bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflammation, physical activity, and disease-free survival in stage III colon cancer: Cancer and Leukemia Group B–Southwest Oncology Group 80702 (Alliance)
Authors: Brown Justin C , Ma Chao , Shi Qian , Couture Felix , Kuebler Philip , Kumar Pankaj , Tan Benjamin , Krishnamurthi Smitha , Chang Victor , Goldberg Richard M , O’Reilly Eileen M , Shields Anthony F , Meyerhardt Jeffrey A
Published: August 2024

Background

Inflammation and insufficient physical inactivity contribute to individual-level risk of disease recurrence and death in stage III colon cancer. The extent to which increased inflammatory risk can be offset by sufficient physical activity remains unknown.

Methods

This cohort study was nested within the Cancer and Leukemia Group B (now part of the Alliance for Clinical Trials in Oncology) and Southwest Oncology Group randomized trial. Inflammatory burden was quantified by high-sensitivity C-reactive protein, interleukin-6, and soluble tumor necrosis factor-α receptor 2 after recovery from tumor resection. Physical activity was measured during and after postoperative chemotherapy. The primary endpoint was disease-free survival.

Results

The 3-year disease-free survival rate was 88.4% among patients with low inflammation and sufficient physical activity (referent group for all comparisons), 84.9% with low inflammation and insufficient physical activity (absolute risk difference = −3.5 percentage points, 95% confidence interval [CI] = −11.3 to 4.3; P = .38), 78.0% with intermediate inflammation and insufficient physical activity (absolute risk difference = −10.4 percentage points, 95% CI = −17.4 to −3.3; P = .007), and 79.7% with high inflammation and insufficient physical activity (absolute risk difference = −8.7 percentage points, 95% CI = −15.7 to −1.6; P = .022). In contrast, the 3-year disease-free survival rate was 87.3% among patients with intermediate inflammation and sufficient physical activity (absolute risk difference = −1.1 percentage points, 95% CI = −7.5 to 5.3; P = .74) and 84.4% with high inflammation and sufficient physical activity (absolute risk difference = −4.0 percentage points, 95% CI = −12.3 to 4.3; P = .34).

Conclusion

In this observational study of stage III colon cancer patients, physical activity was associated with improved disease-free survival despite high inflammation. Patients with intermediate or high inflammation who were physically active had disease-free survival rates that were not statistically significantly different from those with low inflammation.
Association between CH4 uptake and N2O emission in grassland depends on nitrogen inputs
Authors: Ren Yiming , Zao Yangxinzi , Zhao Ying , Su Rui , Yang Guowei , Li Xiran , Kang Jingru , Shi Yiyu , Xie Yuru , Wang Nannan , Zuo Yunjiang , Li Kexin , He Liyuan , Xu Xiaofeng , Zhang Lihua
Published: August 2024

Increasing nitrogen (N) input has been recognized as one of the important factors inﬂuencing methane (CH4) uptake and nitrous oxide (N2O) emission in arid and semiarid grasslands. Numerous studies have examined the spatiotemporal variations of CH4 and N2O fluxes in various ecosystems; however, the variation of the interplay between CH4 uptake and N2O emission with increasing N has not yet been well understood. This study explored the relationship between CH4 uptake and N2O emission in a semiarid grassland in Inner Mongolia, northern China, under a gradient of 12-year N additions. We found a synergistic relationship at low-N levels, where CH4 uptake and N2O emission are positively correlated. Conversely, an antagonistic interaction emerged with a negative correlation between CH4 uptake and N2O emission observed at high-N levels, which was evidenced by a 33.62% decrease in CH4 uptake and a 264.91% increase in N2O emission. Further independent analysis, covering at least five N addition levels across grassland ecosystems in China, confirmed the general pattern: three of four cases showed a synergistic relationship at low-N levels and an antagonistic relationship at high-N levels. Given the increasing N deposition in the future, the dynamics between CH4 uptake and N2O emission are critical for understanding the impact of external N input on net greenhouse gas emission and consequent global climate change.
Acquired colonic atresia in children: a report of three cases and review of the literature
Authors: Fouad Dina , Bethell George S , Hall Nigel J
Published: August 2024

We describe cases of three infants who developed acquired colonic atresia presumed secondary to significant systemic cardiovascular compromise and in the absence of necrotizing enterocolitis. An acquired colonic atresia may present as feed intolerance and should be investigated with a lower gastrointestinal contrast study. We would also recommend routine lower gastrointestinal contrast study prior to stoma closure in an infant with history of significant cardiovascular compromise, even in the absence of significant widespread colonic inflammation such as necrotizing enterocolitis.
Bilateral cranioorbital foramina (Hyrtl foramina): crucial anatomical findings in the management of giant olfactory groove meningioma - a case report and literature review
Authors: Al-Barbarawi Mohammad Khalil , Badary Amr , Moustafa Wahab , Atallah Oday , Stock Karsten , Czapiewski Piotr , Renner Hans-Christof
Published: August 2024

Presence of bilateral cranio-orbital foramina, AKA Hyrtl foramina is rare yet existing. They carry the risks of retinal artery emboli due to reflux embolization for the neurovascular interventionalists, navigating complexities in olfactory groove meningioma management. A 59-year-old woman with progressive frontal lobe syndrome presented a large olfactory groove meningioma primarily supplied by bilateral sphenopalatine arteries together with bilateral anterior cerebral arteries, necessitating risky preoperative embolization and meticulous resection. This case underscores the intricate nature of vascular supply in frontal skull base tumors, emphasizing the need for multidisciplinary approaches, thorough preoperative planning, and detective research to optimize treatment outcomes.
Oropharyngocutaneous fistula—a case report of conservative management in a diabetic patient
Authors: Alshaalan Yazeed , Althunayan Thamer , Alwadi Fahad , Alessa Mohammed , Waheed Sheikh
Published: August 2024

Oropharyngocutaneous fistula following deep neck space infections is a rare entity. Patients can present with feeding difficulty and food leakage through the wound. The fistula is suspected to have formed not only due to the infectious process but also due to the combination of transoral and transcervical approach. Infection eradication, aggressive wound care, control of risk factors, and strict NPO with NGT feeding are all important parts of management.
Double-opposing negative pressure dressing—a useful method for splinting skin grafts on the penile shaft
Authors: Zhang Steven L , Chung Benjamin Z W , Wong Allen Wei-Jiat
Published: August 2024

The care of skin grafts in the penile shaft is challenging because of its cylindrical shape and constantly changing length and lie, which makes it difficult to apply uniform compression and ensure immobilization during the critical period of skin graft take. These challenges are difficult to overcome with conventional dressings. The authors describe a technique of applying a double-opposing negative pressure dressing to sandwich the penile shaft following reconstruction with a skin graft, which is simple to apply and addresses these issues. Adoption of this technique may allow the reconstructive surgeon to manage skin grafts on the penile shaft with greater ease and confidence of optimum graft take.
The Impact of Mail, Web, and Mixed-Mode Data Collection on Participation in Establishment Surveys
Authors: Küfner Benjamin , Sakshaug Joseph W , Zins Stefan , Globisch Claudia
Published: August 2024

Over the past 30 years, self-administered establishment surveys have increasingly transitioned away from using mail to more online and mixed-mode data collection. To examine the potential impact of this transition on survey participation, we evaluate several mail and web single- and mixed-mode designs implemented experimentally in a large-scale job vacancy survey. We find that neither response rates nor nonresponse bias significantly differed between the alternative designs. Subgroup analyses revealed that establishments of all size classes showed a preference for the mail mode in the concurrent mixed-mode design, but larger establishments were more likely to participate via web than mail in the single-mode designs. Potential cost savings (over 50 percent per respondent) were evident when utilizing the web mode in either a single- or sequential mixed-mode design. Qualitative follow-up interviews indicated a general preference for the web mode due to easier handling, smoother collaboration between colleagues, avoidance of a cumbersome mail return, and being seen as a modern sustainable solution.
Autochthonous dengue outbreak in Rome, Italy, in 2023
Authors: Salvo Pierluigi Francesco , Baldin Gianmaria , Raffaelli Francesca , Ciccullo Arturo , Borghetti Alberto , Tamburrini Enrica , Ricci Rosalba , Di Donato Michele , Di Giambenedetto Simona , Torti Carlo
Published: August 2024

Dengue, traditionally confined to endemic regions, is now emerging in non-endemic areas, including Italy. This manuscript describes the 2023 Italian autochthonous dengue outbreak, reporting the clinical and demographic characteristics of 19 patients followed by the Fondazione Policlinico Universitario Gemelli IRCCS in Rome, Italy.
Leveraging Natural Ecosystems to Reoptimize Education and Training for Great Power Competition in the Air Force Medical Service
Authors: Lazarus Melanie M , McMichael Charles R , Rizzuto Bettina M , Watson Daniel J , Venth Betty A , Blair Bradley K , Grussendorf Christopher M
Published: August 2024

Organizations today are complex, hyperdimensional, and continuously changing in response to the environment. Over the past decade, the Military Health System has seen continuous organizational change to transform healthcare delivery, and the Air Force Medical Service (AFMS) is currently transitioning to an Air Force Medical Command (AFMEDCOM) structure to best prepare for Great Power Competition and other challenges ahead. The current state of the enterprise involves decision making, resourcing, and execution of education and training that is largely decentralized in nature. To support these efforts, in February 2024, a team of diverse AFMS stakeholders gathered in Washington, D.C. to examine the future of medical education and training for the U.S. Air Force in a new way: through systems theory and ecosystem mapping. This ecosystem approach enables development of an organizational structure and process for change that considers how all stakeholders relate, what external factors threaten the desired transformation, and how the resulting enterprise could become more resilient with future uncertainty and change. This paper discusses the theory behind the ecosystem approach and how it was used to develop a transformed model for the AFMS to organize its education and training. Additionally, a dialogue is presented on how this unique methodology to understanding stakeholder relationships can be leveraged in the re-optimization efforts for Great Power Competition.
The Allium cepa comet assay for environmental sample assessment: a scoping review
Authors: Alias Carlotta , Zerbini Ilaria , Zani Claudia , Feretti Donatella
Published: August 2024

The purposes of this review were to investigate the application of the comet assay in Allium cepa root cells to assess the genotoxicity of environmental samples and to analyse the experimental procedures employed. A literature search was performed selecting articles published between January 2000 and October 2023 from online databases using the combined search terms ‘comet assay’ and ‘A. cepa’. Only 18 papers met the inclusion criteria. None of these were published in the first eight years (2000–2007), highlighting the increasing interest in using the comet assay on A. cepa to analyse environmental samples over the last decade. The majority of the selected studies (15/18, 83%) were performed on samples belonging to the water compartment on onion bulbs. Half of the selected studies (9/18) were conducted to demonstrate the DNA damaging effect of the sample, while the other half of the studies not only recognized the presence of genotoxic agents but also addressed possible remediation measures. Detailed analysis of the experimental procedures revealed heterogeneity in many key steps, such as exposure time, test controls, nuclei isolation solutions, duration of electrophoresis, and number of nuclei scored. This literature review has shown that the comet assay on A. cepa, although recognized as an appropriate tool, is underutilized in environmental toxicology. Greater standardization could lead to its more widespread use, providing valuable information on the genotoxicity of environmental samples and the ability of different processes to mitigate their negative effects on plants.
Limited Impact of Cannabidiol on Health-related Quality of Life of People With Long-term Controlled HIV: A Double-blind, Randomized, Controlled Trial
Authors: Barré Tangui , Couton Clémence , Mourad Abbas , Carrieri Patrizia , Protopopescu Camelia , Klein Hélène , de Dieuleveult Barbara , Hocqueloux Laurent , Mollet Lucile , Prazuck Thierry
Published: August 2024

Background

People with HIV (PWH) with undetectable HIV viral load still have an impaired health-related quality of life (HRQoL). Cannabidiol (CBD) is a nonintoxicating cannabis-derived cannabinoid that holds promise for the treatment of many ailments. In the present study, we tested whether oral CBD-rich medication could significantly improve PWH's HRQoL.

Methods

Eighty participants with undetectable HIV viral load were randomized to either a placebo or full-spectrum CBD (1 mg/kg twice a day) arm for 12 weeks plus a 4-week follow-up period. HRQoL was assessed at baseline, week 12, and week 16 using the 36-Item Short Form Health Survey questionnaire (SF-36). Primary outcomes were physical and mental component summary scores; secondary outcomes were the 8 SF-36 subscale scores. Treatment effects on outcomes were estimated using generalized estimating equations.

Results

We found no effect of CBD intake on the summary score for either component. However, CBD intake was associated with a higher physical functioning score at week 12 only (regression coefficient [95% confidence interval], 7.72 [0.55–14.89]; P = .035). No significant main effect of CBD intake on the other HRQoL subscale scores was observed. Furthermore, there was no difference in self-reported adverse effects between the 2 arms.

Conclusions

Twice-daily CBD full-spectrum oil at 1 mg/kg had no major effect on virologically suppressed PWH's HRQoL but had a positive effect on physical functioning. Further randomized controlled trials including PWH with lower baseline HRQoL are needed to confirm this finding.
Sequential therapy for hereditary leiomyomatosis and renal cell cancer-associated renal cell carcinoma: a case report and report of a new family pedigree
Authors: Tsuboi Ichiro , Araki Momoko , Yokoyama Shuhei , Tanaka Gen , Mitani Kazutaka , Yosioka Saori , Kobayashi Yusuke , Nakajima Hirochika , Nagami Taichi , Ogawa Kohei , Koike Chiaki , Wada Koichiro
Published: August 2024

Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a rare autosomal-dominant disorder caused by a heterozygous germline mutation in the fumarate hydratase (FH) gene. HLRCC is clinically characterized by the development of three tumors: uterine leiomyomata, cutaneous leiomyomata, and renal cell carcinoma (RCC). HLRCC-associated RCC is aggressive and diagnosed at a much earlier age than sporadic RCC. It is essential for carriers of HLRCC to undergo annual renal screening by magnetic resonance imaging to detect early stage RCCs. Metastatic HLRCC-associated RCC must be treated by systemic therapy; however, it is unclear which medicines are most effective in treating this cancer owing to its low incidence rate. Immune checkpoint inhibitor (ICI) combinations or ICIs plus tyrosine kinase inhibitors are administered as systemic therapy for clear cell RCC. Here, we report a patient with HLRCC-associated RCC treated with sequential therapy, including ipilimumab plus nivolumab combination and cabozantinib, after diagnosis of HLRCC-associated RCC using FoundationOne Liquid CDx and single-site analysis. We also investigated familial FH mutations and describe a new family pedigree for HLRCC.
Cracking the code: high ferritin load with Salmon-Colored skin episodes
Authors: Satyal Paraash , Sukhcharan Walia , Yakubov Neriy , Babu Benson
Published: August 2024

A 37-year-old previously healthy male presented to the Emergency Department with a two-week history of intermittent fevers, joint pain, sore throat, and a diffuse salmon-colored rash. Examination revealed a pruritic rash with joint swelling and red spots in the oropharynx. Initial sepsis management was instituted, but subsequent investigations, including infectious, hematologic, and autoimmune workups, were inconclusive. Notably, elevated ferritin levels prompted consideration of life-threatening conditions like Hemophagocytic Lymphohistiocytosis, which was ultimately ruled out. Adult-onset Still’s Disease (AOSD) emerged as the leading diagnosis following the exclusion of other potential causes. A skin biopsy was performed with non-specific findings and corticosteroid treatment led to significant improvement. This case illustrates the clinical decision-making process of diagnosing AOSD and highlights the potential utility of novel AI technology in dermatologic assessments.
Microhistory as Industrial History: Environment, Sugar Capitalism and Labour in Egypt, 1863–1879
Authors: Mestyan Adam
Published: August 2024

This article argues that the microhistorical analysis of one specific industrial enterprise offers a useful perspective from which to study local participation in global industrialization and to unite business and environmental history. Using the example of the Daira Sanieh, a giant sugar holding in late Ottoman Egypt (the so-called ‘khedivate’), I map the economic logic of this non-sovereign polity and suggest that capturing capital was its rulers’ main priority. The article follows how Ismail Pasha, the khedive of Egypt, and his men looked for partners in trans-Mediterranean sugar capitalism, including even the establishment of a khedivial bank in Paris in 1870. It proceeds then to consider the problem of capturing human labour, necessitated by fire-engine sugar machines with increased processing capacity; and, drawing on the accountancy books of a single sugar factory, it discusses the Daira’s factories as the earliest pockets of high wage inequality in Africa. The conclusion poses the question whether this type of mechanization was a form of de-industrialization and suggests that global histories of capital can profit from industrial microhistory by considering how the interplay between non-sovereignty and industrialization hinders economic centralization.
EARLY NODULIN93 acts via cytochrome c oxidase to alter respiratory ATP production and root growth in plants
Authors: Lee Chun Pong , Le Xuyen H , Gawryluk Ryan M R , Casaretto José A , Rothstein Steven J , Millar A Harvey
Published: August 2024

EARLY NODULIN 93 (ENOD93) has been genetically associated with biological nitrogen fixation in legumes and nitrogen use efficiency in cereals, but its precise function is unknown. We show that hidden Markov models define ENOD93 as a homolog of the N-terminal domain of RESPIRATORY SUPERCOMPLEX FACTOR 2 (RCF2). RCF2 regulates cytochrome oxidase (CIV), influencing the generation of a mitochondrial proton motive force in yeast (Saccharomyces cerevisiae). Knockout of ENOD93 in Arabidopsis (Arabidopsis thaliana) causes a short root phenotype and early flowering. ENOD93 is associated with a protein complex the size of CIV in mitochondria, but neither CIV abundance nor its activity changed in ruptured organelles of enod93. However, a progressive loss of ADP-dependent respiration rate was observed in intact enod93 mitochondria, which could be recovered in complemented lines. Mitochondrial membrane potential was higher in enod93 in a CIV-dependent manner, but ATP synthesis and ADP depletion rates progressively decreased. The respiration rate of whole enod93 seedlings was elevated, and root ADP content was nearly double that in wild type without a change in ATP content. We propose that ENOD93 and HYPOXIA-INDUCED GENE DOMAIN 2 (HIGD2) are the functional equivalent of yeast RCF2 but have remained undiscovered in many eukaryotic lineages because they are encoded by 2 distinct genes.
When Jack isn’t Jacques: Simultaneous opposite language-specific speech perceptual learning in French–English bilinguals
Authors: Caudrelier Tiphaine , Ménard Lucie , Beausoleil Marie-Michèle , Martin Clara D , Samuel Arthur G
Published: August 2024

Humans are remarkably good at understanding spoken language, despite the huge variability of the signal as a function of the talker, the situation, and the environment. This success relies on having access to stable representations based on years of speech input, coupled with the ability to adapt to short-term deviations from these norms, e.g. accented speech or speech altered by ambient noise. In the last two decades, there has been a robust research effort focused on a possible mechanism for adjusting to accented speech. In these studies, listeners typically hear 15 – 20 words in which a speech sound has been altered, creating a short-term deviation from its longer-term representation. After exposure to these items, listeners demonstrate “lexically driven phonetic recalibration”—they alter their categorization of speech sounds, expanding a speech category to take into account the recently heard deviations from their long-term representations. In the current study, we investigate such adjustments by bilingual listeners. French–English bilinguals were first exposed to nonstandard pronunciations of a sound (/s/ or /f/) in one language and tested for recalibration in both languages. Then, the exposure continued with both the original type of mispronunciation in the same language, plus mispronunciations in the other language, in the opposite direction. In a final test, we found simultaneous recalibration in opposite directions for the two languages—listeners shifted their French perception in one direction and their English in the other: Bilinguals can maintain separate adjustments, for the same sounds, when a talker's speech differs across two languages.
Understanding the limits of binary diffusion for enhanced clay barrier design
Authors: Im Jooyoung , Santamarina J Carlos
Published: August 2024

Waste containment and isolation strategies often utilize bentonite as a buffer material due to its swelling capacity, sealing efficiency, low permeability, and limited diffusive transport. However, previous experimental studies of ionic diffusion through bentonite have shown discrepancies with binary diffusion assumptions. Meticulous experiments and complementary analyses reveal that the migration of preexisting ions in the medium enables the differential flux of diffusing anions and cations, while maintaining local electroneutrality in all cases. The separation between the cationic and anionic fronts is electrically tied to the motion of the preexisting ions and reflects the interplay between valence, concentration, and self-diffusion coefficients of the ions involved. Imposing binary diffusion conditions forces the faster anions to diffuse at the same rate as cations. Therefore, effective barriers to mitigate both cation and anion transport should have low surface charge and low excess salts to minimize the preexisting ionic concentration.
Cerebral microvascular changes in healthy carriers of the APOE-ɛ4 Alzheimer's disease risk gene
Authors: Aamand Rasmus , Rasmussen Peter M , Andersen Katrine Schilling , de Paoli Stine , Weitzberg Eddie , Christiansen Michael , Lund Torben E , Østergaard Leif
Published: August 2024

APOE-ɛ4 is a genetic risk factor for Alzheimer's disease (AD). AD is associated with reduced cerebral blood flow (CBF) and with microvascular changes that limit the transport of oxygen from blood into brain tissue: reduced microvascular cerebral blood volume and high relative transit time heterogeneity (RTH). Healthy APOE-ɛ4 carriers reveal brain regions with elevated CBF compared with carriers of the common ɛ3 allele. Such asymptomatic hyperemia may reflect microvascular dysfunction: a vascular disease entity characterized by suboptimal tissue oxygen uptake, rather than limited blood flow per se. Here, we used perfusion MRI to show that elevated regional CBF is accompanied by reduced capillary blood volume in healthy APOE-ɛ4 carriers (carriers) aged 30–70 years compared with similarly aged APOE-ɛ3 carriers (noncarriers). Younger carriers have elevated hippocampal RTH and more extreme RTH values throughout both white matter (WM) and cortical gray matter (GM) compared with noncarriers. Older carriers have reduced WM CBF and more extreme GM RTH values than noncarriers. Across all groups, lower WM and hippocampal RTH correlate with higher educational attainment, which is associated with lower AD risk. Three days of dietary nitrate supplementation increased carriers' WM CBF but caused older carriers to score worse on two of six aggregate neuropsychological scores. The intervention improved late recall in younger carriers and in noncarriers. The APOE-ɛ4 gene is associated with microvascular changes that may impair tissue oxygen extraction. We speculate that vascular risk factor control is particularly important for APOE-ɛ4 carriers' healthy aging.
‘Fund people, not projects’: From narrative CVs to lotteries in science funding policy
Authors: Shaw Jamie
Published: August 2024

There has been a recent increase in attention toward the proper targets of evaluation in science funding policy. Specifically, some claim that we should ‘fund people, not projects’ to allow for increased autonomy for researchers. Critics argue that this movement unduly opens room for biases against several marginalized groups of scientists. In this paper, I contribute to this discussion by accomplishing a few related tasks. First, I analyze the idea of ‘funding people, not projects’ and show that it actually suggests multiple positions. Second, I propose a mechanism for evaluating researchers through narrative CVs. Finally, I respond to critics by showing that we should shift the goalposts from debiasing peer review to arrangements of science funding policies that are debiasing as a whole. In doing so, I hope to clarify and assess the movement, while pointing to ways forward.
Recognising Palestinian Refugees: Applicability of Article 1D of the 1951 Refugee Convention in Turkey
Authors: Bülbül Hasan Basri
Published: August 2024

The special international regime for Palestinian refugees established by Article 1D of the 1951 Refugee Convention has yet to receive sufficient attention in Turkish asylum literature. Although Turkish law has incorporated Article 1D, neither scholars nor practitioners have pushed for its implementation. This research contends that Palestinians should be recognised as refugees in Turkey. Despite Turkey only granting refugee status to individuals from Europe due to the Convention’s geographical limitation, this article argues that an exception should be made for Palestinians. To this end, this article addresses how Article 1D of the 1951 Refugee Convention applies in Turkey by focusing on the interplay between the Convention and Turkish laws and regulations, as well as considering recent case law in other jurisdictions, particularly in Europe. By doing so, it aims to demonstrate that it is possible, though challenging, to improve the legal status of Palestinians in Turkey, mainly through strategic litigation.
Derivation of dental epithelial-like cells from murine embryonic stem cells for tooth regeneration
Authors: Hu Hong , Zhao Yifan , Shan Ce , Fu Huancheng , Cai Jinglei , Li Zhonghan
Published: August 2024

Teeth are comprised of epithelial and mesenchymal cells, and regenerative teeth rely on the regeneration of both cell types. Transcription factors play a pivotal role in cell fate determination. In this study, we establish fluorescence models based on transcription factors to monitor and analyze dental epithelial cells. Using Pitx2-P2A-copGFP mice, we observe that Pitx2+ epithelial cells, when combined with E14.5 dental mesenchymal cells, are sufficient for the reconstitution of teeth. Induced-Pitx2+ cells, directly isolated from the embryoid body that employs the Pitx2-GFP embryonic stem cell line, exhibit the capacity to differentiate into ameloblasts and develop into teeth when combined with dental mesenchymal cells. The regenerated teeth exhibit a complete structure, including dental pulp, dentin, enamel, and periodontal ligaments. Subsequent exploration via RNA-seq reveals that induced-Pitx2+ cells exhibit enrichment in genes associated with FGF receptors and WNT ligands compared with induced-Pitx2- cells. Our results indicate that both primary Pitx2+ and induced Pitx2+ cells possess the capability to differentiate into enamel-secreting ameloblasts and grow into teeth when combined with dental mesenchymal cells.
Comparison of differences in performance between pigs whose sires were identified using different selection strategies after experimental infection with PRRSV
Authors: Little Erin A , Dunkelberger Jenelle , Hanson Daniel , Eggert John , Gonda Michael G , MacNeil Michael D , Dee Scott
Published: August 2024

The objective of this study was to evaluate differences in the performance of offspring of boars selected with an index emphasizing resilience and boars selected based on a traditional index, emphasizing feed efficiency and carcass quality (traditional) index vs. a customized (resilience) index. The resilience index was identical to the traditional index, except that extra emphasis was placed on piglet vitality (increased by 66%), growth rate (decreased by 14%), and feed intake (increased substantially by 5,157%). Sows were mated to either boars selected based on the resilience index or boars selected on the traditional index. Weaned offspring were vaccinated for Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) and experimentally infected with PRRSV RFLP 1-7-4 four weeks later. Offspring were allocated to pens (n ~ 27 pigs/pen; n = 27 pens/group) by sire-selection group for a total of 1,458 pigs in 54 pens. The weight of each pen was recorded on 0, 42, and 110 d postinfection (DPI) and used to calculate average daily gain (ADG), average daily feed intake (ADFI), and feed conversion ratio (FCR). Mortalities were recorded from 0 to 110 DPI and necropsies were routinely performed to characterize pathogens present within the barn. Pigs classified as full value (i.e., >104 kg and void of defects) were slaughtered and hot carcass weight (HCW), backfat, loin depth, and lean weight were obtained from the slaughter plant. Effects of progeny group on performance, carcass characteristics, and mortality rate were estimated with a mixed linear model. Differences between progeny groups in ADG (P > 0.27), HCW (P = 0.68), backfat (P = 0.13), or loin depth (P = 0.39), and mortality rate (P = 0.29) were not detected. From 0 to 42 DPI, offspring of boars selected based on the resilience index had higher ADFI (0.06 kg/d, P = 0.01) and higher FCR (0.12, P = 0.01). In summary, results from this study do not support selection of boars for increased feed intake, piglet viability, and robustness in order to prevent losses caused by PRRSV, but selection response was only measured after one generation of male selection. The impact of multiple generations of selection, or the development of an index including traits derived from data collected under disease-challenged conditions should be explored. The data collected for this study are a valuable resource to explore additional genetic selection strategies for enhanced resilience to a multifactorial PRRS challenge.
Limited genetic depletion despite extinction risk: genomic diversity of a peripheral population of red-spotted bluethroats in Central Europe
Authors: Damnjanović Dragomir , Nazarizadeh Masoud , Wisniewska Monika M , Pavel Václav , Chutný Bohumír , Johnsen Arild , Nováková Milena , Štefka Jan
Published: August 2024

Small and isolated populations are at risk of local extinction, either due to the reduction of genetic diversity or due to stochastic events. We assessed genetic diversity in populations of the red-spotted (Luscinia svecica svecica) and white-spotted bluethroat (L. s. cyanecula) subspecies from six European sites, focusing on a peripheral and declining, red-spotted population from Central Europe (Krkonoše Mountains, Czech Republic). Analysis of population structure using mitochondrial sequences (cytochrome b) and ddRAD genomic data revealed that the two subspecies form clearly defined clusters, but traces of possible admixture were found in three populations of the white-spotted bluethroat. Demographic history reconstruction indicates past population range expansion in both subspecies, while the occurrence of short (0.4 Mbp) runs of homozygosity (ROH) segments suggests possible inbreeding 50 to 200 generations ago. Interestingly, although established by a small number of individuals, the Krkonoše population show reduced genetic diversity in only one measure of summary statistics, possibly due to sustained gene flow. Correspondingly, nine highly homozygous genes were recovered within a 2.6-Mbp long ROH region on the Chr 5. Thus, we found only a small reduction of genetic diversity in a population facing extinction, contrary to the expectations for a geographically distant and small population.
Moderate IV Fluid Resuscitation Is Associated With Decreased Sepsis Mortality
Authors: Corl Keith A. , Levy Mitchell M. , Holder Andre L. , Douglas Ivor S. , Linde-Zwirble Walter T. , Alam Aftab
Published: August 2024

OBJECTIVES:

Significant practice variation exists in the amount of resuscitative IV fluid given to patients with sepsis. Current research suggests equipoise between a tightly restrictive or more liberal strategy but data is lacking on a wider range of resuscitation practices. We sought to examine the relationship between a wide range of fluid resuscitation practices and sepsis mortality and then identify the primary driver of this practice variation.

DESIGN:

Retrospective analysis of the Premier Healthcare Database.

SETTING:

Six hundred twelve U.S. hospitals.

PATIENTS:

Patients with sepsis and septic shock admitted from the emergency department to the ICU from January 1, 2016, to December 31, 2019.

INTERVENTIONS:

The volume of resuscitative IV fluid administered before the end of hospital day- 1 and mortality.

MEASUREMENTS AND MAIN RESULTS:

In total, 190,682 patients with sepsis and septic shock were included in the analysis. Based upon patient characteristics and illness severity, we predicted that physicians should prescribe patients with sepsis a narrow mean range of IV fluid (95% range, 3.6–4.5 L). Instead, we observed wide variation in the mean IV fluids administered (95% range, 1.7–7.4 L). After splitting the patients into five groups based upon attending physician practice, we observed patients in the moderate group (4.0 L; interquartile range [IQR], 2.4–5.1 L) experienced a 2.5% reduction in risk-adjusted mortality compared with either the very low (1.6 L; IQR, 1.0–2.5 L) or very high (6.1 L; IQR, 4.0–9.0 L) fluid groups p < 0.01). An analysis of within- and between-hospital IV fluid resuscitation practices showed that physician variation within hospitals instead of practice differences between hospitals accounts for the observed variation.

CONCLUSIONS:

Individual physician practice drives excess variation in the amount of IV fluid given to patients with sepsis. A moderate approach to IV fluid resuscitation is associated with decreased sepsis mortality and should be tested in future randomized controlled trials.
Surgical Strategies to Manage Stromal Interface Irregularity Following Deep Anterior Lamellar Keratoplasty
Authors: Lucisano Andrea , Mancini Alessandra , Taloni Andrea , Giannaccare Giuseppe , Yu Angeli Christy , Carnevali Adriano , Scalzo Giovanna Carnovale , Scorcia Vincenzo
Published: August 2024

Purpose:

The purpose of this study was to describe the various surgical approaches to manage stromal interface irregularity following deep anterior lamellar keratoplasty (DALK).

Methods:

This interventional case series included patients requiring repeat keratoplasty procedures for stromal interface opacity and/or irregularity following DALK. The following surgical techniques with the aim of restoring transparency and regularity of the central optical zone and improving visual acuity in eyes that underwent unsuccessful DALK were performed: 1) simple anterior lamellar graft exchange, 2) repeat DALK with pneumatic dissection, 3) repeat DALK with deepening of manual lamellar dissection, 4) small diameter stripping of the central stroma–endothelium–Descemet complex and its replacement with a new endothelial lamella, and 5) 2-piece microkeratome-assisted mushroom penetrating keratoplasty. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp examination, tonometry, and anterior corneal tomography were evaluated preoperatively, as well as 3, 6, and 12 months after surgery. Intraoperative and postoperative complications were recorded.

Results:

Preoperative BCVA was less than 20/200 and improved to 20/40 or better in all cases, reaching 20/20 in 1 patient. Corneal clarity was restored in all eyes, and no recurrence of underlying disease was observed. No intraoperative or postoperative complications were reported.

Conclusions:

This case series describes several successful surgical approaches to improve the transparency and regularity of stromal interface obtained after a DALK procedure; the choice of the technique should be customized for the single eyes to still maintain the advantages of lamellar or minimally invasive grafts.
Exploring the Experiences of Latina Mothers in a Culturally Tailored Early Parent-Mediated Neurodevelopmental Intervention
Authors: DuBay Michaela , Rios Kristina , Montenegro Daniel , Guerra Karen
Published: August 2024

Children begin to show symptoms of neurodevelopmental disorders early on in their development. Providing early intervention that is culturally responsive to both families and the child receiving the service is vital for the child’s growth. The purpose of this study was to qualitatively explore 14 Latin American Spanish-speaking parents’ reactions to and perceptions of Communication Interaction Training on Autism for Spanish-speaking caregivers (CITAS), a waitlist-style parent-mediated program that focuses on teaching parents strategies to support their child’s language development and enhance learning. Focus group, interview, and field note data were analyzed using the Ecological Validity Framework to determine areas of cultural fit and cultural misalignment. Notably, participants demonstrated appreciation for the CITAS program, including several specific elements that provided unique cultural fit. Some logistical and contextual challenges were also identified. Implications for research and practice are discussed.
Coaching Coaches to Guide Classroom Implementation of Pyramid Model Practices
Authors: Taylor Abby L. , Hemmeter Mary Louise , Barton Erin E. , Fox Lise , Vatland Chris , Horth Kymberly
Published: August 2024

Identifying effective professional development related to providing social–emotional support in early childhood classrooms is a critical need. We used a multiple probe across participants and behaviors design to examine the impact of external coaching support on classroom coaches’ use of coaching strategies with teachers in childcare programs. As secondary measures, we assessed the implementation of the Pyramid Model using a standardized tool and teachers’ perceptions of children’s engagement and behavior. Two classroom coaches increased their implementation of two Practice-Based Coaching components: (a) collaboration and planning and (b) reflection and feedback. Results from secondary measures were inconclusive. Our study extends the professional development research by focusing on increasing the implementation fidelity of evidence-based coaching strategies to improve teachers’ use of social–emotional teaching practices in early childhood classrooms.
A Psychometric Development and Evaluation of the Flow State Scale for Caregiving Tasks Among Clinical Nurses
Authors: LIN Jong-Ni , SU Pin-Yen , WANG Lin-Hua , WANG Jing-Jy , Wang Chi-Jane
Published: August 2024

Background

The extensive research already conducted in numerous non-healthcare disciplines has consistently demonstrated the effectiveness of flow in alleviating work-related stress and boosting employee engagement in the workplace. Despite the potential benefits to nursing of improving flow, no valid instrument is currently available to measure the work-related flow experience of clinical nurses.

Purpose

This study was designed to develop the Flow State Scale for Caregiving Tasks (FSS-CT) and to evaluate its psychometric properties in the context of clinical nurses.

Methods

This study, guided by the flow theory of Mihaly Csikszentmihalyi (1975), employed a three-phase approach to developing and evaluating the psychometric properties of the FSS-CT. Five hundred thirty-six full-time clinical nurses working in hospitals of various levels in Taiwan were recruited via cluster random sampling to participate in an anonymous online survey. The content validity of the developed scale was established through expert panel verification, criterion-related validity was assessed by correlating the scale with the Work-related Flow Inventory, and construct validity was evaluated via explanatory and confirmatory factor analyses. Scale reliability was determined using Cronbach's α coefficient.

Results

The FSS-CT, a 12-item Likert scale comprising four domains, was developed. These domains capture the elements of nurses' work-related flow, including professional confidence, merging of action and awareness, balance between skill and challenge, and autotelic experience. The FSS-CT demonstrated high content validity (content validity index > .90) and satisfactory criterion-related validity (coefficient = .55, p < .001). Furthermore, the scale was found to have excellent internal consistency (Cronbach's α = .91). Factor analyses yielded a four-factor structure accounting for 69.34% of the total variance, indicating a good fit for the final model based on recommended goodness-of-fit indices.

Conclusions

The FSS-CT is a viable and dependable instrument for assessing the work-related flow experiences of nurses, with the measured outcomes offering to nursing administrators valuable insights into or directions for personnel development and work allocation initiatives.
Development and validation of MRI-PDFF cutoffs for living liver donor eligibility assessment
Authors: Kim Hae Young , Jeon Sun Kyung , Ha Tae-Yong , Jung Dong-Hwan , Lee Seungjae , Song In Hye , Chung Sung Won , Kim So Yeon , Lee Seung Soo
Published: August 2024

Hepatic steatosis (HS) criteria for living donor liver transplantation (LDLT) donor eligibility should be based on large droplet fat as per Banff consensus recommendations. We aimed to establish magnetic resonance imaging proton density fat fraction cutoffs for HS assessment in potential LDLT donors. This retrospective study included consecutive potential LDLT donors who underwent MRI and liver biopsy between 2013 and 2023 at 2 tertiary institutions, each as development (n = 3062; 2015 men; median [IQR] age of 32 [25–38] y) and external validation (n = 472; 287 men; 35 [26–44] y) data sets. Proton density fat fraction (PDFF) was measured using dedicated MRI sequences. Histologic HS, defined as a large droplet fat fraction, was used as the reference standard. Dual PDFF cutoffs aimed at 95% sensitivity or 95% specificity, for diagnosing histologic HS of ≥10%, ≥20%, ≥30%, and ≥40%, were determined in the development data set using 10-fold cross-validation. The cutoffs were then validated in the external validation data set. The equation for estimating histologic HS from PDFF was also derived using linear regression. The PDFF cutoffs for histologic HS of ≥10%, ≥20%, ≥30%, and ≥40%, targeting 95% sensitivity, were 3.7%, 5.5%, 8.0%, and 10.0%, respectively. External validation demonstrated high sensitivities ≥97.9% with specificities ranging from 60.9% to 95.1%. The PDFF cutoffs targeting 95% specificity were 6.3%, 8.0%, 9.1%, and 10.1%, respectively. External validation rendered high specificities ranging from 88.5% to 95.3%, with sensitivities ranging from 76.6% to 100%. For diagnosing histologic HS ≥30%, which is the most prevalently used threshold for LDLT donor eligibility assessment, the PDFF cutoffs achieved sensitivities and specificities of over 90%. The equation of (Histologic HS = −2.95 + 1.93 × PDFF) was derived.
Givosiran for the Treatment of Pediatric Acute Intermittent Porphyria
Authors: Bujold Kenneth E. , Kasher Nicole , McKiernan Christine
Published: August 2024

Acute intermittent porphyria (AIP) causes neurovisceral symptoms and organ toxicity resulting in acute and chronic health conditions. Treatment has traditionally involved avoiding triggers and utilizing carbohydrates and hemin infusions for acute attacks. Givosiran, an FDA-approved small interfering RNA, has shown benefit in adults in reducing attacks. However, its usage in pediatrics is extremely limited. We present a pediatric patient with AIP, requiring frequent hemin infusions for severe attacks, which have a resolution of her disease state and symptoms with the initiation of givosiran therapy.
Hereditary multiple exostoses with cervical spine involvement: a case report
Authors: Roy Ujjawal , Rouniyar Sangam , Adhikari Bikash Chandra , Rimal Kushal , Zoowa Ronit
Published: August 2024

Introduction and Importance:

Hereditary multiple exostoses (HME) is a rare genetic disorder characterized by the formation of multiple benign bone tumors known as osteochondromas. Management of HME involves a multidisciplinary approach encompassing surgical expertise and genetic counseling. This case report highlights the significance of such an approach in optimizing outcomes for patients with HME, emphasizing the importance of individualized treatment strategies and future management.

Case Presentation:

We present the case of a 12-year-old male patient with a history of HME, who presented with symptoms including progressively enlarging and painful mass at the posterior aspect of his neck since last year. Surgical intervention was undertaken to address symptomatic lesions, focusing on preserving joint function and alleviating discomfort. The surgical approach involved careful consideration of lesion characteristics and their impact on surrounding structures.

Clinical Discussion:

The case shows the importance of a tailored surgical approach in managing symptomatic osteochondromas associated with HME, highlighting the need for careful consideration of lesion characteristics and their impact on joint function. By integrating surgical expertise with genetic counseling, clinicians can optimize outcomes while addressing familial implications and ensuring informed decision-making.

Conclusion:

This case report illustrates the significance of a multidisciplinary approach encompassing surgical intervention and genetic counseling in the management of hereditary multiple exostoses. Through individualized treatment strategies and informed decision-making, clinicians can optimize outcomes for patients with HME while providing comprehensive support and guidance for future management.