bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiabortion legal mobilization in Brazil: Human rights as a field of contention
Authors: de Assis Machado Marta R
Published: May 2023

This article analyzes the legal strategies used by the Brazilian antiabortion movement, observing its frames and argumentative strategies. It contextualizes the importance of the antiabortion movement within the recent conservative wave, as the movement had recently undergone a process of renewal, becoming one of the support bases for right-wing populist President Jair Bolsonaro’s government. The new configurations and strategies advanced by the movement reveal the centrality of lawyers and legal strategies, using the language of human rights. An analysis of court documents and public hearings at different political moments highlights recent shifts in antiabortion legal framings. While human rights language has always been ambivalent and contested, this article argues that what is taking place in the context of the reframed antiabortion movement is an appropriation (or misappropriation) of human rights, which distorts its most fundamental feature and advocates for anti-pluralist ends.
The interaction of human rights and religion in Africa’s sexuality politics
Authors: Kaoma Kapya
Published: May 2023

This article examines varieties of human rights appropriation in the context of sexuality politics in Africa. Noting how contested the landscape of human rights has been in Africa, it demonstrates how the human rights of lesbians, gays, bisexual, trans, queer, and intersex persons or sexual and gender minorities (LGBTQI+) are excluded from protection as a result of what are described as three interconnected predispositions. These predispositions are postcolonial, cultural, and religious tendencies within many African countries which adopt “othering” narratives that justify, and even sacralize, discrimination or violence based on gender identity and sexual orientation. The article analyzes the rights-based arguments—the appropriation of human rights language—used by anti-gay advocates in Africa, which emphasize rights to religion, culture, and family and exclude or deny the rights of LGBTQI+ people. This presentation of a human rights corpus and discourse which excludes LGBTQI+ rights, and which circulates both within and outside Africa, relies on alliances with the US Christian Right, and with the Vatican and Islamic leaders, to oppose sexual rights, and is often deployed by African politicians to retain political power. The article concludes by exploring the concept of ubuntu as a potential alternative to or as an accompaniment to human rights language, as a way of vernacularizing and Africanizing LGBTQI+ rights.
Strong CD4+ T-Cell Responses to Ancestral and Variant Spike Proteins Are Established by NVX-CoV2373 Severe Acute Respiratory Syndrome Coronavirus 2 Primary Vaccination
Authors: Fries Louis , Formica Neil , Mallory Raburn M , Zhou Haixia , Plested Joyce S , Kalkeri Raj , Moldovan Ioana , Patel Nita , Albert Gary , Robinson Michelle , Cho Iksung , Chau Gordon , Dubovsky Filip , Glenn Gregory M ,   for the 2019nCoV-101 Study Group, Adams Mark , Arya Mark , Athan Eugene , Berger Ira , Bradley Paul , Glover Richard , Griffin Paul , Kim Joshua , Kitchener Scott , Klein Terry , Leah Amber , Lemech Charlotte , Lickliter Jason , Manning Mary Beth , Napier-Flood Fiona , Nugent Paul , Thackwray Susan , Turner Mark
Published: May 2023

Background

NVX-CoV2373 is an efficacious coronavirus disease 2019 (COVID-19) vaccine comprising full-length recombinant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (rS) glycoprotein and Matrix-M adjuvant. Phase 2 of a randomized, placebo-controlled, phase 1/2 trial in healthy adults (18–84 years of age) previously reported good safety/tolerability and robust humoral immunogenicity.

Methods

Participants were randomized to placebo or 1 or 2 doses of 5-µg or 25-µg rS with 50 µg Matrix-M adjuvant 21 days apart. CD4+ T-cell responses to SARS-CoV-2 intact S or pooled peptide stimulation (with ancestral or variant S sequences) were measured via enzyme-linked immunosorbent spot assay and intracellular cytokine staining.

Results

A clearly discernable spike antigen-specific CD4+ T-cell response was induced after 1 dose, but markedly enhanced after 2 doses. Counts and fold increases in cells producing Th1 cytokines exceeded those secreting Th2 cytokines, although both phenotypes were clearly present. Interferon-γ responses to rS were detected in 93.5% of 2-dose 5-µg recipients. A polyfunctional CD4+ T-cell response was cross-reactive and of equivalent magnitude to all tested variants, including Omicron BA.1/BA.5.

Conclusions

NVX-CoV2373 elicits a moderately Th1-biased CD4+ T-cell response that is cross-reactive with ancestral and variant S proteins after 2 doses.

Clinical Trials Registration

NCT04368988.
Molecular characterization of cefepime and aztreonam nonsusceptibility in Haemophilus influenzae
Authors: Cheng Wei-Hung , Shao Wan-Yu , Wen Man-Yu , Su Pei-Yi , Ho Cheng-Hsun
Published: May 2023

Background

Cefepime and aztreonam are highly efficacious against H. influenzae, and resistant strains are rare. In this study, we isolated cefepime- and aztreonam-nonsusceptible H. influenzae strains and addressed the molecular basis of their resistance to cefepime and aztreonam.

Methods

Two hundred and 28 specimens containing H. influenzae were screened, of which 32 isolates were enrolled and applied to antimicrobial susceptibility testing and whole-genome sequencing. Genetic variations that were detected in all nonsusceptible isolates with statistical significance by Fisher’s exact tests were identified as cefepime or aztreonam nonsusceptibility related. Functional complementation assays were conducted to assess the in vitro effects of proteins with sequence substitutions on drug susceptibility.

Results

Three H. influenzae isolates were nonsusceptible to cefepime, one of which was also nonsusceptible to aztreonam. Genes encoding TEM, SHV and CTX-M extended-spectrum β-lactamases were not detected in the cefepime- and aztreonam-nonsusceptible isolates. Five genetic variations in four genes and 10 genetic variations in five genes were associated with cefepime and aztreonam nonsusceptibility, respectively. Phylogenetic analyses revealed that changes in FtsI were correlated strongly with the MIC of cefepime and moderately with aztreonam. FtsI Thr532Ser-Tyr557His cosubstitution linked to cefepime nonsusceptibility and Asn305Lys-Ser385Asn-Glu416Asp cosubstitution to aztreonam nonsusceptibility. Functional complementation assays revealed that these cosubstitutions increased MICs of cefepime and aztreonam in susceptible H. influenzae isolates, respectively.

Conclusions

Genetic variations relevant to resistant phenotypes of cefepime and aztreonam nonsusceptibility in H. influenzae were identified. Moreover, the effects of FtsI cosubstitutions on increasing MICs of cefepime and aztreonam in H. influenzae were demonstrated.
The Impact of Ethiopian Productive Safety Net Program on Children's Educational Aspirations and Attainments
Authors: Gebremariam Aregawi G , Lodigiani Elisabetta , Pasini Giacomo
Published: May 2023

The Productive Safety Net Program (PSNP) was launched by the government of Ethiopia in 2005 to support food-insecure rural households. In this paper, we evaluate the impact of PSNP on children's educational aspirations and actual attainments. We use longitudinal data from the Ethiopian sample of the Young Lives' survey and by means of a differences-in-differences, individual fixed-effects estimator, we find that the program increases both educational aspirations and actual attainment of children. In our preferred specification, the immediate effect (after 3 years) of the program is to increase by 1.05 years of educational aspirations and by about 0.35 years actual education of children. Furthermore, there is evidence that the program has significant effect even in the long run (after 6 years). The results point to broad and long-lasting positive effects on children education of a program designed primarily to relieve chronically poor households from food insecurity.
Host-Genetic-Based Outcome of Coinfection by PCV2b and PRRSV in Pigs
Authors: Eaton Christian W , Vu Hiep L , Hodges Arabella L , Harris Seth P , Kachman Stephen D , Ciobanu Daniel C
Published: May 2023

Replication of porcine circovirus type 2 (PCV2), an important worldwide swine pathogen, has been demonstrated to be influenced by host genotype. Specifically, a missense DNA polymorphism (SYNGR2 p.Arg63Cys) within the SYNGR2 gene was demonstrated to contribute to variation in PCV2b viral load and subsequent immune response following infection. PCV2 is known to induce immunosuppression leading to an increase in susceptibility to subsequent infections with other viral pathogens such as porcine reproductive and respiratory syndrome virus (PRRSV). In order to assess the role of SYNGR2 p.Arg63Cys in coinfections, pigs homozygous for the favorable SYNGR2 p.63Cys (n=30) and unfavorable SYNGR2 p.63Arg (n=29) alleles were infected with PCV2b followed a week later by a challenge with PRRSV. A lower PCV2b viremia (P < 0.001) and PCV2-specific IgM antibodies (P < 0.005) were observed in SYNGR2 p.63Cys compared to SYNGR2 p.63Arg genotypes. No significant differences in PRRSV viremia and specific IgG antibodies were observed between SYNGR2 genotypes. Lung histology score, an indicator of disease severity, was lower in the pigs with SYNGR2 p.63Cys genotypes (P < 0.05). Variation in the lung histology scores within SYNGR2 genotypes suggests that additional factors, environmental and/or genetic, could be involved in disease severity.
Diabetic Fibrous Mastopathy: Imaging Features With Histopathologic Correlation
Authors: Patel Priya B , Carter Gloria J , Berg Wendie A
Published: May 2023

Diabetic fibrous mastopathy (DFM) is a rare benign fibrotic disease of the breast that develops in patients with longstanding and often uncontrolled diabetes mellitus. Clinically, patients may present with an irregular, firm, palpable mass, which may be solitary or multiple, occurring in one or both breasts. Diabetic fibrous mastopathy occurs most often in premenopausal women with heterogeneously or extremely dense breasts; mammography may show focal asymmetry or, less often, a noncalcified mass with indistinct or obscured margins, but there are usually no discrete findings. On US, DFM may have marked hypoechogenicity and posterior shadowing secondary to extensive fibrosis. Diabetic fibrous mastopathy features on contrast-enhanced MRI are also nonspecific, with gradual persistent nonmass enhancement reported. Because the clinical presentation and US features of DFM overlap with those of breast cancer, histopathologic correlation is needed to confirm diagnosis and exclude malignancy. These findings include collagenous stroma often with keloidal features and chronic perilobular and perivascular inflammation. Histopathologic findings of lymphocytic lobulitis and perivascular inflammation are common to other autoimmune conditions.
Evaluation of winter cover crop methods for management of flatheaded appletree borer (Coleoptera: Buprestidae)
Authors: Gonzalez Axel , Oliver Jason B , Perkovich Cindy L , Addesso Karla M
Published: May 2023

Winter cover crops grown at the base of red maples (Acer rubrum L.) can reduce flatheaded appletree borer (Chrysobothris femorata Olivier; Coleoptera: Buprestidae; FAB) damage by both physically blocking preferred oviposition sites and altering the environment around them. However, cover crop competition negatively affects tree growth. To investigate long-term cover crop effects, trees grown with cover crop for 2 yr were transitioned to a standard herbicide practice. After 4 yr, trees in the initial 2 yr cover crop plots were 1 yr behind in growth compared to trees grown in bare rows for all 4 yr. Most growth reduction occurred in the first year following transplant. Additional borer losses of 1–2% per year were observed in production years 3 and 4. A second experiment answered 2 questions: Can killing the cover crop once it reaches maximal height protect trees from borers while also reducing competition and thereby increase tree growth? and Do herbicide applications increase borer attacks? In this experiment, red maples were grown with (i) a standard herbicide program, (ii) a mulch mat, (iii) a cover crop that was killed early, or (iv) a cover crop allowed to senesce naturally. Evaluations after 2 yr indicated early kill of the cover crop was not enough to improve tree growth. Further, trees in the early kill cover crop treatment had the most FAB attacks. Cover crops allowed to senesce naturally reduced FAB attacks in both studies; however, more work is needed to minimize disparities in tree growth during the initial year post-transplant and determine the causal relationship between herbicide use and borer attacks.
Making a “Happy Hospital”: Emotional Investment and Professional Identity Amongst Anglo-American Hospital Administrators
Authors: Begley Philip
Published: May 2023

This article examines the place of emotion in modern hospital administration and the relationship between professional identities and emotional landscapes in the healthcare field. The focus is a broad emotional and philosophical investment that many administrators made in their work. In the United States and then in Britain, amidst rapid change in the practice and provision of health services, a new sense of professional identity emerged. This was often underpinned by a kind of emotional investment, one which had to be constructed and cultivated. Here formal training and education, collective identities, and a shared understanding of the kind of personal qualities required were important. The extent to which developments in Britain were influenced by best practice in the US is also striking. This process might best be understood as the further drawing out of established beliefs and ways of working rather than an abstract transfer of ideas and practices across the Atlantic, but there was a distinct Anglo-American dimension to the development of hospital administration.
Legal personhood and frozen embryos: implications for fertility patients and providers in post-Roe America
Authors: Letterie Gerard , Fox Dov
Published: May 2023

The demise of Roe v. Wade has prompted some state lawmakers to try to redefine legal personhood to begin before birth and even before pregnancy. The sweeping abortion bans passed and pending in the wake of Dobbs pose a threat to reproductive rights that extends beyond abortion. That threat spills over into in vitro fertilization (IVF) and other assisted reproductive technologies (ART). If legislatures designate embryos as legal persons, fertility clinics will be forced to change how they manage embryos, including current standard practices such as pre-implantation genetic testing, storage of unused embryos, and the disposal of those unlikely to have reproductive potential. This essay examines the many ways in which conferring the status of persons under private and public law is likely to impact patients pursuing IVF and clinics practicing ART.
Persistent variation in insecticide resistance intensity in container breeding Aedes (Diptera: Culicidae) co-collected in Houston, TX
Authors: Estep Alden , Kissoon Kimberley , Saldana Miguel , Fredregill Chris
Published: May 2023

As observed in many locations worldwide, resistance to pyrethroids is common in Aedes aegypti (L.) in the southern United States and northern Mexico. Strong resistance in Aedes albopictus (Skuse) is less common and is not as well characterized. These 2 species have been undergoing range expansion and are sympatric in many locations including Houston, Texas. They are often collected from the same locations and lay eggs in the same larval habitats. In this study, we colonized both Ae. aegypti and Ae. albopictus from 4 locations in Houston and characterized insecticide resistance using permethrin as a model pyrethroid. We found differences in resistance intensity between the species at all 4 sites. Within the Ae. aegypti, resistance ratios ranged from 3.5- to 30.0-fold when compared to the ORL1952 laboratory susceptible strain. Expression of several P450s was higher than in the ORL1952 strain, but the pattern was similar between the field strains of Ae. aegypti. Higher resistance ratios did correlate with increasing percentages of the dilocus knockdown resistance (kdr) genotype. In contrast, Ae. albopictus from the 4 locations all had very low resistance ratios (<4-fold) when compared to the same laboratory susceptible strain. Five years later, we performed additional collections and characterization from the most resistant location to assess the temporal persistence of this difference in resistance between the species. The same pattern of high resistance in Ae. aegypti and low resistance in sympatric Ae. albopictus remained 5 yr later and this may have implications for operational efficacy.
Children’s literature and philosophy: comments on Gareth B. Matthews, The Child’s Philosopher
Authors: Brighouse Harry
Published: May 2023

This article looks at Maughn Rollins Gregory and Megan Jane Laverty’s Gareth B. Matthews, The Child’s Philosopher (2022), specifically considering how Matthews conceptualized philosophy and how he found philosophy in children’s literature.
Tolerance limit of external beam radiotherapy combined with low-dose rate brachytherapy in normal rabbit tissue
Authors: Ling Hang , Huang Wenxiao , Zhong Waisheng , Tan Pingqing , Zhang Hailin , Liu Yong , Chen Jie
Published: May 2023

Background

Dosage-optimized multimodal radiotherapies that are safe for head and neck cancer patients are desirable. In this study, we investigated tissue tolerance to varying doses of external beam radiotherapy (EBRT) combined with low-dose rate brachytherapy in the neck of a rabbit model.

Methods

Twenty rabbits were used in the four test groups (five each) with iodine-125 seeds implanted in the neck treated with EBRT in four doses at 50, 40, 30 and 20 Gy each. Twelve rabbits for three control groups (four each). Three months after implantation, all rabbits were euthanized, and target tissues were collected. Analyses included seed implantation assessment, histopathological evaluation, immunohistochemistry staining, terminal deoxynucleotidyl transferase dUTP nick end labeling assay, electron microscopy and statistics with the SPSS software.

Results

Five rabbits died in the four test groups, and three rabbits died in the three control groups (one per group), which showed no significant difference by survival analysis. The calculated minimum peripheral dose was 17.6 Gy, the maximum dose near the seed was 1812.5 Gy, the D90 was 34.5 Gy and the mean dose was 124.5 Gy. In all groups that received radiation, apoptosis occurred primarily in the esophageal mucosa and corresponded to the dose of radiation; a higher dose caused a greater apoptosis, with significant difference between groups (P < 0.05). Electron microscopy of carotid arteries revealed that endothelial cells were swollen and some were shed from basement membrane, but no other noticeable tissue damages.

Conclusions

Limited EBRT at maximal dose (50 Gy) combined with the brachytherapy interstitially applied to the neck was tolerated well in the rabbit model.
Small bowel volvulus due to jejunal diverticula: a rare case of acute abdomen
Authors: Molina Gabriel A , Ojeda Rommel H , Jimenez Galo , Heredia Andrea , Cadena C Augusto , Martic Davor
Published: May 2023

Jejunal diverticula are rare, and small bowel diverticular disease resulting in volvulus can lead to severe complications; as symptoms are non-specific, many patients are misdiagnosed and treated wrongly for other conditions. When a small bowel volvulus is detected, urgent surgical treatment is needed to avoid troublesome difficulties. We present the case of a 36-year-old woman who presented to the emergency room with an acute abdomen due to small bowel obstruction. After further testing, a volvulus was detected and promptly treated. Jejunal diverticula that caused a small bowel volvulus was the final diagnosis.
Foot drop secondary to rhabdomyolysis: improved foot dorsiflexion and gait after neurolysis and distal nerve transfer—a case series and literature review
Authors: Nath Rahul K , Somasundaram Chandra
Published: May 2023

Rhabdomyolysis is a triad syndrome of myalgia, muscle weakness and myoglobinuria due to muscle necrosis. Trauma, exertions, strenuous exercise, infections, metabolic and electrolyte disorders, drug overdoses, toxins and genetic defects are the most common causes of rhabdomyolysis. The etiologies of foot drop are diverse. A few cases of rhabdomyolysis-associated foot drop are reported in the literature. We present five patients with foot drop secondary to rhabdomyolysis; two underwent neurolysis and distal nerve transfer (superficial peroneal nerve to the deep peroneal nerve) surgeries and follow-up evaluations. We found five-foot drop patients secondary to rhabdomyolysis among the 1022-foot drop patients who consulted our clinic since 2004, representing a 0.5% incidence. In two patients, rhabdomyolysis was caused by drug overdose and abuse. In the other three patients, the causes were an assault with a hip injury, a prolonged hospitalization due to multiple illnesses, and an unknown cause with compartment syndrome. Pre-operatively, a 35-year-old male patient had aspiration pneumonia, rhabdomyolysis and foot drop resulting from prolonged ICU hospitalization and a medically induced coma due to a drug overdose. The second patient (a 48-year-old male) had no history of trauma but had a sudden onset of right foot drop after compartment syndrome following the insidious onset of rhabdomyolysis. Both patients had difficulty dorsiflexing their involved foot and walked with a steppage gait before surgery. In addition, the 48-year-old patient had foot slapping while walking. However, both patients had strong plantar flexion (5/5). After 14 and 17 months of surgery, both patients had improved foot dorsiflexion to an MRC grade of 4/5 with an improved gait cycle and walked with no or minimal slapping, respectively. Distal motor nerve transfers in the lower limb facilitate faster recovery and less surgical dissection because of the shorter regeneration distance from the donor axons to the targeted motor end plates through residual neural network connections and descending motor signals.
Adult with concurrent mesenteric cyst and acute appendicitis: a case report
Authors: Hernandez Cervantes Barbara Y , Martinez Lopez Duniesky , Almaguer Acevedo Fernando M , Betamcourt Benjamin Manuel , Guzman Lambert Radisnay , Rodriguez Gonzalez Mariuska
Published: May 2023

Mesenteric cysts are uncommon intra-abdominal lesions that account for only one in every 100 000 adult hospitalizations. Their diagnosis is based on a comprehensive clinical examination as well as radiological modalities such as ultrasonography and computed tomography (CT) scans, and it is usually a clinical challenge because of non-specific symptoms. We present our first case of a 51-year-old man with a simple mesenteric cyst accompanying acute appendicitis diagnosed by CT scan of the abdomen and treated by exploratory laparotomy, complete enucleation of the cyst and appendectomy with a 10 month follow-up without complications or recurrence. This type of presentation has not been thoroughly investigated, with only two children reported during our literature review. Even if there is a high level of suspicion, a CT scan is required for confirmation.
Metachronic distal rectovaginal septum metastasis with prior laparoscopic anterior resection for proximal rectal carcinoma
Authors: Tweed Thaís T T , van Dam Kayleigh A M , Sosef Meindert N , Belgers Henricus J
Published: May 2023

Metastatic disease in the vagina of other origins such as rectal cancer is rare and only very few cases have been reported. A female patient developed an isolated metachronic metastasis located at the lower part of the rectovaginal septum, 8 months after curative resection for proximal rectal cancer. An excision of the tumour was performed with primary closure of the vaginal wall. Histopathological examination confirmed the solid tumour to be metastatic disease from rectal origin with free margins. A year later, the patient received a lobectomy of the left lower lobe, due to distant metastasis of rectal origin 2 years after primary surgery. The patient is currently 4 years postoperatively, alive and shows no sign on recurrent disease. This case illustrates that awareness and early recognition of this rare presentation can lead to adequate treatment plans.
Plasmodesmal endoplasmic reticulum proteins regulate intercellular trafficking of cucumber mosaic virus in Arabidopsis
Authors: Ham Byung-Kook , Wang Xiaohua , Toscano-Morales Roberto , Lin Jinxing , Lucas William J
Published: May 2023

Plasmodesmata (PD) are plasma membrane-lined cytoplasmic nanochannels that mediate cell-to-cell communication across the cell wall. A range of proteins are embedded in the PD plasma membrane and endoplasmic reticulum (ER), and function in regulating PD-mediated symplasmic trafficking. However, knowledge of the nature and function of the ER-embedded proteins in the intercellular movement of non-cell-autonomous proteins is limited. Here, we report the functional characterization of two ER luminal proteins, AtBiP1/2, and two ER integral membrane proteins, AtERdj2A/B, which are located within the PD. These PD proteins were identified as interacting proteins with cucumber mosaic virus (CMV) movement protein (MP) in co-immunoprecipitation studies using an Arabidopsis-derived plasmodesmal-enriched cell wall protein preparation (PECP). The AtBiP1/2 PD location was confirmed by TEM-based immunolocalization, and their AtBiP1/2 signal peptides (SPs) function in PD targeting. In vitro/in vivo pull-down assays revealed the association between AtBiP1/2 and CMV MP, mediated by AtERdj2A, through the formation of an AtBiP1/2–AtERdj2–CMV MP complex within PD. The role of this complex in CMV infection was established, as systemic infection was retarded in bip1/bip2w and erdj2b mutants. Our findings provide a model for a mechanism by which the CMV MP mediates cell-to-cell trafficking of its viral ribonucleoprotein complex.
Interprofessional Experiences of Family Nurse Practitioner Students During a Military Field Practicum
Authors: Vojta Leslie , Roberts Cindy L , Cole Rebekah , Barry Erin S
Published: May 2023

Introduction

Team building is a real-world necessity in military and civilian health care settings. Interprofessional education (IPE) is therefore an essential component of health care education. At the Uniformed Services University, there are continued, deliberate attempts for IPE to occur to successfully prepare students to work together and adapt to ever-changing contexts. Although past quantitative research has analyzed interprofessional collaboration among military medical students, this study explores the interprofessional experiences of family nurse practitioner (FNP) students during a military medical field practicum.

Materials and Methods

This study was reviewed by the Uniformed Services University Human Research Protections Program Office (Protocol DBS.2021.257). We used the qualitative transcendental phenomenological approach to design our study. We analyzed the reflection papers of 20 family nurse practitioner students who participated in Operation Bushmaster in order to explore their interprofessional experiences. Our research team coded and categorized the data, developing textural and structural descriptions of these categories, which served as the results of our study.

Results

We present the study’s three key findings that students expressed and include perspectives from their viewpoints to illustrate each theme. The three themes related to IPE are (1) quality of integration determines perception of experience, (2) challenges inspire continued growth, and (3) increased self-awareness of one’s own strengths.

Conclusions

It is important for educators and leaders to find ways to allow for positive team integration and cohesion so that students do not feel overwhelmed by their perceived lack of knowledge or experience. Educators can use that perception to motivate a growth mindset so that they can continually seek out ways to improve and grow. Additionally, educators can prepare students with adequate knowledge to ensure that each team member meets mission success. Finally, to continually develop, students need to have awareness of their own strengths as well as areas for growth to enhance their own performance as well as that of the military interprofessional health care teams.
A Caenorhabditis elegans Male Pheromone Feminizes Germline Gene Expression in Hermaphrodites and Imposes Life-History Costs
Authors: Angeles-Albores David , Aprison Erin Z , Dzitoyeva Svetlana , Ruvinsky Ilya
Published: May 2023

Sex pheromones not only improve the reproductive success of the recipients, but also impose costs, such as a reduced life span. The underlying mechanisms largely remain to be elucidated. Here, we show that even a brief exposure to physiological amounts of the dominant Caenorhabditis elegans male pheromone, ascr#10, alters the expression of thousands of genes in hermaphrodites. The most dramatic effect on the transcriptome is the upregulation of genes expressed during oogenesis and the downregulation of genes associated with male gametogenesis. This result reveals a way in which social signals help to resolve the inherent conflict between spermatogenesis and oogenesis in a simultaneous hermaphrodite, presumably to optimally align reproductive function with the presence of potential mating partners. We also found that exposure to ascr#10 increased the risk of persistent intestinal infections in hermaphrodites due to pathological pharyngeal hypertrophy. Thus, our study reveals ways in which the male pheromone can not only have beneficial effects on the recipients’ reproduction, but also cause harmful consequences that reduce life span.
Long-Term Balancing Selection and the Genetic Load Linked to the Self-Incompatibility Locus in Arabidopsis halleri and A. lyrata
Authors: Le Veve Audrey , Burghgraeve Nicolas , Genete Mathieu , Lepers-Blassiau Christelle , Takou Margarita , De Meaux Juliette , Mable Barbara K , Durand Eléonore , Vekemans Xavier , Castric Vincent
Published: May 2023

Balancing selection is a form of natural selection maintaining diversity at the sites it targets and at linked nucleotide sites. Due to selection favoring heterozygosity, it has the potential to facilitate the accumulation of a “sheltered” load of tightly linked recessive deleterious mutations. However, precisely evaluating the extent of these effects has remained challenging. Taking advantage of plant self-incompatibility as one of the best-understood examples of long-term balancing selection, we provide a highly resolved picture of the genomic extent of balancing selection on the sheltered genetic load. We used targeted genome resequencing to reveal polymorphism of the genomic region flanking the self-incompatibility locus in three sample sets in each of the two closely related plant species Arabidopsis halleri and Arabidopsis lyrata, and used 100 control regions from throughout the genome to factor out differences in demographic histories and/or sample structure. Nucleotide polymorphism increased strongly around the S-locus in all sample sets, but only over a limited genomic region, as it became indistinguishable from the genomic background beyond the first 25–30 kb. Genes in this chromosomal interval exhibited no excess of mutations at 0-fold degenerated sites relative to putatively neutral sites, hence revealing no detectable weakening of the efficacy of purifying selection even for these most tightly linked genes. Overall, our results are consistent with the predictions of a narrow genomic influence of linkage to the S-locus and clarify how natural selection in one genomic region affects the evolution of the adjacent genomic regions.
Reliability and head-loading effects in imaging diagnosis of vertical subluxation in patients with rheumatoid arthritis
Authors: Tamaki Ryo , Wada Keiji , Inoue Tomohisa , Doi Toru , Okazaki Ken
Published: May 2023

Objectives

The purpose of this study was to examine the reproducibility of vertical subluxation (VS) parameters using X-ray, computed tomography (CT), and tomosynthesis (TS) while comparing the head-loading effects.

Methods

The VS parameters of 26 patients (retrospective review) were evaluated. Using the intra-class correlation coefficient, we statistically examined the intra-rater and inter-rater reliabilities of the parameters. Head-loaded and -unloaded imagings were compared using a Wilcoxon signed-rank test.

Results

The intra-rater reliability of TS and CT showed intra-class correlation coefficients of ≥0.8 (X-ray range: 0.6–0.8), with similar results for the inter-rater reliabilities. Furthermore, in head-loading imaging, the TS had significantly higher VS scores than that of CT (P < .05).

Conclusions

In comparison with the X-ray, TS and CT were more accurate and reproducible. In terms of head loading, the VS values for TS were worse than those for CT, indicating that TS was more effective than CT in diagnosing VS.
Successful peficitinib monotherapy for the new-onset skin manifestations of rheumatoid vasculitis after long-term treatment with tocilizumab for rheumatoid arthritis
Authors: Oba Yuki , Sawa Naoki , Ikuma Daisuke , Mizuno Hiroki , Inoue Noriko , Sekine Akinari , Hasegawa Eiko , Yamanouchi Masayuki , Suwabe Tatsuya , Yamaguchi Yuko , Takasawa Yutaka , Ubara Yoshifumi
Published: May 2023

Rheumatoid vasculitis (RV) is a severe extra-articular systemic manifestation of rheumatoid arthritis (RA). Its prevalence has been decreasing for decades because of improved early diagnosis of RA and advances in RA treatment, but it remains a life-threatening disease. The standard treatment for RV has been a glucocorticoid and disease-modifying antirheumatic drugs. Biological agents, including antitumour necrosis factor inhibitors, are also recommended for refractory cases. However, there are no reports of Janus kinase (JAK) inhibitor use in RV. We experienced a case of an 85-year-old woman with a 57-year history of RA who had been treated with tocilizumab for 9 years after receiving three different biological agents over 2 years. Her RA seemed to be in remission in her joints, and her serum C-reactive protein had decreased to 0.0 mg/dL, but she developed multiple cutaneous leg ulcers associated with RV. Because of her advanced age, we changed her RA treatment from tocilizumab to the JAK inhibitor peficitinib in monotherapy, after which the ulcers improved within 6 months. This is the first report to indicate that peficitinib is a potential treatment option for RV that can be used in monotherapy without glucocorticoids or other immunosuppressants.
Myasthenia gravis with inclusion body myositis: A case report
Authors: Kakutani Takuya , Yoshizawa Masaki
Published: May 2023

We present the case of a 75-year-old man diagnosed with myasthenia gravis (MG) based on lower leg weakness and ptosis for the past 2 months before admission to our hospital. The patient was anti-acetylcholine receptor antibody–positive at admission. He was treated with pyridostigmine bromide and prednisolone, which improved the ptosis, but the lower leg muscle weakness remained. An additional lower leg magnetic resonance imaging examination suggested myositis. Inclusion body myositis (IBM) was diagnosed after a subsequent muscle biopsy. Although MG is often associated with inflammatory myopathy, IBM is rare. There is no effective treatment for IBM, but various treatment possibilities have recently been proposed. This case emphasises that myositis complications, including IBM, should be considered when elevated creatine kinase levels are observed and conventional treatments do not address chronic muscle weakness.
What Can Current Biomarker Data Tell Us About the Risks of Lung Cancer Posed by Heated Tobacco Products?
Authors: Braznell Sophie , Campbell John , Gilmore Anna B
Published: May 2023

Introduction

Heated tobacco products (HTPs) are marketed as less harmful alternatives to cigarettes, but the lung cancer risk of HTPs is unknown. In the absence of epidemiological data, assessing the risks of HTPs relies on biomarker data from clinical trials. This study examined existing biomarker data to determine what it tells us about the lung cancer risk posed by HTPs.

Aims and Methods

We identified all biomarkers of exposure and potential harm measured in HTP trials and evaluated their appropriateness based on ideal characteristics for measuring lung cancer risk and tobacco use. The effects of HTPs on the most appropriate biomarkers within cigarette smokers switched to HTPs and compared to continued cigarette smoking or cessation were synthesized.

Results

Sixteen out of eighty-two biomarkers (7 exposure and 9 potential harm) measured in HTP trials have been associated with tobacco use and lung cancer, dose-dependently correlated with smoking, modifiable upon cessation, measured within an appropriate timeframe, and had results published. Three of the exposure biomarkers significantly improved in smokers who switched to HTPs and were not significantly different from cessation. The remaining 13 biomarkers did not improve—in some instances worsening upon switching to HTPs—or were inconsistently affected across studies. There were no appropriate data to estimate the lung cancer risk of HTPs in non-smokers.

Conclusions

The appropriateness of existing biomarker data in assessing lung cancer risk of HTPs, both relative to cigarettes and their absolute risk, is limited. Furthermore, findings on the most appropriate biomarkers were conflicting across studies and largely showed no improvement following a switch to HTPs.

Implications

Biomarker data are fundamental to assessing the reduced risk potential of HTPs. Our evaluation suggests much of the existing biomarker data on HTPs is inappropriate for determining the risk of lung cancer posed by HTPs. In particular, there is a paucity of data on the absolute lung cancer risk of HTPs, which could be obtained from comparisons to smokers who quit and never smokers exposed to or using HTPs. There is an urgent need for further exploration of the lung cancer risks posed by HTPs, via clinical trials and, in the long-term, confirmation of these risks via epidemiological studies. However, careful consideration should be given to biomarker selection and study design to ensure both are appropriate and will provide valuable data.
The association between self-treatment and mental health among Swedish physicians
Authors: Jonsson P , Christiansen F , Brulin E
Published: May 2023

Background

Despite a high prevalence of mental health problems among physicians, the rate of help-seeking behaviour is low. Instead, physicians tend to self-treat. This can have a negative impact on individual physicians and society.

Aims

The aim was to explore the relationship between self-rated depression, the use of psychotropic medication, and the extent of self-treatment across gender and hierarchical position among Swedish physicians. In addition, the aim was to investigate whether social support can buffer against self-treatment.

Methods

This study draws on data from the Longitudinal Occupational Health for Health Care in Sweden 2021 study, comprising a representative sample of physicians. Descriptive statistics and logistic regressions were carried out.

Results

The present study showed that approximately 60% of the physicians using narcotic or non-narcotic psychotropic medication were self-prescribing. Male and more senior physicians self-treated to a greater extent. Physicians without depression were self-treating to a greater extent than those with depression. Those who used non-narcotic psychotropic medication intermittently were more likely to self-treat than those who used these medications regularly. The frequency of use was insignificant in relation to self-treatment with narcotic psychotropic medication. No buffering effect from social support at work was found.

Conclusions

Self-treatment was common among physicians in Sweden, particularly among those who reported mild or no symptoms of depression. This may have negative long-term effects on an individual level and for Swedish health care at large.
Understanding the Relationship Between Antiviral Prescription Data and COVID-19 Incidence in New York City: A Retrospective Cohort Study
Authors: Kaul Christina M , Cohen Gabriel M , Silverstein Matthew , Wallach Andrew B , Diago-Navarro Elizabeth , Holzman Robert S , Foote Mary K
Published: May 2023

The coronavirus disease 2019 (COVID-19) pandemic has caused more than 675 million confirmed cases and nearly 7 million deaths worldwide [1]. While testing for COVID-19 was initially centered in health care facilities, with required reporting to health departments, it is increasingly being performed in the home with rapid antigen testing [2]. Most at-home tests are self-interpreted and not reported to a provider or health department, which could lead to delayed reporting or underreporting of cases [3]. As such, there is a strong possibility that reported cases may become a less reliable indicator of transmission over time.
Undiagnosed Cognitive Impairment and Impact on Instrumental Activities of Daily Living Among People With HIV Infection in Primary Care
Authors: Lam Jennifer O , Hou Craig E , Gilsanz Paola , Lee Catherine , Lea Alexandra N , Satre Derek D , Silverberg Michael J
Published: May 2023

Background

Little is known about the prevalence of undiagnosed cognitive impairment and its impact on instrumental activities of daily living (IADL) among people with HIV (PWH) in primary care.

Methods

PWH were recruited from an integrated health care setting in the United States. PWH were eligible for recruitment if they were ≥50 years old, taking antiretroviral therapy (ie, ≥1 antiretroviral therapy [ART] prescription fill in the past year), and had no clinical diagnosis of dementia. Participants completed a cognitive screen (St. Louis University Mental Status exam) and a questionnaire on IADL (modified Lawton-Brody).

Results

Study participants (n = 47) were mostly male (85.1%), 51.1% White, 25.5% Black, 17.0% Hispanic, and the average age (SD) was 59.7 (7.0) years. Overall, 27 (57.5%) participants were categorized as cognitively normal, 17 (36.2%) as having mild cognitive impairment, and 3 (6.4%) as having possible dementia. Of the 20 participants with mild cognitive impairment or possible dementia, 85.0% were men, the average age (SD) was 60.4 (7.1) years; 45.0% were White, 40.0% were Black, 10.0% were Hispanic, and 30.0% reported difficulty with at least 1 IADL. Most (66.7%) attributed difficulty with IADL primarily (33.3%) or in part (33.3%) to cognitive problems.

Conclusions

Undiagnosed cognitive impairment is frequent among ART-treated PWH, with possible elevated risk among Black PWH, and may be accompanied by difficulty with IADL. Efforts are needed to optimize identification of factors contributing to cognitive and IADL difficulties among ART-treated PWH in primary care.
Adjuvant Olaparib for Germline BRCA Carriers With HER2-Negative Early Breast Cancer: Evidence and Controversies
Authors: Morganti Stefania , Bychkovsky Brittany L , Poorvu Philip D , Garrido-Castro Ana C , Weiss Anna , Block Caroline C , Partridge Ann H , Curigliano Giuseppe , Tung Nadine M , Lin Nancy U , Garber Judy E , Tolaney Sara M , Lynce Filipa
Published: May 2023

In the OlympiA study, 1 year of adjuvant olaparib significantly extended invasive disease-free survival and overall survival. The benefit was consistent across subgroups, and this regimen is now recommended after chemotherapy for germline BRCA1/2 mutation (gBRCA1/2m) carriers with high-risk, HER2-negative early breast cancer. However, the integration of olaparib in the landscape of agents currently available in the post(neo)adjuvant setting—ie, pembrolizumab, abemaciclib, and capecitabine—is challenging, as there are no data suggesting how to select, sequence, and/or combine these therapeutic approaches. Furthermore, it is unclear how to best identify additional patients who could benefit from adjuvant olaparib beyond the original OlympiA criteria. Since it is unlikely that new clinical trials will answer these questions, recommendations for clinical practice can be made through indirect evidence. In this article, we review available data that could help guide treatment decisions for gBRCA1/2m carriers with high-risk, early-stage breast cancer.
Regarding “Neoadjuvant Versus Adjuvant Chemotherapy for Resectable Metastatic Colon Cancer in Non-academic and Academic Programs”
Authors: Su I-Hsuan , Lund Jennifer L , Gaber Charles E , Sanoff Hanna K , Strassle Paula D , Duchesneau Emilie D
Published: May 2023

This letter to the editor expresses concerns related to immortal time bias that may partially account for recently published study results.
The role of childhood left-behind experience on childhood trauma exposure and mental health outcomes: a propensity score matching (PSM) analysis
Authors: Duan Zhizhou , Feng Yi , Xu Shicun , Gao Desheng , Ji Yan , Sun Xi , Chen Runsen , Wang Yuanyuan
Published: May 2023

Background

China has a significant number of left-behind families. This study focuses on the long-term effects of childhood left-behind experience on different type of childhood trauma and mental health outcomes in later life development.

Methods

participants were 67 795 Chinese young adults. Psychosocial characteristics were screened by sleep quality, the nine-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, trauma screening questionnaire for post-traumatic stress, a short form of the Childhood Trauma Questionnaire for childhood trauma. Propensity score matching (PSM) and multivariate linear regression were applied to analyze the data.

Results

the results of the post-PSM analysis showed that the distributions of propensity scores for the two groups were approximately equal. And the total sample size in post-analysis dropped to 2358 (Nnuclear family = 1179, Nleft-behind family = 1179), with unmatched cases excluded. Post-matching results showed that the students from left-behind family were significantly associated with severer post-traumatic stress (b = 0.39, 95% CI = [0.15, 0.62]), loneliness (b = 0.29, 95% CI = [0.16, 0.42]), depressive symptoms (b = 0.44, 95% CI = [0.06, 0.82]) and CTQ-physical neglect (b = 0.34, 95% CI = [0.11, 0.58]).

Conclusion

our study showed that childhood left-behind experiences are tightly related to childhood trauma experience and mental health issues (post-traumatic stress, loneliness and depression) in late adolescents.