bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstruction of gene regulatory networks for Caenorhabditis elegans using tree-shaped gene expression data
Authors: Wu Yida , Zhou Da , Hu Jie
Published: August 2024

Constructing gene regulatory networks is a widely adopted approach for investigating gene regulation, offering diverse applications in biology and medicine. A great deal of research focuses on using time series data or single-cell RNA-sequencing data to infer gene regulatory networks. However, such gene expression data lack either cellular or temporal information. Fortunately, the advent of time-lapse confocal laser microscopy enables biologists to obtain tree-shaped gene expression data of Caenorhabditis elegans, achieving both cellular and temporal resolution. Although such tree-shaped data provide abundant knowledge, they pose challenges like non-pairwise time series, laying the inaccuracy of downstream analysis. To address this issue, a comprehensive framework for data integration and a novel Bayesian approach based on Boolean network with time delay are proposed. The pre-screening process and Markov Chain Monte Carlo algorithm are applied to obtain the parameter estimates. Simulation studies show that our method outperforms existing Boolean network inference algorithms. Leveraging the proposed approach, gene regulatory networks for five subtrees are reconstructed based on the real tree-shaped datatsets of Caenorhabditis elegans, where some gene regulatory relationships confirmed in previous genetic studies are recovered. Also, heterogeneity of regulatory relationships in different cell lineage subtrees is detected. Furthermore, the exploration of potential gene regulatory relationships that bear importance in human diseases is undertaken. All source code is available at the GitHub repository https://github.com/edawu11/BBTD.git.
Role of Lugol solution before total thyroidectomy for Graves’ disease: randomized clinical trial
Authors: Schiavone Donatella , Crimì Filippo , Cabrelle Giulio , Pennelli Gianmaria , Sacchi Diana , Mian Caterina , Torresan Francesca , Iacobone Maurizio
Published: August 2024

Background

Lugol solution is often administered to patients with Graves’ disease before surgery. The aim is to reduce thyroid vascularization and surgical morbidity, but its real effectiveness remains controversial. The present study was designed to evaluate the effects of preoperative Lugol solution on thyroid vascularization and surgical morbidity in patients with Graves’ disease undergoing total thyroidectomy.

Methods

Fifty-six patients undergoing total thyroidectomy for Graves’ disease were randomly assigned to receive 7 days of Lugol treatment (Lugol+ group, 29) or no Lugol treatment (LS– group, 27) before surgery in this single-centre and single-blinded trial. Preoperative hormone and colour Doppler ultrasonographic data for assessing thyroid vascularization were collected 8 days before surgery (T0) and on the day of surgery (T1). The primary outcome was intraoperative and postoperative blood loss. Secondary outcomes included duration of surgery, thyroid function, morbidity, vascularization, and microvessel density at final pathology.

Results

No differences in demographic, preoperative hormone or ultrasonographic data were found between LS+ and LS– groups at T0. At T1, free tri-iodothyronine (FT3) and free thyroxine (FT4) levels were significantly reduced compared with T0 values in the LS+ group, whereas no such variation was observed in the LS– group. No differences between T0 and T1 were found for ultrasonographic vascularization in either group, nor did the histological findings differ. There were no significant differences between the LS+ and LS– groups concerning intraoperative/postoperative blood loss (median 80.5 versus 94 ml respectively), duration of surgery (75 min in both groups) or postoperative morbidity.

Conclusion

Lugol solution significantly reduces FT3 and FT4 levels in patients undergoing surgery for Graves’ disease, but does not decrease intraoperative/postoperative blood loss, thyroid vascularization, duration of surgery or postoperative morbidity.

Registration number

NCT05784792 (https://www.clinicaltrials.gov).
Implementing distinct spatial proteogenomic technologies: opportunities, challenges, and key considerations
Authors: Verstappe Bram , Scott Charlotte L
Published: August 2024

Our ability to understand the cellular complexity of tissues has been revolutionized in recent years with significant advances in proteogenomic technologies including those enabling spatial analyses. This has led to numerous consortium efforts, such as the human cell atlas initiative which aims to profile all cells in the human body in healthy and diseased contexts. The availability of such information will subsequently lead to the identification of novel biomarkers of disease and of course therapeutic avenues. However, before such an atlas of any given healthy or diseased tissue can be generated, several factors should be considered including which specific techniques are optimal for the biological question at hand. In this review, we aim to highlight some of the considerations we believe to be important in the experimental design and analysis process, with the goal of helping to navigate the rapidly changing landscape of technologies available.
Variations in head tilt during the acquisition of cone beam computed tomography scans and their effects on effective radiation dose
Authors: Mancini Arthur X M , Carmozini Gabriela A , Inácio Thiago M , Réa Marcela T , Viccari Cassiana , Brasil Danieli M , Oliveira-Santos Christiano
Published: August 2024

Objectives

This study evaluated the impact of variations in anteroposterior and lateral tilts of patients head on radiation-weighted doses to organs/tissues and effective doses using 3 different cone beam computed tomography (CBCT) machines.

Methods

An anthropomorphic phantom was used to estimate radiation doses in 3 CBCT machines (OP300, Eagle X 3D, and Eagle Edge). Thermoluminescent dosimeters were placed in regions corresponding to pre-stablished organ/tissues. CBCT examinations from the posterior mandible and anterior maxilla regions were acquired, with 3 different anteroposterior angulations (0°, 30°, and 45°), and from the posterior mandible in 3 different lateral angulations (0°, 20° to the left, and 20° to the right side). Radiation-weighted doses for each organ/tissue and effective doses were calculated for each machine and angulation.

Results

For the posterior mandible acquisitions, anteroposterior angulations of the head at 30° and 45° yielded a reduction in effective doses in all 3 devices. A 20° tilt to the right side resulted in lower doses than to the left [same side as the field of view (FOV)]. For the anterior maxilla, increased anteroposterior angulation was associated with reduction in effective dose in 2 devices.

Conclusions

Effective doses are lower when small FOV CBCT exams of the posterior mandible and anterior maxilla are acquired with increased anteroposterior head angulation at 30° and 45°. For FOV in the posterior mandible, a 20° lateral tilt towards the side opposite to the FOV also yields lower effective doses. The main contribution to these dose reductions is the decrease in dose to salivary glands.
Cardiac sarcoidosis manifesting with atrioventricular block and intracardiac masses: case report and literature review
Authors: Newman Noah , Garcia Mariana , Ayele Frehiywot , Gandiga Prateek , Bhatt Kunal
Published: August 2024

Background

Cardiac sarcoidosis (CS) typically manifests with atrioventricular block (AVB), ventricular arrhythmias, or heart failure. Intracardiac masses due to CS are rare, and there is both a paucity of evidence and guidelines of how manage them.

Case summary

We describe a 45-year-old woman who presented with palpitations and dyspnoea on exertion found to have second-degree AVB. Further work-up noted two right atrial masses that, following excision and pathology, were identified as CS. Within several months of immunosuppressive treatment, imaging and device reports demonstrated mass resolution without arrhythmia recurrence.

Discussion

Intracardiac masses are a rare manifestation of CS. Immunosuppressive therapy remains the mainstay of treatment, with consideration of mass resection for diagnostic purposes.
Associations Between Attachment and Depressive Symptoms Among Older Adults Living With Early-Stage Cognitive Impairment and Their Adult Children
Authors: Monin Joan K , Shah Maya , Chang Wei , Feeney Brooke C , Birditt Kira , Gaugler Joseph E , Vranceanu Ana Maria , Marottoli Richard
Published: August 2024

Objectives

This study examined the extent to which multiple relationship-specific attachment schemas (general, parent-child, and romantic) are interrelated and relate to depressive symptoms among older adults living with early-stage dementia and their adult children, a context likely to activate the attachment system.

Methods

The study consisted of 150 early-stage cognitively impaired parents and one child. Both self-reported general, parent-child, and romantic attachment anxiety as well as avoidance and depressive symptoms. Parents’ cognitive and functional impairment were assessed.

Results

Most attachment variables were interrelated for individuals, except that the child’s parent-child-specific avoidance was not associated with their general or romantic avoidance. The parent’s worse functional, but not cognitive, impairment was associated with the child’s greater parent-child-specific attachment anxiety. Using Actor Partner Interdependence Models, general attachment anxiety was associated with greater depressive symptoms (actor effects). When both dyad members were high in general avoidance, depressive symptoms were greatest (actor × partner effect). A parent had the greatest depressive symptoms when they were avoidantly attached to their child (role × actor effect) and their child was high in anxiety and low in avoidance toward them (role × partner effects). A child had the greatest depressive symptoms when they were low in avoidance toward the parent (role × actor effect) and the parent was low in anxiety and high in avoidance toward the child (role × partner effects). Romantic anxiety was associated with greater depressive symptoms (actor effects).

Discussion

Psychosocial interventions that incorporate attachment theory as a framework may benefit parent-child dyads coping with dementia.
Environmental factors and management practices associated with beef cattle carcass quality in the mid-west of Brazil
Authors: Amaral Thaís B , Le Cornec Alain P , Rosa Guilherme J M
Published: August 2024

The “Precoce MS” program, established by the Brazilian government in Mato Grosso do Sul in 2017, aims to encourage beef producers to harvest animals at younger ages to enhance carcass quality. About 40% of the beef produced in the state now comes from this program, which offers tax refunds ranging from 49% to 67% based on carcass classification and production system. Despite the program success, with participants delivering younger animals (with a maximum of 4 incisors), there remains significant variability in carcass quality. This paper investigates management practices and environmental factors affecting farm performance regarding carcass quality. Data from all animals harvested between the beginning of 2017 and the end of 2018 were analyzed, totaling 1,107 million animals from 1,470 farms. Farm performance was assessed based on the percentage of animals achieving grades “AAA” and “AA.” Each batch of harvested cattle from each farm was categorized into two groups: high farm performance (HFP, with more than 50% of animals classified as “AAA” or “AA”) and low farm performance (LFP, with less than 50% classified as such). A predictive logistic model was developed to forecast farm performance (FP) using 14 continuous and 15 discrete pre-selected variables. The most effective model, obtained through backward stepwise variable selection, had an R2 of 0.18, accuracy of 71.5%, and AUC of 0.715. Key predictors included animal category, production system type, carcass weight, individual identification, traceability system, presence of a feed plant, location, and the Normalized Difference Vegetation Index (NDVI) from the 12-mo average before harvest. Developing predictive models of carcass quality by integrating data from commercial farms with other sources of information (animal, production system, and environment) can improve our understanding of production systems, optimize resource allocation, and advance sustainable animal production. Additionally, they offer valuable insights for designing and implementing better sectorial, social, and environmental policies by public administrations, not only in Brazil but also in other tropical and subtropical regions worldwide.
Assessing Soybean Cultivar Resistance to Target Spot Using a Detached Leaf Assay
Authors: Wolf Rachael , Holland Robert , Rojas J. Alejandro , Fernandes Samuel , Fernandes Igor , Rupe John C.
Published: August 2024

Target spot (TS), caused by the fungus Corynespora cassiicola, is a foliar disease of increasing importance to soybean in the United States. Identifying cultivar resistance to TS is challenging. The objective of this research was to determine the reactions of a diverse collection of soybean genotypes to TS using a detached leaf inoculation method. A detached unifoliate leaf of each soybean genotype was placed in a Petri dish on moist filter paper, wounded at three locations, inoculated with 10 μl of a 105-conidial suspension of C. cassiicola, and incubated at room temperature (23°C). The percent leaf area with TS symptoms (TSS) was measured digitally at 7, 10, 14, and 17 days after inoculation (DAI), and the area under the disease progress curve (AUDPC) was calculated. Thirty-seven soybean genotypes and three soybean cultivars were evaluated in three replicated trials. At 17 DAI, TSS ranged from 2 to 84%. Significant differences occurred between soybean genotypes at each rating time in each trial. Across the three trials, the reaction of most soybean genotypes ranged from resistant to susceptible. These soybean genotypes were evaluated in the field with natural inoculum at two locations in 2022. TS developed late but differed significantly between genotypes, averaging from 0.35 to 3.35% TSS. Field results were not significantly correlated to the detached leaf results. The detached leaf assay is another tool for screening soybean genotypes for resistance to TS but needs field validation.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Hymenoptera venom allergy in children and adolescents
Authors: Norelli Francesca , Gueli Valentina , Bonadonna Patrizia
Published: August 2024

Purpose of review

This review will identify and summarize the published existing data pertaining specifically to Hymenoptera venom allergy in children and adolescents, highlighting the major studies currently available on venom immunotherapy (VIT) and its prognosis in children.

Recent findings

The current review covers the incidence and prevalence of Hymenoptera venom allergy (HVA) in children, factors influencing occurrence and severity of reactions (age, sex, comorbidities, etc.), indications to perform diagnostic tests and start VIT in children, different existing VIT protocols and their safety and efficacy.

Hymenoptera venom allergy is the second most common cause of anaphylaxis in children and it considerably affects quality of life. Cutaneous reactions are the most prevalent clinical presentation in children who usually have a more favourable prognosis than adult patients. However, studies on HVA in children and adolescents are still limited. Currently VIT is the only treatment able to modify the natural history of HVA in adults as well as in children, and to protect patients from systemic reactions after subsequent stings.
Ocular surface disorders: office procedures for the allergist/clinical immunologist
Authors: Norris Matthew Ryan , Katelaris Constance , Rosario Nelson , Delgado Luis , Leonardi Andrea , Bielory Leonard
Published: August 2024

Purpose of review

Ocular surface disorders (OSDs) are a prevalent and often debilitating condition encountered in clinical practice, particularly by allergists and clinical immunologists.

Recent findings

A comprehensive guide to office procedures for evaluating and managing OSDs, with a specific focus on ocular allergies, would assist in the evaluation process that begins with an initial patient assessment utilizing standardized forms to systematically gather detailed medical history, symptomatology, and environmental exposure data. This structured approach ensures a thorough understanding of the patient's condition and facilitates targeted interventions. In addition to allergy testing, the assessment of the tear film is essential for a comprehensive evaluation of OSDs. The Schirmer test is employed to quantify tear production, providing objective data on tear film adequacy and guiding interventions for tear film deficiencies.

This multifaceted diagnostic approach ensures that all contributing factors to OSDs are identified and appropriately managed. By integrating these office procedures, allergists and clinical immunologists can enhance their diagnostic accuracy and therapeutic efficacy, ultimately improving patient outcomes. This manuscript provides a practical resource, outlining some of the methodologies and clinical applications of each procedure, and highlighting their role in the holistic management of OSDs in allergic patients.
The Concept of Treatment-Refractory Addiction: Implications for Addiction Treatment Systems and Research
Authors: Nunes Edward V. , McLellan A. Thomas
Published: August 2024

The concept of treatment-refractory addiction, proposed by Eric Strain in this edition of the Journal, has the potential to invigorate the field of addiction treatment and research by focusing on a phenomenon that is familiar to any clinician treating patients with substance use disorders, namely, the patient who does not experience sufficient improvement from standard treatments. An analogy is drawn to the concept of treatment-resistant depression and the STAR*D study, which demonstrated an algorithmic approach to treatment, where if the first antidepressant medication tried did not result in remission from depression, subsequent trials of medications or cognitive behavioral therapy doubled the proportion of patients achieving remission. Recognizing treatment-refractory addiction challenges our field to develop analogous, stepwise, algorithmic approaches to treatment of substance use disorders, moving away from siloed treatment programs toward integrated treatment systems where alternative treatments are available, offering the kind of personalized, tailored forms of care used in the treatment of most other chronic illnesses. Like in STAR*D, research could focus on samples of patients who have not benefitted from initial trials of standard addiction treatments, addressing the key clinical question of what to do next when previous treatments fail.
Deep and Superficial Debridement Techniques in Lower Extremity Split-thickness Skin Grafting
Authors: Rohrich Rachel N. , Li Karen R. , Lava Christian X. , Alahmadi Sami , Stanton Henry L. , Kim Victoria H. , Spoer Daisy L. , Evans Karen K. , Steinberg John S. , Attinger Christopher E.
Published: August 2024

Background:

Patients with nonhealing lower extremity (LE) wounds often require a split-thickness skin graft (STSG) for closure. Nonviable tissue must be debrided before STSG inset. Our study aimed to compare differences in debridement depth on STSG outcomes.

Methods:

Chronic, atraumatic LE wounds receiving STSG from December 2014 to December 2022 at a single institution were reviewed. Demographics, wound characteristics, operative details, and outcomes were collected. Superficially debrided wounds were compared with wounds receiving deep debridement (DD), defined by debriding to the level of white tissue underlying the granulation tissue. Subanalysis was performed on wounds that had a negative and positive postdebridement culture. Primary outcome was graft failure.

Results:

Overall, 244 wounds in 168 patients were identified. In total, 158 (64.8%) wounds were superficially debrided and 86 (35.3%) received DD. The cohort had a median Charlson Comorbidity Index of 4 [interquartile range (IQR): 3]. Diabetes (56.6%) and peripheral artery disease (36.9%) were prevalent. The only statically significant demographic difference between groups was congestive heart failure (SD: 14.9% versus DD: 3.0%, P = 0.017). Wound size, depth, and all microbiology results were similar between groups. Postoperatively, the DD group demonstrated significantly less graft failure (10.5% versus 22.2%, P = 0.023). In a multivariate regression, DD was independently associated with lower odds of graft failure (OR: 0.0; CI, 0.0–0.8; P = 0.034). Sub-analysis of graft failure supported this finding in culture-positive wounds (DD: 7.6% versus DD: 22.1%, P = 0.018) but not in culture-negative wounds (13.6% versus 22.2%, P = 0.507).

Conclusions:

The DD technique demonstrates improved outcomes in chronic, culture-positive LE wounds receiving STSG.
Research Letter: Retrograde Amnesia and Posttraumatic Amnesia in Service Members and Veterans With Remote History of TBI
Authors: Lippa Sara M. , Gillow Kelly C. , Hungerford Lars D. , Bailie Jason M. , French Louis M. , Brickell Tracey A. , Lange Rael T.
Published: August 2024

Objective:

The recently updated American Congress of Rehabilitation Medicine diagnostic criteria for mild traumatic brain injury (mTBI) removed retrograde amnesia (RA) as a main criterion for mTBI, recommending it be included as a substitute criterion only when posttraumatic amnesia (PTA) cannot be reliably assessed. This study aimed to investigate the evidence base for this recommendation.

Setting:

Military treatment facility.

Participants:

A total of 752 US military service members/veterans (mean age = 36.1 years, SD = 9.4 years) with a history of TBI prospectively enrolled in the Defense and Veterans Brain Injury Center-Traumatic Brain Injury Center of Excellence 15-Year Longitudinal TBI study who sustained a total of 1015 TBIs with substantiated RA and PTA. Most participants were male (93.6%), not of Hispanic Origin (84.7%), and White (84.5%). Evaluations were conducted on average 7.6 years (SD = 6.9 years) after injury.

Design:

Case series.

Main Measures:

Presence and duration of RA and PTA; and ratio of PTA and RA (PTA:RA).

Results:

There were no TBIs where RA was present but PTA was absent. Within the 1015 TBIs, 896 (88.3%) involved both RA and PTA, 65 (6.4%) involved PTA only, and 54 (5.3%) did not involve RA or PTA. For the 635 TBI events with substantiated recorded minutes of RA and PTA both >0, the mean ratio of PTA:RA was 31:1. In only one instance was the ratio of PTA:RA <1.

Conclusion:

There were no TBIs where RA was present without PTA. RA tended to be much shorter than PTA. Findings support the American Congress of Rehabilitation Medicine’s decision to remove RA as a main criterion for mTBI.
Relationship Between Retinal Oxygen Saturation and the Severity of Visual Field Damage in Glaucoma
Authors: Mahmoudinezhad Golnoush , Moghimi Sasan , Micheletti Eleonora , Du Kelvin H. , Adelpour Mohsen , Latif Kareem , Walker Evan , Salcedo Matthew , Rubio Veronica , Weinreb Robert N.
Published: August 2024

Précis:

Increased oxygen saturation (StO2) was significantly associated with the severity of visual field (VF) damage in patients with glaucoma.

Objective:

To investigate the association between retinal StO2 percentage and the severity of VF loss in glaucoma.

Methods:

A total of 198 eyes from 131 patients with glaucoma were included in this cross-sectional study. Participants underwent imaging using ocular oximetry (Zilia) and 24-2 Swedish Interactive Threshold Algorithm standard VF (Carl Zeiss-Meditec). StO2 (%) was measured at 2 locations of the peripapillary optic nerve head (superotemporal, and inferotemporal). Measurements were reported as the mean of at least 5 measurements in each location. Associations between the severity of VF loss, reported as mean deviation, and StO2 (%) were calculated.

Results:

A total of 198 eyes of 131 patients (mean (95% CI) age, 71.1 (68.9,73.3) years, 68 females (51.9%), and 63 males (48.1%) were analyzed. In univariable analysis, higher StO2 −0.06 (−0.12, 0.00) was associated with severity in all hemifields (P = 0.047). Multivariate regression analysis showed that each 1% increase in StO2 was associated with −0.06 (−0.12, -0.00) dB loss in mean deviation in all hemifields (P = 0.043). In multivariate regression analysis in the superior hemifields, higher StO2 −0.07 (−0.16, 0.01) tended to be associated with superior hemifield severity (P = 0.09).

Conclusions:

Retinal oximetry enabled the continuous quantitative measurement of retinal StO2. Increased StO2 was significantly associated with the severity of VF damage in patients with glaucoma.
Development of an Acute Stroke Care Seeking Framework
Authors: Smith Fiona S. , Whisenant Meagan , Johnson Constance M. , Burnett Jason , Savitz Sean I. , Beauchamp Jennifer E. S.
Published: August 2024

BACKGROUND: A multitude of variables influence an individual's decision to seek care in emergency situations. By recognizing these variables and their impact on the timeline of an individual seeking care for a stroke, nurses have an opportunity to positively affect the outcomes of stroke within the community. The purpose of this narrative review was to develop a research framework describing the variables involved in care seeking during an acute stroke. METHODS: Using a theory synthesis methodology that included variable identification and the establishment of relationships between variables based on existing literature, a framework describing variables relevant to acute stroke care seeking behavior was developed. RESULTS: Fourteen recently published studies reported significant variables related to seeking emergency medical care during the hyperacute phase of a stroke. Eight variables were identified and characterized as either promoters or distractors. Promoters led an individual to seek acute stroke care earlier, such as perceived symptom severity, stroke knowledge, and the presence of others. Distractors led an individual to delay seeking acute stroke care and resulted in later hospital arrival times, such as a lack of social network or resources, comorbid conditions, and incongruity with the local health system. CONCLUSION: Although individual decision making is exceedingly complex and varies by individual and situation, the developed acute stroke care seeking framework may provide a basis on which to develop stroke awareness programs and interventions targeted at individuals at risk for delayed acute stroke care.
Fluid Management in Critically Ill Children: Single-Center Retrospective Comparison of Trauma and Postoperative Patients, 2020–2022*
Authors: Wu Yeu Sanz , Gennell Tania , Porigow Chloe , Fan Weijia , Rubsam Jeanne , Dorrello Nicolino Valerio , Stylianos Steven , Duron Vincent P.
Published: August 2024

OBJECTIVE:

Injury and surgery both represent well-defined starting points of a predictable inflammatory response, but the consequent response to IV fluids has not been studied. We aimed to review and compare our single-center fluid management strategies in these two populations.

DESIGN:

Retrospective cohort study from January 2020 to July 2022. The primary outcome was total IV fluid volume administered. Net fluid balances and select clinical outcomes were also evaluated.

SETTING:

Single tertiary academic center and level 1 pediatric trauma center in New York.

PATIENTS:

A dataset of critically ill trauma and surgical patients aged 0–18 years who were admitted to the PICU, 2020–2022. Trauma patients had at least moderate traumatic injuries (Injury Severity Score ≥ 9) and surgical patients had at least a 1-hour operation time.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We identified 25 trauma and 115 surgical patients. During the first 5 days of hospitalization, we did not identify an association between grouping and total IV fluids administered and fluid balance in the prehospital, emergency department, and operating room (p = 0.90 and p = 0.79), even when adjusted for weight (p = 0.96). Time trend graphs of net fluid balance and IV fluid administered illustrated analogous fluid requirement and response with the transition from net positive to net negative fluid balance between 48 and 72 hours. There was an association between total IV fluid and ventilator requirement (p = 0.003).

CONCLUSIONS:

Critically ill pediatric trauma and postoperative patients seem to have similar fluid management and balance after injury or surgery. In our opinion, these two critically ill populations could be combined in large prospective studies on optimal fluid therapy in critically ill children.
Surgeon Perception and Attitude Toward the Moral Imperative of Institutionally Addressing Second Victim Syndrome in Surgery
Authors: Hsiao Li-Hsuan , Kopar Piroska K
Published: August 2024

BACKGROUND:

Second victim syndrome (SVS) is described as when healthcare providers encounter significant moral distress after traumatic patient care events. Although broadly recognized in medicine, this remains underrecognized in surgery, and no systemic approaches exist to mitigate potential harms of SVS among surgeons. When SVS is left unaddressed, surgeons not only suffer personal psychological harm but their ability to care for future patients can also be compromised. The aim was to examine surgeons’ perceptions and attitudes regarding mitigation of SVS.

STUDY DESIGN:

This study was conducted at a tertiary-care university hospital using a mixed-methods approach coupling quantitative and qualitative assessments including a 13-item survey, follow-up focus group, and semistructured interviews, The Wilcoxon signed rank test was used for quantitative analysis and content analysis used to report qualitative findings.

RESULTS:

Surgeons believe SVS is a universal experience among surgeons that healthcare institutions have a moral obligation to address. Surgeons further believe that any effective mitigation strategy must receive legal protection similar to morbidity and mortality conferences. The culture, tenor, and tone of review processes after surgical complications can either reduce or exacerbate the burden of SVS. Successful interventions must be easily accessible, voluntary, and culturally acceptable. Surgeons may suffer greater SVS compared with nonprocedural physicians as adverse events can be inevitable in operation and may potentially be a high-frequency outcome depending on patient population.

CONCLUSIONS:

Surgeons agreed that healthcare organizations have a moral imperative to assist surgeons in navigating the psychosocial impacts of SVS after adverse surgical outcomes. The success of mitigation strategies was viewed as ethically relevant to patients and surgeons and dependent on the culture, tenor, and tone of the process.
Population structure of
Dugong dugon
across the Indo-Pacific revealed by historical mitogenomes
Authors: Furness Lydia Hildebrand , Kersten Oliver , Boilard Aurélie , Keith-Diagne Lucy , Brito Cristina , Barrett James H. , Kitchener Andrew , Sabin Richard , Lavery Shane , Plön Stephanie , Star Bastiaan
Published: August 2024

Sirenia
, an iconic marine taxon with a tropical and subtropical worldwide distribution, face an uncertain future. All species are designated ‘Vulnerable’ to extinction by the IUCN. Nonetheless, a comprehensive understanding of geographic structuring across the global range is lacking, impeding our ability to highlight particularly vulnerable populations for conservation priority. Here, we use ancient DNA to investigate dugong (
Dugong dugon
) population structure, analysing 56 mitogenomes from specimens comprising the known historical range. Our results reveal geographically structured and distinct monophyletic clades characterized by contrasting evolutionary histories. We observe deep-rooted and divergent lineages in the East (Indo-Pacific) and obtain new evidence for the relatively recent dispersal of dugongs into the western Indian Ocean. All populations are significantly differentiated from each other with western populations having approximately 10-fold lower levels of genetic variation than eastern Indo-Pacific populations. Additionally, we find a significant temporal loss of genetic diversity in western Indian Ocean dugongs since the mid-twentieth century, as well as a decline in population size beginning approximately 1000 years ago. Our results add to the growing body of evidence that dugong populations are becoming ever more susceptible to ongoing human action and global climate change.
Gilvimarinus gilvus sp. nov. and Gilvimarinus algae sp. nov., isolated from kelp seedlings
Authors: Sun Yang-Yang , Chen Rui-Ying , Zhou Zi-Yang , Gong Ya , Du Zong-Jun
Published: August 2024

Two novel rod-shaped, strictly aerobic, non-motile and Gram-stain-negative bacterial strains, designated SDUM040013T and SDUM040014T, were isolated from kelp seedlings in Weihai, PR China. Cells of strain SDUM040013T were 0.3–0.4 µm wide and 0.8–1.8 µm long, catalase-positive and oxidase-positive. Growth of SDUM040013T was observed at 0–37 °C (optimum, 28–30 °C) and pH 5.5–9 (optimum, pH 8.0) and in the presence of 1–8 % (w/v) NaCl (optimum, 2 %). The DNA G+C content of strain SDUM040013T was 50.5 %. Strain SDUM040013T showed the highest 16S rRNA gene sequence similarity (97.1 %) to Gilvimarinus chinensis. Cells of strain SDUM040014T were 0.4–0.5 µm wide and 1.0–1.4 µm long, catalase-positive and oxidase-positive. Growth of SDUM040014T was observed at 4–40 °C (optimum, 28–30 °C) and pH 5.5–9 (optimum, pH 8.5) and in the presence of 0–8 % (w/v) NaCl (optimum, 2 %). The DNA G+C content of strain SDUM040014T was 56.5 %. Strain SDUM040014T showed the highest 16S rRNA gene sequence similarity (96.2%) to Gilvimarinus polysaccharolyticus. The isoprenoid quinone of both strains was Q-8 and the predominant fatty acids were summed feature 3 (C16 : 1
 ω7c and/or C16 : 1
 ω6c), summed feature 8 (C18 : 1
 ω7c) and C16 : 0. Diphosphatidylglycerol, phosphatidylglycerol and phosphatidylethanolamine were the major polar lipids. Given these phenotypic and chemotaxonomic properties, as well as phylogenetic data, strains SDUM040013T and SDUM040014T were considered to represent two novel species of the genus Gilvimarinus, for which the names Gilvimarinus gilvus sp. nov. and Gilvimarinus algae sp. nov. are proposed. The type strains are SDUM040013T (=KCTC 8123T=MCCC 1H01413T) and SDUM040014T (=KCTC 8124T=MCCC 1H01414T), respectively.
Molecular characterization of Streptococcus pyogenes (StrepA) non-invasive isolates during the 2022–2023 UK upsurge
Authors: Hall Jennifer N. , Bah Saikou Y. , Khalid Henna , Brailey Alison , Coleman Sarah , Kirk Tracey , Hussain Naveed , Tovey Mark , Chaudhuri Roy R. , Davies Steve , Tilley Lisa , de Silva Thushan , Turner Claire E.
Published: August 2024

At the end of 2022 into early 2023, the UK Health Security Agency reported unusually high levels of scarlet fever and invasive disease caused by Streptococcus pyogenes (StrepA or group A Streptococcus). During this time, we collected and genome-sequenced 341 non-invasive throat and skin S. pyogenes isolates identified during routine clinical diagnostic testing in Sheffield, a large UK city. We compared the data with that obtained from a similar collection of 165 isolates from 2016 to 2017. Numbers of throat-associated isolates collected peaked in early December 2022, reflecting the national scarlet fever upsurge, while skin infections peaked later in December. The most common emm-types in 2022–2023 were emm1 (28.7 %), emm12 (24.9 %) and emm22 (7.7 %) in throat and emm1 (22 %), emm12 (10 %), emm76 (18 %) and emm49 (7 %) in skin. While all emm1 isolates were the M1UK lineage, the comparison with 2016–2017 revealed diverse lineages in other emm-types, including emm12, and emergent lineages within other types including a new acapsular emm75 lineage, demonstrating that the upsurge was not completely driven by a single genotype. The analysis of the capsule locus predicted that only 51 % of throat isolates would produce capsule compared with 78% of skin isolates. Ninety per cent of throat isolates were also predicted to have high NADase and streptolysin O (SLO) expression, based on the promoter sequence, compared with only 56% of skin isolates. Our study has highlighted the value in analysis of non-invasive isolates to characterize tissue tropisms, as well as changing strain diversity and emerging genomic features which may have implications for spillover into invasive disease and future S. pyogenes upsurges.
Causal Associations of Circulating Helicobacter pylori Antibodies with 5 Skin Disorders: A Mendelian Randomization Analysis
Authors: He Ao , Ni Yao , Qiao Na , Huang Wenli , Gan Fengshan , Gong Zhuo , Yang Xuesong , Zhao Xian
Published: August 2024

Helicobacter pylori (H. pylori) infection, a prevalent bacterial ailment affecting the stomach, has been linked to diverse gastrointestinal disorders. Nevertheless, the correlation between H. pylori infection and skin disorders has not been definitively established. We use Mendelian randomization analysis to explore causal relationships with seven pylori antibody levels and five skin diseases, such as rosacea, psoriasis, alopecia areata, pruritus and urticaria. The primary analytical method employed was inverse variance weighted (IVW), and a sensitivity analysis was executed to evaluate the robustness of the primary findings. The results revealed a positive causal relationship between H. pylori catalase antibody levels and AA (IVW: OR = 1.32, 95% CI = 1.07 to 1.61, P = 0.008), as well as a positive causal relationship between H. pylori UreA antibody levels and pruritus (IVW: OR = 1.17, 95% CI = 1.05 to 1.31, P = 0.006). These effects were robust to sensitivity analyses. Our results suggested that H. pylori infection was a risk factor for AA and pruritus. This finding may have implications for the prevention and treatment of these skin disorders.
Salicaceae endophyte inoculation alters stomatal patterning and improves the intrinsic water-use efficiency ofPopulus trichocarpaafter a water-deficit
Authors: Hendrickson Matthew , Banan Darshi , Tournay Robert , Bakker Jonathan D. , Doty Sharon L. , Kim Soo-Hyung
Published: August 2024

Microorganisms may enhance plant resilience to water stress by influencing their hosts’ physiology and anatomy at the leaf-level. Bacterial and yeast endophytes, isolated from wild poplar and willow, can improve the intrinsic water-use efficiency (iWUE) of cultivated poplar (Populus) under water-deficits by lowering stomatal conductance (gsw). However, the relevance of stomatal anatomy underlying this reduction remains unclear. We hypothesized endophyte inoculation could change host stomatal anatomy, and this would relate to decreases ingsw. We subjected Salicaceae endophyte-inoculated and uninoculatedPopulus trichocarpato well-watered and water-deficit treatments in greenhouse studies. We examined the changes of individual stomatal traits and related the composition of these parameters, termed stomatal patterning, to leaf gas-exchange under light saturation. After a water-deficit, inoculation improvediWUEat light saturation from preserving carbon assimilation (Anet) and loweringgsw, but these changes were independent of soil-moisture status. Drops ingswcorresponded to underlying shifts in stomatal patterning. Inoculated plants had smaller, more compact stomata and greater anatomical maximum stomatal conductance (gsmax) relative to the control. Salicaceae endophytes may alter stomatal density and size, loweringgswand increasingiWUE. Future efforts may quantify endophyte colonization of the host to draw direct relationships between microbes and stomatal traits.

HIGHLIGHT

Poplars inoculated with specific bacteria had leaves containing many, tiny pores relative to the trees without the microbes; these plants with the small, dense pores related to greater intrinsic water-use efficiency.
Factors determining hemoglobin levels in vaginally delivered term newborns at public hospitals in Lusaka, Zambia
Authors: Ogah Adenike Oluwakemi , Mwando Chrispin , Chanda Kenneth , Nganjo Selia
Published: August 2024

Background

Limited data is available regarding the prevalence of neonatal anemia and its associated risk factors in areas with constrained resources.

Subject and methods

In a cross-sectional study, data pertaining to socio-demographic and clinical characteristics of 489 mother-singleton, term newborn pairs were consecutively collected from the admission wards of six public hospitals in Lusaka. The information was then analyzed to determine the prevalence of newborn anemia and its associated risk factors. Newborn and maternal anemia were defined as hemoglobin levels below 15g/dl and 11g/dl, respectively. The relationship between the variables was explored using Chi-square tests and a binary logistic regression model. The findings were reported in terms of p-values, odds ratios, and 95% confidence intervals.

Results

The prevalence of anemia and severe anemia in newborns was 72.4% and 2.5% respectively, while in mothers it was 30.5% and 14.7% respectively. Delayed cord clamping was performed in 71.4% of the deliveries, and 86.5% of newborns had their hemoglobin levels estimated between 4-6 hours after birth. Maternal pre-delivery hemoglobin data were obtained from the hospital records of 246 (49.7%) out of the 489 mothers in the study. The majority (63.4%) of maternal hemoglobin levels were determined more than 4 weeks before delivery, and this infrequent hemoglobin assessment was significantly associated with newborn anemia (p<0.001; OR 3.60; 95% CI 1.81, 7.14). Additionally, 11% of the 489 mothers had underlying medical conditions, which were also significantly associated with newborn anemia (p=0.019; OR=2.96; [95%CI 1.20, 7.32]). The top three maternal medical conditions were HIV (35.2%), hypertension (25.9%), and Hepatitis B virus infection (13%). Maternal age was significantly associated with newborn anemia, with teenage pregnancy posing the highest risk (93.8%; p<0.001; OR 5.68; [95%CI 1.94, 16.60]). Furthermore, primiparous (p<0.001; OR 5.46 [95% CI 2.02, 14.93]), para 2 (p=0.014; OR=2.11 [95% CI 1.16, 3.83]), and multiparous (p=0.009; OR=4.77; [95% CI 1.48, 15.35]) mothers were more likely to produce anemic newborns compared to other parity. Newborns born before 40 weeks gestation were 3.11 times (95% CI 1.75, 5.52) more likely to have anemia, p<0.001, compared to full-term babies. Normal birthweight babies were less likely to become anemic compared to low birthweight babies (p=0.003; OR=0.31 [95% CI 0.14, 0.68]).

Conclusion

Enhanced antenatal care for pregnant mothers in resource-limited settings is essential, with particular focus on maternal hemoglobin, nutrition, and medical conditions. Attention should also be given to teenage pregnancy, primiparous and multiparous mothers, as well as preterm and low birthweight babies, to prevent newborn anemia and consequently reduce infant morbidity and mortality.
“It’s because they are my kids and I love them”: The impact of family and community substance use on children and families
Authors: Ford Meghan K , Truong Ryan , Knox Bruce , Bartels Susan , Davidson Colleen , Cole Michele , Jackson Logan , Purkey Eva , Bayoumi Imaan
Published: August 2024

Background

Substance use disorders (SUD) significantly impact the physical, social, and mental health of individuals, their families, and the wider community. Parental substance use can lead to long-term social and health problems for children. Examining resilience and its determinants among families directly affected by SUD (e.g., having a parent who misuses substances) or indirectly exposed to substance use (e.g., living in a community impacted by drug use) may uncover valuable insights to support families addressing SUD. The existing literature does not adequately address substance use within the context of families with young children and community resilience. The current study aims to enhance our understanding of the daily impact of family member substance use (direct substance use) or exposure to substance use within the community (indirect substance use) on children and families through qualitative interviews.

Methods

The present study was a qualitative secondary analysis. Families were recruited within the Kingston, Frontenac, Lennox, and Addington area during 2022 and 2023 with a focus on maximum variation. Families were eligible to participate if they: 1) included at least one adult caring for a child under 18; 2) had a history of adversity; 3) were interested in participating; and 4) could consent to all parts of the study. Arts-based qualitative methods and community based participatory methods were employed. Participating families created a visual timeline, participated in a focus group discussion, and an individual interview. The qualitative transcripts were then analyzed following reflexive thematic analysis.

Findings

Six families (12 adults, 4 children) were included in the secondary analysis. The analysis generated four themes: (1) How children affect resilience in families affected by SUD; (2) Service needs of parents with SUD to enhance family resilience; (3) The role of social support in family resilience; and (4) How perceptions of safety and trust challenge community resilience. The main limitation of this study was a small sample size.

Conclusions

The study highlights the significant impact of family and community on the resilience of individuals affected by SUD. It emphasizes the importance of developing addictions services and social environments that are supportive of families with young children. These spaces should be designed to be substance-free, inclusive, and welcoming to children. Additionally, there is a need to improve service navigation and address the barriers to care commonly experienced by individuals affected by SUD.
Selective regulation of IFN-γ and IL-4 co-producing unconventional T cells by purinergic signalling
Authors: Xu Calvin , Obers Andreas , Qin Minyi , Brandli Alice , Wong Joelyn , Huang Xin , Clatch Allison , Fayed Aly , Starkey Graham , D’Costa Rohit , Gordon Claire L , Beattie Lynette , Mackay Laura K. , Godfrey Dale I. , Koay Hui-Fern
Published: August 2024

Unconventional T cells, including mucosal-associated invariant T (MAIT), natural killer T (NKT), and gamma-delta T (γδT) cells, comprise distinct T-bet+, IFN-γ+and RORγt+, IL-17+subsets which play differential roles in health and disease. NKT1 cells are susceptible to ARTC2-mediated P2X7 receptor (P2RX7) activation, but the effects on other unconventional T-cell types are unknown. Here, we show that MAIT, γδT, and NKT cells express P2RX7 and are sensitive to P2RX7-mediated cell death. Mouse peripheral T-bet+MAIT1, γδT1, and NKT1 cells, especially in liver, co-express ARTC2 and P2RX7, which can be further upregulated by retinoic acid. Blocking ARTC2 or inhibiting P2RX7 protected MAIT1, γδT1, and NKT1 cells from cell death, enhanced their survivalin vivo, and increased the number of IFN-γ-secreting cells without affecting IL-17 production. Importantly, this revealed the existence of IFN-γ and IL-4 co-producing unconventional T-cell populations normally lost upon isolation due to ARTC2/P2RX7-induced death. Administering extracellular NADin vivoactivated this pathway, depleting P2RX7-sensitive unconventional T cells. Our study reveals ARTC2/P2RX7 as a common regulatory axis modulating the unconventional T-cell compartment, affecting the viability of IFN-γ- and IL-4-producing T cells, offering important insights to facilitate future studies into how these cells can be regulated in health and disease.