bluuebunny/crossref_metadata_2025 huggingface dataset:
Angina pectoris? Fake news: a case report of infective endocarditis with giant aortic root abscess detected by cardiac magnetic resonance imaging
Authors: Wissel Stephanie , Drayß Maria , Christa Martin , Leyh Rainer G , Frantz Stefan
Published: June 2024

Background

Infective endocarditis (IE) is a rare disease associated with high mortality rates. Clinical presentation is highly variable with a time interval between first onset of symptoms and diagnosis > 1 month in 25% of patients. We present a case of aortic valve endocarditis with aortic root abscess (ARA) with chest pain and ischaemic changes on the electrocardiogram (ECG).

Case summary

A 59-year-old Caucasian male with a known bicuspid aortic valve presented at our emergency department with a 2-week history of malaise, subfebrile temperatures, and chest pain episodes. The ECG exhibited ischaemic changes, and laboratory workup showed elevated inflammatory markers and troponin levels. Coronary angiography revealed a one-vessel coronary artery disease with a borderline significant stenosis of the left circumflex artery. Cardiac magnetic resonance imaging showed a large aortic valve vegetation with an ARA expanding intramyocardially, which was not seen on bedside echocardiography. The patient was set on intravenous (i.v.) antibiotics and urgently referred for surgery. The patient received surgical aortic root and valve replacements, reconstruction of the anterior mitral leaflet, and a venous bypass. After successful surgical management followed by 6 weeks of i.v. antibiotics, the patient completely recovered.

Discussion

Diagnosing IE in atypical cases, such as those with ischaemic ECG changes, remains challenging. Infective endocarditis should be considered as an early differential diagnosis in individuals with prosthetic or native valve disease. Infective endocarditis poses a significant risk for perivalvular and ARA formation with high mortality. Aortic root abscess may present with unspecific symptoms or unusual ECG changes and might be missed in standard transthoracic echocardiography in up to 30% of cases. Multimodal imaging can help in establishing a prompt and accurate diagnosis, aid in timely treatment and mitigating the risk of complications of IE.
Regulation of thiamine and pyruvate decarboxylase genes by Pdc2 in Nakaseomyces glabratus (Candida glabrata) is complex
Authors: Dottor Cory A , Iosue Christine L , Loshnowsky Anita M , Hopkins Rachael A , Stauffer Peyton L , Ugras Julia M , Spagnuola Jack C , Kraut Daniel A , Wykoff Dennis D
Published: June 2024

Thiamine (vitamin B1) is essential for glucose catabolism. In the yeast species, Nakaseomyces glabratus (formerly Candida glabrata) and Saccharomyces cerevisiae, the transcription factor Pdc2 (with Thi3 and Thi2) upregulates pyruvate decarboxylase (PDC) genes and thiamine biosynthetic and acquisition (THI) genes during starvation. There have not been genome-wide analyses of Pdc2 binding. Previously, we identified small regions of Pdc2-regulated genes sufficient to confer thiamine regulation. Here, we performed deletion analyses on these regions. We observed that when the S. cerevisiae PDC5 promoter is introduced into N. glabratus, it is thiamine starvation inducible but does not require the Thi3 coregulator. The ScPDC5 promoter contains a 22-bp duplication with an AT-rich spacer between the 2 repeats, which are important for regulation. Loss of the first 22-bp element does not eliminate regulation, but the promoter becomes Thi3 dependent, suggesting cis architecture can generate a Thi3-independent, thiamine starvation inducible response. Whereas many THI promoters only have 1 copy of this element, addition of the first 22-bp element to a Thi3-dependent promoter confers Thi3 independence. Finally, we performed fluorescence anisotropy and chromatin immunoprecipitation sequencing. Pdc2 and Thi3 bind to regions that share similarity to the 22-bp element in the ScPDC5 promoter and previously identified cis elements in N. glabratus promoters. Also, while Pdc2 binds to THI and PDC promoters, neither Pdc2 nor Thi3 appears to bind the evolutionarily new NgPMU3 promoter that is regulated by Pdc2. Further study is warranted because PMU3 is required for cells to acquire thiamine from environments where thiamine is phosphorylated, such as in the human bloodstream.
Horizontal duodenal papilla is associated with a special spectrum of pancreaticobiliary diseases: a retrospective magnetic resonance cholangiopancreatography-based study
Authors: Zhang Tiantian , Shi Xin , Li Jing , Zhang Jingsong , Li Xixian , Ren Gui , Luo Hui , Kang Xiaoyu , Liang Shuhui , Wang Xiangping , Pan Yanglin
Published: June 2024

Background

Horizontal duodenal papilla (HDP) is not an uncommon ectopic major papilla. The impact of HDP on the occurrence of pancreaticobiliary diseases remains unclear. Here, we explored the associations in patients who underwent magnetic resonance cholangiopancreatography (MRCP).

Methods

Consecutive patients who underwent MRCP at Xijing Hospital (Xi’an, China) between January 2020 and December 2021 were eligible. Patients were divided into HDP and regular papilla (RP) according to the position of the major papilla. The primary outcome was the proportion of congenital pancreaticobiliary diseases.

Results

A total of 2,194 patients were included, of whom 72 (3.3%) had HDP. Compared with the RP group (n = 2,122), the HDP group had a higher proportion of congenital pancreaticobiliary diseases, especially choledochal cyst (CC) or anomalous pancreaticobiliary junction (APBJ) (6.9% vs 1.4%, P = 0.001). More gallbladder cancer (6.9% vs 1.2%, P < 0.001) and pancreatic cysts (27.8% vs 16.3%, P = 0.01) were also identified in the HDP group. Morphologically, the HDP group had a longer extrahepatic bile duct (8.4 [7.6–9.3] cm vs 7.2 [6.5–8.1] cm, P < 0.001), and larger angles between the common bile duct-duodenum and pancreatic duct-duodenum. Multivariate analysis showed that the presence of HDP was an independent risk factor for gallbladder cancer.

Conclusions

This study confirmed that HDP was not rare in patients underwent MRCP. A higher prevalence of congenital pancreaticobiliary malformations (especially CC or APBJ), gallbladder cancer and pancreatic cysts was observed in patients with HDP, as well as distinctive morphologic features.
Access to care for patients with chronic pain receiving prescription opioids, cannabis, or other treatments
Authors: Bicket Mark C , Stone Elizabeth M , Tormohlen Kayla , Pierre Reekarl , McGinty Emma E
Published: June 2024

Changes in chronic noncancer pain treatment have led to decreases in prescribing of opioids and increases in the availability of medical cannabis, despite its federal prohibition. Patients may face barriers to establishing new care with a physician based on use of these treatments. We compared physician willingness to accept patients based on prescription opioid, cannabis, or other pain treatment use. This study of 36 states and Washington, DC, with active medical cannabis programs surveyed physicians who treat patients with chronic noncancer pain between July 13 and August 4, 2023. Of 1000 physician respondents (34.5% female, 63.2% White, 78.1% primary care), 852 reported accepting new patients with chronic pain. Among those accepting new patients with chronic pain, more physicians reported that they would not accept new patients taking prescription opioids (20.0%) or cannabis (12.7%) than those taking nonopioid prescription analgesics (0.1%). In contrast, 68.1% reported willingness to accept new patients using prescribed opioids on a daily basis. For cannabis, physicians were more likely to accept new patients accessing cannabis through medical programs (81.6%) than from other sources (60.2%). Access to care for persons with chronic noncancer pain appears to be the most restricted among those taking prescription opioids, although patients taking cannabis may also encounter reduced access.
Phylosymbiosis shapes skin bacterial communities and pathogen-protective function in Appalachian salamanders
Authors: Osborne Owen G , Jiménez Randall R , Byrne Allison Q , Gratwicke Brian , Ellison Amy , Muletz-Wolz Carly R
Published: June 2024

Phylosymbiosis is an association between host-associated microbiome composition and host phylogeny. This pattern can arise via the evolution of host traits, habitat preferences, diets, and the co-diversification of hosts and microbes. Understanding the drivers of phylosymbiosis is vital for modelling disease-microbiome interactions and manipulating microbiomes in multi-host systems. This study quantifies phylosymbiosis in Appalachian salamander skin in the context of infection by the fungal pathogen Batrachochytrium dendrobatidis (Bd), while accounting for environmental microbiome exposure. We sampled ten salamander species representing >150M years of divergence, assessed their Bd infection status, and analysed their skin and environmental microbiomes. Our results reveal a significant signal of phylosymbiosis, whereas the local environmental pool of microbes, climate, geography, and Bd infection load had a smaller impact. Host-microbe co-speciation was not evident, indicating that the effect stems from the evolution of host traits influencing microbiome assembly. Bd infection is correlated with host phylogeny and the abundance of Bd-inhibitory bacterial strains, suggesting that the long-term evolutionary dynamics between salamander hosts and their skin microbiomes affect the present-day distribution of the pathogen, along with habitat-linked exposure risk. Five Bd-inhibitory bacterial strains showed unusual generalism: occurring in most host species and habitats. These generalist strains may enhance the likelihood of probiotic manipulations colonising and persisting on hosts. Our results underscore the substantial influence of host-microbiome eco-evolutionary dynamics on environmental health and disease outcomes.
Amino acid residues responsible for the different pH dependency of cell-specific ferredoxins in the electron transfer reaction with ferredoxin-NADP+ reductase from maize leaves
Authors: Kimata-Ariga Yoko , Tanaka Hikaru , Kuwano Shunsuke
Published: June 2024

In the chloroplast stroma, dynamic pH changes occur from acidic to alkaline in response to fluctuating light conditions. We investigated the pH dependency of the electron transfer reaction of ferredoxin-NADP+ reductase (FNR) with ferredoxin (Fd) isoproteins, Fd1 and Fd2, which are localized in mesophyll cells and bundle sheath cells, respectively, in the leaves of C4 plant maize. The pH-dependent profile of the electron transfer activity with FNR was quite different between Fd1 and Fd2, which was mainly explained by the opposite pH dependency of the Km value of these Fds for FNR. Replacement of the amino acid residue at position of 65 (D65N) and 78 (H78A) between the two Fds conferred different effect on their pH dependency of the Km value. Double mutations of the two residues between Fd1 and Fd2 (Fd1D65N/H78A and Fd2N65D/A78H) led to the mutual exchange of the pH dependency of the electron transfer activity. This exchange was mainly explained by the changes in the pH-dependent profile of the Km values. Therefore, the differences in Asp/Asn at position 65 and His/Ala at position 78 between Fd1 and Fd2 were shown to be the major determinants for their different pH dependency in the electron transfer reaction with FNR.
Toxic megacolon: a potentially lethal condition. Case report
Authors: Fabián-Méndez José Jesús , Torres-Salazar Quitzia Libertad
Published: June 2024

Toxic megacolon denotes an abrupt non-obstructive distension of the colon, accompanied by systemic signs of toxicity. Mortality rates can soar as high as 7.9%. While primarily linked with chronic bowel conditions, the incidence attributed to Clostridioides difficile has surged due to the indiscriminate use of broad-spectrum antibiotics. Surgical intervention becomes necessary in the majority of cases. Herein, we illustrate the case of a 50-year-old female presenting with episodic epigastric pain lasting 9 h, vomiting, and watery bowel movements, devoid of peritoneal irritation findings and lacking a history of chronic intestinal inflammation. Under certain circumstances, toxic megacolon may manifest atypically, underscoring the importance of conducting a comprehensive medical history and clinical assessment. Moreover, it is imperative to solicit pertinent paraclinical investigations to address the patient holistically and foster a favorable clinical outcome.
Primary ocular adnexal mantle cell lymphoma with distant spread and involvement of the contralateral eye one year later; a case report and literature review
Authors: Amir Amaar , Amir Baraa , Sheikh Salwa
Published: June 2024

We herein report a middle-aged gentleman who initially presented with ocular adnexal mantle cell lymphoma (MCL) on the right eyelid. The lesion was excised and the patient was treated with radiation therapy. During the initial presentation, a PET CT was performed and did not reveal disease involvement beyond the eyelid. The patient presented 3 months later with ocular adnexal MCL of the contralateral eye. Re-evaluation using PET CT revealed a slight increase in the uptake in several lymph nodes and the spleen, which, after biopsy, confirmed systemic MCL. The patient was started on six cycles of chemotherapy. The patient also underwent autologous hematopoietic stem cell transplant. Approximately 80% of primary ocular adnexal lymphomas are B-cell in origin, with MCL being the rarest subtype constituting only 5% of B-cell ocular adnexal lymphomas. Despite its rarity, it is crucial for clinicians to detect the entity early and ensure rapid initiation of appropriate therapy.
A simple method to overcome paraproteinemic interferences in chemistry and immunoassays
Authors: Sarkar Rajarshi
Published: June 2024

Background

Interferences on chemistry and immunoassay results due to paraproteinemia may lead to erroneous diagnoses and treatment. Such interferences are difficult to recognize and even more difficult to deal with. This report describes 1 such case where multiple measurands were affected and how the interferant was overcome.

Case Report

Paraproteins present in an immunoglobulin (Ig)G-lambda multiple myeloma specimen interfered with results of total bilirubin, direct bilirubin, inorganic phosphate, iron, ferritin, and total thyroxine measured on 3 platforms: AU5800, Alinity ci, and cobas pure. Repeat testing upon dilution with normal saline or deproteinization by polyethylene glycol precipitation gave unsatisfactory results on some or all the affected measurands. Repeat testing after dilution of the interferant serum with a healthy serum corrected the anomalous results for all the affected measurands.

Conclusion

Dilution of paraproteinemic serum with a healthy serum of known concentrations appears to be the most suitable method to negate the effects of paraproteinemic interferences.
PhyloBench: A Benchmark for Evaluating Phylogenetic Programs
Authors: Spirin Sergey , Sigorskikh Andrey , Efremov Aleksei , Penzar Dmitry , Karyagina Anna
Published: June 2024

Phylogenetic inference based on protein sequence alignment is a widely used procedure. Numerous phylogenetic algorithms have been developed, most of which have many parameters and options. Choosing a program, options, and parameters can be a nontrivial task. No benchmark for comparison of phylogenetic programs on real protein sequences was publicly available. We have developed PhyloBench, a benchmark for evaluating the quality of phylogenetic inference, and used it to test a number of popular phylogenetic programs. PhyloBench is based on natural, not simulated, protein sequences of orthologous evolutionary domains. The measure of accuracy of an inferred tree is its distance to the corresponding species tree. A number of tree-to-tree distance measures were tested. The most reliable results were obtained using the Robinson–Foulds distance. Our results confirmed recent findings that distance methods are more accurate than maximum likelihood (ML) and maximum parsimony. We tested the bayesian program MrBayes on natural protein sequences and found that, on our datasets, it performs better than ML, but worse than distance methods. Of the methods we tested, the Balanced Minimum Evolution method implemented in FastME yielded the best results on our material. Alignments and reference species trees are available at https://mouse.belozersky.msu.ru/tools/phylobench/ together with a web-interface that allows for a semi-automatic comparison of a user’s method with a number of popular programs.
Clinical utility of DNA methylation profiling for choroid plexus tumors
Authors: Yeo Kee Kiat , Macrae Cassie B , Gampel Bradley , Ahrendsen Jared T , Lidov Hart , Wright Karen D , Chi Susan , Fehnel Katie , Baird Lissa , Clymer Jessica , Aldape Kenneth , Alexandrescu Sanda
Published: June 2024

Background

Choroid plexus tumors (CPTs) are rare, potentially aggressive CNS tumors with defined histologic criteria for grading. In recent years, several patients within our practice have demonstrated discordance between the histologic diagnosis and clinical behavior. DNA methylation profiling has emerged as a potential diagnostic adjunct for aiding the clinical approach.

Methods

We reviewed the clinical and pathologic data of all CPTs diagnosed at Boston Children’s Hospital from 1995 to 2023. All cases with available material (38/48) underwent DNA methylation profiling at NIH/NCI, and the classifier results were correlated with the WHO histologic grade and patient outcomes. Survival information was analyzed using Kaplan–Meier curves.

Results

There was good correlation (11/12, 92%) between methylation class and WHO histologic grade for choroid plexus carcinomas (CPC); one histologic CPC grouped with choroid plexus papilloma (CPP) group pediatric (P). Five CPPs grouped with methylation class CPC (5/17, 29%). In the group of atypical CPPs (n = 9), there were two that grouped with methylation class CPC. Survival analysis showed utility of methylation classes in the prediction of biologic behavior.

Conclusions

Results indicated that methylation profiling may serve as a valuable tool in the clinical decision-making process for patients with CPTs, providing additional prognostic information compared to WHO histologic grade alone. The value of methylation array analysis is particularly important given the lack of consensus on treatment regimens for CPTs.
Pb Isotope Signature of a Low-μ (238U/204Pb) Lunar Mantle Component
Authors: Merle Renaud E , Nemchin Alexander A , Whitehouse Martin J , Kenny Gavin G , Snape Joshua F
Published: June 2024

The chemical and isotopic characteristics of terrestrial basalts are constrained within the concept of mantle chemical geodynamics that explains the existing variety of basaltic rocks within a framework of several end-member reservoirs in Earth’s mantle. In contrast, there is no comparable fully developed model explaining the isotopic composition of lunar basaltic rocks, in part owing to the lack of well-constrained age–isotope relationships in different groups of basalts identified on the Moon. Notably, the absence of agreement upon ages includes basalts from a unique group of meteorites collectively known as ‘YAMM’ (basalts Yamato-793169: Y-793169, Asuka-881757: A-881757, Miller Range 05035: MIL 05035 and regolith breccia Meteorite Hill 01210: MET 01210), which appear to show chemical signatures different from all other known lunar basaltic rocks. We present high-precision Pb–Pb ages and initial Pb isotopic ratios for two samples from this group, MIL 05035 and A-881757. These meteorites have Pb isotope ratios different from those of the other lunar basalts, suggesting they are derived from a distinct and depleted mantle source, with a 238U/204Pb ratio (μ value) lower than any other mantle source. Their depletion in rare earth elements, in conjunction with recalculated initial Nd and Sr isotopic ratios from published data and using our new age, appear to support this conclusion. The chemical and Sr-Nd-Pb isotopic characteristics of this low-μ source appear to be the opposite of those of the KREEP reservoir and many, if not all, features described in other lunar basalts (such as low- and high-Ti mare basalts) can be explained by a binary mixing of material derived from low-μ and KREEP-like reservoirs. This mixing might be the result of a slow, convection-like mantle overturn.
The “Octopus Head” Dermoglandular Flap: A Novel Technique for Breast Tissue Rearranging after Implant Removal
Authors: Rossi Matteo , Cammarata Emanuele , Cipolla Calogero , Vieni Salvatore , Toia Francesca , Cordova Adriana
Published: June 2024

Background:

Patients with previous breast augmentation may need implant removal for mechanical complications or other causes. After prosthesis removal, the residual parenchyma can be reshaped through a mastopexy with rearrangement of breast tissue. Several techniques have been described in the literature, but none of them can be considered the gold standard. In this study, we present our preliminary experience in breast tissue rearranging after implant removal through a novel technique: the “octopus head” dermoglandular flap.

Methods:

From January 2019 to October 2022, nine patients (18 breasts) underwent implant removal and simultaneous breast remodeling with the tissue obtained from the dermoglandular excess of the breast and shaped like an octopus head. Patient’s demographic and clinical characteristics, postoperative complications, and patient-reported satisfaction were recorded.

Results:

Mean age was 46.7 years. Body mass index ranged between 22.5 and 27.6 kg per m2. The majority of patients had moderate ptosis (67%). Breast implants were removed due to bilateral capsular contracture (n = 3), unilateral implant rupture with contralateral capsular contracture (n = 2), bilateral implant rupture (n = 3), and unilateral periprosthetic seroma (n = 1). We observed two minor complications: one postoperative hemorrhage with subsequent hematoma that was managed conservatively, and one nipple–areola complex malposition that underwent revision surgery. All patients were satisfied with the aesthetic and functional result.

Conclusions:

The octopus head dermoglandular flap has proved to be a safe and reliable option for breast tissue rearranging after implant removal, providing a good and stable cosmetic result, a low complication rate, and high patient-reported satisfaction.
INTRAVITREAL 0.18-mg FLUOCINOLONE ACETONIDE IMPLANT FOR PEDIATRIC UVEITIS
Authors: Wangyu Stephanie , Jung Jennifer L. , Pecen Paula E. , Palestine Alan G. , Reddy Amit K.
Published: June 2024

Purpose:

This study reports the outcomes of the 0.18-mg intravitreal fluocinolone acetonide implant in the treatment of pediatric noninfectious uveitis.

Methods:

A retrospective cohort study was performed on patients under 18 years old who received fluocinolone acetonide implant between June 1, 2020 and March 1, 2023. Data collected included demographics, uveitis diagnosis, use of anti-inflammatory therapy, visual acuity, intraocular pressure, and grading of uveitis activity. Uveitis recurrence was defined as increased inflammation that required additional anti-inflammatory therapy.

Results:

Eleven eyes from seven patients were included in this study. One patient (one eye) had a diagnosis of immune recovery uveitis and the remaining six patients (10 eyes) had pars planitis. The rate of remaining recurrence-free was 82% at 6 months, 60% at 12 months, and 60% at 24 months. Two of the six phakic eyes at baseline required cataract extraction during follow-up. Two of the four eyes that did not have intraocular pressure-lowering surgery before implantation required surgery in follow-up.

Conclusion:

The 0.18-mg fluocinolone acetonide implant has a similar efficacy for the treatment of pediatric uveitis, particularly pars planitis, as in the adult population, although with higher rates of ocular hypertension requiring intervention.
A Quality Initiative to Improve Appropriate Medication Dosing in Pediatric Patients with Obesity
Authors: Cloyd Colleen P. , Macedone Danielle , Merandi Jenna , Pierson Shawn , Sellas Wcislo Maria , Lutmer Jeffrey , MacDonald Jennifer , Ayad Onsy , Kalata Lindsay , Thompson R. Zachary
Published: June 2024

Introduction:

Emerging evidence supports the use of alternative dosing weights for medications in patients with obesity. Pediatric obesity presents a particular challenge because most medications are dosed based on patient weight. Additionally, building system-wide pediatric obesity safeguards is difficult due to pediatric obesity definitions of body mass index-percentile-for-age via the Center for Disease Control growth charts. We describe a quality initiative to increase appropriate medication dosing in inpatients with obesity. The specific aim was to increase appropriate dosing for 7 high-risk medications in inpatients with obesity ≥2 years old from 37% to >74% and to sustain for 1 year.

Methods:

The Institute for Healthcare Improvement model for improvement was used to plan interventions and track outcomes progress. Interventions included a literature review to establish internal dosing guidance, electronic health record (EHR) functionality to identify pediatric patients with obesity, a default selection for medication weight with an opt-out, and obtaining patient heights in the emergency department.

Results:

Appropriate dosing weight use in medication ordered for patients with obesity increased from 37% to 83.4% and was sustained above the goal of 74% for 12 months.

Conclusions:

Implementation of EHR-based clinical decision support has increased appropriate evidence-based dosing of medications in pediatric and adult inpatients with obesity. Future studies should investigate the clinical and safety implications of using alternative dosing weights in pediatric patients.
Dermatofibrosarcoma Protuberans in “Slow Mohs-tion”: Multidisciplinary Approach of A Pediatric Dermatofibrosarcoma Protuberans of the Scalp with Slow Mohs Micrographic Surgery and A Double Rotational-Advancement Scalp Flap
Authors: Lindemann Cameron B. , Miladi Anis , Ortiz Kenneth
Published: June 2024

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft-tissue sarcoma with primary incidence of 4.1 per million person-years and accounts for 0.1% of all malignancies. In patients under the age of 19, DFSP comprises 6% of cases with an annual incidence of 1 in 1,000,000. It is a slow-growing malignancy with low metastatic potential. However, DFSP is notable for its high rates of local recurrence due to local invasion with its classic “finger-like” projections into normal tissue. We discuss a case of dermatofibrosarcoma protuberans on the scalp of a 14-year-old male with delayed diagnosis, which required extensive resection through slow Mohs Micrographic Surgery (sMMS). This resection created a sizeable scalp defect of nearly 100 cm2, which mandated creative reconstruction using a novel double rotational-advancement scalp flap to close the defect while maintaining the patient’s hairline for optimal cosmesis.
Dermoid Cysts on the Floor of the Mouth
Authors: Yeom Sujung , Lee Dong Hoon , Lim Sang Chul
Published: June 2024

Objective:

The authors analyzed the clinical features and treatment results of surgical patients with a final diagnosis of dermoid cyst on the floor of the mouth over 14 years at our hospital.

Patients and Methods:

A total of 5 patients with a final diagnosis of dermoid cyst of the floor of the mouth from January 2010 to December 2023 were enrolled.

Results:

All patients complained of swelling in the submentum or floor of the mouth. The mean tumor size was 4.2±1.0 cm. All patients underwent complete surgical resection. A transcervical approach was performed in 3 patients, and an intraoral approach was implemented in 2 patients. There were no major complications after surgery with either method. The follow-up period was 71.4±75.7 months. There was no disease recurrence during follow-up.

Conclusion:

Dermoid cysts rarely occur on the floor of the mouth but should be considered in the differential diagnosis of other oral cavity tumors. Dermoid cysts on the floor of the mouth can be safely removed using the current transoral approach without scarring or recurrence.
Evaluating the Success of ChatGPT in Addressing Patient Questions Concerning Thyroid Surgery
Authors: Şahin Şamil , Tekin Mustafa Said , Yigit Yesim Esen , Erkmen Burak , Duymaz Yasar Kemal , Bahşi İlhan
Published: June 2024

Objective:

This study aimed to evaluate the utility and efficacy of ChatGPT in addressing questions related to thyroid surgery, taking into account accuracy, readability, and relevance.

Methods:

A simulated physician-patient consultation on thyroidectomy surgery was conducted by posing 21 hypothetical questions to ChatGPT. Responses were evaluated using the DISCERN score by 3 independent ear, nose and throat specialists. Readability measures including Flesch Reading Ease), Flesch-Kincaid Grade Level, Gunning Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, and Automated Readability Index were also applied.

Results:

The majority of ChatGPT responses were rated fair or above using the DISCERN system, with an average score of 45.44 ± 11.24. However, the readability scores were consistently higher than the recommended grade 6 level, indicating the information may not be easily comprehensible to the general public.

Conclusion:

While ChatGPT exhibits potential in answering patient queries related to thyroid surgery, its current formulation is not yet optimally tailored for patient comprehension. Further refinements are necessary for its efficient application in the medical domain.
Optimal Timing for Initiation of Thromboprophylaxis After Hepatic Angioembolization
Authors: Collie Brianna L. , Lyons Nicole B. , Goddard Logan , Cobler-Lichter Michael D. , Delamater Jessica M. , Shagabayeva Larisa , Lineen Edward B. , Schulman Carl I. , Proctor Kenneth G. , Meizoso Jonathan P. , Namias Nicholas , Ginzburg Enrique
Published: June 2024

Objective:

To evaluate the optimal timing of thromboprophylaxis (TPX) initiation after hepatic angioembolization in trauma patients.

Background:

TPX after hepatic trauma is complicated by the risk of bleeding, but the relative risk after hepatic angioembolization is unknown.

Methods:

Patients who underwent hepatic angioembolization within 24 hours were retrospectively identified from the 2017 to 2019 American College of Surgeons Trauma Quality Improvement Project data sets. Cases with <24-hour length of stay and other serious injuries were excluded. Venous thromboembolism (VTE) included deep venous thrombosis and PE. Bleeding complications included hepatic surgery, additional angioembolization, or blood transfusion after TPX initiation. Differences were tested with univariate and multivariate analyses.

Results:

Of 1550 patients, 1370 had initial angioembolization. Bleeding complications were higher in those with TPX initiation within 24 hours (20.0% vs 8.9%, P<0.001) and 48 hours (13.2% vs 8.4%, P=0.013). However, VTE was higher in those with TPX initiation after 48 hours (6.3% vs 3.3%, P=0.025). In the 180 patients with hepatic surgery before angioembolization, bleeding complications were higher in those with TPX initiation within 24 hours (72% vs 20%, P <0.001), 48 hours (50% vs 17%, P<0.001), and 72 hours (37% vs 14%, P=0.001). Moreover, deep venous thrombosis was higher in those with TPX initiation after 96 hours (14.3% vs 3.1%, P =0.023).

Conclusions:

This is the first study to address the timing of TPX after hepatic angioembolization in a national sample of trauma patients. For these patients, initiation of TPX at 48 to 72 hours achieves the safest balance in minimizing bleeding while reducing the risk of VTE.

Level of Evidence

Level III—retrospective cohort study.
Tumor Mutational Burden From Circulating Tumor DNA Predicts Recurrence of Hepatocellular Carcinoma After Resection
Authors: Wehrle Chase J. , Hong Hanna , Kamath Suneel , Schlegel Andrea , Fujiki Masato , Hashimoto Koji , Kwon David Choon Hyuck , Miller Charles , Walsh R. Matthew , Aucejo Federico
Published: June 2024

Objective:

Describe the utility of circulating tumor DNA in the postoperative surveillance of hepatocellular carcinoma (HCC).

Background:

Current biomarkers for HCC like alpha-fetoprotein (AFP) are lacking. Circulating tumor DNA (ctDNA) has shown promise in colorectal and lung cancers, but its utility in HCC remains relatively unknown.

Methods:

Patients with HCC undergoing curative-intent resection from November 1, 2020, to July 1, 2023, received ctDNA testing using the Guardant360 platform. Tumor mutational burden (TMB) is calculated as the number of somatic mutations-per-megabase of genomic material identified.

Results:

Forty-seven patients had postoperative ctDNA testing. The mean follow-up was 27 months, and the maximum was 43.2 months. Twelve patients (26%) experienced recurrence. Most (n=41/47, 87.2%) had identifiable ctDNA postoperatively; 55.3% (n=26) were TMB-not detected versus 45.7% (n=21) TMB-detectable. Postoperative identifiable ctDNA was not associated with RFS (P=0.518). Detectable TMB was associated with reduced RFS (6.9 vs 14.7 mo, P=0.049). There was a higher rate of recurrence in patients with TMB (n=9/21, 42.9%, vs n=3/26, 11.5%, P=0.02). Area under the curve for TMB-prediction of recurrence was 0.752 versus 0.550 for AFP. ROC analysis established a TMB cutoff of 4.8mut/mB for predicting post-operative recurrence (P=0.002) and RFS (P=0.025). AFP was not correlated with RFS using the lab-normal cutoff (<11 ng/mL, P=0.682) or the cutoff established by ROC analysis (≥4.6 ng/mL, P=0.494). TMB-high was associated with poorer RFS on cox-regression analysis (hazard ratio=5.386, 95% CI: 1.109–26.160, P=0.037), while microvascular invasion (P=0.853) and AFP (P=0.439) were not.

Conclusions:

Identifiable TMB on postoperative ctDNA predicts HCC recurrence and outperformed AFP in this cohort. Perioperative ctDNA may be a useful surveillance tool following curative-intent hepatectomy. Larger-scale studies are needed to confirm this utility and investigate additional applications in HCC patients, including the potential for prophylactic treatment in patients with residual TMB after resection.
Executive Function as an Underlying Mechanism of Alcohol Use, Aggression, and ADHD
Authors: Spychala Kellyn M. , Friedman Naomi P. , Gizer Ian R.
Published: June 2024

Background

Executive functioning (EF) has been proposed as a transdiagnostic risk factor for externalizing disorders and behavior more broadly, including attention-deficit/hyperactivity disorder (ADHD), aggression, and alcohol use. Previous research has demonstrated both phenotypic and genetic overlap among these behaviors, but has yet to examine EF as a common causal mechanism. The current study examined reciprocal causal associations between EF and several externalizing behaviors using a Mendelian randomization (MR) approach.

Methods

Two-sample MR was conducted to test causal associations between EF and externalizing behaviors. Summary statistics from several genome-wide association studies (GWASs) were used in these analyses, including GWASs of EF, ADHD diagnostic status, drinks per week, aggressive behavior, and alcohol use disorder (AUD) diagnostic status. Multiple estimation methods were employed to account for horizontal pleiotropy (e.g., inverse variance weighted, MR-PRESSO, MR-MIX).

Results

EF demonstrated significant causal relationships with ADHD (P < 0.01), AUD (P < 0.03), and alcohol consumption (P < 0.01) across several estimation methods. Reciprocally, ADHD showed a significant causal influence on EF (P < 0.03). Nonetheless, caution should be used when interpreting these findings as there was some evidence for horizontal pleiotropy in the effect of EF on ADHD and significant heterogeneity in variant effects in the other relations tested. There were no significant findings for aggression.

Conclusions

Findings suggest that EF may be a causal mechanism underlying some externalizing behaviors, including ADHD and alcohol use, and that ADHD may also lead to lower performance on EF tasks.
Fostering inclusivity: Navigating loneliness and wellbeing among Nigerian international students in the UK Higher Education
Authors: Ajibade Benjamin O. , Mwalillanda Petronella
Published: June 2024

Background

Loneliness is a state of solitude or being alone. Research addressing loneliness has increased dramatically over the past two decades; however, despite the psychological state risks related to being lonely, the connection between loneliness and mental health disorders still needs to be sufficiently explored. Loneliness is when one’s relationships do not meet the psychosocial needs and expectations. Loneliness is a state of emotion that can be a barrier to social development and, at the same time, impact physical health and mental state. However, loneliness may be a distressing and pervasive experience, defined as the feeling that one’s desired quantity or quality of the social connection is unfulfilled.

Method

A qualitative primary research study was conducted for this study. The participants were selected using the purposive sampling method, and 8 participants of Nigerian origin were interviewed for this research. The participants interviewed were of Yoruba, Benin and Igbo origin; therefore, the results cannot represent the entire Nigerian population because it is missing the Hausa tribe. The data were analysed using the thematic analysis method. Ethical approval was obtained from the institution.

Results

The most salient themes were Voices of Loneliness: International Students’ Coping Strategies and Personal Journeys; Building Bridges: The Role of Community and Social Networks in Overcoming Loneliness; Exploring the Emotional Turmoil and Coping Mechanisms in a Foreign Landscape; Navigating New Realities: The Integration and Adaptation Challenges of International Students and Navigating Loneliness and Seeking Connection. The results showed that feelings of loneliness could result from emotional, psychological, or mental health and the problematic aspect of adaptation to the UK weather, as this greatly impacted their studies. Therefore, emphasis should be placed on understanding each student’s cultural background, assisting international students in examining their bicultural realities to recognise how clients internalise and adhere to culture considering their Nigerian cultural identities and values.
Galápagos yellow warblers differ in behavioural plasticity in response to traffic noise depending on proximity to road
Authors: Hohl Leon , Yelimlieş Alper , Akçay Çağlar , Kleindorfer Sonia
Published: June 2024

Acoustic communication between animals is increasingly disrupted by noise in human-altered environments making signals less effective. Birdsong is a signal used in agonistic interactions between territorial rivals, and birds may modify their song and singing behaviour in response to noise. However, if these modifications are still ineffective, this can lead to increased conflict between rivals. Here, we asked whether experimental traffic noise induces immediate changes in acoustic characteristics of song and aggressive behaviour in populations and territories that differ greatly in traffic noise exposure. We conducted simulated territorial intrusions on Galápagos yellow warblers (Setophaga petechia aureola) living on Santa Cruz (high traffic) and Floreana (low traffic) islands. Territories were either adjacent to the nearest road or at least 100 m away from it. We assessed the focal birds’ physical response levels and recorded their vocalisations in response to playback of conspecific song (control) and conspecific song coupled with traffic noise (noise treatment). We found that physical response levels mostly depended on treatment and distance to the nearest road: on both islands, birds living adjacent to the nearest road increased their aggression levels with experimental noise compared to control, while birds living farther away decreased their aggression levels. Birds on all islands irrespective of their distance to a road increased minimum frequency of their songs during the noise treatment. However, change in peak frequency and duration of their songs depended on the habitat they live in. Our results suggest behavioural flexibility in territorial responses and birdsong in response to traffic noise, which appears to depend at least in part on prior experience with traffic noise.

Highlights

Galápagos yellow warblers modified their behaviour in response to traffic noise.

Behavioural plasticity depended on the island and distance to the nearest road.

Birds living close to a road increased their aggression in response to an intruder

Birds living farther away from a road decreased their aggression.
Landmark knowledge overrides optic flow in honeybee waggle dance distance estimation
Authors: Menzel Randolf , Galizia C. Giovanni
Published: June 2024

Honeybees encode in their waggle dances the vector (distance and direction) of an outbound flight to a food source or a new nest side. Optic flow has been identified as the major source of information in the distance estimation. Additional components of distance estimation were also identified, e.g. the sequence of experienced landmarks. Here we address the question of whether bees also use the landscape memory developed during exploratory orientation flights to estimate distance. We took advantage of the fact that flights in a narrow tunnel lead to further distance measures due to higher optic flow. We find that this effect is lost when bees had explored the area in which the tunnel is located and when they have somewhat restricted visual access to the surrounding environment through the mesh on top of the tunnel. These data are interpreted in the context of other findings about the structure of navigational memory in bees that develops during exploratory orientation flights. In particular, the data suggest that bees embed distance measures into a representation of navigational space that stores previously experienced landscape features.

Summary statement

The distance code in the honeybee waggle dance is embedded in the landscape memory that bees establish during their exploratory and their foraging flights.
Pro-oxidant influence of quercetin supplementation inSaccharomyces cerevisiae
Authors: Carrillo-Garmendia Andres , Vaca-Martinez Ana Leticia , Carmona-Moreno Blanca Lucia , González-Hernández Juan Carlos , Granados-Arvizu Jose Angel , Arvizu-Medrano Sofia Maria , Gracida Jorge , Nava Gerardo M. , Regalado-Gonzalez Carlos , Madrigal-Perez Luis Alberto
Published: June 2024

How could quercetin exert a pro-survival phenotype (antioxidant) in mammalian cells while toxic to other eukaryotic cells? The redox capacity of quercetin may explain its antioxidant and toxic effects, based on the idea that quercetin impairs the electron transport chain, affecting ATP production and forming quercetin-derived free radicals. Herein, we provide evidence that quercetin supplementation: 1) depolarizes the mitochondrial membrane and augments the ADP/ATP ratio; 2) increases superoxide anion cellular levels; 3) changes the cellular response to H2O2challenge associated with the antioxidant cellular response; 4) sensitizes the cellular response to lipoperoxidation challenge, and 5) augments cardiolipin levels. These events suggest that the quercetin pro-oxidant effect is related to mitochondrial respiration dysfunction and could induce cellular antioxidant response.
COMMD10 Regulates Endosomal Recycling of Epithelial Sodium Channel (ENaC)
Authors: Rasulov Sahib R. , McDonald Fiona J.
Published: June 2024

The epithelial sodium channel (ENaC) plays an essential role in the regulation of sodium transport in distal nephron. ENaC cell surface population of renal principal cells is tightly regulated by hormones such as aldosterone and vasopressin through protein trafficking pathways that translocate ENaC to and from the cell surface. Internalized ENaC from the plasma membrane follows the degradative pathway promoted by ubiquitin fusion or the recycling pathway after deubiquitination and sorting on early endosomes. The mechanism by which ENaC is recycled back to the plasma membrane through regulated recycling is less known. Here, we show that regulated recycling of ENaC is strictly dependent on COMMD10 and localization pattern of COMMD10 on Rab5, −7, and −11 vesicles is similar to that of WASH and Arp2/3. Furthermore, here we report that COMMD1 and −10 protein levels are regulated by aldosterone and calcium. This study proposes that for regulated recycling of ENaC, conventional endosomal sorting and recycling complexes such as CCC complex are recruited.

Highlights

COMMD10 alters ENaC cell surface population through the regulated recycling pathway. COMMD10 localizes on Rab5-, Rab7-, and Rab11-positive endosomes in a similar pattern as endosomal actin polymerization complexes WASH and Arp2/3. Aldosterone downregulates COMMD1 and −10 protein levels while calcium upregulates COMMD10 protein level.

Graphical Abstract
Generation and control of nonlocal chiral currents in graphene superlattices by orbital Hall effect
Authors: Salvador-Sánchez Juan , Canonico Luis M. , Pérez-Rodríguez Ana , Cysne Tarik P. , Baba Yuriko , Clericò Vito , Vila Marc , Vaquero Daniel , Delgado-Notario Juan Antonio , Caridad José M. , Watanabe Kenji , Taniguchi Takashi , Molina Rafael A. , Domínguez-Adame Francisco , Roche Stephan , Diez Enrique , Rappoport Tatiana G. , Amado Mario
Published: June 2024

Graphene-based superlattices offer a unique materials playground to exploit and control a higher number of electronic degrees of freedom, such as charge, spin, or valley for disruptive technologies. Recently, orbital effects, emerging in multivalley band structures lacking inversion symmetry, have been discussed as possible mechanisms for developing . Here, we report nonlocal transport measurements in small gap hBN/graphene/hBN moiré superlattices which reveal very strong magnetic field-induced chiral response which is stable up to sizable temperatures. The measured sign dependence of the nonlocal signal with respect to the magnetic field orientation clearly indicates the manifestation of emerging orbital magnetic moments. The interpretation of experimental data is well supported by numerical simulations, and the reported phenomenon stands as a formidable way of manipulation of the transverse flow of orbital information that could enable the design of orbitronic devices.

Published by the American Physical Society
2024