bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating the impact of implementing an integrated care management approach with Atrial fibrillation Better Care (ABC) pathway for patients with atrial fibrillation in England from 2020 to 2040
Authors: Camacho Elizabeth M , Lip Gregory Y H
Published: September 2023

Background

Stroke prevention is central to the management of atrial fibrillation (AF), but there remains a residual risk of adverse outcomes in anticoagulated AF patients. Hence, current guidelines have proposed a more holistic or integrated approach to AF management, based on the Atrial fibrillation Better Care (ABC) pathway, as follows: (A) avoid stroke with anticoagulation; (B) better symptom control with patient-centred symptom directed decisions on rate or rhythm control; and (C) cardiovascular and comorbidity management, including lifestyle factors. There has been no formal healthcare cost analysis from the UK National Health Service (NHS) perspective of ABC pathway implementation to optimize the management of AF. Our aim was to estimate the number of patients with AF in the UK each year up to 2040, their morbidity and mortality, and the associated healthcare costs, and secondly, to estimate improvements in morbidity and mortality of implementing an ABC pathway, and the impact on costs.

Results

In 2020, there were an estimated 1 463 538 AF patients, resulting in £286 million of stroke care and £191 million of care related to bleeds annually. By 2030, it is expected that there will be 2 115 332 AF patients, resulting in £666 million of stroke healthcare and £444 million of healthcare related to bleeds. By 2040, this is expected to rise to 2 856 489 AF patients, with £1096 million of stroke healthcare and £731 million of healthcare related to bleeds for that year. If in 2040 patients are managed on an ABC pathway, this could prevent between 3724 and 18 622 strokes and between 5378 and 26 890 bleeds, and save between 16 131 and 80 653 lives depending on the proportion of patients managed on the pathway. This would equate to cost reductions of between £143.9 million and £719.6 million for the year.

Conclusion

We estimate that there will be a substantial healthcare burden in the UK NHS associated with AF, from strokes, bleeds, and mortality over the next decades. If patients are managed with a holistic or integrated care approach based on the ABC pathway, this could prevent strokes and bleeds that equate to substantial NHS healthcare cost reductions, and save lives.
Corrupted by Algorithms? How AI-generated and Human-written Advice Shape (Dis)honesty
Authors: Leib Margarita , Köbis Nils , Rilke Rainer Michael , Hagens Marloes , Irlenbusch Bernd
Published: September 2023

Artificial intelligence increasingly becomes an indispensable advisor. New ethical concerns arise if artificial intelligence persuades people to behave dishonestly. In an experiment, we study how artificial intelligence advice (generated by a natural language processing algorithm) affects (dis)honesty, compare it to equivalent human advice and test whether transparency about the advice source matters. We find that dishonesty-promoting advice increases dishonesty, whereas honesty-promoting advice does not increase honesty. This is the case for both artificial intelligence and human advice. Algorithmic transparency, a commonly proposed policy to mitigate artificial intelligence risks, does not affect behaviour. The findings mark the first steps towards managing artificial intelligence advice responsibly.
Characterization of the Gut Microbiota and Mycobiota in Italian Pediatric Patients With Primary Sclerosing Cholangitis and Ulcerative Colitis
Authors: Del Chierico Federica , Cardile Sabrina , Baldelli Valerio , Alterio Tommaso , Reddel Sofia , Bramuzzo Matteo , Knafelz Daniela , Lega Sara , Bracci Fiammetta , Torre Giuliano , Maggiore Giuseppe , Putignani Lorenza
Published: September 2023

Background

Primary sclerosing cholangitis (PSC) is a chronic, fibroinflammatory, cholestatic liver disease of unknown etiopathogenesis, often associated with inflammatory bowel diseases. Recent evidence ascribes, together with immunologic and environmental components, a significant role to the intestinal microbiota or its molecules in the PSC pathogenesis.

Methods

By metagenomic sequencing of 16S rRNA and ITS2 loci, we describe the fecal microbiota and mycobiota of 26 pediatric patients affected by PSC and concomitant ulcerative colitis (PSC-UC), 27 patients without PSC but with UC (UC), and 26 healthy subjects (CTRLs).

Results

Compared with CTRL, the bacterial and fungal gut dysbiosis was evident for both PSC-UC and UC groups; in particular, Streptococcus, Saccharomyces, Sporobolomyces, Tilletiopsis, and Debaryomyces appeared increased in PSC-UC, whereas Klebsiella, Haemophilus, Enterococcus Collinsella, Piptoporus, Candida, and Hyphodontia in UC. In both patient groups, Akkermansia, Bacteroides, Parabacteroides, Oscillospira, Meyerozyma and Malassezia were decreased. Co-occurrence analysis evidenced the lowest number of nodes and edges for fungi networks compared with bacteria. Finally, we identified a specific patient profile, based on liver function tests, bacterial and fungal signatures, that is able to distinguish PSC-UC from UC patients.

Conclusions

We describe the gut microbiota and mycobiota dysbiosis associated to PSC-UC disease. Our results evidenced a gut imbalance, with the reduction of gut commensal microorganisms with stated anti-inflammatory properties (ie, Akkermansia, Bacteroides, Parabacteroides, Oscillospira, Meyerozyma, and Malassezia) and the increase of pathobionts (ie, Streptococcus, Saccharomyces, and Debaryomyces) that could be involved in PSC progression. Altogether, these events may concur in the pathophysiology of PSC in the framework of UC.
Co-feeding enhances the yield of methyl ketones
Authors: Ziegler Anita L , Grütering Carolin , Poduschnick Leon , Mitsos Alexander , Blank Lars M
Published: September 2023

The biotechnological production of methyl ketones is a sustainable alternative to fossil-derived chemical production. To date, the best host for microbial production of methyl ketones is a genetically engineered Pseudomonas taiwanensis VLB120 ∆6 pProd strain, achieving yields of 101 mgg−1 on glucose in batch cultivations. For competitiveness with the petrochemical production pathway, however, higher yields are necessary. Co-feeding can improve the yield by fitting the carbon-to-energy ratio to the organism and the target product. In this work, we developed co-feeding strategies for P. taiwanensis VLB120 ∆6 pProd by combined metabolic modeling and experimental work. In a first step, we conducted flux balance analysis with an expanded genome-scale metabolic model of iJN1463 and found ethanol as the most promising among five cosubstrates. Next, we performed cultivations with ethanol and found the highest reported yield in batch production of methyl ketones with P. taiwanensis VLB120 to date, namely, 154 mg g−1 methyl ketones. However, ethanol is toxic to the cell, which reflects in a lower substrate consumption and lower product concentrations when compared to production on glucose. Hence, we propose cofeeding ethanol with glucose and find that, indeed, higher concentrations than in ethanol-fed cultivation (0.84 g Laq−1 with glucose and ethanol as opposed to 0.48 g Laq−1 with only ethanol) were achieved, with a yield of 85 mg g−1. In a last step, comparing experimental with computational results suggested the potential for improving the methyl ketone yield by fed-batch cultivation, in which cell growth and methyl ketone production are separated into two phases employing optimal ethanol to glucose ratios.

One-Sentence Summary

By combining computational and experimental work, we demonstrate that feeding ethanol in addition to glucose improves the yield of biotechnologically produced methyl ketones.
Therapeutic mechanism of Liangxue-Guyuan-Yishen decoction on intestinal stem cells and tight junction proteins in gastrointestinal acute radiation syndrome rats
Authors: Yan Ziqiao , Yin Bofeng , Wang Yuguo , Ni Zhexin , Feng Jian , Yang Qianyu , Li Xiao , Zhu Heng , Dou Yongqi
Published: September 2023

On the basis of the previous research, the Traditional Chinese Medicine theory was used to improve the drug composition for gastrointestinal acute radiation syndrome (GI-ARS). The purpose of this study was to study the therapeutic mechanism of Liangxue-Guyuan-Yishen decoction (LGYD) on GI-ARS and to provide a new scheme for the treatment of radiation injury. Here, we investigated the effects of LGYD on intestinal stem cells (ISCs) in a GI-ARS rat model. Rat health and survival and the protective efficacy of LGYD on the intestines were analyzed. The active principles in LGYD were detected using liquid chromatography-mass spectrometry (LC–MS). ISC proliferation, intestinal epithelial tight junction (TJ) protein expression and regulatory pathways were explored using immunohistochemistry, western blotting (WB) and reverse transcription quantitative polymerase chain reaction (RT-qPCR), respectively. Involvement of the WNT and MEK/ERK pathways in intestinal recovery was screened using network pharmacology analysis and validated by WB and RT-qPCR. LGYD administration significantly improved health and survival in GI-ARS rats. Pathological analysis showed that LGYD ameliorated radiation-induced intestinal injury and significantly promoted LGR5+ stem cell regeneration in the intestinal crypts, upregulated TJ protein, and accelerated crypt reconstruction in the irradiated rats. LC–MS revealed ≥13 constituents that might contribute to LGYD’s protective effects. Collectively, LGYD can promote crypt cell proliferation and ISCs after radiation damage, the above effect may be related to WNT and MEK/ERK pathway.
The Sufi Writing Tradition in Arabic
Authors: Salamah-Qudsi Arin
Published: September 2023

This paper addresses Sufi writing in its contemporary third/ninth-fifth/eleventh century CE context, looking at how writing was shaped by other Sufi and non-Sufi forms. Beginning with an overview of the Sufi writing tradition in Arabic during Sufism's formative period, between the early third/ninth and the late sixth/twelfth centuries, the article goes on to discuss early Sufi piety and the ways it challenged common conceptions and epistemological paradigms of early medieval Islamic thought. Looking at the mid fourth/tenth century case of al-Niffarī shows how mystical piety interacterd with a deep-rooted tradition in Arabic literature to forge the unique dynamics of what we know today as Sufi writing.
Using Auxiliary Information in Probability Survey Data to Improve Pseudo-Weighting in Nonprobability Samples: A Copula Model Approach
Authors: Zhu Tingyu , Gamble Laura J , Klapman Matthew , Xue Lan , Lesser Virginia M
Published: September 2023

While probability sampling has been considered the gold standard of survey methods, nonprobability sampling is increasingly popular due to its convenience and low cost. However, nonprobability samples can lead to biased estimates due to the unknown nature of the underlying selection mechanism. In this article, we propose parametric and semiparametric approaches to integrate probability and nonprobability samples using common ancillary variables observed in both samples. In the parametric approach, the joint distribution of ancillary variables is assumed to follow the latent Gaussian copula model, which is flexible to accommodate both categorical and continuous variables. In contrast, the semiparametric approach requires no assumptions about the distribution of ancillary variables. In addition, logistic regression is used to model the mechanism by which population units enter the nonprobability sample. The unknown parameters in the copula model are estimated through the pseudo maximum likelihood approach. The logistic regression model is estimated by maximizing the sample likelihood constructed from the nonprobability sample. The proposed method is evaluated in the context of estimating the population mean. Our simulation results show that the proposed method is able to correct the selection bias in the nonprobability sample by consistently estimating the underlying inclusion mechanism. By incorporating additional information in the nonprobability sample, the combined method can estimate the population mean more efficiently than using the probability sample alone. A real-data application is provided to illustrate the practical use of the proposed method.
Adapting international natural gas and LNG agreements in the light of the energy transition
Authors: Talus Kim
Published: September 2023

This article will examine the bidirectional relationship between private energy contracts and the transition towards a net-zero world. It will focus on long-term take-or-pay natural gas and liquefied natural gas sale and purchase agreements (natural gas and LNG SPAs) that are commonly used in the natural gas sector. These agreements often contain highly restrictive clauses that are designed to ensure stability of supply and demand, which makes them suitable for acquiring the project financing necessary for large capital-intensive energy projects. At the same time, these agreements create an important lock-in effect for the contracting parties. This article will examine the details of gas SPAs from the perspective of this lock-in effect. It will show that current contractual formulations do not provide an adequate solution in the context of the energy transition. Because of this lock-in effect, there is an urgent need to adapt existing contract forms for future use, and to modify the continued application of existing executory contracts to accommodate new realities.
Alone Together: Is Strain Experienced Concurrently by Members of Operating Room Teams?: An Event-based Study
Authors: Keller Sandra , Yule Steven , Smink Douglas S. , Zagarese Vivian , Safford Shawn , Valea Fidel A. , Beldi Guido , Henrickson Parker Sarah
Published: September 2023

Objective:

To identify which strain episodes are concurrently reported by several team members; to identify triggers of strain experienced by operating room (OR) team members during the intraoperative phase.

OR teams are confronted with many sources of strain. However, most studies investigate strain on a general, rather than an event-based level, which does not allow to determine if strain episodes are experienced concurrently by different team members.

Methods:

We conducted an event-based, observational study, at an academic medical center in North America and included 113 operations performed in 5 surgical departments (general, vascular, pediatric, gynecology, and trauma/acute care). Strain episodes were assessed with a guided-recall method. Immediately after operations, participants mentally recalled the operation, described the strain episodes experienced and their content.

Results:

Based on 731 guided recalls, 461 strain episodes were reported; these refer to 312 unique strain episodes. Overall, 75% of strain episodes were experienced by a single team member only. Among different categories of unique strain episodes, those triggered by task complexity, issues with material, or others’ behaviors were typically experienced by 1 team member only. However, acute patient issues (n = 167) and observations of others’ strain (n = 12) (respectively, 58.5%; P < 0.001 and 83.3%; P < 0.001) were often experienced by 2 or more team members.

Conclusions and relevance:

OR team members are likely to experience strain alone, unless patient safety is at stake. This may jeopardize the building of a shared understanding among OR team members.
National ICU Registries as Enablers of Clinical Research and Quality Improvement
Authors: Salluh Jorge I. F. , Quintairos Amanda , Dongelmans Dave A. , Aryal Diptesh , Bagshaw Sean , Beane Abigail , Burghi Gaston , López Maria del Pilar Arias , Finazzi Stefano , Guidet Bertrand , Hashimoto Satoru , Ichihara Nao , Litton Edward , Lone Nazir I. , Pari Vrindha , Sendagire Cornelius , Vijayaraghavan Bharath Kumar Tirupakuzhi , Haniffa Rashan , Pisani Luigi , Pilcher David ,   on behalf of Linking of Global Intensive Care (LOGIC) and Japanese Intensive care PAtient Database (JIPAD) Working Group
Published: September 2023

OBJECTIVES:

Clinical quality registries (CQRs) have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. This narrative review describes the challenges, proposed solutions, and evidence generated by National ICU registries as facilitators for research and quality improvement.

DATA SOURCES:

English language articles were identified in PubMed using phrases related to ICU registries, CQRs, outcomes, and case-mix.

STUDY SELECTION:

Original research, review articles, letters, and commentaries, were considered.

DATA EXTRACTION:

Data from relevant literature were identified, reviewed, and integrated into a concise narrative review.

DATA SYNTHESIS:

CQRs have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. The initial experience in European countries and in Oceania ensured that through locally generated data, ICUs could assess their performances by using risk-adjusted measures and compare their results through fair and validated benchmarking metrics with other ICUs contributing to the CQR. The accomplishment of these initiatives, coupled with the increasing adoption of information technology, resulted in a broad geographic expansion of CQRs as well as their use in quality improvement studies, clinical trials as well as international comparisons, and benchmarking for ICUs.

CONCLUSIONS:

ICU registries have provided increased knowledge of case-mix and outcomes of ICU patients based on real-world data and contributed to improve care delivery through quality improvement initiatives and trials. Recent increases in adoption of new technologies (i.e., cloud-based structures, artificial intelligence, machine learning) will ensure a broader and better use of data for epidemiology, healthcare policies, quality improvement, and clinical trials.
Ray-Tracing Transepithelial Excimer Laser Central Corneal Remodeling Plus Pachymetry-Guided Accelerated Corneal Crosslinking for Keratoconus
Authors: Mazzotta Cosimo , Stojanovic Aleksandar , Romano Vito , Addabbo Giuseppe , Borroni Davide , Balamoun Ashraf Armia , Ferrise Marco
Published: September 2023

Purpose:

The aim of this study was to report the 12 to 96 months results of a tissue-preservation algorithm based on ray-tracing-guided transepithelial excimer laser central corneal ablation (RT t-PRK) combined with individualized pachymetry-guided accelerated crosslinking (M nomogram ACXL) in young adult patients with stable keratoconus (KC).

Methods:

This was a prospective interventional study including 38 eyes of 38 young adult patients (stage II KC) with a mean age of 35 years (range 26–46 years) who underwent simultaneous RT with t-PRK plus pachymetry-based ACXL in the worst eye. The treatments were performed using the iViS Suite iRES Excimer Laser (Ligi, Taranto, Italy). Ray-tracing–guided treatments were planned using the customized interactive programmed transepithelial ablation (CIPTA) 2 web software and diagnostic data were assessed by the Precisio 2 tomographer (Ligi, Taranto, Italy) and Sirius tomographer (C.S.O., Florence, Italy). The main outcome measures included uncorrected distance visual acuity, best spectacle–corrected visual acuity, Kmax, high-order aberrations, minimum corneal thickness, and posterior elevation, with a mean follow-up of 52 months (range 12–96 m).

Results:

The mean UDVA improved + 3.5 ±1.28 Snellen lines (SL); 38% gained ≥ 4 ±1.34 SLs, 35% ≥ 3 ±1.21 SLs, 22% ≥ 2 ±1.12 SLs, and 5% ≥ 1 ±0.75 SLs. The mean best spectacle–corrected visual acuity increased by + 4.3 ±1.3 SL. Sixty-eight percent gained ≥ 4 ±0.88 SLs and 30% ≥ 3 ±0.78 SL. No SLs were lost.

Conclusions:

RT t-PRK plus ACXL significantly improved the quality of vision in patients with KC, preventing overcorrection and minimizing tissue consumption.
Residual Dialkyl Phosphate Metabolite Concentrations of Organophosphate Pesticides Among Indian Farmworkers
Authors: Lari Summaiya , Pandiyan Arun , Vanka Janardhan , Jee Babban , Yamagani Praveen , Kumar Senthil Balakrishnan , Naidu Mohan , Jonnalagadda Padmaja
Published: September 2023

Objective

Biomonitoring of urinary dialkyl phosphate (DAP) metabolites, a sensitive biomarker to assess pesticides exposure and also to study the impact of the use of personal protective equipment (PPE).

Methods

A preintervention-postintervention study to biomonitor dimethylphosphate, diethylphosphate, diethylthiophosphate, and diethyl-dithiophosphate using liquid chromatography with tandem mass spectrometry among Indian farmworkers (n = 120).

Results

Dimethylphosphate was detected in all samples at a mean concentration of 74.91 μg · L−1 (17.616 μg · g−1 creatinine), whereas diethylthiophosphate and diethyl-dithiophosphate were detected in 88% and 82% of samples, respectively, among farmworkers who adopted unsafe pesticide-handling practices. Intervention studies showed a significant reduction in the urinary DAP metabolites detected among the farmworkers using PPE provided to them (P < 0.01).

Conclusions

Study confirms the exposure to pesticides among farmworkers and highlights the importance of the use of PPE to minimize exposure.
Treatment strategies for hepatic artery complications after pediatric liver transplantation: A systematic review
Authors: Li Weihao , Bokkers Reinoud P.H. , Dierckx Rudi A.J.O. , Verkade Henkjan J. , Sanders Dewey H. , de Kleine Ruben , van der Doef Hubert P.J.
Published: September 2023

This study aimed to evaluate the effectiveness of different treatments for hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) after pediatric liver transplantation. We systematically reviewed studies published since 2000 that investigated the management of HAT and/or HAS after pediatric liver transplantation. Studies with a minimum of 5 patients in one of the treatment methods were included. The primary outcomes were technical success rate and graft and patient survival. The secondary outcomes were hepatic artery patency, complications, and incidence of HAT and HAS. Of 3570 studies, we included 19 studies with 328 patients. The incidence was 6.2% for HAT and 4.1% for HAS. Patients with an early HAT treated with surgical revascularization had a median graft survival of 45.7% (interquartile range, 30.7%–60%) and a patient survival of 61.3% (interquartile range, 58.7%–66.9%) compared with the other treatments (conservative, endovascular revascularization, or retransplantation). As for HAS, endovascular and surgical revascularization groups had a patient survival of 85.7% and 100% (interquartile range, 85%–100%), respectively. Despite various treatment methods, HAT after pediatric liver transplantation remains a significant issue that has profound effects on the patient and graft survival. Current evidence is insufficient to determine the most effective treatment for preventing graft failure.
Correlation between the preoperative maximum soleal vein diameter and the postoperative bilateral deep venous thrombosis in THA: a case–control study
Authors: Kimura Fumihiko , Watarai Keisuke , Okada Nobuhiko , Moronuki Takahisa , Kamatsuda Yoko , Nomura Kazuhiro , Kim Yoon Taek , Oda Hiromi , Kadono Yuho
Published: September 2023

Background:

Patients with bilateral lower limb deep venous thrombosis (DVT) have a higher risk of pulmonary thromboembolism (PTE) and mortality than patients with unilateral lower limb DVT. Preoperative dilatation of the soleal vein (SV) diameter is a predictor of postoperative DVT. The purpose of this study is to investigate the cutoff value for SV diameter as a risk factor for VTE development.

Materials and methods:

The authors examined 274 patients with unilateral THA who met the inclusion criteria in a retrospective study. The mean age of the patients was 65.7±11.2 years, with 70 males and 204 females. Bilateral lower limb vein ultrasonography was performed preoperatively and ~1 week after THA. The frequency and localization of DVT were investigated in postoperative ultrasonography. The patients were divided into three groups: no DVT (non-DVT), unilateral lower limb DVT (Uni-DVT), and bilateral lower limb DVT (Bi-DVT). The three groups were compared in terms of preoperative venous vessel maximum diameter.

Results:

There were 62 patients (22.6%) who had postoperative DVT. There are no symptomatic PTE patients. DVT was found in 44 patients (16.0%) of the Uni-DVT group and 18 patients (6.6%) of the Bi-DVT group. The SV maximum diameter was 6.41±1.79 mm in the non-DVT group, 7.06±2.13 mm in the Uni-DVT group, and 8.06±2.26 mm in the Bi-DVT group, with a significant difference (P=0.001) between the non-DVT and Bi-DVT groups. In the Bi-DVT group, the cutoff value for preoperative SV maximum diameter was 6.75 mm (95% CI: 0.625–0.831; P=0.001; sensitivity, 77.8%; specificity, 60.4%; area under the curve, 0.728).

Conclusions:

In THA, preoperative ultrasonography with a maximum SV diameter of 6.75 mm or greater was the risk of bilateral DVT leading to fatal PTE is increased.
Prospective quantitative study: Doppler ultrasound in the evaluation of chronic renal allograft disease and correlation with histopathological finding
Authors: Katwal Shailendra , Suwal Sundar , Bhandari Rajan M. , Chataut Dinesh , Ansari Mukhtar Alam , Lamichhane Suman
Published: September 2023

Background and Objectives:

Renal allograft biopsy is the gold standard for diagnosing chronic allograft nephropathy, but noninvasive methods are needed to avoid unnecessary biopsies. Doppler ultrasonography, particularly the resistive index (RI), correlates with renal allograft dysfunction. This study aims to assess the relationship between renal sonographic parameters and biochemical parameters in diagnosing graft interstitial fibrosis.

Methods:

The study evaluated 60 renal allograft recipients for sonographic renal morphological features and Doppler indices. The estimated glomerular filtration rate (eGFR) was calculated, and cortical fibrosis after the biopsy was determined using the Banff score. Continuous variables like mean and SD were calculated, and categorical variables were reported using frequencies and proportions. Associations were examined using independent sample t-tests, χ
2tests, and multivariate regression analysis.

Results:

The mean eGFR was 75.23±25.45 ml/min/1.73 m2. A significant correlation of eGFR with RI (r=0.341, P=0.008) was seen. A significant difference in mean RI (F=10.167; df=2,57; P<0.001) was seen among the histological grades of fibrosis. Among the histological grades of fibrosis, significant differences in RI among mild and moderate (S.E. 0.033, P=0.043), mild and severe (S.E. 0.026, P=0.001) as well as moderate and severe (S.E. 0.036, P=0.029) was seen.

Conclusion:

Doppler was able to noninvasively predict allograft fibrosis and could be used as a complementary imaging tool during the follow-up of renal allograft patients. Future research is needed to improve evidence, diagnostic criteria, guidelines, and long-term impact.
Cardiac arrhythmias in STEMI patients in ICU: study on occurrence in first 48 h and correlation with age, sex, infarction site, and risk factors
Authors: Alkatib Mahmoud , Alkotyfan Abdul Rahman Naeem , Alshaghel Mohammed Moutaz , Shamiyeh Marwan
Published: September 2023

Introduction:

Acute myocardial infarction (AMI) is one of the leading causes of death in the developed world. The spread of the disease approaches three million people worldwide, with more than one million deaths in the United States annually. Myocardial ischemia and infarction can lead to electrophysiological and metabolic alterations that result in potentially fatal arrhythmias, some of which may be asymptomatic. About 90% of patients with AMI develop some form of arrhythmia during or immediately after the event, and in 25% of patients, these arrhythmias appear within the first 48 h. The most common cause of death in patients with AMI in pre-hospitalization is ventricular tachycardia/ventricular fibrillation (VT/VF).

Methods:

A cross-sectional study targeting 150 patients with myocardial infarction attending tertiary hospital. According to certain acceptance and exclusion criteria.

Results:

The sample consisted of 150 patients who suffered from heart infarction, the mean age of patients in the sample was 59.41 years with a standard deviation of 11.02 years and range of 28–90. Males constituted the largest portion of patients, with 112 males, that is 75%. The study identified that the anterior wall was the most frequent location for myocardial infarction among patients, with 64% of patients experiencing an infarction in this area. Additionally, ventricular fibrillation was the most commonly occurring arrhythmia, affecting 27% of myocardial infarction patients in the study.

Recommendations:

One of the most important recommendations of our study is the necessity of keeping the patient under observation for at least 48 h after myocardial infarction within the hospital to monitor the ECG (Holter) in order to detect arrhythmias. Detection of arrhythmias in every patient with extensive anterior, lateral, or posterior myocardial infarction. And the need to know and take into account ventricular fibrillation and how to manage it in every patient with a heart infarction. And conducting future studies, including a larger number of patients, to study cardiac arrhythmias more precisely.
Changing Life Plans
Authors: Parajuli Jyotsana , Larson Kim L.
Published: September 2023

Advance care planning (ACP) is a continuous process where individuals discuss and document their end-of-life preferences with trusted caregivers and health care providers. Caregivers are pivotal to include in ACP discussions because they assist loved ones to navigate serious medical illness. The purpose of this study was to examine caregivers' engagement in ACP decision making with their loved ones with cancer. A qualitative descriptive design was used, informed by Engel's biopsychosocial model, with a convenience sample of 14 caregivers in North Carolina. Virtual interviews were conducted using a semistructured interview guide. Using prevalence logic, the overarching theme of “Changing Life Plans” was explained by two subthemes, “Learning the Diagnosis” and “Keeping Them on Track.” The timing and location of ACP conversations were important considerations. Over half of the participants (64%) had no knowledge or had misconceptions about ACP, and 5 had accurate knowledge. Nurses could develop partnerships with community leaders trained in palliative care principles to begin conversations early with community members. Advocacy groups might hold events, such as the Hello Game, in community settings to facilitate early ACP conversations.
Outcomes of Cochlear Implantation in Age Subgroups of Veterans Over 50 Years Old
Authors: Petito Gabrielle T. , Tripathi Siddhant H. , Dhanda Patil Reena
Published: September 2023

Objective:

This study aimed to determine whether there was a difference in postoperative Arizona Biomedical (AzBio) speech recognition scores in 2 differently aged subgroups of veterans 50 years and older after cochlear implantation (CI).

Study Design:

Retrospective chart review.

Setting:

Tertiary referral center.

Patients:

Seventy-one patients aged 50 to 74 years (younger cohort) were compared with 56 patients aged 75 years and older (older cohort) at the time of CI.

Intervention(s):

Patients underwent therapeutic CI.

Main Outcome Measure(s):

Comparison of AzBio speech recognition test scores in a quiet environment between the 2 differently aged cohorts of veterans 50 years and older.

Results:

Despite no significant differences in preoperative AzBio score between the younger (mean 22.2%) and older cohorts (mean, 17.3%; P > 0.05), when examining the 6- and 12-month postoperative time points, the older cohort had significantly lower mean AzBio scores (50%, 55.8%; P < 0.05) than the younger cohort (69.8%, 71.9%; P < 0.05).

Conclusions:

All patients aged >50 years experienced significant improvement in speech recognition scores following CI, although the cohort of ages 50 to 74 years scored significantly higher in later follow-up visits. These findings suggest that CI should be offered to appropriate candidates, regardless of age, although earlier intervention may be more advantageous.
Vestibular Schwannoma: Long-term Outcome of the Vestibular Function After Stereotactic Radiosurgery
Authors: Anschuetz Lukas , Ermiş Ekin , Gebhart Isabel , Stalder Odile , Raabe Andreas , Mantokoudis Georgios , Caversaccio Marco , Hermann Evelyne , Wagner Franca , Vibert Dominique
Published: September 2023

Objective:

Evaluation at long term of the impact of the stereotactic surgery (SRS) on the vestibular function in vestibular schwannoma (VS) patients.

Study design and setting:

Retrospective study in a tertiary referral center.

Patients:

Fifty-one VS patients were included (34 females;17 males), aged from 41 to 78 years treated exclusively with SRS.

Intervention:

Vestibular function was assessed before SRS and with median time interval of 14 (FU1) and 25 (FU2) months after treatment. Vestibular evaluation included: history, clinical vestibular examination, videonystagmography, head impulse test (v-HIT) and cervical vestibular evoked myogenic potentials (c-VEMPS).

Results:

Before SRS, caloric testing (Caloric) was impaired in 77%; after treatment, in 92% (FU1) and 77% (FU2). Lateral HIT was decreased in 22% before SRS, in 39% at FU1 and FU2. C-VEMPS were absent in 50% before SRS, in 76% at FU1 and, FU2. Before SRS, no statistically significant association was found between asymptomatic and symptomatic patients with respect to the results of Caloric, v-HIT and c-VEMPS. This lack of association was also seen after SRS, at FU1 and FU2.

Conclusion:

Our study showed that the impairment of the vestibular function might be attributed to the VS itself as well as to the radiation of the inner ear during SRS. The lateral SSC at low frequencies and the saccular function seem to be more involved with the time.
Modeling Cystic Fibrosis Chronic Infection Using Engineered Mucus-like Hydrogels
Authors: O’Brien Courtney L. , Spencer Sarah , Jafari Naeimeh , Huang Andy J. , Scott Alison J. , Cheng Zhenyu , Leung Brendan M.
Published: September 2023

The airway mucus of patients with cystic fibrosis has altered properties which create a microenvironment primed for chronic infections that are difficult to treat. These complex polymicrobial airway infections and corresponding mammalian-microbe interactions are challenging to modelin vitro. Here, we report the development of mucus-like hydrogels with varied compositions and viscoelastic properties reflecting differences between healthy and cystic fibrosis airway mucus. Models of cystic fibrosis and healthy airway microenvironments were created by combining the hydrogels with relevant pathogens, human bronchial epithelial cells, and an antibiotic. Notably, pathogen antibiotic resistance was not solely dependent on the altered properties of the mucus-like hydrogels but was also influenced by culture conditions including microbe species, monomicrobial or polymicrobial culture, and the presence of epithelial cells. Additionally, the cystic fibrosis airway model showed the ability to mimic features characteristic of chronic cystic fibrosis airway infections including sustained polymicrobial growth and increased antibiotic tolerance.
Scale-dependent landscape-biodiversity relationships shape multi-taxa diversity in an oil palm monoculture under restoration
Authors: Cayetano Denver T. , Zemp Delphine Clara , Buchori Damayanti , Fiedler Sebastian , Grass Ingo , Hölscher Dirk , Irawan Bambang , Korol Yevgeniya , Khokthong Watit , Paterno Gustavo Brant , Polle Andrea , Potapov Anton , Sundawati Leti , Tscharntke Teja , Westphal Catrin , Weigelt Patrick , Wiegand Kerstin , Kreft Holger , Guerrero-Ramírez Nathaly R.
Published: September 2023

Enhancing biodiversity in monoculture-dominated landscapes is a pressing restoration challenge. Tree islands can enhance biodiversity locally, but the role of scale-dependent processes on local biodiversity remains unclear. Using a multi-scale approach, we explored how scale-dependent processes influence the diversity of seven taxa (woody plants, understory arthropods, birds, herbaceous plants and soil bacteria, fauna, and fungi) within 52 experimental tree islands embedded in an oil palm landscape. We show that local, metacommunity (between islands), and landscape properties shaped above- and below-ground taxa diversity, with the stronger effects on above-ground taxa. The spatial extent that best-predicted diversity ranged from 150 m for woody plants to 700 m for understory arthropods with below-ground taxa responding at large spatial extents. Our results underscore the need for multi-scale approaches to restoration. Additionally, our findings contribute to understanding the complex processes shaping multi-taxa diversity and offer insights for targeted conservation and restoration strategies.
Characterization of SARS-CoV-2 Convalescent Patients’ Serological Repertoire Reveals High Prevalence of Iso–RBD Antibodies
Authors: Curtis Nicholas C. , Shin Seungmin , Hederman Andrew P. , Connor Ruth I. , Wieland-Alter Wendy F. , Ionov Steven , Boylston Jennifer , Rose Josh , Sakharkar Mrunal , Dorman Dana B. , Dessaint John A. , Gwilt Lorraine L. , Crowley Andrew R. , Feldman Jared , Hauser Blake M. , Schmidt Aaron G. , Ashare Alix , Walker Laura M. , Wright Peter F. , Ackerman Margaret E. , Lee Jiwon
Published: September 2023

While our understanding of SARS-CoV-2 pathogenesis and antibody responses following infection and vaccination has improved tremendously since the outbreak in 2019, the sequence identities and relative abundances of the individual constituent antibody molecules in circulation remain understudied. Using Ig-Seq, we proteomically profiled the serological repertoire specific to the whole ectodomain of SARS-CoV-2 prefusion-stabilized spike (S) as well as to the receptor binding domain (RBD) over a 6-month period in four subjects following SARS-CoV-2 infection before SARS-CoV-2 vaccines were available. In each individual, we identified between 59 and 167 unique IgG clonotypes in serum. To our surprise, we discovered that ∼50% of serum IgG specific for RBD did not recognize prefusion-stabilized S (referred to as iso–RBD antibodies), suggesting that a significant fraction of serum IgG targets epitopes on RBD inaccessible on the prefusion-stabilized conformation of S. On the other hand, the abundance of iso–RBD antibodies in nine individuals who received mRNA-based COVID-19 vaccines encoding prefusion-stabilized S was significantly lower (∼8%). We expressed a panel of 12 monoclonal antibodies (mAbs) that were abundantly present in serum from two SARS-CoV-2 infected individuals, and their binding specificities to prefusion-stabilized S and RBD were all in agreement with the binding specificities assigned based on the proteomics data, including 1 iso–RBD mAb which bound to RBD but not to prefusion-stabilized S. 2 of 12 mAbs demonstrated neutralizing activity, while other mAbs were non-neutralizing. 11 of 12 mAbs also bound to S (B.1.351), but only 1 maintained binding to S (B.1.1.529). This particular mAb binding to S (B.1.1.529) 1) represented an antibody lineage that comprised 43% of the individual’s total S-reactive serum IgG binding titer 6 months post-infection, 2) bound to the S from a related human coronavirus, HKU1, and 3) had a high somatic hypermutation level (10.9%), suggesting that this antibody lineage likely had been elicited previously by pre-pandemic coronavirus and was re-activated following the SARS-CoV-2 infection. All 12 mAbs demonstrated their ability to engage in Fc-mediated effector function activities. Collectively, our study provides a quantitative overview of the serological repertoire following SARS-CoV-2 infection and the significant contribution of iso–RBD antibodies, demonstrating how vaccination strategies involving prefusion-stabilized S may have reduced the elicitation of iso–RBD serum antibodies which are unlikely to contribute to protection.
magpie: a power evaluation method for differential RNA methylation analysis in N6-methyladenosine sequencing
Authors: Guo Zhenxing , Duan Daoyu , Tang Wen , Zhu Julia , Bush William S. , Zhang Liangliang , Zhu Xiaofeng , Jin Fulai , Feng Hao
Published: September 2023

Motivation

Recently, novel biotechnologies to quantify RNA modifications became an increasingly popular choice for researchers who study epitran-scriptome. When studying RNA methylations such as N6-methyladenosine (m6A), researchers need to make several decisions in its experimental design, especially the sample size and a proper statistical power. Due to the complexity and high-throughput nature of m6A sequencing measurements, methods for power calculation and study design are still currently unavailable.

Results

We propose a statistical power assessment tool,magpie, for power calculation and experimental design for epitranscriptome studies using m6A sequencing data. Our simulation-based power assessment tool will borrow information from real pilot data, and inspect various influential factors including sample size, sequencing depth, effect size, and basal expression ranges. We integrate two modules inmagpie: (i) a flexible and realistic simulator module to synthesize m6A sequencing data based on real data; and (ii) a power assessment module to examine a set of comprehensive evaluation metrics.

Availability

The proposed power assessment toolmagpieis publicly available as a R/Bioconductor package at:https://bioconductor.org/packages/magpie/.
Ecological selection of dispersal strategies in metacommunities: impact of landscape features and competitive dynamics
Authors: Khattar Gabriel , Savary Paul , Peres-Neto Pedro R.
Published: September 2023

Dispersal is simultaneously a cause and a consequence of metacommunity dynamics. While the influence of dispersal on metacommunities is subject of intense research, we still do not understand how species-species and species-environment relationships determine the success of different dispersal strategies in metacommunities. To address this, we employed simulation models considering species with distinct context-dependent dispersal strategies involved in the three stages of dispersal (departure, transience, and settlement). These species were allowed to reach coexistence at the metacommunity scale under various competitive hierarchies and different levels of spatial and temporal environmental variability. By assessing the dispersal strategies of species that persisted and dominated metacommunities, we could understand how metacommunity dynamics impose ecological selection on dispersal. Our simulation model reproduced empirical patterns in species dispersal across different scales, ranging from changes in the success of dispersal strategies caused by local intraspecific and interspecific competition, to observed shifts in dispersal strategies along broad-scale ecological gradients. Additionally, we derived new empirically testable predictions regarding how metacommunity dynamics select for different dispersal strategies. Collectively, our results foster a comprehensive understanding of the factors influencing the success and diversity of dispersal strategies in a large array of ecological contexts.
The role of ion dissolution in metal and metal oxide surface inactivation of SARS-CoV-2
Authors: Hilton Jane , Nanao Yoshiko , Flokstra Machiel , Askari Meisam , Smith Terry K. , Falco Andrea Di , King Phil D.C. , Wahl Peter , Adamson Catherine S
Published: September 2023

Antiviral surface coatings are under development to prevent viral fomite transmission from high-traffic touch surfaces in public spaces. Copper’s antiviral properties have been widely documented; but the antiviral mechanism of copper surfaces is not fully understood. We screened a series of metal and metal oxide surfaces for antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease (COVID-19). Copper and copper oxide surfaces exhibited superior anti-SARS-CoV-2 activity; however, level of antiviral activity was dependent upon the composition of the carrier solution used to deliver virus inoculum. We demonstrate that copper ions released into solution from test surfaces can mediate virus inactivation, indicating a copper ion dissolution-dependent antiviral mechanism. Level of antiviral activity is, however, not dependent on the amount of copper ions released into solutionper se. Instead, our findings suggest that degree of virus inactivation is dependent upon copper ion complexation with other biomolecules (e.g., proteins/metabolites) in the virus carrier solution that compete with viral components. Although using tissue culture-derived virus inoculum is experimentally convenient to evaluate the antiviral activity of copper-derived test surfaces, we propose that the high organic content of tissue culture medium reduces the availability of “uncomplexed” copper ions to interact with the virus, negatively affecting virus inactivation and hence surface antiviral performance. We propose that laboratory antiviral surface testing should include virus delivered in a physiologically relevant carrier solution (saliva or nasal secretions when testing respiratory viruses) to accurately predict real-life surface antiviral performance when deployed in public spaces.

Importance

The purpose of evaluating antiviral activity of test surfaces in the laboratory is to identify surfaces that will perform efficiently in preventing fomite transmission when deployed on high-traffic touch surfaces in public spaces. The conventional method in laboratory testing is to use tissue culture-derived virus inoculum, however this study demonstrates that antiviral performance of test copper-containing surfaces is dependent on the composition of the carrier solution in which the virus inoculum is delivered to test surfaces. Therefore, we recommend that laboratory surface testing should include virus delivered in a physiologically relevant carrier solution, to accurately predict real-life test surface performance in public spaces. Understanding the mechanism of virus inactivation is key to future rational design of improved antiviral surfaces. Here, we demonstrate that copper ions released from copper surfaces into small liquid droplets containing SARS-CoV-2, is a mechanism by which the virus that causes COVID-19 can be inactivated.
Fat body glycolysis defects inhibit mTOR and promote distant muscle disorganization through TNF-α/egr and ImpL2 signaling inDrosophilalarvae
Authors: Rodríguez-Vázquez Miriam , Falconi Jennifer , Heron-Milhavet Lisa , Lassus Patrice , Géminard Charles , Djiane Alexandre
Published: September 2023

The fat body inDrosophilalarvae serves as a reserve tissue and participates, through its endocrine function, in the regulation of organismal growth and homeostasis. To better understand its role in growth coordination, we induced severe fat body atrophy by knocking down in adipose cells several key enzymes of the glycolytic pathway. Our results show that impairing the last steps of glycolysis led to a drastic shrinkage in adipose cell size and lipid droplets content, and a downregulation of the mTOR pathway. Strikingly, fat body atrophy resulted in the distant disorganization of body wall muscles and the release of muscle-specific proteins in the hemolymph. Molecularly we showed that REPTOR activity was required for fat body atrophy downstream of glycolysis inhibition, and that the effect of fat body atrophy on muscles did not require upd3 secretion, but depended the production of egr/TNF-α and of the insulin pathway inhibitor ImpL2.