bluuebunny/crossref_metadata_2025 huggingface dataset:
The clinical efficacy of cefoperazone-sulbactam versus piperacillin-tazobactam in the treatment of severe community-acquired pneumonia
Authors: Lai Chih-Cheng , Chen Wei-Chih , Kuo Li-Kuo , Wang Yao-Tung , Fu Pin-Kuei , Ku Shih-Chi , Fang Wen-Feng , Chen Chin-Ming , Tu Chih-Yen , Cheng Wen-Chien , Chen Chia-Hung
Published: July 2023

The objective was to compare the clinical efficacy of cefoperazone-sulbactam with piperacillin-tazobactam in the treatment of severe community-acquired pneumonia (SCAP). The retrospective study was conducted from March 1, 2018 to May 30, 2019. Clinical outcomes were compared for patients who received either cefoperazone-sulbactam or piperacillin-tazobactam in the treatment of SCAP. A total of 815 SCAP patients were enrolled. Among them, 343 received cefoperazone-sulbactam, and 472 received piperacillin-tazobactam. Patients who received cefoperazone-sulbactam presented with higher Charlson Comorbidity Index scores. (6.20 ± 2.77 vs 5.72 ± 2.61; P = .009). The clinical cure rates and effectiveness for patients receiving cefoperazone-sulbactam and piperacillin-tazobactam were 84.2% versus 80.3% (P = .367) and 85.4% versus 83.3% (P = .258), respectively. In addition, the overall mortality rate of the cefoperazone-sulbactam group was 16% (n = 55), which was also comparable to the piperacillin-tazobactam group (17.8%, n = 84, P = .572). The primary clinical outcomes for patients receiving cefoperazone-sulbactam were superior compared to those receiving piperacillin-tazobactam after adjusting disease severity status. The clinical efficacy of cefoperazone-sulbactam in the treatment of adult patients with SCAP is comparable to that of piperacillin-tazobactam. After adjusting for disease severity, cefoperazone-sulbactam tended to be superior to piperacillin-tazobactam.
Dietary patterns and their associations with glycemic control among type 2 diabetic patients in Jazan, Saudi Arabia: A cross-sectional study
Authors: Elfaki Fatima A. , Chandika Rama M. , Kahlani Saleha H. , Hakami Huda H. , Hakami Ahlam Sh. , Alsayegh Abdulrahman A. , Dighriri Abdulrahim Y. , Khalafalla Husameldin E.
Published: July 2023

Diabetes is an important global health concern. According to the World Health Organization, the Kingdom of Saudi Arabia (KSA) has 2.8 to 4.3 million diabetic patients between the ages of 27 to 60 in the year 2022. Medical nutrition therapy an essential component of diabetes management, helps improve diabetes outcomes by assisting patients in achieving a target glycated hemoglobin (HbA1c) level of <7. This study aimed to describe the pattern of food consumption in the study population and determine its association with glycemic control. This was a cross-sectional study among health facility attendees at the Endocrinology and Diabetes Center (EDC) in Jazan, KSA. A total of 315 patients with type 2 diabetes (T2D) were enrolled using a systematic random sampling technique. Sociodemographic and dietary habit information gathered through face-to-face interviews, anthropometric measurements, and HbA1c were collected from medical records. Participants were mostly females (55.6%), and more than half of them were above 50 years of age. More than 90% of the patients had poor HbA1c levels, and 2-thirds of the patients were overweight and obese (43.8% and 37.1%, respectively). The most consumed foods were bread (8 times/week) and coffee/tea and vegetables (7 times per week), and the least consumed was soda beverages (once/week). Multivariate logistic regression revealed that the consumption of fruits (consumed 5 times/week) significantly decreased HbA1c, while the consumption of pastries/pizza (consumed twice/week) significantly increased it. The pattern of consumption of fruits and vegetables in the study population conformed to the recommended levels, and that of fruits showed a statistically significant association with the control of HbA1c. Another food item that has a significant negative effect on HbA1c is pastries/pizza. Further studies that include more potentially confounding variables, such as treatment type, are needed.
The effects of heatwaves on hospital admissions in the Edirne province of Turkey: A cohort study
Authors: Ozturk Yunus , Baltaci Hakki , Akkoyunlu Bulent Oktay
Published: July 2023

Studies show that heat waves (HWs) are among the most important atmospheric phenomena that negatively affect human health. This study aims to determine the effects of HWs on hospital admissions (HA) in the Edirne province of Turkey. Polyclinic admission and atmospheric data, including daily maximum temperatures, were used. HW is defined as temperature at the % 90 threshold of daily maximum temperatures that persists for at least 3 consecutive days or more. With this definition, a 6-day HW was detected, and a lag of 3 days was added to this HW. Logarithmic Z test was used for the analysis. As a result of the study, The Risk Ratio (RR) showing the relationship between 9-day HW and HAs was calculated as 1.19 (95% confident interval [CI]: 1.17–1.21, P < .05), and it was determined that there were 2557 extra HAs in total. When HAs were analyzed according to sex, it was observed that female admissions were higher than male admissions. To analyze admissions by age, the data were divided into 3 groups: children (<15 years), adult (15–64 years), and elderly (≥65 years). As a result of the analysis, the highest increase was observed in patients < 15 years of age, and the RR was 1.33 (95% CI: 1.24–1.42 P < .05). When the patient density in polyclinics was analyzed, the Cardiology polyclinic had the highest number of patient admissions with an RR, 1.36 (95% CI: 1.30–1.43 P < .05). The results of this study will guide measures to be taken against HWs.
The safety of vedolizumab in a patient with Crohn’s disease who developed anti-TNF-alpha agent associated latent tuberculosis infection reactivation: A case report
Authors: Sugiyama Yuya , Ueno Nobuhiro , Tachibana Shion , Kobayashi Yu , Murakami Yuki , Sasaki Takahiro , Sakatani Aki , Takahashi Keitaro , Ando Katsuyoshi , Kashima Shin , Moriichi Kentaro , Tanabe Hiroki , Okumura Toshikatsu , Fujiya Mikihiro
Published: July 2023

Rationale:

Latent tuberculosis (TB) infection screening before inducing anti-tumor necrosis factor (anti-TNF) alpha agents is important to prevent TB reactivation. However, latent TB infection reactivation may still occur, and the ideal therapeutic strategy for patients with inflammatory bowel disease (IBD) who develop active TB infection has not been established. Vedolizumab (VDZ) has a good safety profile, with low incidence rates of serious infections. However, its safety in patients with latent TB infection reactivation associated with anti-TNF-alpha agents remains unknown.

Patient concerns:

A 21-year-old Vietnamese male patient presented to our hospital with hemorrhagic stool. He had no personal or family history of IBD or TB.

Diagnoses:

Colonoscopy revealed multiple longitudinal ulcers and a cobblestone appearance in the terminal ileum, as well as multiple small erosions and aphtha throughout the colon. Computed tomography revealed a right lung nodular lesion. Serological interferon-gamma release assay and several culture tests were all negative. Thus, he was diagnosed with ileocolonic Crohn’s disease (CD) without TB.

Interventions:

The intravenous anti-TNF-alpha agent administration with an immunomodulator was initiated.

Outcomes:

Computed tomography revealed nodular lesion expansion at the right lung, and serological interferon-gamma release assay was positive. He was diagnosed with latent TB infection reactivation. Anti-TNF-alpha agent with an immunomodulator was immediately discontinued, and anti-TB therapy was initiated. His endoscopic findings were still active, and VDZ was selected for maintenance therapy because VDZ has a favorable safety profile with low incidence rates of serious infections. Consequently, mucosal healing was achieved without active TB relapse.

Lessons:

This case report presented a patient in whom VDZ was continued as maintenance therapy without inducing TB relapse in a patient with CD who developed latent TB infection reactivation associated with anti-TNF-alpha agents and summarized the safety profile of VDZ for patients with IBD with active or latent TB infection. VDZ may be a safe option for induction and maintenance therapy in patients with CD, even in cases with latent TB infection reactivation.
Efficacy analysis of axillary approach in the treatment of Ideberg type I and II scapular glenoid fractures: Case series
Authors: Ding Hao , Bao Yong-Gang , Yin Bo , Chang Qing-Hua , Zai Qing-Shu , Shi Qiang , Hu Hua-Jian , Wang Hai-Bin , Zhao Yi-Feng , Song Fu-Qiang , Wu Bin
Published: July 2023

Rationale:

To investigate the clinical efficacy of the axillary approach in the surgical treatment of Ideberg type I and II scapular glenoid fractures.

Patient concerns and diagnosis:

Retrospective analysis of 13 cases of scapular glenoid fracture treated in the affiliated Hospital of Jining Medical College, Jiaxiang County People hospital, Zoucheng City people Hospital, Yanzhou District People Hospital, and Juancheng County people Hospital from December 2020 to January 2022. Eight males (including 1 bilateral) and 5 females, with an average age of 57.5 years (range from 33 to 75 years). According to Ideberg classification, there were 10 cases of type I a, 1 case of type I a combined with type I b, and 2 cases of type II. All patients were treated with axillary approach surgery and 7 patients with combined anterior shoulder dislocation were treated by first-stage manipulation and second-stage reoperation. Seven patients were fixed with a wire anchor, 3 patients with type I a were fixed with a “T” plate, and 5 patients were complicated with rotator cuff tear and were repaired with a wire anchor. At the last follow-up, the Constant-Murley shoulder function score, visual analog score, DASH score, and Hawkins grade were used to evaluate shoulder function, pain, and stability after treatment.

Intervention:

The intervention was to treat patients with Ideberg type I and II scaphoid fractures using an axillary approach.

Outcomes:

All 13 patients in this group were followed up thoroughly, and the follow-up time was 12 to 25 months, with an average of 18.6 months. The operation time was 65 to 135 minutes, with an average of 85.6 minutes. Intraoperative blood loss ranged from 20 to 120 mL, averaging 55.6 mL. The duration of hospitalization ranged from 7 to 22 days, with an average of 9.6 days. The surgical incisions of all patients were grade-A healing. Bone healing of glenoid fractures was observed 3 months after the operation.

Lessons:

The axillary approach for Ideberg type I and II scapular glenoid fractures is a feasible surgical approach with complete access through the muscle gap, minimal surgical trauma, mild postoperative pain, and satisfactory clinical results.
A study examining the correlation between serum 25-OH-VitD levels, CD3-CD19+ B lymphocytes, and the risk of early spontaneous abortion in pregnant women
Authors: Ai Cuifang
Published: July 2023

The objective of this retrospective cohort study was to investigate the correlation between serum 25-OH-VitD levels, coagulation function, immune factors, and the risk of spontaneous abortion in the first trimester of pregnancy. Additionally, independent risk factors for spontaneous abortion in the first trimester of pregnancy were identified. A total of 412 pregnant women who attended Hubei Maternal and Child Health Care Hospital between October 2021 and February 2022 were included in the study. Of these, 221 met the eligibility criteria and were categorized into the early spontaneous abortion case group (n = 107) or the normal pregnancy control group (n = 114). The serum levels of 25-OH-VitD, CD3 + CD19- T lymphocytes, CD3-CD19 + B lymphocytes, NK (Natural Killer) cells, TNF-α (tumor necrosis factor-α) and coagulation factors (D-dimer, Protein C, Protein S) in both these groups were measured during early pregnancy (within 12 weeks) and evaluated using logistic regression analysis. Compared to the control group, body mass index, Protein S, CD19 + CD3-B lymphocytes, and 25-OH-VitD were significantly lower in the spontaneous abortion group during early pregnancy (P = .001; P = .004; P = .009; P = .001), blood glucose (fasting) and TNF-α significantly increased (P = .001; P = .046). Logistic regression analysis of potential mixed factors showed that fasting blood glucose and TNF-α were significantly different from the control group and were positively correlated (P = .001, P = .038). Fasting blood glucose 0R value is 2.264, 95% confidence interval is 0.043~0.25, TNF-α 0R value is 0.126, 95% confidence interval is 0.800~0.972. CD19 + CD3-B cells and 25-OH-VitD were correlated with spontaneous abortion (P = .005; P = .001), respectively 0R value and 95% confidence interval being −0.007 (1.002~1.012), −0.179 (1.139~1.256). Risk factors for spontaneous abortion in the first trimester (<12 weeks) of pregnancy include fasting glucose tolerance, decreased CD19 + CD3-energy B lymphocytes and 25-OH-VitD, and abnormal increase of TNF-α. Therefore, it is recommended that women with fertility needs be examined as early as possible to avoid adverse outcomes.
Kinesiology taping and ankle foot orthosis equivalent therapeutic effects on gait function in stroke patients with foot drop: A preliminary study
Authors: Choi Jong-Bae , Lee Sang-Hoon , Park Ji-Su
Published: July 2023

An ankle foot orthosis (AFO) is a standard type of orthosis applied to immediately treat foot drop symptoms. Kinesiology taping (KT) is a therapeutic method used in patients with neurological diseases, such as stroke, as well as in patients after orthopedic and sports injuries. This study aimed to compare outcomes of AFO treatment with those of KT to investigate the effect on gait ability in patients with foot drop after stroke. We recruited 18 patients exhibiting foot drop from stroke. Gait ability was assessed under 2 conditions: treatment with KT and that with AFO using the GAITRite system according to the following parameters: cadence, velocity, swing time, stance time, step length, and stride length. As a result, gait ability after treatment with KT and that after treatment with AFO showed no significant differences in cadence (P = .851), velocity (P = .865), swing time (P = .289 and .123), stance time (P = .255 and .711), step length (P = .955 and .975), and stride length (P = .711 and .690) of the affected and less-affected limbs. This study demonstrated that KT and AFO use have similar effects on gait function in patients with foot drop after stroke. Thus, treatment of foot drop with KT may be an alternative in patients for whom AFO use is contraindicated.
Attitudes and demands on medical statistical education during the COVID-19 pandemic among undergraduates-postgraduates-teachers: A cross-sectional study in eastern China
Authors: Cheng Jian , Ni Jing , Zhang Qin , Fan Yinguang
Published: July 2023

Global coronavirus disease 2019 pandemic leads to the soaring demand for medical statistical applications, bringing a great challenge to medical education at universities worldwide. The purpose of our study is to investigate medical students and teachers attitudes and demands on statistical software education. A multi-city cross-sectional study was conducted in 2021 at medical universities in eastern China. Students and teachers were surveyed through online electronic questionnaires. We collected information on each participant attitudes and demands on medical statistical software usage experience. A total of 895 responses were collected using a validated questionnaire. Most students showed great interest in learning medical statistical software (undergraduates 91.9% vs post-graduates 97.8%, P < .01), thought that statistical software was important (undergraduates 99.2% vs post-graduates 94.7%, P < .01), highly relied on using the SPSS (undergraduates 52.9 % vs post-graduates 77.6%, P < .01) and R package, and felt difficulty in learning statistical software (undergraduates 82.7% vs post-graduates 98.4%, P < .01). Among teachers, the most commonly used statistical software was SPSS (91.2%), followed by the R package. Notably, very few students and teachers thought “Statistical software met needs” (from 21.8% of undergraduates to 8.8% of teachers). There were 75.4% of post-graduates and 96.5% of teachers who thought it was necessary for a university to offer an advanced statistical software curriculum such as the R package in the preferred teaching format of offline class as well as the combination of theory and software practice teaching. This study for the first time demonstrated that most medical undergraduates, post-graduates, and teachers in Anhui Province of eastern China were not satisfied with statistical software usage experience, calling for prompt adjustments to statistical software education in medical universities.
Value of CT in COVID-19-pandemia: A systematic analysis of CT-findings and outcomes in patients with COVID-19 pneumonia
Authors: Nadem Boueini Nima , Haage Patrick , Abanador-Kamper Nadine , Kamper Lars
Published: July 2023

Chest-computer tomography (CT) is a crucial factor in the clinical course and evaluation of patients with COVID-pneumonia. In the initial phase of the COVID-19 pandemic little information was known on the prognostic value of the initially taken thoracic CTs. The purpose of this study was to determine predictive values for clinical outcome based on CT classification of the pulmonary pathologies in patients with COVID-pneumonia. This single center study included 51 non-immunized patients during the first COVID-19 outbreak in Germany. The patients underwent a clinically indicated chest-CT. Using the radiological society of North America (RSNA)-report template, chest-CTs were classified into 4 categories (typical, atypical, indeterminate, and no changes). We analyzed the outcomes based on these imaging classifications and relevant comorbidities. Among the 51 patients of our study population 14 (27.5%) patients had a lethal outcome. Typical radiological COVID-19 pattern was found in 92.9% of the deceased patients and in 59.5% of the surviving patients (P = .022). The lethal group showed a significant higher proportion of diabetes mellitus (50% vs 10.8%; P = .003) and arterial hypertension (aHTN) (85.7% vs 54.1%; P = .037). Male sex, higher age and coronary heart disease (CHD) were also seen more often in the lethal group. In patients with clinically proven COVID-19 pneumonia, typical chest CT findings show a negative outcome. A classification system used in this study is helpful for classifying imaging features and is recommended as a standardized CT reporting tool. It could also help in triaging of the therapy of patients with COVID-19 pneumonia. Especially the comorbidities, diabetes and arterial hypertonia triggered a negative outcome in our study population.
Incidence, risk factors and outcomes of early post-operative stroke in a university-based, tertiary care hospital: A 7-year retrospective case-control study
Authors: Somnuke Pawit , Kattiyawittayakul Kanya , Wongyingsinn Mingkwan , Raksakietisak Manee
Published: July 2023

Most post-operative stroke cases occur within 24 hours. This retrospective case-control study aimed to investigate the incidence, risk factors, and outcomes of early post-operative stroke that occurred within 24 hours after surgery in a university-based tertiary care hospital. Medical records were collected and reviewed between 2015 and 2021. Early post-operative stroke cases were compared with age-matched controls in a 1:3 ratio, and data regarding patient characteristics, intra-operative events, and post-operative outcomes were analyzed. Multiple logistic regression was performed to identify the risk factors for post-operative stroke. The incidence of early (≤24 hours) post-operative stroke was 0.015% (43 out of 284,105 cases). The multivariable analysis revealed that American Society of Anesthesiologists (ASA) physical status ≥3 (adjusted odds ratio [OR]: 3.12; 95% confidence interval [CI]: 1.22–7.99, P = .017), operation time >120 minutes (adjusted OR: 10.69; 95% CI: 3.95–28.94, P < .001), and intra-operative hypotension and inotrope/vasopressor use (adjusted OR: 2.80; 95% CI: 1.08–7.24, P = .034) were risk factors for early post-operative stroke. Compared to the controls, stroke patients had higher rates of planned and unplanned intensive care unit (ICU) admission, length of stay, ventilator use, and death. Despite its low incidence (0.015%), stroke is associated with poor clinical outcomes and increased mortality. Stratification of potential risks and establishment of risk optimization may help reduce stroke incidence.
Acute Hemodynamics in the Fontan Circulation: Open-Label Study of Vasopressin*
Authors: Adamson Gregory T. , Yu Jane , Ramamoorthy Chandra , Peng Lynn F. , Taylor Anne , Lennig Michael , Schmidt Alexander R. , Feinstein Jeffrey A. , Navaratnam Manchula
Published: July 2023

OBJECTIVE:

To describe the acute hemodynamic effect of vasopressin on the Fontan circulation, including systemic and pulmonary pressures and resistances, left atrial pressure, and cardiac index.

DESIGN:

Prospective, open-label, nonrandomized study (NCT04463394).

SETTING:

Cardiac catheterization laboratory at Lucile Packard Children’s Hospital, Stanford.

PATIENTS:

Patients 3–50 years old with a Fontan circulation who were referred to the cardiac catheterization laboratory for hemodynamic assessment and/or intervention.

INTERVENTIONS:

A 0.03 U/kg IV (maximum dose 1 unit) bolus of vasopressin was administered over 5 minutes, followed by a maintenance infusion of 0.3 mU/kg/min (maximum dose 0.03 U/min).

MEASUREMENTS AND MAIN RESULTS:

Comprehensive cardiac catheterization measurements before and after vasopressin administration. Measurements included pulmonary artery, atrial, and systemic arterial pressures, oxygen saturations, and systemic and pulmonary flows and resistances. There were 28 patients studied. Median age was 13.5 (9.1, 17) years, and 16 (57%) patients had a single or dominant right ventricle. Following vasopressin administration, systolic blood pressure and systemic vascular resistance (SVR) increased by 17.5 (13.0, 22.8) mm Hg (Z value −4.6, p < 0.001) and 3.8 (1.8, 7.5) Wood Units (Z value −4.6, p < 0.001), respectively. The pulmonary vascular resistance (PVR) decreased by 0.4 ± 0.4 WU (t statistic 6.2, p < 0.001), and the left atrial pressure increased by 1.0 (0.0, 2.0) mm Hg (Z value −3.5, p < 0.001). The PVR:SVR decreased by 0.04 ± 0.03 (t statistic 8.1, p < 0.001). Neither the pulmonary artery pressure (median difference 0.0 [−1.0, 1.0], Z value −0.4, p = 0.69) nor cardiac index (0.1 ± 0.3, t statistic −1.4, p = 0.18) changed significantly. There were no adverse events.

CONCLUSIONS:

In Fontan patients undergoing cardiac catheterization, vasopressin administration resulted in a significant increase in systolic blood pressure, SVR, and left atrial pressure, decrease in PVR, and no change in cardiac index or pulmonary artery pressure. These findings suggest that in Fontan patients vasopressin may be an option for treating systemic hypotension during sedation or general anesthesia.
Moral Distress and Its Relating Factors Among Pediatric Emergency Department Nurses
Authors: Topan Aysel , Taşdelen Yeliz , Yiğit Derya , Terzi Sevinç , Üstüner Top Fadime
Published: July 2023

Objectives

Emergency services are patient circulation units that require chaos, trauma, and high tension. It was aimed to determine the moral distress levels of pediatric nurses in pediatric emergency and emergency departments and relevant factors.

Methods

This study is a descriptive and cross-sectional study. It consists of 255 nurses with their data. The Participant Information Form and the Moral Distress Scale–Revised for Pediatric Nurses (MDS-R) were used to collect data.

Results

In the study, the mean score of MDS-R frequency was found to be 27.36 ± 13.16, the mean score of MDS-R intensity to be 37.65 ± 17.53, and the mean total score of MDS-R to be 58.96 ± 39.40. It was determined that 93.7% of the nurses received training on moral distress, and education level was effective on moral distress levels of the nurses. The nurses working in the pediatric emergency service had higher moral distress levels than the nurses serving pediatric patients in the emergency department (P
(total MDS-R) = 0.02, P
(frequency of MDS-R) = 0.008). Job satisfaction (P
(total MDS-R) = 0.003, P
(frequency of MDS-R) < 0.001, P
(intensity of MDS-R) < 0.001) and frequency of thinking about changing working unit (P
(frequency of MDS-R) = 0.02, P
(intensity of MDS-R) = 0.01) were found to be effective on the level of moral distress. It was determined that the type of emergency service, the working time in the emergency service, and the level of job satisfaction significantly affected the total moral distress scores of the nurses (P < 0.001, R
2 = 0.09).

Conclusions

It was found in the study that nurses had low levels of moral distress; however, many factors relevant to working conditions were associated with moral distress. The pediatric emergency service nurses were determined to experience a higher moral distress compared with the emergency department nurses serving pediatric patients.
Blast Lung Injury in Children
Authors: Korkmaz İnan , Çelikkaya Mehmet Emin
Published: July 2023

Background

Bombings are the most common cause of civilian deaths in wars, and unfortunately, a large proportion of civilian victims are children.

Objective

This study aimed to evaluate the frequency of blast lung injury (BLI), to evaluate lung injury patterns on tomographic images, and to document the relationship between blast lung and mortality in children exposed to the blast effect.

Methods

Thirty-six children (25.3% of pediatric patients brought to our hospital with blast injury) with BLI were included in the study. The pediatric trauma score evaluations made in the emergency department in the first admission were recorded. Lung injury findings in the computed tomography images of the patients were examined, and injuries detected in other systems were recorded.

Results

The most common lung injury pattern was contusion (right: 69.4%, left: 80.6%). The incidence of brain damage (52.4%) and intra-abdominal injury (76.2%) in children with low pediatric trauma score value was statistically significantly higher (P = 0.049, P = 0.017, respectively). There was no statistically significant correlation between the presence of lung injury, injury patterns, and mortality. The incidence of brain damage in deceased patients (61.5%) was statistically significantly higher than the incidence of brain damage in surviving patients (26.1%) (P = 0.036). Low pediatric trauma score was observed in 11 (84.6%) of the deceased children and in 10 (43.5%) of the survivors (P = 0.016). The mean age of children with hemothorax in the right lung was statistically significantly lower than those without (P = 0.014).

Conclusion

Our findings revealed that pediatric BLI is common after a blast, that it is associated with other system injuries, and that a multimodal radiological approach is required in child victims.
Host microbiome-pathogen interactions in pediatric infections
Authors: Hurst Jillian H. , Heston Sarah M. , Kelly Matthew S.
Published: July 2023

Purpose of review

In this review, we discuss recent research that has furthered our understanding of microbiome development during childhood, the role of the microbiome in infections during this life stage, and emerging opportunities for microbiome-based therapies for infection prevention or treatment in children.

Recent findings

The microbiome is highly dynamic during childhood and shaped by a variety of host and environmental factors. In turn, the microbiome influences risk and severity of a broad range of infections during childhood, with recent studies highlighting potential roles in respiratory, gastrointestinal, and systemic infections. The microbiome exerts this influence through both direct interactions with potential pathogens and indirectly through modulation of host immune responses. The elucidation of some of these mechanisms by recent studies and the development of effective microbiome-based therapies for adults with recurrent Clostridioides difficile infection highlight the enormous promise that targeting the microbiome has for reducing the burden of infectious diseases during childhood.

The microbiome has emerged as a key modifier of infection susceptibility and severity among children. Further research is needed to define the roles of microbes other than bacteria and to elucidate the mechanisms underlying microbiome-host and microbiome-pathogen interactions of importance to infectious diseases in children.
Application of 3D SLICER in Cerebral Arteriovenous Malformations in Functional Areas: Case Report
Authors: Zhang Lianfu , Zhang Weiwen , Shi Jian , Zhang Shengbang , Xu Xudong , Yu Hao , Zhang Yongming
Published: July 2023

The authors report a case of intracranial arteriovenous malformation in functional areas, initially presenting with symptomatic epilepsy was surgically excised by the Neurosurgery Department of our hospital. The patient’s head computed tomography, magnetic resonance imaging, and digital subtraction angiography examination suggested intracranial arteriovenous malformations in the left frontal functional area. A preoperative 3D-reconstruction technique was used to reconstruct the malformed vascular mass, supplying arteries, draining veins, and precise surgical resection was performed. Postoperative pathology indicated vascular malformation. No seizures occurred after surgery. There was no further neurological impairment. Preoperative use of image postprocessing techniques can facilitate precise surgical resection of brain arteriovenous malformations. Three-dimensional Slicer in cerebral arteriovenous malformations in functional areas not only shortened the preoperative planning time but also improved the efficiency of the surgery. Reduce the incidence of postoperative complications. It is helpful for further popularization and application.
Long-term Stability Over 2 Years After Isolated Maxillary Orthognathic Surgery Combined With Mandibular Autorotation in Risk Patients for Condylar Resorption
Authors: Xiong Ni , Yang Hoon Joo , Kim Soung Min , Hwang Soon Jung
Published: July 2023

Objective:

Counterclockwise rotation of mandible can cause condylar resorption and condylar displacement posteroinferiorly after maxillary orthognathic surgery with mandibular in patients with high-angle mandibular retrognathism. This study was aimed to evaluate long-term stability >2 years and postoperative changes of condylar displacement.

Materials and methods:

In 15 patients who underwent Le Fort I osteotomy with mandibular autorotation, postoperative stability was cephalometrically investigated until 2 years. Condylar changes were analyzed with transcranial temporomandibular joint projection. Correlation between condylar displacement and surgical movement was analyzed.

Results:

Significant clockwise relapse of mandible (P<0.01 for SNB reduction and backward movement of point B) was observed between 6 months and >2 years after surgery, even though the values were small (0.5±0.1 degrees and 1.14±0.13 mm, respectively). The condyle was displaced posteroinferiorly immediately after surgery; however, it achieved a stable position at postoperative 6 weeks. The amount of vertical condylar displacement was significantly correlated with surgical change in mandibular posterior border sagittal angle, palatal plane angle, facial height ratio, and point B in the horizontal dimension. Greater mandibular rotation prompted more vertical condylar displacement.

Conclusions:

Small mandibular relapse in long term should be considered after maxillary orthognathic surgery with mandibular autorotation, although it is regarded as a surgical maneuver to minimize mandibular instability in patients susceptible to postoperative condylar resorption.
Identification of PP2A-B55 targets uncovers regulation of emerin during nuclear envelope reassembly inDrosophila
Authors: Emond-Fraser Virginie , Larouche Myreille , Kubiniok Peter , Bonneil Éric , Li Jingjing , Bourouh Mohammed , Frizzi Laura , Thibault Pierre , Archambault Vincent
Published: July 2023

Mitotic exit requires the dephosphorylation of many proteins whose phosphorylation was needed for mitosis. Protein phosphatase 2A with its B55 regulatory subunit (PP2A-B55) promotes this transition. However, the events and substrates that it regulates are incompletely understood. We used proteomic approaches inDrosophilato identify proteins that interact with and are dephosphorylated by PP2A-B55. Among several candidates, we identified emerin (otefin inDrosophila). Emerin resides in the inner nuclear membrane and interacts with the DNA-binding protein barrier-to-autointegration factor (BAF) via a LEM domain. We found that the phosphorylation of emerin at Ser50 and Ser54 near its LEM domain negatively regulates its association with BAF, lamin and additional emerin in mitosis. We show that dephosphorylation of emerin at these sites by PP2A-B55 determines the timing of nuclear envelope reformation. Genetic experiments indicate that this regulation is required during embryonic development. Phosphoregulation of the emerin–BAF complex formation by PP2A-B55 appears as a key event of mitotic exit that is likely conserved across species.
Metabolic Interactive Nodular Network for Omics (MINNO): Refining and investigating metabolic networks based on empirical metabolomics data
Authors: Mandwal Ayush , Bishop Stephanie L. , Castellanos Mildred , Westlund Anika , Chaconas George , Lewis Ian , Davidsen Jörn
Published: July 2023

Metabolomics is a powerful tool for uncovering biochemical diversity in a wide range of organisms, and metabolic network modeling is commonly used to frame results in the context of a broader homeostatic system. However, network modeling of poorly characterized, non-model organisms remains challenging due to gene homology mismatches. To address this challenge, we developed Metabolic Interactive Nodular Network for Omics (MINNO), a web-based mapping tool that takes in empirical metabolomics data to refine metabolic networks for both model and unusual organisms. MINNO allows users to create and modify interactive metabolic pathway visualizations for thousands of organisms, in both individual and multi-species contexts. Herein, we demonstrate an important application of MINNO in elucidating the metabolic networks of understudied species, such as those of theBorreliagenus, which cause Lyme disease and relapsing fever. Using a hybrid genomics-metabolomics modeling approach, we constructed species-specific metabolic networks for threeBorreliaspecies. Using these empirically refined networks, we were able to metabolically differentiate these genetically similar species via their nucleotide and nicotinate metabolic pathways that cannot be predicted from genomic networks. These examples illustrate the use of metabolomics for the empirical refining of genetically constructed networks and show how MINNO can be used to study non-model organisms.

GRAPHICAL ABSTRACT

MINNO tool facilitates refining of metabolic networks, multi omics integration and investigation of cross-species interactions.
THE CEREBELLUM CONVERTS INPUT DATA INTO A HYPER LOW-RESOLUTION GRANULE CELL CODE WITH SPATIAL DIMENSIONS: A HYPOTHESIS
Authors: Gilbert Mike , Rasmussen Anders
Published: July 2023

We present a theory of the inner layer of the cerebellar cortex, the granular layer, where the main excitatory input to the cerebellum is received. We ask how input signals are converted into an internal code and what form that has. While there is a computational element, and the ideas are quantified with a computer simulation, the approach is primarily evidence-led and aimed at experimenters rather than the computational community. Network models are often simplified to provide a noiseless medium for sophisticated computations. We propose, with evidence, the reverse: physiology is highly adapted to provide a noiseless medium for straightforward computations. We find that input data are converted to a hyper low-resolution internal code. Information is coded in the joint activity of large cell groups and therefore has minimum spatial dimensions – the dimensions of a code group. The conversion exploits statistical effects of random sampling. Code group dimensions are an effect of topography, cell morphologies and granular layer architecture. The activity of a code group is the smallest unit of information but not the smallest unit of code – the same information is coded in any random sample of signals. Code in this form is unexpectedly wasteful – there is a huge sacrifice of resolution – but may be a solution to fundamental problems involved in the biological representation of information.
The Effect of Gradual Ovarian Failure on Dynamic Muscle Function and the Role of High Intensity Interval Training on Mitigating Impairments
Authors: Hubbard Emma F. , Mashouri Parastoo , Pyle W Glen , Power Geoffrey A
Published: July 2023

Skeletal muscle function is impaired in menopause and exercise may mitigate tshis decline. We used the VCD model of menopause to investigate the effects of gradual ovarian failure on skeletal muscle contractile function and whether high intensity interval training (HIIT) can mitigate impairments. Sexually mature female CD-1 mice were assigned to one of three groups: control (n=5), VCD-sedentary (n=5), or VCD-training (n=5). Following ovarian failure, the VCD-training group underwent 8 weeks of uphill HIIT. Mice were sacrificed 8 weeks after ovarian failure, representing late menopause. Single muscle fibres from the soleus (SOL) and extensor digitorum longus (EDL) muscles were dissected, chemically permeabilized, and mechanically tested. Single muscle fibres were maximally activated (pCa 4.5) then isotonic load clamps were performed to calculate force-velocity-power curves. Absolute force and peak power were 31% and 32% lower in VCD-sedentary fibres compared to control fibres, respectively, in both SOL and EDL muscles. Despite reductions in absolute force and therefore lighter relative loads imposed during the isotonic contractions in VCD-sedentary fibres, there were no concomitant increases in contractile velocity. HIIT was partially effective at mitigating power loss (22% higher peak power in VCD-training compared to VCD-sedentary), but only in fast-type SOL fibres. These findings indicate that ovarian failure impairs dynamic contractile function – likely through a combination of lower force-generating capacity and slower shortening velocity – and that HIIT may be insufficient to completely counteract the deleterious effects of menopause at the cellular level.

New & Noteworthy

Reductions in circulating ovarian hormones impair static muscle contractile performance, but less is known about dynamic properties like power.

Typically, rodent models of menopause completely remove the ovaries and fail to mimic the prolonged and complex hormonal transition that includes a retention in ovarian androgen production.

Using an ovary intact VCD model of ovarian failure, we found that single fibre power was impaired compared with controls in both SOL and EDL fibres.

Our uphill high intensity interval training program was partially sufficient to reverse power loss, but only in fast-type SOL fibres.

Impairments in muscle power following ovarian failure are likely driven by a combination of decreased muscle size and force-generating capacity.
Broadscale dampening of uncertainty adjustment in the aging brain
Authors: Kosciessa Julian Q. , Mayr Ulrich , Lindenberger Ulman , Garrett Douglas D.
Published: July 2023

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The ability to prioritize among input features according to relevance enables adaptive behaviors across the human lifespan. However, relevance often remains ambiguous, and such uncertainty increases demands for dynamic control. While both cognitive stability and flexibility decline during healthy ageing, it is unknown whether aging alters how uncertainty impacts perception and decision-making, and if so, via which neural mechanisms. Here, we assess uncertainty adjustment across the adult lifespan (N = 100; cross-sectional) via behavioral modelling and a theoretically informed set of EEG-, fMRI-, and pupil-based signatures. On the group level, older adults show a broad dampening of uncertainty adjustment relative to younger adults. At the individual level, older individuals with more young-like neural responses also showed better maintained cognitive control. Our results highlight neural mechanisms whose maintenance plausibly enables flexible task-set, perception, and decision computations across the adult lifespan.
iPSC-Astrocyte morphology reflects patient clinical markers
Authors: Rowland Helen A. , Miller Georgina , Liu Qiang , Sharp Nicola , Ng Bryan , Wei Tina , Arunasalam Kanisa , Koychev Ivan , Hedegaard Anne , Ribe Elena M. , Chan Dennis , Chessell Tharani , Kocagoncu Ece , Lawson Jennifer , Malhotra Paresh , Ridha Basil H. , Rowe James B. , Thomas Alan J. , Zamboni Giovanna , Zetterberg Henrik , Cader M. Zameel , Wade-Martins Richard , Lovestone Simon , Nevado-Holgado Alejo , Kormilitzin Andrey , Buckley Noel J.
Published: July 2023

Human iPSCs provide powerful cellular models of Alzheimer’s disease (AD) and offer many advantages over non-human models, including the potential to reflect variation in individual-specific pathophysiology and clinical symptoms Previous studies have demonstrated that iPSC-neurons from individuals with Alzheimer’s disease (AD) reflect clinical markers, including β-amyloid (Aβ) levels and synaptic vulnerability. However, despite neuronal loss being a key hallmark of AD pathology, many risk genes are predominantly expressed in glia, highlighting them as potential therapeutic targets. In this work iPSC-derived astrocytes were generated from a cohort of individuals with high versus low levels of the inflammatory marker YKL-40, in their cerebrospinal fluid (CSF). iPSC-derived astrocytes were treated with exogenous Aβ oligomers and high content imaging demonstrated a correlation between astrocytes that underwent the greatest morphology change from patients with low levels of CSF-YKL-40 and more protectiveAPOEgenotypes. This finding was subsequently verified using similarity learning as an unbiased approach. This study shows that iPSC-derived astrocytes from AD patients reflect key aspects of the pathophysiological phenotype of those same patients, thereby offering a novel means of modelling AD, stratifying AD patients and conducting therapeutic screens.

Graphical Abstract
Nonlinear feedback modulation contributes to the optimization of flexible decision-making
Authors: Wu Xuanyu , Zhou Yang
Published: July 2023

Neural activity in the primate brain correlates with both sensory evaluation and action selection aspects of decision-making. However, the intricate interaction between these distinct neural processes and their impact on decision behaviors remains unexplored. Here, we examined the interplay of these decision processes in posterior parietal cortex (PPC) when monkeys performed a flexible decision task. We found that the PPC activity related to monkeys’ abstract decisions about visual stimuli was nonlinearly modulated by monkeys’ following saccade choices directing outside each neuron’s response field. Recurrent neural network modeling indicated that the feedback connections, matching the learned stimuli-response associations during the task, mediated such feedback modulation. Further analysis on network dynamics revealed that selectivity-specific feedback connectivity intensified the attractor basins of population activity underlying saccade choices, thereby increasing the consistency of flexible decisions. These results highlight an iterative computation between different decision processes, mediated primarily by precise feedback connectivity, contributing to the optimization of flexible decision-making.
In vivofate of systemically administered encapsulin protein nanocages and implications for their use in targeted drug delivery
Authors: Rennie Claire , Sives Caitlin , Boyton India , Diaz Dennis , Gorrie Catherine A , Vittorio Orazio , Collins-Praino Lyndsey , Care Andrew
Published: July 2023

Encapsulins, self-assembling protein nanocages derived from prokaryotes, are promising nanoparticle-based drug delivery systems (NDDS). However, thein vivobehavior and fate of encapsulins are poorly understood. In this pre-clinical study, we probe the interactions between the model encapsulin fromThermotoga maritima(TmEnc) and key biological barriers encountered by NDDS. Here, a purified TmEnc formulation that exhibited colloidal stability, storability, and blood compatibility was intravenously injected into BALB/c mice. TmEnc had an excellent nanosafety profile, with no abnormal weight loss or gross pathology observed, and only temporary alterations in toxicity biomarkers detected. Notably, TmEnc demonstrated immunogenic properties, inducing the generation of nanocage-specific IgM and IgG antibodies, but without any prolonged pro-inflammatory effects. An absence of antibody cross-reactivity also suggested immune-orthogonality among encapsulins systems. Moreover, TmEnc formed a serum-derived protein corona on its surface which changed dynamically and appeared to play a role in immune recognition. TmEnc’s biodistribution profile further revealed its sequestration from the blood circulation by the liver and then biodegraded within Kupffer cells, thus indicating clearance via the mononuclear phagocyte system. Collectively, these findings provide critical insights into how encapsulins behavein vivo,thereby informing their future design, modification, and application in targeted drug delivery.
Epigenetic Variation in Tree Evolution: a case study in black poplar (Populus nigra)
Authors: Sow Mamadou Dia , Rogier Odile , Lesur Isabelle , Daviaud Christian , Mardoc Emile , Sanou Edmond , Duvaux Ludovic , Civan Peter , Delaunay Alain , Descauses Marie-Claude Lesage- , Benoit Vanina , Le-Jan Isabelle , Buret Corinne , Besse Celine , Durufle Harold , Fichot Régis , Le-Provost Grégoire , Guichoux Erwan , Boury Christophe , Garnier Abel , Senhaji-Rachik Abdeljalil , Jorge Véronique , Ambroise Christophe , Tost Jorg , Plomion Christophe , Segura Vincent , Maury Stéphane , Salse Jérôme
Published: July 2023

How perennial organisms adapt to environments is a key question in biology. To address this question, we investigated ten natural black poplar (Populus nigra) populations from Western Europe, a keystone forest tree of riparian ecosystems. We assessed the role of (epi)genetic regulation in driving tree species evolution and adaptation over several millions of years (macro-evolution) up to a few generations (micro-evolution). At the macro-evolution scale, polar experienced differential structural (gene loss) and regulation (expression and methylation) reprogramming between sister genomic compartments inherited from polyploidization events. More interestingly, at the micro-evolution scale, both genetic and epigenetic variations differentiate populations from different geographic origins, targeting specifically genes involved in disease resistance, immune response, hormonal and stress response that can be considered as key functions of local adaptation of long lifespan species. Moreover, genes involved in cambium formation, an important functional trait for forest trees, as well as basal functions for cell survival are constitutively expressed though methylation control. These results highlight DNA methylation as a marker of population differentiation, evolutionary adaptation to diverse ecological environments and ultimately opening the need to take epigenetic marks into account in breeding strategies, especially for woody plants.