bluuebunny/crossref_metadata_2025 huggingface dataset:
TRANSPARENT TESTA GLABRA1 regulates high-intensity blue light-induced phototropism by reducing CRYPTOCHROME1 levels
Authors: Wang Yu-xi , Zhao Qing-ping , Zhu Jin-dong , Chu Fang-yuan , Fu Xiang-lin , Li Xing-kun , Ding Mei-chen , Liu Yan-fei , Wu Qi-qi , Xue Lin-lin , Xin Guang-yuan , Zhao Xiang
Published: June 2024

The asymmetrical distribution of auxin supports high intensity blue light (HBL)-mediated phototropism. Flavonoids, secondary metabolites induced by blue light and TRANSPARENT TESTA GLABRA1 (TTG1), alter auxin transport. However, the role of TTG1 in HBL-induced phototropism in Arabidopsis (Arabidopsis thaliana) remains unclear. We found that TTG1 regulates HBL-mediated phototropism. HBL-induced degradation of CRYPTOCHROME 1 (CRY1) was repressed in ttg1-1, and depletion of CRY1 rescued the phototropic defects of the ttg1-1 mutant. Moreover, overexpression of CRY1 in a cry1 mutant background led to phototropic defects in response to HBL. These results indicated that CRY1 is involved in the regulation of TTG1-mediated phototropism in response to HBL. Further investigation showed that TTG1 physically interacts with CRY1 via its N-terminus and that the added TTG1 promotes the dimerization of CRY1. The interaction between TTG1 and CRY1 may promote HBL-mediated degradation of CRY1. TTG1 also physically interacted with blue light inhibitor of cryptochrome 1 (BIC1) and Light-Response Bric-a-Brack/Tramtrack/Broad 2 (LRB2), and these interactions either inhibited or promoted their interaction with CRY1. Exogenous gibberellins (GA) and auxins, two key plant hormones that crosstalk with CRY1, may confer the recovery of phototropic defects in the ttg1-1 mutant and CRY1-overexpressing plants. Our results revealed that TTG1 participates in the regulation of HBL-induced phototropism by modulating CRY1 levels, which are coordinated with GA or IAA signaling.
Anti-FHL1 autoantibodies in adult patients with myositis: a longitudinal follow-up analysis
Authors: Galindo-Feria Angeles S , Lodin Karin , Horuluoglu Begum , Sarrafzadeh-Zargar Sepehr , Wigren Edvard , Gräslund Susanne , Danielsson Olof , Wahren-Herlenius Marie , Dastmalchi Maryam , Lundberg Ingrid E ,   SweMyoNet Consortium, Mohammad Aladdin J , Leonard Dag , Sjöwall Christopher , Husmark Thomas , Ask Malin , Puksic Silva , Lappas Theodoros , Hanna Balsam
Published: June 2024

Objectives

To determine prevalence and clinical associations of anti-Four-and-a-half-LIM-domain 1 (FHL1) autoantibodies in patients with idiopathic inflammatory myopathies (IIM) and to evaluate autoantibody levels over time.

Methods

Sera at the time of diagnosis from patients with IIM (n = 449), autoimmune disease controls (DC, n = 130), neuromuscular diseases (NMDs, n = 16) and healthy controls (HC, n = 100) were analysed for anti-FHL1 autoantibodies by enzyme-linked immunosorbent assay (ELISA). Patients with IIM FHL1+ and FHL1− were included in a longitudinal analysis. Serum levels were correlated to disease activity.

Results

Autoantibodies to FHL1 were more frequent in patients with IIM (122/449, 27%) compared with DC (autoimmune DC and NMD, 13/146, 9%, P < 0.001) and HC (3/100.3%, P < 0.001). Anti-FHL1 levels were higher in IIM [median (IQR)=0.62 (0.15–1.04)] in comparison with DC [0.22 (0.08–0.58)], HC [0.35 (0.23–0.47)] and NMD [0.48 (0.36–0.80)] P < 0.001. Anti-FHL1+ patients with IIM were younger at the time of diagnosis compared with the anti-FHL1− group (P = 0.05) and were seronegative for other autoantibodies in 25%.

In the first follow-up, anti-FHL1+ sample 20/33 (60%) positive at baseline had turned negative for anti-FHL1 autoantibodies. Anti-FHL1 autoantibodies rarely appeared after initiating treatment. Anti-FHL1 autoantibody levels correlated with CK (r = 0.62, P= 0.01), disease activity measured using the Myositis Disease Activity Assessment Tool (MYOACT) (n = 14, P = 0.004) and inversely with Manual Muscle Test-8 (r = −0.59, P = 0.02) at baseline.

Conclusion

Anti-FHL1 autoantibodies were present in 27% of patients with IIM; of these, 25% were negative for other autoantibodies. Other autoimmune diseases had lower frequencies and levels. Anti-FHL1 levels often decreased with immunosuppressive treatment, correlated with disease activity measures at diagnosis and rarely appeared after start of treatment.
First- and Second-Generation Women’s Economic Assimilation: An Analysis of Longitudinal Earnings Records
Authors: Villarreal Andrés , Tamborini Christopher R
Published: June 2024

Research on the economic assimilation of immigrants and their descendants has disproportionately focused on men. In this study, we examine the life-course employment and earnings trajectories of first- and second-generation women using a restricted-use dataset linking individual respondents of the Current Population Survey (CPS) to their tax earnings records. We compare the age-specific probability of employment and annual earnings of women of each immigrant generation by race and ethnicity from early to middle adulthood covering a span of 20 years. We consider alternative explanations for observed disparities including differences in the level of education and the timing and response to childbearing. Our analyses reveal distinct patterns across immigrant generations and ethnoracial groups. We find that first- and second-generation women are assimilating economically at a fast pace although significant ethnoracial differences remain. First-generation Hispanic women in particular experience low employment and earnings growth. Second-generation women have higher employment rates than later-generation Whites and avoid the dip in employment trajectories in early and middle adulthood experienced by the latter group. The higher employment rates of second-generation women cannot be fully explained by differences in educational attainment or the presence of young children.
Disruption of central and peripheral circadian clocks and circadian controlled estrogen receptor rhythms in night shift nurses in working environments
Authors: Yang Zhenning , Black Kathleen , Ohman‐Strickland Pamela , Graber Judith M. , Kipen Howard M. , Fang Mingzhu , Zarbl Helmut
Published: June 2024

Chronic disruption of circadian rhythms by night shift work is associated with an increased breast cancer risk. However, little is known about the impact of night shift on peripheral circadian genes (CGs) and circadian‐controlled genes (CCGs) associated with breast cancer. Hence, we assessed central clock markers (melatonin and cortisol) in plasma, and peripheral CGs (PER1, PER2, PER3, and BMAL1) and CCGs (ESR1 and ESR2) in peripheral blood mononuclear cells (PBMCs). In day shift nurses (n = 12), 24‐h rhythms of cortisol and melatonin were aligned with day shift‐oriented light/dark schedules. The mRNA expression of PER2, PER3, BMAL1, and ESR2 showed 24‐h rhythms with peak values in the morning. In contrast, night shift nurses (n = 10) lost 24‐h rhythmicity of cortisol with a suppressed morning surge but retained normal rhythmic patterns of melatonin, leading to misalignment between cortisol and melatonin. Moreover, night shift nurses showed disruption of rhythmic expressions of PER2, PER3, BMAL1, and ESR2 genes, resulting in an impaired inverse correlation between PER2 and BMAL1 compared to day shift nurses. The observed trends of disrupted circadian markers were recapitulated in additional day (n = 20) and night (n = 19) shift nurses by measurement at early night and midnight time points. Taken together, this study demonstrated the misalignment of cortisol and melatonin, associated disruption of PER2 and ESR2 circadian expressions, and internal misalignment in peripheral circadian network in night shift nurses. Morning plasma cortisol and PER2, BMAL1, and ESR2 expressions in PBMCs may therefore be useful biomarkers of circadian disruption in shift workers.
Reducing Lung Injury from Blind Insertion of Small-Bore Feeding Tubes
Authors: Jahn Teresa , Overgaard Jenelle , Mondloch Mallory , Plante Elizabeth , Burris Jennifer , Suresh Mithun , Berndt Jodi
Published: June 2024

Using a blind insertion technique to insert small-bore feeding tubes can result in inadvertent placement in the lungs, leading to lung perforation and even mortality. In a Magnet-designated, 500-bed, level 2 trauma center, two serious patient safety events occurred in a four-week period due to nurses blindly inserting a small-bore feeding tube. A patient safety event review team convened and conducted an assessment of reported small-bore feeding tube insertion events that occurred between March 2019 and July 2021. The review revealed six lung perforations over this two-year period. These events prompted the creation of a multidisciplinary team to evaluate alternative small-bore feeding tube insertion practices. The team reviewed the literature and evaluated several evidence-based small-bore feeding tube placement methods, including placement with fluoroscopy, a two-step X-ray, electromagnetic visualization, and capnography. After the evaluation, capnography was selected as the most effective method to mitigate the complications of blind insertion. In this article, the authors describe a quality improvement project involving the implementation of capnography-guided small-bore feeding tube placement to reduce complications and the incidence of lung perforation. Since the completion of the project, which took place from December 13, 2021, through April 18, 2022, no lung injuries or perforations have been reported. Capnography is a relatively simple, noninvasive, and cost-effective technology that provides nurses with a means to safely and effectively insert small-bore feeding tubes, decrease the incidence of adverse events, and improve patient care.
Parent-patient Discrepancies in the Quality of Life Assessment of Early-onset Scoliosis: A Comparison Between 2 Questionnaires Completed on 2 Different Time Points – A Preliminary Report
Authors: Goker Barlas , Beydemir Ataberk , Kinikli Gizem Irem , Yavuz Yasemin , Ramazanov Rafik , Demirkiran Halil Gokhan , Yazici Muharrem
Published: June 2024

Background:

EOSQ-24 is a parent proxy questionnaire designed to assess the health-related quality of life (HRQoL) of early-onset scoliosis (EOS) patients during their childhood years. EOSQ-SELF, a novel self-reported questionnaire, assesses HRQoL in older children (>8 y) and adolescents. So far, the same group of EOS patients has not been evaluated with both EOSQ-24 and EOSQ-SELF. The aim of this study was to evaluate how the same pathology was reflected in the parent and patient at different time points by comparing the answers to the common questions between EOSQ-24 and EOSQ-SELF.

Methods:

A group of otherwise healthy EOS patients whose parents filled out EOSQ-24 at the early phase of growth-friendly treatment was re-tested by the EOSQ-SELF questionnaire at the end of treatment. Both EOSQ-24 and EOSQ-SELF are validated in Turkish. Inclusion criteria were patients with EOS, independent ambulation, age of 8 years or older at EOSQ-SELF enrollment, literacy in Turkish, no apparent intellectual impairment, and a minimum of 24 months after graduation. The common questions between the 2 surveys with nearly identical phrasings were extracted. Common items from the 2 tests were compared with a Wilcoxon signed rank test.

Results:

Twenty-one patients (15 females, 6 males) who previously filled out EOSQ-24 met the inclusion criteria. The mean age of the group was 10 (5 to 16) years at EOSQ-24 participation and 18 (13 to 24) at the final analysis. Fourteen questions were found common in 10 domains. The scores were significantly different in 5 questions of 4 domains. EOSQ-SELF had significantly less favorable scores in the pain/discomfort, pulmonary function, and fatigue/energy level domains. Scores in the parental burden/relationships domain were significantly higher (P<0.05).

Conclusions:

The self-reported group had a general trend of worse results. Parents and caregivers may not accurately perceive the problems of EOS patients. Our findings indicate a disconnect between caregivers and the patients, as both parties underreported the other side in some domains. These findings suggest the challenges faced by EOS patients are not adequately reflected on proxy questionnaires that assess the HRQoL of children.

Level of Evidence:

Diagnostic Level I
Rambam Hospital Protocol for Treatment of Early Stages of Legg-Calve-Perthes Disease
Authors: Eidelman Mark , Keshet Doron , Abu-Dalu Khaled , Rinott Nadav , Kotlarsky Pavel
Published: June 2024

Introduction:

The treatment of Leg-Calve-Perthes Disease (LCPD) is an orthopedic enigma without consensus in the literature. Despite all efforts, coxa breva with overgrowth of the greater trochanter (GT) is commonly present in many patients. In 2013, we introduced a protocol that included transepiphyseal drilling of the femoral head, closure of the GT, adductor tenotomy, and 4 months of non–weight-bearing on the affected leg. The purpose of this study was to evaluate midterm results in patients treated by our protocol.

Methods:

Over 11 years, we treated 31 patients with LCPD. Average age was 7.1 (range 5 to 10) years. We divided all patients into 2 groups: group A included 18 patients in early fragmentation stage, group B contained 12 patients in late fragmentation and one in reossification stage. All patients underwent the same treatment protocol as described.

Results:

Mean follow-up was 52 months. All patients had a limp before surgery. At the latest follow-up, 22 had no limp, and 23 had substantial improvement in hip range of motion. In group A, 12 patients had Stulberg type 1, 5 Stulberg 2, and 1 Stulberg type 3. In group B, 1 patient had Stulberg type 2, 9 patients had Stulberg type 4, and 3 patients had Stulberg type 5.

Conclusions:

On the basis of our experience, the proposed protocol can be effective in the treatment of the early fragmentation stage of LCPD.
COVID-19 Pandemic and Impact on Research Publications in Critical Care
Authors: Razavi Syrus , Sharma Arjun , Lavin Cassidy , Pourmand Ali , Smalls Norma , Tran Quincy K.
Published: June 2024

OBJECTIVES:

The COVID-19 pandemic precipitated a significant transformation of scientific journals. Our aim was to determine how critical care (CC) journals and their impact may have evolved during the COVID-19 pandemic. We hypothesized that the impact, as measured by citations and publications, from the field of CC would increase.

DESIGN:

Observational study of journal publications, citations, and retractions status.

SETTING:

All work was done electronically and retrospectively.

SUBJECTS:

The top 18 CC journals broadly concerning CC, and the top 5 most productive CC journals on the SCImago list.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

For the top 18 CC journals and specifically Critical Care Medicine (CCM), time series analysis was used to estimate the trends of total citations, citations per publication, and publications per year by using the best-fit curve. We used PubMed and Retraction Watch to determine the number of COVID-19 publications and retractions. The average total citations and citations per publication for all journals was an upward quadratic trend with inflection points in 2020, whereas publications per year spiked in 2020 before returning to prepandemic values in 2021. For CCM total publications trend downward while total citations and citations per publication generally trend up from 2017 onward. CCM had the lowest percentage of COVID-related publications (15.7%) during the pandemic and no reported retractions. Two COVID-19 retractions were noted in our top five journals.

CONCLUSIONS:

Citation activity across top CC journals underwent a dramatic increase during the COVID-19 pandemic without significant retraction data. These trends suggest that the impact of CC has grown significantly since the onset of COVID-19 while maintaining adherence to a high-quality peer-review process.
Ultraprocessed foods and cancer risk: the importance of distinguishing ultraprocessed food groups
Authors: Augustin Livia S.A. , D’Angelo Angela , Palumbo Elvira , La Vecchia Carlo
Published: June 2024

Several case–control, cohort studies, and meta-analyses found a moderate association between ultraprocessed food consumption and the risk of colorectal and a few other cancers. The evidence is, however, not consistent. A reason for such inconsistence is that the NOVA classification of ultraprocessed foods may include unfavorable but also favorable dietary components, and it may vary across different populations.
Emergence of Artificial Intelligence and Machine Learning Models in Sudden Cardiac Arrest: A Comprehensive Review of Predictive Performance and Clinical Decision Support
Authors: Jain Hritvik , Marsool Mohammed Dheyaa Marsool , Odat Ramez M. , Noori Hamid , Jain Jyoti , Shakhatreh Zaid , Patel Nandan , Goyal Aman , Gole Shrey , Passey Siddhant
Published: June 2024

Sudden cardiac death/sudden cardiac arrest (SCD/SCA) is an increasingly prevalent cause of mortality globally, particularly in individuals with preexisting cardiac conditions. The ambiguous premortem warnings and the restricted interventional window related to SCD account for the complexity of the condition. Current reports suggest SCD to be accountable for 20% of all deaths hence accurately predicting SCD risk is an imminent concern. Traditional approaches for predicting SCA, particularly “track-and-trigger” warning systems have demonstrated considerable inadequacies, including low sensitivity, false alarms, decreased diagnostic liability, reliance on clinician involvement, and human errors. Artificial intelligence (AI) and machine learning (ML) models have demonstrated near-perfect accuracy in predicting SCA risk, allowing clinicians to intervene timely. Given the constraints of current diagnostics, exploring the benefits of AI and ML models in enhancing outcomes for SCA/SCD is imperative. This review article aims to investigate the efficacy of AI and ML models in predicting and managing SCD, particularly targeting accuracy in prediction.
Fondaparinux Sodium for Anticoagulant Therapy After Primary Percutaneous Coronary Intervention: A Single-Center Randomized Trial in China
Authors: Li Yi-Yi , Zhong Xin-Jing , Luo Jun-Ting , Zeng Chun-Mei , Li He , Zhong Li-Qiu , Zou Guang-Xin
Published: June 2024

In this study, we investigated the safety and efficacy of fondaparinux sodium in postpercutaneous coronary intervention (PCI) anticoagulation therapy for patients with ST-segment elevation myocardial infarction. There are a total of 200 patients with ST segment elevation myocardial infarction underwent PCI and anticoagulation therapy. They were randomly split into experimental (n = 108) and control groups (n = 92). The experimental group received postoperative fondaparinux sodium (2.5 mg q.d), while the control group received enoxaparin (4000 IU q12 h). We did not use a loading dose for enoxaparin. Bleeding incidence and major adverse cardiovascular/cerebrovascular events were monitored during hospitalization, and at 1, 3, and 6 months postsurgery. The primary end points, including bleeding, mortality, and myocardial infarction during hospitalization, were not significantly different between the 2 groups. For secondary end points, the incidence of combined end point events at 1 month, 3 months, and 6 months after surgery in the experimental group was lower than in the control group (P < 0.05). According to Cox regression analysis, the risk of bleeding in the experimental group was significantly lower than that in the control group [hazard ratios: 0.506, 95% confidence interval (CI): 0.284–0.900] (P = 0.020). The risk of mortality in the experimental group was significantly lower than in the control group (hazard ratio: 0.188, 95% CI: 0.040–0.889) (P = 0.035). In summary, perioperative use of fondaparinux sodium during PCI in patients with STEMI in this study was associated with a lower risk of bleeding and death compared with enoxaparin use in the absence of loading dose.
Phospholipid metabolism-related genotypes of PLA2R1 and CERS4 contribute to nonobese MASLD
Authors: Shao Congxiang , Ye Junzhao , Dong Zhi , Liao Bing , Feng Shiting , Hu Shixian , Zhong Bihui
Published: June 2024

Background:

Abnormal phospholipid metabolism is linked to metabolic dysfunction–associated steatotic liver disease (MASLD) development and progression. We aimed to clarify whether genetic variants of phospholipid metabolism modify these relationships.

Methods:

This case-control study consecutively recruited 600 patients who underwent MRI-based proton density fat fraction examination (240 participants with serum metabonomics analysis, 128 biopsy-proven cases) as 3 groups: healthy control, nonobese MASLD, and obese MASLD, (n = 200 cases each). Ten variants of phospholipid metabolism-related genes [phospholipase A2 Group VII rs1805018, rs76863441, rs1421378, and rs1051931; phospholipase A2 receptor 1 (PLA2R1) rs35771982, rs3828323, and rs3749117; paraoxonase-1 rs662 and rs854560; and ceramide synthase 4 (CERS4) rs17160348)] were genotyped using SNaPshot.

Results:

The T-allele of CERS4 rs17160348 was associated with a higher risk of both obese and nonobese MASLD (OR: 1.95, 95% CI: 1.20–3.15; OR: 1.76, 95% CI: 1.08–2.86, respectively). PLA2R1 rs35771982-allele is a risk factor for nonobese MASLD (OR: 1.66, 95% CI: 1.11–1.24), moderate-to-severe steatosis (OR: 3.24, 95% CI: 1.96–6.22), and steatohepatitis (OR: 2.61, 95% CI: 1.15–3.87), while the paraoxonase-1 rs854560 T-allele (OR: 0.50, 95% CI: 0.26–0.97) and PLA2R1 rs3749117 C-allele (OR: 1.70, 95% CI: 1.14–2.52) are closely related to obese MASLD. After adjusting for sphingomyelin level, the effect of the PLA2R1 rs35771982CC allele on MASLD was attenuated. Furthermore, similar effects on the association between the CERS4 rs17160348 C allele and MASLD were observed for phosphatidylcholine, phosphatidic acid, sphingomyelin, and phosphatidylinositol.

Conclusions:

The mutations in PLA2R1 rs35771982 and CERS4 rs17160348 presented detrimental impact on the risk of occurrence and disease severity in nonobese MASLD through altered phospholipid metabolism.
Partial liver resection alters the bile salt-FGF19 axis in patients with perihilar cholangiocarcinoma: Implications for liver regeneration
Authors: Koelfat Kiran V.K. , Schaap Frank G. , van Mierlo Kim M.C. , Leníček Martin , Sauer Ilka , van der Kroft Gregory , Röth Anjali A.J. , Bednarsch Jan , Amygdalos Iakovos , Lurje Georg , Dewulf Maxime J.L. , Lang Sven A. , Neumann Ulf P. , Olde Damink Steven W.M.
Published: June 2024

Background:

Extended liver resection is the only treatment option for perihilar cholangiocarcinoma (pCCA). Bile salts and the gut hormone FGF19, both promoters of liver regeneration (LR), have not been investigated in patients undergoing resection for pCCA. We aimed to evaluate the bile salt-FGF19 axis perioperatively in pCCA and study its effects on LR.

Methods:

Plasma bile salts, FGF19, and C4 (bile salt synthesis marker) were assessed in patients with pCCA and controls (colorectal liver metastases), before and after resection on postoperative days (PODs) 1, 3, and 7. Hepatic bile salts were determined in intraoperative liver biopsies.

Results:

Partial liver resection in pCCA elicited a sharp decline in bile salt and FGF19 plasma levels on POD 1 and remained low thereafter, unlike in controls, where bile salts rose gradually. Preoperatively, suppressed C4 in pCCA normalized postoperatively to levels similar to those in the controls. The remnant liver volume and postoperative bilirubin levels were negatively associated with postoperative C4 levels. Furthermore, patients who developed postoperative liver failure had nearly undetectable C4 levels on POD 7. Hepatic bile salts strongly predicted hyperbilirubinemia on POD 7 in both groups. Finally, postoperative bile salt levels on day 7 were an independent predictor of LR.

Conclusions:

Partial liver resection alters the bile salt-FGF19 axis, but its derailment is unrelated to LR in pCCA. Postoperative monitoring of circulating bile salts and their production may be useful for monitoring LR.
Autoimmune hepatitis: Current and future therapies
Authors: Reau Nancy S. , Lammert Craig S. , Weinberg Ethan M.
Published: June 2024

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that can lead to cirrhosis and liver failure. AIH can present in all ages, races, and ethnicities, but it predominantly affects women. As a heterogeneous disease, AIH presents variably in different patients, making diagnosis and treatment a challenge. Currently, the standard treatment for AIH comprises immunosuppressants; however, their long-term use is associated with adverse effects. The pathogenesis of AIH is complex, involving T cells, macrophages, and plasma cells that invade the periportal parenchyma and lead to an inflammatory cascade that can result in liver damage. Due to the complexity of AIH pathogenesis, treatment targets several inflammatory pathways. However, unlike other autoimmune diseases in which targeted treatments have been approved, there has been little progress made in advancing the treatment paradigm for AIH. Major obstacles to progress include challenges in conducting clinical trials, particularly patient recruitment and ensuring a diverse range of backgrounds; poorly defined outcomes to assess treatment response and improved quality of life; and a lack of study designs that account for the stage of disease and variations in treatment. A focus on individualized and steroid-free treatment approaches is needed to improve AIH prognosis and minimize steroid-associated adverse effects.
Anticipated Effects of Higher-valency Pneumococcal Conjugate Vaccines on Colonization and Acute Otitis Media
Authors: Kaur Ravinder , Schulz Steven , Sherman Andrew , Andrejko Kristin , Kobayashi Miwako , Pichichero Michael
Published: June 2024

Background:

Bacterial etiologies of acute otitis media (AOM) have shifted from the introduction of pneumococcal conjugate vaccines (PCVs), antibiotic selection and competition among species. We characterized Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hflu) and Moraxella catarrhalis (Mcat) in the nasopharynx during well-child healthy visits and at the onset of AOM, and in middle ear fluid (MEF) of children with AOM to assess anticipated effects of higher-valency PCVs (PCV15 and PCV20).

Methods:

From September 2021 to September 2023, we conducted a prospective longitudinal cohort study of PCV13 immunized children 6–36 months old. MEF was collected via tympanocentesis. Serotyping and antibiotic susceptibility testing were performed on Spn, Hflu and Mcat isolates.

Results:

We obtained 825 nasopharyngeal and 216 MEF samples from 301 children. The order of frequency of nasopharyngeal colonization was Mcat, Spn and Hflu; Hflu was the predominant otopathogen in MEF. Among Spn isolates, non-PCV15, non-PCV20 serotypes predominated in the nasopharynx and in MEF; the most frequent serotype was 35B. Among MEF samples, 30% of Spn isolates were amoxicillin nonsusceptible; 23% of Hflu isolates and 100% of Mcat isolates were β-lactamase-producing.

Conclusion:

The majority of Spn isolates among young children were non-PCV15, non-PCV20 serotypes, especially serotype 35B; therefore, the impact of higher-valency PCVs in reducing pneumococcal colonization or AOM is expected to be limited. Hflu continues to be the most frequent AOM pathogen. Antibiotic susceptibility data suggest a high dose of amoxicillin/clavulanate or alternative drugs that are effective against contemporary mix of otopathogens could be considered for optimal empiric selection to provide the best efficacy.
A dynamic nomogram for predicting in-hospital major adverse cardiovascular and cerebrovascular events in patients with both coronary artery disease and atrial fibrillation: a multicenter retrospective study
Authors: Jian Jie , Zhang Lingqin , Zhang Yang , Jian Chang , Wang Tingting , Xie Mingxuan , Wu Wenjuan , Liang Bo , Xiong Xingliang
Published: June 2024

Background and objective

Patients with both coronary artery disease (CAD) and atrial fibrillation (AF) are at a high risk of major adverse cardiovascular and cerebrovascular events (MACCE) during hospitalization. Accurate prediction of MACCE can help identify high-risk patients and guide treatment decisions. This study was to elaborate and validate a dynamic nomogram for predicting the occurrence of MACCE during hospitalization in Patients with CAD combined with AF.

Methods

A total of 3550 patients with AF and CAD were collected. They were randomly assigned to a training group and a validation group in a ratio of 7 : 3. Univariate and multivariate analyses were utilized to identify risk factors (P < 0.05). To avoid multicollinearity and overfit of the model, the least absolute shrinkage and selection operator was conducted to further screen the risk factors. Calibration curves, receiver operating characteristic curves, and decision curve analyses are employed to assess the nomogram. For external validation, a cohort consisting of 249 patients was utilized from the Medical Information Mart for Intensive Care IV Clinical Database, version 2.2.

Results

Eight indicators with statistical differences were screened by univariate analysis, multivariate analysis, and the least absolute shrinkage and selection operator method (P < 0.05). The prediction model based on eight risk factors demonstrated good prediction performance in the training group, with an area under the curve (AUC) of 0.838. This performance was also maintained in the internal validation group (AUC = 0.835) and the external validation group (AUC = 0.806). Meanwhile, the calibration curve indicates that the nomogram was well-calibrated, and decision curve analysis revealed that the nomogram exhibited good clinical utility.

Conclusion

The nomogram we constructed may aid in stratifying the risk and predicting the prognosis for patients with CAD and AF.
Lactose malabsorption and intolerance in older adults
Authors: Gallo Antonella , Marzetti Emanuele , Pellegrino Simona , Montalto Massimo
Published: June 2024

Purpose of review

Lactose malabsorption and intolerance are very common conditions. However, their optimal approach, including the diagnostic assessment, remains a matter of debate, especially in advanced age. In this brief review, we focused on current knowledge, concerns, and impact in clinical practice of lactose malabsorption and intolerance in elderly.

Recent findings

Older adults are at high risk of malnutrition, owing to frequent occurrence of cognitive impairment, loss of appetite, dysphagia, and poor oral health. A significant decrease in the consumption of dairy products may lead to inadequate intake of high-quality protein and minerals, with a consequent impact on muscle and bone health. Testing for lactose malabsorption may be challenging in older adults, if not useless. Instead, a detailed clinical evaluation should always be pursued to identify both lactose intolerance and all confounding factors mimicking the same clinical picture.

The management of lactose malabsorption and intolerance in older adults deserves a personalized approach. Because of the importance of maintaining an adequate nutritional status in this age group, efforts should be put forth to avoid excessively restrictive diets.
Risks and benefits of nonsugar sweeteners: conflicting evidence between observational studies and randomized controlled trials
Authors: Faeh David
Published: June 2024

Purpose of review

Recommendations on the use of nonsugar sweeteners are contradictory, even if they come from official sources. The aim is to review and discuss recent findings on the potential impact of nonsugar sweeteners on human health.

Recent findings

While randomized controlled trials (RCTs) with short duration and risk factors endpoints mostly show favourable effects on body weight and cardiometabolic parameters when nonsugar sweeteners are used to replaced sugar-sweetened products, observational studies mostly show a positive association between the consumption of nonsugar sweeteners and cardiometabolic diseases. The conflicting results may be explained by the heterogenous nature of nonsugar sweeteners but also likely is a consequence of serious weaknesses of available studies.

For more evidence-based recommendations for practice and policy, scientifically sound studies with long follow-up are required.
Nutritional risk screening: a need to guide Alice in Nutritionland
Authors: Jager-Wittenaar Harriët , Sealy Martine , Naumann Elke , de van der Schueren Marian
Published: June 2024

Purpose of review

With the shifts in society, healthcare and the profile of the malnourished individual, a re-consideration of the goal of nutritional risk screening is needed: screening for malnutrition, or screening for risk of malnutrition? In this review article, we reflect on the role of nutritional risk screening in relation to prevention and treatment of malnutrition.

Recent findings

Within the Global Leadership Initiative on Malnutrition (GLIM) Initiative, modified Delphi studies are currently being conducted to reach global consensus on the conceptual definition and operationalization of ‘risk of malnutrition’. This is necessary because various studies have demonstrated that different nutritional screening tools identify different individuals, due to variability in screening tool criteria, which influences GLIM outcomes. Upon screening, three different situations can be distinguished: having risk factors for malnutrition without clear signs of presence of malnutrition, having mild signs of malnutrition (malnutrition in progress), or having obvious signs of malnutrition.

The outcomes of the studies on ‘risk of malnutrition’ will guide the screening step within the GLIM process, and will help professionals to make informed choices regarding screening policy and screening tool(s).
Cefuroxime induced agranulocytosis during heart transplant period: A case report
Authors: Liang Chu-Chun , Wei Jeng , Chang Chung-Yi
Published: June 2024

Rationale:

Cefuroxime is a commonly prescribed antibiotic known for its overall safety profile. However, in rare instances, it can lead to a life-threatening condition known as idiosyncratic drug-induced agranulocytosis (IDIA). While there have been few documented cases linking cefuroxime to this severe adverse reaction, a recent study sheds light on a critical case involving a patient awaiting a heart transplant.

Patient concern:

In this study, the patient developed agranulocytosis after 16 days and 72 grams of cefuroxime treatment. Agranulocytosis is characterized by a drastic reduction in neutrophil count, in this case dropping to 0/mm3.

Diagnosis:

IDIA is characterized by a drastic reduction in neutrophil count, in this case dropping to 0/mm3.

Intervention:

This IDIA coincided with the availability of a donor heart, prompting the medical team to proceed with an immediate heart transplant despite the patient’s compromised immune status. Ceasing cefuroxime administration and initiating treatment with G-CSF for 3 days played a pivotal role in normalizing neutrophil levels. A meticulously planned immunosuppressant regimen was also initiated.

Outcomes:

Precise management of immunosuppressants contributed to the patient’s successful recovery, leading to discharge.

Lessons:

The rationale for studying cases like these lies in the need for heightened awareness among healthcare providers. By documenting and analyzing such cases, medical professionals can better understand the risk factors, clinical presentation, and optimal management strategies for this uncommon yet serious adverse reaction. Furthermore, the study underscores the significance of individualized patient care, especially in complex scenarios such as organ transplantation. Precise adjustments to immunosuppressant therapy are crucial to balance the risks of rejection and infection, particularly in patients with compromised immune systems due to drug-induced agranulocytosis. In conclusion, this case serves as a reminder of the unpredictable nature of drug reactions and the importance of vigilant monitoring and rapid intervention in managing potentially life-threatening complications.
Artificial intelligence in maxillofacial and facial plastic and reconstructive surgery
Authors: Fung Ethan , Patel Dhruv , Tatum Sherard
Published: June 2024

Purpose of review

To provide a current review of artificial intelligence and its subtypes in maxillofacial and facial plastic surgery including a discussion of implications and ethical concerns.

Recent findings

Artificial intelligence has gained popularity in recent years due to technological advancements. The current literature has begun to explore the use of artificial intelligence in various medical fields, but there is limited contribution to maxillofacial and facial plastic surgery due to the wide variance in anatomical facial features as well as subjective influences. In this review article, we found artificial intelligence's roles, so far, are to automatically update patient records, produce 3D models for preoperative planning, perform cephalometric analyses, and provide diagnostic evaluation of oropharyngeal malignancies.

Artificial intelligence has solidified a role in maxillofacial and facial plastic surgery within the past few years. As high-quality databases expand with more patients, the role for artificial intelligence to assist in more complicated and unique cases becomes apparent. Despite its potential, ethical questions have been raised that should be noted as artificial intelligence continues to thrive. These questions include concerns such as compromise of the physician-patient relationship and healthcare justice.
Extracellular vesicles as novel uro-oncology biomarkers: insights toward clinical applications
Authors: Urabe Fumihiko , Tamura Takaaki , Sakamoto Shinichi , Kimura Takahiro , Ochiya Takahiro
Published: June 2024

Purpose of review

We discussed the challenges associated with the clinical application of extracellular vesicles and summarized their potential impact on oncological clinical practice in urology.

Recent findings

Despite extensive research on extracellular vesicles, their clinical applications remain limited; this is likely to be because of small study cohorts, a lack of large-scale analyses, and the impact of variable extraction and storage methods on analysis outcomes. However, promising results have emerged from clinical trials targeting urinary extracellular vesicles in prostate cancer using ExoDx Prostate Test. The ExoDx Prostate Test has demonstrated its efficacy in diagnosing prostate cancer in previous studies and is the only FDA-approved kit for this purpose. Moreover, recent trials have investigated the use of the ExoDx Prostate Test to determine the optimal timing for biopsies in prostate cancer patients undergoing active surveillance.

We summarized recent studies on the potential of extracellular vesicles in the management of urological cancers. Particularly, the diagnosis of prostate cancer using the ExoDx Prostate Test has yielded positive results in several clinical trials. Additionally, while there are other studies suggesting its efficacy, most of these are based on retrospective analyses. These findings warrant further large-scale studies to optimize extracellular vesicle-based diagnostic and monitoring strategies. Although further research is required, extracellular vesicles would be attractive for early detection and surveillance.
Abnormal Development of the Corpus Callosum in Autism Spectrum Disorder: An MRI Study
Authors: Badhe Suvarna , Nivins Samson , Kulkarni Pooja , Jose Alitta , Manek Divesh , Badhe Satyendra , Sane Hemangi , Gokulchandran Nandini , Badhe Prerna , Sharma Alok
Published: June 2024

Background:

Altered size in the corpus callosum (CC) has been reported in individuals with autism spectrum disorder (ASD), but few studies have investigated younger children. Moreover, knowledge about the age-related changes in CC size in individuals with ASD is limited.

Objectives:

Our objective was to investigate the age-related size of the CC and compare them with age-matched healthy controls between the ages of 2 and 18 years.

Methods:

Structural-weighted images were acquired in 97 male patients diagnosed with ASD; published data were used for the control group. The CC was segmented into 7 distinct subregions (rostrum, genu, rostral body, anterior midbody, posterior midbody, isthmus, and splenium) as per Witelson's technique using ITK-SNAP software. We calculated both the total length and volume of the CC as well as the length and height of its 7 subregions. The length of the CC measures was studied as both continuous and categorical forms. For the continuous form, Pearson's correlation was used, while categorical forms were based on age ranges reflecting brain expansion during early postnatal years. Differences in CC measures between adjacent age groups in individuals with ASD were assessed using a Student t-test. Mean and standard deviation scores were compared between ASD and control groups using the Welch t-test.

Results:

Age showed a moderate positive association with the total length of the CC (r = 0.43; P
adj = 0.003) among individuals with ASD. Among the subregions, a positive association was observed only in the anterior midbody of the CC (r = 0.41; P
adj = 0.01). No association was found between the age and the height of individual subregions or with the total volume of the CC. In comparison with healthy controls, individuals with ASD exhibited shorter lengths and heights of the genu and splenium of the CC across wide age ranges.

Conclusion:

Overall, our results highlight a distinct abnormal developmental trajectory of CC in ASD, particularly in the genu and splenium structures, potentially reflecting underlying pathophysiological mechanisms that warrant further investigation.
Genetic diversity and spread dynamics of SARS-CoV-2 variants present in African populations
Authors: Mtetwa Desire , Manjengwa Tafadzwa , Chikwambi Zedias
Published: June 2024

The dynamics of coronavirus disease-19 (COVID-19) have been extensively researched in many settings around the world, but little is known about these patterns in Africa. A total of 7540 complete nucleotide genomes from 51 African nations were obtained and analysed using the National Center for Biotechnology Information and Global Initiative on Sharing Influenza Data databases to examine the genetic diversity and spread dynamics of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineages circulating in Africa. Using various clade and lineage nomenclature schemes, we examined their diversity and used maximum parsimony inference methods to reconstruct the evolutionary hypotheses about the spread of the virus in Africa. According to this study, only 465 of the 2610 Pango lineages found to have existed in the world circulated in Africa three years after the COVID-19 pandemic, with five different lineages dominating at various points during the outbreak. We identified South Africa, Kenya and Nigeria as key sources of viral transmission among sub-Saharan African nations. These findings provide insights into the viral strains that circulate in Africa and their evolutionary patterns.
On the solubility of azodicarbonamide in water/DMSO mixtures: an experimental and computational study
Authors: Macetti Giovanni , Sironi Luca , Rovida Costanza , Geremia Ilaria , Soave Raffaella , Presti Leonardo Lo
Published: June 2024

This work aims at studying why azodicarbonamide (ADCA), a formally apolar compound with good hydrogen bond (HB) acceptors, is soluble only in polar aprotic solvents like dimethyl sulfoxide (DMSO) but not in water. Solubility measurements, as well as quantum mechanical and classical molecular dynamics simulations, were employed to tackle the problem. We found that in the liquid phase a polar conformer of ADCA (
µ
= 8.7 D), unreported to date, is favoured under the enthalpic drive provided by a highly polar solvent. At the same time, the very high hydrogen bond propensity of water with itself prevents this solvent from providing an effective hydrogen bond-mediated solvation. Solvents bearing good HB acceptors, while lacking strong HB donors, contribute to further stabilizing solute–solvent adducts through weak and fluxional HBs that involve the amide groups of ADCA. Implications for the solubility of ADCA down to
µ
M concentrations were evaluated, also with the aid of classical simulations of solution nanodroplets.
The genetic origins and impacts of historical Papuan migrations into Wallacea
Authors: Purnomo Gludhug A. , Kealy Shimona , O’Connor Sue , Schapper Antoinette , Shaw Ben , Llamas Bastien , Teixeira Joao C. , Sudoyo Herawati , Tobler Raymond
Published: June 2024

The tropical archipelago of Wallacea was first settled by anatomically modern humans (AMH) by 50 thousand years ago (kya), with descendent populations thought to have remained genetically isolated prior to the arrival of Austronesian seafarers around 3.5 kya. Modern Wallaceans exhibit a longitudinal countergradient of Papuan- and Asian-related ancestries widely considered as evidence for mixing between local populations and Austronesian seafarers, though converging multidisciplinary evidence suggests that the Papuan-related component instead comes primarily from back-migrations from New Guinea. Here, we reconstruct Wallacean population genetic history using more than 250 newly reported genomes from 12 Wallacean and three West Papuan populations and confirm that the vast majority of Papuan-related ancestry in Wallacea (∼75–100%) comes from prehistoric migrations originating in New Guinea and only a minor fraction is attributable to the founding AMH settlers. Mixing between Papuan and local Wallacean lineages appear to have been confined to the western and central parts of the archipelago and likely occurred contemporaneously with the widespread introduction of genes from Austronesian seafarers—which now comprise between ∼40–85% of modern Wallacean ancestry—though dating historical admixture events remains challenging due to mixing continuing into the Historical Period. In conjunction with archaeological and linguistic records, our findings point to a dynamic Wallacean population history that was profoundly reshaped by the spread of Papuan genes, languages, and culture in the past 3,500 years.
Tracking the genetic diversity of SARS-CoV-2 variants in Nicaragua throughout the COVID-19 Pandemic
Authors: Alemán Gerald Vásquez , Cerpas Cristhiam , Juarez Jose G. , Moreira Hanny , Arguello Sonia , Coloma Josefina , Harris Eva , Gordon Aubree , Bennett Shannon N. , Balmaseda Ángel
Published: June 2024

The global circulation of SARS-CoV-2 has been extensively documented, yet the dynamics within Central America, particularly Nicaragua, remain underexplored. This study characterizes the genomic diversity of SARS-CoV-2 in Nicaragua from March 2020 through December 2022, utilizing 1064 genomes obtained via next-generation sequencing. These sequences were selected nationwide and analyzed for variant classification, lineage predominance, and phylogenetic diversity. We employed both Illumina and Oxford Nanopore Technologies for all sequencing procedures. Results indicated a temporal and spatial shift in dominant lineages, initially from B.1 and A.2 in early 2020 to various Omicron subvariants towards the study’s end. Significant lineage shifts correlated with changes in COVID-19 positivity rates, underscoring the epidemiological impact of variant dissemination. The comparative analysis with regional data underscored the low diversity of circulating lineages in Nicaragua and their delayed introduction compared to other countries in the Central American region. The study also linked specific viral mutations with hospitalization rates, emphasizing the clinical relevance of genomic surveillance. This research advances the understanding of SARS-CoV-2 evolution in Nicaragua and provide valuable information regarding its genetic diversity for public health officials in Central America. We highlight the critical role of ongoing genomic surveillance in identifying emergent lineages and informing public health strategies.