bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of computerized self-reported medical history taking and HEAR score for safe early rule-out of cardiac events in acute chest pain patients: the CLEOS-CPDS prospective cohort study
Authors: Brandberg Helge , Schierenbeck Fanny , Sundberg Carl Johan , Koch Sabine , Spaak Jonas , Kahan Thomas
Published: November 2024

Aims

A simplified version of the history, electrocardiogram, age, risk factors, troponin (HEART) score, excluding troponin, has been proposed to rule-out major adverse cardiac events (MACEs). Computerized history taking (CHT) provides a systematic and automated method to obtain information necessary to calculate the HEAR score. We aimed to evaluate the efficacy and diagnostic accuracy of CHT in calculating the HEAR score for predicting MACE.

Methods and results

Prospective study including clinically stable adults presenting with chest pain at the emergency department (ED) of Danderyd University Hospital (Stockholm, Sweden), in 2017–19. Participants entered their medical histories on touchscreen tablets using CHT software. The HEAR and HEART scores were calculated from CHT data. Thirty-day MACE and acute coronary syndrome (ACS) outcomes were retrieved, and the diagnostic accuracy was assessed. Logistic regression was used to determine the most predictive components of the HEAR score. Among 1000 patients, HEART and HEAR scores could be calculated from CHT data in 648 and 666 cases, respectively, with negative predictive values [95% confidence interval (CI)] of 0.98 (0.97–0.99) and 0.99 (0.96–1.00). Two patients with HEAR score <2 experienced a 30-day MACE. The age [odds ratio (OR) 2.75, 95% CI 1.62–4.66] and history (OR 2.38, 95% CI 1.52–3.71) components of the HEAR score were most predictive of MACE. Acute coronary syndrome outcomes provided similar results.

Conclusion

The HEAR score acquired by CHT identifies very-low-risk patients with chest pain in the ED, safely ruling out ACS and MACE. This highlights the value of computerized history taking by patients, which may reduce unnecessary tests and hospital admissions.

Trial Registration

ClinicalTrials.gov NCT03439449.
The burden and trends of heart failure caused by ischaemic heart disease at the global, regional, and national levels from 1990 to 2021
Authors: Zhang Hongwei , Zheng Xiaoyu , Huang Pingping , Guo Lijun , Zheng Yuan , Zhang Dawu , Ma Xiaochang
Published: November 2024

Background

Ischaemic heart disease (IHD) is a major cause of heart failure (HF), a condition expected to increasingly affect global health and economics. This study evaluates the global burden, trends, and disparities of HF linked to IHD, aiming to inform health policy development.

Methods and results

Data from the Global Burden of Disease Study 2021 (GBD2021) are analysed using joinpoint regression, decomposition analysis, and Bayesian age–period–cohort analysis (BAPC). Health disparities are assessed through the Socio-demographic Index (SDI) via the Slope Index of Inequality and the Concentration Index, with future trends projected from 2022 to 2045. In 2021, global HF cases due to IHD were over 19.16 million, with an age-standardized prevalence rate (ASPR) of 228.31 per 100 000 [95% Uncertainty Interval (UI), 188.18–279.55] and age-standardized years lived with disability (ASYLDs) rate of 20.43 per 100 000 [95% UI, 13.55–28.7]. In 2021, there was a 2.87% increase in ASPR and ASYLDs compared with 1990, primarily driven by population growth and aging. Significant reductions in global ASPR and ASYLDs disparities are observed, though the disease burden has intensified in countries with lower SDI levels. Projections indicate that by 2045, while the prevalence and years lived with disability for HF caused by IHD will increase, the ASPR and ASYLDs are expected to decrease.

Conclusion

The global burden of HF due to IHD remains a significant concern. Urgent improvements in the allocation of medical resources and the implementation of effective prevention and management strategies are necessary to address this issue.
“The Butcher on the Bus” Is Less Familiar to Older Adults Than She Is to Younger Adults
Authors: Myftaraj Evi , Skrepnek Olivia , Anderson Nicole D
Published: November 2024

Objectives

The “butcher on the bus” is a term describing recognizing someone as familiar but failing to recollect how we know them. Previous studies probing this phenomenon have not used paradigms that mimic real life, and age-related differences have not been adequately addressed.

Methods

In two studies, younger and older adults studied faces in scene contexts a variable number of times. In the test phases, studied faces were presented identical to the study phase, new faces were presented with new scenes, or studied faces were presented in a different context. In Study 1, this different context was the face presented with new features (pose, hairstyle, and clothing) and in a new scene. In Study 2, this different context was the same scene, but with new features. Participants made recollect, familiar, or new judgments, as well as source memory judgments for each face.

Results

In both studies, younger adults had better recognition discrimination and recollection. The critical finding of both studies was that when faces were presented with new features, in either the same scene or a different scene, older adults did not find these faces as familiar as did younger adults.

Discussion

Age-related declines in face recognition when features change may affect social interactions and everyday recognition tasks, highlighting the need for further research and supportive strategies to assist older adults in recognizing people.
Advancing a geopolitical Europe: the new EU leadership and the Iranian conundrum
Authors: Naeni Amin , Kaunert Christian
Published: November 2024

Since 2019 European leaders have emphasized the necessity for the European Union to proactively project power and embrace its geopolitical responsibilities. Although leaders have developed the concept of a ‘geopolitical EU’ as a new discourse, it remains largely unimplemented. Following the June 2024 elections to the European Parliament, a new EU leadership has taken shape amid escalating geopolitical risks that go beyond Russia's war in Ukraine. This development underscores the urgency of advancing a more robust geopolitical EU. The growing strategic power of Iran, which defines itself as a determined revisionist actor, is perceived as a critical challenge to Europe. This policy paper argues that the EU's current Iran policy is misaligned with its geopolitical ambitions, depicting Iran–EU relations as a geopolitical contestation between a defender and a challenger of the existing international order. In this context, the perspective of a geopolitical EU would create a foundation for the new EU leadership to formulate its foreign policy towards Iran. The EU should enhance institutional and policy coordination to elevate Iran's significance on its geopolitical agenda, and the bloc's new leadership needs to develop a cohesive geopolitical mindset within the EU's decision-making framework. The President of the European Commission should lead efforts to foster a unified approach, while the High Representative should build consensus among member states, aligning with the established geopolitical mindset to engage with Iran. Eventually, the new EU leadership needs to define clear geopolitical objectives and establish effective enforcement mechanisms through its diplomatic, political and economic assets.
Optimal sizing of PV/wind/diesel generator/battery hybrid system for supplying electrical vehicle charging station under different load demands in Saudi Arabia
Authors: Basem Ali , Elbarbary Zakaria Mohamed Salem , Atamurotov Farruh , Abdullayeva Iroda , Reyimberganov Anvar , Benti Natei Ermias
Published: November 2024

Knowing the effect of different load distributions on the optimized sizes of the hybrid renewable energy systems (HRES) and the fixed price of Electric Vehicle (EV) charging station can be useful to potential investors in this sector. Additionally, the amount of CO2 emission under different load demands can help decision-makers in the installation of environmentally friendly EV charging stations. Investigation of fixed prices of installing power stations under different load demands leads to know whether electricity sell prices, and serves by the station owners are economically or not. This would also lead to give a reliable and economical plan to customers by station owners, where both time of arrival and charging prices have a pivotal role. Unlike previous similar studies that mostly consider one type of load demand, this study investigates the optimized HRESs including Photovoltaic panel (PV), Wind Turbine (WT), Diesel Generator (DG), and Battery (Bat) under five different proposed load demands (as electricity serving plans), reaching to the best economic, environmental, and space optimality systems. Three main sensitivity analyses upon the capacity shortage/inflation rate, capital cost of PV/WT, and solar global horizontal irradiation (GHI)/wind speed show the effect of changing the mentioned parameters on the economic, environment, and optimized systems’ sizes. It is observed that increase in the solar radiation and/or wind speed leads to reduction in the optimal size of designed systems.
Phylogeny and evolution of larval feeding mode in the megadiverse superfamily Sciaroidea (Diptera)
Authors: Lim Wonseop , Bang Woo Jun , Baek Min Jeong , Park Sun-Jae , Shin Seunggwan
Published: November 2024

Sciaroidea is a megadiverse clade within Diptera that exhibits diverse larval feeding modes. In this study, we explored the phylogenetic relationships and evolution of larval feeding modes within the superfamily using a fossil-calibrated time tree. We found that filtering out potentially fast-evolving sites altered the family-level tree topology, and that species within Sciaroidea incertae sedis might be crucial in determining the general tree topology. The most recent common ancestor of Sciaroidea was inferred to have originated in the Upper Triassic (~225 Ma). A major radiation of families occurred from the Uppermost Triassic to the Lowermost Jurassic (190–200 Ma). The ancestral larval feeding mode was inferred to be mycophagy. Most families retained this feature with only minor transitions occurring in some clades; however, Cecidomyiidae and Keroplatidae went through notable shifts in larval feeding mode. Cecidomyiidae underwent a transition from mycophagy to phytophagy in the Lower Cretaceous, in line with angiosperm radiation as suggested in previous studies. The larvae of stem Keroplatidae were inferred to be predators since the Jurassic. A transition back to mycophagy occurred within the subfamily Keroplatinae during the Paleogene to Uppermost Cretaceous, coinciding with the origin and radiation of species-rich mycophagous clades of other sciaroid families. Our study highlights the importance of taxon sampling and sequence filtering in phylogenetic analyses of Sciaroidea. We suggest, based on temporal patterns of lineage diversification, that the evolution of larval feeding modes within the group might be correlated with the diversification of mushroom-forming fungi and angiosperms.
Use of mobile applications and mental health services among veterans who received internet-connected tablets
Authors: Griffin Ashley C , Greene Liberty , Slightam Cindie , Wray Charlie M , Wielgosz Joseph , Kuhn Eric , Blonigen Daniel , Zulman Donna M
Published: November 2024

Objectives

Among Veterans Health Administration (VHA) patients receiving internet-connected tablets, we examined (1) app usage, (2) clusters of commonly used apps and patient characteristics across clusters, and (3) the relationship between app clusters and mental health services.

Materials and Methods

A survey was distributed to a national sample of VHA patients (n = 5449) within 6 months of tablet receipt. Self-reported app use was clustered with agglomerative hierarchical clustering. Survey data were combined with electronic health record data that included sociodemographics and mental health care utilization during the 6 months following survey completion. Differences in patient characteristics by cluster were examined using chi-square tests. A multivariable model assessed prediction of mental health services across app clusters.

Results

Among 1664 patients with complete survey and health care utilization data, the majority (74%) reported using at least 1 app. The most used apps were for video visits (60%) and VA’s patient portal (53%). Cluster analysis revealed 5 distinct groups reflecting app usage: Patient Portal (n = 685, 41%), Video Connection (n = 319, 19%), Treatment Companion (n = 166, 10%), Self-Management (n = 85, 5%), and Non-App Group (n = 409, 25%). Cluster characteristics varied, and those in the Patient Portal Group (adjusted odds ratio  = 1.64; 95% CI = 1.15-2.32) and Video Connection Group (adjusted odds ratio = 1.52; 95% CI = 1.02-2.26) were more likely to have a mental health visit in the 6 months after survey completion when compared to the Non-App Group (P < .05).

Discussion

Tablet provision supports opportunities to use apps for multiple health management tasks, and app use clusters vary across patient characteristics and health care utilization.

Conclusion

Patients most commonly used apps to connect with their care team, and use of some apps and app combinations may improve engagement with mental health services.
Developing a Career as a Clinician-Educator in Breast Imaging
Authors: Chetlen Alison Lynn , Beatty-Chadha Jeanine , Choe Angela I
Published: November 2024

For the breast imaging radiologist, developing a career as a clinician-educator can be accomplished in a number of ways. Whether it be a new graduate or perhaps a radiologist making a midcareer or late-career pivot to the academic world, there are several opportunities and resources that can support a faculty member at any stage in this journey. In this article, the breast imaging radiologist will learn a variety of methods to strengthen their professional identity and career path as a clinician-educator through the early-, mid-, and late-career professional journey.
Enhancing Offshore Wind Turbines Performance with Hybrid Control Strategies Using Neural Networks and Conventional Controllers
Authors: Muñoz-Palomeque Eduardo , Sierra-García J Enrique , Santos Matilde
Published: November 2024

A wind turbine is a complex energy converter that requires a robust control solution to overcome performance limitations caused by its mechatronics and external disturbances. Within the turbine operation regions, in the area below the nominal power, the challenge of achieving a precise and highly efficient response must be addressed using multi-objective control strategies that can also contribute to the stability of the structure, reducing vibrations. In this work, a control architecture to maximize the power generation and minimize the vibrations is proposed. Based on this architecture four different hybrid control strategies exploiting radial basis function neural networks and conventional regulators are proposed to cover this twofold objective. The controllers calculate the appropriate electromagnetic torque to track the maximum power point and thus achieve the generation of maximum power, while reducing the acceleration of the tower movement. The neural controllers use a non-supervised learning algorithm to adaptively adjust the weights of the neuros to better couple to the wind turbine dynamics. These combined control methods are tested on a 5 MW floating offshore wind turbine under the influence of winds and waves. The results show that these hybrid strategies are valid for achieving a more efficient response and decreasing turbine fatigue, thus extending their lifetime.
Expressing knowledge as linked data by FOOL
Authors: Giunti Marco , Pinna Simone
Published: November 2024

The vision underlying the development of the Semantic Web is that the whole complex of our knowledge forms a huge semantic network, which should be represented and made explicit by means of languages such as RDF, RDFS or OWL. However, these languages have important expressive limits, since none of them reaches the full expressive power of a first-order language. As a result, large parts of our knowledge—in particular, mathematical and scientific theories—cannot currently be made available on the Semantic Web as linked data, not even in principle. In this work, we are going to define FOOL (first-order ontology language), a new ontological language compatible with RDF, which allows the expression of any formula of a first-order language as a connected RDF graph. FOOL is as expressive as a first-order language, but unlike it, its statements do not have a serialized form. Instead, like a RDF statement, each statement of a FOOL knowledge base is a connected graph, and different statements link to each other through the meaningful nodes they share. In this way, the semantic relationships between statements are made explicit, and given FOOL’s compatibility with RDF, virtually the entire complex of our knowledge can in principle be made available on the Semantic Web as linked data. The semantic relationships made explicit by a FOOL ontology are not those of logical consequence, but they are meaning connections between statements represented as graphs. It is not far-fetched to think that, by devising appropriate measures of the linking patterns between statements, such relations can be mechanized, thus opening the way to new and possibly unforeseen results and applications.
Identification of plasmids from thermophilic Streptomyces strains and development of a gene cloning system for thermophilic Streptomyces species
Authors: Yamada Yuuki , Ikeda Haruo
Published: November 2024

To develop a host-vector system for use in thermophilic Streptomyces, multi-copy plasmids were screened for thermophilic Streptomyces species using data from public bioresource centers (JCM and NBRC). Of 27 thermophilic Streptomyces strains, 3 harbored plasmids. One plasmid (pSTVU1), derived from S. thermovulgaris NBRC 16615 (= JCM 4520, ATCC 19284, DSM 40444, ISP 5444, NRRL B-12375, and NCIMB 10078), was multi-copy and relatively small in size. Analysis of the sequence of this multi-copy plasmid revealed that it was 7,838 bp and contained at least 10 predicted open reading frames. The plasmid was introduced into 14 thermophilic Streptomyces strains (of 18 strains examined) and several mesophilic Streptomyces strains (S.lividans, S.parvulus, and S.avermitilis). pSTVU1 can be transferred by mixed culture because the plasmid encodes the ORF that regulates the transfer function. Plasmid transfer was observed not only between strains within the same species but also between mesophilic Streptomyces and thermophilic Streptomyces (and vice versa); however, the efficiency of this transfer was extremely low. We also confirmed that a derivative of pSTVU1 can be used as a multi-copy vector in the gene expression system that is expected to exhibit gene-dosage effects, establishing a method for efficient production of thermophilic α-amylase.

One-sentence summary

A multi-copy plasmid was identified in thermophilic Streptomyces and used to develop a gene cloning system for thermophilic Streptomyces species.
Neutrophil swarming is crucial for limiting oral mucosal infection by Candida albicans
Authors: Saraswat Darpan , Rojas Isolde Gina , Kumar Rohitashw , Li Rui , Salvatori Ornella , Irimia Daniel , Edgerton Mira
Published: November 2024

Oral mucosal colonization by Candida albicans is benign in healthy people but progresses to deeper infection, known as oropharyngeal candidiasis, that may become disseminated when combined with immunosuppression. Cortisone use and neutropenia are risk factors for invasive mucosal fungal infections; however, the mechanisms are poorly understood. Here, we identify in vivo neutrophil functional complexes known as swarms that are crucial for preventing C. albicans epithelial invasion. Anti-Ly6G antibody treatment impaired swarm formation and increased fungal infection depth, confirming the role of neutrophil swarms in limiting C. albicans invasion. Neutrophil swarm function could be disrupted by administration of resolvins, and required BLT1 (leukotriene B4 receptor 1) expression so that administration of a leukotriene synthesis inhibitor reduced neutrophil swarm size permitting C. albicans invasion beyond the basement membrane. Cortisone treatment similarly reduced neutrophil swarming behavior and BLT1 expression and delayed expression of epithelial cytokines and chemokines. Thus, swarm structures have an important function in preventing deep invasion by C. albicans within the oral mucosa and represent a mechanism for increased disease severity under immune deficient clinical settings.
Music Therapy Sessions With Older Adults on YouTube: A Content Analysis for Academic Instruction
Authors: Stull Jennifer Denk , Wilhelm Lindsey Stradt
Published: November 2024

Prior research in music therapy has examined the availability and content of YouTube videos overall and in relation to veterans with post-traumatic stress disorder and pediatric medical music therapy. Anecdotally music educators use YouTube videos to provide students with clinical examples of music therapy sessions. It is unclear what clinical video content about music therapy with older adults is available. Therefore, this descriptive study aimed to examine the content of YouTube videos related to the clinical practice of music therapy with older adults for academic instruction. After conducting an initial search for music therapy clinical videos with older adults on YouTube, the authors completed a descriptive analysis of 23 videos that included clinical footage. Videos were analyzed to describe video-specific and therapy-specific content. In addition, the authors completed an exploratory analysis of diversity-specific content. Finally, the authors investigated the presence of American Music Therapy Association’s (AMTA) Competencies in clinical videos from the past 5 years (2018–2022). Results demonstrate varying amounts of video-specific, therapy-specific, and diversity-specific content leading to clinical and educational implications. The authors identify a need for future investigation of the use of videos in teaching by music therapy faculty, as well as student perceptions of music therapy content provided in clinical video clips.
Refining SARS-CoV-2 intra-host variation by leveraging large-scale sequencing data
Authors: Mostefai Fatima , Grenier Jean-Christophe , Poujol Raphaël , Hussin Julie
Published: November 2024

Understanding viral genome evolution during host infection is crucial for grasping viral diversity and evolution. Analyzing intra-host single nucleotide variants (iSNVs) offers insights into new lineage emergence, which is important for predicting and mitigating future viral threats. Despite next-generation sequencing’s potential, challenges persist, notably sequencing artifacts leading to false iSNVs. We developed a workflow to enhance iSNV detection in large NGS libraries, using over 130 000 SARS-CoV-2 libraries to distinguish mutations from errors. Our approach integrates bioinformatics protocols, stringent quality control, and dimensionality reduction to tackle batch effects and improve mutation detection reliability. Additionally, we pioneer the application of the PHATE visualization approach to genomic data and introduce a methodology that quantifies how related groups of data points are represented within a two-dimensional space, enhancing clustering structure explanation based on genetic similarities. This workflow advances accurate intra-host mutation detection, facilitating a deeper understanding of viral diversity and evolution.
A general kernel machine regression framework using principal component analysis for jointly testing main and interaction effects: Applications to human microbiome studies
Authors: Koh Hyunwook
Published: November 2024

The effect of a treatment on a health or disease response can be modified by genetic or microbial variants. It is the matter of interaction effects between genetic or microbial variants and a treatment. To powerfully discover genetic or microbial biomarkers, it is crucial to incorporate such interaction effects in addition to the main effects. However, in the context of kernel machine regression analysis of its kind, existing methods cannot be utilized in a situation, where a kernel is available but its underlying real variants are unknown. To address such limitations, I introduce a general kernel machine regression framework using principal component analysis for jointly testing main and interaction effects. It begins with extracting principal components from an input kernel through the singular value decomposition. Then, it employs the principal components as surrogate variants to construct three endogenous kernels for the main effects, interaction effects, and both of them, respectively. Hence, it works with a kernel as an input without knowing its underlying real variants, and also detects either the main effects, interaction effects, or both of them robustly. I also introduce its omnibus testing extension to multiple input kernels, named OmniK. I demonstrate its use for human microbiome studies.
High Rates of High-risk HPV Anal Infection and Abnormal Cytology in a Cohort of Transgender People Assigned Male at Birth
Authors: Harfouch Omar , Lisco Andrea , Omari Habib , Eyasu Rahwa , Davis Ashley , Zoltick Meredith , Ebah Emade , Cover Amelia , Bijole Phyllis , Silk Rachel , Sternberg David , Liu Tina , Garrett Grace , Jones Miriam , Kier Randy , Masur Henry , Kottilil Shyamasundaran , Kattakuzhy Sarah , Rosenthal Elana S
Published: November 2024

Background

Transgender people assigned male at birth (TG-AMAB) have higher rates of anal human papillomavirus (HPV) infection and anal cancer compared with cisgender populations. In a cohort of TG-AMAB in Washington DC, we determined the prevalence and epidemiological factors associated with anal high-risk HPV (HR-HPV) infection and cytological abnormalities.

Methods

In an urban academic–community clinic, we recruited adults identifying as a gender different than their sex assigned at birth. Participants provided blood samples, anal swabs for HR-HPV and cytology, and completed surveys on sexual behaviors and use of gender-affirming hormones. Logistic regression was used to identify predictors of HR-HPV and abnormal cytology.

Results

Of 97 TG, 80 were AMAB, of whom 66% were people with HIV (PWH); 73% tested positive for any anal HR-HPV, and 48% had abnormal cytology. Only 24% recalled HPV immunization. While TG-AMAB PWH had increased risk of HPV16 infection (37% vs 8%; P = .014), the prevalence rates of any HR-HPV (80% vs 62%; P = .097) and abnormal cytology (56% vs 32%; P = .085) were similarly elevated regardless of HIV status. Among TG-AMAB, estradiol use was not associated with increased odds of any HR-HPV or abnormal cytology (all P > .05); however, higher testosterone levels were associated with any HR-HPV (P = .014). Age ≥35 years was associated with abnormal cytology in TG-AMAB (59% vs 34%; P = .035).

Conclusions

TG-AMAB have a high prevalence of any HR-HPV and abnormal cytology, regardless of age, HIV status, or hormone use. Given high risk for anal cancer and low rates of HPV vaccination, there is a pressing need for primary and secondary anal cancer prevention strategies targeting this population.
Integrating energy systems for zero-carbon residential buildings: a case study on design and performance
Authors: Jiao Xuefeng , Wang Jiarui , Xu Zixuan , Han Xiaotian , Wang Jianjun , Xu Daojin , Xu Gang , Li Kaichun , Zhang Jingshan , Jiao Qingtai
Published: November 2024

Integrating electric technologies such as photovoltaics (PV), energy storage, heat pumps, and electric vehicle (EV) charging systems is pivotal for increasing energy independence and reducing emissions in buildings. This study explores the combination of these technologies through a system in Lianyungang, China, to enhance social and economic benefits. The experimental system was monitored during the heating season 2023–2024. Through system simulations with TRNSYS and optimizations, the system configurations were developed considering peak and off-peak electricity pricing schemes, inverter and battery operation logic, equipment efficiency, and load changes. The results show that the PV system is able to satisfy much of the building’s energy needs, with a self-sufficiency rate exceeding 85%. The most cost-effective setup involves three energy storage batteries (totaling 15 kWh) and 20 PV panels (11 kWp total capacity), reducing the payback period to under five years and providing new insight for cost-effective sustainable energy solutions.
Large herbivores link plant phenology and abundance in Arctic tundra
Authors: Post Eric , Higgins R Conor , Bøving Pernille Sporon , John Christian , Post Mason , Kerby Jeffrey T
Published: November 2024

Plant phenological dynamics have been well studied in relation to abiotic conditions and climate change, but comparatively poorly studied in relation to herbivory. In contrast, plant abundance dynamics have been well studied in relation to abiotic conditions and herbivory, but poorly studied in relation to phenology. Consequently, the contribution of herbivory to plant phenological dynamics and therefrom to plant abundance dynamics remains obscure. We conducted a 9-year herbivore exclusion experiment to investigate whether herbivory might link plant phenological and abundance dynamics in arctic tundra. From 2009 to 2017, we monitored annual green-up timing and abundance of nine plant taxa, including deciduous shrubs, forbs, and graminoids, on plots that were either grazed or experimentally exclosed from herbivory by caribou (Rangifer tarandus) and muskoxen (Ovibos moschatus). In 62% of cases, green-up occurred earlier under herbivory, and in 75% of cases abundance was greater under herbivory, compared to green-up and abundance under herbivore exclusion. Moreover, taxa that responded to herbivory with earlier green-up also had comparatively greater abundance later in the growing season. Conversely, taxa that responded to herbivory with delayed green-up exhibited comparatively lower abundance later in the growing season. Hence, well-documented influences of large herbivores on plant abundance and community composition in arctic tundra may relate, at least to some extent, to influences of herbivory on plant phenology. We recommend that ongoing and future assessments of the contribution of herbivores to plant abundance and community responses to climate change, especially in the Arctic, should also consider impacts of herbivores on plant phenology.
Choroid plexus extracellular vesicle transport of blood-borne insulin-like growth factor 1 to the hippocampus of the immature brain
Authors: Ortenlöf Niklas , Vallius Suvi , Karlsson Helena , Ekström Claes , Kristiansson Amanda , Holmqvist Bo , Pankratova Stanislava , Barton Norman , Ley David , Gram Magnus
Published: November 2024

Reduced serum level of insulin-like growth factor 1 (IGF-1), a major regulator of perinatal development, in extremely preterm infants has been shown to be associated with neurodevelopmental impairment. To clarify the mechanism of IGF-1 transport at the blood–cerebrospinal fluid (CSF) barrier of the immature brain, we combined studies of in vivo preterm piglet and rabbit models with an in vitro transwell cell culture model of neonatal primary murine choroid plexus epithelial (ChPE) cells. We identified IGF-1-positive intracellular vesicles in ChPE cells and provided data indicating a directional transport of IGF-1 from the basolateral to the apical media in extracellular vesicles (EVs). Exposure of the ChPE cells to human IGF-1 on the basolateral side increased the secretion of IGF-1-positive EVs in the apical media. Mass spectrometry analysis displayed similarities in protein content between EVs derived from preterm piglet CSF-derived and ChPE cell–derived EVs. Furthermore, exposure of ChPE cells to human IGF-1 caused an enrichment of human IGF-1 and transmembrane p24 trafficking protein 2, proteins important for perinatal development, in apical media–derived EVs. Moreover, intraventricular injections of ChPE cell–derived EVs in preterm rabbit pups resulted in an uptake of EVs in the brain, displaying penetration through the ependymal lining and deep into the hippocampus. Finally, exposure of rat hippocampus neurons to ChPE cell–derived EVs resulted in internalization of the EVs in hippocampal soma and neurites. In summary, we describe a transport pathway for blood-borne IGF-1 in EVs through the blood–CSF barrier to the hippocampus in the immature brain.
Sleep is necessary for experience-dependent sequence plasticity in mouse primary visual cortex
Authors: Hosamane Nishitha S , Didouchevski Adam M , Malci Ayse , Gavornik Jeffrey P , Sidorov Michael S
Published: November 2024

Study Objectives

Repeated exposure to familiar visual sequences drives experience-dependent and sequence-specific plasticity in mouse primary visual cortex (V1). Prior work demonstrated a critical role for sleep in consolidating a related but mechanistically distinct form of experience-dependent plasticity in V1. Here, we assessed the role of sleep in consolidation of spatiotemporal sequence learning (sequence plasticity) in mouse V1.

Methods

Visually evoked potentials were recorded in awake, head-fixed mice viewing sequences of four visual stimuli. Each sequence was presented 200 times per session, across multiple sessions, to drive plasticity. The effects of sleep consolidation time and sleep deprivation on plasticity were assessed.

Results

Sequence plasticity occurred in V1 following as little as 1 hour of ad libitum sleep and increased with longer periods of sleep. Sleep deprivation blocked sequence plasticity consolidation, which recovered following subsequent sleep.

Conclusions

Sleep is required for the consolidation of sequence plasticity in mouse V1.
In vitro pharmacological evaluation of Methanolic leaf extract of Calotropis procera for antifungal and anti-breast cancer activities
Authors: Rasool Shafqat , Rashid Abid , Akram Muhammad , Sierra Francisco Gracia
Published: November 2024

Background

Medicinal plants remained the primary choice worldwide from several centuries due to many therapeutic effects in the management of infectious and non-infectious diseases. Therefore, exploration of new medicinalplants as a green medicine has the major concern of many research groups. Microbial infections and different types of cancers in human are among the common health problems both in developing as well as in developed countries. Medicinal plants as a source of anti-microbial and anti-cancer agents are still in their initial stage in modern medicine.

Objectives

So current research work was planned to explore the anti-fungal and anticancer potential of Calotropis procera.

Material and Methods

C. procera leaves were collected from local area of Faisalabad, Pakistan, and phytochemical, anti-microbial, and anti-cancer activities were studied following reference methods. In vitro anti-microbial study of methanolic extracts of C. procera leaves against different strains of fungal was performed.

Results

Results showed that plant extract in a dose of 5 mg/mL have significant (P < 0.05) antifungal activity. Moreover, the methanolic leaf extract of C. procera displayed strong anti-cancer activity in breast cancer cells (MCF-7), with a cytotoxic activityat 200 μg/mL comparable to that found for Taxol as standard drug.

Conclusion

Findings of current research work showed that the leaf extracts of C. procera has strong potential as an antibacterial, antifungal and anti-cancer agent. However, characterization and purification of phytochemicals is required to develop drug from natural resources.
A phylogenetic assessment of HIV-1 transmission trends among people who inject drugs from Coastal and Nairobi, Kenya
Authors: Kingston Hanley , Nduva George , Chohan Bhavna H , Mbogo Loice , Monroe-Wise Aliza , Sambai Betsy , Guthrie Brandon L , Wilkinson Eduan , Giandhari Jennifer , Masyuko Sarah , Sinkele William , de Oliveria Tulio , Bukusi David , Scott John , Farquhar Carey , Herbeck Joshua T
Published: November 2024

Although recent modeling suggests that needle–syringe programs (NSPs) have reduced parenteral HIV transmission among people who inject drugs (PWID) in Kenya, the prevalence in this population remains high (∼14–20%, compared to ∼4% in the larger population). Reducing transmission or acquisition requires understanding historic and modern transmission trends, but the relationship between the PWID HIV-1 sub-epidemic and the general epidemic in Kenya is not well understood. We incorporated 303 new (2018–21) HIV-1 pol sequences from PWID and their sexual and injecting partners with 2666 previously published Kenyan HIV-1 sequences to quantify relative rates and direction of HIV-1 transmissions involving PWID from the coast and Nairobi regions of Kenya. We used genetic similarity cluster analysis (thresholds: patristic distance <0.045 and <0.015) and maximum likelihood and Bayesian ancestral state reconstruction to estimate transmission histories at the population group (female sex workers, men who have sex with men, PWID, or general population) and regional (coast or Nairobi) levels. Of 1081 participants living with HIV-1, 274 (25%) were not virally suppressed and 303 (28%) had sequences available. Of new sequences from PWID, 58% were in phylogenetic clusters at distance threshold <0.045. Only 21% of clusters containing sequences from PWID included a second PWID sequence. Sequences from PWID were similarly likely to cluster with sequences from female sex workers, men who have sex with men, and the general population. Ancestral state reconstruction suggested that transmission to PWID from other populations was more common than from PWID to other populations. This study expands our understanding of the HIV-1 sub-epidemic among PWID in Kenya by incorporating four times more HIV-1 sequences from this population than prior studies. Despite recruiting many PWID from local sexual and injecting networks, we found low levels of linked transmission in this population. This may suggest lower relative levels of parenteral transmission in recent years and supports maintaining NSPs among PWID, while also strengthening interventions to reduce HIV-1 sexual acquisition and transmission for this population.
Tibial Malalignment Is an Independent Predictor of Nonunion After Intramedullary Nailing of Tibial Shaft Fractures
Authors: Goch Abraham , Healey Kathleen , Zingas Nicolas , Raffetto Michael , McKibben Natasha , Benzel Caroline , Stockton David J. , O'Hara Nathan N. , Slobogean Gerard P. , Nascone Jason W. , O'Toole Robert V.
Published: November 2024

OBJECTIVES:

This study aimed to assess the relationship between postoperative alignment and nonunion in patients with tibial shaft fractures treated with intramedullary nailing.

METHODS:

Design:

Retrospective case–control study.

Setting:

Single academic trauma center.

Patients Selection Criteria:

Adult patients with closed or open tibial shaft fractures (42A-C) treated with intramedullary nailing from 2007 to 2018.

Outcomes Measures and Comparisons:

Case patients with nonunion were compared with control patients with radiographic evidence of healing in terms of the postoperative tibial alignment measured in the coronal and sagittal planes.

RESULTS:

Of the 192 included patients (median age, 38 years; 76% male), 51 patients had a nonunion, and 141 patients had united fractures and served as the control group. A strong association between postoperative tibial malalignment in 1 plane and nonunion (odds ratio, 3.0; 95% confidence interval, 1.1–8.3; P = 0.03) was demonstrated. This association was even greater for malalignment in both coronal and sagittal planes (odds ratio, 5.7; 95% confidence interval, 2.1–16.1; P < 0.001) after controlling for confounders.

CONCLUSIONS:

After controlling for confounding factors, postoperative malalignment in the coronal or sagittal plane was associated with significantly increased odds of tibial shaft nonunion after intramedullary nailing.

LEVEL OF EVIDENCE:

Prognostic, Level III. See Instructions for Authors for a complete description of levels of evidence.
Co-administration of dexmedetomidine with total intravenous anaesthesia in carotid endarterectomy reduces requirements for propofol and improves haemodynamic stability
Authors: Vetter Christian , Meyer Eva R. , Seidel Kathleen , Bervini David , Huber Markus , Krejci Vladimir
Published: November 2024

BACKGROUND

Total intravenous anaesthesia guided by electroencephalography and neurophysiological monitoring may be used for carotid endarterectomy. Reduction of brain metabolic demand during cross-clamping of the internal carotid artery with propofol titrated to burst suppression requires effect-site concentrations that may delay emergence and interfere with intraoperative neurophysiological monitoring.

OBJECTIVE

To test the hypothesis that dexmedetomidine decreases the effect-site concentration of propofol required for burst-suppression in patients undergoing carotid endarterectomy.

DESIGN

Randomised controlled trial.

PARTICIPANTS

Patients undergoing carotid endarterectomy.

SETTING

University Hospital of Berne, Switzerland, from October 2018 to September 2024

INTERVENTIONS

Patients were randomised into a control (n = 23) and a dexmedetomidine groups (n = 22). Total intravenous anaesthesia was administered to both groups. Patients in the dexmedetomidine group received an intravenous bolus of dexmedetomidine (0.4 μg kg−1 over 10 min) before induction, followed by a continuous intravenous infusion (0.4 μg kg−1 h−1). The effect-site concentrations of propofol were titrated against frontal electroencephalography parameters. Burst suppression was induced with propofol during cross-clamping of the internal carotid artery.

OUTCOME MEASURES

The primary outcome was the effect-site concentration of propofol required for burst-suppression. The secondary outcomes were the requirement for vasoactive substances, neurophysiological monitoring parameters, and postoperative delirium.

RESULTS

The effect-site concentration of propofol required for burst suppression was 4.0 μg ml−1 [3.50 to 4.90] (median [interquartile range]) in the dexmedetomidine group compared with 6.0 μg ml−1 [5.5 to 7.3] in the control group (P < 0.001). Less norepinephrine was required in the dexmedetomidine group (total 454 μg [246 to 818] compared with 1000 μg [444 to 1326] (P = 0.015) in the control group). Dexmedetomidine did not affect intraoperative neurophysiological monitoring.

CONCLUSION

Co-administration of dexmedetomidine to total intravenous anaesthesia for carotid endarterectomy decreased the effect-site concentrations of propofol required for burst suppression by 33%. The propofol-sparing effect and peripheral alpha-agonism of dexmedetomidine may explain the reduced requirement for vasopressors.

TRIAL REGISTRATION

Clinicaltrials.gov identifier: NCT04662177.
A Guide to the Implementation and Design of Ex Vivo Perfusion Machines for Vascularized Composite Allotransplantation
Authors: Muss Tessa E. , Loftin Amanda H. , Zamore Zachary H. , Drivas Eleni M. , Guo Yi-Nan , Zhang Yichuan , Brassil John , Oh Byoung Chol , Brandacher Gerald
Published: November 2024

Background:

Ex vivo machine perfusion (EVMP) is a versatile platform utilized in vascularized composite allotransplantation (VCA) to prolong preservation, salvage tissue, and evaluate graft viability. However, there is no consensus on best practices for VCA. This article discusses the common components, modifications, and considerations necessary for a successful VCA perfusion.

Methods:

A systematic literature review was performed in several databases (PubMed, Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov) to identify articles published on VCA EVMP (face, limb, abdominal wall, uterus, penis, and free flaps) before August 2022. Graft type and animal model, general perfusion parameters, core components of the circuit, and optional components for enhanced monitoring were extracted from the articles.

Results:

A total of 1370 articles were screened, and 46 articles met inclusion criteria. Most articles (84.8%) were published in the last 10 years. Pigs were the main model used, but 10 protocols used human grafts. Free flaps were the most common graft type (41.3%), then upper extremities/forelimbs (28.3%), uteruses (17.4%), and hindlimbs (13.0%). Postperfusion replantation occurred in 15.2% of studies. Normothermic perfusion predominated (54.1%), followed by hypothermic (24.3%), and subnormothermic (21.6%). The majority of studies (87.0%) oxygenated their systems, most commonly with carbogen.

Conclusions:

EVMP is a rapidly growing area of research. Leveraging EVMP in VCA can optimize VCA procedures and allow for expansion into replantation, flap salvage, and other areas of plastic surgery. Currently, VCA EVMP is achieved through a variety of approaches, but standardization is necessary to advance this technology and attain clinical translation.
Cutaneous Metastasis of Breast Carcinoma in the Distal Phalanx of the Left Little Finger: A Case Report
Authors: Albalawi Ibrahim Abdullah S. , Nukaly Houriah Y. , Said May Ibrahim , Moharram Laila , Elgazzar Khaled
Published: November 2024

With breast cancer cases escalating globally, the risk of uncommon sequelae like cutaneous metastatic carcinoma also rises. The identification of such metastases is essential in posttreatment surveillance. A 73-year-old woman with a history of hypertension and diabetes initially presented with postmenopausal bleeding, leading to the discovery and treatment of endometrial carcinoma via hysterosalpingo-oophorectomy. Nearly a decade later, she developed bilateral breast carcinoma, confirmed via radiology and biopsies, necessitating a bilateral-modified radical mastectomy. Her postoperative phase was complicated by the development of sternum bone metastasis and a peculiar metastatic lesion on the left little finger, presenting as a fungating swelling on the distal phalanx. This lesion was later identified as metastatic metaplastic carcinoma from the breast, a rarity for cutaneous metastases. An amputation of the distal phalanx was performed, but her overall condition worsened. Ten months posttreatment, she was hospitalized with a severely deteriorated condition and died shortly after. This case highlights the insidious nature of cutaneous metastases in breast cancer and the potential for unusual presentations, such as the rare involvement of the distal phalanx. It emphasizes the importance of continuous vigilance in the follow-up of breast cancer patients, particularly when unusual symptoms arise, and underscores the value of a multidisciplinary approach in managing complex metastatic diseases to potentially improve survival outcomes.