bluuebunny/crossref_metadata_2025 huggingface dataset:
Stochastic modelling of Karlotoxin influence on prey
Authors: Pei Hansen , Fok Pak-Wing , Rossi Louis
Published: February 2024

Karlodinium veneficum is type of dinoflagellate plankton present in coastal regions. Harmful algae blooms resulting from uncontrolled growth of K. veneficum often leads to fish kills. They release a toxin named Karlotoxin that is known to affect their prey’s bio-locomotion by stunning and slowing them down. We investigate whether the toxin plays a role in aggregating the prey around the a predator, thereby leading to a local increase in prey density. To achieve this, we closely examine the toxin’s influence on the prey’s probability density distribution with different assumptions on their relative speed in 1D, with either the predator being stationary or swimming at a constant speed. When the predator is stationary, we fully solve the prey’s density distribution for all times, and verify the result by a Monte-Carlo simulation. For a swimming predator, we find the steady-state density distribution of prey analytically. When the predator’s speed $s$ is strictly greater (or less) than the prey ($s-1>0$ or $s-1<0$), the results are verified by Monte-Carlo simulations; when their relative speed $s-1$ has roots, we use the Frobenius method to perform a local analysis for the prey’s density at steady state near the roots, and use the result to derive a scheme for finding the analytical solution. This solution is then verified numerically using a finite difference method. When the roots $x_{1}$ and $x_{3}$ satisfy $s^{\prime}(x_{1})<0$ and $s^{\prime}(x_{3})>0$, we show that the probability density for the prey has a form $|x-x_{1}|^{-s^{\prime}(x_{1})^{-1} -1}$ near the root $x_{1}$, leading to either an integrable singularity or a local maximum. Near the root $x_{3}$, the prey’s density can be represented as a Taylor series and is smooth. In most of the cases mentioned above, toxin leads to the aggregation of prey, however the maximum density does not always occur where the toxin has the highest concentration.
Commensal protistTritrichomonas musculusexhibits a dynamic life cycle that induces extensive remodeling of the gut microbiota
Authors: Popovic Ana , Cao Eric Y , Han Joanna , Nursimulu Nirvana , Alves-Ferreira Eliza V C , Burrows Kyle , Kennard Andrea , Alsmadi Noor , Grigg Michael E , Mortha Arthur , Parkinson John
Published: February 2024

Commensal protists and gut bacterial communities exhibit complex relationships, mediated at least in part through host immunity. To improve our understanding of this tripartite interplay, we investigated community and functional dynamics between the murine protist Tritrichomonas musculus and intestinal bacteria in healthy and B-cell-deficient mice. We identified dramatic, protist-driven remodeling of resident microbiome growth and activities, in parallel with Tritrichomonas musculus functional changes, which were accelerated in the absence of B cells. Metatranscriptomic data revealed nutrient-based competition between bacteria and the protist. Single-cell transcriptomics identified distinct Tritrichomonas musculus life stages, providing new evidence for trichomonad sexual replication and the formation of pseudocysts. Unique cell states were validated in situ through microscopy and flow cytometry. Our results reveal complex microbial dynamics during the establishment of a commensal protist in the gut, and provide valuable data sets to drive future mechanistic studies.
Implications of two-component systems EnvZ/OmpR and BaeS/BaeR in in vitro temocillin resistance in Escherichia coli
Authors: Pérez-Palacios Patricia , Rodríguez-Ochoa José Luis , Velázquez-Escudero Ana , Rodríguez-Baño Jesús , Rodríguez-Martínez José Manuel , Pascual Álvaro , Docobo-Pérez Fernando
Published: February 2024

Background

BaeS/BaeR is a two-component system of Escherichia coli that controls the expression of porins and efflux pumps. Its role in beta-lactam resistance is limited.

Objectives

To study the role of baeS/baeR two-component system in temocillin resistance in E. coli.

Methods

E. coli strain BW25113 and single-gene deletion mutants related to two-component systems were collected from the KEIO collection. Double-gen deletion mutants were generated. Temocillin-resistant mutant frequencies were determined at 32 mg/L. E. coli BW25113 mutants were selected by selective pressure from serial passages. Biological costs were analysed by growth curves. Genomes of the generated mutants were sequenced. The expression level of the mdtA, mdtB, mdtC, acrD and tolC in the ΔbaeS mutant was determined by RT–PCR (with/without temocillin exposure).

Results

The frequency of temocillin mutants ranged from 2.12 × 10−8 to 4.51 × 10−8 in single-porin mutants. No mutants were recovered from E. coli BW25113 (>10−9). Selection of temocillin-resistant variants by serial passage yielded mutants up to 128 mg/L. Mutations were found in the baeS gene. Temocillin MICs ranged from 4 to 32 mg/L (highest MICs for ΔbaeS and ΔompR). The efflux pumps mdtA, mdtB, mdtC and acrD pumps were overexpressed 3–10-fold in the presence of temocillin in ΔbaeS compared to control.

Conclusions

Mutations in the sensor histidine kinase, baeS, may be involved in temocillin resistance through the expression of the efflux pumps mdtABC and acrD. In addition, the low mutation rate may be a good predictor of temocillin activity.
CHD7 regulates craniofacial cartilage development via controlling HTR2B expression
Authors: Breuer Maximilian , Rummler Maximilian , Singh Jaskaran , Maher Sabrina , Zaouter Charlotte , Jamadagni Priyanka , Pilon Nicolas , Willie Bettina M , Patten Shunmoogum A
Published: February 2024

Mutations in the Chromodomain helicase DNA-binding protein 7 – coding gene (CHD7) cause CHARGE syndrome (CS). Although craniofacial and skeletal abnormalities are major features of CS patients, the role of CHD7 in bone and cartilage development remain largely unexplored. Here, using a zebrafish (Danio rerio) CS model, we show that chd7-/- larvae display abnormal craniofacial cartilage development and spinal deformities. The craniofacial and spine defects are accompanied by a marked reduction of bone mineralization. At the molecular level, we show that these phenotypes are associated with significant reduction in the expression levels of osteoblast differentiation markers. Additionally, we detected a marked depletion of collagen 2α1 in the cartilage of craniofacial regions and vertebrae, along with significantly reduced number of chondrocytes. Chondrogenesis defects are at least in part due to downregulation of htr2b, which we found to be also dysregulated in human cells derived from an individual with CHD7 mutation-positive CS. Overall, this study thus unveils an essential role for CHD7 in cartilage and bone development, with potential clinical relevance for the craniofacial defects associated with CS.
The comparative analysis of the Ex and Hz fields sensitivity generated by electric dipole sources
Authors: Wang Xianxiang , Li Jiaqi , Lei Songda
Published: February 2024

In the controlled source audio-frequency magnetotelluric method, orthogonal electric and magnetic fields are commonly measured to determine the Cagniard apparent resistivity. However, in the near-field zone, the Cagniard resistivity is severely distorted, which is unrelated to underground structures. The Ex and Hz amplitudes in a homogeneous half-space monotonically vary in resistivity, and a numerical algorithm could achieve high-precision apparent resistivity without distortion for all frequencies. On this basis, the main focus of this investigation is on the comparative analysis of the sensitivity for the Exfield, Hzfield, and Cagniard apparent resistivity to conductive and resistivity targets via synthetic models. The achieved results confirm that the Ex field could exhibit a more enhanced sensitivity for the resistive objects, whereas the Hz field could more effectively identify the conductive target. Besides, the static effect often distorts the electromagnetic data, which rigorously influences their application. The influence of the static effect on both the Exand Hzfields is also examined in detail. The apparent resistivity based on the Exfield and Cagniard apparent resistivity is significantly affected by the static effect, which can mask deep anomalous blocks. However, the apparent resistivity based on the Hz field is almost unaffected by the static effect. Finally, a more efficient observation approach is provided for both the insulating and conductive targets.
The First Folio and the transatlantic trade in early drama c.1900–1929
Authors: Cleaver Laura , Magnusson Danielle
Published: February 2024

In early twentieth-century America, ownership of all four Shakespeare folios was a benchmark for rare-book collectors, showcasing a dedication to assembling an exceptional library. The First Folio (1623) typically commanded the highest prices. Dealers sought to capitalize on the popularity of Shakespeare’s works by labelling a wide range of material as ‘Shakespeareana’, and the 1920s saw a boom in the market for early English plays. For some American collectors, notably Henry Folger, one copy of an edition was not enough, but others, including Henry Huntington, released duplicates back into the market, helping to keep interest high and facilitating the use of books as investments in the 1920s. This article examines the transatlantic trade in early English drama from c.1900 to 1929, to situate sales of First Folios in their economic and cultural context and to explore why large numbers of sixteenth-century English plays are now held in a handful of American libraries.
The genome assembly of Island Oak (Quercus tomentella), a relictual island tree species
Authors: Mead Alayna , Fitz-Gibbon Sorel T , Escalona Merly , Beraut Eric , Sacco Samuel , Marimuthu Mohan P A , Nguyen Oanh , Sork Victoria L
Published: February 2024

Island oak (Quercus tomentella) is a rare relictual island tree species that exists only on six islands off the coast of California and Mexico, but was once widespread throughout mainland California. Currently, this species is endangered by threats such as non-native plants, grazing animals, and human removal. Efforts for conservation and restoration of island oak currently underway could benefit from information about its range-wide genetic structure and evolutionary history. Here we present a high-quality genome assembly for Q. tomentella, assembled using PacBio HiFi and Omni-C sequencing, developed as part of the California Conservation Genomics Project (CCGP). The resulting assembly has a length of 781 Mb, with a contig N50 of 22.0 Mb and a scaffold N50 of 63.4 Mb. This genome assembly will provide a resource for genomics-informed conservation of this rare oak species. Additionally, this reference genome will be the first one available for a species in Quercus section Protobalanus, a unique oak clade present only in western North America.
Round-up of UK trade mark disputes 2023
Authors: Meale Darren
Published: February 2024

This article reviews seven notable decisions of the English courts from 2023. Rather than providing a traditional review of the facts, law and application of the law to the facts in each instance, the article instead has sought to draw out from each case a key point of law or practice considered by the author to be of particular interest.
Determination of enzalutamide long-term safety and efficacy for castration-resistant prostate cancer patients after combined anti-androgen blockade followed by alternative anti-androgen therapy: a multicenter prospective DELC study
Authors: Nagahara Akira , Uemura Motohide , Sato Mototaka , Nakata Wataru , Tsujihata Masao , Takao Tetsuya , Matsumura Soichi , Nishimura Kensaku , Takada Shingo , Iwanishi Toshichika , Kobayashi Yasuyuki , Ishizuya Yu , Takada Tsuyoshi , Okada Koichi , Inoue Hitoshi , Kato Taigo , Hatano Koji , Kawashima Atsunari , Ujike Takeshi , Fujita Kazutoshi , Nonomura Norio
Published: February 2024

Background

Alternative anti-androgen therapy has been widely used as a first-line treatment for castration-resistant prostate cancer, and it may affect treatment outcome of subsequent agents targeting the androgen receptor axis. We conducted the prospective observational DELC (Determination of Enzalutamide Long-term safety and efficacy for Castration-resistant prostate cancer patients after combined anti-androgen blockade followed by alternative anti-androgen therapy) study to evaluate the efficacy of enzalutamide in patients with castration-resistant prostate cancer who underwent prior combined androgen blockade with bicalutamide and then alternative anti-androgen therapy with flutamide.

Methods

The DELC study enrolled 163 Japanese patients with castration-resistant prostate cancer who underwent alternative anti-androgen therapy with flutamide following failure of initial combined androgen blockade with bicalutamide in multiple institutions between January 2016 and March 2019. Primary endpoint was overall survival. Administration of enzalutamide was started at 160 mg orally once daily in all patients.

Results

The rate of decline of prostate-specific antigen by 50% or more was 72.2%, and median overall survival was 42.05 months. Multivariate analysis revealed that higher pretreatment serum levels of prostate-specific antigen (≥11.3 ng/mL; P = 0.004), neuron-specific enolase (P = 0.014) and interleukin-6 (≥2.15 pg/mL; P = 0.004) were independent risk factors for overall survival. Fatigue (30.0%), constipation (19.6%) and appetite loss (17.8%) were the most common clinically relevant adverse events. The enzalutamide dose was not reduced in any patient under the age of 70, but adherence was decreased in those over 70.

Conclusions

In the DELC study, the safety of enzalutamide was comparable to that in previous reports. Serum levels of neuron-specific enolase and interleukin-6 were suggested as prognostic factors for castration-resistant prostate cancer with potential clinical utility.
Abnormal expression of CUX1 influences autophagy activation in paroxysmal nocturnal hemoglobinuria
Authors: Wu Junshu , Li Liyan , Liu Zhaoyun , Wang Honglei , Chen Yingying , Zeng Lijie , Wang Guanrou , Liu Hui , Fu Rong
Published: February 2024

The mechanism underlying autophagy in paroxysmal nocturnal hemoglobinuria (PNH) remains largely unknown. We previously sequenced the entire genome exon of the CD59– cells from 13 patients with PNH and found genes such as CUX1 encoding Cut-like homeobox 1. Peripheral blood samples from 9 patients with PNH and 7 healthy control subjects were obtained to measure CUX1 expression. The correlation between CUX1 messenger RNA expression and PNH clinical indicators was analyzed. To simulate CUX1 expression in patients with PNH, we generated a panel of PNH cell lines by knocking out PIGA in K562 cell lines and transfected lentivirus with CUX1. CCK-8 and EDU assay assessed cell proliferation. Western blotting was used to detect Beclin-1, LC3A, LC3B, ULK1, PI3K, AKT, p-AKT, mTOR, and p-mTOR protein levels. Autophagosomes were observed with transmission electron microscopy. Chloroquine was used to observe CUX1 expression in PNH after autophagy inhibition. Leukocytes from patients with PNH had lower levels of CUX1 messenger RNA expression and protein content than healthy control subjects. The lactose dehydrogenase level and the percentage of PNH clones were negatively correlated with CUX1 relative expression. We reduced CUX1 expression in a PIGA knockout K562 cell line, leading to increased cell proliferation. Levels of autophagy markers Beclin-1, LC3B, LC3A, and ULK1 increased, and autophagosomes increased. Furthermore, PI3K/AKT/mTOR protein phosphorylation levels were lower. CUX1 expression did not change and cell proliferation decreased in CUX1 knocked down PNH cells after inhibition of autophagy by chloroquine. In brief, CUX1 loss-of-function mutation resulted in stronger autophagy in PNH.
Methods for assembling complex mitochondrial genomes in land plants
Authors: Štorchová Helena , Krüger Manuela
Published: February 2024

The large size and complex structural rearrangements inherent in the mitochondrial genomes of land plants pose challenges for their sequencing. Originally, the assembly of these genomes required the cloning of mitochondrial DNA fragments followed by Sanger sequencing. Subsequently, the advent of next-generation sequencing significantly expedited the process. This review highlights examples of plant mitochondrial genome assembly employing various technologies, including 454 sequencing, Illumina short sequencing reads, and Pacific Biosciences or Oxford Nanopore Technology long sequencing reads. The combination of short and long reads in hybrid assembly has proven to be the most efficient approach for achieving reliable assemblies of land plant mitochondrial genomes.
Ethical challenges of using trial transcripts for research purposes: A case study of the International Criminal Tribunal for the Former Yugoslavia
Authors: Veličković Marina
Published: February 2024

Drawing on three years of empirical research, the article explores four ethical challenges of working with trial transcripts: lack of participant consent; impossibility of research reciprocity; the risk that one’s use of these materials can be harmful to the local communities, and the risk that this use might be harmful to the researchers themselves.
A simple method for estimating time-irreversible nucleotide substitution rates in the SARS-CoV-2 genome
Authors: Misawa Kazuharu , Ootsuki Ryo
Published: February 2024

SARS-CoV-2 is the cause of the current worldwide pandemic of severe acute respiratory syndrome. The change of nucleotide composition of the SARS-CoV-2 genome is crucial for understanding the spread and transmission dynamics of the virus because viral nucleotide sequences are essential in identifying viral strains. Recent studies have shown that cytosine (C) to uracil (U) substitutions are overrepresented in SARS-CoV-2 genome sequences. These asymmetric substitutions between C and U indicate that traditional time-reversible substitution models cannot be applied to the evolution of SARS-CoV-2 sequences. Thus, we develop a new time-irreversible model of nucleotide substitutions to estimate the substitution rates in SARS-CoV-2 genomes. We investigated the number of nucleotide substitutions among the 7862 genomic sequences of SARS-CoV-2 registered in the Global Initiative on Sharing All Influenza Data (GISAID) that have been sampled from all over the world. Using the new method, the substitution rates in SARS-CoV-2 genomes were estimated. The C-to-U substitution rates of SARS-CoV-2 were estimated to be 1.95 × 10−3 ± 4.88 × 10−4 per site per year, compared with 1.48 × 10−4 ± 7.42 × 10−5 per site per year for all other types of substitutions.
Conserved transcription factors NRZ1 and NRM1 regulate NLR receptor-mediated immunity
Authors: Zhang Qingling , Wang Jubin , Li Yuanyuan , Tung Jeffrey , Deng Yingtian , Baker Barbara , Dinesh-Kumar Savithramma P , Li Feng
Published: February 2024

Plant innate immunity mediated by the nucleotide-binding leucine-rich repeat (NLR) class of immune receptors plays an important role in defense against various pathogens. Although key biochemical events involving NLR activation and signaling have been recently uncovered, we know very little about the transcriptional regulation of NLRs and their downstream signaling components. Here, we show that the Toll-Interleukin 1 receptor homology domain containing NLR (TNL) gene N (Necrosis), which confers resistance to Tobacco mosaic virus, is transcriptionally induced upon immune activation. We identified two conserved transcription factors, N required C3H zinc finger 1 (NRZ1) and N required MYB-like transcription factor 1 (NRM1), that activate N in an immune responsive manner. Genetic analyses indicated that NRZ1 and NRM1 positively regulate coiled-coil domain-containing NLR- and TNL-mediated immunity and function independently of the signaling component Enhanced Disease Susceptibility 1. Furthermore, NRZ1 functions upstream of NRM1 in cell death signaling, and their gene overexpression induces ectopic cell death and expression of NLR signaling components. Our findings uncovered a conserved transcriptional regulatory network that is central to NLR-mediated cell death and immune signaling in plants.
Actors, alterations, and authorities: three observations of global policy and its transnational administration
Authors: Moloney Kim , Legrand Tim
Published: February 2024

This Special Issue and its seven contributions seek to shift the gaze of public policy scholarship toward the authorities, legitimacies, and influences of transnational actors on the creation and implementation of global policy and its transnational administration. It is, in large part, both a demonstration of the analytical and explanatory value of accounting for the influence of non-state actors on global issues as well as a normative reflection on what this means for already tenuous connections between publics and those that make decisions on their behalf in global forums. This Issue breaks with heterodox public policy approaches that center on the capabilities of states and international organizations to determine and to deliver global public policy and outcomes. Instead, we widen our gaze to capture the influence of transnational actors such as global commissions, transnational public–private partnerships, philanthropic foundations, non-government organization networks, domestic associations with global influence, quasi-judicial authorities, and global citizen activists. The articles discuss the impact of transnational actors on the policy and administrative spaces of global actors and states alike. By dispensing with the notion that the state and state-created international organizations are the primary locus for public policy and public administration scholarship, the included papers conclude with the implications for scholarship on transnational actor authorities and legitimacies.
Human extracellular matrix (ECM)-like collagen and its bioactivity
Authors: Zhou Hui , Li Wenwei , Pan Lixin , Zhu Tianci , Zhou Teng , Xiao E , Wei Qiang
Published: February 2024

Collagen, the most abundant structural protein in the human extracellular matrix (ECM), provides essential support for tissues and guides tissue development. Despite its widespread use in tissue engineering, there remains uncertainty regarding the optimal selection of collagen sources. Animal-derived sources pose challenges such as immunogenicity, while the recombinant system is hindered by diminished bioactivity. In this study, we hypothesized that human ECM-like collagen (hCol) could offer an alternative for tissue engineering. In this study, a facile platform was provided for generating hCol derived from mesenchymal stem cells with a hierarchical structure and biochemical properties resembling native collagen. Our results further demonstrated that hCol could facilitate basal biological behaviors of human adipose-derived stem cells, including viability, proliferation, migration and adipocyte-like phenotype. Additionally, it could promote cutaneous wound closure. Due to its high similarity to native collagen and good bioactivity, hCol holds promise as a prospective candidate for in vitro and in vivo applications in tissue engineering.
MRVAS—introducing a standardized magnetic resonance scoring system for assessing the extent of inflammatory burden in giant cell arteritis
Authors: Froehlich Matthias , Guggenberger Konstanze V , Vogt Marius , Mihatsch Patrick W , Dalla Torre Giulia , Werner Rudolf A , Gernert Michael , Strunz Patrick P , Portegys Jan , Weng Andreas M , Schmalzing Marc , Bley Thorsten A
Published: February 2024

Objectives

Our aim was to introduce a standardized system for assessing the extent of GCA on MRI, i.e. the Magnetic Resonance Vasculitis Activity Score (MRVAS). To obtain a comprehensive view, we used an extensive MRI protocol including cranial vessels and the aorta with its branches. To test reliability, MRI was assessed by four readers with different levels of experience.

Methods

A total of 80 patients with suspected GCA underwent MRI of the cranial arteries and the aorta and its branches (20 vessel segments). Every vessel was rated dichotomous [inflamed (coded as 1) or not (coded as 0)], providing a summed score of 0–20. Blinded readers [two experienced radiologists (ExR) and two inexperienced radiologists (InR)] applied the MRVAS on an individual vessel and an overall level (defined as the highest score of any of the individual vessel scores). To determine interrater agreement, Cohen’s κ was calculated for pairwise comparison of each reader for individual vessel segments. Intraclass correlation coefficients (ICCs) were used for the MRVAS.

Results

Concordance rates were excellent for both subcohorts on an individual vessel-based (GCA: ICC 0.95; non-GCA: ICC 0.96) and overall MRVAS level (GCA: ICC 0.96; non-GCA: ICC 1.0). Interrater agreement yielded significant concordance (P < 0.001) for all pairs (κ range 0.78–0.98). No significant differences between ExRs and InRs were observed (P = 0.38).

Conclusion

The proposed MRVAS allows standardized scoring of inflammation in GCA and achieved high agreement rates in a prospective setting.
Nonlinear Effect of Preexisting Cranial Adjacent Disc Degeneration on Cumulative 12-Year Revision Risk Following Lumbar Fusions
Authors: Toivonen Leevi A. , Mäntymäki Heikki , Benneker Lorin M. , Kautiainen Hannu , Häkkinen Arja , Neva Marko H.
Published: February 2024

Study Design.

Retrospective analysis of prospectively collected data.

Objective.

To evaluate how preexisting adjacent segment degeneration status impacts revision risk for adjacent segment disease (ASD) after lumbar fusions.

Summary of Background Data.

ASD incurs late reoperations after lumbar fusion surgeries. ASD pathogenesis is multifactorial. Preexisting adjacent segment degeneration, measured by Pfirrmann, is suggested as one of the predisposing factors. We sought to find deeper insights into this association by using a more granular degeneration measure, the combined imaging score (CIS).

Patients and Methods.

A total of 197 consecutive lumbar fusions for degenerative pathologies were enrolled in a prospective follow-up (median: 12 yr). Preoperative cranial adjacent segment degeneration status was determined using Pfirrmann and CIS, which utilize both radiographs and magnetic resonance imaging. On the basis of CIS, patients were trichotomized into tertiles (CIS <7, CIS 7–10, and CIS >10). The cumulative ASD revision risk was determined for each tertile. After adjusting for age, sex, body mass index, sacral fixation, and fusion length, hazard ratios (95% CI) for ASD revisions were determined for each Pfirrmann and CIS score.

Results.

Patients in the intermediate CIS tertile had a cumulative ASD revision risk of 25.4% (17.0%–37.0%), while both milder degeneration (CIS <7) [13.2% (6.5%–25.8%)] and end-stage degeneration (CIS >10) [13.6% (7.0%–25.5%)] appeared to be protective against surgical ASD. Pfirrmann failed to show a significant association with ASD revision risk. Adjusted analysis of CIS suggested increased ASD revisions after CIS 7, which turned contrariwise after CIS 10.

Conclusions.

The effect of preexisting adjacent segment degeneration on ASD reoperation risk is not linear. The risk appears to increase with advancing degeneration but diminishes with end-stage degeneration. Therefore, end-stage degenerative segments may be considered to be excluded from fusion constructs.

Level of Evidence.

Therapeutic 3.
Ocular Surface Analysis of Dry Eye Disease After Cataract Surgery
Authors: Tangpagasit Wimolwan , Srivanich Onnicha
Published: February 2024

Purpose:

We aimed to compare the efficacy and safety of 0.3% hydroxypropyl methylcellulose/dextran (HPMC/Dextran) and 0.3% sodium hyaluronate (SH) in the treatment of dry eye disease (DED) in postcataract surgery patients by analyzing the presurgery and postsurgery ocular surface.

Methods:

This double-blinded, randomized, parallel-group study enrolled 96 patients with ocular surface dysfunction, specifically DED, after phacoemulsification. Patients were randomized to receive either HPMC/Dextran (n = 56) or 0.3% SH (n = 40). All patients received 1 drop per eye, 4 times per day. Data from OCULUS Keratograph 5M and Schirmer I tests without anesthesia were collected at baseline and 1 week, 1 month, and 3 months postoperatively.

Results:

Three months postsurgery, the ocular surface, Schirmer I test, tear meniscus height (TMH), noninvasive tear film break-up time (NITBUT), meibography, redness, and Ocular Surface Disease Index were significantly improved. The Schirmer I test, TMH, and NITBUT improved significantly (P= 0.07, 0.17, and 0.43, respectively; analysis of variance,P< 0.05) in the SH group compared with the HPMC/Dextran group. In a subgroup analysis of patients with severe dry eye, Schirmer I test ≤ 5 mm/5 minutes and NITBUT < 5 significantly improved (P= 0.00 and 0.001, respectively) at 3 months in the SH group compared with the HPMC/Dextran group. Thus, 0.3% SH gave significantly superior tear secretion and tear film instability outcomes.

Conclusions:

Both types of preservative-free artificial tears are effective in treating postsurgery DED. Compared with HPMC/Dextran, 0.3% SH artificial tears showed more improvements in Schirmer I test and NITBUT postsurgery.
Study of IL-17 and Intercellular Adhesion Molecule-1 in Conjunctivochalasis Using Correlation Analysis
Authors: Ma Kai , Zhou Huanming , Zhang Wei , Liu Jiang , Sha Yongyi , Kong Xueqing , Ni Zhenhua , Xiang Minhong
Published: February 2024

Purpose:

The aim of this study was to observe the expression of interleukin (IL)-17 and intercellular adhesion molecule (ICAM)-1 in conjunctivochalasis (CCH) and to analyze the correlations between cytokines and the severity of CCH.

Methods:

Serum samples were collected from 22 patients with CCH and 18 normal controls (NCs). The Ocular Surface Disease Index, tear film break-up time, Schirmer I test, and corneal fluorescein staining were used to evaluate the ocular surface signs and symptoms. The concentrations of IL-17, IL-23, and ICAM-1 in serum and cellular supernatants were measured by enzyme-linked immunosorbent assays, and the gene expression levels of cytokines were measured by a quantitative real-time polymerase chain reaction. The relationships between serum concentrations of IL-17, IL-23, and ICAM-1 with clinical ocular surface parameters in CCH were analyzed using the Spearman correlation analysis.

Results:

The concentrations of IL-17 and ICAM-1 in serum and cellular supernatants of CCH were significantly higher than those of NCs (all P < 0.001). The concentrations of IL-23 in serum and cellular supernatants of CCH showed no significant difference from those of NCs (P > 0.05). The mRNA expression levels of IL-17 and ICAM-1 in conjunctival fibroblasts of CCH were significantly higher than those of NCs (all P < 0.001). The mRNA expression of IL-23 in conjunctival fibroblasts of CCH was higher than that of NCs, without a significant difference (P > 0.05). Furthermore, the serum concentrations of IL-17 and ICAM-1 were positively correlated with Ocular Surface Disease Index and fluorescein staining (all P < 0.05), and negatively correlated with break-up time and Schirmer I test of CCH (all P < 0.05).

Conclusions:

The expression levels of IL-17 and ICAM-1 were significantly increased in CCH serum and associated with the disease severity. We postulate that IL-17 and ICAM-1 may play a role in the pathogenesis of CCH. IL-17 and ICAM-1 antagonists may be a potential treatment option for CCH in the future.
Hyperopic LASIK and postoperative corneal steepness: revisiting the 49-diopter limit
Authors: Sella Ruti , Sorkin Nir , Safir Margarita , Beylin Yonatan , Sela Tzahi , Munzer Gur , Kaiserman Igor , Mimouni Michael
Published: February 2024

Purpose:

To compare corrected distance visual acuity (CDVA) outcomes of hyperopic laser in situ keratomileusis (LASIK) with a postoperative corneal steepness above vs below 49 diopters (D).

Setting:

Care-Vision Laser Centers, Tel-Aviv, Israel.

Design:

Retrospective study.

Methods:

This study included consecutive patients who underwent hyperopic LASIK between January 2013 and December 2019. Hyperopic patients were divided into 2 groups based on postoperative corneal steepness with steep corneas defined >49.0 D and the control group ≤49.0 D. Adjustments were performed to account for differences in baseline and intraoperative parameters.

Results:

Overall, 1703 eyes of 1703 patients were included. Mean age was 48.3 ± 10.0 years, and 45.3% were male. Preoperatively, the steep group (2.4%, n = 41/1703) had steeper mean (44.6 D vs 43.1 D, P < .001) and steep (45.1 D vs 43.5 D, P < .001) keratometry, worse logMAR CDVA (0.07 vs 0.04, P = .02), and higher sphere (4.9 D vs 2.9 D, P < .001). Intraoperatively, they had a higher spherical treatment (4.6 D vs 2.8 D, P < .001). After hyperopic LASIK, the steep group had worse logMAR CDVA (0.10 vs 0.06, P = .01). However, after accounting for differences in baseline and spherical treatment, no significant differences were found in postoperative logMAR CDVA (0.06 vs 0.06, P = .99). The factors that remained associated with worse postoperative CDVA were higher spherical treatment (0.01 logMAR per 1 D, P < .001) and preoperative CDVA (0.60 logMAR per 1.00 logMAR, P < .001).

Conclusions:

Postoperative corneal steepness greater than 49 D is not associated with worse visual outcomes after hyperopic LASIK. However, lower preoperative visual potential and higher spherical treatment applied are associated with worse outcomes. The 49 D cutoff should be revisited.
Caregivers' Contributions to Heart Failure Self-care
Authors: Buck Harleah G. , Howland Chelsea , Stawnychy Michael A. , Aldossary Heba , Cortés Yamnia I. , DeBerg Jennifer , Durante Angela , Graven Lucinda J. , Irani Elliane , Jaboob Saida , Massouh Angela , Oberfrank Natany Da Costa Ferreira , Saylor Martha Abshire , Wion Rachel K. , Bidwell Julie T.
Published: February 2024

Background

A previous systematic review reporting the contributions of informal, unpaid caregivers to patient heart failure (HF) self-care requires updating to better inform research, practice, and policy.

Objective

The aim of this study was to provide an updated review answering the questions: (1) What specific activities do informal caregivers of adults with HF take part in related to HF self-care? (2) Have the activities that informal caregivers of adults with HF take part in related to HF self-care changed over time? (3) What are the gaps in the science?

Methods

This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, CINAHL, EMBASE, and Cochrane CENTRAL databases were searched. Eligible studies involved an informal, unpaid caregiver of an adult with HF as a study variable or participant. Caregiving activities were benchmarked using the theory of self-care in chronic illness.

Results

Two thousand one hundred fifty-four research reports were identified, of which 64 met criteria. Caregivers' contributions occurred in self-care maintenance (91%), monitoring (54%), and management (46%). Activities performed directly on or to the patient were reported more frequently than activities performed for the patient. Change over time involved the 3 domains differentially. Gaps include ambiguous self-care activity descriptions, inadequate caregiving time quantification, and underrepresented self-care monitoring, supportive, and communication activities.

Conclusions

Newly identified caregiver-reported activities support updating the theory of self-care in chronic illness to include activities currently considered ancillary to HF self-care. Identified gaps highlight the need to define specific caregiving activities, determine task difficulty and burden, and identify caregiver self-care strategy and education needs. Exposing the hidden work of caregiving is essential to inform policy and practice.
Response to apheretic platelet transfusion in children of acute lymphoblastic leukemia receiving induction chemotherapy: a cross-sectional study from Bangladesh
Authors: Basak Sushanta Kumar , Iktidar Mohammad Azmain , Chowdhury Romana , Khatun Ayesha , Rahman Atiar , Miah Sonia Shormin , Shaheen Sheikh Saiful Islam , Mazumder Sudeshna
Published: February 2024

Background:

Disease and therapy-related hypoproliferative thrombocytopenia is a significant barrier to managing acute lymphoblastic leukaemia (ALL) patients. To reduce the risk of haemorrhage, apheretic platelet transfusion is a modern, effective, and expensive option. Since most ALL patients in Bangladesh have financial constraints, this study can shed light on the magnitude of benefit regarding the effectiveness of apheretic platelet prophylactically and therapeutically in children of ALL receiving induction chemotherapy.

Materials and methods:

This observational cross-sectional study was conducted in the department of transfusion medicine and the department of paediatric haematology and oncology at a tertiary level hospital in Bangladesh from June 2020 to June 2021. A total of 33 cases of ALL were enroled in this study according to inclusion and exclusion criteria. After receiving written informed consent, relevant data were collected using a face-to-face interview with the guardian of the patients, thorough clinical examination, and relevant investigation. After the collection of all the required data, analysis was done by Stata (v.16).

Results:

Mean age of the patients was 7.39±4.46 (SD), ranging from 1 to 18 years. The majority of children were aged younger than or equal to 10 years (69.70%). Male children were slightly predominant (51.5%). Significant post-transfusion platelet increment (Median pre-transfusion count 16×103/μl vs. Median post-transfusion count 133×103/μl, P<0.001) was observed. WHO bleeding grades also improved after apheretic platelet transfusion (P<0.05). Age was a significant factor associated with corrected count increment (CCI) in both univariate and multivariate analysis. In subgroup analysis, age and gender were significant predictors of CCI in therapeutic transfusion group but not in prophylactic transfusion group.

Conclusions:

Significant improvement in bleeding status and platelet count was observed following apheretic platelet transfusion.
Postoperative screw pullout of severe spondylolisthesis in osteogenesis imperfecta: a case report with 3-year follow-up
Authors: Zhang Zhongtai , Ling Feng , Chen Kangwu , Liu Yuxuan , Ding Qingfeng , Zhang Zhigang
Published: February 2024

Introduction and importance:

Osteogenesis imperfecta (OI) is a rare skeletal disorder characterized by bone fragility and deformities in both paediatric and adult populations. The occurrence of severe spondylolisthesis in OI patients is even more infrequent. However, there is no consensus regarding the optimal treatment approach for OI patients afflicted with severe spondylolisthesis. The selection of surgical procedures and the effective management of postoperative complications present significant challenges in this context.

Case presentation:

A 30-year-old male patient diagnosed with OI type IV (Sillence classification) underwent the lumbar laminectomy and postero-lateral fusion due to severe spondylolisthesis (grade Ⅲ). Following the surgery, the patient experienced postoperative screw pullout while on bedrest. However, aside from experiencing back pain, there were no neurological symptoms present. To address this issue, the patient received salvage treatment in the form of cast immobilization combined with bisphosphonates. At the 3-year follow-up, the patient exhibited absence of sciatic nerve pain and reported mild numbness in the lower extremities. Moreover, the patient demonstrated the ability to ambulate a distance exceeding 1500 m. Nevertheless, the persistence of sexual dysfunction was observed.

Clinical discussion:

This study presented the initial instance of surgical complications observed in patients with severe spondylolisthesis and OI. This highlights the importance to exercise meticulous caution and thoroughness when assessing surgical interventions.

Conclusion:

In cases where the fixation fails to offer adequate biomechanical stability, the administration of bisphosphonates and robust immobilization remains crucial, even in the presence of complications.
Is cranioplasty the optimal treatment for contralateral subdural effusion after decompressive craniectomy?: a case report
Authors: Ouyang Qing , Yang Yongxiang , Cheng Jingmin , Sun Bing , Ma Yuan
Published: February 2024

Introduction and importance:

Contralateral subdural effusion (CSDE) is a rare complication secondary to decompressive craniectomy (DC), which can lead to encephalocele and neurologic deterioration. The authors report a case that confirm the existence of unidirectional membrane valve, and cranioplasty is an effective treatment for CSDE.

Case presentation:

The authors reported a case of 43-year-old female was diagnosed with ruptured intracranial aneurysm and treated with interventional embolization. She underwent DC because of postoperative cerebral infarction subsequently. Her conscious state deteriorated accompanied by encephalocele in postoperative 2 week. A craniocerebral computed tomography (CT) confirmed the diagnosis of CSDE with cerebral hernia. A compression bandaging of the skull defect was applicated, whereas, her conscious state progressive deteriorated. She was transferred to the author’s hospital where she underwent burr-hole drainage and clinical symptom has been improved. However, a relapse of CSDE was observed after the removal of drainage tube. Continuous lumbar drainage was employed, and which was ineffective for CSDE in this case. Finally, she underwent cranioplasty, with the help of drainage of subdural effusion, CSDE was completely resolved.

Clinical discussion:

CSDE is occasionally observed in patients after DC. Intracranial pressure (ICP) gradient and unidirectional membrane valve are the possible mechanisms of CSDE. At present, there is no optimal therapy for CSDE. For symptomatic CSDE patients, one or more treatment measures should be applicated.

Conclusion:

Cranioplasty is one of the curative and optimal method to treat symptomatic CSDE patients, early cranioplasty combined with burr-hole drainage should be performed for conservative treatment failed and intractable cases.
Syphilis Diagnosis After a Chlamydia, Gonorrhea, or HIV Diagnosis Among Reproductive-Aged Women in Baltimore, MD
Authors: Kretz Alyssa M. , Schumacher Christina M. , Thornton Nicole , Powell Anna Maya , Tilchin Carla , Muvva Ravikiran , Jennings Jacky M.
Published: February 2024

Background

Syphilis incidence is increasing among reproductive-aged women, and previous sexually transmitted infections (STIs) are a risk factor for subsequent STIs. This study aimed to determine syphilis incidence after a chlamydia, gonorrhea, or HIV diagnosis, and identify characteristics associated with higher syphilis incidence rates among reproductive-aged women in 1 mid-Atlantic city.

Methods

A retrospective cohort of 85,113 chlamydia, gonorrhea, and HIV diagnoses occurring between 2009 and 2021 and among women aged 13 to 50 years was constructed using public health surveillance data. Cumulative incidence curves were estimated to examine time to early syphilis (i.e., primary, secondary, or early latent) diagnosis, and multivariable analyses determined incidence rate ratios by age (<25 vs. ≥25 years) and number of prior STI diagnoses (0 vs. ≥1) during the study period, stratified by STI.

Results

There were 85,113 reportable STI diagnoses and 646 syphilis diagnoses in the cohort. Approximately 1 of 150 chlamydia, 1 of 100 gonorrhea, and 1 of 50 HIV diagnoses were followed by a syphilis diagnosis within 5 years. Cumulative incidence of syphilis differed significantly by STI diagnosis (P < 0.001). In multivariable analysis, syphilis incidence rates were higher among women diagnosed with ≥1 (vs. 0) prior STI regardless of STI type (P < 0.05) and among women ≥25 (vs. <25) years old diagnosed with gonorrhea (P < 0.05).

Conclusions

There were significant differences in syphilis incidence by prior STI type, number of STIs, and age. Our data support targeted screening for syphilis among women with a history of STIs, parwomen with ≥1 prior STI diagnosis, and older women diagnosed with gonorrhea.
Provider-Reported Barriers in Sexual Health Care Services for Women With Upstream Barriers: The Case of Syphilis and Congenital Syphilis in Southern Colorado, 2022
Authors: Hackett Colleen , Frank Leslie , Heldt-Werle Lindsey , Loosier Penny S.
Published: February 2024

Background

Syphilis and congenital syphilis rates have increased sharply in Colorado in the past 5 years. Congenital syphilis is passed during pregnancy in utero and can cause lifelong physical, developmental, and neurologic problems for the child, or can lead to miscarriage, stillbirth, or early infant death. Congenital syphilis is easily prevented if the mother receives timely testing, treatment, and prenatal care. Providers can play a key role in preventing congenital syphilis for women with social vulnerabilities, who have a higher likelihood of syphilis and/or congenital syphilis infection.

Methods

We surveyed 23 and interviewed 4 health care providers in southern Colorado in 2022 to record their experiences in providing sexual health care services. We asked providers with direct care experience about perceived barriers in effectively treating syphilis.

Results

The most significant barriers reported in the survey were the cost of treatment (26%) and the loss to follow-up (22%). Interviews revealed further challenges, including discretionary testing procedures, delays in screening results, treatment referral issues, and stigma around substance use and sexual activity.

Conclusions

Elevated syphilis and congenital syphilis rates pose significant public health challenges. Coordinated interventions are necessary to effectively reduce the transmission of syphilis and congenital syphilis among women with upstream barriers. Potential care solutions include expanding rapid, point-of care testing and treatment options, supporting bicillin delivery or web-based inventory systems, offering anti-stigma training for providers, offering mental and behavioral health resources at providers' clinics, and expanding partnerships with syringe access programs.
Two Bullet Wounds, One Bullet: The Atypical Fragmentation of a .223 Caliber Ammunition
Authors: Hancock Addie , Giffen Mark
Published: February 2024

As the fifth leading cause of death in individuals aged 1 to 64 years in the United States, forensic pathologists frequently encounter firearm-related deaths and are trained to approach these cases by utilizing information from the investigation, radiographs, and autopsy findings to discern the logical sequence of events that lead to death. We also emphasize the importance and utility of various factors such as bullet wound characteristics, type of ammunition used, and type of tissues involved in a forensic pathologist's determination of events and in medicolegal investigations. However, the unusual presentations of firearm-related deaths can cause confusion and even frustration when there are contradicting circumstances or findings at work. We present the case of a 61-year-old woman with an atypical pattern of 2 distinct irregular entrance gunshot wounds determined to be caused by a single projectile.
Cerebrovascular Malformation Mimicking Recurrent Lymphoma on Dual Time-Point 18F-FDOPA PET
Authors: Park Sonya Youngju , Lee Min Kyoung , Han Eun Ji , Jeon Young-Woo
Published: February 2024

Although 18F-FDG is the dominant radiotracer for PET imaging of hematological malignancies, radiolabeled amino acids have also been investigated to improve image quality in areas of high 18F-FDG uptake such as the central nervous system. We present a case of a 57-year-old woman who underwent an 18F-FDOPA scan for primary CNS lymphoma, which demonstrated an unexpected false-positive uptake in the right frontal lobe, due to a developmental venous anomaly.