bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic evidence for causal relationships between age at natural menopause and the risk of ageing-associated adverse health outcomes
Authors: Lankester Joanna , Li Jin , Salfati Elias Levy Itshak , Stefanick Marcia L , Chan Kei Hang Katie , Liu Simin , Crandall Carolyn J , Clarke Shoa L , Assimes Themistocles L
Published: November 2022

Background

A later age at natural menopause (ANM) has been linked to several ageing-associated traits including an increased risk of breast and endometrial cancer and a decreased risk of lung cancer, osteoporosis and Alzheimer disease. However, ANM is also related to several proxies for overall health that may confound these associations.

Methods

We investigated the causal association of ANM with these clinical outcomes using Mendelian randomization (MR). Participants and outcomes analysed were restricted to post-menopausal females. We conducted a one-sample MR analysis in both the Women’s Health Initiative and UK Biobank. We further analysed and integrated several additional data sets of post-menopausal women using a two-sample MR design. We used ≤55 genetic variants previously discovered to be associated with ANM as our instrumental variable.

Results

A 5-year increase in ANM was causally associated with a decreased risk of osteoporosis [odds ratio (OR) = 0.80, 95% CI (0.70–0.92)] and fractures (OR = 0.76, 95% CI, 0.62–0.94) as well as an increased risk of lung cancer (OR = 1.35, 95% CI, 1.06–1.71). Other associations including atherosclerosis-related outcomes were null.

Conclusions

Our study confirms that the decline in bone density with menopause causally translates into fractures and osteoporosis. Additionally, this is the first causal epidemiological analysis to our knowledge to find an increased risk of lung cancer with increasing ANM. This finding is consistent with molecular and epidemiological studies suggesting oestrogen-dependent growth of lung tumours.
Factors Associated With Vaccine-Induced T-Cell Immune Responses Against Severe Acute Respiratory Syndrome Coronavirus 2 in Kidney Transplant Recipients
Authors: Tometten Inga , Landmann Sinje , Kantauskaite Marta , Lamberti Joshua , Hillebrandt Jonas , Müller Lisa , Kittel Margarethe , Kolb Thilo , Ivens Katrin , Schmitz Michael , Voges Anja , Adams Ortwin , Andrée Marcel , Schaal Heiner , Lübke Nadine , Königshausen Eva , Rump Lars Christian , Stegbauer Johannes , Timm Jörg
Published: November 2022

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important prophylactic measure in kidney transplant recipients (KTRs), but the immune response is often impaired. Here, we examined the T-cell immune response against SARS-CoV-2 in 148 KTRs after 3 or 4 vaccine doses, including 35 KTRs with subsequent SARS-CoV-2 infection. The frequency of spike-specific T cells was lower in KTRs than in immunocompetent controls and was correlated with the level of spike-specific antibodies. Positive predictors for detection of vaccine-induced T cells were detection of spike-specific antibodies, heterologous immunization with messenger RNA and a vector vaccine, and longer time after transplantation. In vaccinated KTRs with subsequent SARS-CoV-2 infection, the T-cell response was greatly enhanced and was significantly higher than in vaccinated KTRs without SARS-CoV-2 infection. Overall, the data show a correlation between impaired humoral and T-cell immunity to SARS-CoV-2 vaccination and provide evidence for greater robustness of hybrid immunity in KTRs.
Housing Insecurity and Homelessness: Evidence from the United Kingdom
Authors: Fetzer Thiemo , Sen Srinjoy , Souza Pedro C L
Published: November 2022

Homelessness and precarious living conditions are on the rise across much of the Western world. This paper exploits quasi-exogenous variation in the affordability of rents due to a cut in rent subsidies for low-income households in the United Kingdom in April 2011. Using comprehensive district-level administrative data, we show that the affordability shock caused a significant increase in financial distress, evictions, property crimes, insecure temporary housing arrangements, statutory homelessness, and actual rough sleeping. The most notable rise in statutory homelessness is driven by families with children, lone parents, individuals with existing health conditions, and as a result of having been evicted. We estimate that the fiscal savings were low and shifted toward the local administration: Savings by the central government were partially offset by an increase in council spending to meet statutory obligations for homelessness.
The formation mechanism of the typical hot dry rocks in Hunan Province, China
Authors: Ou Jian , Chen Liangjing , Zhang Baojian , Zhou Hua , Tang Xianchun , Bai Huaqing , Zhang Dailei , Gao Jun
Published: November 2022

Calculated by using the pipeline model, the burial depths of the 150 and 180°C hot dry rocks (HDRs) are 3.20–3.56 and 3.92–4.36 km in the Reshuiwei geothermal field, respectively, while those in the Huitang geothermal field are 3.13–3.50 and 3.84–4.28 km, respectively. Based on the analysis of the geophysical and terrestrial heat flow data, rock thermal generation rates, and the hydrochemical thermometric scale data, we summarized the formation mechanisms of the HDRs in Hunan Province: (i) the boundary deep faults in the welding area have made the intersection part of the deep faults an open tectonic environment, which is beneficial to the upwelling of deep-mantle-sourced thermal matter. (ii) The southeastern Hunan Province is the front region of the West Pacific subduction and retreat. Lithospheric thinning in this area is significant since the Mesozoic era, especially in the Dongting Lake basin, which was formed during extension and depression. This kind of regional lithospheric thinning is favorable for the lateral and upward migration and the intrusion of the deep-mantle-sourced hot substances. (iii) Rocks with high radioactive heat production rates are important crustal thermal sources for the formation of HDRs. Besides that, plutons with similar geological conditions are favorable for the formation of HDR resources. These plutons include the Baimashan pluton and its surrounding areas, and the eastern Dongting Lake plain. Moreover, the intermediate and acid granites distributed in the Chenzhou-Linwu deep fault are also part of the plutons, and the area where the Chenzhou-Linwu deep fault convergent with the Changde-Anren deep fault.
The Draft Italian Code of International Crimes
Authors: Fronza Emanuela , Meloni Chantal
Published: November 2022

In a major effort of coordination, on 31 May 2022, the Committee of Experts appointed by the Italian Minister of Justice delivered the draft Italian ‘Code of International Crimes’ (CIC), whose purpose is to fully implement the Rome Statute into the domestic legal system by adopting substantive legislation on international crimes. The aim of this article is to give an account of the work of the Committee, outlining the prospective legislation and presenting the choices made within the process of implementation. The draft Italian law analysed here represents one example of the different implementation processes which followed the adoption of the ICC Statute, both with respect to the chosen method of implementation — the adoption of an ad hoc code of international crimes — and with respect to some substantive choices, such as the introduction of the crime of cultural genocide and the responsibility of legal persons for international crimes. Ensuring coherence with the fundamental principles of the domestic legal system was of course of utmost importance and guided the entire Committee’s work, in light of the state’s margin of appreciation within the implementation process. In this sense, the implementation process underlying the draft CIC entailed both a transposition of concepts and elements of the ICC Statute into the domestic legal order (internationalization of national laws) and their adaptation to the specific features of the domestic system (nationalization of international criminal law).
Single-molecule localization microscopy based on denoising, interpolation and local maxima
Authors: Cheng Tao
Published: November 2022

A single fluorescent molecule is highly likely to be located at the center pixel position of a raw image diffused spot in an ideal situation. Even if the molecule and the center pixel position do not completely overlap, they are very close. A single-molecule localization method based on denoising, interpolation and local maxima (DIL) is proposed. The low-resolution raw image is denoised and interpolated, and a new image with a pixel size equal to that of the super-resolution image is attained. The local maxima of the new image are extracted. With this method, it is found that the local maxima positions can be regarded as the fluorescent molecule positions. Simulation results demonstrate that the DIL single-molecule localization accuracy reaches ∼18 nm when the Gaussian noise variance is equal to 0.01. Experimental results demonstrate that the DIL localization methodology is comparable to the Gaussian fitting algorithm and is faster.
Pharmacovigilance practices in South Asian Association for Regional Cooperation countries: the need for collaboration
Authors: Khan Muhammad Akhtar Abbas , Hamid Saima , Babar Zaheer-Ud-Din
Published: November 2022

Objectives

One-fifth of the world’s population lives in eight countries that constitute the South Asian Association for Regional Cooperation (SAARC). There is very little coordination among SAARC countries regarding the harmonization of pharmaceutical regulations and medicines safety. Pakistan, India and Bangladesh have experienced medicine-related tragedies where many patients have died. This study aims to examine current pharmacovigilance activity in the SAARC region to improve pharmacovigilance practices and to make recommendations for building a platform for collaboration to improve the safety monitoring of medicines in the region.

The current review utilized secondary data. We reviewed the official websites of all SAARC countries’ national regulatory authorities for pharmacovigilance-related information. A data set with eleven pharmacovigilance indicators were gathered and synthesized.

Key findings

All eight SAARC member countries have pharmacovigilance systems with full membership in the WHO Program for International Drug Monitoring. Out of eleven pharmacovigilance indicators, India met ten; Pakistan, Bangladesh and Bhutan nine; Maldives and Afghanistan seven; Nepal and Sri Lanka five. The SAARC countries do not have a harmonized pharmacovigilance system or centralized database. Due to positioning in different WHO regions, it is proposed to create a consortium on medicine safety among SAARC countries like other regional organizations of the world to strengthen the pharmacovigilance systems and harmonize the pharmacovigilance practices among member countries.

To improve the quality of medicines and to strengthen regional medicine safety, the SAARC secretariat should consider forming a technical group of all member countries’ regulatory authorities.
Solitary abdominal wall hydatid cyst—a rare condition
Authors: Kofina Konstantinia , Papatheodorou Nikolaos , Konomi Michael , Giannopoulos Ioannis , Valkanos Anastasios , Karanikas Michael
Published: November 2022

Hydatid disease is a parasitic infection by a tapeworm of the genus Echinococcus that usually presents in the liver and lungs. Presentation of the disease as a solitary abdominal wall lesion, however, is a rare entity and only nine cases have been reported in the literature thus far. We present the case of a 53-year-old Caucasian female presenting with a mass located in the left flank that was proven to be a solitary hydatid cyst intraoperatively.
Efficient planet formation by pebble accretion in ALMA rings
Authors: Jiang (蒋昊昌) Haochang , Ormel Chris W
Published: November 2022

In the past decade, ALMA observations have revealed that a large fraction of protoplanetary discs contains rings in the dust continuum. These rings are the locations where pebbles accumulate, which is beneficial for planetesimal formation and subsequent planet assembly. We investigate the viability of planet formation inside ALMA rings in which pebbles are trapped by either a Gaussian-shaped pressure bump or by the strong dust backreaction. Planetesimals form at the mid-plane of the ring via streaming instability. By conducting N-body simulations, we study the growth of these planetesimals by collisional mergers and pebble accretion. Thanks to the high concentration of pebbles in the ring, the growth of planetesimals by pebble accretion becomes efficient as soon as they are born. We find that type-I planet migration plays a decisive role in the evolution of rings and planets. For discs where planets can migrate inward from the ring, a steady state is reached where the ring spawns ∼20 M⊕ planetary cores as long as rings are fed with materials from the outer disc. The ring acts as a long-lived planet factory and it can explain the ‘fine-tuned’ optical depths of the observed dust rings in the DSHARP large program. In contrast, in the absence of a planet removal mechanism (migration), a single massive planet will form and destroy the ring. A wide and massive planetesimals belt will be left at the location of the planet-forming ring. Planet formation in rings may explain the mature planetary systems observed inside debris discs.
Witnessing the star formation quenching in L* ellipticals
Authors: Dhiwar Suraj , Saha Kanak , Dekel Avishai , Paswan Abhishek , Pandey Divya , Cortesi Arianna , Pandge Mahadev
Published: November 2022

We study the evolution of L* elliptical galaxies in the colour–magnitude diagram in terms of their star formation history and environment, in an attempt to learn about their quenching process. We have visually extracted 1109 L* galaxies from a sample of 36 500 galaxies that were spectroscopically selected from Stripe82 of the Sloan Digital Sky Survey (SDSS). From this sample, we have selected 51 ellipticals based on their surface-brightness profile being well-fitted by a single S$\acute{e}$rsic profile with S$\acute{e}$rsic indices 3 < n < 6. Our sample consists of 12 blue-cloud L* ellipticals (BLEs), 11 green-valley L* ellipticals (GLEs), and 28 red-sequence L* ellipticals (RLEs). We find that most of the RLEs and GLEs have been quenched only recently, or are still forming stars, based on their [O iii] and H α emission, while the BLEs are forming stars vigorously. The star formation in BLEs is found to be extended over the galaxy and not confined to their central region. In about 40 per cent of the L* ellipticals (10 BLEs, 4 GLEs, and 5 RLEs), star formation quenching seems to have started only recently, based on the lower [O iii] emission compared to the [O ii] and H α emission, at a given metallicity. We also find that the galaxy colour is correlated with the cosmic-web environment, with the BLEs tending to reside in lower density regions, the RLEs preferring denser, clustered regions, and the GLEs found in either. One possible scenario is that as the star-forming ellipticals migrate into the clusters, their star formation is suffocated by the hot intracluster medium.
Characterizing the high-mass star forming region IRAS 18144–1723 through methanol maser observations
Authors: Khafagy Esraa , Edris K A , Shalabiea O M , Bartkiewicz A , Richards A M S , Awad Z
Published: November 2022

We introduce a study of the massive star forming region IRAS 18144–1723 using observations of the 6.7 GHz methanol maser line. Such regions are opaque at short wavelengths but can be observed through radio emission lines. In this study, we traced the kinematics of the source on milliarcsecond scales using the Multi-Element-Radio-Interferometer-Network (MERLIN). We found 52 maser spots in the LSR velocity range 45–52 km s−1, near the centre of the previously detected CO range of 21.3–71.3 km s−1, lying within ∼ 0${_{.}^{\prime\prime}}$5 of IRAS 18144–1723 ‘B’, thought to be a young Class I protostar. Their distribution can be approximated as an ellipse, which, if it were rotating, would have its axis oriented south-east to north-west. The most probable morphology of the emitting regions is interaction between a disc and an outflow, possibly with a very large opening angle. The arcmin-scale CO outflow centred on source ‘B’ is oriented East–West, and the methanol masers do show the highest dispersion of velocity gradients in approximately this direction, so the kinematics are complex and suggest that more than one source may be responsible. We also tested kinematic models for a Keplerian disc or a simple bipolar outflow, but neither are compatible with the kinematics of the maser clumps and the characteristics of their internal velocities.
Radiographic study of the distal ulna in rheumatoid arthritis with extensor digitorum communis ruptures
Authors: Sato Kotaro , Otake Shinpei , Takahashi Gaku , Murakami Kenya , Mimata Yoshikuni , Doita Minoru
Published: November 2022

Objectives

Extensor digitorum communis (EDC) rupture of the wrist often occurs in patients with rheumatoid arthritis (RA). Early operation is desirable for patients with a high risk of rupture; therefore, rheumatologists should diagnose it during daily examinations. This study aimed to clarify radiographic changes in the distal ulna and related factors associated with EDC rupture in patients with RA.

Methods

We analysed plain radiographs of 40 patients with RA associated with EDC rupture and 62 healthy controls. We investigated the deformation of the distal ulna, Larsen grades, and radiological parameters such as ulnar variance (UV), ulnar bowing angle, dorsal protrusion (DP), and dorsal bowing angle.

Results

The ratios of the ulna head deformation, Larsen grades, UV, DP, and dorsal bowing angle were significantly larger in the ruptured group than in the control group. Multiple logistic regression analysis revealed that DP and Larsen grades were significantly associated with EDC rupture.

Conclusions

Deformity of the distal ulna is evident in patients with an EDC rupture. Ulnar head deformation, high Larsen grades, and large DP are the potential risk factors for EDC rupture.
Perspectives on current and emerging therapies for immunoglobulin G4–related disease
Authors: Tanaka Yoshiya , Stone John H
Published: November 2022

Understanding of the pathophysiology of immunoglobulin G4–related disease (IgG4-RD) over the last dozen years has opened the door to a variety of targeted treatment approaches. Glucocorticoids are an effective treatment for IgG4-RD if used at a sufficiently high dose, but disease flares are common during or after glucocorticoid tapers and these medications seldom lead to long-term, treatment-free remissions. Moreover, their long-term use in a disease that frequently affects middle-aged to elderly individuals and often causes major pancreatic damage leads to a narrow therapeutic index. Biological therapies offer the possibility of effective disease control with fewer treatment-associated side effects. Promising avenues of investigation include B-cell depletion, immunomodulation of B-cell subsets, interference with co-stimulation, Bruton’s tyrosine kinase inhibition, and Signaling lymphocytic activation molecule F7-directed treatment.
The B. subtilis Rok protein is an atypical H-NS-like protein irresponsive to physico-chemical cues
Authors: Erkelens Amanda M , Qin Liang , van Erp Bert , Miguel-Arribas Andrés , Abia David , Keek Helena G J , Markus Dorijn , Cajili Marc K M , Schwab Samuel , Meijer Wilfried J J , Dame Remus T
Published: November 2022

Nucleoid-associated proteins (NAPs) play a central role in chromosome organization and environment-responsive transcription regulation. The Bacillus subtilis-encoded NAP Rok binds preferentially AT-rich regions of the genome, which often contain genes of foreign origin that are silenced by Rok binding. Additionally, Rok plays a role in chromosome architecture by binding in genomic clusters and promoting chromosomal loop formation. Based on this, Rok was proposed to be a functional homolog of E. coli H-NS. However, it is largely unclear how Rok binds DNA, how it represses transcription and whether Rok mediates environment-responsive gene regulation. Here, we investigated Rok's DNA binding properties and the effects of physico-chemical conditions thereon. We demonstrate that Rok is a DNA bridging protein similar to prototypical H-NS-like proteins. However, unlike these proteins, the DNA bridging ability of Rok is not affected by changes in physico-chemical conditions. The DNA binding properties of the Rok interaction partner sRok are affected by salt concentration. This suggests that in a minority of Bacillus strains Rok activity can be modulated by sRok, and thus respond indirectly to environmental stimuli. Despite several functional similarities, the absence of a direct response to physico-chemical changes establishes Rok as disparate member of the H-NS family.
Post–Intensive Care Syndrome Among Survivors in a Safety Net Hospital in South Bronx: A Comparison of Patients With and Without Coronavirus Disease 2019
Authors: Heraud Sebastian Ocrospoma , Shah Virali , Perez-Gutierez Victor , Al-Khateeb Mohannad , Fraga Sebastian Gandarillas , Afzal Afsheen , Rubin Mayer , Edding Sherida , Nino Jessica , Horoub Ali , Paracha Nushra , Gujral Manmeet , Cemalovic Nail , Menon Vidya
Published: November 2022

Comparison of post–intensive care syndrome between critically ill survivors with or without coronavirus disease 2019 (CovP and CovN, respectively) showed that fewer CovP were able to return to work full time at >1 year and none at <1 year after discharge and that the majority of CovP survivors were able to work part time during both evaluation periods compared to CovN.
Hip osteoarthritis: A novel network analysis of subchondral trabecular bone structures
Authors: Dorraki Mohsen , Muratovic Dzenita , Fouladzadeh Anahita , Verjans Johan W , Allison Andrew , Findlay David M , Abbott Derek
Published: November 2022

Hip osteoarthritis (HOA) is a degenerative joint disease that leads to the progressive destruction of subchondral bone and cartilage at the hip joint. Development of effective treatments for HOA remains an open problem, primarily due to the lack of knowledge of its pathogenesis and a typically late-stage diagnosis. We describe a novel network analysis methodology for microcomputed tomography (micro-CT) images of human trabecular bone. We explored differences between the trabecular bone microstructure of femoral heads with and without HOA. Large-scale automated extraction of the network formed by trabecular bone revealed significant network properties not previously reported for bone. Profound differences were discovered, particularly in the proximal third of the femoral head, where HOA networks demonstrated elevated numbers of edges, vertices, and graph components. When further differentiating healthy joint and HOA networks, the latter showed fewer small-world network properties, due to decreased clustering coefficient and increased characteristic path length. Furthermore, we found that HOA networks had reduced length of edges, indicating the formation of compressed trabecular structures. In order to assess our network approach, we developed a deep learning model for classifying HOA and control cases, and we fed it with two separate inputs: (i) micro-CT images of the trabecular bone, and (ii) the network extracted from them. The model with plain micro-CT images achieves 74.6% overall accuracy while the trained model with extracted networks attains 96.5% accuracy. We anticipate our findings to be a starting point for a novel description of bone microstructure in HOA, by considering the phenomenon from a graph theory viewpoint.
Comment on “Exact solutions of Mathieu’s equation”
Authors: Pereira Luís M S
Published: November 2022

It is shown that the main formulas in Daniel [Prog. Theor. Exp. Phys. 2020, 043A01 (2020)] cannot be correct.
Will Metaverse become a more exciting place to listen to music streaming for mental health?
Authors: Situmorang Dominikus David Biondi
Published: November 2022

In this article, the author provides several points of view regarding some of the advantages of the existence of Metaverse on music streaming, especially as a healing medicine for mental health. It is hoped that it can provide another viewpoint from the five key themes, or a series of criticisms that have been discussed in the previous article.
Facility-level program components leading to population impact: a coincidence analysis of obesity treatment options within the Veterans Health Administration
Authors: Damschroder Laura J , Miech Edward J , Freitag Michelle B , Evans Richard , Burns Jennifer A , Raffa Susan D , Goldstein Michael G , Annis Ann , Spohr Stephanie A , Wiitala Wyndy L
Published: November 2022

Obesity is a well-established risk factor for increased morbidity and mortality. Comprehensive lifestyle interventions, pharmacotherapy, and bariatric surgery are three effective treatment approaches for obesity. The Veterans Health Administration (VHA) offers all three domains but in different configurations across medical facilities. Study aim was to explore the relationship between configurations of three types of obesity treatments, context, and population impact across VHA using coincidence analysis. This was a cross-sectional analysis of survey data describing weight management treatment components linked with administrative data to compute population impact for each facility. Coincidence analysis was used to identify combinations of treatment components that led to higher population impact. Facilities with higher impact were in the top two quintiles for (1) reach to eligible patients and (2) weight outcomes. Sixty-nine facilities were included in the analyses. The final model explained 88% (29/33) of the higher-impact facilities with 91% consistency (29/32) and was comprised of five distinct pathways. Each of the five pathways depended on facility complexity-level plus factors from one or more of the three domains of weight management: comprehensive lifestyle interventions, pharmacotherapy, and/or bariatric surgery. Three pathways include components from multiple treatment domains. Combinations of conditions formed “recipes” that lead to higher population impact. Our coincidence analyses highlighted both the importance of local context and how combinations of specific conditions consistently and uniquely distinguished higher impact facilities from lower impact facilities for weight management.
Genetic Diversity and Pathogenicity of Fusarium fujikuroi Species Complex (FFSC) Causing Sugarcane Pokkah Boeng Disease (PBD) in China
Authors: Bao Yixue , Akbar Sehrish , Yao Wei , Xu Yuzhi , Xu Jianlong , Powell Charles A. , Chen Baoshan , Zhang Muqing
Published: November 2022

Pokkah boeng disease (PBD), a sugarcane foliar disease, is caused by various Fusarium spp. within the Fusarium fujikuroi species complex (FFSC). In the current study, we investigated the diversity of Fusarium spp. associated with PBD in China. In total, 320 leaf samples displaying PBD symptoms were collected over 10 consecutive years (2012 to 2021), during winter and summer, from six various sugarcane-growing regions (Guangxi, Yunnan, Guangdong, Zhejiang, Hainan, and Fujian) in China. Phylogenetic analysis of Fusarium spp. was reconstructed using translation elongation factor 1-α, and DNA-directed RNA polymerase II largest subunit and second-largest subunit multigene sequences. Evolutionary studies of these regions categorized the isolates into four FFSC species (F. sacchari, F. proliferatum, F. verticillioides, and F. andiyazi). The identified isolates, which developed irregular necrotic patches and rotting symptoms on the sugarcane plant after approximately 30 days were tested for their pathogenicity. Symptoms that appeared during pathogenicity testing were consistent with those observed under field conditions. Each strain of the pathogenic Fusarium spp. belonged to different vegetative compatibility groups (VCGs), and there was no affinity between VCGs. Our results contribute to understanding FFSC and accurately identifying Fusarium spp. associated with the sugarcane crop.
Determining the Distribution of QoI Fungicide-Resistant Cercospora sojina on Soybean from Indiana
Authors: Piñeros-Guerrero Natalia , Neves Danilo L. , Bradley Carl A. , Telenko Darcy E. P.
Published: November 2022

Frogeye leaf spot (FLS) is a foliar disease of soybean (Glycine max) caused by Cercospora sojina. Application of fungicide products that contain quinone outside inhibitor (QoI) active ingredients has been one of the major tools used in the management of this disease, but, since 2010, QoI-resistant C. sojina isolates have been confirmed in over 20 states in the United States, including Indiana. In summer 2019 and 2020, 406 isolates of C. sojina were collected from 32 counties across Indiana and screened for QoI resistance using a PCR-restriction fragment length polymorphism (RFLP) method. An in vitro fungicide sensitivity test was also performed on a subset of isolates to evaluate their sensitivity to three QoI fungicides: azoxystrobin, pyraclostrobin, and picoxystrobin. A discriminatory dose of picoxystrobin was established as 1 µg/ml by testing five concentrations (0.001, 0.01, 0.1, 1, and 10 µg/ml). QoI-resistant isolates were found in 29 counties, and 251 of the 406 isolates (61.8%) were confirmed to be resistant to QoI fungicides based on PCR-RFLP results. Partial nucleotide sequences of the cytochrome b gene from four resistant and four sensitive isolates corroborated the presence and absence, respectively, of the G143A mutation. Results from the sensitivity assays with discriminatory doses of azoxystrobin (1 µg/ml) and pyraclostrobin (0.1 µg/ml) also supported the findings from the PCR-RFLP assay, because all QoI-resistant isolates were inhibited less than 50% relative to a no-fungicide control when exposed to these doses. Resistant isolates harboring the G143A mutation also exhibited resistance to picoxystrobin. The effective concentrations to inhibit mycelial growth by 50% relative to the nonamended control (EC50) in QoI-sensitive isolates ranged from 0.087 to 0.243 µg/ml, with an overall mean of 0.152 µg/ml, while EC50 values in QoI-resistant isolates were established as >10 µg/ml for picoxystrobin. Results from this study indicated that QoI-resistant C. sojina isolates are spread throughout Indiana and exhibit cross-resistance to QoI fungicides.
Rapid Movement of ‘Candidatus Liberibacter asiaticus’ on ‘Hamlin’ Sweet Orange and ‘Swingle’ Citrumelo Trunks
Authors: Pulici Jeane Dayse V. S. , Gerberich Kayla M. , Johnson Evan G.
Published: November 2022

Huanglongbing (HLB), caused by phloem-limited ‘ Candidatus Liberibacter asiaticus’ (CLas), is the primary limiting factor of production in most citrus regions of the world. After infection, CLas is transported systemically throughout the phloem tissues following the source-sink movement. Split-root rhizoboxes and one-sided graft inoculation above the split trunk was used to understand if the vertical distance of the inoculum source and different anatomical structures (grafted or seedling trees) can affect the speed of the CLas movement, as well as the effects of the seasonality on these movements. The time for CLas to reach the roots was not affected by either distance of the inoculum source or tree type. The seasonal infection period appears to have an important effect on CLas movement. Trees inoculated in the summer had fast and uniform movement (first detection at 4 weeks after inoculation). Plants inoculated in the winter had a slow and uneven movement (first CLas detection at 14 weeks after inoculation). Our results indicate that summer and spring are the seasons of CLas down and lateral movement, but this is independent of the vertical distance of the inoculum source or anatomical structures of the plants. The findings from this study aid in the management of HLB in the field, as well as improve the methods for CLas detection.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Quality of Life in Patients with Diabetic Foot Ulcers: A Cross-sectional Study
Authors: Dias Ângela , Ferreira Gabriela , Vilaça Margarida , Pereira M. Graça
Published: November 2022

OBJECTIVE

To analyze the associations among and contributions of sociodemographic, clinical, and psychological variables to quality of life (QoL) related to diabetic foot ulcers (DFUs; DFUQoL).

METHODS

The sample comprised 70 patients with DFUs who answered the following questionnaires: the Hospital Anxiety and Depression Scale, Illness Perception Questionnaire-Brief, Diabetic Foot Ulcer-Short Form, Medical Term Recognition test, and a sociodemographic and clinical questionnaire. Pearson and biserial correlation coefficients, hierarchical regressions, and moderation analyses were conducted to study the relationships among variables.

RESULTS

The results showed that a large DFU, threatening representations about DFU, and more psychological distress were associated with lower DFUQoL. Also, more psychological distress, more threatening DFU representations, and taking antibiotics contributed to worse DFUQoL. Clinically significant levels of psychological distress moderated the relationship between the DFU extent and negative emotions.

CONCLUSIONS

This study showed that QoL and its domains were associated with psychological distress and that QoL was more influenced by DFU representations than by a larger-sized wound, emphasizing the importance of psychological interventions in the treatment of patients with DFUs.
Life-Long Steroid Responsive Familial Myopathy With Docking Protein 7 Mutation
Authors: Oh Shin J. , King Peter H. , Schindler Alice
Published: November 2022

Docking protein 7 (DOK7) congenital myasthenic syndrome (CMS) is characterized by limb-girdle weakness and lack of fluctuating fatigability simulating many familial myopathies. Albuterol is the first line of therapy in view of consistent improvement. Two brothers with progressive predominant biceps weakness for 1–3 years responded to prednisone treatment for 40–50 years. Various studies including muscle biopsy and many laboratory studies were unsuccessful for the definite diagnosis. Gene study, 40 years after the initial evaluation, confirmed the diagnosis of DOK7 CMS. These are the first reported cases of DOK7 CMS associated with a sustained benefit from corticosteroids.
Biochemical and Chemical Myopathy as Isolated Initial Manifestation of a Mitochondrial Disorder in a Competitive Swimmer
Authors: Finsterer Josef
Published: November 2022

Isolated and asymptomatic elevation of creatine kinase (hyper-CKemia) can be one of the initial manifestations of a mitochondrial disorder (MID). We present an asymptomatic patient with accidently detected isolated hyper-CKemia and respiratory chain dysfunction as indicators of a chemical and biochemical MID, respectively. A 23-year-old man who performed competitive sport (swimming) underwent workup for accidentally detected asymptomatic and isolated hyper-CKemia. Clinical neurologic examination was normal, but blood tests revealed elevation of creatine kinase (CK), aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and aldolase. Lactate stress testing on a bicycle ergometer was normal. Needle electromyography was noninformative, but muscle biopsy was indicative of a MID, and biochemical investigations revealed a combined complex-II, -III, and -IV defect. Hyper-CKemia persisted asymptomatically over the next 15 years, and he continued with his sports activities. In conclusion, asymptomatic hyper-CKemia together with multiple respiratory chain complex deficiencies can be the only manifestations of a MID over years. Asymptomatic chemical or biochemical MIDs may profit from continuous physical activity. Workup for isolated persisting hyper-CKemia may reveal subclinical mitochondrial pathology in single cases.
One-Year Outcomes in Anticoagulated Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention: Insights From the Greek Antiplatelet Atrial Fibrillation Registry
Authors: Alexopoulos Dimitrios , Dragona Vassiliki-Maria , Varlamos Charalampos , Ktenas Dionysios , Lianos Ioannis , Patsilinakos Sotirios , Sionis Dimitrios , Zarifis Ioannis , Bampali Theodora , Poulimenos Leonidas , Skalidis Emmanouil , Pissimisis Evangelos , Trikas Athanasios , Tsiafoutis Ioannis , Kafkas Nickolaos , Olympios Christoforos , Tziakas Dimitrios , Ziakas Antonios , Voudris Vassilis , Kanakakis Ioannis , Tsioufis Costas , Davlouros Periklis , Benetou Despoina-Rafailia
Published: November 2022

GReek-AntiPlatElet Atrial Fibrillation registry is a multicenter, observational, noninterventional study of atrial fibrillation patients undergoing percutaneous coronary intervention. Primary endpoint included clinically significant bleeding rate at 12 months between different antithrombotic regimens prescribed at discharge; secondary endpoints included major adverse cardiovascular events and net adverse clinical events. A total of 647 patients were analyzed. Most (92.9%) were discharged on novel oral anticoagulants with only 7.1% receiving the vitamin K antagonist. A little over half of patients (50.4%) received triple antithrombotic therapy (TAT)—mostly (62.9%) for ≤1 month—whereas the rest (49.6%) received dual antithrombotic therapy (DAT). Clinically significant bleeding risk was similar between TAT and DAT [Hazard ratio (HR) = 1.08; 95% confidence interval (CI), 0.66–1.78], although among TAT-receiving patients, the risk was lower in those receiving TAT for ≤1 month (HR = 0.50; 95% CI, 0.25–0.99). Anticoagulant choice (novel oral anticoagulant vs. vitamin K antagonist) did not significantly affect bleeding rates (P = 0.258). Age, heart failure, leukemia/myelodysplasia, and acute coronary syndrome were associated with increased bleeding rates. Risk of major adverse cardiovascular events and net adverse clinical events was similar between ΤAT and DAT (HR = 1.73; 95% CI, 0.95–3.18, P = 0.075 and HR = 1.39; 95% CI, 0.93–2.08, P = 0.106, respectively). In conclusion, clinically significant bleeding and ischemic rates were similar between DAT and TAT, although TAT >1 month was associated with higher bleeding risk.
A Re-emergence of Subacute Sclerosing Panencephalitis in the United Kingdom
Authors: Campbell Helen , Lopez Bernal Jamie , Bukasa Antoaneta , Andrews Nick , Baker Elaine , Maunder Polly , Winstone Anne Marie , Ramsay Mary , Verity Christopher , Brown Kevin
Published: November 2022

New pediatric and adult subacute sclerosing panencephalitis cases between 1996 and 2020 were reported based on an established UK registry with no evidence of under-ascertainment using a separate pediatric surveillance system. After 15 years with no pediatric UK-acquired cases, 3 cases arose from 2017 after increased measles. Modeling suggested this was in line with measles notifications, underreporting of laboratory-confirmed measles or increased subacute sclerosing panencephalitis risk.
Allogeneic stem cell transplant in relapsed/ refractory Hodgkin lymphoma: A 21 years’ experience
Authors: Couto Maria Eduarda , Vaz Carlos Pinho , Branca Rosa , Leite Luís , Brás Gil , Roncon Susana , Campos Antonio
Published: November 2022

Background: Allogenic stem cell transplant (alloSCT) has been used for several decades as a salvage strategy for relapsed/ refractory Hodgkin lymphoma (R/R HL), being a durable disease control method for some patients.

Methods: A unicenter retrospective analysis was performed about alloSCT in R/R HL along 21 years. A survival analysis was made in search for prognostic factors with impact in overall survival (OS)/progression free survival (PFS).

Results: Thirty-five patients were reviewed: median age 30years [17-46], 57.1% males, 82.9% had an esclero-nodular HL, 54.3% were in stage II of disease, and 42.9% achieved a complete response before the alloSCT. The donor type was matched-related in 54.3% and the stem cell source was peripheral blood in 97.1% of the grafts. All patients did a reduced intensity conditioning regimen. The overall response rate was 85.7% (complete in 68.6%, partial in 17.1%). Acute graft versus host disease grade II-IVwas seen in 45.7%. Transplant related mortality at day 360 was 17.9%. The median OS was 61 months (95% confidente interval: 33.6-88.3). The median PFS was 1Omonths (95% confidente interval: 3.1-16.9). Patients with >3Oyears at the alloSCT time and a previous autologous SCT showed better OS/PFS in the univariate analysis; having a matched donor and absence of infections along the alloSCT also improved PFS.

Conclusions: AlloSCT is a feasible procedure in patients with R/R HL, being able to stabilize the disease in a large number of patients. However, it has a relevant toxicity in patients highly pre-treated.
Dual beta-lactam treatment: Pros and cons
Authors: Guerra Diogo , Vidal Pauline , Paccoud Olivier , Maillard Alexis , Cachera Laurene , Junot Helga , Gauzit Rémy , Zahar Jean R. , Abreu Miguel A. , Bleibtreu Alexandre
Published: November 2022

The battle against microscopic pathogens has always baffled the scientific community. Nowadays, multidrug-resistant microorganisms lead to high in-hospital mortality, increased hospital stays, and high health-related costs. Treating infections due to these high-resistance pathogens with a low number of antibiotic molecules creates the need for new strategies. Although some already think of a “postantibiotic era” with bacteriophages as the main futuristic weapon in antibacterial armament, others rethink the usage of the already existent drugs. Dual beta-lactam therapy has been used for quite some time as an empirical therapy for some severe infections such as endocarditis or meningitis. However, studies regarding the use of a beta-lactam combination stopped being made a long time ago, and it seems the scientific community has no interest in evaluating this as a treatment option. Could this strategy be applied to treat infections due to multidrug-resistant bacteria? Could this be the answer while waiting for the “postantibiotic era”? What kind of pathogens could we fight using dual beta-lactams? What are the downsides of this strategy? These are some of the questions the authors try to answer in this review. In addition, we try to convince our peers to turn once more into researching beta-lactam combinations and exploring its potential benefits.
Clinicopathological features of head and neck cutaneous basal cell carcinoma observed at the Centro Hospitalar de Trás-os-Montes e Alto Douro ENT Department
Authors: Castanheira António , Boaventura Paula , Vieira Fortunato , Soares Paula , Mota Alberto , Lopes José Manuel
Published: November 2022

Background:

Cutaneous basal cell carcinoma (cBCC) incidence has been increasing, but there are no available data on its epidemiological, clinical, and pathological patterns in Northeast Portugal. cBCC is mainly located in the head and neck, where the ear, neck, and throat (ENT) surgeon may have a major role. We aimed to verify the clinicopathological characteristics of basal cell carcinomas diagnosed in an ENT department.

Methods:

We performed a retrospective clinicopathological evaluation of the head and neck cBCC cases followed up at the Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD) ENT Department between January 2007 and April 2021.

Results:

One hundred seventy-four patients with 293 cBCCs were included in this retrospective study. We observed that about one-third of the patients had multiple cBCCs (30.5%) and an infiltrative-type growth pattern (39.3%), both features considered as patterns that are more aggressive. Infiltrative-type growth pattern cBCCs were significantly larger when compared with the indolent-type growth pattern (16.2 mm vs 10.8 mm).

Conclusions:

To the best of our knowledge, this is the first study about cBCC in a patient population followed up at an ENT hospital department. This study has shown that these patients had cBCCs with more aggressive features, making these tumors an important issue for the ENT surgeon.
Student Performance Metrics and the Physician Assistant National Certifying Exam®: A 3-Year Multi-Institutional Study
Authors: Collett DeShana , Wright Karen A. , Woltenberg Leslie , Nagasawa Pamela R. , LeLacheur Susan
Published: November 2022

Introduction

Given the 2019 Physician Assistant National Certifying Exam (PANCE) blueprint update from the National Commission on the Certification of Physician Assistants, it is imperative that programs conduct analyses of student performance metrics and PANCE scores. The purpose of this multi-institutional study was to examine the relationship between PANCE scores and student performance metrics/attributes from PA program graduates from 2017-2019.

Methods

A multiple linear regression was calculated to predict PANCE score indicators based on student attributes and performance metrics from 3 PA programs. Metrics included: PAEA End of Rotation exams, PACKRAT scores, academic performance in clinical medicine didactic courses, cumulative grade point average, and select demographic and admissions attributes (age, sex, and first generation to attend college). Descriptive statistics were employed to provide contextual information and an overview of the included data points.

Results

A significant regression equation was found with r-square of 0.709. Clinical Medicine II didactic course grades, PACKRAT I & II scores, and PAEA End of Rotation Exam scores in Family Medicine and Internal Medicine were all significant predictors of PANCE score.

Discussion

In consideration of the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) Standards and expectations for ongoing self-assessment, including PANCE analysis, this research was timely and necessary. To date, there is very limited research regarding student performance metrics given the PANCE blueprint update in 2019, and these data are critical to aid programs in ongoing development and best preparation for learners.
Assessing the Utility of Mental Health First Aid Training for Physician Assistant Students
Authors: Forbes Jennifer , Noller Diana T. , Henriquez Madeleine , Scantamburlo Sarah , Ward Ian , Lee Hwal
Published: November 2022

Introduction

Physician assistant (PA) students are at increased risk for anxiety and depression compared with the general population. The demands of studying medicine can contribute to a decline in mental health, which may impede a student’s ability to progress in his or her PA program. Mental Health First Aid (MHFA) is one strategy that can be used to increase mental health literacy, promote help-seeking behavior, reduce stigma, and improve confidence in providing help to individuals showing signs of a mental health disorder. The aim of this outcomes assessment was to assess PA students’ satisfaction with the MHFA course and their posttraining confidence in using the skills learned.

Methods

Participants were PA students (N = 435) across 9 PA programs in their didactic year of training who had completed an MHFA course through the PA Foundation’s Mental Health Outreach Fellowship. MHFA postcourse evaluations, completed by the PA students, were analyzed to determine PA students’ satisfaction with the course and their posttraining confidence in using the skills learned to help both themselves as well as the general population.

Results

The mean of the MHFA course evaluation items corresponding to satisfaction with the course was 4.82 (maximum score of 5), and the mean of the items corresponding to posttraining confidence in using the skills learned was 4.74 (maximum score of 5). When asked, “Would you recommend this course to others?” 99.3% of the PA students trained in MHFA answered “yes,” indicating a high level of satisfaction with the training they had received.

DIscussion

PA students who received MHFA training from the PA Foundation’s Mental Health Outreach fellows showed high levels of satisfaction with the MHFA course and posttraining confidence in using the skills learned.