bluuebunny/crossref_metadata_2025 huggingface dataset:
Aesthetic Considerations in Extremity Salvage and Reconstruction
Authors: Govshievich Alexander , Bauder Andrew , Kovach Stephen J. , Levin L. Scott
Published: March 2023

Learning Objectives:

After studying this article, the participant should be able to: 1. Have an in-depth understanding of the functional and aesthetic requirements of lower extremity reconstruction. 2. Describe the considerations for achieving an optimal aesthetic outcome in the primary reconstruction settings. 3. Describe modalities of secondary flap revision for achieving an optimal aesthetic outcome.

Significant advancements have been made in the management of lower extremity reconstruction since Dr. Taylor’s seminal case in 1973. Improvements in our understanding of vascular anatomy and evolution of microsurgical techniques have allowed for an ever-increasing array of free tissue transfer options for lower extremity reconstruction. The resulting expertise has engendered a paradigm shift toward the reconstructive elevator approach, with increased emphasis on cosmetic results. In the primary setting, aesthetic considerations play an important role in precoverage wound preparation, flap selection, and harvest technique, with the goal of achieving excellent like-with-like reconstruction at the time of initial surgery. Flap selection should be made to best match the three-dimensional architecture of the wound, and take into account the defect thickness, flap thickness, flap composition, and pedicle length. Primary flap thinning and harvest in the superficial fascial plane has been shown to be an effective modality to address excess adiposity and improve contour. Despite these efforts, secondary procedures are often required to optimize the limb’s final appearance and functional outcomes, particularly in the foot and ankle region. These include debulking, liposuction, and staged excisions. As the field of limb salvage keeps evolving, aesthetics will continue to play an important role in extremity reconstruction planning and execution.
Comprehensive analysis of local anesthetics affecting adipose stem cells, in vitro
Authors: Guillaume Vincent G. J. , Lippold Ella F. , Beier Justus P. , Ruhl Tim
Published: March 2023

Background:

Fat grafting represe nts a common technique to treat volume deficits, e.g. for breast augmentation. Therein, adipose stem cells (ASCs) hold a great regenerative capacity, because of their differentiation capability and, more importantly, their secretory activity. Thus, the survival of ASCs is of great significance during perioperative harvesting. Various local anesthetics are commonly applied during fat grafting procedures. Historically, these substances are known to impair cellular viability, which would affect graft survival and its final outcome. However, the exact extent of local anesthetics’ impact on ASC biology is rather unknown.

Methods:

We analyzed the short- and long-term effects of four different local anesthetics, i.e., lidocaine, mepivacaine, ropivacaine, bupivacaine at increasing concentrations (0.1 nM - 10 mM) on primary human ASC proliferation and metabolic activity, evaluated by crystal violet staining and the PrestoBlue assay, respectively. Trilinear differentiation was assessed by OilRedO stain to measure adipogenesis, SafraninO and cresolphthalein labeling was used for chondrogenic and osteogenic differentiation. Supernatants were used to analyze cytokine (IL-6/ -8, VEGF, HGF) secretion by ELISA.

Results:

Bupivacaine at >100 µM demonstrated the strongest anti-proliferative short- and long-term effects, whereas lidocaine and ropivacaine did not affect cell numbers. Mepivacaine evoked reciprocal results regarding cell count at >1 mM. Each compound impaired differentiation into the adipogenic, chondrogenic and osteogenic lineage. Furthermore, secretion of HGF and IL-8 was significantly reduced by local anesthetic exposure, whereas the levels restored after substances were washed out.

Conclusion:

Depending on our in vitro data, lidocaine, mepivacaine and ropivacaine could be applied at concentrations of 1 - 10 mM without affecting ASC survival. Contrariwise, bupivacaine at concentrations >100 µM should be administered with great caution. However, the differentiation of ASCs and the ASC’s secretome might already be decreased by each local anesthetic at 1 mM.
Betadine Soaking of Silicone Coupons Minimally Impacts Acellular Dermal Matrix Incorporation in a Preclinical Primate Model
Authors: Nahabedian Maurice Y. , Kabaria Nimesh , Lombardi Jared , Leung Braden K. , Sandor Maryellen
Published: March 2023

Background:

Microbial pathogens local to prosthetic breast devices may promote infection, inflammation, and capsular contracture. While antimicrobial solutions have been utilized, their effects on human acellular dermal matrix (HADM) incorporation when used with prosthetic devices is unknown. Our objective was to histologically assess the effect of 10% povidone-iodine (PI)-saturated tissue expander (TE) exposure on HADM biological response in a primate model. It was hypothesized that PI exposure would not negatively impact the HADM biological response.

Methods:

Samples (1.5×1.5 cm) from smooth silicone TEs were saturated in saline or PI for 2 minutes and sutured to HADM to create HADM/TE constructs. Primates implanted subcutaneously with saline (n=9) and PI-treated HADM/TE (n=9) construct pairs were evaluated histologically for biologic response following 2 or 4 weeks via a host response scoring scale (1-9), including recellularization, neovascularization, and inflammation. Inflammatory cells (eosinophils, lymphocytes, neutrophils, histiocytes, foreign body giant cells) and evidence of HADM remodeling (fibroblasts, vessels) were further evaluated via a cell-specific scoring scale (0-4) and corroborated by immuno-staining (CD3, CD20, CD68, FSP-1, collagen type IV).

Results:

Mean histology scores were similar between saline and PI-exposed HADM at 2 (5.3±0.9 and 5.6±0.5, ±SD, P=0.52) and 4 weeks (4.6±1.0 and 4.2±0.9, P=0.44). There was no difference in inflammatory cell presence at 2 and 4 weeks between groups. Fibroblast infiltration differences were insignificant between groups but exhibited trends towards an increase between timepoints for saline (1.6±0.7 to 1.8±0.8) and PI (1.3±0.8 to 1.8±1.0) groups, suggesting HADM incorporation over time.

Conclusions:

Data suggests HADM exposure to PI-treated TEs does not negatively impact inflammation, vascularization, recellularization, incorporation, or host response to HADM in this model.

Clinical Relevance Statement:

Povidone-iodine is a surgical pocket irrigant used to address bacterial colonization, but impact on acellular dermal matrix (ADM) incorporation is unknown. This study demonstrates similar biologic response to ADMs adjacent to povidone-iodine or saline-saturated tissue expanders in a primate model.
CD248 Regulates Inflammation and Encapsulation in Silicone-related Capsule Formation
Authors: Chang Tzu-Yen , Hong Yi-Kai , Kuo Yao-Lung , Wu Hua-Lin , Shieh Shyh-Jou
Published: March 2023

Background:

Capsular contracture is the most common reason for having a secondary breast implant surgery. The failure of the implanted device and discomfort are related to foreign body response, which involves a pathologic encapsulation. An upregulated expression of CD248 was previously demonstrated to modulate inflammation and fibrosis. We hypothesized that CD248 contributes to foreign body reaction and contracture during silicone-stimulated capsule formation.

Methods:

A murine capsular contracture model was established to correlate CD248 with capsular contracture. The timing and site of CD248 expression were characterized by protein analysis and histologic examination. The capsules between wild-type mice and CD248 knockout mice were compared in this model to verify the possible role of CD248 in silicone-related capsule formation.

Results:

CD248 was expressed in the peri-silicone implant capsule by stromal fibroblast and perivascular fibroblast. CD248 was overexpressed since day 4 and down to a constant level, but it was still upregulated through day 21 to day 56 after silicone implantation. The CD248 knockout mice showed a prolonged inflammation period, while the wild-type mice developed a thinner but more collagenous capsule.

Conclusions:

In conclusion, an effective murine capsular contracture model was established to study the relationship between CD248 and capsular contracture. CD248 may play a role in inflammation and encapsulation during silicone implantation. CD248 deletion in mice contributed to a loose and irregular collagen bundle in a capsule area, implying a decrease in contracture. Therefore, CD248 could be a potential therapeutic target in capsular contracture.
The Ram Graft: Using One Complete Piece of Conchal Cartilage for Nasal Tip Reconstruction in East Asians
Authors: Qiao Congzhen , Gao Wei , Chang Lei , Qiu Yajing , Lin Xiaoxi
Published: March 2023

Background:

Adequate nasal tip projection remains a challenge in aesthetic rhinoplasty for East Asians. Various surgical techniques have been developed to reshape the nasal tip using auricular cartilage. Here, we introduce the new ram graft to increase nasal tip projection by using one complete piece of conchal cartilage.

Methods:

Between 2019 and 2021, 19 patients who underwent nasal tip reconstruction using ram grafts were reviewed in a single hospital. The complication rate, satisfaction rate, and changes in nasolabial angle and nasal proportion were recorded.

Results:

Nineteen patients with a mean age ± SD of 28.9 ± 6.1 years underwent nasal tip reconstruction. The mean follow-up ± SD time was 15.4 ± 6.6 months. Nasolabial angle increased from 87.4 ± 10.0 degrees to 91.2 ± 10.2 degrees (p>0.05). 84.2% of patients (16/19) were satisfied with their results. The nasal length: nasal tip projection: dorsal height : radix height ratio is 2: 0.8: 0.62: 0.19 preoperatively and 2: 0.92: 0.77: 0.35 postoperatively. Complications including alloplast-related infection (2/19) and septal extension graft-related decrease of nasal tip projection (1/19) were recorded.

Conclusion:

By using one complete piece of conchal cartilage, the ram graft is a simple and effective approach to increase nasal tip projection for East Asians.
The Auricular Injection Technique : A New Treatment For Lying ear
Authors: Chen Chao-Yang , Zhou Yu-Hao , Fang Jun-Ren , Luo Cheng-En , Tan Lin-Lin , Wang Hai-Bin
Published: March 2023

Lying ear deformity refers to an auricle that bends backward excessively, is excessively folded against the head, and has a very prominent antihelix. It usually requires experienced surgeons to perform surgical treatment and a longer postoperative recovery process. This article proposes a simple and effective hyaluronic acid (HA) injection technique that significantly improves the shape of the outer ear and enhances perceived facial aesthetics. Twenty patients underwent treatment with multiple injections. Measure-related parameters were used to evaluate the postoperative effect in patients, and the results were graded using a visual analog scale (VAS). Interrater reliability between graders was evaluated using intraclass correlation coefficients (ICCs). After treatment, no serious complications, such as infection or embolism, occurred. Six months after the procedure, the average auriculocephalic angle increased from 25.11±9.46° to 32.72±8.29°, the average conchoscaphal angle increased from 87.69±9.06° to 95.94±7.11°, and the average VAS score of the patients increased from 4.40±1.14 to 8.57±0.68. Interrater reliability was fair to good for VAS before injection and 6 months after injection (ICC=0.49; p<0.001 and ICC=0.45; p<0.001, respectively). The patients were satisfied with the injection process and results. In conclusion, this injection protocol improved the shape of the outer ear, resulting in excellent postoperative evaluations.
Prediction of Sex and the Potential Use of On-Demand PrEP Among Young Men Who Have Sex With Men in the United States
Authors: Stamp Bryce F. , Powers Kimberly A. , Horvath Keith J. , Soberano Zachary R. , Hosek Sybil G. , Stocks Jacob B. , Rosso Matthew T. , Hightow-Weidman Lisa B.
Published: March 2023

Background:

On-demand dosing of preexposure prophylaxis (PrEP) requires accurate prediction of sex; however, prediction abilities among young men who have sex with men (YMSM) have not been characterized.

Setting:

A nationally recruited prospective cohort of YMSM ages 16–24 years.

Methods:

We followed 120 YMSM for 8 weeks using digital daily surveys (DDSs) to measure engagement in and prediction of anal sex over 24 hours, along with condom use and other encounter-level circumstances. Our main outcome, an “unpredicted spontaneous encounter,” was defined as an anal sex encounter that occurred without sufficient prior knowledge to (hypothetically) enable protective on-demand PrEP use according to dosing guidelines. We operationalized this outcome as an anal sex encounter for which a participant indicated: (1) on the prior day's DDS that there was a low likelihood of sex occurring in the subsequent 24 hours (unpredicted) and (2) on the current day's DDS that he knew ≤2 hours in advance that the encounter would occur (spontaneous).

Results:

Approximately one-third of all anal sex encounters during the study period were unpredicted and spontaneous and would not have been protected (hypothetically) by on-demand dosing. More than two-thirds of participants experienced such an encounter and almost three-quarters of all acts were condomless.

Conclusions:

On-demand PrEP to prevent HIV acquisition may be challenging for many YMSM. Clinical and public health approaches that account for patients' predictive abilities alongside their dosing preferences may help to optimize selection of and adherence to PrEP dosing strategies.
Learning Outcomes From a Virtual Nutrition Care Process Workshop Delivered to Nutrition and Dietetics Professionals in Mexico
Authors: Heitman Kristen , Proaño Gabriela V. , Papoutsakis Constantina , Diaque Ballesteros Paula , Steiber Alison , Taylor Christopher A.
Published: March 2023

A virtual Nutrition Care Process (NCP) workshop was delivered to 11 nutrition professionals in Mexico. Knowledge was evaluated with an NCP pre-/posttest, focus groups were conducted to gain deeper understanding of the workshop experience, and patient notes (n = 79) were assessed for quality as a measure of NCP implementation. Mean knowledge scores increased after the workshop from 73.5% to 83.6% (P = .003). The focus group elucidated facilitators/barriers of NCP resources. Most patient notes were graded “low quality.” Although the online delivery was a viable method to provide NCP education to a global audience, application of knowledge was not demonstrated, indicating the need for follow-up support.
Intestinal Bacteremia After Liver Transplantation Is a Risk Factor for Recurrence of Primary Sclerosing Cholangitis
Authors: Mammadov Ruslan A. , Selten Jasmijn W. , Roest Henk P. , Verhoeven Cornelia J. , Maroni Luca , Bril Sandra I. , Tolenaars Dagmar , Gadjradj Pravesh S. , van de Graaf Stan F.J. , Oude Elferink Ronald P.J. , Kwekkeboom Jaap , Metselaar Herold J. , Peppelenbosch Maikel P. , Beuers Ulrich , IJzermans Jan N.M. , van der Laan Luc J.W.
Published: March 2023

Background.

Primary sclerosing cholangitis (PSC) is a chronic progressive pathological process, related to inflammatory bowel disease and subsequent bacterial translocation. Liver transplantation (LT) is the only curative therapy, but outcomes are compromised by recurrence of PSC (rPSC). The aim of the study was to investigate a potential link between intestinal bacteremia, fucosyltransferase-2 (FUT2), and rPSC after LT.

Methods.

LT recipients with PSC (n = 81) or without PSC (n = 271) were analyzed for clinical outcomes and positive bacterial blood cultures. A link between bacteremia and the genetic variant of the FUT2 gene was investigated.

Results.

The incidence of inflammatory bowel disease was significantly higher in PSC recipients but not associated with rPSC. Bacteremia occurred in 31% of PSC recipients. The incidence of rPSC was 37% and was significantly more common in patients with intestinal bacteremia versus no bacteremia (82% versus 30%; P = 0.003). The nonsecretor polymorphism of the FUT2 gene was identified as a genetic risk factor for both intestinal bacteremia and rPSC. Combined FUT2 genotype and intestinal bacteremia in recipients resulted in the highest risk for rPSC (hazard ratio, 15.3; P < 0.001).

Conclusions.

Thus, in this article, we showed that bacterial translocation is associated with rPSC after LT and related to the FUT2 nonsecretor status.
Failure of Costimulatory Blockade-induced Regulatory T Cells to Sustain Long-term Survival of High Ischemic Allografts
Authors: Kohei Naoki , Tanaka Toshiaki , Miyairi Satoshi , Tsuda Hidetoshi , Abe Toyofumi , Su Charles A. , Kish Danielle D. , Tanabe Kazunari , Valujskikh Anna , Min Booki , Fairchild Robert L.
Published: March 2023

Background.

Costimulatory blockade–induced allograft tolerance has been achieved in rodent models, but these strategies do not translate well to nonhuman primate and clinical transplants. One confounder that may underlie this discrepancy is the greater ischemic inflammation imposed on the transplants. In mice, cardiac allografts subjected to prolonged cold ischemic storage (CIS) before transplant have increased ischemia–reperfusion injury, which amplifies infiltrating endogenous memory CD8 T-cell activation within hours after transplantation to mediate acute graft inflammation and cytotoxic lymphocyte-associated molecule-4 immunoglobulin–resistant rejection. This study tested strategies inhibiting memory CD8 T-cell activation within such high ischemic allografts to achieve long-term survival.

Methods.

A/J (H-2a) hearts subjected to 0.5 or 8 h of CIS were transplanted to C57BL/6 (H-2b) recipients and treatment with peritransplant costimulatory blockade. At 60 d posttransplant, regulatory T cells (Treg) were depleted in recipients of high ischemic allografts with anti-CD25 monoclonal antibody (mAb) or diphtheria toxin.

Results.

Whereas peritransplant (days 0 and +1) anti–lymphocyte function-associated antigen-1 mAb and anti-CD154 mAb prolonged survival of >60% allografts subjected to minimal CIS for >100 d, only 20% of allografts subjected to prolonged CIS survived beyond day 80 posttransplant and rejection was accompanied by high titers of donor-specific antibody. Peritransplant anti–lymphocyte function-associated antigen-1, anti–tumor necrosis factor-α, and anti-CD154 mAb plus additional anti-CD154 mAb on days 14 and 16 obviated this donor-specific antibody and promoted Treg-mediated tolerance and survival of 60% of high ischemic allografts beyond day 100 posttransplant, but all allografts failed by day 120.

Conclusions.

These studies indicate a strategy inducing prolonged high ischemic allograft survival through Treg-mediated tolerance that is not sustained indefinitely.
Evaluation of Transcranial Direct Current Stimulation in Motor Function and Neural Rehabilitation
Authors: Yuan Xiaoxia , Zhong Xiaoke , Wang Chen , Yang Yuan , Jiang Changhao
Published: March 2023

Transcranial direct current stimulation (tDCS) is used in neuromodulation to regulate the excitability of the cerebral cortex and induce neural plasticity. It was initially used to rehabilitate patients with neurological diseases. However, with the increasing number of studies involving healthy individuals, this technology is currently used in the field of sports as well. The administration of tDCS to the cerebral cortex, especially over the primary motor cortex (M1), has been found to improve muscle strength, enhance endurance, and promote motor skills in humans. This study mainly summarizes the effects of tDCS on motor function, mainly involving motor promotion of tDCS in healthy athletes and nonathletes, and in patients diagnosed with neurological diseases. The tDCS is a promising and effective tool used to promote motor function by regulating cortical excitability. However, no consensus is available regarding individually appropriate models of tDCS.
Latitudinal cline of death-feigning behaviour in a beetle (
Tribolium castaneum
)
Authors: Matsumura Kentarou , Miyatake Takahisa
Published: March 2023

Death-feigning behaviour is a phenomenon in which a prey is rendered motionless due to stimulation or threat from a predator. This anti-predator defence mechanism has been observed across numerous animal taxa and is considered adaptive in nature. However, longer durations of death feigning can result in decreased opportunities for feeding and reproduction, and therefore is often associated with fitness costs as compared to environments without predators. Differences have also been observed in the frequencies and durations of death feigning within populations, and these differences are thought to be influenced by the balance between survival and other fitness costs. Furthermore, this balance is predicted to vary in response to changes in environmental conditions. In this study, we examined the death feigning in 38 populations of the red flour beetle (
Tribolium castaneum
). Our results demonstrate that frequencies and durations of the death feigning in
T. castaneum
show geographical variations and a latitude cline, indicating that this behaviour is influenced by location as well as latitude. This study is the first to demonstrate the existence of a latitudinal cline in death feigning and suggests that death-feigning behaviour might have evolved in response to environmental factors that vary with latitude.
Of fiery sparks and glittering spots: melting-resolidification and spherical particle formation in abrasion
Authors: Singh Dhami Harish , Ranjan Panda Priti , S Puneeth , Viswanathan Koushik
Published: March 2023

The curious occurrence of perfectly spherical particle debris when a steel substrate is slid against a hard abrasive was first documented by Robert Hooke in the seventeenth century. Similar observations now abound in other abrasion-type processes, from industrial grinding to sliding rock faults. The prevalent hypothesis, originally proposed by Hooke, is that these particles form due to high local temperatures, resulting in particle ejection, melting and resolidification. In this work, we revisit this hypothesis, using a model steel-abrasive contact, a combination ofin situand post-process investigations, and complementary analytical calculations. Our results reveal two primary findings—firstly, the temperature of particles ejected from the contact zone is far from the melting point, and secondly, exothermic surface oxidation plays a critical role in actually melting the particle. Melting is either complete or partial, leading to spherical particles or ‘slivers’, as described originally by Hooke. Finally, we confirm that resulting particle surface patterns are typical of rapid solidification from the melt. Apart from throwing light on a centuries’ old curiosity, our results precisely quantify the melting-resolidification process, with implications for a variety of applications, ranging from abrasion and powder production to the formation of micrometeorite dust.
Development and analysis of moments preserving finite volume schemes for multi-variate nonlinear breakage model
Authors: DAS Ashok , Paul Jayanta , Heinrich Stefan , Kumar Jitendra
Published: March 2023

Modelling and simulation of collisional particle breakage mechanisms are crucial in several physical phenomena (asteroid belts, molecular clouds, raindrop distribution etc.) and process industries (chemical, pharmaceutical, material etc.). This paper deals with the development and analysis of schemes to numerically solve the multi-dimensional nonlinear collisional fragmentation model. Two numerical techniques are presented based on the finite volume discretization method. It is shown that the proposed schemes are consistent with the hypervolume conservation property. Moreover, the number preservation property law also holds for one of them. Detailed mathematical discussions are presented to establish the convergence analysis and consistency of the multi-dimensional schemes under predefined restrictions on the kernel and initial data. The proposed schemes are shown to be second-order convergent. Finally, several numerical computations (one-, two- and three-dimensional fragmentation) are performed to validate the numerical schemes.
Gustatory polymorphism mediates a new adaptive courtship strategy
Authors: Wada-Katsumata Ayako , Hatano Eduardo , Schal Coby
Published: March 2023

Human-imposed selection can lead to adaptive changes in sensory traits. However, rapid evolution of the sensory system can interfere with other behaviours, and animals must overcome such sensory conflicts. In response to intense selection by insecticide baits that contain glucose, German cockroaches evolved glucose-aversion (GA), which confers behavioural resistance against baits. During courtship the male offers the female a nuptial gift that contains maltose, which expediates copulation. However, the female's saliva rapidly hydrolyses maltose into glucose, which causes GA females to dismount the courting male, thus reducing their mating success. Comparative analysis revealed two adaptive traits in GA males. They produce more maltotriose, which is more resilient to salivary glucosidases, and they initiate copulation faster than wild-type males, before GA females interrupt their nuptial feeding and dismount the male. Recombinant lines of the two strains showed that the two emergent traits of GA males were not genetically associated with the GA trait. Results suggest that the two courtship traits emerged in response to the altered sexual behaviour of GA females and independently of the male's GA trait. Although rapid adaptive evolution generates sexual mismatches that lower fitness, compensatory behavioural evolution can correct these sensory discrepancies.
Bill shape imposes biomechanical tradeoffs in cavity-excavating birds
Authors: Chhaya Vaibhav , Reddy Sushma , Krishnan Anand
Published: March 2023

Organisms are subject to physical forces that influence morphological evolution. Birds use their bills as implements to perform various functions, each exerting unique physical demands. When excavating cavities, bird bills must resist a range of mechanical stresses to prevent fracture. However, the contribution of bill geometry and material composition to excavation stress resistance remains poorly understood. Here, we study the biomechanical consequences of bill diversification in the cavity-excavating palaeotropical barbets. Using finite-element models and beam theory, we compare excavation performance for two loading regimes experienced by barbet bills during cavity excavation: impact and torsion. We find that deeper and wider maxillae perform better for impact loads than for torsional loads, with the converse for narrower maxillae. This results in tradeoffs between impact and torsion resistance imposed by bill geometry. Analytical beam models validate this prediction, showing that this relationship holds even when maxillae are simplified to solid elliptical beams. Finally, we find that composite bill structures broadly exhibit lower stresses than homogeneous structures of the same geometry, indicating a functional synergy between the keratinous rhamphotheca and bony layers of the bill. Overall, our findings demonstrate the strong link between morphological evolution, behaviour and functional performance in organisms.
Host genetic identity determines parasite community structure across time and space in oyster restoration
Authors: Hanley Torrance C. , Grabowski Jonathan H. , Schneider Eric G. , Barrett Patrick D. , Puishys Lauren M. , Spadafore Rachele , McManus Gwendolyn , Helt William S. K. , Kinney Heather , Conor McManus M. , Randall Hughes A.
Published: March 2023

Intraspecific variation in host susceptibility to individual parasite species is common, yet how these effects scale to mediate the structure of diverse parasite communities in nature is less well understood. To address this knowledge gap, we tested how host genetic identity affects parasite communities on restored reefs seeded with juvenile oysters from different sources—a regional commercial hatchery or one of two wild progenitor lines. We assessed prevalence and intensity of three micro- and two macroparasite species for 4 years following restoration. Despite the spatial proximity of restored reefs, oyster source identity strongly predicted parasite community prevalence across all years, with sources varying in their relative susceptibility to different parasites. Oyster seed source also predicted reef-level parasite intensities across space and through time. Our results highlight that host intraspecific variation can shape parasite community structure in natural systems, and reinforce the importance of considering source identity and diversity in restoration design.
A Devonian crinoid with a diamond microlattice
Authors: Gorzelak Przemysław , Kołbuk Dorota , Stolarski Jarosław , Bącal Paweł , Januszewicz Bartłomiej , Duda Piotr , Środek Dorota , Brachaniec Tomasz , Salamon Mariusz A.
Published: March 2023

Owing to their remarkable physical properties, cellular structures, such as triply periodic minimal surfaces (TPMS), have multidisciplinary and multifunctional applications. Although these structures are observed in nature, examples of TPMS with large length scales in living organisms are exceedingly rare. Recently, microstructure reminiscent of the diamond-type TPMS was documented in the skeleton of the modern knobby starfish
Protoreaster nodosus
. Here we report a similar microlattice in a 385 Myr old crinoid
Haplocrinites
, which pushes back the origins of this highly ordered microstructure in echinoderms into the Devonian. Despite the low Mg
2+
/Ca
2+
ratio of the ‘calcite’ Devonian sea, the skeleton of these crinoids has high-Mg content, which indicates strong biological control over biomineralogy. We suggest that such an optimization of trabecular arrangement additionally enriched in magnesium, which enhances the mechanical properties, might have evolved in these crinoids in response to increased predation pressure during the Middle Palaeozoic Marine Revolution. This discovery illustrates the remarkable ability of echinoderms, through the process of evolutionary optimization, to form a lightweight, stiff and damage-tolerant skeleton, which serves as an inspiration for biomimetic materials.
Diddensiella parasantjacobensis f.a., sp. nov., a yeast species from forest habitats
Authors: Dlauchy Dénes , Lee Ching-Fu , Yurkov Andrey M. , Péter Gábor
Published: March 2023

Six conspecific yeast strains, representing an undescribed species, were isolated from rotten wood collected in different locations in Hungary and Germany and an additional one from fungal fruiting body in Taiwan. The seven strains share identical nucleotide sequences in the D1/D2 domain of the nuclear large subunit (LSU) rRNA gene. The Hungarian and Taiwanese isolates share identical internal transcribed spacer (ITS) sequences as well, while the two German isolates differ from them merely by three substitutions and four indels in this region. The investigated strains are very closely related toDiddensiella santjacobensis. Along their LSU D1/D2 domain they differ only by one substitution from the type strain ofD. santjacobensis. However, in the ITS region of Hungarian and Taiwanese strains we detected 3.5 % divergence (nine substitutions and nine indels) between the undescribed species andD. santjacobensis, while the German strains differed by 13 substitutions and nine indels fromD. santjacobensis. This ITS sequence divergence has raised the possibility that the strains investigated in this study may represent a different species fromD. santjacobensis. This hypothesis was supported by comparisons of partial translation elongation factor 1-α (EF-1α) and cytochrome oxidase II (COX II) gene sequences. While no difference and 1–2 substitutions among the partial EF-1α and COX II gene sequences of the strains of the undescribed species, respectively, were detected; the undescribed species differ by about 4 % (36 substitutions) and 10 % (50–51 substitutions) fromD. santjacobensisin these regions. Parsimony network analysis of the partial COX II gene sequences also separated the investigated strains from the type strain ofD. santjacobensis. In this paper we proposeDiddensiella parasantjacobensisf.a., sp. nov. (holotype: NCAIM Y.02121; isotypes: CBS 17819, DSM 114156) to accommodate the above-noted strains.
The novel roles of bovine milk-derived exosomes on skin anti-aging
Authors: Lu Lu , Bai Wei , Wang Miao , Han Chunle , Du Huanqing , Wang Na , Gao Mengya , Li Dan , Dong Fengwei , Ge Xiaohu
Published: March 2023

Exosomes are small vesicles released from cells and present in various mammal biological fluids, such as bovine milk, which worked for skin care for many years besides dairy. In addition, Exosomes were regarded as a vehicle for intercellular communication. Therefore, we aimed to investigate the novel roles of bovine milk-derived exosomes (MK-Exo) on human skin anti-aging. Purified MK-Exo can be directly uptake by the keratinocytes and fibroblastin vitroand upregulate the expression of the natural factors related to skin moisturizing, including Filaggrin (FLG), Aquaporin 3 (AQP3), CD44 in the keratinocytes and hyaluronidase (HAS2) in the fibroblast, and MK-Exo promoted the cell migration of the fibroblast, while rescue its expression of type I collagen (Col I), type III collagen (Col III) after ultraviolet radiation. Furthermore, the phototoxicity test, photoallergy test, repeated skin irritation test, skin allergy test, and patch test confirm the safety of MK-Exo on the skin. Finally, the roles of MK-Exo in preserving moisture and anti-wrinkle were also identified in humans. Then, MK-Exo was smeared on the facial skin of 31 female volunteers twice a day for 28 days, and the functions were evaluated following the safety assessmentin vivo. These studies reveal the novel roles of bovine milk-derived exosomes in human skin aging, which opens a new way of skin care.
Phase II Study of Myeloablative 8/8- or 7/8-Matched Allotransplantation with Post-Transplant Cyclophosphamide, Tacrolimus, and Mycophenolate Mofetil: Marked Reduction in GVHD Risk Without Increased Relapse Risk Compared to Historical Cyclosporine/Methotrexate
Authors: Jurdi Najla El , Hoover Alex , O’Leary Daniel , Cao Qing , Gupta Ashish , Ebens Christen , Maakaron Joseph , Betts Brian C. , Rashidi Armin , Juckett Mark , Lund Troy , Bachanova Veronika , MacMillan Margaret , Miller Jeffrey , Orchard Paul , Wagner John , Vercellotti Gregory , Weisdorf Daniel , Dusenbery Kathryn , Terezakis Stephanie , Holtan Shernan
Published: March 2023

Introduction

Graft-versus host disease (GVHD) is a major limitation to the success of allogeneic hematopoietic cell transplant (HCT). We hypothesized that the GVHD prophylaxis regimen of post-transplant cyclophosphamide (PTCy), tacrolimus (Tac) and mycophenolate mofetil (MMF) would reduce the incidence of GVHD in patients receiving a matched or single antigen mismatched HCT without an increase in risk of malignant relapse.

Methods

This is a phase II study conducted at the University of Minnesota using a myeloablative regimen of either: (A) total body irradiation (TBI, total dose 1320 cGy, administered in 165 cGy fractions, twice a day from days -4 to -1) or (B) Busulfan 3.2mg/kg daily (cumulative AUC 19,000 – 21,000 μmol/min/L) plus fludarabine 160mg/m2days -5 to -2, followed by a GVHD prophylaxis regimen of PTCy (50mg/kg days +3 and +4), Tac and MMF (beginning day +5). The primary endpoint is cumulative incidence of chronic GVHD requiring systemic immunosuppression at 1-year post-transplant. We compared results to our previous myeloablative protocol for matched donors utilizing cyclosporine/methotrexate (CSA/MTX) GVHD prophylaxis.

Results

From March 2018 - June 2022, we enrolled and treated 125 pediatric and adult patients with a median follow up of 472 days. Grade II-IV acute GVHD occurred in 16% (95% confidence interval (CI): 9-23%); Grade III-IV acute GVHD was 4% (CI: 0-8%). No patients experienced grade IV GVHD, and there were no deaths due to GVHD before day 100. Only 3 developed chronic GVHD requiring immune suppression, (4%, CI: 0-8%). Two-year overall survival (OS) was 80% (CI: 69-87%), and (graft-versus-host disease-free, relapse-free survival) GRFS 57% (CI: 45-67%), both higher than historical CSA/MTX. The incidence of grade II-IV aGVHD, cGVHD, and NRM were all lower with PTCy/Tac/MMF compared to historical CSA/MTX. One-quarter (25%) experienced relapse (CI: 15-36%) similar to historical CSA/MTX. There was no statistically significant difference in survival outcomes between recipients of matched versus 7/8 donors.

Conclusion

Myeloablative HCT with PTCy/Tac/MMF results in extremely low incidence of severe acute or chronic GVHD, the primary endpoint of this clinical trial. Relapse risk is not increased compared to our historical CSA/MTX cohort.
Cluster-Based Toxicity Estimation of Osteoradionecrosis via Unsupervised Machine Learning: Moving Beyond Single Dose-Parameter Normal Tissue Complication Probability by Using Whole Dose-Volume Histograms for Cohort Risk Stratification
Authors: Hosseinian Seyedmohammadhossein , Hemmati Mehdi , Dede Cem , Salzillo Travis C. , van Dijk Lisanne V. , Mohamed Abdallah S. R. , Lai Stephen Y. , Schaefer Andrew J. , Fuller Clifton D.
Published: March 2023

Purpose

Given the limitations of extant models for normal tissue complication probability estimation for osteoradionecrosis (ORN) of the mandible, the purpose of this study was to enrich statistical inference by exploiting structural properties of data and provide a clinically reliable model for ORN risk evaluation through an unsupervised-learning analysis.

Materials and Methods

The analysis was conducted on retrospective data of 1,259 head and neck cancer (HNC) patients treated at the University of Texas MD Anderson Cancer Center between 2005 and 2015. The (structural) clusters of mandibular dose-volume histograms (DVHs) were identified through the K-means clustering method. A soft-margin support vector machine (SVM) was used to determine the cluster borders and partition the dose-volume space. The risk of ORN for each dose-volume region was calculated based on the clinical risk factors and incidence rates.

Results

The K-means clustering method identified six clusters among the DVHs. Based on the first five clusters, the dose-volume space was partitioned almost perfectly by the soft-margin SVM into distinct regions with different risk indices. The sixth cluster overlapped the others entirely; the region of this cluster was determined by its envelops. These regions and the associated risk indices provide a range of constraints for dose optimization under different risk levels.

Conclusion

This study presents an unsupervised-learning analysis of a large-scale data set to evaluate the risk of mandibular ORN among HNC patients. The results provide a visual risk-assessment tool (based on the whole DVH) and a spectrum of dose constraints for radiation planning.
The cytokine, chemokine, and growth factor network of prenatal depression
Authors: Maes Michael , Abe Yoshiko , Sirichokchatchawan Wandee , Suwimonteerabutr Junpen , Sangkomkamhangd Ussanee , Almulla Abbas F. , Satthapisit Sirina
Published: March 2023

Background

Neuro-immune pathways are engaged in antenatal and postpartum depression. Aims: To determine if immune profiles influence the severity of prenatal depression above and beyond the effects of adverse childhood experiences (ACE), premenstrual syndrome (PMS) and current psychological stressors.

Methods

Using the Bio-Plex Pro human cytokine 27-plex test kit, we assayed M1 macrophage, T helper (Th)-1, Th-2, Th-17, growth factor, chemokine, T cell growth immune profiles as well as indicators of the immune inflammatory response system (IRS) and compensatory immunoregulatory system (CIRS) in 120 pregnant females in the early (<16 weeks) and late (> 24 weeks) pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess severity of antenatal depression.

Results

Cluster analyses showed that the combined effects of ACE, relationship dissatisfaction, unwanted pregnancy, PMS, and upregulated M1, Th-1, Th-2 and IRS immune profiles and the ensuing early depressive symptoms shape a stress-immune-depression phenotypic class. Elevated IL-4, IL-6, IL-8, IL-12p70, IL-15, IL-17 and GM-CSF are the primary cytokines associated with this new phenotypic class. All immune profiles (except CIRS) were significantly associated with the early EPDS score, independent of the effects of psychological variables and PMS. There was a shift in immune profiles from early to late pregnancy, with an increase in the IRS/CIRS ratio. The late EPDS score was predicted by the early EPDS score, adverse experiences, and immune profiles, mainly the Th-2 and Th-17 phenotypes.

Conclusions

Activated immune phenotypes contribute to early and late perinatal depressive symptoms above and beyond the effects of psychological stressors and PMS.
Post-operative morbidity and mortality in Indigenous Peoples: A scoping review and meta-analysis
Authors: Livergant Rachel J , Stefanyk Kelsey , Binda Catherine , Fraulin Georgia , Maleki Sasha , Sibbeston Sarah , Joharifard Shahrzad , Hillier Tracey , Joos Emilie
Published: March 2023

Indigenous Peoples across North America and Oceania experience worse health outcomes compared to non-Indigenous people, including increased post-operative morbidity and mortality. No data is available on global differences in surgical morbidity and mortality between geographic locations and across surgical specialties. The aim of this study is to evaluate disparities in post-operative morbidity and mortality between Indigenous and non-Indigenous populations. This scoping review and meta-analysis was conducted in accordance with PRISMA-ScR and MOOSE guidelines. Eight electronic databases were searched with no language restriction. Studies reporting on Indigenous populations outside of Canada, the USA, New Zealand, or Australia, or on interventional procedures were excluded. Primary outcomes were post-operative morbidity and mortality. Secondary outcomes included reoperations, readmission rates, and length of hospital stay. The Newcastle Ottawa Scale was used for quality assessment. Eighty-four unique observational studies were included in this review. Of these, 67 studies were included in the meta-analysis (Oceania n=31, North America n=36). Extensive heterogeneity existed among studies and 50% were of poor quality. Indigenous patients worldwide had 1.26 times higher odds of post-operative morbidity (OR=1.26, 95% CI: 1.10-1.44, p<0.01) and 1.34 times higher odds of post-operative infection (OR=1.34, 95% CI: 1.12-1.59, p<0.01) than non-Indigenous patients. Indigenous patients also had 1.33 times higher odds of reoperation (OR=1.33, 95% CI: 1.02-1.74, p=0.04) and longer hospital stays (SMD=0.09; 95% CI: 0.02-1.08; p=0.05). In conclusion, we found that Indigenous patients experience significantly poorer surgical outcomes than their non-Indigenous counterparts. Additionally, there remains a paucity of high-quality research focusing on assessing and improving surgical equity for Indigenous patients worldwide, despite multiple international and national calls to action for reconciliation and decolonization to improve access to quality surgical care for Indigenous populations.
Health-related quality of life and adherence to physical activity and screen time recommendations in schoolchildren: longitudinal cohort Ciao Corona
Authors: Haile Sarah R , Gunz Samuel , Peralta Gabriela P , Ulytė Agnė , Raineri Alessia , Rueegg Sonja , Yasenok Viktoriia , Radtke Thomas , Puhan Milo A , Kriemler Susi
Published: March 2023

Objectives

We investigated changes in adherence to physical activity (PA) and screen time (ST) recommendations of children and adolescents throughout the pandemic, and their association with health-related quality of life (HRQOL).

Methods

1769 primary (PS, grades 1-6) and secondary (SS, 7-9) school children from Ciao Corona, a school-based cohort study in Zurich, Switzerland, with 5 questionnaires 2020-2022. HRQOL was assessed using the KINDL questionnaire. PA (≥ 60 min/day moderate-to-vigorous PA) and ST (≤ 2 hours/day ST) recommendations followed WHO guidelines.

Results

Adherence to PA recommendations dropped in 2020 (83% to 59% PS, 77% to 52% SS), but returned to pre-pandemic levels by 2022 (79%, 66%). Fewer children met ST recommendations in 2020 (74% PS, 29% SS) and 2021 (82%, 37%) than pre-pandemic (95%, 68%). HRQOL decreased 3 points between 2020 and 2022, and was 9.7 points higher (95% CI 3.0-16.3) in March 2021 in children who met both versus no recommendations.

Conclusions

Adherence to WHO guidelines on PA and ST during the pandemic had a consistent association with HRQOL despite longitudinal changes in behavior.
Convergence of HIV and non-communicable disease epidemics: Geospatial mapping of the unmet health needs in a HIV Hyperendemic South African community
Authors: Cuadros Diego F , Devi Chayanika , Singh Urisha , Olivier Stephen , Castle Alison , Moosa Yumna , Edwards Johnathan A , Kim Hae-Young , Siedner Mark J. , Wong Emily B , Tanser Frank
Published: March 2023

Background

As people living with HIV (PLHIV) are experiencing longer survival, the co-occurrence of HIV and non-communicable diseases has become a public health priority. In response to this emerging challenge, we aimed to characterize the spatial structure of convergence of chronic health conditions in a HIV hyperendemic community in KwaZulu-Natal, South Africa.

Methods

We utilized data from a comprehensive population-based disease survey conducted in KwaZulu-Natal, South Africa, which collected data on HIV, diabetes, and hypertension. We implemented a novel health needs scale to categorize participants as: diagnosed and well-controlled (Needs Score 1), diagnosed and sub-optimally controlled (Score 2), diagnosed but not engaged in care (Score 3), or undiagnosed and uncontrolled (Score 4). Scores 2-4 were indicative of unmet health needs. We explored the geospatial structure of unmet health needs using different spatial clustering methods.

Findings

The analytical sample comprised of 18,041 individuals. We observed a similar spatial structure for HIV among those with a combined needs Score 2-3 (diagnosed but uncontrolled) and Score 4 (undiagnosed and uncontrolled), with most PLHIV with unmet needs clustered in the southern peri-urban area, which was relatively densely populated within the surveillance area. Multivariate clustering analysis revealed a significant overlap of all three diseases in individuals with undiagnosed and uncontrolled diseases (unmet needs Score 4) in the southern part of the catchment area.

Interpretation

In a HIV hyperendemic community in South Africa, areas with the highest needs for PLHIV with undiagnosed and uncontrolled disease are also areas with the highest burden of unmet needs for other chronic health conditions, such as diabetes and hypertension. The identification and prioritization of geographically clustered vulnerable communities with unmet health needs for both HIV and non-communicable diseases provide a basis for policy and implementation strategies to target communities with the highest health needs.

Funding

Research reported in this publication was supported by the Fogarty International Center (R21 TW011687; D43 TW010543), the National Institute of Mental Health, the National Institute of Allergy and Infectious Diseases (K24 HL166024; T32 AI007433) of the National Institutes of Health, and Heart Lung and Blood Institute (K24 HL166024, T32 AI007433). The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the funders.