bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncovering the history of recombination and population structure in western Canadian stripe rust populations through mating type alleles
Authors: Holden Samuel , Bakkeren Guus , Hubensky John , Bamrah Ramandeep , Abbasi Mehrdad , Qutob Dinah , de Graaf Mei-Lan , Kim Sang Hu , Kutcher Hadley R. , McCallum Brent D. , Randhawa Harpinder S. , Iqbal Muhammad , Uloth Keith , Burlakoti Rishi R. , Brar Gurcharn S.
Published: October 2023

Background

The population structure of crop pathogens such as Puccinia striiformis f. sp. tritici (Pst), the cause of wheat stripe rust, is of interest to researchers looking to understand these pathogens on a molecular level as well as those with an applied focus such as disease epidemiology. Cereal rusts can reproduce sexually or asexually, and the emergence of novel lineages has the potential to cause serious epidemics such as the one caused by the ‘Warrior’ lineage in Europe. In a global context, Pst lineages in Canada were not well-characterized and the origin of foreign incursions was not known. Additionally, while some Pst mating type genes have been identified in published genomes, there has been no rigorous assessment of mating type diversity and distribution across the species.

Results

We used a whole-genome/transcriptome sequencing approach for the Canadian Pst population to identify lineages in their global context and evidence tracing foreign incursions. More importantly: for the first time ever, we identified nine alleles of the homeodomain mating type locus in the worldwide Pst population and show that previously identified lineages exhibit a single pair of these alleles. Consistently with the literature, we find only two pheromone receptor mating type alleles. We show that the recent population shift from the ‘PstS1’ lineage to the ‘PstS1-related’ lineage is also associated with the introduction of a novel mating type allele (Pst-b3-HD) to the Canadian population. We also show evidence for high levels of mating type diversity in samples associated with the Himalayan center of diversity for Pst, including a single Canadian race previously identified as ‘PstPr’ (probable recombinant) which we identify as a foreign incursion, most closely related to isolates sampled from China circa 2015.

Conclusions

These data describe a recent shift in the population of Canadian Pst field isolates and characterize homeodomain-locus mating type alleles in the global Pst population which can now be utilized in testing several research questions and hypotheses around sexuality and hybridization in rust fungi.
MUC1 attenuates neutrophilic airway inflammation in asthma by reducing NLRP3 inflammasome-mediated pyroptosis through the inhibition of the TLR4/MyD88/NF-κB pathway
Authors: Liu Lu , Zhou Ling , Wang Lingling , Mao Zhenyu , Zheng Pengdou , Zhang Fengqin , Zhang Huojun , Liu Huiguo
Published: October 2023

Background

Neutrophilic airway inflammation is a challenge in asthma management and is associated with poor patient prognosis. Mucin 1 (MUC1), which contains a cytoplasmic tail (MUC1-CT), has been found to mediate glucocorticoid sensitivity in asthma; however, its role in modulating neutrophilic airway inflammation in asthma remains unknown.

Methods

Human-induced sputum cells were collected from healthy participants (n = 12), patients with mild-to-moderate asthma (n = 34), and those with severe asthma (n = 18). In vitro human lung bronchial 1 epithelial cell line (BEAS-2B) was transfected with small interfering RNA against MUC1 (MUC1-siRNA) and then stimulated by lipopolysaccharide (LPS), where some cells were pretreated with a TLR4 inhibitor (TAK-242). In vivo mouse model of asthmatic neutrophil airway inflammation was induced by ovalbumin (OVA)/LPS. Some groups were intraperitoneally injected with MUC1-CT inhibitor (GO-203) and/or TAK-242 .

Results

The mRNA expression of MUC1 was downregulated in the induced sputum of patients with asthma and correlated with asthmatic neutrophilic airway inflammation. The mRNA expressions of TLR4, MyD88, nucleotide-binding oligomerization domain-like pyrin domain-containing protein 3 (NLRP3), caspase-1, interleukin (IL)-18, and IL-1β in induced sputum cells of patients with asthma were upregulated and related to the mRNA expression of MUC1. LPS activated the TLR4 pathway and NLRP3-mediated pyroptosis in BEAS-2B cells in vitro, which were significantly aggravated after MUC1-siRNA transfection. Furthermore, MUCl-CT interacted with TLR4, and the interaction between TLR4 and MyD88 was significantly increased after MUCl-siRNA transfection. Moreover, TAK-242 ameliorated TLR4/MyD88/nuclear factor kappa B (NF-κB) pathway activation, NLRP3 inflammasome-mediated pyroptosis, and neutrophilic inflammation exacerbated by MUC1 downregulation. GO-203 exacerbated TLR4/MyD88/NF-κB pathway activation in vivo, and NLRP3 inflammasome-mediated pyroptosis reduced in a mouse model of asthmatic neutrophil airway inflammation induced by OVA/LPS; these pathological changes were partially alleviated after TAK-242 application.

Conclusion

This study revealed that MUC1 downregulation plays an important role in asthmatic neutrophilic airway inflammation. MUC1-CT reduces NLRP3 inflammasome-mediated pyroptosis by inhibiting the activation of the TLR4/MyD88/NF-κB pathway, thereby attenuating neutrophil airway inflammation in patients with asthma.
The development of amivantamab for the treatment of non-small cell lung cancer
Authors: Brazel Danielle , Nagasaka Misako
Published: October 2023

Non-small cell lung cancer (NSCLC) patients with sensitizing oncogenic driver mutations benefit from targeted therapies. Tyrosine kinase inhibitors are highly effective against classic sensitizing epidermal growth factor receptor (EGFR) mutations, such as exon 19 deletions and exon 21 L858R point mutations. Conversely, EGFR exon 20 insertions (exon20ins) are resistant to the traditional EGFR tyrosine kinase inhibitors (TKIs). In May 2021, the US Federal Drug Administration (FDA) provided accelerated approval to amivantamab (Rybrevant) in adults with locally advanced or metastatic NSCLC with EGFR exon20ins after treatment with platinum-based chemotherapy. Amivantamab was the first EGFR/MET bispecific antibody to be approved specifically for EGFR exon20ins where there was an unmet need. Furthermore, amivantamab is being evaluated in additional settings such as post osimertinib in sensitizing EGFR mutations as well as in MET altered NSCLC. Here we discuss amivantamab in regard to its mechanism of action, preclinical and clinical data, and clinical impact for patients with EGFR exon20ins NSCLC and beyond.
Preventive and therapeutic opportunities: targeting BAP1 and/or HMGB1 pathways to diminish the burden of mesothelioma
Authors: Carbone Michele , Minaai Michael , Takinishi Yasutaka , Pagano Ian , Yang Haining
Published: October 2023

Mesothelioma is a cancer typically caused by asbestos. Mechanistically, asbestos carcinogenesis has been linked to the asbestos-induced release of HMGB1 from the nucleus to the cytoplasm, where HMGB1 promotes autophagy and cell survival, and to the extracellular space where HMGB1 promotes chronic inflammation and mesothelioma growth. Targeting HMGB1 inhibited asbestos carcinogenesis and the growth of mesothelioma. It is hoped that targeting HMGB1 will be a novel therapeutic strategy that benefits mesothelioma patients. Severe restrictions and/or a complete ban on the use of asbestos were introduced in the 80 and early 90s in the Western world. These measures have proven effective as the incidence of mesothelioma/per 100,000 persons is decreasing in these countries. However, the overall number of mesotheliomas in the Western world has not significantly decreased. There are several reasons for that which are discussed here: (1) the presence of asbestos in old constructions; (2) the development of rural areas containing asbestos or other carcinogenic mineral fibers in the terrain; (3) the discovery of an increasing fraction of mesotheliomas caused by germline genetic mutations of BAP1 and other tumor suppressor genes; (4) mesotheliomas caused by radiation therapy; (5) the overall increase in the population and of the fraction of older people who are much more susceptible to develop all types of cancers, including mesothelioma. In summary, the epidemiology of mesothelioma is changing, the ban on asbestos worked, there are opportunities to help mesothelioma patients especially those who develop in a background of germline mutations and there is the opportunity to prevent a mesothelioma epidemic in the developing world, where the use of asbestos is increasing exponentially. We hope that restrictive measures similar to those introduced in the Western world will soon be introduced in developing countries to prevent a mesothelioma epidemic.
Trajectory patterns of metabolic syndrome severity score and risk of type 2 diabetes
Authors: Amouzegar Atieh , Honarvar Mohammadjavad , Masoumi Safdar , Khalili Davood , Azizi Fereidoun , Mehran Ladan
Published: October 2023

Background

The available evidence indicates that the severity of metabolic syndrome tends to worsen progressively over time. We assessed the trajectory of age and sex-specific continuous MetS severity score (cMetS-S) and its association with the development of diabetes during an 18-year follow-up.

Methods

In a prospective population-based Tehran Lipid and Glucose Study, 3931 eligible participants free of diabetes, aged 20–60 years, were followed at three-year intervals. We examined the trajectories of cMetS-S over nine years using latent growth mixture modeling (LGMM) and subsequent risks of incident diabetes eight years later. The prospective association of identified trajectories with diabetes was examined using the Cox proportional hazard model adjusting for age, sex, education, and family history of diabetes, physical activity, obesity (BMI ≥ 30 kg/m2), antihypertensive and lipid-lowering medication, and baseline fasting plasma glucose in a stepwise manner.

Results

Among 3931 participants, three cMetS-S trajectory groups of low (24.1%), medium (46.8%), and high (29.1%) were identified during the exposure period. Participants in the medium and high cMetS-S trajectory classes had HRs of 2.44 (95% CI: 1.56–3.81) and 6.81 (95% CI: 4.07–10.01) for future diabetes in fully adjusted models, respectively. Normoglycemic individuals within the high cMetS-S class had an over seven-fold increased risk of diabetes (HR: 7.12; 95% CI: 6.05–12.52).

Conclusion

Although most adults exhibit an unhealthy metabolic score, its severity usually remains stable throughout adulthood over ten years of follow-up. The severity score of metabolic syndrome has the potential to be utilized as a comprehensive and easily measurable indicator of cardiometabolic dysfunction. It can be employed in clinical settings to detect and track individuals at a heightened risk of developing T2DM, even if their glucose levels are normal.
Quantitative analysis of early apparent diffusion coefficient values from MRIs for predicting neurological prognosis in survivors of out-of-hospital cardiac arrest: an observational study
Authors: Yoon Jung A. , Kang Changshin , Park Jung Soo , You Yeonho , Min Jin Hong , In Yong Nam , Jeong Wonjoon , Ahn Hong Joon , Lee In Ho , Jeong Hye Seon , Lee Byung Kook , Lee Jae Kwang
Published: October 2023

Background

This study aimed to quantitatively analyse ultra-early brain diffusion-weighted magnetic resonance imaging (DW-MRI) findings to determine the apparent diffusion coefficient (ADC) threshold associated with neurological outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA).

Methods

This retrospective study included adult survivors of comatose OHCA who underwent DW-MRI imaging scans using a 3-T MRI scanner within 6 h of the return of spontaneous circulation (ROSC). We investigated the association between neurological outcomes and ADC values obtained through voxel-based analysis on DW-MRI. Additionally, we constructed multivariable logistic regression models with pupillary light reflex (PLR), serum neuron-specific enolase (NSE), and ADC values as independent variables to predict poor neurological outcomes. The primary outcome was poor neurological outcome 6 months after ROSC, determined by the Cerebral Performance Category 3–5.

Results

Overall, 131 patients (26% female) were analysed, of whom 74 (57%) showed poor neurological outcomes. The group with a poor neurological outcome had lower mean whole brain ADC values (739.1 vs. 787.1 × 10–6 mm/s) and higher percentages of voxels with ADC below threshold in all ranges (250–1150) (all P < 0.001). The mean whole brain ADC values (area under the receiver operating characteristic curve [AUC] 0.83) and the percentage of voxels with ADC below 600 (AUC 0.81) had the highest sensitivity of 51% (95% confidence interval [CI] 39.4–63.1; cut-off value ≤ 739.2 × 10−6 mm2/s and > 17.2%, respectively) when the false positive rate (FPR) was 0%. In the multivariable model, which also included PLR, NSE, and mean whole brain ADC values, poor neurological outcome was predicted with the highest accuracy (AUC 0.91; 51% sensitivity). This model showed more accurate prediction and sensitivity at an FPR of 0% than did the combination of PLR and NSE (AUC 0.86; 30% sensitivity; P = 0.03).

Conclusions

In this cohort study, early voxel-based quantitative ADC analysis after ROSC was associated with poor neurological outcomes 6 months after cardiac arrest. The mean whole brain ADC value demonstrated the highest sensitivity when the FPR was 0%, and including it in the multivariable model improved the prediction of poor neurological outcomes.
Compact dual-port MIMO filtenna-based DMS with high isolation for C-band and X-band applications
Authors: Elabd Rania H.
Published: October 2023

A dual-port multiple-input multiple-output (MIMO) filtenna with minimal sizes of 80 × 45 mm2 is set up in this study. Each element in this MIMO filtenna is positioned orthogonally to the one next to it to improve isolation. For the MIMO element to achieve high-frequency selectivity and compact size, a frequency-reconfigurable filtenna that was created by fusing a band-pass filter and a monopole radiator was used. The suggested filtenna can switch between its C-band and X-band operating states with ease. On build the filtenna circuit, a band-pass filter based on defective microstrip structure is inserted to a circular monopole radiator. The developed filtenna operates in the C-band frequency range of 6.5–8 GHz and the X-band frequency range of 8–12 GHz. It is possible to use the X-band operating state for communication in a cognitive radio environment. Used as a decoupling structure, metamaterial structures can increase isolation to more than 40 dB across the bandwidth. The suggested MIMO filtenna system has an envelope correlation coefficient of 2.4e−6, a peak gain of 6 dBi, and an impedance bandwidth of 7.4–7.75 GHz. The MIMO filtenna is constructed and measured, and the findings of the measurement and simulation are in good agreement.
Effect of co-presence of cadmium or procymidone with microplastic films in soil on lettuce growth
Authors: Jho Eun Hea , Yang Ji Won , Ju Won Jung , Lee Sung-Jong , Hasan Md Mehedee
Published: October 2023

Agricultural environment is often contaminated with various chemicals (e.g., pesticides, heavy metals) and microplastics due to the uses of plastic products. The effects of chemical contaminants or microplastics on terrestrial environment have been extensively studied, but the studies on the co-presence of chemical contaminants and microplastics are relatively limited. This study was set to investigate the effect of co-presence of microplastics (i.e., low-density polyethylene (LDPE) and polyvinyl chloride (PVC) microplastic films) and chemical contaminants (i.e., cadmium (Cd) and procymidone (PCM)) in soil on the lettuce growth and Cd and PCM uptake by lettuce using pot tests. The lettuce leaf lengths were not affected by the presence of only Cd or PCM, but the rates of change in the lettuce leaf number were adversely affected by the presence of PCM. The presence of only LDPE or PVC in soil at the concentrations used in this study did not have significant impacts on the lettuce growth. But the co-presence of Cd and LDPE and the co-presence of PCM and PVC resulted in the negligible increases in the lettuce leaf length and leaf number with time, although the lettuce growths were statistically similar in the Cd- or PCM-contaminated soils regardless of the presence of microplastics. The results suggest that the adverse effects of Cd or PCM can be intensified by the co-presence of microplastics, and the effects can be different depending on the types of microplastics. The promoted adverse effects of chemical contaminants in the co-presence of microplastics can be supported by the tendency of the increased absorption of Cd or PCM by lettuce in the co-presence of microplastics. Overall, this study shows the need for management of both chemical contaminants and microplastics that may reside in the agricultural environment.
Integrated multi-omics analysis reveals the positive leverage of citrus flavonoids on hindgut microbiota and host homeostasis by modulating sphingolipid metabolism in mid-lactation dairy cows consuming a high-starch diet
Authors: Zhao Yuchao , Yu Shiqiang , Zhao Huiying , Li Liuxue , Li Yuqin , Liu Ming , Jiang Linshu
Published: October 2023

Background

Modern dairy diets have shifted from being forage-based to grain and energy dense. However, feeding high-starch diets can lead to a metabolic disturbance that is linked to dysregulation of the gastrointestinal microbiome and systemic inflammatory response. Plant flavonoids have recently attracted extensive interest due to their anti-inflammatory effects in humans and ruminants. Here, multi-omics analysis was conducted to characterize the biological function and mechanisms of citrus flavonoids in modulating the hindgut microbiome of dairy cows fed a high-starch diet.

Results

Citrus flavonoid extract (CFE) significantly lowered serum concentrations of lipopolysaccharide (LPS) proinflammatory cytokines (TNF-α and IL-6), acute phase proteins (LPS-binding protein and haptoglobin) in dairy cows fed a high-starch diet. Dietary CFE supplementation increased fecal butyrate production and decreased fecal LPS. In addition, dietary CFE influenced the overall hindgut microbiota’s structure and composition. Notably, potentially beneficial bacteria, including Bacteroides, Bifidobacterium, Alistipes, and Akkermansia, were enriched in CFE and were found to be positively correlated with fecal metabolites and host metabolites. Fecal and serum untargeted metabolomics indicated that CFE supplementation mainly emphasized the metabolic feature “sphingolipid metabolism.” Metabolites associated with the sphingolipid metabolism pathway were positively associated with increased microorganisms in dairy cows fed CFE, particularly Bacteroides. Serum lipidomics analysis showed that the total contents of ceramide and sphingomyelin were decreased by CFE addition. Some differentially abundant sphingolipid species were markedly associated with serum IL-6, TNF-α, LPS, and fecal Bacteroides. Metaproteomics revealed that dietary supplementation with CFE strongly impacted the overall fecal bacterial protein profile and function. In CFE cows, enzymes involved in carbon metabolism, sphingolipid metabolism, and valine, leucine, and isoleucine biosynthesis were upregulated.

Conclusions

Our research indicates the importance of bacterial sphingolipids in maintaining hindgut symbiosis and homeostasis. Dietary supplementation with CFE can decrease systemic inflammation by maintaining hindgut microbiota homeostasis and regulating sphingolipid metabolism in dairy cows fed a high-starch diet.
Planning and meta-planning to cope with disruptive events: what can be learnt from the institutional response to the Covid-19 pandemic in Italy
Authors: Moroni Stefano , De Franco Anita , Pacchi Carolina , Chiffi Daniele , Curci Francesco
Published: October 2023

The Covid-19 pandemic has been analysed and discussed from many disciplinary perspectives. An aspect that still needs critical exploration is the role—that is, the modes and forms—of regulatory interventions during the pandemic. It is interesting to note in this regard that, in many studies, regulatory measures are labelled “non-pharmaceutical interventions”, as if they do not have any specificity on their own and only represent a theoretically residual category. The main aim of this article is instead to focus on the distinctive features of normative measures as such. As regards the article’s focus, it centres on the normative interventions in the first period of the pandemic—that is, 2020—with particular reference to Italy. We have chosen to focus on this period because the most extensive and severe restrictions introduced to combat Covid-19 were established at that time. And we have chosen to consider Italy because it was the first country, after China, to be hard hit by the virus and to react in a draconian manner. As regards the methodology, the article is based, in general and primarily, on an extensive interdisciplinary literature review. With reference to the Italian case, the study is additionally based on: first-hand data collection and analysis (especially concerning Italian normative measures mainly issued at the national level: their type, frequency, target, hierarchical relationships); second-hand data and analysis (for instance as regards the effectiveness of Italy’s and other countries’ regulatory measures). In discussing the Italian response to the Covid-19 pandemic, certain weaknesses have been identified; and possible lessons have been highlighted, in terms of both “planning” (i.e. the necessity to better pre-define concrete and circumscribed sets of actions) and of “meta-planning” (i.e. the necessity of better planning the way in which public authorities could and should plan and act). Although this article is mainly based on the Italian situation, what we can learn from this case is largely generalizable.
Ponds as experimental arenas for studying animal movement: current research and future prospects
Authors: Brönmark Christer , Hellström Gustav , Baktoft Henrik , Hansson Lars-Anders , McCallum Erin S. , Nilsson P. Anders , Skov Christian , Brodin Tomas , Hulthén Kaj
Published: October 2023

Animal movement is a multifaceted process that occurs for multiple reasons with powerful consequences for food web and ecosystem dynamics. New paradigms and technical innovations have recently pervaded the field, providing increasingly powerful means to deliver fine-scale movement data, attracting renewed interest. Specifically in the aquatic environment, tracking with acoustic telemetry now provides integral spatiotemporal information to follow individual movements in the wild. Yet, this technology also holds great promise for experimental studies, enhancing our ability to truly establish cause-and-effect relationships. Here, we argue that ponds with well-defined borders (i.e. “islands in a sea of land”) are particularly well suited for this purpose. To support our argument, we also discuss recent experiences from studies conducted in an innovative experimental infrastructure, composed of replicated ponds equipped with modern aquatic telemetry systems that allow for unparalleled insights into the movement patterns of individual animals.
Transcriptomic and metabolomic insights into the antimicrobial effect of Leuconostoc mesenteroides or lactic acid on pathogenic Gallibacterium anatis
Authors: Zhang Hua , HuangFu HePing , Qin GuangYong , Wu GuoFang , Wang Lei , Tan ZhongFang
Published: October 2023

Gallibacterium anatis (G. anatis) is an opportunistic poultry pathogen that poses a threat to human health via the food chain and can also lead to great economic losses in poultry industries. Our previous studies have demonstrated that the lactic acid-producing bacteria Leuconostoc mesenteroides QZ1178 can effectively inhibit the growth of G. anatis by acid production, but the mechanism remains unclear. The aim of the current research was to further investigate the molecular mechanism underlying this acid-induced antimicrobial effect. The TEM results showed that the cell membrane of G. anatis (GAC026) was damaged and that cells were lysed in the presence of cell-free supernatants from Leuconostoc mesenteroides (CFS) or lactic acid. Lactic acid showed a greater antimicrobial effect than CFS. In this study, the changes in the transcriptome and metabolic profile of G. anatis under acid stress at different stages were studied. Using culture medium supplemented with CFS (pH 3.6) or lactic acid (pH 3.6) at a 1:1 ratio, 677 differentially transcribed genes and 374 metabolites were detected in G. anatis. The interaction network of all identified differentially expressed genes and metabolites was constructed to outline the regulatory genes and dominant pathways in response to acid stress. The results of real-time reverse transcription quantitative PCR (RT‒qPCR) further confirmed the results of the transcriptomic analyses. Typically, succinate, citrate, L-malic acid, and oxaloacetate were reduced by acid stress in G. anatis, which suggested that lactic acid greatly disturbed energy metabolism. Overall, this work provides a comprehensive understanding of the stress response and cell death of G. anatis caused by lactic acid.

Graphical Abstract
A systematic review of the accuracy of digital surgical guides for dental implantation
Authors: Shi Yiting , Wang JunKai , Ma Chao , Shen Jiayi , Dong Xian , Lin Dan
Published: October 2023

Purpose

This review aimed to reveal the influence of implant guides on surgical accuracy with regard to supporting types, manufacturing methods and design (including fixation screws and sleeves).

Methods

A literature search related to accuracy of surgical guides for dental implantation was performed in Web of Science and PubMed. Studies with in vivo or in vitro deviation data published in recent 5 years (2018–2022) were included and assessed by Newcastle–Ottawa Scale with regard to risk of bias and reliability degree of clinical studies. Accuracy-related deviation data were summarized as forest plots and normal distributions.

Results

Forty-one articles were included with high degree of credibility. Data showed that implant surgery accuracy can be achieved with mean distance deviation < 2 mm (most < 1 mm) and angular deviation < 8° (most < 5°).

Conclusions

Bilateral tooth-supported guides exhibited highest in vitro accuracy and similar in vivo accuracy to unilateral tooth-supported guides; mucosa-supported guides exhibit lowest in vivo accuracy, while its in vitro data showed low credibility due to mechanical complexity of living mucosa tissue. Milling exhibited higher in vivo accuracy of guides than 3d-printing, though further data support was needed. Design of fixation screws and sleeves of implant guides affected the surgical accuracy and might remain a research focus in near future. However, lack of universal evaluation standards for implantation accuracy remained a major problem in this field. The influence of implant guides on surgical accuracy revealed in this review might shed light on future development of dental implantology.
Developing Decision-Making Expertise in Professional Sports Staff: What We Can Learn from the Good Judgement Project
Authors: Wilson P. J. , Kiely John
Published: October 2023

Success within performance sports is heavily dependent upon the quality of the decisions taken by educated and experienced staff. Multi-disciplinary teams (MDTs) typically collate voluminous data, and staff typically undergo extensive and rigorous technical and domain-specific training. Although sports professionals operate in sometimes volatile, uncertain, complex and ambiguous decision-making environments, a common assumption seems to be that education and experience will automatically lead to enhanced and effective decision-making capabilities. Accordingly, there are few formal curriculums, in coaching or sports science contexts, focussed on translating the extensive research on judgement and decision-making expertise to professional sports staff. This article aims to draw on key research findings to offer insights and practical recommendations to support staff working within professional performance contexts. Through this distillation, we hope to enhance understanding of the factors underpinning effective decision-making in dynamic, high-stakes professional sporting environments. Broadly, the conclusions of this research demonstrate that decision-making efficacy is enhanced through application of three specific strategies: (i) Design of more engaging professional cultures harnessing the power of collectives encouraging diverse opinions and perspectives, and fostering and promoting collaborative teamwork, (ii) education specifically targeting debiasing training, designed to counter the most common cognitive pitfalls and biases and, (iii) the implementation of evaluation strategies integrating rigorous testing and real-time feedback.
The INSIGHT project: reflections on the co-production of a quality recognition programme to showcase excellence in public involvement in health and care research
Authors: Blackburn Steven , Hine Rachele , Fairbanks Samantha , Parkes Phillip , Murinas Darren , Meakin Andrew , Taylor Robert , Parton Linda , Jones Marilyn , Tunmore Jessica , Lench Jennifer , Evans Nicola , Lewney Katharine , O’Mara Lucy , Fryer Anthony A.
Published: October 2023

Background

The quality of Patient and Public Involvement (PPI) in healthcare research varies considerably and is frequently tokenistic. We aimed to co-produce the Insight | Public Involvement Quality Recognition and Awards programme, based on the UK Standards for Public Involvement (UKSPI) alongside an incremental scale designed by Expert Citizens (a lived experience-led community group), to incentivise and celebrate continuous improvement in PPI.

Methods

We used Task and Finish Groups (19/44 [43%] public contributor membership) to co-produce the programme which we piloted in three organisations with different healthcare research models. We used surveys and review sessions to capture learning and reflections.

Results

We co-created:

A Quality descriptor matrix comprising four incremental quality levels (Welcoming, Listening, Learning, Leading) for each UKSPI standard.

An assessment framework including guidance materials, self-assessment form and final report template.

An assessor training package.

The quality awards event format and nomination form. These materials were modified based on pilot-site feedback.

Of survey respondents: 94.4% felt they had made at least ‘Some’ personal contribution (half said ‘Quite a lot’/‘A great deal’), 88.9% said they were ‘Always’/‘Often’ able to express their views freely and, 100% stated the programme would have ‘A lot of impact’/‘Quite a bit of impact’.

During the project, we identified the importance of taking time to explain project aims and contributor roles, adapting to the needs of individual contributors and, using smaller bespoke sessions outside the main Task and Finish Groups.

Conclusions

We co-produced and piloted a quality recognition programme to incentivise and celebrate continuous quality improvement in PPI. One public contributor stated, “I feel strongly that the Insight framework and awards will raise awareness of the [public involvement] work going on in many community settings. [It] is likely to result in better sharing of positive practice, incentivising research groups of any size to start work or to improve the quality of [PPI] could be one of the main benefits. I’m excited that if this initiative takes off, regionally and then in the longer term nationally, it could be a significant step in advancing the [public] voice.”
Anesthetic management with remimazolam in very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation plus off-pump coronary artery bypass grafting: report of two cases
Authors: Oyoshi Takafumi , Mitsuta Yuki , Uemura Yumiko , Tajima Koichiro , Hirata Naoyuki
Published: October 2023

Background

Remimazolam is a short-acting benzodiazepine with small circulatory depression. We used remimazolam for general anesthesia management in two very elderly patients undergoing hybrid surgery of transcatheter aortic valve implantation (TAVI) plus off-pump coronary artery bypass grafting (OPCABG).

Case presentation

A 96-year-old man (case 1) and a 92-year-old woman (case 2) had complex coronary artery disease (CAD) and severe aortic stenosis (AS) and were scheduled for TAVI plus OPCAB. Anesthesia in both patients was induced with 6 mg/kg/h remimazolam and fentanyl and maintained with 0.3 mg/kg/h and 0.5 mg/kg/h remimazolam and fentanyl, respectively. Although catecholamines were required, we successfully maintained circulation during the induction of anesthesia and the procedures of OPCAB and TAVI. Both patients were discharged without complications.

Conclusion

Remimazolam can be a useful option for safe general anesthesia in very elderly patients when performing hybrid surgery.
Formation of the mutagenic DNA lesion 1,N2-ethenoguanine induced by heated cooking oil and identification of causative agents
Authors: Kasai Hiroshi , Kawai Kazuaki
Published: October 2023

Background

The DNA-damaging compounds in heated cooking oil were identified as guanosine adducts. Heated vegetable oil was subjected to deep-frying conditions at 170 °C for 45 min, reacted with isopropylidene guanosine (ipG) at pH 7.4, and the resulting compounds were separated by high-performance liquid chromatography (HPLC).

Results

Two adducts, 8-hydroxy-ipG and 1,N2-etheno-ipG, were identified in the reaction mixture. One of the major components in heated cooking oil, 2,4-heptadienal (HDE), efficiently produced etheno-ipG from ipG in the presence of tBuOOH. An oxidized HDE solution was fractionated using HPLC to identify causative agents, and each fraction was tested for etheno-ipG formation. In addition to the known lipid peroxidation product, 4,5-epoxy-2-heptenal, two unknown polar components with potent etheno-ipG formation activity were discovered. Based on Mass and UV spectra, their structures were identified as 6-oxo- and 6-hydroxy-2,4-HDE. Similarly, 6-oxo- and 6-hydroxy-2,4- decadienal (DDE) were formed from 2,4-DDE. Significant amounts of 6-oxo- and 6-hydroxy-2,4-alkadienal were detected in the heated cooking oil. These compounds induced the formation of 1,N2-ethenoguanine in nucleosides and DNA, especially in the presence of tBuOOH. Moreover, the formation of 6-oxo- and 6-OH-HDE from 2,4-HDE was accelerated in the presence of hemin and tBuOOH.

Conclusion

The results suggest that these compounds are not only generated during the oil heating process but also produced from 2,4-alkadienal through digestion under normal physiological conditions, especially after ingesting heme- and alkyl-OOH-containing diets. Moreover, these compounds can be formed within cells under oxidative stress, potentially linking them to gastrointestinal carcinogenesis.
Interprofessional staff perspectives on the adoption of or black box technology and simulations to improve patient safety: a multi-methods survey
Authors: Campbell Krystle , Gardner Aimee , Scott Daniel J. , Johnson Jada , Harvey Jillian , Kazley Abby
Published: October 2023

Introduction

Medical errors still plague healthcare. Operating Room Black Box (ORBB) and ORBB-simulation (ORBBSIM) are innovative emerging technologies which continuously capture as well as categorize intraoperative data, team information, and audio-visual files, in effort to improve objective quality measures. ORBB and ORBBSIM have an opportunity to improve patient safety, yet a paucity of implementation literature exists. Overcoming implementation barriers is critical. This study sought to obtain rich insights while identifying facilitators and barriers to adoption of ORBB and ORBBSIM in alignment with Donabedian’s model of health services and healthcare quality. Enrichment themes included translational performance improvement and real-world examples to develop sessions.

Methods

Interprofessional OR staff were invited to complete two surveys assessing staff’s perceptions using TeamSTEPPS’s validated Teamwork Perceptions Questionnaire (T-TPQ) and open-ended questions. Descriptive statistics were calculated for quantitative variables, and inductive phenomenological content analysis was used for qualitative.

Results

Survey 1 captured 71 responses from 334 invited (RR 21%) while survey 2 captured 47 responses from 157 (RR 29.9%). The T-TPQ score was 65.2, with Communication (70.4) the highest construct and Leadership (58.0) the lowest. Quality Improvement (QI), Patient Safety, and Objective Case Review were the most common perceived ORBB benefits. Trends suggested a reciprocal benefit of dual ORBB and ORBBSIM adoption. Trends also suggested that dual implementation can promote Psychological Safety, culture, trust, and technology comfort. The need for an implementation plan built on change management principles and a constructive culture were key findings.

Conclusions

Findings supported ORBB implementation themes from previous literature and deepened our understanding through the exploration of team culture. This blueprint provides a model to help organizations adopt ORBB and ORBBSIM. Outcomes can establish an empirical paradigm for future studies.
Face validity and reliability test of the Danish version of the compliance questionnaire rheumatology in patients with early rheumatoid arthritis
Authors: Knudsen Line Raunsbæk , de Thurah Annette
Published: October 2023

Background

Supporting adherence to medication is an essential part of the treatment and care of patients with rheumatic and musculoskeletal diseases. The Compliance Questionnaire Rheumatology (CQR) measures adherence in rheumatic diseases through 19 items covering drug-taking behaviour to identify the reasons for adhering to treatment and the factors that contribute to suboptimal adherence. The objective of this study was to present the translation of the CQR into Danish and the face validity and reliability test.

Methods

The CQR was translated into Danish according to international guidelines, followed by a face validity test among 10 patients with rheumatoid arthritis in 2009. The test–retest reliability of the Danish CQR was evaluated in 49 patients with rheumatoid arthritis in 2020 - 2021 using the standard error of the measurement (SEM) converted into the minimally detectable change (MDC) and the intraclass correlation coefficient (ICC). Questionnaires were administered with a minimum of 10 days between assessments.

Results

The participants in the reliability test had a mean age of 57.4 years (SD 16.1) and a mean disease duration of 1.13 years (range 2 months–2 years). The mean CQR score in the test and retest was 62.7 (confidence interval (CI) 58.8; 66.6) and 62.5 (CI 58.9; 66.1), respectively, with a SEM of 8.59 (7.16; 10.73) and an MDC of 16.83. A satisfactory test–retest reliability was confirmed by an ICC value of 0.79 (CI 0.68; 0.89).

Conclusion

The Danish CQR has satisfactory test–retest reliability in patients newly diagnosed with rheumatoid arthritis and is considered a reliable tool to measure adherence in this group.
Computer-guided cranioplasty using ultra-high molecular weight polyethylene patient-specific implants: a case series
Authors: Abdelwahed Mariam S. K. , Ahmed Mamdouh S. , Abdelwahed Ahmed S. Kamel , Aziz Mohamed M.
Published: October 2023

Introduction

Cranioplasty is the surgical correction of a cranial defect. Three-dimensional software designs have allowed patient-specific single-step cranial reconstruction for neuroprotection and cosmesis. Ultra-high molecular weight polyethylene for partial or total bone replacement has been recently introduced as a promising material for cranioplasty. The objectives of this study are to evaluate the complications and esthetic results concerning the use of ultra-high molecular weight polyethylene patient-specific implants in craniectomy patients.

Methods

We report a series of nine patients with cranial defects from a previous craniectomy, or patients eligible for simultaneous craniectomy and cranioplasty via computer designed ultra-high molecular weight polyethylene patient-specific implants. We have analyzed the complications and cosmetic outcomes over a course of six months.

Results

None of the cases developed infection, extra/subdural hematoma, cerebrospinal fluid leak, or implant failure. Three cases had postoperative sequalae: The first patient had mild postoperative seroma which subsided after medical therapy and compression, the second showed wound breakdown due to tumor metastasis and recurrence but did not necessitate implant removal, while the third sequela was a subgaleal hematoma which was aspirated, and the patient healed uneventfully afterward. Esthetic results were highly satisfactory in 75% of the patients (good patient acceptance without touch-ups).

Conclusion

Ultra-high molecular weight polyethylene is in all respects suitable for primary and secondary cranioplasty, combined with computer-aided manufacturing–computer-aided design techniques, excellent esthetic and functional results were achieved. However, proper preoperative planning is important, and we recommend further prospective studies with larger number of patients followed up for longer periods for better assessment.
Efficacy and safety of transdermal electrical stimulation in patients with nonarteritic anterior ischemic optic neuropathy
Authors: Miura Gen , Fujiwara Tadami , Ozawa Yoshihito , Shiko Yuki , Kawasaki Yohei , Nizawa Tomohiro , Tatsumi Tomoaki , Kurimoto Takuji , Mori Sotaro , Nakamura Makoto , Hanaoka Hideki , Baba Takayuki , Yamamoto Shuichi
Published: October 2023

Background

No effective treatment for NAION with strong evidence has been established till date. The aim of this investigator-led, prospective, non-randomized, open-label, uncontrolled multi-center exploratory clinical trial is to evaluate the efficacy and safety of transdermal electrical stimulation (TdES) using skin electrodes in patients with NAION.

Methods

Five patients with monocular NAION underwent TdES (10-ms biphasic pulses, 1.0 mA, 20 Hz, 30 min) of the affected eye six times at 2-week intervals. The primary endpoint was the logarithm of the mini-mum angle of resolution (logMAR) visual acuity at 12 weeks compared with 0 weeks. The secondary endpoints were changes in the best-corrected logMAR visual acuity, Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity, and mean deviation (MD) of the Humphrey field analyzer (HFA) 10–2 and HFA Esterman test scores. Additionally, the safety of TdES was evaluated.

Results

LogMAR visual acuity improved by ≥ 0.1 in two eyes, and ETDRS visual acu-ity improved by ≥ 5 characters in one eye. The mean change in logMAR visual acuity from week 0 showed an increasing trend. The mean MD of HFA 10–2 showed no obvious change, while HFA Esterman score improved in four eyes. All patients completed the study according to the protocol, and no treatment-related adverse events were observed.

Conclusions

TdES treatment may have improved visual acuity and visual field in some patients. Further sham-controlled study in larger cohort is needed on its effectiveness.

Trial registration

UMIN, UMIN000036220. Registered 15 March, 2019, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041261.
Microsatellite instability screening in colorectal carcinoma: immunohistochemical analysis of MMR proteins in correlation with clinicopathological features and Ki-67 protein expression
Authors: Yassen Noha N. , Abouelfadl Dalia M. , Abbas Naglaa F. , Soliman Ahmed S. A. , Shabana Marwa E.
Published: October 2023

Background

Defects in mismatch repair (MMR) system or microsatellite instability (MSI) and detected in colorectal carcinoma (CRC), both in sporadic and more frequently in hereditary cases. Immunohistochemistry (IHC) is the most frequent method for MMR protein deficiency screening in CRCs. In this study, we aimed to evaluate immunohistochemical expression of MMR and Ki-67 in colorectal carcinoma with clinicopathological features.

Methods

In this study, we evaluated the immunohistochemical expression of MMR proteins including MSH6, MSH2, PMS2 and MLH1 in 50 resection materials with colorectal carcinoma. Their expression is correlated with clinicopathological features of patients together, with Ki-67 protein expression in attempt to screen the most significant predictor of microsatellite instability.

Results

Of the 50 cases of cancer colon, 28% were classified as MSI-H, 20% were MSI-L, and 52% were MSS. The most frequent pattern in MSI-H tumors was concurrent loss of MSH6 and PMS2 proteins. There was a significant correlation between MMR protein expression pattern with tumor size, grade, T-classification and stage (0.015, 0.0515, 0.0162 and 0.0391), respectively. MSI-H tumors were located more frequently in right colon, early TNM stage and poorly differentiated and infrequent distant metastases. There was a significant correlation between Ki-67 high expression and MSI status patterns in their common biological aspects distinct from MSI-negative tumors.

Conclusions

Mismatch repair defective colorectal carcinoma has characteristics clinicopathological features different from MSS tumors. The role of immunohistochemistry (IHC) for MSI evaluation is the easiest and effective way for evaluation of MMR deficiency in colorectal carcinoma.
Progression of pancreatic branch duct-type intraductal papillary mucinous neoplasms (BD-IPMNs) after surgery for extrapancreatic malignancies
Authors: Imoto Akira , Ogura Takeshi , Masuda Daisuke , Narabayashi Ken , Okada Toshihiko , Abe Yosuke , Takeuchi Toshihisa , Inoue Takuya , Ishida Kumi , Nouda Sadaharu , Higuchi Kazuhide , Abdelaal Usama M.
Published: October 2023

Background/aims

The natural history of pancreatic branch duct-type intraductal papillary mucinous neoplasms (BD-IPMNs) is still unknown. This retrospective study aims to determine the morphological changes of BD-IPMNs with attention to the history of surgical resection for extrapancreatic malignancies.

Methods and materials

This study included 427 subjects with BD-IPMN at the Osaka Medical College from January 2001 to December 2019; 134 patients were included. The predictive factors for the progression of BD-IPMN based on morphological changes were evaluated by univariate as well as multivariate analyses. Furthermore, the clinical features of BD-IPMNs with progressive lesions during follow-up were investigated.

Results

The average interval of follow-up was 35.8 months (with a range between 12.1 and 157 months). Disease progression occurred in 6 subjects (4.5%). In two of them (1.5%), IPMN-related invasive carcinoma was found. Multivariate analysis demonstrated that surgical resection for extrapancreatic malignancies was a significant predictor of BD-IPMN progression.

Conclusion

The history of resection of extrapancreatic malignancies should be considered during the follow-up of BD-IPMN.