bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic and molecular landscapes of the generalist phytopathogen Botrytis cinerea
Authors: Singh Ritu , Caseys Celine , Kliebenstein Daniel J.
Published: December 2023

Botrytis cinerea Pers. Fr. (teleomorph: Botryotinia fuckeliana) is a necrotrophic fungal pathogen that attacks a wide range of plants. This updated pathogen profile explores the extensive genetic diversity of B. cinerea, highlights the progress in genome sequencing, and provides current knowledge of genetic and molecular mechanisms employed by the fungus to attack its hosts. In addition, we also discuss recent innovative strategies to combat B. cinerea.

Taxonomy

Kingdom: Fungi, phylum: Ascomycota, subphylum: Pezizomycotina, class: Leotiomycetes, order: Helotiales, family: Sclerotiniaceae, genus: Botrytis, species: cinerea.

Host range

B. cinerea infects almost all of the plant groups (angiosperms, gymnosperms, pteridophytes, and bryophytes). To date, 1606 plant species have been identified as hosts of B. cinerea.

Genetic diversity

This polyphagous necrotroph has extensive genetic diversity at all population levels shaped by climate, geography, and plant host variation.

Pathogenicity

Genetic architecture of virulence and host specificity is polygenic using multiple weapons to target hosts, including secretory proteins, complex signal transduction pathways, metabolites, and mobile small RNA.

Disease control strategies

Efforts to control B. cinerea, being a high‐diversity generalist pathogen, are complicated. However, integrated disease management strategies that combine cultural practices, chemical and biological controls, and the use of appropriate crop varieties will lessen yield losses. Recently, studies conducted worldwide have explored the potential of small RNA as an efficient and environmentally friendly approach for combating grey mould. However, additional research is necessary, especially on risk assessment and regulatory frameworks, to fully harness the potential of this technology.
Eragrostis shrirangiisp. nov. (Poaceae) from Uttar Pradesh, India
Authors: Lohit Tushar Anilrao , Wagh Vijay Vishnu
Published: December 2023

Eragrostris shrirangii(Poaceae), a new species from the Agra district of Uttar Pradesh, India, is described and illustrated. A morphological comparison ofE. shrirangiiand the closely related speciesE. henryiandE. minoris provided. In addition, habitat details, a distribution map and the conservation status of the new species are given.
New species and new record of the genus Poa L. (Poaceae, Pooideae, Poeae) from India
Authors: Sharma Sangam , Prasad Dileshwar , Jaiswal Shubham , Agnihotri Priyanka
Published: December 2023

Poa sachensis, a new species from the Sach Pass, Western Himalaya, is described and illustrated. It is a member of P. subg. Ochlopoa sect. Alpinae, and closely allied to P. alpina, but differs from the latter by its lower glume one‐nerved, callus scantly hairy, lemma (3.87–) 4.18–4.54 (–4.65) mm long, purplish, surface between nerves glabrous, palea proliferate and keels ciliate 1/2nd to 1/3rd part, and two stamens in fertile floret with anther (2.42–) 2.67–3.08 (–3.21) mm long. Further, we have added P. diaphora var. alpina for the first time to the flora of India based on specimens collected from the semiarid habitats of Spiti Valley. Information on the distribution, habitat, flowering, and fruiting cycles is provided along with a distribution map for each taxon.

Keywords: alpine grasses, Poa alpina, P. subg. Pseudopoa, P. subg. Ochlopoa, Western Himalaya
Sir2‐mediated cytoplasmic deacetylation facilitates pathogenic fungi infection in host plants
Authors: Zhang Ning , Hu Jicheng , Liu Zhishan , Liang Wenxing , Song Limin
Published: December 2023

Lysine acetylation is an evolutionarily conserved and widespread post‐translational modification implicated in the regulation of multiple metabolic processes, but its function remains largely unknown in plant pathogenic fungi.

A comprehensive analysis combined with proteomic, molecular and cellular approaches was presented to explore the roles of cytoplasmic acetylation in Fusarium oxsysporum f.sp. lycopersici (Fol).

The divergent cytoplasmic deacetylase FolSir2 was biochemically characterized, which is contributing to fungal virulence. Based on this, a total of 1752 acetylated sites in 897 proteins were identified in Fol via LC–MS/MS analysis. Further analyses of the quantitative acetylome revealed that 115 proteins representing two major pathways, translational and ribosome biogenesis, were hyperacetylated in the ∆Folsir2 strain. We experimentally examined the regulatory roles of FolSir2 on K271 deacetylation of FolGsk3, a serine/tyrosine kinase implicated in a variety of cellular functions, which was found to be crucial for the activation of FolGsk3 and thus modulated Fol pathogenicity. Cytoplasmic deacetylation by FolSir2 homologues has a similar function in Botrytis cinerea and likely other fungal pathogens.

These findings reveal a conserved mechanism of silent information regulator 2‐mediated cytoplasmic deacetylation that is involved in plant‐fungal pathogenicity, providing a candidate target for designing broad‐spectrum fungicides to control plant diseases.
Group‐specific redistribution, inequality, and subjective well‐being in China
Authors: Deng Peihua , Schöb Ronnie
Published: December 2023

Using survey data from the China Family Panel Studies (CFPS) from 2010 to 2018, this paper analyzes the relationship between income inequality, group‐specific income redistribution, and subjective well‐being among China's urban, rural, and migrant populations. Income redistribution significantly reduces the within‐group inequality for urban residents while widening the income gap among urban residents, rural residents, and migrants. Using narrowly defined reference groups, our findings indicate that there is no significant correlation of within‐group inequality and subjective well‐being of the respective group members. By contrast, the increased income gap between urban and rural residents is positively correlated with the rural residents' subjective well‐being. More importantly, the group‐specific redistribution inherent in the Hukou system that widens the income gap between urban residents and both migrants and rural residents makes both the aforementioned worse off. The existing Hukou system thus bars the way to implement the concept of “common prosperity” of the Chinese government that aims to foster a more balanced and sustainable development.
Psychological science and its societal mission during the SARS‐CoV‐2 pandemic: The Motivation Barometer as an evidence‐informed policy instrument in Belgium
Authors: Vansteenkiste Maarten , Waterschoot Joachim , Morbée Sofie , Van Oost Pascaline , Schmitz Mathias , Klein Olivier , Luminet Olivier , Yzerbyt Vincent , Van den Bergh Omer
Published: December 2023

Upon the outbreak of the SARS‐CoV‐2 virus, it was clear that the pandemic would not only entail physical but also psychological challenges and threats to individuals’ sustained motivation, behavioral adherence, and mental health. To encourage the Belgian authorities to take these psychological aspects into account, the Motivation Barometer, a large‐scale and dynamic survey, was launched in March 2020. Its purpose was to monitor cognitive, affective, and behavioral aspects of citizens’ functioning across the pandemic, with special attention given to motivational and social factors. In the present review, we provide a description of the methodology of the Motivation Barometer, we synthesize the key findings emerging from the Motivation Barometer, we clarify how these findings were used in practice to the benefit of different societal stakeholders (i.e., the broader public, policymakers, intermediate‐level organizations, and media), and we highlight its potential contribution for the management of other societal challenges (e.g., climate change, well‐being). We conclude that the Motivation Barometer was a critical policy instrument during the SARS‐CoV‐2 pandemic in Belgium. It helped to bridge the gap between social scientists, policymakers, the media, and the general public, and, as such, allowed to demonstrate the incremental value of psychological sciences for society.
Predictors of prejudice towards childfree individuals in Poland
Authors: Ciesielski Paweł
Published: December 2023

Individuals who choose to be childfree often face misunderstanding and a lack of acceptance from others. In many cases, this results in negative attitudes, followed by discrimination and prejudice. There have been few studies that would allow us to determine which features are responsible for treating childfree individuals with prejudice. This study aimed to explore the effect of five possible features that could influence others' prejudice towards childfree individuals: collective narcissism, right‐wing authoritarianism, religiosity, political beliefs, and generativity. The study was conducted in Poland among 229 participants (age 19–59, M = 30.23; SD = 6.72). Commonality analysis was performed which allowed us to isolate both unique and common effects of possible predictors on the dependent variable (prejudice). Right‐wing authoritarianism, political beliefs, and collective narcissism had both a unique and common effect on the dependent variable. Religiosity only had a common effect on prejudice, whereas generativity had no effect (neither common nor unique) on the dependent variable. The total explained variance of the dependent variable was R2 = 0.46. The study isolated four predictors of prejudice towards childfree individuals: right‐wing authoritarianism, political beliefs, collective narcissism, and religiosity. This provides a better understanding of the possible origin of prejudice towards childfree individuals and allows us to explore the relation between these predictors in the future. These results can be used to promote more positive attitudes towards childfree individuals as well as create more targeted actions to tackle the prejudice towards them.
An Empirical Model and Feedforward Control of Laser Powder Bed Fusion
Authors: Shkoruta Aleksandr , Park Bumsoo , Mishra Sandipan
Published: December 2023

Reliable process control for the laser powder bed fusion process, especially at the melt pool scale, remains an open challenge. One of the reasons for this is the lack of suitable control-oriented models and associated control design strategies. To address this issue, this paper (1) identifies an empirical control-oriented model of geometry-dependent melt pool behavior and (2) experimentally demonstrates melt pool regulation with a feedforward controller for laser power based on this model. First, the study establishes that the melt pool signature increases as the scan lines decrease in length. An empirical model of this behavior is developed and validated on different geometries at varying laser power levels. Second, the model is used to design a line-to-line feedforward controller that provides an optimal laser power sequence for a given geometry. Finally, this controller is validated experimentally and is demonstrated to suppress the in-layer geometry-related melt pool signal deviations for different test geometries.
The first days of diagnostic ultrasound
Authors: Mast T. Douglas
Published: December 2023

The Reflections series takes a look back on historical articles from The Journal of the Acoustical Society of America that have had a significant impact on the science and practice of acoustics.
Structural and functional evolution of the mechanosensory lateral line system of fishes
Authors: Webb Jacqueline F.
Published: December 2023

The mechanosensory lateral line system is the flow sensing system present in all 34 000+ species of fishes. Its neuromast receptor organs, located on the skin or in bony canals on the head and tubed scales on the trunk, respond to the near field component of acoustic stimuli as well as short range, low frequency (0–200 Hz) water flows of biotic and abiotic origin. Here, I discuss the genesis of my research career and its focus on the structural and functional evolution of the lateral line system among a wide taxonomic range of fishes including those from different aquatic habitats (tropical lakes to coral reefs and the deep sea). I discuss the importance of investigating structure before function, using investigations in my laboratory that had unexpected outcomes, as well as the role of serendipity in the evolution of a career and in the nature of scientific discovery.
Effects of Timing and Types of Protein Supplementation on Improving Muscle Mass, Strength, and Physical Performance in Adults Undergoing Resistance Training: A Network Meta-Analysis
Authors: Zhou Huan-Huan , Liao Yuxiao , Zhou Xiaolei , Peng Zhao , Xu Shiyin , Shi Shaojun , Liu Liegang , Hao Liping , Yang Wei
Published: December 2023

Precise protein supplementation strategies for muscle improvement are still lacking. The timing or type of protein supplementation has been debated as a window of opportunity to improve muscle mass, strength, and physical performance. We conducted a network meta-analysis of randomized controlled trials with protein supplements and resistance training. PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases were searched until May 1, 2023. We included 116 eligible trials with 4,711 participants that reported on 11 timing and 14 types of protein supplementation. Compared with placebo, protein supplementation after exercise (mean difference [MD]: 0.54 kg [95% confidence intervals 0.10, 0.99] for fat-free mass, MD: 0.34 kg [95% confidence intervals 0.10, 0.58] for skeletal muscle mass) and at night (MD: 2.85 kg [0.49, 5.22] for handgrip strength, MD: 12.12 kg [3.26, 20.99] for leg press strength) was most effective in improving muscle mass and strength, respectively (moderate certainty). Milk proteins (milk, whey protein, yogurt, casein, and bovine colostrum), red meat, and mixed protein were effective for gains in both muscle mass and strength (moderate certainty). No timing or type of protein showed a significant enhancement in physical performance (timed up-to-go test, 6-min walk test, and gait speed). Pre/postexercise and Night are key recommended times of protein intake to increase muscle mass and strength, respectively. Milk proteins are the preferred types of protein supplements for improving muscle mass and strength. Future randomized controlled trials that directly compare the effects of protein timing or types are needed. This trial was registered at International Prospective Register of Systematic Reviews as CRD42022358766.
Excess mortality in U.S. prisons during the COVID-19 pandemic
Authors: Sugie Naomi F. , Turney Kristin , Reiter Keramet , Tublitz Rebecca , Kaiser Daniela , Goodsell Rebecca , Secrist Erin , Patil Ankita , Jiménez Monik
Published: December 2023

U.S. prisons were especially susceptible to COVID-19 infection and death; however, data limitations have precluded a national accounting of prison mortality (including but not limited to COVID-19 mortality) during the pandemic. Our analysis of mortality data collected from public records requests (supplemented with publicly available data) from 48 Departments of Corrections provides the most comprehensive understanding to date of in-custody mortality during 2020. We find that total mortality increased by 77% in 2020 relative to 2019, corresponding to 3.4 times the mortality increase in the general population, and that mortality in prisons increased across all age groups (49 and under, 50 to 64, and 65 and older). COVID-19 was the primary driver for increases in mortality due to natural causes; some states also experienced substantial increases due to unnatural causes. These findings provide critical information about the pandemic’s toll on some of the country’s most vulnerable individuals while underscoring the need for data transparency and standardized reporting in carceral settings.
A general and robust Ni-based nanocatalyst for selective hydrogenation reactions at low temperature and pressure
Authors: Hu Yue , Liu Mingyang , Bartling Stephan , Lund Henrik , Atia Hanan , Dyson Paul J. , Beller Matthias , Jagadeesh Rajenahally V.
Published: December 2023

Catalytic hydrogenations are important and widely applied processes for the reduction of organic compounds both in academic laboratories and in industry. To perform these reactions in sustainable and practical manner, the development and applicability of non-noble metal–based heterogeneous catalysts is crucial. Here, we report highly active and air-stable nickel nanoparticles supported on mesoporous silica (MCM-41) as a general and selective hydrogenation catalyst. This catalytic system allows for the hydrogenation of carbonyl compounds, nitroarenes, N-heterocycles, and unsaturated carbon─carbon bonds in good to excellent selectivity under very mild conditions (room temperature to 80°C, 2 to 10 bar H
2
). Furthermore, the optimal nickel/meso–silicon dioxide catalyst is reusable (4 cycles) without loss of its catalytic activity.
Structural principles of peptide-centric chimeric antigen receptor recognition guide therapeutic expansion
Authors: Sun Yi , Florio Tyler J. , Gupta Sagar , Young Michael C. , Marshall Quinlen F. , Garfinkle Samuel E. , Papadaki Georgia F. , Truong Hau V. , Mycek Emily , Li Peiyao , Farrel Alvin , Church Nicole L. , Jabar Shereen , Beasley Matthew D. , Kiefel Ben R. , Yarmarkovich Mark , Mallik Leena , Maris John M. , Sgourakis Nikolaos G.
Published: December 2023

Peptide-centric chimeric antigen receptors (PC-CARs) recognize oncoprotein epitopes displayed by cell-surface human leukocyte antigens (HLAs) and offer a promising strategy for targeted cancer therapy. We have previously developed a PC-CAR targeting a neuroblastoma-associated PHOX2B peptide, leading to robust tumor cell lysis restricted by two common HLA allotypes. Here, we determine the 2.1-angstrom crystal structure of the PC-CAR–PHOX2B–HLA-A*24:02–β
2
m complex, which reveals the basis for antigen-specific recognition through interactions with CAR complementarity-determining regions (CDRs). This PC-CAR adopts a diagonal docking mode, where interactions with both conserved and polymorphic HLA framework residues permit recognition of multiple HLA allotypes from the A9 serological cross-reactive group, covering a combined global population frequency of up to 46.7%. Biochemical binding assays, molecular dynamics simulations, and structural and functional analyses demonstrate that high-affinity PC-CAR recognition of cross-reactive pHLAs necessitates the presentation of a specific peptide backbone, where subtle structural adaptations of the peptide are critical for high-affinity complex formation, and CAR T cell killing. Our results provide a molecular blueprint for engineering CARs with optimal recognition of tumor-associated antigens in the context of different HLAs, while minimizing cross-reactivity with self-epitopes.
A high-quality genome of an undescribed
Flavobacterium
species uncovered using Q20+ Nanopore chemistry
Authors: Hofer Cyrill , Wälchli Denise , Moncadas Lucas Serra , Rain-Franco Angel , Andrei Adrian-Stefan
Published: December 2023

Herein, we document the complete genome of the
Flavobacterium
strain ZE23DGlu08, isolated from Lake Zurich, Switzerland. The circular genome was assembled using long-read Nanopore data (coverage: 226×) with the Q20+ chemistry. The described strain displays a genome size of ~3.9 Mbp with a GC content of 34%.
Draft genome sequence of
Lactiplantibacillus plantarum
KCKM 0106, isolated from mustard leaf kimchi
Authors: Ko Hye In , Kim So-Rim , Jeong Chae-Rim , Lee Moeun , Eun Jong-Bang , Kim Tae-Woon
Published: December 2023

Lactiplantibacillus plantarum
KCKM 0106, isolated from mustard leaf kimchi, demonstrates probiotic properties, such as acid tolerance and adhesion to intestinal epithelial cells. We present the draft genome sequence of
L. plantarum
KCKM 0106, comprising 3,328,662 bp and 44.4% GC content.
Draft genome sequence of
Mannheimia haemolytica
strain Oliden, isolated from a calf lung infection in Argentina
Authors: Franchi Agustín , Fazzio Luis , Fernandez Julieta , Sisti Federico
Published: December 2023

We present the draft genome sequence of a
Mannheimia haemolytica
strain isolated from a postmortem lung lesion from a calf diagnosed with bovine respiratory disease. The genome sequence was 2,749,707-bp long with 2,909 putative protein-encoding genes.
Insight into bacterial and archaeal community structure ofSuaeda altissimaandSuaeda dendroidesrhizosphere in response to different salinity level
Authors: Wang Qiqi , He Dalun , Zhang Xinrui , Cheng Yongxiang , Sun Yanfei , Zhu Jianbo
Published: December 2023

Suaedaas a halophyte with wide adaptability of salinization level plays an important role in saline soil improvement and management. To some extent, the strong salt tolerance ofSuaedais influenced by rhizobacteria. However, the effect of differentSuaedaspecies and salinization level on the microbial community diversity still unknown. In our study, high-throughput sequencing technology was used to explore the difference in the bacterial and archaeal community diversity ofSuaeda altissimaandSuaeda dendroidesrhizosphere under high (EC, 8–16 dS/m) and severe (EC > 16 dS/m) saline soil. The result showed that complex soil environment andSuaedaspecies co-shaped bacterial and archaeal community structure, and pH was one of the most important driving factors. In addition, the increase of soil salinity significantly decreased the complexity of bacterial and archaeal co-occurrence network. We exploredHalomonasandCandidatus Nitrocosmicusas core microorganisms in theSuaedarhizosphere, which may play a key ecological role in improving salt tolerance and promoting growth ofSuaeda. Our study improves the macroscopic understanding of the interrelationships between soil environments-microbes-plants.

IMPORTANCE

Suaedaplay an important ecological role in reclamation and improvement of agricultural saline soil due to strong salt tolerance. At present, research onSuaedasalt tolerance mainly focuses on the physiological and molecular regulation. However, the important role played by microbial communities in the high-salinity tolerance ofSuaedais poorly studied. Our findings have important implications for understanding the distribution patterns and the driving mechanisms of different Suaeda species and soil salinity levels. In addition, we explored the key microorganisms that played an important ecological role inSuaedarhizosphere. We provide a basis for biological improvement and ecological restoration of salinity-affected areas.
A novel mRNA vaccine, TGGT1_278620 mRNA-LNP, prolongs the survival time in BALB/c mice with acute toxoplasmosis
Authors: Zhang Yizhuo , Li Shiyu , Chu Hongkun , Li Jing , Lu Shaohong , Zheng Bin
Published: December 2023

Toxoplasmosis is a global health issue; however, there is a lack of safe and effective drugs and vaccines. Herein, we developed a novel mRNA vaccine, TGGT1_278620 mRNA-lipid nanoparticle (LNP), and evaluated its safety and efficacy in BALB/c mice. The vaccine elicited a significant increase not only immunoglobulin (Ig)G and IgG subclasses (IgG2a and IgG1) antibodies but also interleukin (IL)-12, interferon-gamma, IL-4, and IL-10 cytokines. We showed that specific cellular immunity and humoral immunity were activated by combining splenocyte proliferation, cytotoxic T-cell activity, and T-cell surface molecule CD8 and CD4 ratios. Dendritic cell signaling pathway members interferon regulatory factor 8, T-Box 21, and nuclear factor kappa B were analyzed at the mRNA and protein levels, and increased differentiation and maturation were observed by examining dendritic cell surface molecules (CD83, CD86, MHC-I, and MHC-II) using flow cytometry. Finally, the survival time of the vaccinated mice was significantly prolonged after
Toxoplasma gondii
RH challenge, and the adoptive transfer of splenocytes and sera from the vaccinated mice also significantly prolonged survival. These findings suggested that the TGGT1_278620 mRNA-LNP vaccine might be a promising candidate for further development in anti-toxoplasmosis therapy.

IMPORTANCE

Toxoplasma gondii
, an obligate intracellular eukaryotic parasite, can infect about one-third of the world’s population. One vaccine, Toxovax, has been developed and licensed commercially; however, it is only used in the sheep industry to reduce the losses caused by congenital toxoplasmosis. Various other vaccine approaches have been explored, including excretory secretion antigen vaccines, subunit vaccines, epitope vaccines, and DNA vaccines. However, current research has not yet developed a safe and effective vaccine for
T. gondii
. Here, we generated an mRNA vaccine candidate against
T. gondii
. We investigated the efficacy of vaccination with a novel identified candidate, TGGT1_278620, in a mouse infection model. We screened
T. gondii
-derived protective antigens at the genome-wide level, combined them with mRNA-lipid nanoparticle vaccine technology against
T. gondii
, and investigated immune-related factors and mechanisms. Our findings might contribute to developing vaccines for immunizing humans and animals against
T. gondii
.
Rare presentation of pneumothorax in a young woman with underlying congenital pulmonary airway malformation
Authors: Shafiq Muhammad , Qadeer Tariq , Tentzeris Vasileios , Kastelik Jack
Published: December 2023

Congenital pulmonary airway malformation (CPAM) is the most common among a rare group of congenital anomalies of the lower respiratory tract. It has variable presentation depending on its subtype and the patient’s age. It may lead to respiratory distress in neonates. It can be a particularly challenging diagnosis in children born asymptomatic but present with complications later in life such as haemoptysis, recurrent chest infections, breathlessness and pneumothorax. Prenatal ultrasound, chest X-ray, CT scan and MRI are helpful in making a radiological diagnosis.

A woman in her late teens presented with shortness of breath and right pleuritic chest pain. CT’s chest showed a number of bullae of varying sizes on the right, including one huge bulla compressing all three lobes. She underwent lung volume reduction surgery via video-assisted thoracoscopy, and the histology specimen confirmed the diagnosis of CPAM type 1.
Embolism from a left ventricular myxoma presenting with acute limb ischaemia
Authors: Billones Aileen Rufo , Imperial Cindy Ruth , Gutierrez-Cayetano Maribel
Published: December 2023

Acute limb ischaemia (ALI) secondary to cardiac myxoma is uncommon. Embolic myxoma should be considered a differential diagnosis in young patients with ALI who do not have apparent cardiovascular risk factors. A multidisciplinary approach and comprehensive care can improve outcomes and optimise the collaborative treatment of ALI. Early referral to a hospital that can provide specialised treatment for ALI helps prevent significant tissue loss and surgical complications, such as amputation.

A man in his 20s presented with bilateral ALI of both lower extremities, and an arterial duplex scan revealed a thrombus occluding all arterial segments of the bilateral lower extremities. An intracardiac mass adherent to the apical and anterior interventricular septum on two-dimensional echocardiography suggested a complex myxoma. The patient was diagnosed with ALI Rutherford category III, and bilateral hip disarticulation was performed. The patient was discharged with an anticoagulant.
Severe complication after microwave thermoablation of a residual limb: multifocal full thickness cutaneous necrosis and deep venous thrombosis
Authors: Schieve Bailey , Belovs Laura , Potter Benjamin , Lannan Ford Michael
Published: December 2023

Patients with limb loss face the challenge of having an increased risk of skin disease at residual limb sites. Hyperhidrosis is a common concern for persons with amputation and excessive sweat can cause various skin pathology. Recently, microwave thermoablation (MT) was reported as an effective off-label treatment for hyperhidrosis in patients with limb loss. We present a case in which a patient following MT procedure for hyperhidrosis of a transtibial amputation developed multifocal full thickness cutaneous necrosis and deep venous thrombosis. The possible aetiologies of these complications are discussed including vascular congestion and external thermal injury.

Such a case warrants the attention of individuals and providers seeking to use MT for off-label purposes, particularly for patients with limb loss, due to the large treatment surface area and potential for temporary or permanent functional loss of the amputated limb.
Expedited awake tracheal intubation using ropivacaine topicalisation for the evacuation of a postoperative neck haematoma in the presence of lignocaine allergy
Authors: Martis Walston , Chahal Rani
Published: December 2023

Progressive airway compromise from a neck haematoma is a feared complication of head and neck surgery that can rapidly lead to death if not urgently intervened upon. We report a case of a patient developing a progressively expanding neck haematoma on the first postoperative night after parotidectomy and neck dissection for malignancy. Although he did not have respiratory compromise or stridor, ultrasound examination of his airway revealed marked tracheal deviation, and flexible nasoendoscopy showed significant supraglottic swelling. The decision was made for an awake fibreoptic intubation; however, a complicating factor was a history of lignocaine allergy. This case report describes the unconventional use of atomised ropivacaine in a concentration of 0.5% for topicalisation of the airway. Along with conscious sedation with remifentanil, ropivacaine provided excellent conditions for awake intubation, following which a significant amount of blood was evacuated from the face and neck.
Preventing cervical cancer: what are the risks and benefits of different treatments?
Authors: Saul Helen , Cassidy Samantha , Imison Candace , Athanasiou Antonios , Kyrgiou Maria
Published: December 2023

The study

Kyrgiou M, Athanasiou A, Cieslak-Jones D. Comparative effectiveness and risk of preterm birth of local treatments for cervical intraepithelial neoplasia and stage IA1 cervical cancer: a systematic review and network meta-analysis.
Lancet Oncol
2022;23:1097-108.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/prevention-of-cervical-cancer-what-are-the-risks-and-benefits-of-different-treatments/
Population-based birth cohort study on diabetes in pregnancy and infant hospitalisations in Cree, other First Nations and non-Indigenous communities in Quebec
Authors: Huang Rong , Xiao Lin , Zhu Jane , Cheng Justin , Torrie Jill , McHugh Nancy Gros-Louis , Auger Nathalie , Luo Zhong-Cheng
Published: December 2023

Objectives

Diabetes in pregnancy, whether pre-gestational (chronic) or gestational (de novo hyperglycaemia), increases the risk of adverse birth outcomes. It is unclear whether gestational diabetes increases the risk of postnatal morbidity in infants. Cree First Nations in Quebec are at high risk for diabetes in pregnancy. We assessed whether pre-gestational or gestational diabetes may increase infant hospitalisation (an infant morbidity indicator) incidence, and whether this may be related to more frequent infant hospitalisations in Cree and other First Nations in Quebec.

Design

Population-based birth cohort study through administrative health data linkage.

Setting and participants

Singleton infants (≤1 year) born to mothers in Cree (n=5070), other First Nations (9910) and non-Indigenous (48 200) communities in rural Quebec.

Results

Both diabetes in pregnancy and infant hospitalisation rates were much higher comparing Cree (23.7% and 29.0%) and other First Nations (12.4% and 34.1%) to non-Indigenous (5.9% and 15.5%) communities. Compared with non-diabetes, pre-gestational diabetes was associated with an increased risk of any infant hospitalisation to a greater extent in Cree and other First Nations (relative risk (RR) 1.56 (95% CI 1.28 to 1.91)) than non-Indigenous (RR 1.26 (1.15 to 1.39)) communities. Pre-gestational diabetes was associated with increased risks of infant hospitalisation due to diseases of multiple systems in all communities. There were no significant associations between gestational diabetes and risks of infant hospitalisation in all communities. The population attributable risk fraction of infant hospitalisations (overall) for pre-gestational diabetes was 6.2% in Cree, 1.6% in other First Nations and 0.3% in non-Indigenous communities.

Conclusions

The study is the first to demonstrate that pre-gestational diabetes increases the risk of infant hospitalisation overall and due to diseases of multiple systems, but gestational diabetes does not. High prevalence of pre-gestational diabetes may partly account for the excess infant hospitalisations in Cree and other First Nations communities in Quebec.
Cognitive task analysis of clinicians’ drug–drug interaction management during patient care and implications for alert design
Authors: Russ-Jara Alissa L , Elkhadragy Nervana , Arthur Karen J , DiIulio Julie B , Militello Laura G , Ifeachor Amanda P , Glassman Peter A , Zillich Alan J , Weiner Michael
Published: December 2023

Background

Drug–drug interactions (DDIs) are common and can result in patient harm. Electronic health records warn clinicians about DDIs via alerts, but the clinical decision support they provide is inadequate. Little is known about clinicians’ real-world DDI decision-making process to inform more effective alerts.

Objective

Apply cognitive task analysis techniques to determine informational cues used by clinicians to manage DDIs and identify opportunities to improve alerts.

Design

Clinicians submitted incident forms involving DDIs, which were eligible for inclusion if there was potential for serious patient harm. For selected incidents, we met with the clinician for a 60 min interview. Each interview transcript was analysed to identify decision requirements and delineate clinicians’ decision-making process. We then performed an inductive, qualitative analysis across incidents.

Setting

Inpatient and outpatient care at a major, tertiary Veterans Affairs medical centre.

Participants

Physicians, pharmacists and nurse practitioners.

Outcomes

Themes to identify informational cues that clinicians used to manage DDIs.

Results

We conducted qualitative analyses of 20 incidents. Data informed a descriptive model of clinicians’ decision-making process, consisting of four main steps: (1) detect a potential DDI; (2) DDI problem-solving, sensemaking and planning; (3) prescribing decision and (4) resolving actions. Within steps (1) and (2), we identified 19 information cues that clinicians used to manage DDIs for patients. These cues informed their subsequent decisions in steps (3) and (4). Our findings inform DDI alert recommendations to improve clinicians’ decision-making efficiency, confidence and effectiveness.

Conclusions

Our study provides three key contributions. Our study is the first to present an illustrative model of clinicians’ real-world decision making for managing DDIs. Second, our findings add to scientific knowledge by identifying 19 cognitive cues that clinicians rely on for DDI management in clinical practice. Third, our results provide essential, foundational knowledge to inform more robust DDI clinical decision support in the future.
Cohort profile: a large EHR-based cohort with linked pharmacy refill and neighbourhood social determinants of health data to assess heart failure medication adherence
Authors: Adhikari Samrachana , Mukhyopadhyay Amrita , Kolzoff Samuel , Li Xiyue , Nadel Talia , Fitchett Cassidy , Chunara Rumi , Dodson John , Kronish Ian , Blecker Saul B
Published: December 2023

Purpose

Clinic-based or community-based interventions can improve adherence to guideline-directed medication therapies (GDMTs) among patients with heart failure (HF). However, opportunities for such interventions are frequently missed, as providers may be unable to recognise risk patterns for medication non-adherence. Machine learning algorithms can help in identifying patients with high likelihood of non-adherence. While a number of multilevel factors influence adherence, prior models predicting non-adherence have been limited by data availability. We have established an electronic health record (EHR)-based cohort with comprehensive data elements from multiple sources to improve on existing models. We linked EHR data with pharmacy refill data for real-time incorporation of prescription fills and with social determinants data to incorporate neighbourhood factors.

Participants

Patients seen at a large health system in New York City (NYC), who were >18 years old with diagnosis of HF or reduced ejection fraction (<40%) since 2017, had at least one clinical encounter between 1 April 2021 and 31 October 2022 and active prescriptions for any of the four GDMTs (beta-blocker, ACEi/angiotensin receptor blocker (ARB)/angiotensin receptor neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter 2 inhibitor (SGLT2i)) during the study period. Patients with non-geocodable address or outside the continental USA were excluded.

Findings to date

Among 39 963 patients in the cohort, the average age was 73±14 years old, 44% were female and 48% were current/former smokers. The common comorbid conditions were hypertension (77%), cardiac arrhythmias (56%), obesity (33%) and valvular disease (33%). During the study period, 33 606 (84%) patients had an active prescription of beta blocker, 32 626 (82%) had ACEi/ARB/ARNI, 11 611 (29%) MRA and 7472 (19%) SGLT2i. Ninety-nine per cent were from urban metropolitan areas.

Future plans

We will use the established cohort to develop a machine learning model to predict medication adherence, and to support ancillary studies assessing associates of adherence. For external validation, we will include data from an additional hospital system in NYC.
HIV, hypertension and diabetes care and all-cause mortality in rural South Africa in the HIV antiretroviral therapy era: a longitudinal cohort study
Authors: Chidumwa Glory , Mazibuko Lusanda , Olivier Stephen , Rahman Kashfia , Gareta Dickman , Aung Taing N , Busang Jacob , Herbst Kobus , Wong Emily , Baisley Kathy , Siedner Mark
Published: December 2023

Introduction

South Africa is in the midst of rapid epidemiological transition from extremely high HIV and tuberculosis (TB) mortality to one characterised increasingly non-communicable disease-related deaths. However, longitudinal data linking modifiable risk factors and disease care indices to mortality in the country are extremely rare, and a prerequisite to appropriately prioritise health system responses.

Methods

Individuals in the Africa Health Research Institute Southern Demographic Health Surveillance area were invited to health fairs to collect data on modifiable risk factors and HIV, TB, diabetes and hypertension disease status and control. Individuals are then followed longitudinally through routine surveillance to detect deaths. We fit Cox proportional hazards models and estimated population-attributable fractions (PAFs) to identify modifiable risk factors and disease control indicators associated with all-cause mortality.

Results

A total of 18 041 individuals completed health screening and were followed for 114 692 person-years. Men had higher mortality rates than women across all age bands. The median follow-up time was 3.3 years (IQR: 3.0–3.5 years). For men, communicable diseases accounted for a higher PAF of mortality (PAF=13.7% for HIV and 8.3% for TB) than non-communicable diseases (6.6% for hypertension and 1.9% for diabetes). By contrast, despite extremely high HIV prevalence, non-communicable diseases with comorbid communicable disease accounted for the greatest share of deaths. In both sexes, having a chronic disease with poor control was most predictive of all-cause mortality. For example, among men, compared with those without each condition, adjusted HRs of all-cause mortality for people with uncontrolled disease were 3.47 (95% CI 2.10 to 5.72) for HIV, 1.52 (95% CI 1.05 to 2.20) for hypertension and 2.34 (95% CI 1.75 to 6.79) for diabetes. Among women, these same ratios were 5.32 (95% CI 3.54 to 7.99) for HIV, 1.73 (95% CI 1.31 to 2.28) for hypertension and 3.11 (95% CI 2.02 to 4.77) for diabetes.

Discussion

Poor control of chronic, treatable diseases predicts all-cause mortality in rural South Africa in the HIV antiretroviral therapy era. Health system strengthening to improve chronic disease and multimorbidity care should be prioritised.
What factors are associated with paediatric admissions and their outcomes in a rural hospital in northern Sierra Leone? Insights from a pilot observational study
Authors: Afolabi Muhammed Olanrewaju , Ayieko Philip , Njie Yusupha , Kowuor Dickens , Adetola Hammed Hassan , Kamara Bomposseh , Jalloh Abdulai Berber , Sesay Francis , Swaray Ernest , Odeny Lazarus , Pearce Richmonda M , Samai Mohamed H , Deen Gibrilla Fadlu , Koedoyoma Songor , Sesay Isaac G , Ishola David , Leigh Bailah , Watson-Jones Deborah , Greenwood Brian
Published: December 2023

Introduction

Data on the pattern of admissions and causes of child death are crucial in informing priorities for improving child survival. In many health facilities in sub-Saharan Africa, understanding the pattern of paediatric admissions and their outcomes is constrained by poor documentation of these important features.

Methods

We developed and piloted a simple paper-based tool for documentation of basic, standardised patient-level information on causes of admissions, diagnoses, treatments and outcomes in children admitted to a rural hospital in Sierra Leone. The tool contained sections covering basic sociodemographic information about a patient, chief medical complaints, findings from clinical examinations and tests conducted at admission, results from subsequent clinical and laboratory investigations, working/definitive diagnoses, management and treatment outcomes.

Results

From 1 August 2019 to 31 July 2021, we used this tool to document the admissions, treatments and clinical outcomes of 1663 children admitted to Kambia district hospital in northern Sierra Leone. The majority of the children (1015, 62%) were aged 12–59 months, were boys (942, 57%), were wasted (516, 31%), stunted (238, 14%) or underweight (537, 32%). Above a half of the children lived more than 1 km distance from the hospital (876/1410, 62%). The highest number of admissions occurred in November 2019 and the lowest in April 2020. Severe malaria was the leading cause of admission. More than 80% of the children were successfully treated and discharged home (1356/1663, 81.5%) while 122/1663 (7.3%) died. Children aged under 5 years who were underweight, and those who presented with danger signs (eg, signs of breathing difficulty, dehydration, head injury or severe infections) had a higher risk of death than children without these features (p<0.01; p=0.03; p=0.011 and p=0.009, respectively).

Conclusion

Lack of systematic documentation of medical histories and poor record keeping of hospital admissions and outcomes can be overcome by using a simple tool. Continuous use of the tool with regular audits could improve delivery of paediatric care in resource-limited settings.
Antibodies against advanced glycation end-products and malondialdehyde-acetaldehyde adducts identify a new specific subgroup of hitherto patients with seronegative arthritis with a distinct clinical phenotype and an HLA class II association
Authors: van den Beukel Michelle D , van Wesemael Tineke J , Hoogslag Anna Titia W , Borggreven Nicole V , Huizinga Tom WJ , van der Helm-van Mil Annette HM , Toes René EM , van der Woude Diane , Trouw Leendert A
Published: December 2023

Objective

In rheumatoid arthritis (RA) around two-thirds of patients are autoantibody positive for rheumatoid factor, anti-citrullinated protein antibodies and/or anti-carbamylated protein antibodies. The remaining seronegative subgroup of patients is clinically heterogeneous and thus far, biomarkers predicting the disease course are lacking. Therefore, we analysed the value of other autoantibodies in RA directed against malondialdehyde-acetaldehyde adducts (MAA) and advanced glycation end-products (AGE).

Methods

In sera of 648 patients with RA and 538 patients without RA from the Leiden Early Arthritis Clinic, anti-MAA and anti-AGE IgG antibody levels were measured using ELISA. Associations between genetic risk factors, acute phase reactants, radiological joint damage, remission and anti-PTM positivity were investigated using regression, correlation and survival analyses.

Results

Anti-AGE and anti-MAA were most prevalent in RA (44.6% and 46.1% respectively) but were also present in non-RA arthritis patients (32.9% and 30.3% respectively). Anti-AGE and anti-MAA antibodies were associated with HLA-DRB1*03 within seronegative RA (OR=1.98, p=0.003, and OR=2.37, p<0.001, respectively) and, for anti-AGE also in non-RA arthritis patients (OR=2.34, p<0.001). Presence of anti-MAA antibodies was associated significantly with markers of inflammation, erythrocyte sedimentation rate and C reactive protein, in all groups independent of anti-AGE. Interestingly, the presence of anti-AGE and anti-MAA antibodies was associated with radiological progression in patients with seronegative RA, but not evidently with sustained drug-free remission.

Conclusions

Anti-AGE and anti-MAA were present in around 45% of RA patients and 30% of non-RA arthritis patients, and although not specific for RA, their presence associated with HLA, inflammation and, for RA, with clinical outcomes especially in patients with seronegative RA.
Sodium zirconium cyclosilicate for hyperkalaemia
Authors: Shaikh Aafreen , Stark Toller Claire
Published: December 2023

Hyperkalaemia is a life-threatening medical emergency. Treatment usually requires admission to hospital. This is often inappropriate or unacceptable for patients in a hospice setting. Until recently, there was no palatable and effective non-invasive treatment for hyperkalaemia in a hospice. We present a case where oral sodium zirconium cyclosilicate was given to a hospice inpatient, was well tolerated and may have contributed to two additional weeks of good quality of life.
On twist positive braids with the 2-variable link invariant: 3-braids of width 2
Authors: Elrifai E. A. , Bajrim Sanaa A. , Alqahtani Nouf Abdulrahman
Published: December 2023

The possible [Formula: see text]-variable link polynomial [Formula: see text] for an oriented link [Formula: see text], which has width [Formula: see text] in the variable [Formula: see text] is studied, where width of [Formula: see text] is the minimal number of strands allowed by the index bound. It is shown that if the 2-variable link invariant [Formula: see text] for an oriented link [Formula: see text] has width [Formula: see text] in the variable [Formula: see text] then it is the same as the polynomial of a closed [Formula: see text]-braid, [Formula: see text] Also a complete list of [Formula: see text]- braids of width [Formula: see text] which close to knots, are given. Consequently it is shown that [Formula: see text] determines [Formula: see text] for the full [Formula: see text]-braid [Formula: see text] Finally, the 2-variable polynomial for the non-full 3-braid is calculated.