bluuebunny/crossref_metadata_2025 huggingface dataset:
Aggressive versus controlled fluid resuscitation in acute pancreatitis: A systematic review and meta-analysis of randomized controlled trials
Authors: He Kun , Gao Lin , Yang Zihan , Zhang Yuelun , Hua Tianrui , Hu Wenmo , Wu Dong , Ke Lu
Published: April 2023

Background:

Early fluid resuscitation is one of the fundamental treatments for acute pancreatitis (AP), but there is no consensus on the optimal fluid rate. This systematic review and meta-analysis aimed to compare the efficacy and safety of aggressive vs. controlled fluid resuscitation (CFR) in AP.

Methods:

The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and Web of Science databases were searched up to September 30, 2022, for randomized controlled trials (RCTs) comparing aggressive with controlled rates of early fluid resuscitation in AP patients without organ failure on admission. The following keywords were used in the search strategy: "pancreatitis," "fluid therapy,""fluid resuscitation,"and "randomized controlled trial." There was no language restriction. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the certainty of evidence. Trial sequential analysis (TSA) was used to control the risk of random errors and assess the conclusions.

Results:

A total of five RCTs, involving 481 participants, were included in this study. For primary outcomes, there was no significant difference in the development of severe AP (relative risk [RR]: 1.87, 95% confidence interval [CI] 0.95–3.68; P = 0.07; n = 437; moderate quality of evidence) or hypovolemia (RR: 0.98, 95% CI: 0.32–2.97; P = 0.97; n = 437; moderate quality of evidence) between the aggressive and CFR groups. A significantly higher risk of fluid overload (RR: 3.25, 95% CI: 1.53–6.93; P <0.01; n = 249; low quality of evidence) was observed in the aggressive fluid resuscitation (AFR) group than the controlled group. Additionally, the risk of intensive care unit admission (P = 0.02) and the length of hospital stay (P <0.01) as partial secondary outcomes were higher in the AFR group. TSA suggested that more studies were required to draw precise conclusions.

Conclusion:

For AP patients without organ failure on admission, CFR may be superior to AFR with respect to both efficacy and safety outcomes.

Registration:

PROSPERO; https://www.crd.york.ac.uk/PROSPERO/; CRD 42022363945.
Combining a Chest Wall Perforator Flap and Bioabsorbable Implant to Facilitate Oncoplastic Breast-conserving Surgery
Authors: Schwartz Jean-Claude D.
Published: April 2023

Oncoplastic breast conservation is classically divided into two approaches: volume displacement and volume replacement (VR). These approaches are important to use when more than 20% of the breast is removed to avoid deformity. Smaller, nonptotic breasts require VR strategies from flaps based off of local chest wall perforators. When larger volumes are required, a flap based off the thoracodorsal artery can be used. Although this flap can replace larger volumes, it usually requires a position change with increased operative time, patient morbidity, and longer recovery while also exhausting a major reconstructive modality. In an effort to avoid this increased operative complexity, we have found that combining a local chest wall perforator flap and bioabsorbable implant, which has been previously shown to be safe and effective in reconstructing partial mastectomy defects, allows for a simpler VR strategy in patients who might otherwise require a more extensive thoracodorsal artery-based flap surgery or a mastectomy. Here, we present 10 cases where we combined flaps based off the lateral, anterior or medial intercostal artery perforators or lateral thoracic artery perforator with a bioabsorbable implant to successfully perform oncoplastic breast conservation in patients who might otherwise be marginal candidates for VR using a local chest wall perforator flap.
Outcomes of Phacoemulsification With Toric Intraocular Lenses in Addressing Postkeratoplasty Astigmatism
Authors: Moreno-Martínez Almudena , Martín-Melero Oscar , Andrés-Pretel Fernando , Gómez-Cortés Alfonso , Granados-Centeno José M.
Published: April 2023

Purpose:

The aim of this study was to assess the short-term and long-term effectiveness of toric intraocular lenses (IOLs) as a treatment for significant postkeratoplasty astigmatism.

Methods:

This was a retrospective case review study that analyzes postkeratoplasty eyes after phacoemulsification with toric IOL implantation.

Results:

Seventy-five eyes were included. Previous surgery was penetrating keratoplasty (50.6%), deep anterior lamellar keratoplasty (34.6%), or automated anterior lamellar therapeutic keratoplasty (14.6%). The mean age at phacoemulsification with toric IOL implantation was 55.0 years (SD: ±14.4). The mean follow-up time was 48.2 ± 26.6 months. Preoperative mean topographic astigmatism was 6.34 ± 2.70 D (range 2–13.2 D). The mean IOL cylinder power was 6.00 ± 4.75 D (range 2–12 D). Both mean refractive astigmatism and mean refractive spherical equivalent decreased significantly from −5.30 ± 1.86 D to −1.62 ± 1.94 D (P < 0.001) and from −4.00 ± 4.46 D to −0.25 ± 1.25 D (P < 0.001), respectively. From preoperative to the last visit, there was a significant improvement in mean uncorrected distance visual acuity (UCVA) (from 1.3 ± 1.0 logMAR to 0.4 ± 0.3 logMAR, P < 0.001) and mean corrected distance visual acuity (CDVA) (from 0.7 ± 0.6 logMAR to 0.2 ± 0.3 logMAR, P< 0.001). Postoperative UDVA was 20/40 and 20/30 or better in 34% and 21% of eyes, respectively. Postoperative CDVA was 20/40 and 20/30 or better in 70% and 58% of eyes, respectively.

Conclusions:

Phacoemulsification and toric IOL implantation can effectively reduce moderate to high postkeratoplasty astigmatism, with a corresponding significant visual improvement.
Rates and Reasons for Clozapine Treatment Interruptions
Authors: John Alexander P. , Stanley Susanne , Haywood Darren
Published: April 2023

Background

Differing rates and reasons for interruptions of clozapine treatment have been reported globally. This article evaluated the rates and reasons for clozapine therapy interruptions in Australia and explored the impact of the frequency of hematological monitoring on these parameters.

Methods

Data of the patients who were newly commenced on clozapine at three metropolitan public mental health services in Western Australia over 11 years were retrospectively collated. The rate and reasons for clozapine therapy interruptions and their association with the frequency of hematological monitoring, age, sex, and treatment site were analyzed using parametric, nonparametric, and correlational analyses.

Results

Of the 457 patients whose data were collected, 69.6% had an interruption of treatment with 41.2% of those occurring during the period of mandatory weekly hematological monitoring in the first 18 weeks. Nonadherence (57.4%) and adverse effects (28.8%) were the 2 main reasons for the treatment interruptions. Cardiac issues accounted for the majority of the interruptions (61.8%) due to specified adverse effects, and these occurred significantly more commonly within the first 18 weeks. Location, age, and sex did not predict the possibility of treatment interruptions.

Conclusions

The high rates of clozapine treatment interruption observed during the period of weekly monitoring point toward the need to address the burden of frequent hematological monitoring for patients. Disproportionately higher rates of interruption due to cardiac adverse effects observed in this study compared with research from non-Australian settings raise the possibility of geographical differences in the adverse effects leading to treatment discontinuation.
Midsubstance Vastus Lateralis Tear in the Young Athlete: Case Report and a Review of the Literature
Authors: Miles Rebecca N. , Schroeder Jeremy D. , Creech Julie A. , Hulsopple Chad , Higgins David L.
Published: April 2023

Vastus lateralis tendon tear is an infrequent cause of lateral knee pain. Previously reported cases have described acute injury in middle-aged men after eccentric quadriceps contraction. This case report discusses 2 adolescent patients with longitudinal midsubstance tears diagnosed with MRI and dynamic ultrasound and treated successfully with operative intervention.
AFP-L3 and DCP are superior to AFP in predicting waitlist dropout in HCC patients: Results of a prospective study
Authors: Mehta Neil , Kotwani Prashant , Norman Joshua , Shui Amy , Li P. Jonathan , Saxena Varun , Chan Wesley , Yao Francis Y.
Published: April 2023

In patients with HCC awaiting liver transplantation (LT), there is a need to identify biomarkers that are superior to AFP in predicting prognosis. AFP-L3 and des-gamma-carboxyprothrombin (DCP) play a role in HCC detection, but their ability to predict waitlist dropout is unknown. In this prospective single-center study commenced in July 2017, 267 HCC patients had all 3 biomarkers obtained at LT listing. Among them, 96.2% received local-regional therapy, and 18.8% had an initial tumor stage beyond Milan criteria requiring tumor downstaging. At listing, median AFP was 7.0 ng/mL (IQR 3.4–21.5), median AFP-L3 was 7.1% (IQR 0.5–12.5), and median DCP was 1.0 ng/mL (IQR 0.2–3.8). After a median follow-up of 19.3 months, 63 (23.6%) experienced waitlist dropout, while 145 (54.3%) received LT, and 59 (22.1%) were still awaiting LT. Using Cox proportional hazards analysis, AFP-L3≥35% and DCP≥7.5 ng/mL were associated with increased waitlist dropout, whereas AFP at all tested cutoffs, including ≥20,≥ 100, and≥250 ng/mL was not. In a multivariable model, AFP-L3≥35% (HR 2.25, p=0.04) and DCP≥7.5 ng/mL (HR 2.20, p=0.02) remained associated with waitlist dropout as did time from HCC diagnosis to listing ≥ 1 year and increasing MELD-Na score. Kaplan-Meier probability of waitlist dropout within 2 years was 21.8% in those with AFP-L3<35% and DCP<7.5 ng/mL, 59.9% with either AFP-L3 or DCP elevated, and 100% for those with both elevated (p<0.001). In this prospective study, listing AFP-L3% and DCP were superior to AFP in predicting waitlist dropout with the combination of AFP-L3≥35% and DCP≥7.5 ng/mL associated with a 100% risk of waitlist dropout, thus clearly adding prognostic value to AFP alone.
Asymmetric Ocular Vestibular Evoked Myogenic Potentials in Pediatric Vestibular Migraine
Authors: Hwa Tiffany Peng , Patel Vir , Field Erin , Windsor Alanna , Spencer Lyndsey M. , Caine Melissa , O'Reilly Robert C.
Published: April 2023

Objective

Although ocular vestibular evoked myogenic potentials (oVEMP) abnormalities have been associated with vestibular migraine (VM) in adults, no studies have evaluated this in pediatric patients with VM. oVEMP asymmetry with normal cervical VEMP (cVEMP) findings may be a reliable VM biomarker in adults. We characterize VEMP results among pediatric patients with VM and benign recurrent vertigo of childhood (BRVC), a migraine precursor, and compare these results with VEMP findings from pediatric patients with nonmigrainous vestibular diagnoses.

Methods

Four hundred seventy-four pediatric patients were evaluated over a 3-year period in a multidisciplinary pediatric vestibular clinic, 139 of whom met the inclusion criteria. Records were reviewed for history, audiometry, and vestibular testing results. VEMP testing was performed with a 500-Hz tone burst. Based on adult normative data, oVEMP asymmetry was defined as greater than 33% interaural difference; cVEMP asymmetry was defined as greater than 41%.

Results

Eighty subjects had VM or BRVC (mean [standard deviation] 12.8 [3.8] yr; range, 4.3–18.2 yr). Fifty-nine subjects received vestibular diagnoses other than VM or BRVC (nonmigrainous group; mean [standard deviation] age, 13.0 [3.6] yr; range, 5.14–18.9 yr). A greater proportion of the VM/BRVC group demonstrated oVEMP asymmetry with normal cVEMP as compared with the nonmigrainous group (22.5% versus 10.1%; p < 0.05). Zero subjects in the VM/BRVC group demonstrated cVEMP asymmetry versus three subjects (4.9%) of the nonmigrainous group.

Conclusions

VM and BRVC are notable causes of migraine-related vertigo among pediatric patients. Of VM/BRVC patients, 22.5% had oVEMP asymmetry with normal cVEMP. Similar to the adult VM population, this finding may be a useful biomarker in the right clinical setting for pediatric VM.

Level of Evidence

4.
Should Positive Cytology Revealed by Intraoperative Lavage Preclude Radical Resection in Resectable Pancreatic Cancer?
Authors: Li Bing-Qi , Wang Hang-Yan , Li Lei , Jiang Bin , Ma Chao-Lai , Yuan Chun-Hui , Xiu Dian-Rong
Published: April 2023

Objectives

The aims of this review were to determine whether positive peritoneal lavage cytology (CY+) precludes radical resection in pancreatic cancer and to propose prospections for future studies.

Methods

MEDLINE, Embase, and Cochrane Central were searched for related articles. Dichotomous variables and survival outcomes were analyzed with the estimation of odds ratio and hazards ratio (HR), respectively.

Results

A total of 4905 patients were included, of which 7.8% were CY+. Positive peritoneal lavage cytology was correlated with poor overall survival (univariate survival analysis [HR, 2.35; P < 0.00001]; multivariate analysis [HR, 1.62; P < 0.00001]), poor recurrence-free survival (univariate survival analysis [HR, 2.50; P < 0.00001]; multivariate analysis [HR, 1.84; P < 0.00001]), and higher initial peritoneal recurrence rate (odds ratio, 5.49; P < 0.00001).

Conclusions

Although CY+ predicts poor prognosis and a higher risk of peritoneal metastasis after curative resection, it is not sufficient to preclude curative resection based on the current evidence, and high-quality trials should be conducted to assess the prognostic impact of operation among resectable CY+ patients. In addition, more sensitive and accurate methods to detect peritoneal exfoliated tumor cells and more effective comprehensive treatment for resectable CY+ pancreatic cancer patients are clearly warranted.
Short- and Long-Term Outcomes After Multimodal Treatment of Pancreatic Duct Leakage in Patients With Chronic Pancreatitis
Authors: Roug Stine , Novovic Srdan , Hansen Erik Feldager , Hadi Amer , Schmidt Palle Nordblad , Jørgensen Henrik Løvendahl , Karstensen John Gàsdal
Published: April 2023

Objectives

In patients with chronic pancreatitis, pancreatic duct leakage is associated with a prolonged disease course and serious complications. We aimed to assess the efficacy of this multimodal treatment of pancreatic duct leakage.

Methods

In a retrospective design, patients with chronic pancreatitis, an amylase content greater than 200 U/L in either ascites or pleural fluid and treated between 2011 and 2020, were evaluated. The primary end point was treatment success.

Results

Twenty-seven patients (22 males, median age 60, median American Society of Anesthesiologists score 3) were included.

Endoscopic retrograde pancreatography was performed in 23 patients (85%) with transpapillary stenting of the main pancreatic duct in 22 patients (96%). Pancreatic sphincterotomy and dilation of the main pancreatic duct were done in 14 patients (61%) and 17 patients (74%), respectively. Twelve patients (44%) were treated with somatostatin analogs, parenteral nutrition, and were “nil by mouth” for a median of 11 days (range, 4–34 days). Six patients (22%) had extracorporeal shock wave lithotripsy due to pancreatic duct stones. One patient (4%) was referred for surgery. All 23 patients (100%) were treated with success after a median of 21 days (range, 5–80 days).

Conclusions

Multimodal treatment of pancreatic duct leakage is effective, with minimal need for surgery.
Value of Dual-Energy Computed Tomography for Detecting Small Pancreatic Ductal Adenocarcinoma
Authors: Fujisaki Yosuke , Fukukura Yoshihiko , Kumagae Yuichi , Ejima Fumitaka , Yamagishi Ryoji , Nakamura Shinya , Kamizono Junki , Kurahara Hiroshi , Hashimoto Shinichi , Yoshiura Takashi
Published: April 2023

Objective

The aim of the study is to evaluate the usefulness of virtual monoenergetic imaging (VMI) generated from dual-energy computed tomography (DECT) in detecting small pancreatic ductal adenocarcinomas (PDACs).

Methods

This study included 82 patients pathologically diagnosed with small PDAC (≤30 mm) and 20 without pancreatic tumors who underwent triple-phase contrast-enhanced DECT. To assess diagnostic performance for small PDAC detection via a receiver operating characteristic analysis, 3 observers reviewed 2 image sets (conventional computed tomography [CT] set and combined image set [conventional CT + 40-keV VMI from DECT]). The tumor-to-pancreas contrast-to-noise ratio was compared between conventional CT and 40-keV VMI from DECT.

Results

The area under the receiver operating characteristic curve of the 3 observers were 0.97, 0.96, and 0.97 in conventional CT set and 0.99, 0.99, and 0.99 in combined image set (P = 0.017–0.028), respectively. The combined image set yielded a better sensitivity than the conventional CT set (P = 0.001–0.023), without a loss of specificity (all P > 0.999). The tumor-to-pancreas contrast-to-noise ratios of 40-keV VMI from DECT were approximately threefold higher than those of conventional CT at all phases.

Conclusions

The addition of 40-keV VMI from DECT to conventional CT had better sensitivity for detecting small PDACs without compromising specificity.
A Comparison of Machine Learning Methods and Conventional Logistic Regression for the Prediction of In-Hospital Mortality in Acute Biliary Pancreatitis
Authors: Luthra Anjuli K. , Porter Kyle , Hinton Alice , Chao Wei-Lun , Papachristou Georgios I. , Conwell Darwin L. , Krishna Somashekar G.
Published: April 2023

Objectives

For population databases, multivariable regressions are established analytical standards. The utilization of machine learning (ML) in population databases is novel. We compared conventional statistical methods and ML for predicting mortality in biliary acute pancreatitis (biliary AP).

Methods

Using the Nationwide Readmission Database (2010–2014), we identified patients (age ≥18 years) with admissions for biliary AP. These data were randomly divided into a training (70%) and test set (30%), stratified by the outcome of mortality. The accuracy of ML and logistic regression models in predicting mortality was compared using 3 different assessments.

Results

Among 97,027 hospitalizations for biliary AP, mortality rate was 0.97% (n = 944). Predictors of mortality included severe AP, sepsis, increasing age, and nonperformance of cholecystectomy. Assessment metrics for predicting the outcome of mortality, the scaled Brier score (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.16–0.33 vs 0.18; 95% CI, 0.09–0.27), F-measure (OR, 43.4; 95% CI, 38.3–48.6 vs 40.6; 95% CI, 35.7–45.5), and the area under the receiver operating characteristic (OR, 0.96; 95% CI, 0.94–0.97 vs 0.95; 95% CI, 0.94–0.96) were comparable between the ML and logistic regression models, respectively.

Conclusions

For population databases, traditional multivariable analysis is noninferior to ML-based algorithms in predictive modeling of hospital outcomes for biliary AP.
Model for deformation-induced martensitic transformation in irradiated materials
Authors: Zhao Feng , Liu Wenbin , Sui Haonan , Fu Jiaqi , Cheng Yangyang , Zhang Jingyu , Duan Huiling
Published: April 2023

Deformation-induced martensitic transformation (DIMT) is commonly reported to be easily activated in irradiated materials, but the existing transformation kinetics models of DIMT hardly capture the irradiation effect. In this work, we develop a transformation kinetics model considering the effect of irradiation hardening, shear band evolution and the role of irradiation-induced voids. A crystal plasticity framework incorporating the newly developed transformation kinetics model is established. We show that the framework is capable of capturing the accelerated evolution of martensite volume fraction in both cases with and without irradiation-induced voids. Moreover, the framework successfully simulates two post-irradiation phenomena observed in experiments, i.e. the localized distribution of martensite fraction and the evolution of the dominant transformation pathway. The present work is one of the first attempts at the theoretical modelling of DIMT in irradiated materials, and has the potential to benefit the application of irradiation in tailoring the martensitic transformation behaviour.
New conserved integrals and invariants of radial compressible flow in
n
> 1 dimensions
Authors: Anco Stephen C. , Seifi Sara , Dar Amanullah
Published: April 2023

Conserved integrals and invariants (advected scalars) are studied for the equations of radial compressible fluid/gas flow in

n
>
1

dimensions. Apart from entropy, which is a well-known invariant, three additional invariants are found from an explicit determination of invariants up to first order. One holds for a general equation of state, and the two others hold only for entropic equations of state. A recursion operator on invariants is presented, which produces two hierarchies of higher-order invariants. Each invariant yields a corresponding integral invariant, describing an advected conserved integral on transported radial domains. In addition, a direct determination of kinematic conserved densities uncovers two ‘hidden’ non-advected conserved integrals: one describes enthalpy-flux, holding for barotropic equations of state; the other describes entropy-weighted energy, holding for entropic equations of state. A further explicit determination of a class of first-order conserved densities shows that the corresponding non-kinematic conserved integrals on transported radial domains are equivalent to integral invariants, modulo trivial densities.
Wave resonances and hydroelastic wave motion
Authors: Dora R. , Saha S. , Lu D. Q. , Mohanty S. K.
Published: April 2023

Three different types of resonances, i.e. blocking, trapping and Bragg resonance, associated with flexural gravity wave motion in the presence of current and permeable bottom are discussed. Also, using the different modes of wave propagation, the interconnection among all these resonances is analysed. An uneven pattern in the plate deflection is seen inside the blocking resonance zone. The uniform convergence of the infinite series associated with the trapped mode is proved. We have found that the trapped mode does not exist if the magnitude of the opposing current is higher or whenever we move the cylinder away from the platecovered surface. It is also observed that two propagating modes within the blocking frequencies create the environment for the occurrence of trapped waves. At the same time, all three modes have a remarkable contribution to Bragg resonance. The Bragg reflection increases in the blocking zone and decreases outside of it. We have seen that the amplitude of the Bragg reflection increases with the increase in current speed and porosity parameter. Also, the discontinuities in Bragg reflection coefficients are seen at blocking frequencies. The model is also carefully validated numerically for trapped and Bragg resonances against the results available in the existing literature.
Generative cultural learning in children and adults: the role of compositionality and generativity in cultural evolution
Authors: Varallyay Adrian , Beller Nathalia , Subiaul Francys
Published: April 2023

Are human cultures distinctively cumulative because they are uniquely compositional? We addressed this question using a summative learning paradigm where participants saw different models build different tower elements, consisting of discrete actions and objects: stacking cubes (tower base) and linking squares (tower apex). These elements could be combined to form a tower that was optimal in terms of height and structural soundness. In addition to measuring copying fidelity, we explored whether children and adults (i) extended the knowledge demonstrated to additional tower elements and (ii) productively combined them. Results showed that children and adults copied observed demonstrations and applied them to novel exemplars. However, only adults in the imitation condition combined the two newly derived base and apex, relative to adults in a control group. Nonetheless, there were remarkable similarities between children's and adults' performance across measures. Composite measures capturing errors and overall generativity in children's and adults' performance produced few population by condition interactions. Results suggest that early in development, humans possess a suite of cognitive skills—compositionality and generativity—that transforms phylogenetically widespread social learning competencies into something that may be unique to our species, cultural learning; allowing human cultures to evolve towards greater complexity.
Intergenerational response to sperm competition risk in an invasive mammal
Authors: Firman Renée C. , André Gonçalo Igreja , Hadlow Jessica H. , Simmons Leigh W.
Published: April 2023

Studies of socially mediated phenotypic plasticity have demonstrated adaptive male responses to the ‘competitive’ environment. Despite this, whether variation in the paternal social environment also influences offspring reproductive potential in an intergenerational context has not yet been examined. Here, we studied the descendants of wild-caught house mice, a destructive pest species worldwide, to address this knowledge gap. We analysed traits that define a ‘competitive’ phenotype in the sons of males (sires) that had been exposed to either a high-male density (competitive) or high-female density (non-competitive) environment. We report disparate reproductive strategies among the sires: high-male density led to a phenotype geared for competition, while high-female density led to a phenotype that would facilitate elevated mating frequency. Moreover, we found that the competitive responses of sires persisted in the subsequent generation, with the sons of males reared under competition having elevated sperm quality. As all sons were reared under common-garden conditions, variation in their reproductive phenotypes could only have arisen via nongenetic inheritance. We discuss our results in relation to the adaptive advantage of preparing sons for sperm competition and suggest that intergenerational plasticity is a previously unconsidered aspect in invasive mammal fertility control.
Leptospirosis and characterization of Leptospira isolates from patients in Koprivnica-Križevci County, Croatia from 2000–2004
Authors: Mišić-Majerus Ljiljana , Kišek Tjaša Cerar , Ružić-Sabljić Eva
Published: April 2023

Introduction. Leptospirosis, caused by spirochetes of the genus

Leptospira

, is present in the Koprivnica-Križevci County area, Croatia. Clinical manifestation can range from asymptomatic, short-term mild, non-specific febrile disease, to severe forms with high mortality rates.

Aim. The aim of the study was to valuate culture in front of microscopic agglutination test (MAT) for diagnosis of infection, and to evaluate clinical and laboratory features of the disease. Moreover, we want to characterize

Leptospira

strains involved in infection in Koprivnica-Križevci County, Croatia.

Methods. We included 68 patients with clinical presentation consistent with leptospirosis collected in a 5-year period (2000–2004). Clinical samples (blood, urine and cerebrospinal fluid, CSF) were inoculated in Kolthoff’s medium; species of isolated

Leptospira

strains was determined with Tm of real-time PCR, serogroup/serovar with MAT and NotI-RFLP analysis. Demonstration of specific antibodies in patients’ sera was done using microscopic agglutination test.

Results.

Leptospira

was isolated from the blood of 14/51(27.5 %) patients and the most often identified serogroup/serovar was Icterohaemorrhagiae (8/10, 80%) followed by Grippotyphosa (10%). Regarding to species level, 8/10 isolated belonged to L. interrogans sensu stricto and one to

L. kirschneri

species. MAT was carried out on 51 patients with suspected leptospirosis, and was positive in 11/51(21.5 %) patients. Most of our patients presented with moderate severe symptoms, were hospitalized from August to October, and were infected mainly during the work or recreation in our county. The frequency of particular clinical features and pathological laboratory findings correlated with the severity of the clinical condition.

Conclusions. Leptospirosis can be confirmed microbiologically, culture and MAT contributed almost equally to the diagnosis of infection. Serovar Icterohaemorrhagiae was found as the dominant one, and L. interrogans sensu stricto as dominant species in our county. Epidemiological data shown that leptospirosis occurs seasonally, affects the rural population, and most commonly is presented with moderate severe clinical course.
Dasania phycosphaerae sp. nov., isolated from phytoplankton sample from the south coast of the Republic of Korea
Authors: Jiang Yue , Guan Yong , Kang Sungmo , Lee Mi-Kyung , Kim Ki-Hyun , Li Zhun
Published: April 2023

A novel bacterial strain, designated as GY-18T, was isolated from particulate material sampled from the Korean south coast. The bacterium was Gram-stain-negative, aerobic and rod-shaped. Oxidase and catalase were positive. Optimal growth was observed at 30 °C, pH 7.0, in the presence of 1 % (w/v) NaCl. Phylogenetic analyses based on 16S rRNA gene and whole-genome sequences suggested that strain GY-18T was a member of the genus

Dasania

, but represented a separate lineage. The 16S rRNA gene sequence of strain GY-18T showed high similarities to

Dasania marina

KCTC 12566T (98.4 %),

Halioglobus japonicus

KCTC 23429T (92.2 %),

Marimicrobium arenosum

KCTC 42300T (92.4 %) and

Seongchinamella unica

KCTC 62383T (92.2 %), respectively. The genome length of strain GY-18T was 3 808 450 bp with a DNA G+C content of 47.8 mol %. The major cellular fatty acids of strain GY-18T were summed feature 3 (comprising C16 : 1
 ω7c and/or C16 : 1
 ω6c), C16 : 0 and C10 : 0 3-OH (>10 %). Diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and phospholipids were shown to be the major polar lipids. The predominant isoprenoid quinone was Q-8. Based on phylogenetic, phenotypic, chemotaxonomic and genomic features, we propose that strain GY-18T represents a novel species in the genus

Dasania

of the family

Spongiibacteraceae

, with the proposed name Dasania phycosphaerae sp. nov. The type strain is GY-18T (=KCTC 92290T=GDMCC 1.3586T).
Paenibacillus melissococcoides sp. nov., isolated from a honey bee colony affected by European foulbrood disease
Authors: Ory Florine , Dietemann Vincent , Guisolan Anne , von Ah Ueli , Fleuti Charlotte , Oberhaensli Simone , Charrière Jean-Daniel , Dainat Benjamin
Published: April 2023

A novel, facultatively anaerobic, Gram-stain-positive, motile, endospore-forming bacterium of the genus

Paenibacillus

, designated strain 2.1T, was isolated from a colony of Apis mellifera affected by European foulbrood disease in Switzerland. The rod-shaped cells of strain 2.1T were 2.2–6.5 µm long and 0.7–1.1 µm wide. Colonies of strain 2.1T were orange-pigmented under oxic growth conditions on solid basal medium at 35–37 °C. Strain 2.1T showed catalase and cytochrome c oxidase activity. Its polar lipid profile consisted of diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, aminophospholipid and phospholipid. The only respiratory quinone was menaquinone 7, and the major cellular fatty acids were anteiso-C15 : 0, anteiso-C17 : 0, iso-C15 : 0, iso-C17 : 0 and palmitic acid (C16 : 0), which is consistent with other members of the genus

Paenibacillus

. The G+C content of the genomic DNA of strain 2.1T was 53.3 mol%. Phylogenetic analyses based on the 16S rRNA gene sequence similarity showed that strain 2.1T was closely related to

Paenibacillus dendritiformis

LMG 21716T (99.7 % similarity) and

Paenibacillus thiaminolyticus

DSM 7262T (98.8 %). The whole-genome average nucleotide identity between strain 2.1T and the type strains of

P. dendritiformis

and

P. thiaminolyticus

was 92 and 91 %, respectively, and thus lower than the 95 % threshold value for delineation of genomic prokaryotic species. Based on the results of phylogenetic, genomic, phenotypic and chemotaxonomic analyses we propose the name Paenibacillus melissococcoides sp. nov. for this novel

Paenibacillus

species. The type strain is 2.1T (=CCOS 2000T=DSM 113619T=LMG 32539T).
Sellimonas catena sp. nov., isolated from human faeces
Authors: Hisatomi Atsushi , Ohkuma Moriya , Sakamoto Mitsuo
Published: April 2023

Obligately anaerobic, Gram-stain-positive, small-chain coccobacilli, strains 12EGH17T and 18CBH55, were isolated from faecal samples of healthy Japanese humans. Strain 12EGH17T showed the highest 16S rRNA gene sequence similarity to

Sellimonas intestinalis

BR72T (95.5 %),

Coprococcus comes

ATCC 27758T (94.4 %) and

Clostridium nexile

DSM 1787T (93.7 %). The percentage of conserved proteins values between the genome of strain 12EGH17T and that of the members of the genus

Sellimonas

were >54 %, suggesting that strain 12EGH17T belongs to the genus

Sellimonas

. The digital DNA–DNA hybridization (dDDH) and average nucleotide identity (ANI) values between strains 12EGH17T and 18CBH55 were higher than the cut-off values of species demarcation (90 % dDDH and 99 % ANI), indicating these two strains are the same species. However, the dDDH and ANI values of these strains were lower than the cut-off values of species demarcation against other strains (<30 % dDDH and <79 % ANI). These results indicate that the isolates should be considered to represent a new species of the genus

Sellimonas

. The isolates were differentiated from the type species,

S. intestinalis

, by the ability of aesculin hydrolysis. Based on the collected data, strains 12EGH17T and 18CBH55 represent a novel species in the genus

Sellimonas

, for which the name Sellimonas catena sp. nov. is proposed. The type strain of S. catena is 12EGH17T (=JCM 35622T=DSM 114916T).
Phenotyping Refractory Cardiogenic Shock Patients Receiving Venous-arterial Extracorporeal Membrane Oxygenation with Machine Learning Algorithms
Authors: Wang Shuo , Wang Liangshan , Du Zhongtao , Yang Feng , Hao Xing , Wang Xiaomeng , Shao Chengcheng , Li Chenglong , Wang Hong , Hou Xiaotong
Published: April 2023

Background

Refractory cardiogenic shock (CS) patients receiving venous-arterial extracorporeal membrane oxygenation (VA-ECMO) have a wide range of mortality, machine algorithm methods may explain the potential heterogeneity of these patients.

Methods

Between January 2018 and May 2021, 210 patients with CS who were receiving VA-ECMO support were enrolled and analyzed retrospectively. The k-means consensus agnostic algorithm was used. Patients were divided into three clusters based on covariates, such as platelet count (PLT), aspartic acid transaminase (AST), Interleukin-6 (IL-6), prothrombin time (PT), and serum lactate level 24 hours after ECMO initiation. The clinical and laboratory profiles were analyzed.

Results

Among 210 CS with CS receiving ECMO, 148 (70.5%) were men, with a median age of 62 years (interquartile range (IQR): 53-67). Overall, 104 (49.5%) patients survived to discharge with 142 (67.6%) survived on ECMO. The patients were phenotyped into three clusters: (1) “platelet preserved (I)” Phenotype (36 [17.1%] patients), characterized by a preserved platelet count; (2) “hyperinflammatory (II)” phenotype (72 [34.3%] patients), characterized by a significant inflammatory response with higher Interleukin-6 (IL-6), and Interleukin-10 (IL-10) levels; and (3) “hepatic-renal (III)” phenotype (102 [48.6%] patients), characterized by unfavorable conditions in creatinine, aspartic acid transaminase, alanine aminotransferase, direct bilirubin, and prothrombin time. The in-hospital mortality rates were 25.0%, 52.8%, and 55.9% for phenotypes I, II, and III, respectively (P = 0.005).

Conclusion

The consensus k-means algorithm analysis identified three phenotypes in refractory patients with CS receiving VA-ECMO: “platelet preserved,” “hyperinflammatory,” and “hepatic-renal.” The phenotypes are associated with the clinical profile and mortality, allowing treatment strategies for subsets of patients with CS receiving ECMO to be developed.
Aerosol Jet Printing Enabled Dual-Function Electrochemical and Colorimetric Biosensor for SARS-CoV-2 Detection
Authors: Liu Li , Xu Zhiheng , Molina Vargas Adrian Moises , Dollery Stephen J. , Schrlau Michael G. , Cormier Denis , O’Connell Mitchell R. , Tobin Gregory J. , Du Ke
Published: April 2023

An aerosol jet printing enabled dual-function biosensor for the sensitive detection of pathogens using SARS-CoV-2 RNA as an example has been developed. A CRISPR-Cas13: guide-RNA complex is activated in the presence of a target RNA, leading to the collateral trans-cleavage of ssRNA probes that contain a horseradish peroxidase (HRP) tag. This, in turn, catalyzes the oxidation of 3,3′,5,5′-tetramethylbenzidine (TMB) by HRP, resulting in a color change and electrochemical signal change. The colorimetric and electrochemical sensing protocol does not require complicated target amplification and probe immobilization and exhibits a detection sensitivity in the femtomolar range. Additionally, our biosensor demonstrates a wide dynamic range of 5 orders of magnitude. This low-cost aerosol inkjet printing technique allows for an amplification-free and integrated dual-function biosensor platform, which operates at physiological temperature and is designed for simple, rapid, and accurate point-of-care (POC) diagnostics in either low-resource settings or hospitals.
WITHDRAWN: Epigenetic clocks and risk assessment in adult spinal deformity: A novel association between pace of aging with frailty, disability, and postoperative complications
Authors: Safaee Michael M. , Dwaraka Varun B. , Lee Justin M. , Fury Marissa , Mendez Tavis L , Smith Ryan , Lin Jue , Smith Dana L. , Burke John F. , Scheer Justin K. , Went Hannah , Ames Christopher P.
Published: April 2023

Withdrawal statement

The authors have withdrawn their manuscript owing to altered the findings and conclusions related to complication data. The changes in results were due to further scrutiny of the datasets, and led to the removal of 3 patients due to incomplete data. This refinement led to updated results which changed the conclusion of the complication data. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
Spiritual and religious aspects influence mental health and viral load: A quantitative study among young people living with HIV in Zimbabwe
Authors: Wüthrich-Grossenbacher Ursula , Mutsinze Abigail , Wolf Ursula , Maponga Charles Chiedza , Midzi Nicholas , Mutsaka-Makuvaza Masceline Jenipher , Merten Sonja
Published: April 2023

Introduction

The role of religion and spirituality as social determinants of health have been widely discussed in and outside the World Health Organization. Studies among people living with Human Immunodeficiency Virus (HIV) describe positive and negative influences of religion and spirituality on health outcome. With a HIV prevalence of 14.8% for females and 8.6% for males, and 22’000 Aids related deaths in 2020, HIV infection remains a life-threatening condition in Zimbabwe, especially for young people. The aim of this research was to measure the influence of religion and spirituality on the health outcome of young people living with HIV in Zimbabwe.

Methods

A quantitative questionnaire with three different validated measures of religion and spirituality (Belief in Action Scale, Brief Religious Coping Index, Religious and Spiritual Struggles Scale), demographic, cultural, behavioral, and health questions was administered to 804 young Zvandiri program clients in rural, urban, and peri-urban Zimbabwe between July and October 2021. Regression analysis established significant relations between the result of the three different measures and mental health and viral load results.

Results

Religious coping significantly reduced the probability of common mental disorder, while high religious activity increased the risk. The Religious and Spiritual Struggles scale proved to be a reliable indicator of higher viral loads, risk for treatment failure, and the probability of common mental disorder.

Conclusions

The Religious and Spiritual Struggles scale should be used and validated in other sub-Saharan contexts. It could serve as a new diagnostic tool for the early detection and prevention of treatment failure as well as of common mental disorder.
Trends of health and dietary disparities by economic status among elderly individuals in Japan from 2004 to 2014: A repeated cross-sectional survey
Authors: Machida Daisuke
Published: April 2023

This study examines the trends in health and dietary disparities by economic status among elderly individuals in Japan from 2004 to 2014 with subjective measures. The study design utilized a repeated cross-sectional approach, using data from the Survey of Attitudes among the Elderly toward Daily Life in 2004 and 2014. Logistic regression analysis was performed with subjective economic status, survey year, and their interactions as independent variables, and self-rated health, dietary satisfaction, and intake of balanced meals as dependent variables. The results revealed that disparities in self-rated health, dietary satisfaction, and intake of a balanced meal were present due to economic status. Furthermore, the disparities in self-rated health, dietary satisfaction, and balanced meal intake by economic status remained unchanged from 2004 to 2014 (p for interaction ≥ 0.05). The findings were consistent in sensitivity analyses conducted on those aged 75 and older, as well as on long-term care insurance recipients.
No evidence for trans-generational immune priming inDrosophila melanogaster
Authors: Radhika R. , Lazzaro Brian P.
Published: April 2023

Most organisms are under constant and repeated exposure to pathogens, leading to perpetual natural selection for more effective ways to fight-off infections. This could include the evolution of memory-based immunity to increase protection from repeatedly-encountered pathogens both within and across generations. There is mixed evidence for intra- and trans-generational priming in non-vertebrates, which lack the antibody-mediated acquired immunity characteristic of vertebrates. In this work, we tested for trans-generational immune priming in adult offspring of the fruit fly,Drosophila melanogaster, after maternal challenge with 10 different bacterial pathogens. We focused on natural opportunistic pathogens ofDrosophilaspanning a range of virulence from 10% to 100% host mortality. We infected mothers via septic injury and tested for enhanced resistance to infection in their adult offspring, measured as the ability to suppress bacterial proliferation and survive infection. We categorized the mothers into four classes for each bacterium tested: those that survived infection, those that succumbed to infection, sterile-injury controls, and uninjured controls. We found no evidence for trans-generational priming by any class of mother in response to any of the bacteria.
Induced pluripotent stem cell model revealed impaired neurovascular interaction in genetic small vessel disease CADASIL
Authors: Zhang Wenjun , Zhao Xiangjun , Qi Xuewei , Kimber Susan J , Hooper Nigel , Wang Tao
Published: April 2023

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is the most common genetic small vessel disease caused by variants in theNOTCH3gene. Patients with CADASIL experience recurrent strokes, developing into cognitive defect and vascular dementia. CADASIL is a late-onset vascular condition, but migraine and brain MRI lesions appear in CADASIL patients as early as their teens and twenties, suggesting an abnormal neurovascular interaction at the neurovascular unit (NVU) where microvessels meet the brain parenchyma. To understand the molecular mechanisms of CADASIL, we established induced pluripotent stem cell (iPSC) models from CADASIL patients and differentiated the iPSCs into the major NVU cell types including brain microvascular endothelial-like cells (BMECs), vascular mural cells (MCs), astrocytes and cortical projection neurons. We then built anin vitroNVU model by co-culturing different neurovascular cell types in Transwells and evaluated the blood brain barrier (BBB) function by measuring transendothelial electrical resistance (TEER). Results showed that, while the wild-type MCs, astrocytes and neurons could all independently and significantly enhance TEER values of the iPSC-BMECs, such capability of MCs from iPSCs of CADASIL patients was significantly impeded. Additionally, the barrier function of the BMECs from CADASIL iPSCs was significantly impaired, accompanied with disorganised tight junctions in iPSC-BMECs, which could not be effectively rescued by the wild-type MCs, astrocytes and neurons. Our findings provide new insight into early disease pathologies on the neurovascular interaction and BBB function at the molecular and cellular levels for CADASIL, which helps inform future therapeutic development.
The type III secretion chaperone SctY may shield the hydrophobic export gate-binding C-terminus of its substrate SctX
Authors: Gilzer Dominic , Kowal Julia L. , Flottmann Franziska , Niemann Hartmut H.
Published: April 2023

Gram-negative bacteria such as Aeromonas and Yersinia spp. have developed mechanisms to inhibit the immune defense of their host. Effector proteins are directly injected into the host cytoplasm from the bacterial cytosol via type III secretion systems (T3SSs), where they modulate the cytoskeleton and signaling of the cell. Assembly of, and secretion via, T3SSs is tightly regulated by a number of bacterial proteins, including SctX (AscX in Aeromonas), the secretion of which is essential for T3SS function. Here, crystal structures of AscX in complex with SctY chaperones from Yersinia or Photorhabdus spp. carrying homologous T3SSs are described. There are crystal pathologies in all cases, with one crystal form diffracting anisotropically and the other two exhibiting strong pseudotranslation. The new structures reveal that the positioning of the substrate is very similar on different chaperones. However, the two C-terminal SctX helices that cap the N-terminal tetratricopeptide repeat of SctY shift and tilt depending on the identity of the chaperone. Moreover, the C-terminus of the α3 helix of AscX exhibits an unprecedented kink in two of the structures. In previous structures, the C-terminus of SctX protrudes beyond the chaperone as a straight helix: a conformation that is required for binding to the nonameric export gate SctV but that is unfavorable for binary SctX–SctY complexes due to the hydrophobicity of helix α3 of SctX. A kink in helix α3 may allow the chaperone to shield the hydrophobic C-terminus of SctX in solution.