bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamical distribution of continuous service time model involving non-Maxwellian collision kernel and value functions
Authors: Zhao 赵 Minfang 敏芳 , Kong 孔 Lingting 令婷 , Liu 刘 Miao 淼 , Lai 赖 Shaoyong 绍永
Published: July 2024

The distribution of continuous service time in call centers is investigated. A non-Maxwellian collision kernel combining two different value functions in the interaction rule are used to describe the evolution of continuous service time, respectively. Using the statistical mechanical and asymptotic limit methods, Fokker–Planck equations are derived from the corresponding Boltzmann-type equations with non-Maxwellian collision kernels. The steady-state solutions of the Fokker–Planck equation are obtained in exact form. Numerical experiments are provided to support our results under different parameters.
The Backscatter Gating method for time, energy, and position resolution characterization of long form factor organic scintillators
Authors: Ratliff Hunter N. , Kögler Toni , Pausch Guntram , Setterdahl Lena M. , Skjerdal Kyrre , Turko Joseph A. , Meric Ilker
Published: July 2024

This work details a Compton-scattering-based methodology, referred to as Backscatter Gating (BSG), for characterizing the time, energy, and position resolutions of long form factor organic scintillators using a single, fairly minimal measurement setup. Such a method can ease the experimental burden in scenarios where many such scintillator elements may need to be individually characterized before assembly into a larger detector system. A thorough theoretical exploration of the systematic parameters is provided, and the BSG method is then demonstrated by a series of experimental measurements. This “complete” characterization via the BSG method is novel, having previously been used primarily for energy resolution characterization. The method also allows for determination of the assembled scintillator's technical attenuation length and provides a means of verifying the presence or absence of flaws within the scintillator or its optical coupling.
Rising above the noise: the influence of population dynamics on the evolution of acoustic signaling
Authors: Suswaram Megha , Bhat Uttam , Yeakel Justin D
Published: July 2024

Acoustic signaling is employed by many sexually reproducing species to select for mates and enhance fitness. However, signaling in dense populations can create an auditory background, or chorus, which may interfere with a signal receiver’s phonotactic selectivity, or the ability to distinguish individual signals. Feedback between the strength of an individual’s signal, phonotactic selectivity, and population size, may interact in complex ways to impact the evolution of signaling within a population, potentially leading to the emergence of silence. Here we formulate a general model that captures the dynamic feedback between individual acoustic signalers, phonotactic selectivity, and the population-level chorus to explore the eco-evolutionary dynamics of an acoustic trait within a population. We find that population dynamics have a significant influence on the evolutionary dynamics of the signaling trait, and that very sharp transitions separate conspicuous from silent populations. Our framework also reveals that increased phonotactic selectivity promotes the stability of signaling populations, and that transitions from signaling to silence are prone to hysteresis. We suggest that understanding the relationship between factors influencing population size, such as environmental productivity, as well as factors influencing phonotactic selectivity, such as anthropogenic noise, are central to understanding the complex mosaic of acoustically signaling and silent populations.
Community-engaged flood mitigation and ecological restoration on a university campus
Authors: Samuels Brendon , Cull Tom , Smeltzer Sandra
Published: July 2024

Urban flooding is a major climate change risk that can be mitigated with green infrastructure such as tree plantings and restored naturalised buffers along watercourses. The creation and maintenance of green infrastructure projects for climate change adaptation provides opportunities for community partnerships and programming with co-benefits for human well-being and biodiversity. Here we present findings of action research on flood mitigation and education that was implemented on an urban higher education institution’s campus in partnerships within the university and with local Indigenous peoples, the regional conservation authority, the municipal government, and the public library. Through participatory workshops, we applied bioengineering and mixed planting methods to restore a creek bank. Using a combination of oral storytelling, digital media, and visual art that integrated perspectives across disciplines and knowledge systems, we situated our creek restoration project within a framework of environmental justice, emphasising specific acts of stewardship to improve watershed health and advance reconciliation. We produced digital resources and outreach materials to disseminate lessons from the project into the community and to support similar flood mitigation efforts at local and global scales. Our project demonstrates how incorporating partnerships into the design and implementation of nature-based solutions can build cross-cultural ecological knowledge, forge important on- and off-campus relationships, and create place-based opportunities for students to take direct and measurable action on climate change.
Natural Resource Contracts and Net Zero
Authors: Talus Kim , Hasan Qaraman M , Olawuyi Damilola S
Published: July 2024

The chapter argues that the regulatory regime in general, and natural resources contracts in particular, require a radical shift to be aligned with net zero objectives. With increasing demand for transition minerals, contractual clauses and provisions, such as stabilization and dispute resolution clauses in preexisting long-term resource contracts, may constrain or even freeze states’ sovereign rights and abilities to advance net zero. On the other hand, failure to address new and emerging environment, social, and governance risks associated with the rush for transition minerals may result in complex disputes and conflicts. There is an urgent need to move towards more net zero and climate-aligned natural resource contracts that accommodate new realities. Legal and institutional barriers facing resource-rich countries in adapting existing contract forms to accommodate new realities in a net zero era are examined, while the need for increased international solidarity, through capacity development, is highlighted.
Hydrogen and the Net Zero Transition
Authors: van den Berg Hugo Meyer
Published: July 2024

Hydrogen has the potential to become a primary energy source for transportation and heat generation. It can also be used for sustainable and long-term energy storage and transport and could offer an attractive solution to address energy insecurity concerns during the net zero transition, mainly if hydrogen can be produced pollution-free. Notwithstanding the promises of green hydrogen, the introduction thereof in a country’s energy mix, especially in countries with no specific regulatory frameworks on hydrogen production, poses various challenges. In addition to meeting capital requirements, since most existing regulatory frameworks do not expressly envisage green hydrogen production, introducing green hydrogen projects in many countries will require substantial and apposite policy measures to accommodate hydrogen production. This chapter examines the role that hydrogen can play in achieving net zero. It then discusses the legal barriers to introducing green hydrogen in the energy mix before discussing the policy considerations that may guide in addressing these barriers.
Temporal dynamics of depressive symptoms and cognitive decline in the oldest old: dynamic time warp analysis of the Leiden 85-plus study
Authors: van der Slot Abe J C , Bertens Anne Suzanne , Trompet Stella , Mooijaart Simon P , Gussekloo Jacobijn , van den Bos Frederiek , Giltay Erik J
Published: July 2024

Background

The prevalence of depressive symptoms and cognitive decline increases with age. We investigated their temporal dynamics in individuals aged 85 and older across a 5-year follow-up period.

Methods

Participants were selected from the Leiden 85-plus study and were eligible if at least three follow-up measurements were available (325 of 599 participants). Depressive symptoms were assessed at baseline and at yearly assessments during a follow-up period of up to 5 years, using the 15-item Geriatric Depression Scale (GDS-15). Cognitive decline was measured through various tests, including the Mini Mental State Exam, Stroop test, Letter Digit Coding test and immediate and delayed recall. A novel method, dynamic time warping analysis, was employed to model their temporal dynamics within individuals, in undirected and directed time-lag analyses, to ascertain whether depressive symptoms precede cognitive decline in group-level aggregated results or vice versa.

Results

The 325 participants were all 85 years of age at baseline; 68% were female, and 45% received intermediate to higher education. Depressive symptoms and cognitive functioning significantly covaried in time, and directed analyses showed that depressive symptoms preceded most of the constituents of cognitive impairment in the oldest old. Of the GDS-15 symptoms, those with the strongest outstrength, indicating changes in these symptoms preceded subsequent changes in other symptoms, were worthlessness, hopelessness, low happiness, dropping activities/interests, and low satisfaction with life (all P’s < 0.01).

Conclusion

Depressive symptoms preceded cognitive impairment in a population based sample of the oldest old.
MiPRIME: an integrated and intelligent platform for mining primer and probe sequences of microbial species
Authors: Zhang Zhiming , Ren Jing , Ren Lili , Zhang Lanying , Ai Qubo , Long Haixin , Ren Yi , Yang Kun , Feng Huiying , Li Sabrina , Li Xu
Published: July 2024

Motivation

Accurately detecting pathogenic microorganisms requires effective primers and probe designs. Literature-derived primers are a valuable resource as they have been tested and proven effective in previous research. However, manually mining primers from published texts is time-consuming and limited in species scop.

Results

To address these challenges, we have developed MiPRIME, a real-time Microbial Primer Mining platform for primer/probe sequences extraction of pathogenic microorganisms with three highlights: (i) comprehensive integration. Covering >40 million articles and 548 942 organisms, the platform enables high-frequency microbial gene discovery from a global perspective, facilitating user-defined primer design and advancing microbial research. (ii) Using a BioBERT-based text mining model with 98.02% accuracy, greatly reducing information processing time. (iii) Using a primer ranking score, PRscore, for intelligent recommendation of species-specific primers. Overall, MiPRIME is a practical tool for primer mining in the pan-microbial field, saving time and cost of trial-and-error experiments.

Availability and implementation

The web is available at {{https://www.ai-bt.com}}.
Unravelling reference bias in ancient DNA datasets
Authors: Dolenz Stephanie , van der Valk Tom , Jin Chenyu , Oppenheimer Jonas , Sharif Muhammad Bilal , Orlando Ludovic , Shapiro Beth , Dalén Love , Heintzman Peter D
Published: July 2024

Motivation

The alignment of sequencing reads is a critical step in the characterization of ancient genomes. However, reference bias and spurious mappings pose a significant challenge, particularly as cutting-edge wet lab methods generate datasets that push the boundaries of alignment tools. Reference bias occurs when reference alleles are favoured over alternative alleles during mapping, whereas spurious mappings stem from either contamination or when endogenous reads fail to align to their correct position. Previous work has shown that these phenomena are correlated with read length but a more thorough investigation of reference bias and spurious mappings for ancient DNA has been lacking. Here, we use a range of empirical and simulated palaeogenomic datasets to investigate the impacts of mapping tools, quality thresholds, and reference genome on mismatch rates across read lengths.

Results

For these analyses, we introduce AMBER, a new bioinformatics tool for assessing the quality of ancient DNA mapping directly from BAM-files and informing on reference bias, read length cut-offs and reference selection. AMBER rapidly and simultaneously computes the sequence read mapping bias in the form of the mismatch rates per read length, cytosine deamination profiles at both CpG and non-CpG sites, fragment length distributions, and genomic breadth and depth of coverage. Using AMBER, we find that mapping algorithms and quality threshold choices dictate reference bias and rates of spurious alignment at different read lengths in a predictable manner, suggesting that optimized mapping parameters for each read length will be a key step in alleviating reference bias and spurious mappings.

Availability and implementation

AMBER is available for noncommercial use on GitHub (https://github.com/tvandervalk/AMBER.git). Scripts used to generate and analyse simulated datasets are available on Github (https://github.com/sdolenz/refbias_scripts).
Policy and Practice with Lesbian, Gay, Bisexual, Trans and Queer (LGBTQ+) Care-Experienced Young People—A National Survey of Local Authorities in England
Authors: Cossar Jeanette , Belderson Pippa
Published: July 2024

There is scant research on the experiences and needs of lesbian, gay, bisexual, trans and queer/questioning young people growing up in care in the UK. This article reports on a national survey of local authorities (LAs) in England, which aimed to explore what data LAs collect relating to sexual orientation and gender identity, as well as exploring existing LA policies and practices in relation to LGBTQ+ young people growing up in out-of-home care. The survey asked about policy, recording, support and training. Respondents were senior managers in LAs with responsibility for looked after children. The survey response rate was 78 per cent (n = 118). The survey found a lack of specific policy relating to this population and little central recording of sexual orientation and gender identity (SOGI) data, although most LAs suggested information would be recorded in individual case records. LAs described a variety of ways in which they supported LGBTQ+ young people in practice at both individual and organisational levels but highlighted a lack of staff knowledge and confidence. Training provision was more likely to be provided for social workers than for foster carers or residential staff. Implications for practice are discussed.
2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Complicated Intra-abdominal Infections: Risk Assessment in Adults and Children
Authors: Bonomo Robert A , Chow Anthony W , Abrahamian Fredrick M , Bessesen Mary , Dellinger E Patchen , Edwards Morven S , Goldstein Ellie , Hayden Mary K , Humphries Romney , Kaye Keith S , Potoski Brian A , Rodríguez-Baño Jesús , Sawyer Robert , Skalweit Marion , Snydman David R , Tamma Pranita D , Donnelly Katelyn , Kaur Dipleen , Loveless Jennifer
Published: July 2024

This paper is part of a clinical practice guideline update on the risk assessment, diagnostic imaging, and microbiological evaluation of complicated intra-abdominal infections in adults, children, and pregnant people, developed by the Infectious Diseases Society of America. In this paper, the panel provides a recommendation for risk stratification according to severity of illness score. The panel's recommendation is based on evidence derived from systematic literature reviews and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.
Neurodegenerative diseases associated with the disruption of proteostasis and their therapeutic strategies using chemical chaperones
Authors: Sugiyama Takashi , Nishitoh Hideki
Published: July 2024

Aberrant proteostasis is thought to be involved in the pathogenesis of neurodegenerative diseases. Some proteostasis abnormalities are ameliorated by chaperones. Chaperones are divided into three groups: molecular, pharmacological and chemical. Chemical chaperones intended to alleviate stress in organelles, such as the endoplasmic reticulum (ER), are now being administered clinically. Of the chemical chaperones, 4-phenylbutyrate (4-PBA) has been used as a research reagent, and its mechanism of action includes chaperone effects and the inhibition of histone deacetylase. Moreover, it also binds to the B-site of SEC24 and regulates COPII-mediated transport from the ER. Although its therapeutic effect may not be strong, elucidating the mechanism of action of 4-PBA may contribute to the identification of novel therapeutic targets for neurodegenerative diseases.
Genomic instability in non–breast or ovarian malignancies of individuals with germline pathogenic variants in BRCA1/2
Authors: Elze Lisa , van der Post Rachel S , Vos Janet R , Mensenkamp Arjen R , Pamidimarri Naga Samhita , Hampstead Juliet E , Vermeulen Emma , Oorsprong Michiel , Hofste Tom , Simons Michiel , Nagtegaal Iris D , Hoogerbrugge Nicoline , de Voer Richarda M , Ligtenberg Marjolijn J L
Published: July 2024

Background

Individuals with germline pathogenic variants in BRCA1 or BRCA2 are at a high risk of breast and ovarian carcinomas with BRCA1/2 deficiency and homologous recombination deficiency that can be detected by analysis of genome-wide genomic instability features such as large-scale state transitions, telomeric allelic imbalances, and genomic loss of heterozygosity. Malignancies with homologous recombination deficiency are more sensitive to platinum-based therapies and poly(ADP-ribose) polymerase inhibitors. We investigated the fraction of non–breast or ovarian malignancies that have BRCA1/2 deficiency and genomic instability features.

Methods

The full tumor history of a large, historical, clinic-based, consecutive cohort of 2965 individuals with germline pathogenic variants in BRCA1/2 was retrieved from the Dutch nationwide pathology databank (Palga). In total, 169 non–breast or ovarian malignancies were collected and analyzed using targeted next-generation sequencing and shallow whole-genome sequencing to determine somatic second-hit alterations and genomic instabilities indicative of homologous recombination deficiency, respectively.

Results

BRCA1/2 deficiency was detected in 27% (21/79) and 23% (21/90) of 20 different types of non–breast or ovarian malignancies in individuals with germline pathogenic variants in BRCA1 and BRCA2, respectively. These malignancies had a higher genomic instability score than BRCA1- or BRCA2-proficient malignancies (P < .001 and P < .001, respectively).

Conclusions

BRCA1/2 deficiency and genomic instability features were found in 27% and 23% of a broad spectrum of non–breast or ovarian malignancies in individuals with germline pathogenic variants in BRCA1 and BRCA2, respectively. Evaluation of the effectiveness of poly(ADP-ribose) polymerase inhibitors in these individuals should be focused on tumors with a confirmed absence of a wild-type allele.
Dramatic response to crizotinib through MET phosphorylation inhibition in rare TFG-MET fusion advanced squamous cell lung cancer
Authors: Cheng Wanwan , Xu Ting , Yang Lu , Yan Naimeng , Yang Jie , Fang Shencun
Published: July 2024

With the widespread use of next-generation sequencing (NGS) for solid tumors, mesenchymal-to-epithelial transition factor (MET) rearrangement/fusion has been confirmed in multiple cancer types. MET amplification and MET exon 14 skipping mutations induce protein autophosphorylation; however, the pathogenic mechanism and drug sensitivity of MET fusion remain unclear. The following report describes the clinical case of a patient diagnosed with squamous lung cancer bearing a TFG-MET gene fusion. In vitro assays demonstrated MET phosphorylation and oncogenic capacity due to the TFG-MET rearrangement, both of which were inhibited by crizotinib treatment. The patient was treated with crizotinib, which resulted in sustained partial remission for more than 17 months. Collectively, cellular analyses and our case report emphasize the potential of MET fusion as a predictive biomarker for personalized target therapy for solid tumors.
Soybean ethylene response factors GmENS1 and GmENS2 promote nodule senescence
Authors: Xiao Aifang , Wu Jiashan , Wang Weiyun , Guan Yuxin , Zhuang Mengting , Guo Xiaoli , Zhu Hui , Yu Haixiang , Cao Yangrong
Published: July 2024

The final phase in root nodule development is nodule senescence. The mechanism underlying the initiation of nodule senescence requires further elucidation. In this study, we investigate the intrinsic signals governing soybean (Glycine max L. Merr.) nodule senescence, uncovering ethylene as a key signal in this intricate mechanism. Two AP2/ethylene response factor (ERF) transcription factor (TF) genes, GmENS1 and GmENS2 (Ethylene-responsive transcription factors required for Nodule Senescence), exhibit heightened expression levels in both aged nodules and nodules treated with ethylene. An overexpression of either GmENS1 or GmENS2 accelerates senescence in soybean nodules, whereas the knockout or knockdown of both genes delays senescence and enhances nitrogenase activity. Furthermore, our findings indicate that GmENS1 and GmENS2 directly bind to the promoters of GmNAC039, GmNAC018, and GmNAC030, encoding 3 NAC (NAM, ATAF1/2, and CUC2) TFs essential for activating soybean nodule senescence. Notably, the nodule senescence process mediated by GmENS1 or GmENS2 overexpression is suppressed in the soybean nac039/018/030 triple mutant compared with the wild-type control. These data indicate GmENS1 and GmENS2 as pivotal TFs mediating ethylene-induced nodule senescence through the direct activation of GmNAC039/GmNAC018/GmNAC030 expression in soybean.
Selective decision-making and collective behavior of fish by the motion of visual attention
Authors: Ito Susumu , Uchida Nariya
Published: July 2024

Collective motion provides a spectacular example of self-organization in Nature. Visual information plays a crucial role among various types of information in determining interactions. Recently, experiments have revealed that organisms such as fish and insects selectively utilize a portion, rather than the entirety, of visual information. Here, focusing on fish, we propose an agent-based model where the direction of attention is guided by visual stimuli received from the images of nearby fish. Our model reproduces a branching phenomenon where a fish selectively follows a specific individual as the distance between two or three nearby fish increases. Furthermore, our model replicates various patterns of collective motion in a group of agents, such as vortex, polarized school, swarm, and turning. We also discuss the topological nature of the visual interaction, as well as the positional distribution of nearby fish and the map of pairwise and three-body interactions induced by them. Through a comprehensive comparison with existing experimental results, we clarify the roles of visual interactions and issues to be resolved by other forms of interactions.
Upper Limb Function in People With Upper and Lower Limb Loss 8 Years Postinjury: The Armed Services Trauma Outcome Study (ADVANCE) Cohort Study
Authors: Watson Fraje C E , Kedgley Angela E , Schofield Susie , Behan Fearghal P , Boos Christopher J , Fear Nicola T , Bennett Alexander N , Bull Anthony M J
Published: July 2024

Objective

Upper limb (UL) disability in people with UL loss is well reported in the literature, less so for people with lower limb loss. This study aimed to compare UL disability in injured (major trauma) and uninjured UK military personnel, with particular focus on people with upper and lower limb loss.

Methods

A volunteer sample of injured (n = 579) and uninjured (n = 566) UK military personnel who served in a combat role in the Afghanistan war were frequency matched on age, sex, service, rank, regiment, role, and deployment period and recruited to the Armed Services Trauma Rehabilitation Outcome (ADVANCE) longitudinal cohort study. Participants completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, scored from 0 (no disability) to 100 (maximum disability) 8 years postinjury. Mann–Whitney U and Kruskal–Wallis tests were used to compared DASH scores between groups. An ordinal model was used to assess the effect of injury and amputation on DASH scores.

Results

DASH scores were higher in the Injured group compared to the Uninjured group (3.33 vs 0.00) and higher in people with lower limb loss compared to the Uninjured group (0.83 vs 0.00), although this was not statistically significant. In the adjusted ordinal model, the odds of having a higher DASH score was 1.70 (95% CI = 1.18–2.47) times higher for people with lower limb loss compared to the Uninjured group. DASH score was not significantly different between people with major and partial UL loss (15.42 vs 12.92). The odds of having a higher DASH score was 8.30 (95% CI = 5.07–13.60) times higher for people with UL loss compared to the Uninjured group.

Conclusion

People with lower limb loss have increased odds of having more UL disability than the Uninjured population 8 years postinjury. People with major and partial UL loss have similar UL disability. The ADVANCE study will continue to follow this population for the next 20 years.

Impact

For the first time, potential for greater long-term UL disability has been shown in people with lower limb loss, likely resulting from daily biomechanical compensations such as weight-bearing, balance, and power generation. This population may benefit from prophylactic upper limb rehabilitation, strength, and technique.
Clinical Outcomes Associated With a Remote Postpartum Hypertension Monitoring Program
Authors: Lemon Lara S. , Quinn Beth , Binstock Anna , Larkin Jacob C. , Simhan Hyagriv N. , Hauspurg Alisse
Published: July 2024

OBJECTIVE:

To evaluate differences in health care utilization and guideline adherence for postpartum individuals with hypertensive disorders of pregnancy (HDP) who are engaged in a remote monitoring program, compared with usual care.

METHODS:

This was a retrospective cohort study of postpartum individuals with HDP who delivered between March 2019 and June 2023 at a single institution. The primary exposure was enrollment in a remote hypertension management program that relies on patient home blood pressure (BP) measurement and centralized nursing team management. Patients enrolled in the program were compared with those receiving usual care. Outcomes included postpartum readmission, office visit within 6 weeks postpartum, BP measurement within 10 days, and initiation of antihypertensive medication. We performed multivariable logistic and conditional regression in a propensity score matched cohort. Propensity scores, generated by modeling likelihood of program participation, were assessed for even distribution by group, ensuring standardized bias of less than 10% after matching.

RESULTS:

Overall, 12,038 eligible individuals (6,556 participants, 5,482 in the control group) were included. Program participants were more likely to be White, commercially insured, be diagnosed with preeclampsia, and have higher prenatal and inpatient postpartum BPs. Differences in baseline factors were well-balanced after implementation of propensity score. Program enrollment was associated with lower 6-week postpartum readmission rates, demonstrating 1 fewer readmission for every 100 individuals in the program (propensity score–matched adjusted risk difference [aRD] −1.5, 95% CI, −2.6 to −0.46; adjusted risk ratio [aRR] 0.78, 95% CI, 0.65–0.93). For every 100 individuals enrolled in the program, 85 more had a BP recorded within 10 days (propensity score–matched aRD 85.4, 95% CI, 84.3–86.6), and six more had a 6-week postpartum office visit (propensity score–matched aRD 5.7, 95% CI, 3.9–7.6). Program enrollment was also associated with increased initiation of an antihypertensive medication postpartum (propensity score–matched aRR 4.44, 95% CI, 3.88–5.07).

CONCLUSION:

Participation in a postpartum remote BP monitoring program was associated with fewer postpartum hospital readmissions, higher attendance at postpartum visits, improved guideline adherence, and higher rates of antihypertensive use.
Cardiovascular Risk Factor Management After Hypertensive Disorders of Pregnancy
Authors: Lewey Jennifer , Sheehan Megan , Bello Natalie A. , Levine Lisa D.
Published: July 2024

Hypertensive disorders of pregnancy (HDP) are associated with significantly increased risk of developing future cardiovascular disease (CVD). Obstetricians play a crucial role in CVD prevention for postpartum women and birthing people with HDP because they are primarily responsible for immediate postpartum management and can assist with care transitions to other health care practitioners for long-term management of CVD risk factors. Standardized calculators can be used to evaluate long-term CVD risk, which can help guide intensity of treatment. Emerging technologies such as remote blood pressure monitoring demonstrate promise for improving outcomes among patients with HDP. After HDP, all patients should be advised of their increased CVD risk. A plan should be made to initiate lifestyle modifications and antihypertensive therapy to achieve optimal blood pressure control with a target of lower than 130/80 mm Hg, assess lipids within 2–3 years of delivery, and evaluate for development of type 2 diabetes. Other CVD risk factors such as nicotine use should similarly be identified and addressed. In this review, we summarize the essential components of managing CVD risk after a pregnancy complicated by HDP, including blood pressure monitoring, risk stratification tools, and evidence-based lifestyle recommendations.
From Bed to Bench: Pre-analytical Stability of 29 Anti-infective Agents in Plasma and Whole Blood to Improve Accuracy of Therapeutic Drug Monitoring
Authors: Magreault Sophie , Pierredon Dorine , Akinotcho-Relouzat Judith , Méchaï Frédéric , Lamy Brigitte , Jaureguy Françoise , Jullien Vincent
Published: July 2024

Background:

Therapeutic drug monitoring requires a validated assay and appropriate conditions for sample shipment and storage based on the stability of the compound to be analyzed. This study evaluated the stability of 29 antimicrobial compounds in whole blood (WB) and plasma samples under various storage conditions.

Methods:

The pre-analytical stability of 22 antibiotics (amoxicillin, aztreonam, cefazolin, cefepime, cefotaxime, cefoxitin, ceftazidime, ceftobiprole, ceftolozane, ceftriaxone, ciprofloxacin, clindamycin, cloxacillin, daptomycin, levofloxacin, linezolid, meropenem, metronidazole, moxifloxacin, piperacillin, sulfamethoxazole, and trimethoprim), 2 beta-lactamase inhibitors (avibactam, tazobactam), and 5 antituberculosis drugs (ethambutol, isoniazid, pyrazinamide, rifabutin, and rifampicin) was assessed by WB for up to 24 hours at room temperature (RT) and 72 hours at +4°C. The stability in plasma was evaluated for up to 6 hours at RT, 24 hours at +4°C, 1 month at −20°C, and 6 months at −80°C.

Results:

Concerning WB stability, all investigated compounds were stable for 24 hours at RT, except meropenem and isoniazid, which were stable for 6 hours; however, for 24 hours at +4°C, all the compounds were stable. For storage durations of 48 and 72 hours at +4°C, all compounds were stable, except for ciprofloxacin, cotrimoxazole, and isoniazid. Concerning stability in plasma, all compounds were stable for 6 hours at RT, and all except isoniazid were stable for 24 hours at +4°C. All the tested compounds were stable for 7 days at −20°C, except isoniazid, for which a degradation of approximately 20% was observed. An important degradation was observed for beta-lactam antibiotics after 1 month at −20°C. All compounds were stable at −80°C for 6 months.

Conclusions:

The pre-analytical stabilities of several anti-infective compounds was described. The present results can be used to determine the appropriate conditions for shipping and storing samples dedicated to therapeutic drug monitoring of the investigated compounds.
Quantification of the Plasma Concentration of Vadadustat by High-Performance Liquid Chromatography with Ultraviolet Detection and Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry
Authors: Yokoyama Satoshi , Nakagawa Junichi , Shimada Michiko , Ueno Kayo , Ishiyama Masahiro , Nakamura Norio , Tomita Hirofumi , Niioka Takenori
Published: July 2024

Background:

An inexpensive, simple, and accurate plasma concentration measurement system is needed to actively conduct pharmacokinetic and pharmacodynamic analyses of vadadustat, hypoxia-inducible factor-prolyl hydroxylase inhibitor, in clinical settings. In this study, the authors aimed to develop a method for measuring vadadustat in human plasma that could be applied for therapeutic drug monitoring using high-performance liquid chromatography with ultraviolet detection (HPLC-UV) in a clinical setting.

Methods:

Plasma samples (100 μL) were pretreated with acetonitrile using butyl paraoxybenzoate as an internal standard. Chromatographic separation was performed on a SunShell PFP C18 column (2.6 μm, 4.6 mm × 150 mm). The mobile phase consisted of (A) 20 mM of phosphate buffer (pH 2.4) and (B) acetonitrile (60:40, v/v), delivered isocratically at a flow rate of 1 mL/min. The analytes were detected by UV absorbance at a wavelength of 220 nm, and the column temperature was 40°C. To evaluate the applicability of HPLC-UV in a clinical setting, blood samples were collected at 19 time points from 7 patients who had been taking vadadustat.

Results:

The calibration curve was linear over the concentration range of 0.2–150 mcg/mL (R

2
> 0.99). Intra-assay and interassay accuracy, precision, and stability met the Food and Drug Administration recommendations. The vadadustat plasma concentrations of patients analyzed using the current HPLC-UV method were almost equal to those measured using ultra-performance liquid chromatography-tandem mass spectrometry (mean difference: 0.13 mcg/mL). Large variability in the dose-adjusted plasma concentrations of vadadustat at 12 hours after administration was observed between patients (coefficient of variation = 57.6%).

Conclusions:

This HPLC-UV method is a simple, accurate quantification method for evaluating plasma concentrations in patients taking vadadustat in a clinical setting.
Interim analysis of short-term outcomes after laparoscopic spleen-preserving distal pancreatectomy with or without preservation of splenic vessels: a randomised controlled trial
Authors: Chen Qiangxing , Fu Yangzhi , Li Yongbin , Cai He , Wang Xin , Wu Zhong , Meng Lingwei , Zhang Man , Chen Zixin , Jiang Jingwen , Cheng Ke , Li Jun , Zhang Dian , Cai Yu , You Jiaying , Cai Yunqiang , Peng Bing
Published: July 2024

Background:

Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) is a widely adopted surgical approach for benign and low-grade malignant neoplasms of the distal pancreas. The Kimura and Warshaw techniques represent two principal strategies, yet it still needs to be determined which one is superior. Our investigation aimed to evaluate the clinical outcomes associated with each technique.

Materials and methods:

This single-center, parallel-group, patient-blinded randomized controlled trial was conducted at the West China Hospital of Sichuan University. Stratified block randomization was utilized to enroll 114 patients starting in March 2022, with an interim analysis of short-term outcomes scheduled after 45–50% of participant enrollment. Patients were randomized to receive LSPDP via either the Kimura or Warshaw technique. The primary endpoint was intraoperative blood loss, while secondary endpoints included a range of outcomes from composite outcome to quality of life, as quantified by the EQ-5D-5L.

Results:

From March 2022 to November 2023, 53 patients were randomly allocated to the Kimura (n=25) or Warshaw (n=28) groups for LSPDP. Baseline characteristics and postoperative outcomes were similar between the groups, such as pancreatic fistula incidence, EQ-5D-5L index scores, and delayed gastric emptying rates. Per-protocol (PP) analysis revealed that the Kimura group experienced significantly less blood loss (52.5±51.6 ml vs. 91.7±113.5 ml, P=0.007) and a reduced rate of composite outcome (23.8 vs. 56.7%, P=0.019), but incurred higher costs in the Warshaw group (¥56 227.4±¥7027.0 vs. ¥63 513.8±¥12 944.5, P=0.013). Splenic infarction rates were higher in the Warshaw group, though not statistically significant (ITT: 39.3 vs. 12.5%, P=0.058; PP: 36.7 vs. 14.3%, P=0.113), without necessitating intervention. Neither group experienced postpancreatectomy hemorrhage, 90-day mortality, or ICU admissions, and all postoperative complications were mild (Clavien–Dindo Grade <III).

Conclusions:

The 90-day interim analysis postoperatively indicates that both Kimura and Warshaw techniques for LSPDP are safe and viable. The Kimura technique, however, confers superior in terms of reduced intraoperative blood loss and fewer complications, alongside lower costs.
The Diagnostic Utility of Cervical Spine Proprioception for Adolescent Concussion
Authors: Smulligan Katherine L. , Magliato Samantha N. , Keeter Carson L. , Wingerson Mathew J. , Smith Andrew C. , Wilson Julie C. , Howell David R.
Published: July 2024

Objective:

Cervical spine proprioception may be impaired after concussion. Our objective was to determine the diagnostic utility of cervical spine proprioception for adolescent concussion.

Design:

Cross-sectional.

Setting:

Research laboratory.

Participants:

Adolescents ≤18 days of concussion and uninjured controls.

Interventions:

N/A.

Main Outcomes:

Head repositioning accuracy (HRA) testing, a measure of cervical spine proprioception. The HRA test involved patients relocating their head back to a neutral starting position with eyes closed after maximal cervical spine flexion, extension, and right and left rotations. The overall HRA error score was the mean error (distance from the starting point to self-reported return to neutral) across 12 trials: 3 trials in each direction. We used t-tests to compare group means and logistic regression (outcome = group, predictor = HRA, covariates) to calculate odds ratios. We used a receiver operator characteristic curve to evaluate area under the curve (AUC) and calculate the optimal HRA cutpoint to distinguish concussion from controls.

Results:

We enrolled and tested 46 participants with concussion (age = 15.8 ± 1.3 years, 59% female, mean = 11.3 ± 3.3 days postconcussion) and 83 uninjured controls (age = 16.1 ± 1.4 years, 88% female). The concussion group had significantly worse HRA than controls (4.3 ± 1.6 vs 2.9 ± 0.7 degrees, P < 0.001, Cohen d = 1.19). The univariable HRA model AUC was 0.81 (95% CI = 0.73, 0.90). After adjusting for age, sex, and concussion history, the multivariable model AUC improved to 0.85 (95% CI = 0.77, 0.92). The model correctly classified 80% of participants as concussion/control at a 3.5-degree cutpoint.

Conclusions:

Adolescents with concussion demonstrated worse cervical spine proprioception than uninjured controls. Head repositioning accuracy may offer diagnostic utility for subacute concussion.
Just the tip of the iceberg: Extensive flexor tenosynovitis due to Candida parapsilosis, a case report
Authors: Schade Meredith , Payatakes Alexander , Fanburg-Smith Julie , Petscavage-Thomas Jonelle
Published: July 2024

Rationale:

We present a case of a healthy 51-year-old female who developed extensive flexor tenosynovitis due to Candida parapsilosis following treatment for trigger thumb.

Patient concerns:

Initial care had included corticosteroid injections and operative trigger finger release. She presented to us with reduced range of motion of her right thumb and a nodular swelling of the thenar eminence. No purulence was found with incision and drainage of the nodule and an empiric course of trimethoprim-sulfamethoxazole was given.

Diagnosis:

Weeks later, an increase in thenar swelling and inability to extend her fingers lead to operative debridement. Multiple intraoperative samples grew C. parapsilosis, and a diagnosis of extensive flexor tenosynovitis was made.

Interventions:

We suspect that corticosteroid injections to treat trigger finger and exposure to a broad-spectrum antibacterial selected for the growth of Candida species. The unique anatomy of the hand, indolent nature of Candida in a normal host and underestimation of the infectious burden contributed to a delay in diagnosis.

Outcomes and Lessons:

The purpose of our report is to alert others to consider all commensal organisms of the skin in recalcitrant infections of the hand.
Kinked Again! From Congenital Brachial Plexus Palsy to Adult Neurogenic Thoracic Outlet Syndrome: A Case Report
Authors: Hearn Sandra L. , Medley Kyle , Liao Eric A.
Published: July 2024

Neurogenic thoracic outlet syndrome is a chronic, focal lesion of the lower trunk of the brachial plexus or of the T1 and C8 anterior primary rami, often arising due to distortion of neural structures by a fibrous congenital band extending from a C7 transverse process or cervical rib. Accordingly, patients present with chronic weakness or atrophy of the hand, most prominently of the thenar eminence, which receives most innervation from the T1 root. We present clinical, electrophysiologic, and imaging findings in a case of neurogenic thoracic outlet syndrome presenting in an adult with a history most suggestive of congenital brachial plexus palsy, another pathology sharing the mechanism of nerve compression or injury within the supracostoclavicular space. The patient had new right thenar eminence atrophy and a lifelong history of medial forearm sensory deficit and she improved after first rib resection. The convergence of two disorders in the same patient arising in different phases of life illustrates how anatomic or structural variation in this space can predispose to lower brachial plexus injury.
Where Will I Go? Relative Location of Physical Medicine and Rehabilitation Residencies Compared With Medical Schools Among Recent Residents
Authors: Wen Jimmy , Alam Meraj , Ansari Ubaid , Shehabat Mouhamad , Syed Burhaan , Akhtar Muzammil , Razick Daniel , Puglisi Jose , Wang Austin
Published: July 2024

Physical medicine and rehabilitation has rapidly been garnering interest as health care increases the emphasis on rehabilitation and management for acute and chronic diseases. This study analyzes recent geographical trends of physical medicine and rehabilitation residents via physical medicine and rehabilitation residents from 2019 to 2023, which were identified from publicly available data. The relative distribution from medical school to residency, medical school to preliminary program, and preliminary program to residency were analyzed. These locations were categorized as within 100 miles, same state, same region, or different region. Odds ratio were calculated for the aforementioned relative locations with respect to the presence of a home residency program. A total of 1836 residents were included. The majority of residents (51%) stayed within the same region as their medical school. Residents from medical schools with a home program were more likely to stay within 100 miles (odds ratio: 3.64), the same state (odds ratio: 3.19), and same region (odds ratio: 2.56). Overall, physical medicine and rehabilitation residents are likely to stay within the same region as their medical school and preliminary year. In addition, the presence of a home program significantly increases the odds of matching within 100 miles, same state, and same region.
Full Robotic Whole Graft Liver Transplantation
Authors: Pinto-Marques Hugo , Sobral Mafalda , Magistri Paolo , Gomes da Silva Sílvia , Guerrini Gian Piero , Mega Raquel , Guidetti Cristiano , Coelho João Santos , Di Sandro Stefano , Di Benedetto Fabrizio
Published: July 2024

Objective:

To report the first European series of full robotic whole liver transplantation (RLT) with technical details and future perspectives.

Background:

Few cases of liver transplantation with a minimally invasive approach using partial grafts have been reported so far, and no cases of robotic whole liver transplantation have been reported in the scientific literature.

Methods:

The adopted technique was full robotic liver hepatectomy, followed by robotic implantation after graft introduction through a small midline incision. Patients presenting with hepatocellular carcinoma in liver cirrhosis with a small caudate lobe, low degree of portal hypertension, no porto-mesenteric thrombosis, as well as low Model for End-Stage Liver Disease patients have been considered ideal candidates.

Results:

Six patients underwent RLT between February and March 2024 at Lisbon and Modena University Liver Transplant Centers. Warm ischemia time during RLT ranged between 55 and 90 minutes, with a total surgery duration between 440 and 710 minutes. The median total operative time was 595 (±111.3) minutes. Only 1 recipient had prolonged hyperbilirubinemia, which was safely treated. The median in-hospital stay was 7.5 days (±4.8 d).

Conclusions:

RLT is a promising technique to further reduce the impact of liver transplantation thanks to smaller incision, gentle tissue manipulation, high magnification and precision for vascular and biliary anastomosis, and reduced postoperative pain. This is the first step toward the demonstration of the feasibility of minimally invasive surgery in liver transplantation, although further selection and technical refinements are needed to improve reproducibility.
Symptomatic Autonomic Dysfunction in Interstitial Cystitis/Bladder Pain Syndrome
Authors: Ritts Rory , Wolff Dylan , Namugosa Mary , Hsu Fang-Chi , Ferrara Kaylee , Evans Robert , Walker Stephen J.
Published: July 2024

Importance

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a highly prevalent condition with incompletely understood pathophysiology, especially in relation to the systemic symptoms experienced. The role of autonomic nervous system dysfunction in IC/BPS remains poorly understood.

Objective

The purpose of this study was to assess the relationship between autonomic symptom severity and clinical characteristics of patients with IC/BPS.

Study Design

This is a retrospective cohort study of 122 IC/BPS patients who completed the Composite Autonomic Symptoms Score (COMPASS-31) questionnaire. Data were collected on anesthetic bladder capacity (BC), Hunner lesion (HL) status, results for validated IC/BPS symptom questionnaires (O’Leary Sant Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index (ICSI/ICPI) and the Pelvic Pain and Urgency/Frequency (PUF) scale), and comorbid nonurologic associated syndromes. Using the first quartile of COMPASS-31 scores as the cutoff, we compared patients within the first quartile (low symptom load; n = 30), to the remainder of the patients (high symptom load; n = 92).

Results

Patients scoring ≥20.36 were significantly less likely to be HL positive (10.9% vs 26.7%; P = 0.043) and had a significantly higher BC (823.10 ± 396.07 vs 635.00 ± 335.06; P = 0.027), higher scores on the PUF questionnaire (23.80 ± 4.98 vs; 19.61 ± 5.22 P < 0.001), and a higher number of nonurologic associated syndromes (5.65 ± 2.90 vs 2.60 ± 1.89; P < 0.001).

Conclusions

Patients with IC/BPS experience widespread symptoms associated with autonomic nervous system dysfunction. A higher symptom load strongly correlates with a nonbladder-centric phenotype. These findings provide further evidence that total body nervous system dysfunction is present in patients with nonbladder centric IC/BPS.