bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstruction method of computational ghost imaging under atmospheric turbulence based on deep learning
Authors: Xia Jingyao , Zhang Leihong , Zhai Yunjie , Zhang Yiqiang
Published: December 2023

Ghost imaging, as an emerging imaging method, has great advantages in harsh environment with its off-object imaging characteristics. In this paper, we use a turbulence model based compressive sensing computational ghost imaging system to simulate atmospheric turbulence, analyze the effects of various factors on the imaging results, and recover the images under extreme turbulence conditions using conditional generation adversarial network, which can finally recover the images well. The simulation results show that the image reconstruction method proposed in this paper can recover the image well under the condition of very low sampling rate (1.56%).
Maps of active layer thickness in northern Alaska by upscaling P-band polarimetric synthetic aperture radar retrievals
Authors: Whitcomb Jane , Chen Richard , Clewley Daniel , Kimball John S , Pastick Neal J , Yi Yonghong , Moghaddam Mahta
Published: December 2023

Extensive, detailed information on the spatial distribution of active layer thickness (ALT) in northern Alaska and how it evolves over time could greatly aid efforts to assess the effects of climate change on the region and also help to quantify greenhouse gas emissions generated due to permafrost thaw. For this reason, we have been developing high-resolution maps of ALT throughout northern Alaska. The maps are produced by upscaling from high-resolution swaths of estimated ALT retrieved from airborne P-band synthetic aperture radar (SAR) images collected for three different years. The upscaling was accomplished by using hundreds of thousands of randomly selected samples from the SAR-derived swaths of ALT to train a machine learning regression algorithm supported by numerous spatial data layers. In order to validate the maps, thousands of randomly selected samples of SAR-derived ALT were excluded from the training in order to serve as validation pixels; error performance calculations relative to these samples yielded root-mean-square errors (RMSEs) of 7.5–9.1 cm, with bias errors of magnitude under 0.1 cm. The maps were also compared to ALT measurements collected at a number of in situ test sites; error performance relative to the site measurements yielded RMSEs of approximately 11–12 cm and bias of 2.7–6.5 cm. These data are being used to investigate regional patterns and underlying physical controls affecting permafrost degradation in the tundra biome.
Unconfined mechanical properties and micromechanism of short-age recycled aggregate from road solid waste modified by waterborne polyurethane
Authors: Zhao Wenqin , Wang Yuxiang , Tian Qing , Yan Ping , Wu Yanting
Published: December 2023

In recent years, road waste treatment has become a hot topic, and how to solve and utilize these solid wastes is becoming an interesting research field. In order to explore the mechanical modification effect of waterborne polyurethane (PU) on short age road solid waste recycled aggregate, unconfined compression test and scanning electron microscope test were carried out on samples with different dry density and PU content. The dry density was 1.6 g cm−3, 1.7 g cm−3 and 1.8 g cm−3, and the PU content was 0%, 3%, 4%, 5% and 6%, respectively. The tested results show that, the strength of recycled aggregate (RA) increases with the increase of dry density. PU improves the strength and ductility of recycled aggregate (RA), and the residual strength and peak strength of RA increase with the increase of PU content. The peak strength and residual strength of waterborne polyurethane improved recycled aggregate (WPRA) increase with the increase of dry density, too. Polyurethane forms a three-dimensional network structure by film shape and linear shape, and its network structure can provide cohesion and effectively inhibit the crack propagation of the sample. The results demonstrate that adding appropriate amount of PU can effectively improve the mechanical properties of RA, which provides a technical reference for the recycling of RA.
Frictional performance of surface-textured phenolic resin-impregnated graphite materials under water lubrication
Authors: Xu Kaisong , Yuan Zhenyu , Luo Yan , Xie Yongkai , Xu Qingyao , Gao Xing , Xu Jimin
Published: December 2023

The frictional performance between impregnated graphite materials and YG-8 cemented carbide is investigated on a self-developed rotating-type tribometer. The test configuration is a cemented carbide plate rotating against the graphite surface. Three types of concave-type textures, including linear grooves, circular dimples and isosceles triangular dimples, are fabricated by laser process on the graphite surfaces to improve the tribological properties. The test environments include dry condition and water lubrication. The corresponding friction coefficients, surface micrographs of graphite samples and cemented carbide plates are analyzed. To reveal the underlying mechanism of the frictional modification effect under water lubrication, the formation of graphite transfer film on cemented carbide plates, the water contact angles of graphite surface and the hydrodynamic effect are further discussed. It is verified that the introduction of textures on graphite surfaces can significantly improve the tribological performance of water-lubricated graphite materials.
Electron density measurement by the three boundary channels of HCOOH laser interferometer on the HL-3 tokamak
Authors: MOU 牟 Junren 俊任 , LI 李 Yonggao 永高 , LI 李 Yuan 远 , WANG 王 Zaihong 再宏 , DING 丁 Baogang 宝钢 , WANG 王 Haoxi 浩西 , YI 易 Jiang 江 , SHI 石 Zhongbing 中兵
Published: December 2023

Far-infrared (FIR) interferometer is widely used to measure the electron density in the magnetically confined fusion plasma devices. A new FIR laser interferometer with a total of 13 channels (8 horizontal channels and 5 oblique channels) is under development on the HL-3 tokamak by using the formic-acid laser (HCOOH, f = 694 GHz). In order to investigate the boundary electron density activity during the divertor discharge, three horizontal interferometry channels located at Z = −97, −76, 76.5 cm have been successfully developed on HL-3 in 2023, and put into operation in recent experimental campaign, with a time resolution of < 1.0 μs and line-integrated electron density resolution of ~ 7.0 × 1016 m−2. This paper mainly focuses on the optical design of the three-channel interferometry system, as well as optical elements and recent experimental result on HL-3.
Seeing Black America in Iran
Authors: Baghoolizadeh Beeta
Published: December 2023

From the 1960s onwards, many Iranians closely followed Black American protests during the Civil Rights and Black Power movements in the United States. This period proved pivotal for Iranian understandings of race, where intellectuals, revolutionaries, and those in media would use US-centric histories of enslavement, racism, and Black Americans to erase nineteenth-century histories of enslavement and racism in Iran, tacitly displacing the existence of Black Iranians across the national landscape. Black American Muslims, particularly Malcolm X, emerged as the ideal form of Blackness. After the 1979 revolution, non-Black Iranians and the Iranian government would continue this focus on US-based racism through an official narrative that repeatedly defined racism as a US-only problem, ultimately cementing the erasures around histories of enslavement and Black Iranians that began with abolition in 1929. Through an analysis of speeches, memoirs, poetry, newspaper articles, photography, and other illustrated media, this article weaves together vignettes to demonstrate how the pervasiveness of racial hierarchies fashioned around US histories came to shift an Iranian vocabulary and conceptualization of race. This article traces the changes in racial discourse during the 1960s and 1970s, the 1979 revolution, and the Iran-Iraq War from an Iranian perspective.
Are disorders of consciousness ‘dis’connection or ‘dys’connection syndromes?
Authors: Edlow Brian L , Massimini Marcello
Published: December 2023

This scientific commentary refers to ‘Functional hub disruption emphasizes consciousness recovery in severe traumatic brain injury’, by Oujamaa et al. (https://doi.org/10.1093/braincomms/fcad319).
Judicial Capture
Authors: Mehmood Sultan , Ali Bakhtawar
Published: December 2023

We use data from Pakistan to establish a reciprocal exchange relationship between the judiciary and the government. We document large transfers in the form of expensive real estate from the government to the judiciary, and reciprocation in the form of pro-government rulings from the judiciary to the government. Our estimates indicate that the allocation of houses to judges increases pro-government rulings and reduces decisions on case merits. The allocation also incurs a cumulative cost of 0.03% of GDP to the government. However, it allows the government to expropriate additional land worth 0.2% of GDP in one year.
Impartiality and the Construction of Trust in Investor-State Dispute Settlement
Authors: Brekoulakis Stavros , Howard Anna
Published: December 2023

This article analyses impartiality in investor-State dispute settlement (ISDS) by identifying the way that the parties’ trust in arbitrators is constructed. Drawing on the findings of a large-scale empirical project, it questions the applicability of an orthodox judicial doctrine of impartiality to ISDS on the grounds that trust in arbitrators is constructed on a fundamentally different basis from that of trust in judges. The primary feature of a judicial doctrine of impartiality is that trust is founded on an absolutist approach to impartiality which is intended to ensure that judges have no predispositions to parties. In contrast, trust in ISDS is founded on the method of party appointment which is based on a very different assumption—that arbitrators’ predispositions can be valuable and appropriate in the decision-making process. The empirical findings show that the parties’ choice of a predisposed arbitrator is generally considered compatible with the understanding of impartiality in ISDS. Accordingly, this article calls for a new, and contextualised, approach which better corresponds to the fundamental value of trust in ISDS.
In situ microscopy techniques for understanding Li plating and stripping in solid-state batteries
Authors: Motoyama Munekazu
Published: December 2023

Solid-state batteries have potential to realize a rechargeable Li-metal anode. However, several challenges persist in the charging and discharging processes of the Li-metal anode, which require a fundamental understanding of Li plating and stripping across the interface of solid-state electrolytes (SEs) to address. This review overviews studies on Li-metal anodes in solid-state batteries using in situ observation techniques with an emphasis on Li electrodeposition and dissolution using scanning electron microscopy and SEs such as lithium phosphorus oxynitride and garnet-type compounds such as Li7La3Zr2O12. The previous research is categorized into three topics: (i) Li nucleation, growth and dissolution at the anode-free interface, (ii) electrochemical reduction of SE and (iii) short-circuit phenomena in SE. The current trends of each topic are summarized.
Detection of oxaliplatin- and cisplatin-DNA lesions requires different global genome repair mechanisms that affect their clinical efficacy
Authors: Slyskova Jana , Muniesa-Vargas Alba , da Silva Israel Tojal , Drummond Rodrigo , Park Jiyeong , Häckes David , Poetsch Isabella , Ribeiro-Silva Cristina , Moretton Amandine , Heffeter Petra , Schärer Orlando D , Vermeulen Wim , Lans Hannes , Loizou Joanna I
Published: December 2023

The therapeutic efficacy of cisplatin and oxaliplatin depends on the balance between the DNA damage induction and the DNA damage response of tumor cells. Based on clinical evidence, oxaliplatin is administered to cisplatin-unresponsive cancers, but the underlying molecular causes for this tumor specificity are not clear. Hence, stratification of patients based on DNA repair profiling is not sufficiently utilized for treatment selection. Using a combination of genetic, transcriptomics and imaging approaches, we identified factors that promote global genome nucleotide excision repair (GG-NER) of DNA-platinum adducts induced by oxaliplatin, but not by cisplatin. We show that oxaliplatin-DNA lesions are a poor substrate for GG-NER initiating factor XPC and that DDB2 and HMGA2 are required for efficient binding of XPC to oxaliplatin lesions and subsequent GG-NER initiation. Loss of DDB2 and HMGA2 therefore leads to hypersensitivity to oxaliplatin but not to cisplatin. As a result, low DDB2 levels in different colon cancer cells are associated with GG-NER deficiency and oxaliplatin hypersensitivity. Finally, we show that colon cancer patients with low DDB2 levels have a better prognosis after oxaliplatin treatment than patients with high DDB2 expression. We therefore propose that DDB2 is a promising predictive marker of oxaliplatin treatment efficiency in colon cancer.
Trends in Incidence of Carbapenem-Resistant Enterobacterales in 7 US Sites, 2016─2020
Authors: Duffy Nadezhda , Li Rongxia , Czaja Christopher A , Johnston Helen , Janelle Sarah J , Jacob Jesse T , Smith Gillian , Wilson Lucy E , Vaeth Elisabeth , Lynfield Ruth , O’Malley Sean , Vagnone Paula Snippes , Dumyati Ghinwa , Tsay Rebecca , Bulens Sandra N , Grass Julian E , Pierce Rebecca , Cassidy P Maureen , Hertzel Heather , Wilson Christopher , Muleta Daniel , Taylor Jacquelyn , Guh Alice Y
Published: December 2023

Background

We described changes in 2016─2020 carbapenem-resistant Enterobacterales (CRE) incidence rates in 7 US sites that conduct population-based CRE surveillance.

Methods

An incident CRE case was defined as the first isolation of Escherichia coli, Klebsiella spp., or Enterobacter spp. resistant to ≥1 carbapenem from a sterile site or urine in a surveillance area resident in a 30-day period. We reviewed medical records and classified cases as hospital-onset (HO), healthcare-associated community-onset (HACO), or community-associated (CA) CRE based on healthcare exposures and location of disease onset. We calculated incidence rates using census data. We used Poisson mixed effects regression models to perform 2016─2020 trend analyses, adjusting for sex, race/ethnicity, and age. We compared adjusted incidence rates between 2016 and subsequent years using incidence rate ratios (RRs) and 95% confidence intervals (CIs).

Results

Of 4996 CRE cases, 62% were HACO, 21% CA, and 14% HO. The crude CRE incidence rate per 100 000 was 7.51 in 2016 and 6.08 in 2020 and was highest for HACO, followed by CA and HO. From 2016 to 2020, the adjusted overall CRE incidence rate decreased by 24% (RR, 0.76 [95% CI, .70–.83]). Significant decreases in incidence rates in 2020 were seen for HACO (RR, 0.75 [95% CI, .67–.84]) and CA (0.75 [.61–.92]) but not for HO CRE.

Conclusions

Adjusted CRE incidence rates declined from 2016 to 2020, but changes over time varied by epidemiologic class. Continued surveillance and effective control strategies are needed to prevent CRE in all settings.
Microfinance and savings
Authors: Rutherford Stuart
Published: December 2023

The paper discusses the degree to which their longstanding informal savings practices influenced the way in which the unbanked poor responded to modern microfinance. The practices are described using evidence from the author’s many decades of talking to poor people about how they manage their money. The histories of four very different kinds of microfinance projects are reviewed to examine the extent to which they respect informal practices, and what the outcome was in terms of their success in offering good savings services to low-income households on a large scale. We see how a formal bank first showed how to offer a service comparable to popular ‘money guards’; how an NGO-led movement has demonstrated the effectiveness of introducing robust informal group-based savings-and-loan devices to populations that had not previously been using them; and how Bangladesh’s famous microcredit revolution eventually spawned a second microsavings revolution.
Management and treatment of children, young people and adults with systemic lupus erythematosus: British Society for Rheumatology guideline scope
Authors: Md Yusof Md Yuzaiful , Smith Eve M D , Ainsworth Sammy , Armon Kate , Beresford Michael W , Brown Morgan , Cherry Lindsey , Edwards Christopher J , Flora Kalveer , Gilman Rebecca , Griffiths Bridget , Gordon Caroline , Howard Paul , Isenberg David , Jordan Natasha , Kaul Arvind , Lanyon Peter , Laws Philip M , Lightsone Liz , Lythgoe Hanna , Mallen Christian D , Marks Stephen D , Maxwell Naomi , Moraitis Elena , Nash Clare , Pepper Ruth J , Pilkington Clarissa , Psarras Antonios , Rostron Heather , Skeates Jade , Skeoch Sarah , Tremarias Dalila , Wincup Chris , Zoma Asad , Vital Edward M
Published: December 2023

The objective of this guideline is to provide up-to-date, evidence-based recommendations for the management of SLE that builds upon the existing treatment guideline for adults living with SLE published in 2017. This will incorporate advances in the assessment, diagnosis, monitoring, non-pharmacological and pharmacological management of SLE. General approaches to management as well as organ-specific treatment, including lupus nephritis and cutaneous lupus, will be covered. This will be the first guideline in SLE using a whole life course approach from childhood through adolescence and adulthood. The guideline will be developed with people with SLE as an important target audience in addition to healthcare professionals. It will include guidance related to emerging approved therapies and account for National Institute for Health and Care Excellence Technology Appraisals, National Health Service England clinical commissioning policies and national guidance relevant to SLE. The guideline will be developed using the methods and rigorous processes outlined in ‘Creating Clinical Guidelines: Our Protocol’ by the British Society for Rheumatology.
Interaction of Whitefly Effector G4 with Tomato Proteins Impacts Whitefly Performance
Authors: Naalden Diana , Dermauw Wannes , Ilias Aris , Baggerman Geert , Mastop Marieke , Silven Juliette J. M. , van Kleeff Paula J. M. , Dangol Sarmina , Gaertner Nicolas Frédéric , Roseboom Winfried , Kwaaitaal Mark , Kramer Gertjan , van den Burg Harrold A. , Vontas John , Van Leeuwen Thomas , Kant Merijn R. , Schuurink Robert C.
Published: December 2023

The phloem-feeding insect Bemisia tabaci is an important pest, responsible for the transmission of several crop-threatening virus species. While feeding, the insect secretes a cocktail of effectors to modulate plant defense responses. Here, we present a set of proteins identified in an artificial diet on which B. tabaci was salivating. We subsequently studied whether these candidate effectors can play a role in plant immune suppression. Effector G4 was the most robust suppressor of an induced- reactive oxygen species (ROS) response in Nicotiana benthamiana. In addition, G4 was able to suppress ROS production in Solanum lycopersicum (tomato) and Capsicum annuum (pepper). G4 localized predominantly in the endoplasmic reticulum in N. benthamiana leaves and colocalized with two identified target proteins in tomato: REF-like stress related protein 1 (RSP1) and meloidogyne-induced giant cell protein DB141 (MIPDB141). Silencing of MIPDB141 in tomato reduced whitefly fecundity up to 40%, demonstrating that the protein is involved in susceptibility to B. tabaci. Together, our data demonstrate that effector G4 impairs tomato immunity to whiteflies by interfering with ROS production and via an interaction with tomato susceptibility protein MIPDB141.

[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 .
Flow induces common and specific transcriptional changes in renal tubular epithelial cells involving the PI3K pathway
Authors: Tröndle Kevin , Rizzo Ludovica , Pichler Roman , Zimmermann Stefan , Lienkamp Soeren S.
Published: December 2023

Flow‐induced shear stress affects renal epithelial cells in the nephron tubule with potential implications for differential functionalities of the individual segments. Disruptions of cellular mechanosensation or flow conditions are associated with the development and progression of various renal diseases. This study investigates the effects of flow on the transcriptome of various renal tubular epithelial cell types. We analyzed the transcriptome of induced renal epithelial cells (iREC) cultured under physiological flow (0.57 ± 0.05 dyn/cm2) or in static conditions for 72 h. RNA sequencing showed 861 differentially expressed genes (DEGs), with 503 up‐ and 358 downregulated under flow. DEGs were linked to extracellular matrix (ECM) components (e.g. Col1a1, Col4a3, Col4a4, Fn1, Smoc2), junctions (Gja1, Tubb5), channel activities (Abcc4, Aqp1), and transcription factors (Foxq1, Lgr6). Next, we performed a meta‐analysis comparing our data with three published datasets that subjected epithelial cell lines from distinct segments to flow, including proximal tubule and collecting duct cells. We found that TGF‐ß, p53, MAPK, and PI3K are common flow‐regulated pathways. Tfrc expression and thus the capability of iron uptake is commonly upregulated under flow. Many DEGs were related to kidney diseases, such as fibrosis (e.g. Tgfb1‐3 and Serpine1). To obtain further mechanistic insights we investigated the role of the PI3K pathway in flow sensing. Applying flow and inhibition of PI3K showed significantly altered expression of transcripts related to ECM remodeling, angiogenesis, and ion transport. This suggests that the PI3K pathway is a critical mediator in flow‐dependent cellular processes and gene expression, potentially influencing renal development and tissue remodeling. Finally, we derived a cross‐cell‐line summary of common as well as segment‐specific transcriptomic effects, thus providing insights into the molecular mechanisms underlying flow sensing in the nephron tubule.
Overcoming barriers to recognizing and reporting child abuse
Authors: Harding-Bremner Meredith
Published: December 2023

Infants and children under age 3 years have the highest risk of dying from child abuse and neglect. Clinicians treating children must recognize and report child abuse. Barriers to consistent recognition and reporting leave children in harm's way. Often, the signs of abuse in very young children are subtle, and clinicians may fail to recognize and report these signs. Clinicians also must understand the role of bias in the reporting of child abuse and ways to address abuse individually and as part of a larger system.
Mosquito-borne diseases in Pakistan: challenges, strategies, and future prospects
Authors: Fatima Tehreem , Habib Ashna , Khan Afsheen , Riaz Rumaisa , ul Haq Muhammad Zain , Raufi Nahid
Published: December 2023

Mosquito-borne diseases, notably malaria and dengue, present substantial health concerns in Pakistan, necessitating urgent and evidence-based strategies for prevention. The epidemiology of these diseases is influenced by climate change, inadequate vector control, and socioeconomic factors. Aedes mosquitoes are the primary vectors for dengue, while Anopheles mosquitoes transmit malaria. Vulnerable populations, including those in poverty-stricken areas, face higher risks. Prevention strategies encompass vector control, vaccinations, health education, and community engagement. Government initiatives emphasize healthcare infrastructure, community involvement, and inter-departmental coordination. However, challenges such as climate impact, urbanization, and public awareness gaps persist. Overcoming these challenges requires a multidimensional approach and sustained efforts to curb the spread of mosquito-borne diseases in Pakistan.
ALDOB/KAT2A interactions epigenetically modulate TGF-β expression and T cell functions in hepatocellular carcinogenesis
Authors: Yin Chunzhao , Zhang Cunzhen , Wang Yongqiang , Liu Guijun , Wang Ningning , Liang Ningning , Zhang Lili , Tu Qiaochu , Lv Jingwen , Jiang Huimin , Ma Haoran , Du Chenxi , Li Min , He Xuxiao , Chen Shiting , Guo Jiacheng , Li Shengxian , Qin Jun , Li Nan , Tao Yongzhen , Yin Huiyong
Published: December 2023

Background and Aims:

Cross talk between tumor cells and immune cells enables tumor cells to escape immune surveillance and dictate responses to immunotherapy. Previous studies have identified that downregulation of the glycolytic enzyme fructose-1,6-bisphosphate aldolase B (ALDOB) in tumor cells orchestrated metabolic programming to favor HCC. However, it remains elusive whether and how ALDOB expression in tumor cells affects the tumor microenvironment in HCC.

Approach and Results:

We found that ALDOB downregulation was negatively correlated with CD8+ T cell infiltration in human HCC tumor tissues but in a state of exhaustion. Similar observations were made in mice with liver-specific ALDOB knockout or in subcutaneous tumor models with ALDOB knockdown. Moreover, ALDOB deficiency in tumor cells upregulates TGF-β expression, thereby increasing the number of Treg cells and impairing the activity of CD8+ T cells. Consistently, a combination of low ALDOB and high TGF-β expression exhibited the worst overall survival for patients with HCC. More importantly, the simultaneous blocking of TGF-β and programmed cell death (PD) 1 with antibodies additively inhibited tumorigenesis induced by ALDOB deficiency in mice. Further mechanistic experiments demonstrated that ALDOB enters the nucleus and interacts with lysine acetyltransferase 2A, leading to inhibition of H3K9 acetylation and thereby suppressing TGFB1 transcription. Consistently, inhibition of lysine acetyltransferase 2A activity by small molecule inhibitors suppressed TGF-β and HCC.

Conclusions:

Our study has revealed a novel mechanism by which a metabolic enzyme in tumor cells epigenetically modulates TGF-β signaling, thereby enabling cancer cells to evade immune surveillance and affect their response to immunotherapy.
Limitations of GPT-4 as a geriatrician in geri-oncology case conference: A case series
Authors: Kuk Ling-Yuk , Kwong Dora Lai-Wan , Chan Wing-Lok Wendy , Shea Yat-Fung
Published: December 2023

Generative pre-trained transformer 4 (GPT-4) is an artificial intelligence (AI) system with a chat interface. The number of studies testing GPT-4 in clinical applications has been increasing. We hypothesized that GPT-4 would be able to suggest management strategies for medical issues in elderly oncology patients, similar to those provided by geriatricians. We compared the responses of GPT-4 to those of a geriatrician for four oncological patients. After these case conferences, none of the patients required admission for medical consultation. In three out of four scenarios, GPT-4 was able to offer a multidisciplinary approach in the first prompt. In all three scenarios, GPT-4 identified medication-related side effects and suggested appropriate medications in the first prompt. However, GPT-4 was unable to suggest initial dosages of medications to be used in the first prompt and was unable to suggest a more humanistic and non-pharmacological approach to anorexia, even with a follow-up prompt. In conclusion, GPT-4 may be used as a screening tool to provide potential rudimentary directions for management, which can then be reviewed by medical professionals before considering a formal consultation for more tailored and refined opinions from specialists.
Outcomes of selective non-operative management in adults with abdominal gunshot wounds: A systematic review and meta-analysis
Authors: Liu Tingwei , Fang Xiaohui , Bai Zhaohui , Liu Lu , Lu Hui , Qi Xingshun
Published: December 2023

Background and Aims:

Abdominal gunshot wounds (GSWs), a clinically devastating injury, can result in a variety of severe and lethal complications. Traditionally, exploratory laparotomy is the first-line approach for the management of abdominal GSWs, but associated with a considerable amount of unnecessary surgeries. At present, selective non-operative management (SNOM) of abdominal GSWs is becoming an effective and well-recognized approach, but remains widely disputed since many surgeons are skeptical about the validity of SNOM in clinical practice. This meta-analysis aims to estimate the outcomes of SNOM and immediate laparotomy in patients with GSWs by collecting the currently available evidence.

Methods:

The PubMed, EMBASE, and Cochrane Library databases were searched. A random-effects model was employed. Pooled proportion with 95% confidence intervals (CIs) was calculated. Heterogeneity was evaluated using the Cochran’s Q test and I2 statistics.

Results:

Overall, 53 studies involving 60,291 participants were included. The pooled proportions of SNOM and SNOM failure were 27.0% (95%CI=24.0%-30.0%) and 10.0% (95%CI=7.0%-13.0%), respectively. The pooled mortality after SNOM and SNOM failure were 0.0% (95%CI=0.0%-1.0%) and 0.0% (95%CI=0.0%-0.0%), respectively. The pooled proportions of immediate laparotomy and unnecessary immediate laparotomy were 73.0% (95%CI=70.0%-76.0%) and 10.0% (95%CI=8.0%-13.0%), respectively. The pooled mortality after immediate laparotomy and unnecessary immediate laparotomy were 10.0% (95%CI=8.0%-13.0%) and 0.0% (95%CI=0.0%-1.0%), respectively. Heterogeneity was statistically significant in nearly all meta-analyses.

Conclusion:

Immediate laparotomy is still the mainstay approach for the management of abdominal GSWs. Approximately one third of patients with abdominal GSWs undergo SNOM. SNOM failure is not frequent and its related mortality is also rare.
A Case of Metastatic Renal Cell Carcinoma to the Maxillary Sinus Initially Presenting as Recurrent Epistaxis
Authors: Mehr Justin P. , Blum Kyle A. , Jones William S. , Maithel Neha , Citardi Martin J. , Canfield Steven
Published: December 2023

Metastatic neoplasms to the sinonasal tract are rare. Here, we report the case of a 74-year-old woman with no notable oncological history, presenting to the emergency department with a 3-week history of intermittent epistaxis. CT and MRI revealed a right-sided sinonasal tract mass with histopathological analysis revealing cells of clear cell renal cell carcinoma origin. Full-body CT revealed a 4.9-cm L renal mass for which cytoreductive nephrectomy was performed after immunotherapy. The patient experienced recurrence of the sinonasal mass 14 months from initial discovery, for which they continue to follow with our multidisciplinary cancer care team.
Utilization of Instagram by Urology Residency Programs for Applicant Recruitment
Authors: Li Oscar , Grutman Aurora , Rabinowitz Matthew , Clifton Marisa
Published: December 2023

Purpose:

To assess Instagram content and trends by urology residency programs.

Materials and Methods:

A cross-sectional analysis of urology residency program Instagram accounts was completed after data collection between October 1 and 20, 2022. Included accounts were reviewed and descriptive details were recorded, such as number of followers, those followed, and post content. All posts were then coded on a predetermined list of 7 categories: (1) resident promotion; (2) faculty/departmental promotion; (3) activities outside medicine; (4) research, presentation, or awards; (5) urology match/application-related promotion; (6) “urology in general”; and (7) other.

Results:

Overall, 66 of 147 (44.9%) programs had an account at the time of analysis. About half (31 of 66, 47%) of accounts were created between June and December 2020. Accounts had a median of 633 followers (IQR: 254,844) and 39 posts (IQR: 18,64). Of the 3236 posts analyzed, the majority featured residents or activities outside medicine; video posts were least used. Posts promoting residents had significantly higher average likes per post compared with all other categories except posts about “urology in general.”

Conclusions:

To our knowledge, this is the first study analyzing the use of Instagram by urology residency programs for recruitment. Our study describes an increasing number of urology residency program Instagram accounts for showcasing residents and life outside of medicine to engage with followers.
International Survey on Mechanical Ventilation During Extracorporeal Membrane Oxygenation
Authors: van Minnen Olivier , Jolink Floris E.J. , van den Bergh Walter M. , Droogh Joep M. , Oude Lansink-Hartgring Annemieke ,   on behalf of the Dutch ECLS Study Group
Published: December 2023

The optimal ventilation strategy for patients on extracorporeal membrane oxygenation (ECMO) remains uncertain. This survey reports current mechanical ventilation strategies adopted by ECMO centers worldwide. An international, multicenter, cross-sectional survey was conducted anonymously through an internet-based tool. Participants from North America, Europe, Asia, and Oceania were recruited from the extracorporeal life support organization (ELSO) directory. Responses were received from 48 adult ECMO centers (response rate 10.6%). Half of these had dedicated ventilation protocols for ECMO support. Pressure-controlled ventilation was the preferred initial ventilation mode for both venovenous ECMO (VV-ECMO) (60%) and venoarterial ECMO (VA-ECMO) (34%). In VV-ECMO, the primary goal was lung rest (93%), with rescue therapies commonly employed, especially neuromuscular blockade (93%) and prone positioning (74%). Spontaneous ventilation was typically introduced after signs of pulmonary recovery, with few centers using it as the initial mode (7%). A quarter of centers stopped sedation within 3 days after ECMO initiation. Ventilation strategies during VA-ECMO focused less on lung-protective goals and transitioned to spontaneous ventilation earlier. Ventilation strategies during ECMO support differ considerably. Controlled ventilation is predominantly used initially to provide lung rest, often facilitated by sedation and neuromuscular blockade. Few centers apply “awake ECMO” early during ECMO support, some utilizing partial neuromuscular blockade.
Left Ventricular Assist Device With External Iliac Artery Outflow Graft Anastomosis
Authors: Maigrot Jean-Luc A. , Soltesz Edward G.
Published: December 2023

Durable left ventricular assist devices (LVADs) are a cornerstone therapy for patients with end-stage heart failure, and thus efforts to develop techniques that facilitate their use in an expanded population of patients are critical. Although the preferred outflow graft anastomosis site is the ascending aorta, alternative sites have been described including the descending thoracic and supraceliac abdominal aorta, as well as the innominate and axillary arteries. However, these vessels can be unfavorable targets in the setting of atherosclerosis, aneurysm, insufficient caliber, dissection, or complicated anatomy due to prior interventions. We present the case of a patient undergoing destination therapy LVAD implantation who had a complex surgical history leaving these targets unviable and thus necessitating selection of an alternative site. In this case, the right external iliac artery was successfully used for LVAD outflow graft anastomosis.
The immunogenicity of an HIV-1 Gag conserved element DNA vaccine in people with HIV and receiving antiretroviral therapy
Authors: Jacobson Jeffrey M. , Felber Barbara K. , Chen Huichao , Pavlakis George N. , Mullins James I. , De Rosa Stephen C. , Kuritzkes Daniel R. , Tomaras Georgia D. , Kinslow Jennifer , Bao Yajing , Olefsky Maxine , Rosati Margherita , Bear Jenifer , Heptinstall Jack R. , Zhang Lu , Sawant Sheetal , Hannaman Drew , Laird Gregory M. , Cyktor Joshua C. , Heath Sonya L. , Collier Ann C. , Koletar Susan L. , Taiwo Babafemi O. , Tebas Pablo , Wohl David A. , Belaunzaran-Zamudio Pablo F. , McElrath M. Juliana , Landay Alan L. ,   ACTG 5369 Study Team
Published: December 2023

Objective:

The primary objective of the study was to assess the immunogenicity of an HIV-1 Gag conserved element DNA vaccine (p24CE DNA) in people with HIV (PWH) receiving suppressive antiretroviral therapy (ART).

Design:

AIDS Clinical Trials Group A5369 was a phase I/IIa, randomized, double-blind, placebo-controlled study of PWH receiving ART with plasma HIV-1 RNA less than 50 copies/ml, current CD4+ T-cell counts greater than 500 cells/μl, and nadir CD4+ T-cell counts greater than 350 cells/μl.

Methods:

The study enrolled 45 participants randomized 2 : 1 : 1 to receive p24CE DNA vaccine at weeks 0 and 4, followed by p24CE DNA admixed with full-length p55Gag DNA vaccine at weeks 12 and 24 (arm A); full-length p55Gag DNA vaccine at weeks 0, 4, 12, and 24 (arm B); or placebo at weeks 0, 4, 12, and 24 (arm C). The active and placebo vaccines were administered by intramuscular electroporation.

Results:

There was a modest, but significantly greater increase in the number of conserved elements recognized by CD4+ and/or CD8+ T cells in arm A compared with arm C (P = 0.014). The percentage of participants with an increased number of conserved elements recognized by T cells was also highest in arm A (8/18, 44.4%) vs. arm C (0/10, 0.0%) (P = 0.025). There were no significant differences between treatment groups in the change in magnitude of responses to total conserved elements.

Conclusion:

A DNA-delivered HIV-1 Gag conserved element vaccine boosted by a combination of this vaccine with a full-length p55Gag DNA vaccine induced a new conserved element-directed cellular immune response in approximately half the treated PWH on ART.
Promising developments in gonococcal vaccines
Authors: Waltmann Andreea , Chen Jane S. , Duncan Joseph A.
Published: December 2023

Purpose of review

While effective vaccines to prevent invasive infections by Neisseria meningitidis have been deployed around the world, development of a vaccine to prevent Neisseria gonorrhoeae has lagged. After multiple failed vaccine candidates, vaccine development for N. gonorrhoeae is showing promise for the first time in several decades. This review highlights recent progress in the field.

Recent findings

Vaccines containing outer-membrane vesicles (OMV) have been used to manage outbreaks of the serogroup B N. meningitidis in a number of countries. Epidemiologic studies indicate these vaccination campaigns were associated with reductions in reported N. gonorrhoeae infections. Recently, a serogroup B N. meningitidis vaccine containing both recombinant antigens and OMV has been licensed through much of the world. Epidemiologic studies also demonstrate associations between 4CMenB immunization and reduced N. gonorrhoeae infections. Additionally, mathematical modeling studies have begun to identify potential strategies for vaccine deployment to maximize reduction of infections.

After several decades with little progress towards an effective gonococcal vaccine, large observational studies have provided evidence that a new generation of group B N. meningitidis vaccines containing OMV have serendipitously restarted the field. Ongoing clinical trials will soon provide definitive evidence regarding the efficacy of these vaccines in preventing N. gonorrhoeae infection.
68Ga-PSMA-11 Uptake in a Large Fibroadenoma in a Male Axillary Accessory Breast
Authors: Solanki Ritanshu , Mittal Bhagwant Rai , Kumar Rajender , Singh Harmandeep , Sekar Aravindh , Dahiya Divya
Published: December 2023

Prostate-specific membrane antigen PET imaging has revolutionized the role of prostate cancer diagnosis and management, with very high sensitivity and specificity. To prevent misdiagnosis and for accurate therapy planning, prostate-specific membrane antigen (PSMA) uptake in nonprostatic diseases needs to be recognized correctly. Besides the physiological PSMA expression, 68Ga-PSMA-11 uptake has been mentioned in multiple oncological and nononcological lesions. The present case report exhibits 68Ga-PSMA-11 uptake in fibroadenoma in a male accessory breast in the right axillary region.
Unusual Perineal Metastasis in a Case of Prostate Cancer on 68Ga-PSMA-11 PET/CT
Authors: Solanki Ritanshu , Mittal Bhagwant Rai , Kumar Rajender , Sekar Aravindh , Kumar Narender
Published: December 2023

Prostate cancer is the fifth leading cause of death in the male population worldwide. 68Ga-PSMA PET/CT has proved to be an excellent modality with greater accuracy for nodal and bone/visceral metastases staging than bone scintigraphy and CT scan, with high sensitivity and specificity. Common sites of metastasis include bone (84%), lymph nodes (10.6%), liver (10.2%), lung, and pleura (9.1%); however, metastasis to the skin is quite rare (≤0.36%). The present case demonstrates PSMA-avid perineal metastasis in a patient of prostate cancer postchemoradiotherapy on 68Ga-PSMA PET/CT scan.
Staphylococcus Great Britain and Ireland 2023 (StaphGBI 2023) Conference Report
Authors: O'Gara James P. , Zeden Merve S.
Published: December 2023

Since 1997,

Staphylococcus

Great Britain and Ireland (StaphGBI) conferences have brought together the

Staphylococcus

research community in the UK and Ireland. The 12th StaphGBI conference, hosted by University of Galway 22–23 June 2023, was co-chaired by Dr Merve S. Zeden and Professor James P. O’Gara, supported by a local organizing committee of Chloe Hobbs-Tobin, Dr Rakesh Roy, Órla Burke and Aaron Nolan. Anchored by keynote speaker Professor Vinai Thomas, all other StaphGBI 2023 oral and post presentations were delivered by early career researchers. The conference attracted approximately 100 delegates, including 72 MRes/PhD students and postdoctoral fellows, 22 principal investigators and 4 exhibitors. The mix of scientists, clinicians and early career researchers stimulated excellent discussions on key issues and challenges in the

Staphylococcus

field.

Staphylococcus aureus

interactions with the host immune system, antimicrobial resistance (AMR) and new therapeutic approaches using antimicrobial peptides or metabolites, chronic wound and device-associated infections, and improving our understanding of staphylococcal genomics were common themes at StaphGBI 2023.
Variovorax durovernensis sp. nov., a novel species isolated from an infected prosthetic aortic graft in a human
Authors: Alcolea-Medina Adela , Snell Luke B. , Payne Lara , Alder Christopher J. , Turnbull Jake D. , Charalampous Themoula , Bryan Lisa , Klein John L. , Edgeworth Jonathan D. , Batra Rahul , Goodman Anna L.
Published: December 2023

A novel bacterial strain, GSTT-20T was isolated from an infected, prosthetic endovascular graft explanted from a shepherd in London, United Kingdom. This strain was an aerobic, catalase-positive, oxidase-negative, Gram-stain-negative, motile, curved rod. It grew on blood agar, chocolate agar and MacConkey agar incubated at 37 °C in an aerobic environment after 48 h, appearing as yellow, mucoid colonies. Analysis of the complete 16S rRNA gene sequence showed closest similarity to

Variovorax paradoxus

with 99.6 % identity and

Variovorax boronicumulans

with 99.5 % identity. Phylogenetic analysis of the 16S rRNA gene sequence and phylogenomic analysis of single nucleotide polymorphisms within 1530 core genes showed GSTT-20T forms a distinct lineage in the genus

Variovorax

of the family

Comamonadaceae

. In silico DNA–DNA hybridization assays against GSTT-20T were estimated at 32.1 % for

V. boronicumulans

and 31.9 % for

V. paradoxus

. Genome similarity based on average nucleotide identity was 87.50 % when comparing GSTT-20T to

V. paradoxus

. Based on these results, the strain represented a novel species for which the name Variovorax durovernensis sp. nov. was proposed. The type strain is GSTT-20T (NCTC 14621T=CECT 30390T).
Folic acid prevents interferon-induced iron accumulation and ferroptosis and improves liver health in children with biliary atresia
Authors: Xu Yanhui , Chen Xixi , Fang Rongli , Ning Yu , Zhu Zhijun , Wang Xiaolei , Xiao Yunnan , Li Xiaotian , Ren Huifang , Zhang Yanfang , Zuo Xiaoyu , Chai Chengwei , Zhong Kanghua , Liang Jiankun , Liang Qifeng , Luo Yuanyuan , Xu Yi , Liao Kaili , He Qiuming , Tan Xuying , Ye Qingqing , Lin Zefeng , Han Yang , Luo Zhenhua , Gu Xiaoqiong , Zhang Yan , Sun Liying , Bai Fan , Liu Jinbao , Lv Junqiang , Yao Zhi , Lew Andrew M , Xia Huimin , Zhou Wenhao , Wen Zhe , Chen Zhanghua , Zhang Yuxia
Published: December 2023

Background & Aims

Biliary atresia (BA) is an obstructive newborn jaundice disease that leads to liver failure in the majority of affected infants. Viral infection is an important environmental trigger of BA. The aim of the study is to establish how viral infection rewires the cellular and metabolic processes of the digestive systems in at-risk infants and leads to BA development.

Methods

Single cell RNA (scRNA) transcriptomes and V(D)J sequences were generated using small intestine and liver biopsies from BA and control infants. Candidate risk genes were identified by genome-wide association study. Patient specimens, mouse model of experimental biliary atresia, and a myeloid-specificFolr2knockout mice (folr2Mko) were used to determine immune pathologies that lead to BA development. An open label clinical trial was conducted to determine the therapeutic effect of folic acid on post-Kasai’s outcomes of patients with BA.

Results

Type I interferon (IFN-I) signaling is persistently activated in infants with BA. This promotes expression of hepcidin in hepatic TREM2+macrophages and hepatocytes, which impairs SLC40A1-mediated iron excretion from the small intestine, leading to iron accumulation, lipid peroxidation, dysbiosis and folic acid deficiency. By genetic ablation ofFolr2,we show that folinate supplementation halts persistent IFN-I activation and suppresses hepcidin expression by TREM2+macrophages. In an open label clinical study, folic acid supplementation decreased post-Kasai’s cholangitis incidences and liver transplantation rates by 70%.

Conclusion

Persistent IFN-I signaling plays a critical role in virally induced pathological jaundice in infants, and that folic acid supplementation is an effective therapy for BA.
GPT-4 and Neurologists in Screening for Mild Cognitive Impairment in the Elderly: A Comparative Analysis Study
Authors: Yang Hao , Wang Ruihan , Wang Changyu , Gao Hui , Cai Hanlin , Zhang Fengying , Liu Jialin , Liu Siru
Published: December 2023

This study evaluates the efficacy of GPT-4 in screening for Mild Cognitive Impairment (MCI) in the elderly, comparing it with junior neurologists. MCI is a precursor to dementia, presenting a significant public health concern due to the rising global aging population. With over 55 million people affected by dementia worldwide, early detection is essential for timely intervention. Common screening tools, while effective, are resource-intensive, highlighting the need for more efficient methods. The study used an exploratory design with 174 participants, comparing the performance of GPT-4 against three junior neurologists. The GPT-4 model was trained using a set of language analysis indicators to evaluate the severity of MCI. Participants’ test texts and voices were grouped and independently assessed by the neurologists and the GPT-4 model. The neurologists and the GPT-4 model independently assessed the participants’ test corpus. The neurologists assessed both the text and voice of the test, while the GPT model assessed the text only. Results showed that the GPT-4 model had higher accuracy (0.81) compared to the neurologists (ranging from 0.41 to 0.49). GPT-4 demonstrated better discrimination of MCI with significant statistical difference (p < 0.001). The study also developed a clinical risk assessment nomogram based on the top ten weighted features from GPT-4’s analysis, aiding in MCI patient evaluation. In conclusion, the GPT-4 model shows promise as a diagnostic aid for MCI, potentially improving patient outcomes and reducing healthcare burdens. However, its practical applicability in real-world scenarios requires further investigation and clinical validation.