bluuebunny/crossref_metadata_2025 huggingface dataset:
Beetroot juice, exercise, and cardiovascular function in women planning to conceive
Authors: Osman Mubarak M.A. , Mullins Edward , Kleprlikova Hana , Wilkinson Ian B. , Lees Christoph
Published: September 2023

Objective:

Prepregnancy optimization of cardiovascular function may reduce the risk of pre-eclampsia. We aimed to assess the feasibility and effect of preconception cardiovascular monitoring, exercise, and beetroot juice on cardiovascular parameters in women planning to conceive.

Design and method:

Prospective single-site, open-label, randomized controlled trial. Thirty-two women, aged 18–45 years, were allocated into one of four arms (1 : 1 : 1 : 1): exercise, beetroot juice, exercise plus beetroot juice and no intervention for 12 weeks. Blood pressure (BP) was measured at home daily. Cardiac output (CO) and total peripheral resistance (TPR) were assessed via bio-impedance.

Results:

Twenty-nine out of 32 (91%) participants completed the study. Adherence to daily BP and weight measurements were 81% and 78%, respectively (n = 29). Eight out of 15 (53%) of participants did not drink all the provided beetroot juice because of forgetfulness and taste. After 12 weeks, exercise was associated with a reduction in standing TPR (−278 ± 0.272 dynes s cm−5, P < 0.05), and an increase in standing CO (+0.88 ± 0.71 l/min, P < 0.05). Exercise and beetroot juice together was associated with a reduction in standing DBP ( 7 ± 6 mmHg, P < 0.05), and an increase in standing CO (+0.49 ± 0.66 l/min, P < 0.05). The control group showed a reduction in standing TPR ( 313 ± 387 dynes s cm−5) and standing DBP ( 8 ± 5mmHg). All groups gained weight.

Conclusion:

Exercise and beetroot juice in combination showed a signal towards improving cardiovascular parameters. The control group showed improvements, indicating that home measurement devices and regular recording of parameters are interventions in themselves. Nevertheless, interventions before pregnancy to improve cardiovascular parameters may alter the occurrence of hypertensive conditions during pregnancy and require further investigation in adequately powered studies.
A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/amlodipine single-pill vs. multiple-pill combination in Italy
Authors: Snyman Jacques R. , Bortolotto Luiz Aparecido , Degli Esposti Luca , Jayagopal Pathiyil Balagopalan , Konradi Alexandra O. , Perrone Valentina , Borghi Claudio
Published: September 2023

Objectives:

This analysis compared adherence, cardiovascular (CV) events and all-cause mortality incidence, and healthcare costs among hypertensive patients treated with perindopril (PER)/indapamide (IND)/amlodipine (AML) in single-pill combination (SPC) vs. multiple-pill combination, in a real-world setting in Italy.

Methods:

In this observational retrospective analysis of Italian administrative databases, adult patients treated with PER/IND/AML between 2010 and 2020 were divided into two cohorts: single-pill vs. multiple-pill. Patient data were available for at least one year before and after index date. Propensity score matching (PSM) was applied to reduce selection bias. Adherence was defined as proportion of days covered: non-adherence, <40%; partial adherence, 40–79%, and adherence ≥80%. Mortality incidence and CV events as single, or composite, endpoints were evaluated after first year of follow-up. Healthcare cost analyses were performed from the perspective of the Italian National Health Service.

Results:

Following PSM, the single-pill cohort included 12 150 patients, and the multiple-pill cohort, 6105. The SPC cohort had a significantly higher percentage of adherent patients vs. the multiple-pill cohort (59.9% vs. 26.9%, P < 0.001). Following the first year of follow-up, incidence of all-cause mortality, and combined endpoint of all-cause mortality and CV events were lower in the SPC cohort compared with multiple-pill cohort. Average annual direct healthcare costs were lower in the single-pill cohort (€2970) vs. multiple-pill cohort (€3642); cost of all drugs and all-cause hospitalizations were major contributors.

Conclusion:

The SPC of PER/IND/AML, compared with multiple-pill combination, is associated with higher adherence to medication, lower incidence of CV events and mortality, and reduced healthcare costs.
Insights into spaceflight-associated neuro-ocular syndrome with review of intraocular and orbital findings
Authors: Milner Dallin C. , Subramanian Prem S.
Published: September 2023

Purpose of review

Spaceflight-associated neuro-ocular syndrome (SANS) remains a phenomenological term, and advances in ophthalmic imaging as well as new insights from ground-based experiments have given support to new theories of how SANS develops and what may be done to counter it.

Recent findings

SANS has been postulated to arise from elevated intracranial pressure (ICP) during long-duration spaceflight (LDSF). However, recent work has shown that acute microgravity exposure does not increase ICP, and the effect of cephalad fluid shifts on ICP in microgravity remain unknown. In addition, structural imaging of the retina and optic nerve show changes after LDSF that are distinct from findings in terrestrial patients with elevated ICP. Since astronauts have not reported symptoms that would be expected with chronic ICP elevation, new theories that orbital and/or intracranial venous pressure may be the primary contributors to the development of SANS.

Research has been filling knowledge gaps that exist regarding the cause(s) of SANS, and these advances are crucial steps in the effort to design countermeasures that will be required before human deep space exploration missions can be undertaken.
Neuro-ophthalmic manifestations of Ehlers–Danlos syndrome
Authors: Rachapudi Sruti S. , Laylani Noor A. , Davila-Siliezar Pamela A. , Lee Andrew G.
Published: September 2023

Purpose of review

To review the neuro-ophthalmic manifestations of Ehlers–Danlos syndrome (EDS).

Recent findings

Ehlers–Danlos syndrome (EDS) is a rare genetic disorder with an estimated prevalence of 1 in 5000 individuals, but its true prevalence may be underestimated because of variable clinical presentations and limited awareness among healthcare professionals. The neuro-ophthalmic features of EDS may be difficult to recognize in context but new molecular genetic testing is now available for identification of specific subtypes of EDS.

Ophthalmic manifestations of EDS include loss of vision and double vision (strabismus), high myopia, retinal detachment, and blue sclera. The vascular subtype of EDS can present as a carotid-cavernous fistula, intracranial aneurysm, or arterial dissection.
Outcomes of radiocarpal pinning to facilitate nerve repair in wrist-level ulnar nerve injuries with defect
Authors: Lo I-Ning , Yin Cheng-Yu , Huang Hui-Kuang , Huang Yi-Chao , Wang Jung-Pan
Published: September 2023

Background:

The ideal scenario for ulnar nerve repair is primary end-to-end neurorrhaphy in a tension-free environment. However, this could be complicated by soft tissue loss, scarring, and neuroma formation in a delayed injury, creating a nerve defect. With a wrist-level nerve defect, a flexion position can help shorten the nerve gap; however, maintaining the position can be challenging intraoperatively and postoperatively.

Methods:

Previously, we proposed our method of using a 1.6-mm K wire for radius-lunate-capitate pinning of the wrist in flexion to minimize the nerve gap, thereby facilitating neuroma excision and end-to-end neurorrhaphy in delayed ulnar nerve injury. In this study, we elaborate our method and present our case series.

Results:

From October 2018 to July 2020, five patients (mean age: 48.2 years; mean delay from injury to surgery: 84.6 days; mean follow-up: 17.5 months) were retrospectively reviewed. The mean flexion fixation angle was 52°, and the K wire was removed at an average of 5.1 weeks postoperatively. All patients were followed up for a minimum of 12 months. All patients achieved M4 and S3 or S3+ neurologically (according to the criteria of the Nerve Injuries Committee of the British Medical Research Council). The mean disabilities arm, shoulder, and hand score was 14.1. The mean grasp and pinch strengths were, respectively, 76.8% and 63.6% of the contralateral hand. All wrist range of motion returned to normal within 12 weeks. No complications were noted intraoperatively or postoperatively.

Conclusion:

Our study showed that radiocarpal pinning of the wrist in flexion was safe and convenient to minimize the nerve gap and to facilitate end-to-end neurorrhaphy in limited-sized wrist-level ulnar nerve defects.
Plasma Cell Vulvitis: A Classification Into Two Clinical Phenotypes
Authors: Wendling Jeanne , Plantier Françoise , Moyal-Barracco Micheline
Published: September 2023

Objective

The etiology of plasma cell vulvitis (PCV) is debated. The authors aimed to test the hypothesis that PCV could be divided into 2 clinical phenotypes.

Methods

Patients with a clinico-pathological diagnosis of PCV and with available vulvar photos seen in a vulvar clinic were retrospectively studied. The cases of PCV were divided into 2 groups: non–lichen-associated (primary PCV) and lichen-associated (secondary PCV). The 2 groups were compared in terms of age, menopausal status, location of the PCV, and 12 histologic parameters (Fisher exact test, p < .05).

Results

Thirty-five patients (20 primary and 15 secondary PCV) were included. The 2 groups did not differ in terms of age (mean, 65; range, 50–85) or menopausal status. Primary PCV was located exclusively on the vestibule for 19/20 patients, whereas secondary PCV was extravestibular for 14 of 15 patients, either exclusively (2) or both extravestibular and vestibular (12). One patient with secondary PCV had solely vestibular involvement. Five histological features were observed significantly more often in case of secondary PCV: epidermal atrophy, parakeratosis, dermal and epidermal neutrophils, and dermal eosinophils.

Conclusions

Plasma cell vulvitis can be divided clinically into 2 phenotypes. Primary non–lichen-associated PCV is restricted to the vestibule and could be the vulvar counterpart of atrophic vaginitis. Secondary lichen-associated PCV is both extravestibular and vestibular, and its clinical and histological features should be looked for outside the PCV areas. This division of PCV into 2 clinical phenotypes could have therapeutic implications.
Correlating Vestibular Migraine Patient Assessment Tool and Handicap Inventory to Daily Dizziness Symptoms
Authors: Kim Eric K. , Hum Maxwell , Sharon Jeffrey D.
Published: September 2023

Objective

Investigate the relationship between Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI) scores and daily dizziness symptoms.

Study Design

Prospective cohort analysis of 52 patients with vestibular migraine (VM).

Setting

Tertiary referral center.

Patients

Fifty-two patients diagnosed with VM or probable VM according to Barany Society criteria.

Interventions

Subjects reported their dizzy symptoms (on a scale of 0 [no symptoms], 1 [mild], 2 [moderate], and 3 [severe]) every day for 1 month via automated text messaging linked to a cloud-based research database. Subjects completed VM-PATHI and Dizziness Handicap Inventory (DHI) scores at the end of the month. We examined the correlation between a composite of daily dizziness scores with VM-PATHI and DHI scores through linear regression and correlation analysis.

Main Outcome Measures

Pearson correlation coefficient,R2value.

Results

VM-PATHI showed a moderate correlation with daily dizziness symptoms (correlation coefficient, 0.51). DHI showed a lower correlation with daily dizziness (correlation coefficient, 0.38). VM-PATHI score was a strong predictor of daily dizziness with univariate linear regression (R2= 0.26,p= 0.001). In a multiple linear regression model with age, history of anxiety and/or depression, and VM-PATHI, the VM-PATHI score was the only statistically significant predictor of daily dizziness (p< 0.001).

Conclusions

Daily dizziness symptoms are better correlated with VM-PATHI score than the DHI, providing further validation of VM-PATHI as a disease-specific outcome measure for patients with VM.
Coagulation management during liver transplantation: monitoring and decision making for hemostatic interventions
Authors: Vandyck Kofi B. , Rusin Walter , Mondal Samhati , Tanaka Kenichi A.
Published: September 2023

Purpose of review

Rebalanced hemostasis describes the precarious balance of procoagulant and antithrombotic proteins in patients with severe liver failure. This review is aimed to discuss currently available coagulation monitoring tests and pertinent decision-making process for plasma coagulation factor replacements during liver transplantation (LT).

Recent findings

Contemporary viscoelastic coagulation monitoring systems have demonstrated advantages over conventional coagulation tests in assessing the patient's coagulation status and tailoring hemostatic interventions. There is increasing interest in the use of prothrombin complex and fibrinogen concentrates, but it remains to be proven if purified factor concentrates are more efficacious and safer than allogeneic hemostatic components. Furthermore, the decision to use antifibrinolytic therapy necessitates careful considerations given the risks of venous thromboembolism in severe liver failure.

Perioperative hemostatic management and thromboprophylaxis for LT patients is likely to be more precise and patient-specific through a better understanding and monitoring of rebalanced coagulation. Further research is needed to refine the application of these tools and develop more standardized protocols for coagulation management in LT.
Ureterorenoscopy for stone disease in pregnancy: a literature review and update
Authors: Graf Sebastian , Somani Bhaskar K.
Published: September 2023

Purpose of review

Management of stone disease in pregnancy poses a challenge for all healthcare professionals involved in their care. During pregnancy, there is an increase in the incidence of urolithiasis. Major technological and procedural advances have been seen in the last decade for endoscopic management of urolithiasis. The purpose of this review is to provide a comprehensive workup of available literature on use of ureteroscopy for stone treatment during pregnancy.

Recent findings

We identified 268 articles on screening, of which 28 were included in the final review. Overall adverse event rates were low, with no severe complications reported in the included studies. On multivariate analysis, the only significant correlation was an inverse relationship between calculated caseload and adverse obstetric events. No further correlation could be found between caseload, operation technique and adverse event rates. Data quality was low among the included studies.

While ureteroscopy is a relatively safe and effective option for active stone treatment during pregnancy, they should be performed in experienced endourology centres in conjunction with obstetric teams.
Communicating Patient Discharge Readiness
Authors: Keniston Angela , McCreight Marina S. , Burden Marisha , Moore Susan L. , Haugen Heather , Rice John , Battaglia Catherine
Published: September 2023

Background:

The progression of patients through a hospital from admission to discharge can be slowed by delays in patient discharge, increasing pressure on health care staff. We designed and piloted the Discharge Today tool, with the goal of improving the efficiency of patient discharge; however, adoption remained low.

Purpose:

To close this implementation gap, we deployed and evaluated a 4-part implementation strategy bundle.

Methods:

We measured the success of implementation by evaluating validated implementation outcomes using both quantitative and qualitative methods, grounded in Normalization Process Theory.

Results:

The implementation strategies used were effective for increasing use of the Discharge Today tool by hospital medicine physicians and advanced practice providers during both the active and passive implementation periods.

Conclusions:

While the implementation strategies used were effective, qualitative findings indicate that limitations in the functionality of the tool, alongside inconsistent use of the tool across clinical staff, continued to inhibit adoption.
Symptoms in Patients Receiving Noninvasive Ventilation in the Intensive Care Unit
Authors: Peterson Pamela E. , Tracy Mary Fran , Mandrekar Jay , Chlan Linda L.
Published: September 2023

Background

While a multitude of studies have demonstrated the effectiveness of noninvasive ventilation (NIV) for treatment of respiratory insufficiency, there have been few investigations of patients’ experiences while receiving this common treatment. Identification of the presence, intensity, and distress of symptoms during NIV will inform the development and testing of interventions to best manage them and improve patients’ intensive care unit (ICU) experiences.

Objective

The objectives of this study were to (a) identify the presence, intensity, and distress of symptoms in patients receiving NIV in the ICU using a modified version of the Edmonton Symptom Assessment Scale (MESAS) and (b) describe the most common and distressing symptoms experienced by patients.

Method

A cross-sectional descriptive design was used with a convenience sample of 114 participants enrolled from three ICUs at one Midwestern medical center. Participants were approached if they were English-speaking, age 18 or older, and had an active order for NIV; exclusions included use of personal NIV equipment, severe cognitive impairment, or problems communicating. Demographic and clinical data were obtained from the electronic health record. Presence, intensity, and distress of patient-reported symptoms were obtained once using a modified, 11-item version of the MESAS.

Results

The mean age of participants was 68 years old, and 54.4% were male. The primary type of NIV was bi-level positive airway pressure; a nasal/oral mask was most frequently used. The symptoms experienced by a majority of participants were thirst, anxiety, tiredness, and restlessness; these symptoms were rated as moderate or severe in both intensity and distress by most participants experiencing the symptoms.

Discussion

Patients in the ICU experience both intense and distressful symptoms that can be severe while undergoing treatment with NIV. Future research is warranted to determine these symptoms’ interrelatedness and develop interventions to effectively manage patient-reported symptoms.
Feasibility, Acceptability, and Preliminary Effectiveness of a Sleep Intervention in Adults at Risk for Metabolic Syndrome With Short Sleep Duration
Authors: Malone Susan Kohl , Patterson Freda , Grunin Laura , Yu Gary , Dickson Victoria Vaughan , Melkus Gail D’Eramo
Published: September 2023

Background

The prevalence of short sleep duration is rising and is linked to chronic comorbidities, such as metabolic syndrome (MetS). Sleep extension interventions in adults with MetS comorbidities and short sleep duration are limited and vary widely in terms of approach and duration.

Objectives

This pilot study aimed to test the feasibility and acceptability of a personalized 12-week systematic sleep time extension intervention on post-intervention sleep outcomes in middle-aged adults at risk for MetS with actigraphy-estimated short sleep duration.

Methods

A single-arm, 12-week, 12-session systematic sleep time extension intervention was delivered weekly via videoconferencing. Feasibility and acceptability were assessed using retention rates and mean sleep diary completions. Sleep was estimated for 14 consecutive days prior to and immediately following the 12-week intervention using wrist actigraphy. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Paired sample t-tests modeled changes in study outcomes.

Results

Study participants (N = 41) had a mean age of 52 years and were mostly female and White; 86% attended >80% of sessions, and mean sleep diary completion was 6.7 diaries/week. Significant improvements in sleep from pre- to post-intervention included increased total sleep time, earlier sleep onsets, more regular sleep onsets, a higher sleep regularity index, and reduced daytime sleepiness. Extending sleep, as well as improving sleep timing and regularity in middle-aged adults with actigraphy-estimated short sleep duration and at risk for MetS, is feasible and acceptable.

Discussion

Behavioral sleep characteristics may be modifiable and present a novel behavioral paradigm for mitigating MetS risk. This pilot study provides a proof of concept for the feasibility, acceptability, and preliminary effectiveness of a systematic sleep time extension for middle-aged adults at risk for MetS with actigraphy-estimated short sleep duration.
Radioguided Occult Lesion Localization Technique for Biopsy of Nonpalpable Subcutaneous Lesions in Suspected Metastatic Melanoma
Authors: Di Lorenzo Sara , Milia Walter R. , Corradino Bartolo , Rinaldi Gaetana , Rao Marco , Cordova Adriana
Published: September 2023

In patients with a history of melanoma, the risk of recurrence depends on the stage at diagnosis. Patients who present with more advanced disease are more likely to experience recurrence; patients with less advanced disease at presentation have slower progression and lower likelihood of recurrence. The aim of this study was to evaluate the use of a minimally invasive and targeted technique as a diagnostic and therapeutic tool for the excision of nonpalpable lesions suspected to be melanoma metastases. The authors evaluated 21 patients with stage IIB, IIC, or III melanoma and subcutaneous nonpalpable lesions with a high risk of malignancy on positron emission tomography/computed tomography scan during oncologic follow-up. To guide biopsy, the authors used the radioguided occult lesion localization technique, using intralesional injection of technetium-99m albumin macroaggregates the day before surgery. During surgery, a handheld gamma probe was used to locate the lesions. Surgical localization of radiolabeled lesions was achieved in all cases. Relapsed melanoma was histologically confirmed in 13 patients. This technique proved to be a simple, safe, and effective method to detect and biopsy nonpalpable or difficult-to-locate lesions in suspected metastatic melanoma. The main advantage was disease restaging (eg, from stage II to III), allowing patients to access adjuvant therapies not approved as early-stage melanoma treatment.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Intraoperative Evaluation of Textured Anatomical Implant Rotation: A Prospective Study
Authors: Gary Cyril S. , Kirloskar Kunal M. , Koh Min Jung , Abadeer Andrew I. , Wang Jessica S. , del Corral Gabriel , Fan Kenneth L. , Song David H.
Published: September 2023

Background:

Textured implants were developed with the goal of reducing rates of capsular contracture and preventing implant malposition (eg, malrotation). Recent evidence has questioned whether textured implants are as resistant to malrotation as previously reported.

Methods:

Women presenting to a single health care system for removal of textured implants were prospectively enrolled in the study from September of 2019 to July of 2022. Patients who underwent removal of an anatomical, textured implant in the operating room were included in the study; whereas those who did not undergo implant removal, or were found to have a smooth implant, or a round, textured implant, were excluded. The degree of implant rotation on removal of the implant was measured intraoperatively. Information regarding implant-specific factors, patient demographics, clinical factors, and operative characteristics, was collected.

Results:

A total of 51 patients (80 implants) were included in the study; 45% of implants were malrotated (rotated >30 degrees), and the median degree of rotation was 30 degrees. Having more than one previous revision of the breast pocket was predictive of implant rotation (42 degrees) on multivariate linear regression analysis. Patients who presented with a complaint of “aesthetic dissatisfaction” had 2.89 increased odds of having an implant rotated greater than 30 degrees.

Conclusion:

The authors’ study found a high rate of malrotation of textured shaped implants on explantation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
Chest Wall Injury Society recommendation for surgical stabilization of nonunited rib fractures to decrease pain, reduce opiate use, and improve patient reported outcomes in patients with rib fracture nonunion after trauma
Authors: Forrester Joseph D. , Bauman Zachary M. , Cole Peter A. , Edwards John G. , Knight Ariel W. , LaRoque Michael , Raffa Taylor , White Thomas W. , Kartiko Susan
Published: September 2023

BACKGROUND

Rib fractures are common injuries which can be associated with acute pain and chronic disability. While most rib fractures ultimately go on to achieve bony union, a subset of patients may go on to develop non-union. Management of these nonunited rib fractures can be challenging and variability in management exists.

METHODS

The Chest Wall Injury Society’s Publication Committee convened to develop recommendations for use of surgical stabilization of nonunited rib fractures (SSNURF) to treat traumatic rib fracture nonunions. PubMed, Embase, and the Cochrane database were searched for pertinent studies. Using a process of iterative consensus, all committee members voted to accept or reject the recommendation.

RESULTS

No identified studies compared SSNURF to alternative therapy and the overall quality of the body of evidence was rated as low. Risk of bias was identified in all studies. Despite these limitations, there is lower-quality evidence suggesting that SSNURF may be beneficial for decreasing pain, reducing opiate use, and improving patient reported outcomes among patients with symptomatic rib nonunion. However, these benefits should be balanced against risk of symptomatic hardware failure and infection.

CONCLUSION

This guideline document summarizes the current CWIS recommendations regarding use of SSNURF for management of rib nonunion.

LEVEL OF EVIDENCE

Therapeutic/Care Management; Level IV.
Catatonic postpartum paternal depression as a first debut of a bipolar disorder: a case report
Authors: de Juan Oscar , Mas Albert , Giménez-Palomo Anna , Gil-Badenes Joaquín , Ilzarbe Lídia , Colomer Lluc , Andreu Helena , Bueno Laura , Olivier Luis , Estévez Beatriz , Fernández-Plaza Tábatha , Tardón-Senabre Laia , Arbelo Néstor , Valentí Marc , Gomes da Costa Susana , Pujol-Fontrodona Gabriel , Vieta Eduard , Pacchiarotti Isabella
Published: September 2023

Paternal postpartum depression (PD) is considered an affective disorder that affects fathers during the months following childbirth. Interestingly, it has been observed that during these months the chances of a male parent suffering from depression are double that for a non-parent male counterpart. We present the case of a 34-year-old man with no relevant medical history in who, overlapping her daughter’s birth, several depressive symptoms emerged, such as fatigue, lack of concentration, sleeping disturbances and abandonment of care of the newborn. Prior to consultation, patient refused to eat and open his eyes, and his speech became progressively more parsimonious until reaching mutism. The patient was diagnosed with a severe depressive disorder with catatonia. Given the lack of improvement with pharmacological treatment and due to the evidence of electroconvulsive therapy (ECT)’s effectiveness on patients with catatonia, acute ECT treatment was indicated and started. It should be noted that PD is an important entity to consider in our differential diagnosis of young parents who present a depressive episode. Few cases of relatively young patients presenting with such clinical presentation have been described and, although this case presents some of the characteristics described in the epidemiology of PD, other clinical aspects are not typical of this entity. Informed consent was obtained from the patient for the purpose of publication.
Manic episode in a patient with pancreatic adenocarcinoma: a case report
Authors: Mena Juan I. , Andreu Helena , Giménez-Palomo Anna , Bueno Laura , Cesari Eduard , De Juan Óscar , Ochandiano Iñaki , Olivier Luis , Salmeron Sergi , Vieta Eduard , Pacchiarotti Isabella
Published: September 2023

Psychiatric comorbidity is common in cancer patients, emphasizing the need for comprehensive care. While depressive symptoms in pancreatic cancer have been studied, there is limited attention given to manic symptoms. This case report aims to contribute to the knowledge of pancreatic cancer psychiatric comorbidities by describing a case of a patient with stage IV pancreatic cancer who presented a sudden onset manic episode. The patient, a 61-year-old male with stage IV pancreatic cancer, presented at the Emergency Room with abrupt behavioural changes suggestive of a manic episode of 2 weeks of evolution. The patient had been undergoing chemotherapy and short 3-day cycles of corticosteroids for the past 9 months but had been off this treatment for 20 days when the episode began. Acute organic causes were ruled out. The patient was admitted to the psychiatric unit, where organic screening was expanded and treatment with antipsychotics and a mood stabiliser was initiated with subsequent remission of symptoms after 2 weeks. This case shows a manic episode as a rare psychiatric complication in pancreatic cancer. In the literature reviewed, four other similar cases have been observed. Further research is needed to elucidate the underlying pathophysiology and explore possible treatment strategies.
Phylogenomics of weevils revisited: data curation and modelling compositional heterogeneity
Authors: Li Yan-Da , Engel Michael S. , Tihelka Erik , Cai Chenyang
Published: September 2023

Weevils represent one of the most prolific radiations of beetles and the most diverse group of herbivores on land. The phylogeny of weevils (Curculionoidea) has received extensive attention, and a largely satisfactory framework for their interfamilial relationships has been established. However, a recent phylogenomic study of Curculionoidea based on anchored hybrid enrichment (AHE) data yielded an abnormal placement for the family Belidae (strongly supported as sister to Nemonychidae + Anthribidae). Here we reanalyse the genome-scale AHE data for Curculionoidea using various models of molecular evolution and data filtering methods to mitigate anticipated systematic errors and reduce compositional heterogeneity. When analysed with the infinite mixture model CAT-GTR or using appropriately filtered datasets, Belidae are always recovered as sister to the clade (Attelabidae, (Caridae, (Brentidae, Curculionidae))), which is congruent with studies based on morphology and other sources of molecular data. Although the relationships of the ‘higher Curculionidae’ remain challenging to resolve, we provide a consistent and robust backbone phylogeny of weevils. Our extensive analyses emphasize the significance of data curation and modelling across-site compositional heterogeneity in phylogenomic studies.
Sparsification of large ultrametric matrices: insights into the microbial Tree of Life
Authors: Gorman Evan , Lladser Manuel E.
Published: September 2023

Ultrametric matrices appear in many domains of mathematics and science; nevertheless, they can be large and dense, making them difficult to store and manipulate, unlike large but sparse matrices. In this manuscript, we exploit that ultrametric matrices can be represented as binary trees to sparsify them via an orthonormal base change based on Haar-like wavelets. We show that, with overwhelmingly high probability, only an asymptotically negligible fraction of the off-diagonal entries in random but large ultrametric matrices remain non-zero after the base change; and develop an algorithm to sparsify such matrices directly from their tree representation. We also identify the subclass of matrices diagonalized by the Haar-like wavelets and supply a sufficient condition to approximate the spectrum of ultrametric matrices outside this subclass. Our methods give computational access to a covariance matrix model of the microbiologists’ Tree of Life, which was previously inaccessible due to its size, and motivate introducing a new wavelet-based (beta-diversity) metric to compare microbial environments. Unlike the established metrics, the new metric may be used to identify internal nodes (i.e. splits) in the Tree that link microbial composition and environmental factors in a statistically significant manner.
An asymmetric graded indexed helical structured optical fibre for enhanced optical delays
Authors: Chhabra Hardik , Raj Nipun , Rana K. P. S. , Kumar Vineet
Published: September 2023

Optical fibres are generally used to provide a guided path to optical signals. Optical fibres are classified as multi-mode or single-mode fibres. Multi-mode graded index (GRIN) optical fibres have been prevalent in short-range optical networks, while single-mode GRIN fibres are used for long-range links. Another potential application of optical fibre is the optical delays in numerous applications, such as quantum computing, network buffering, data synchronization, pattern correlation, etc. This paper conceptualizes a novel application of an asymmetric GRIN optical fibre for possible enhanced optical delays. An asymmetric GRIN parabolic profile with helical structure geometry has been proposed for this task. A detailed analysis has been presented to investigate the effects of various parameters of the proposed geometry. Further, a guided propagation has also been demonstrated with the help of ray optics and the Helmholtz wave equation to assess the feasibility of the proposal. The presented investigations revealed that the geometrical length of the proposed structure is significantly compact compared with the traditional GRIN fibre, proving it beneficial for optical delays.
Control limit for the quantum state preparation under stochastic control errors
Authors: Kobayashi Kohei
Published: September 2023

We investigate the effect of stochastic control errors on the Hamiltonian that controls a closed quantum system. Quantum information technologies require careful control for preparing a desired state used as an information resource. However, because the stochastic control errors inevitably appear in realistic situations, it is difficult to completely implement the control Hamiltonian. Under this error, the actual performance of quantum control is far away from the ideal one, and thus it is of great importance to evaluate the effect of the control errors. In this paper, we derive a lower bound of the fidelity between two closed quantum systems obeying the dynamics with and without errors. This bound reveals a reachable and unreachable set of the controlled quantum system under stochastic noises. Also, it is easily computable without considering the stochastic process and needing the full dynamics of the states. We demonstrate the actual performance of this bound via a simple control example. Furthermore, based on this result, we quantitatively evaluate the probability of obtaining the target state in the presence of control errors.
The non-local Lotka–Volterra system with a top hat kernel—Part 1: dynamics and steady states with small diffusivity
Authors: Needham D. J. , Billingham J.
Published: September 2023

We study the dynamics of the non-local Lotka–Volterra system

u
t

=

D
u

u

x
x

+
u
(
1
−
ϕ
∗
u
−
α
v
)

,

v
t

=

D
v

v

x
x

+
v
(
1
−
ϕ
∗
v
−
β
u
)

, where a star denotes the spatial convolution and the kernel

ϕ

is a top hat function. We initially focus on the case of small, equal diffusivities (

D
=

D
u

=

D
v

≪
1

) together with weak interspecies interaction (

α

,

β
≪
1

), and specifically

α
,
β
≪
D

. This can then be extended to consider small, but unequal, diffusivities and weak interactions, with now

α
,
β
≪

D
u

,

D
v

≪
1

. Finally, we are able to develop the theory for the situation when the diffusivities remain small, but the interactions become stronger. In each case, we find that

u

and

v

independently develop into periodic spatial patterns that consist of separated humps on an

O
(
1
)

time scale, and that these patterns become quasi-steady on a time scale proportional to the inverse diffusivity. These then interact on a longer time scale proportional to the inverse interaction scale, and approach a meta-stable state. Finally, a stable steady state is achieved on a much longer timescale, which is exponentially large relative to the preceding time scales. We are able to quantify this interaction process by determining a planar dynamical system that governs the temporal evolution of the separation between the two periodic arrays of humps on these sequentially algebraically and then exponentially long time scales. We find that, once the humps no longer overlap, the subsequent dynamics lead to a symmetric disposition of the humps, occurring on the exponentially long time scale. Numerical solutions of the full evolution problem cannot access the behaviour on this final extreme time scale, but it can be fully explored through the dynamical system.
Evidence for cryptic sex in parthenogenetic stick insects of the genus
Timema
Authors: Freitas Susana , Parker Darren J. , Labédan Marjorie , Dumas Zoé , Schwander Tanja
Published: September 2023

Obligately parthenogenetic species are expected to be short lived since the lack of sex and recombination should translate into a slower adaptation rate and increased accumulation of deleterious alleles. Some, however, are thought to have been reproducing without males for millions of years. It is not clear how these old parthenogens can escape the predicted long-term costs of parthenogenesis, but an obvious explanation is cryptic sex. In this study, we screen for signatures of cryptic sex in eight populations of four parthenogenetic species of
Timema
stick insects, some estimated to be older than 1 Myr. Low genotype diversity, homozygosity of individuals and high linkage disequilibrium (LD) unaffected by marker distances support exclusively parthenogenetic reproduction in six populations. However, in two populations (namely, of the species
Timema douglasi
and
T. monikensis
) we find strong evidence for cryptic sex, most likely mediated by rare males. These populations had comparatively high genotype diversities, lower LD, and a clear LD decay with genetic distance. Rare sex in species that are otherwise largely parthenogenetic could help explain the unusual success of parthenogenesis in the
Timema
genus and raises the question whether episodes of rare sex are in fact the simplest explanation for the persistence of many old parthenogens in nature.
Global patterns and correlates in the emergence of antimicrobial resistance in humans
Authors: Mendelsohn Emma , Ross Noam , Zambrana-Torrelio Carlos , Van Boeckel T. P. , Laxminarayan Ramanan , Daszak Peter
Published: September 2023

Antimicrobial resistance (AMR) is a critical global health threat, and drivers of the emergence of novel strains of antibiotic-resistant bacteria in humans are poorly understood at the global scale. We examined correlates of AMR emergence in humans using global data on the origins of novel strains of AMR bacteria from 2006 to 2017, human and livestock antibiotic use, country economic activity and reporting bias indicators. We found that AMR emergence is positively correlated with antibiotic consumption in humans. However, the relationship between AMR emergence and antibiotic consumption in livestock is modified by gross domestic product (GDP), with only higher GDP countries showing a slight positive association, a finding that differs from previous studies on the drivers of AMR prevalence. We also found that human travel may play a role in AMR emergence, likely driving the spread of novel AMR strains into countries where they are subsequently detected for the first time. Finally, we used our model to generate a country-level map of the global distribution of predicted AMR emergence risk, and compared these findings against reported AMR emergence to identify gaps in surveillance that can be used to direct prevention and intervention policies.
Arctic warming drives striking twenty-first century ecosystem shifts in Great Slave Lake (Subarctic Canada), North America's deepest lake
Authors: Rühland Kathleen M. , Evans Marlene , Smol John P.
Published: September 2023

Great Slave Lake (GSL), one of the world's largest and deepest lakes, has undergone an aquatic ecosystem transformation in response to twenty-first-century accelerated Arctic warming that is unparalleled in at least the past two centuries. Algal remains from four high-resolution palaeolimnological records retrieved from the West Basin provide baseline limnological data that we compared with historical phycological surveys undertaken on GSL between the 1940s and 1990s. We document the rapid restructuring of algal community composition
ca
2000 CE that is consistent with recent increases in regional air temperature and declines in ice cover and wind speed, that collectively altered habitats for aquatic biota. This new limnological regime initiated the first observation of scaled chrysophytes and favoured the rapid proliferation of small planktonic cyclotelloid diatoms which replaced the long-established dominance of large filamentous
Aulacoseira islandica
in West Basin sedimentary records. Such abrupt transformations in the primary producers of this socioecologically valuable ‘northern Great Lake’ may have widespread implications for the entire food web with unknown consequences for aquatic ecosystem functioning and fisheries, which First Nations, Métis and other northern communities depend upon, pointing to the need for new studies.
The interplay of drought and hurricanes on tree recovery: insights from dynamic and weak functional responses
Authors: Umaña María Natalia
Published: September 2023

Identifying the functional traits that enable recovery after extreme events is necessary for assessing forest persistence and functioning. However, the variability of traits mediating responses to disturbances presents a significant limitation, as these relationships may be contingent on the type of disturbance and change over time. This study investigates the effects of traits on tree growth—for short and longer terms—in response to two vastly different extreme climatic events (droughts and hurricanes) in a Puerto Rican forest. I found that trees display a dynamic functional response to extreme climatic events. Leaf traits associated with efficient photosynthesis mediated faster tree growth after hurricanes, while trees with low wood density and high water use efficiency displayed faster growth after drought. In the longer term, over both drought and hurricanes, tree size was the only significant predictor of growth, with faster growth for smaller trees. However, despite finding significant trait–growth relationships, the predictive power of traits was overall low. As the frequency of extreme events increases due to climate change, understanding the dynamic relationships between traits and tree growth is necessary for identifying strategies for recovery.
Hannaella oleicumulans sp. nov. and Hannaella higashiohmiensis sp. nov., two novel oleaginous basidiomycetous yeast species
Authors: Tanimura Ayumi , Adachi Hikaru , Tanabe Koichi , Ogawa Jun , Shima Jun
Published: September 2023

Three strains of novel oleaginous yeast species were isolated from soil samples collected in Shiga Prefecture, Japan. The sequences of the internal transcribed spacer (ITS) region and the D1/D2 region of the large subunit (LSU) of the rRNA genes indicated that these novel yeast species are members of the genus Hannaella. The results of molecular phylogenetic analysis indicated that strains 38–3 and 8s1 were closely related to Hannaella oryzae. They differed by 10 nucleotide substitutions and one gap (1.77 %) in the D1/D2 region of the LSU of the rRNA genes and by 17–18 nucleotide substitutions and 10–11 gaps (5.45–5.85 %) in the ITS region. Strain 51–4 differed from the type strain of the most closely related species, Hannaella pagnoccae, by 26 nucleotide substitutions (4.46 %) in the D1/D2 region of the LSU of the rRNA genes and by 20 nucleotide substitutions and six gaps (5.42 %) in the ITS region. The names proposed for these previously undescribed species are Hannaella oleicumulans sp. nov. and Hannaella higashiohmiensis sp. nov.
Coupling of 12 chromosomal inversions maintains a strong barrier to gene flow between ecotypes
Authors: Moan Alan Le , Stankowski Sean , Rafajlovic Marina , Ortega-Martinez Olga , Faria Rui , Butlin Roger , Johannesson Kerstin
Published: September 2023

Chromosomal rearrangements lead to the coupling of reproductive barriers, but whether and how they contribute to completion of speciation remains unclear. Marine snails of the genusLittorinarepeatedly form hybrid zones between taxa segregating for inversion arrangements, providing opportunities to study this question. Here, we analysed two adjacent transects across hybrid zones between large and dwarf ecotypes ofLittorina fabaliscovering wave exposure gradients in a Swedish island. Applying whole-genome sequences we found 12 putative inversions reaching near differential fixation between the opposite ends of each transect, and being in strong linkage disequilibrium. These inversions cover 20% of the genome and carry 93% of divergent SNPs. Bimodal hybrid zones in both transects indicate that the two ecotypes ofLittorina fabalismaintain their genetic and phenotypic integrity following contact due to strong coupling between inversion clines that strengthened the reproductive barrier. The bimodality resulting from the linked inversions extends into collinear parts of the genome, suggesting a genome-wide coupling. Demographic inference suggests that the coupling built up during a period of allopatry, and has been maintained for more than 1K generations after secondary contact. Overall, this study shows that the coupling of multiple chromosomal inversions contributes to strong reproductive isolation. Importantly, two of the inversions overlap with inverted genomic regions associated with ecotype differences in a closely-related species (L. saxatilis), suggesting the same regions, with similar structural variants, repeatedly contribute to ecotype evolution in distinct species.