like MRSA, showing synergistic effect when accompanied by antimicrobial therapy. Henceforth, the article is aimed to examine the synergistic effect ascorbic acid and nicotinamide with a panel of antibiotics used in antimicrobial therapy of MRSA. Material and Methods 2 SCCmec type IV MRSA reference strains (EMRSA-15 and USA300) and 10 MRSA clinical isolates were used in this article. SCCmec typing was conducted on the 10 clinical isolates via multiplex PCR after identification. Synergy of antioxidants and antibiotics were evaluated via checkerboard assay. MIC of each agent was conducted in accordance with CLSI M100 guidelines through 2-fold microdilution assay. Results and Discussion synergy (FIC<0.5) was demonstrated for ascorbic acid (1/2-1/4 MIC) with rifampicin (1/2-1/8 MIC), also, 1/2 to 1/16 MIC of ascorbic acid when associated with vancomycin at 1/2 MIC. Similarly, nicotinamide (1/2-1/16 MIC) showed synergistic response when paired with low concentrations of rifampicin (1/2-1/16 MIC), also, when associating nicotinamide (1/4-1/16 MIC) with vancomycin (1/2 MIC). Conclusion The synergistic activity demonstrated in associating antioxidants and antibiotics is a promising notion in managing superbugs. However, more research required to better understand the synergy mechanism and for utilization in clinical care.
Accurate localization and coactivation profiles of the Frontal Eye Field and Inferior Frontal Junction: an ALE and MACM fMRI meta-analysis
Authors: Bedini Marco , Olivetti Emanuele , Avesani Paolo , Baldauf Daniel
Published: August 2022

The frontal eye field (FEF) and the inferior frontal junction (IFJ) are prefrontal structures involved in mediating multiple aspects of goal-driven behavior. Despite being recognized as prominent nodes of the networks underlying spatial attention and oculomotor control, and working memory and cognitive control, respectively, the limited quantitative evidence on their precise localization has considerably impeded the detailed understanding of their structure and connectivity. In this study, we performed an activation likelihood estimation (ALE) fMRI meta-analysis by selecting studies that employed standard paradigms to accurately infer the localization of these regions in stereotaxic space. For the FEF, we found the highest spatial convergence of activations for prosaccades and antisaccades paradigms at the junction of the precentral sulcus and superior frontal sulcus. For the IFJ, we found consistent activations across oddball/attention, working memory, Stroop, and task-switching paradigms at the junction of the inferior precentral sulcus and inferior frontal sulcus. We related these clusters to previous meta-analyses, sulcal/gyral neuroanatomy, and a recent comprehensive brain parcellation, highlighting important differences compared to their results and taxonomy. Finally, we employed the ALE peak coordinates as seeds to perform a meta-analytic connectivity modeling (MACM) analysis, which revealed systematic coactivation patterns spanning the frontal, parietal and temporal cortices. We decoded the behavioral domains associated with these coactivations, suggesting that these may allow FEF and IFJ to support their specialized roles in flexible behavior. Our study provides meta-analytic groundwork for investigating the relationship between functional specialization and connectivity of two crucial control structures of the prefrontal cortex.
Drought and flooding resistances of maize germplasm are compared and evaluated using a multivariate analysis method
Authors: Wang Guo Yun , Ahmad Shakeel , Wang Yong , Wang Bing Wei , Huang Jing Hua , Jahan Mohammad Shah , Zhou Xun Bo , Shi Cheng Qiao
Published: August 2022

Drought and flooding stress alternately and frequently occur in Guangxi, China, and the whole world, which seriously limit maize production. Few studies focus on the different responses and evaluations of maize to drought and flooding stresses. A pot experiment with 40 varieties was conducted under well water, drought and flooding stresses. A multivariate analysis method of principal component analysis, comprehensive evaluation value, correlation analysis, stepwise regression analysis, and cluster analysis was used to evaluate the resistance of maize. Most varieties had stronger drought resistance rather than flooding resistance because of the higher antioxidant enzyme activities, osmotic adjustment substances, less reactive oxygen species, and a greater than 1.0 drought-resistance coefficient. However, there was an increment of reactive oxygen species (especially O2−), ascorbate peroxidase, peroxidase, soluble sugar, and the decrement of superoxide dismutase, catalase, soluble protein, and a lower than 1.0 of flooding-resistance coefficient of most maize varieties in flooding stress compared with well water. The superoxide dismutase, peroxidase, catalase, ascorbate peroxidase, proline, soluble sugar and protein, plant height, leaf area/plant, and stem diameter were screened out to be accurate and representative indicators to evaluate the drought and flooding resistance of maize. The study provides an insight to comprehend the different mechanisms of maize in response to drought and flooding stresses and provides a multivariate analysis method for screening the resistance of maize germplasm which could be valuable for further research and breeding of drought and flooding resistances of maize.

One-sentence summary

A multivariate analysis method for the screening the resistance of maize germplasm and the different physiological mechanisms of drought and flooding stresses were revealed.
Functional organization of mouse auditory cortex in response to stimulus complexity and brain state
Authors: Afrashteh Navvab , Jafari Zahra , Sun Jianjun , Kyweriga Michael , Mohajerani Majid H.
Published: August 2022

The functional organization of sensory cortices is modulated by both extrinsic events and intrinsic states. The present study aimed to assess the mouse auditory cortex (AC) responses under varying conditions of stimulus complexity and brain state. Using wide-field calcium imaging, our results suggest a complete outline of topographic maps of frequency and FM rate as well as highly responsive regions to mouse ultrasonic vocalizations (USVs) in both awake and anesthetized states. Three new regions responsive to high-frequency tones and four new gradients responsive to frequency modulations (FMs) were identified. These maps are highly replicable across weeks and between animals. In awake versus anesthetized states, cortical responsiveness to pure tones was stronger, and regions that preferentially responded to slow rate FMs were smaller. In both states, fast FM regions showed the greatest contribution to the processing of USVs. Finally, our modeling of how best tone frequency or FM rate changes as a function of distance along a topographic gradient resulted in a sigmoid function. Together, our findings provide a better understanding of mouse AC functional organization and how this organization is modulated by changes in stimulus complexity and brain state. The function of newly identified regions in higher-order auditory/vocal processing and animal behavior should be considered in future research.
Negative legacy effects of past forest use on plant diversity in semi-natural grasslands on ski slopes
Authors: Yaida Yuki A. , Nagai Takuma , Oguro Kazuya , Katsuhara Koki R. , Uchida Kei , Kenta Tanaka , Ushimaru Atushi
Published: August 2022

Over the past century, grassland and forest ecosystems globally have been heavily influenced by land use changes driven by diverse socioeconomic activities. Ski resorts are a modern land-use type associated with biodiversity loss in mountain ecosystems worldwide. Below the treeline, by contrast, some ski slopes have been shown to provide suboptimal semi-natural habitats for native grassland plants and animals, depending on specific construction and management practices. We compared environmental factors and grassland vegetation between two types of ski slopes in central Japan with different land-use histories: slopes constructed on old pastures (pasture slopes) and slopes constructed by clearing secondary forests orLarix kaempferiplantations established on abandoned pastures during the 1940s–1990s (forest slopes). We examined the effects of land use history and machine grading as well as other environmental factors on ski slope vegetation, including total species richness and the richness of native, endangered, and exotic plants, using a total of 108 plots of 2 m × 10 m. Compared to pasture slopes, forest slopes exhibited significantly lower richness of total plants and native grassland species, including endangered species. Forest slopes were more graded than pasture slopes, resulting in lower native and higher exotic grassland species richness. A significantly lower duration of direct sunlight on forest slopes than on pasture slopes possibly decreased endangered species diversity. The lower species richness on forest slopes may be partly caused by seed dispersal limitations. Our findings demonstrate that ski slopes have good potential to support numerous native grassland plant species, including endangered species, but this potential is significantly and negatively affected by forest use history and concomitant environmental changes. The conservation of semi-natural conditions on pasture slopes as habitats for native grassland species can be promoted through the maintenance of annual mowing practices, avoidance of machine grading, and wider ski courses.

Nomenclature

Yonekura & Kajita (2003) BG Plants: index of Japanese names and scientific names (YList;http://ylist.info/index.html)
Itinerant lifestyle and congregation of lesser kestrels in West Africa
Authors: Lopez-Ricaurte Lina , Vansteelant Wouter M.G. , Hernández-Pliego Jesús , García-Silveira Daniel , Casado Susana , Garcés-Toledano Fernando , Martínez-Dalmau Juan , Ortega Alfredo , Rodríguez-Moreno Beatriz , Bustamante Javier
Published: August 2022

Migratory birds often spend a large proportion of their annual cycle in their non-breeding areas. While some species are sedentary after arriving in their non-breeding areas, others engage in itinerary or nomadic movements. Using GPS-tracking we aimed to investigate the little known non-breeding movements of the lesser kestrelFalco namumanniin sub-Saharan Africa. We segment non-breeding tracks (n = 78 tracks by 54 individuals) into staging events (131± 25 days), itinerant movements between staging sites (11 ± 10 days), and non-directed exploratory movements (6 ± 5 days). We then describe timing and directionality of itinerary movements by male and female kestrels, and explore shifts in habitat use throughout the non-breeding season. Regardless of sex, lesser kestrels spent on average 89% of the non-breeding season at 2-3 staging sites in West Africa. Upon arrival at the end of September, kestrels used disparate sites throughout the Sahel. By December, however, they congregated into two clearly delineated areas in Senegal and along the Malian-Mauritanian border. The birds stayed longer and showed greater daily activity in the latter areas, which were situated closer to wetlands compared to their first and intermediate ones. While 20 of 24 individuals tracked across multiple annual cycles showed consistent staging sites, a few switched between the Senegal and Mauritanian/Malian staging clusters. These results show that rather than tracking suitable climatic conditions southward, lesser kestrels survive the West African dry season by moving into wetland areas within the Sahelian climatic belt. Our findings match reports of lesser kestrel super-roosts in West Africa and stress the conservation value of wetlands along the Senegal River and the Inner Niger Delta in West Africa for the Spanish lesser kestrel population. These areas host 81% of lesser kestrels during 20% of their annual cycle.