bluuebunny/crossref_metadata_2025 huggingface dataset:
Aphids increase their rate of survival on emergent aquatic plants through niche construction
Authors: Kodera Taisei , Ohsaki Haruna , Yamawo Akira
Published: January 2024

Flooding or rain is a threat to many insects in nature, including herbivorous invertebrates whose hosts are emergent aquatic plants. They may thus have developed particular adaptations to withstand the flooding that is a feature of emergent plants’ environment. The aphid Hyalopterus pruni (Hemiptera: Aphididae) modifies the physical and chemical conditions of its habitat by periodically spreading wax around itself with its hind legs. This behaviour constitutes a form of niche construction. We hypothesized that the aphid decreases its risk of death of own or around other individuals when submerged in water by spreading wax powder secreted from its body onto the leaves of its host plant, Phragmites australis. We compared the hydrophobicity of waxed and normal leaf surfaces. Next, we compared the survival rates of wax-powdering and nonwax-powdering aphids under submerged and rainy conditions in the laboratory and in the field. Finally, we examined whether the aphids’ wax-powdering behaviour increased as a result of experiencing brief submergence or rain. The surface of the waxed area was significantly more water-repellent than the surface of unwaxed leaves. The waxed areas held air bubbles when under water. In experiments, aphids without wax around themselves exhibited lower survival rates: 22.9% in laboratory conditions and 15.7% in field conditions after 48 hr underwater. In contrast, aphids that secreted wax had higher survival rates, with 41.5% and 38.2% under laboratory and field conditions, respectively, after the same duration. Aphids exposed to rainfall showed similar results. Moreover, aphids that had experienced rain or submersion for 24 hr engaged in increased wax-powdering behaviour. These results indicate that aphids reduce their risk of drowning by powdering secreted wax onto the surface of leaves around them. Our findings suggest that niche construction by herbivorous invertebrates supports their ability to utilize host plants that grow under stressful conditions, such as emergent plants that are subject to periodic inundation.
Article 10bis of the Paris Convention as the common denominator for protection against unfair competition in national and regional contexts
Authors: Senftleben Martin
Published: January 2024

This article explains the historical development of Article 10bis of the Paris Convention and discusses core concepts underlying the international provision, in particular, the overarching requirement of honest practices in industrial or commercial matters, the question of a competitive relationship and the examples of unfair practices given in Article 10bis. It also sheds light on guidance following from the Model Provisions on Protection Against Unfair Competition which the World Intellectual Property Organization presented in 1996. The analysis shows that the honest practices test need not be understood in a traditional, empirical sense. More modern, functional approaches can be adopted to align the application of Article 10bis with a broader spectrum of policy goals: not only fair play between competitors but also consumer protection and the general public interest in a well-functioning marketplace. Similarly, the requirement of a competitive relationship need not focus on direct competition in the same market segment. An indirect competitive relationship can be deemed sufficient. While the prohibited acts listed in Article 10bis(3) reflect central categories of unfair behaviour and harm, current developments and challenges—ranging from computational advertising, influencer marketing and product recommender systems to questions surrounding data exclusivity and sustainability issues—raise the question whether an update and enrichment of the catalogue of prohibited acts could be necessary to provide guidance at the international level.
Ethyl 2,2-difluoro-2-(2-oxo-2H-chromen-3-yl) acetate attenuates the malignant biological behaviors of non-small cell lung cancer via suppressing EGFR/PI3K/AKT/mTOR signaling pathway
Authors: Zou Liyi , Li Xiaodan , Lin Jiansuo , Fang Xuehong , Lin Jie , Zhang Lu , Zhang Yan , Liang Yanwen , Ren Jianwei , Liu Yi , Huang Zunnan
Published: January 2024

Objective

The goal of the study is to examine the impact on the malignant biological behaviors of non-small cell lung cancer (NSCLC) of a novel coumarin derivative, ethyl 2,2-difluoro-2-(2-oxo-2H-chromen-3-yl) acetate (C2F). It also aims to define its underlying mechanism.

Methods

NSCLC cell lines and xenograft nude mice model were conducted to explore the anti-NSCLC effects of C2F in vitro and in vivo. Then, network pharmacology analysis and molecular docking were applied to estimate the possible targets of C2F in NSCLC. Finally, the underlying mechanism of C2F against NSCLC cellular proliferation and tumor development was confirmed using inhibitors or activators of the PI3K/AKT signaling pathway.

Results

Our results showed that C2F was able to inhibit proliferation, migration, and invasion of NSCLC cell lines, induce cell cycle arrest and apoptosis in vitro, and prevent tumor growth in vivo. In addition, the estimated glomerular filtration rate and its downstream pathway (PI3K/AKT/mTOR) were found to be critical for the anti-NSCLC activity of C2F.

Conclusions

C2F inhibits malignant biological behaviors of NSCLC by suppressing EGFR/PI3K/AKT/mTOR signaling pathway.
Recent advances in understanding the role of two mitogen-activated protein kinase cascades in plant immunity
Authors: Wu Guangheng , Wang Wei
Published: January 2024

The mitogen-activated protein kinase (MAPK/MPK) cascade is an important intercellular signaling module that regulates plant growth, development, reproduction, and responses to biotic and abiotic stresses. A MAPK cascade usually consists of a MAPK kinase kinase (MAPKKK/MEKK), a MAPK kinase (MAPKK/MKK/MEK), and a MAPK. The well-characterized MAPK cascades in plant immunity to date are the MEKK1-MKK1/2-MPK4 cascade and the MAPKKK3/4/5-MKK4/5-MPK3/6 cascade. Recently, major breakthroughs have been made in understanding the molecular mechanisms associated with the regulation of immune signaling by both of these MAPK cascades. In this review, we highlight the most recent advances in understanding the role of both MAPK cascades in activating plant defense and in suppressing or fine-tuning immune signaling. We also discuss the molecular mechanisms by which plants stabilize and maintain the activation of MAPK cascades during immune signaling. Based on this review, we reveal the complexity and importance of the MEKK1-MKK1/2-MPK4 cascade and the MAPKKK3/4/5-MKK4/5-MPK3/6 cascade, which are tightly controlled by their interacting partners or substrates, in plant immunity.
SOG1 and BRCA1 Interdependently Regulate RAD54 Expression for Repairing Salinity-Induced DNA Double-Strand Breaks in Arabidopsis
Authors: Mahapatra Kalyan , Roy Sujit
Published: January 2024

As sessile organisms, land plants experience various forms of environmental stresses throughout their life span. Therefore, plants have developed extensive and complicated defense mechanisms, including a robust DNA damage response (DDR) and DNA repair systems for maintaining genome integrity. In Arabidopsis, the NAC [NO APICAL MERISTEM (NAM), ARABIDOPSIS TRANSCRIPTION ACTIVATION FACTOR (ATAF), CUP-SHAPED COTYLEDON (CUC)] domain family transcription factor SUPPRESSOR OF GAMMA RESPONSE 1 (SOG1) plays an important role in regulating DDR. Here, we show that SOG1 plays a key role in regulating the repair of salinity-induced DNA double-strand breaks (DSBs) via the homologous recombination (HR) pathway in Arabidopsis. The sog1-1 mutant seedlings display a considerably slower rate of repair of salinity-induced DSBs. Accumulation of SOG1 protein increases in wild-type Arabidopsis under salinity stress, and it enhances the expression of HR pathway–related genes, including RAD51, RAD54 and BReast CAncer gene 1 (BRCA1), respectively, as found in SOG1 overexpression lines. SOG1 binds specifically to the AtRAD54 promoter at the 5ʹ-(N)4GTCAA(N)3C-3ʹ consensus sequence and positively regulates its expression under salinity stress. The phenotypic responses of sog1-1/atrad54 double mutants suggest that SOG1 functions upstream of RAD54, and both these genes are essential in regulating DDR under salinity stress. Furthermore, SOG1 interacts directly with BRCA1, an important component of the HR-mediated DSB repair pathway in plants, where BRCA1 appears to facilitate the binding of SOG1 to the RAD54 promoter. At the genetic level, SOG1 and BRCA1 function interdependently in modulating RAD54 expression under salinity-induced DNA damage. Together, our results suggest that SOG1 regulates the repair of salinity-induced DSBs via the HR-mediated pathway through genetic interactions with RAD54 and BRCA1 in Arabidopsis.
Dynamic conformational changes of a tardigrade group-3 late embryogenesis abundant protein modulate membrane biophysical properties
Authors: Li Xiao-Han , Yu Conny W H , Gomez-Navarro Natalia , Stancheva Viktoriya , Zhu Hongni , Murthy Andal , Wozny Michael , Malhotra Ketan , Johnson Christopher M , Blackledge Martin , Santhanam Balaji , Liu Wei , Huang Jinqing , Freund Stefan M V , Miller Elizabeth A , Babu M Madan
Published: January 2024

A number of intrinsically disordered proteins (IDPs) encoded in stress-tolerant organisms, such as tardigrade, can confer fitness advantage and abiotic stress tolerance when heterologously expressed. Tardigrade-specific disordered proteins including the cytosolic-abundant heat-soluble proteins are proposed to confer stress tolerance through vitrification or gelation, whereas evolutionarily conserved IDPs in tardigrades may contribute to stress tolerance through other biophysical mechanisms. In this study, we characterized the mechanism of action of an evolutionarily conserved, tardigrade IDP, HeLEA1, which belongs to the group-3 late embryogenesis abundant (LEA) protein family. HeLEA1 homologs are found across different kingdoms of life. HeLEA1 is intrinsically disordered in solution but shows a propensity for helical structure across its entire sequence. HeLEA1 interacts with negatively charged membranes via dynamic disorder-to-helical transition, mainly driven by electrostatic interactions. Membrane interaction of HeLEA1 is shown to ameliorate excess surface tension and lipid packing defects. HeLEA1 localizes to the mitochondrial matrix when expressed in yeast and interacts with model membranes mimicking inner mitochondrial membrane. Yeast expressing HeLEA1 shows enhanced tolerance to hyperosmotic stress under nonfermentative growth and increased mitochondrial membrane potential. Evolutionary analysis suggests that although HeLEA1 homologs have diverged their sequences to localize to different subcellular organelles, all homologs maintain a weak hydrophobic moment that is characteristic of weak and reversible membrane interaction. We suggest that such dynamic and weak protein–membrane interaction buffering alterations in lipid packing could be a conserved strategy for regulating membrane properties and represent a general biophysical solution for stress tolerance across the domains of life.
Utilizing generative conversational artificial intelligence to create simulated patient encounters: a pilot study for anaesthesia training
Authors: Sardesai Neil , Russo Paolo , Martin Jonathan , Sardesai Anand
Published: January 2024

Purpose of the study

Generative conversational artificial intelligence (AI) has huge potential to improve medical education. This pilot study evaluated the possibility of using a ‘no-code’ generative AI solution to create 2D and 3D virtual avatars, that trainee doctors can interact with to simulate patient encounters.

Methods

The platform ‘Convai’ was used to create a virtual patient avatar, with a custom backstory, to test the feasibility of this technique. The virtual patient model was set up to allow trainee anaesthetists to practice answering questions that patients’ may have about interscalene nerve blocks for open reduction and internal fixation surgery. This tool was provided to anaesthetists to receive their feedback and evaluate the feasibility of this approach.

Results

Fifteen anaesthetists were surveyed after using the tool. The tool had a median score [interquartile range (IQR)] of 9 [7–10] in terms of how intuitive and user-friendly it was, and 8 [7–10] in terms of accuracy in simulating patient responses and behaviour. Eighty-seven percent of respondents felt comfortable using the model.

Conclusions

By providing trainees with realistic scenarios, this technology allows trainees to practice answering patient questions regardless of actor availability, and indeed from home. Furthermore, the use of a ‘no-code’ platform allows clinicians to create customized training tools tailored to their medical specialties. While overall successful, this pilot study highlighted some of the current drawbacks and limitations of generative conversational AI, including the risk of outputting false information. Additional research and fine-tuning are required before generative conversational AI tools can act as a substitute for actors and peers.
Exploring the unifying concept of spondyloarthritis: a latent class analysis of the REGISPONSER registry
Authors: Michelena Xabier , Sepriano Alexandre , Zhao Sizheng Steven , López-Medina Clementina , Collantes-Estévez Eduardo , Font-Ugalde Pilar , Juanola Xavier , Marzo-Ortega Helena
Published: January 2024

Objectives

The aim of our study was to identify the potential distinct phenotypes within a broad SpA population.

Methods

We conducted a cross-sectional study using the REGISPONSER registry, which has data from 31 specialist centres in Spain, including patients with SpA who have fulfilled the ESSG criteria. A latent class analysis (LCA) was performed to identify the latent classes underlying SpA according to a set of predefined clinical and radiographic features, independently of expert opinion.

Results

In a population of 2319 SpA patients, a five-classes LCA model yielded the best fit. Classes named ‘Axial with spine involvement’ and ‘Axial with isolated SI joint involvement’ showed a primarily axial SpA phenotype defined by inflammatory back pain and high HLA-B27 prevalence. Patients in class ‘Axial + peripheral’ showed a similar distribution of manifest variables to previous classes but also had a higher likelihood of peripheral involvement (peripheral arthritis/dactylitis) and enthesitis, therefore representing a mixed (axial and peripheral) subtype. Classes ‘Peripheral + psoriasis’ and ‘Axial + peripheral + psoriasis’ were indicative of peripheral SpA (and/or PsA) with high likelihood of psoriasis, peripheral involvement, dactylitis, nail disease, and low HLA-B27 prevalence, while class ‘Axial + peripheral + psoriasis’ also exhibited increased probability of axial involvement both clinically and radiologically.

Conclusion

The identification of five latent classes in the REGISPONSER registry with significant overlap between axial and peripheral phenotypes is concordant with a unifying concept of SpA. Psoriasis and related features (nail disease and dactylitis) influenced the phenotype of both axial and peripheral manifestations.
Phylogenetic analysis of Acanthamoeba isolated from soil samples and nasal cavities of patients with malignancy: a public health concern in the northwest of Iran
Authors: Pezeshki Ali , Tajic Shadi , Farahmandian Parvin , Haniloo Ali , Mahmmodzadeh Abbas , Niyyati Maryam , Behniafar Hamed
Published: January 2024

Background

The genus Acanthamoeba is reported from various environmental sources and can cause multiple complications, including chronic amoebic aeratitis and amoebic granulomatous encephalitis. This study investigated the presence and genotyping of Acanthamoeba in the soil of parks and patients with malignancies referred to health centers in Zanjan city, Iran.

Methods

In this cross-sectional study, 200 soil samples were collected from amusement parks in Zanjan city from September 2017 to May 2018. Samples were cultured on 1.5% non-nutrient agar, and the Acanthamoeba genus was identified using the morphological method. PCR was performed on all positive environmental samples, and six microscopically positive clinical samples belonged to our previous study. DNA sequencing of 18S rRNA was performed to analyze the genetic pattern of some PCR-positive isolates.

Results

Microscopic results showed that 96 (48%) soil samples were positive. PCR confirmed all positive cases of clinical samples and 84 soil samples. Out of the PCR-positive samples, 20 soil samples and five clinical samples were sequenced successfully. All soil isolates belonged to the T4 genotype, and three and two clinical samples belonged to T4 and T5 genotypes, respectively.

Conclusion

: The presence of Acanthamoeba in both the environment and clinical samples of Zanjan city suggests paying greater attention to the infections caused by it.
Task sharing for the management of leprosy by nurses in a tertiary healthcare setting of Northern India
Authors: Pratibha  , Kavita  , Mehta Hitaishi , Narang Tarun , Singh Shubhmohan
Published: January 2024

Background

This study aimed to assess the effectiveness of nurse-led interventions in managing leprosy due to a shortage of dermatologists and other healthcare professionals.

Methods

A total of 100 leprosy patients were divided into experimental (n=50) and control groups (n=50). The intervention included face-to-face counseling by a trained nurse, motivational videos and exercise demonstrations. The control group received standard care. The primary outcome of interest was treatment adherence (Adherence to Refills and Medications Scale); other assessed outcomes included changes in perceived stigma (Stigma Assessment and Reduction of Impact scale), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder seven-item) and quality of life (WHO QOL–BREF Scale) from baseline to week 8.

Results

The intervention group had better treatment adherence (p<0.001). At baseline, moderately severe and severe depression prevalence was 18% and 28%, respectively, and anxiety was 25%, with no intergroup differences. Anxiety significantly decreased in the intervention group (p<0.001), but depression remained similar (p=0.291). Perceived stigma improved notably, especially in disclosure of concern (p<0.001), internal stigma (p<0.001) and anticipated stigma (p<0.001). Quality of life scores improved in the intervention group vs controls.

Conclusion

Nurse-led interventions effectively enhanced quality of life and treatment adherence and reduced anxiety, depression and perceived stigma among leprosy patients. The study recommends strengthening the capacity of nurses for active involvement in leprosy care.
From the dark side of paradise: a new natural replication of cave planthopper evolution from Hawaiian lava tubes (Hemiptera: Fulgoromorpha: Cixiidae)
Authors: Hoch Hannelore , Porter Megan L , Slay Christy M , Slay Michael E , Steck Mireille , Chong Rebecca A
Published: January 2024

The Hawaiian Islands are known to harbour a rich and diverse fauna of troglobionts (obligate subterranean species). To date, 74 obligate cavernicolous arthropod species have been documented from across the main Hawaiian islands, the majority of which were from Hawaiʻi Island, and mostly from lava tubes of Kilauea volcano, the youngest volcano on the island. A recent bioinventory of the Kipuka Kanohina lava tube system on the south-western side of Mauna Loa volcano revealed the existence of previously unknown cave-adapted species. Among them is the first cave-adapted species of the planthopper genus Iolania, Iolania frankanstonei Hoch & Porter sp. nov. Morphological and molecular data suggest that the species is closely related to the epigean (i.e. surface-dwelling) species Iolania perkinsi, which occurs in surface environments on Hawaiʻi Island. Thus, parapatric speciation is assumed, further corroborating the assumption that adaptive shifts are the major evolutionary patterns underlying the evolution of troglobionts on young oceanic islands.
Palliative Care in the Neonatal Intensive Care Unit
Authors: Lenington Kathryn , Dudding Katherine M. , Fazeli Pariya L. , Dick Tracey , Patrician Patricia
Published: January 2024

Background:

Although the concepts of uncertainty and anticipated loss have been explored in a variety of contexts, advances in genetic testing and life-sustaining technology rendered changes in the care of medically complex infants. The separate concepts no longer have the descriptive power to clarify new phenomena endured by parents in the changing neonatal landscape. A current concept analysis examining uncertainty in anticipated loss is necessary to generate knowledge concurrently with deviations observed in the neonatal intensive care unit.

Purpose:

To explore the concept of uncertainty in anticipated loss among parents of infants with genetic disorders.

Methods:

Following Rodgers' method of concept analysis, the concept was named, surrogate terms, antecedents, attributes, and consequences were identified from the literature, and a model case was constructed. The databases CINAHL, PubMed, and PsycINFO were used to conduct the literature search.

Results:

Fifteen articles provided the data for this analysis. Uncertainty in anticipated loss is a complex, nonlinear, and multifaceted experience anteceded by an ultimately terminal diagnosis, an ambiguous prognosis, and a lack of clear knowledge to guide treatment. Its attributes include a loss of control, assumptive world remodeling, role/identity confusion, and prolonged emotional complexity that consequently leads to a cyclical pattern of positive and negative outcomes.

Implications:

This newly defined concept empowers neonatal nurses to provide care that includes a holistic understanding of the experience of uncertainty in anticipated loss. Nurses are ideally positioned and have the responsibility to utilize this concept to become better advocates for infants and facilitators of parental wellness.
Improving Outcomes in Mechanically Ventilated Adult ICU Patients Following Implementation of the ICU Liberation (ABCDEF) Bundle Across a Large Healthcare System
Authors: Barr Juliana , Downs Brenda , Ferrell Ken , Talebian Mojdeh , Robinson Seth , Kolodisner Liesl , Kendall Heather , Holdych Janet
Published: January 2024

OBJECTIVES:

To measure how the ICU Liberation Bundle (aka ABCDEF Bundle or the Bundle) affected clinical outcomes in mechanically ventilated (MV) adult ICU patients, as well as bundle sustainability and spread across a healthcare system.

DESIGN:

We conducted a multicenter, prospective, cohort observational study to measure bundle performance versus patient outcomes and sustainability in 11 adult ICUs at six community hospitals. We then prospectively measured bundle spread and performance across the other 28 hospitals of the healthcare system.

SETTING:

A large community-based healthcare system.

PATIENTS:

In 11 study ICUs, we enrolled 1,914 MV patients (baseline n = 925, bundle performance/outcomes n = 989), 3,019 non-MV patients (baseline n = 1,323, bundle performance/outcomes n = 1,696), and 2,332 MV patients (bundle sustainability). We enrolled 9,717 MV ICU patients in the other 28 hospitals to assess bundle spread.

INTERVENTIONS:

We used evidence-based strategies to implement the bundle in all 34 hospitals.

MEASUREMENTS AND MAIN RESULTS:

We compared outcomes for the 12-month baseline and bundle performance periods. Bundle implementation reduced ICU length of stay (LOS) by 0.5 days (p = 0.02), MV duration by 0.6 days (p = 0.01), and ICU LOS greater than or equal to 7 days by 18.1% (p < 0.01). Performance period bundle compliance was compared with the preceding 3-month baseline compliance period. Compliance with pain management and spontaneous awakening trial (SAT) and spontaneous breathing trial (SBT) remained high, and reintubation rates remained low. Sedation assessments increased (p < 0.01) and benzodiazepine sedation use decreased (p < 0.01). Delirium assessments increased (p = 0.02) and delirium prevalence decreased (p = 0.02). Patient mobilization and ICU family engagement did not significantly improve. Bundle element sustainability varied. SAT/SBT compliance dropped by nearly half, benzodiazepine use remained low, sedation and delirium monitoring and management remained high, and patient mobility and family engagement remained low. Bundle compliance in ICUs across the healthcare system exceeded that of study ICUs.

CONCLUSIONS:

The ICU Liberation Bundle improves outcomes in MV adult ICU patients. Evidence-based implementation strategies improve bundle performance, spread, and sustainability across large healthcare systems.
Data-Centric Machine Learning in Nursing
Authors: Ball Dunlap Patricia A. , Nahm Eun-Shim , Umberfield Elizabeth E.
Published: January 2024

The ubiquity of electronic health records and health information exchanges has generated abundant administrative and clinical healthcare data. The vastness of this rich dataset presents an opportunity for emerging technologies (eg, artificial intelligence and machine learning) to assist clinicians and healthcare administrators with decision-making, predictive analytics, and more. Multiple studies have cited various applications for artificial intelligence and machine learning in nursing. However, what is unknown in the nursing discipline is that while greater than 90% of machine-learning implementations use a model-centric strategy, a fundamental change is occurring. Because of the limitations of this approach, the industry is beginning to pivot toward data-centric artificial intelligence. Nurses should be aware of the differences, including how each approach affects their engagement in designing human-intelligent–like technologies and their data usage, especially regarding electronic health records. Using the Norris Concept Clarification method, this article elucidates the data-centric machine learning concept for nursing. This is accomplished by (1) exploring the concept's origins in the data and computer science disciplines; (2) differentiating data- versus model-centric machine learning approaches, including introducing the machine-learning operation life cycle and process; and (3) explaining the advantages of the data-centric phenomenon, especially concerning nurses' engagement in technological design and proper data usage.
Effect of Benidipine Alone and in Combination With Bosentan and Sildenafil in Amelioration of Pulmonary Arterial Hypertension in Experimental Model in Rats
Authors: Kumari Kalpana , Vishwakarma Vishal Kumar , Kumar Kuldeep , Mridha Asit Ranjan , Arava Sudhir Kumar , Dhingra Sameer , Singh Nirmal , Yadav Harlokesh Narayan
Published: January 2024

Pulmonary arterial hypertension (PAH) is a persistent condition affecting the pulmonary arteries' endothelium. Benidipine, a calcium channel blocker, possesses vasodilatory, anti-inflammatory activity, reduces oxidative stress, and inhibits the activity of Transforming growth factor-β (TGF-β) and α-smooth muscle actin (α-SMA). The present study was designed to investigate the effect of benidipine alone and in combination with bosentan and sildenafil on monocrotaline (MCT)-induced pulmonary hypertension in a rat model. PAH was induced by a single-dose administration of MCT in rats. Animals were randomized into different groups and treated with benidipine alone and in combination with bosentan or sildenafil. Various parameters such as hemodynamic parameters, Fulton's index and oxidative stress parameters were performed. Additionally, histopathology of lung and right ventricular of heart tissue, immunohistochemistry, expression of α-SMA, endothelial nitric oxide synthase (eNOS), TGF-β, and RT-PCR, and an in vitro study using human umbilical vein endothelial cells (HUVECs) was also carried out. Treatment of benidipine and its combination exhibited better prevention in the elevated right ventricular systolic pressure, right ventricular hypertrophy, rise in oxidative stress, and increase in expression of α-SMA and TGF-β receptor 1 compared with MCT control group rats. In HUVECs, the expression of α-SMA was increased, whereas that of eNOS decreased after TGF-β exposure and was substantially reversed after pretreatment with benidipine. We concluded that benidipine and its combination with bosentan and sildenafil exhibit beneficial effects in MCT-induced PAH through the eNOS/TGF-β/α-SMA signaling pathway.
Exploration of the Utility of the Generic ICHOM Standard Set Measures in Evaluating the Speech of Patients with Cleft Lip/Palate
Authors: Del Risco Amanda C. , Dunworth Kristina , Sharif-Askary Banafsheh , Suárez Arthur H. “Barron” , Nyswonger Jillian , Ford Matthew , Kern Jennifer , Jones Carlee , Raynor Eileen , Allori Alexander C.
Published: January 2024

Background:

The International Consortium of Health Outcome Measurements (ICHOM) standard set for cleft care appraisal recommends clinicians assess articulation with percentage consonants correct (PCC) and velopharyngeal function with velopharyngeal competency rating (VPC-R). This study explores the utility and limitations of these generic measures in detecting cleft speech sound disorders by comparing them with two cleft-specific speech-rating systems, cleft audit protocol of speech–augmented Americleft modification (CAPS-A-AM) and Pittsburgh weighted speech scale (PWSS).

Methods:

Consecutive children with repaired, nonsyndromic cleft lip/palate, aged 5 years or older (n = 27) underwent prospective speech evaluations conducted at a single academic institution. These evaluations were conducted, recorded, and evaluated by blinded speech-language pathologists experienced with all tools.

Results:

When comparing measures of articulation, PCC scores correlated better with scores for relevant subcomponents of CAPS-A-AM than PWSS. When comparing measures of velopharyngeal function, VPC-R scores correlated well with relevant components of both scales. Using a “screening test versus diagnostic test” analogy, VPC-R ratings were 87.5% sensitive and 73.7% specific for detecting velopharyngeal dysfunction according to subcomponents of CAPS-A-AM, and 70.6% sensitive and 100% specific according to subcomponents of PWSS.

Conclusions:

This exploratory study demonstrates that PCC and VPC-R perform moderately well in detecting articulatory and velopharyngeal dysfunction in patients with cleft lip/palate; however, these tools cannot describe nuances of cleft speech sound disorder. Thus, although PCC and VPC-R adequately track basic minimum outcomes, we encourage teams to consider extending the standard set by adopting a cleft-specific measurement system for further evaluation of the tools.
Practical Review of Necrotizing Fasciitis: Principles and Evidence-based Management
Authors: Guliyeva Gunel , Huayllani Maria T. , Sharma Nishant T. , Janis Jeffrey E.
Published: January 2024

Necrotizing fasciitis is a severe, life-threatening soft tissue infection that presents as a surgical emergency. It is characterized by a rapid progression of inflammation leading to extensive tissue necrosis and destruction. Nonetheless, the diagnosis might be missed or delayed due to variable and nonspecific clinical presentation, contributing to high mortality rates. Therefore, early diagnosis and prompt, aggressive medical and surgical treatment are paramount. In this review, we highlight the defining characteristics, pathophysiology, diagnostic modalities, current principles of treatment, and evolving management strategies of necrotizing fasciitis.
Postpandemic Rebound in Noninvasive Group a Streptococcal Disease is not Synchronous with Winter RSV and Influenza Epidemics
Authors: De Beir Joana , Lucas Miguel , Jesus Ana Rita , Gata Lia , Finn Adam , Rodrigues Fernanda
Published: January 2024

An increase in invasive group A Streptococcus infections was reported in 2022, associated with intense respiratory virus circulation. We describe a marked increase of noninvasive group A Streptococcus infections. Although the rise coincided with epidemics of respiratory syncytial virus and influenza, it continued after detection of these viruses fell to low levels, suggesting that other factors have contributed to this epidemiologic change.
Acute Hematogenous Osteomyelitis of the Pelvis in Children
Authors: Sarmiento Clemente Adriana , McNeil J. Chase , Hultén Kristina G. , Vallejo Jesus G. , Kaplan Sheldon L.
Published: January 2024

Background:

Pelvic involvement has been reported in 3%–14% of acute hematogenous osteomyelitis (AHO) cases in children. One guideline suggests need for a longer antibiotic course in pelvic AHO, however, recent data are lacking. We describe the clinical course of children with pelvic AHO and compare it to nonpelvic AHO.

Methods:

A retrospective review of patients with a diagnosis of AHO admitted to Texas Children’s Hospital from January 2012 to December 2020 was conducted. Patients 6 months–<19 years old and with ≤14 days of symptoms at admission were eligible. Patients with sickle cell disease or immunocompromised were excluded. Wilcoxon rank-sum test assessed for differences between continuous variables and Fisher exact for categorical variables using STATA 17.

Results:

We compared 104 cases of pelvic AHO to 314 cases of nonpelvic AHO. Patients had similar microbiology, length of stay and length of antibiotic therapy. Patients with pelvic AHO had pyomyositis identified by magnetic resonance imaging more often (28.8 vs. 9.4%, P < 0.001) and bone abscess less often (22.1 vs. 46.5%, P < 0.001). Rates of chronic complications were comparable between patients with pelvic AHO and nonpelvic AHO (8.4% vs. 15.1%, P = 0.1). Nineteen patients (18.3%) with pelvic AHO received ≤30 antibiotic days without complications, but they had less need for intensive care or bone abscesses than patients treated longer.

Conclusions:

Pelvic AHO in children may be more frequent than previously reported but is not associated with more complications. Four weeks of therapy may be sufficient in selected patients. Prospective studies to compare outcomes with different lengths of therapy are needed.
Use of Advanced Diagnostics for Timely Identification of Travel-associated Leptospira santarosai Infection in Four Adolescents Through Plasma Microbial Cell-free DNA Sequencing With the Karius Test
Authors: Nguyen-Tran Hai , Erdem Guliz , Laufer P. Marcelo , Patterson Lori , Ahmed Asim A. , Bower William A. , Galloway Renee , Saporta-Keating Sara
Published: January 2024

Background:

Leptospirosis is an important zoonotic infection worldwide. Diagnosis of leptospirosis is challenging given its nonspecific clinical symptoms that overlap with other acute febrile illnesses and limitations with conventional diagnostic testing. Alternative advanced diagnostics, such as microbial cell-free DNA (mcfDNA), are increasingly being used to aid in the diagnosis of infections and can be applied to pathogens with public health importance such as Leptospira, a nationally notifiable disease.

Methods:

The Karius Test uses plasma mcfDNA sequencing to detect and quantify DNA-based pathogens. This test offered through the Karius lab detected 4 cases of Leptospira santarosai during a 5-month period across the United States in 2021 and were clinically reviewed.

Results:

In our case series, 4 adolescents with recent travel to Central America (Costa Rica, n = 3 and Belize, n = 1) from April to August 2021 were diagnosed with leptospirosis. While a large workup was performed in all cases, mcfDNA testing was the first test to detect L. santarosai as the microbiological diagnosis in all cases.

Conclusions:

Results of the Karius Test enabled rapid, noninvasive diagnosis of leptospirosis allowing for targeted therapy. Use of mcfDNA can be utilized for diagnosis of pathogens where conventional testing is challenging or limited. This in turn can enable quick diagnosis for targeted treatment and potentially aid in supporting case definitions of reportable diseases of public health concern.
Impact of three-dimensional reconstruction visualization technology on short-term and long-term outcomes after hepatectomy in patients with hepatocellular carcinoma: a propensity‐score‐matched and inverse probability of treatment‐weighted multicenter study
Authors: Zeng Xiaojun , Tao Haisu , Dong Yanchen , Zhang Yuwei , Yang Junying , Xuan Feichao , Zhou Jian , Jia Weidong , Liu Jingfeng , Dai Chaoliu , Hu Haoyu , Xiang Nan , Zeng Ning , Zhou Weiping , Lau Wanyee , Yang Jian , Fang Chihua
Published: January 2024

Background:

Three-dimensional reconstruction visualization technology (3D-RVT) is an important tool in the preoperative assessment of patients undergoing liver resection. However, it is not clear whether this technique can improve short-term and long-term outcomes in patients with hepatocellular carcinoma (HCC) compared with two-dimensional (2D) imaging.

Method:

A total of 3402 patients from five centers were consecutively enrolled from January 2016 to December 2020, and grouped based on the use of 3D-RVT or 2D imaging for preoperative assessment. Baseline characteristics were balanced using propensity score matching (PSM, 1:1) and stabilized inverse probability of treatment‐weighting (IPTW) to reduce potential selection bias. The perioperative outcomes, long-term overall survival (OS), and recurrence-free survival (RFS) were compared between the two groups. Cox-regression analysis was used to identify the risk factors associated with RFS.

Results:

A total of 1681 patients underwent 3D-RVT assessment before hepatectomy (3D group), while 1721 patients used 2D assessment (2D group). The PSM cohort included 892 patient pairs. In the IPTW cohort, there were 1608.3 patients in the 3D group and 1777.9 patients in the 2D group. In both cohorts, the 3D group had shorter operation times, lower morbidity and liver failure rates, as well as shorter postoperative hospital stays. The 3D group had more margins ≥10 mm and better RFS than the 2D group. The presence of tumors with a diameter ≥5 cm, intraoperative blood transfusion and multiple tumors were identified as independent risk factors for RFS, while 3D assessment and anatomical resection were independent protective factors.

Conclusion:

In this multicenter study, perioperative outcomes and RFS of HCC patients following 3D-RVT assessment were significantly different from those following 2D imaging assessment. Thus, 3D-RVT may be a feasible alternative assessment method before hepatectomy for these patients.
Intersphincteric resection following robotic-assisted versus laparoscopy-assisted total mesorectal excision for middle and low rectal cancer: a multicentre propensity score analysis of 1571 patients
Authors: Guo Yuchen , He Liang , Tong Weidong , Ren Shuangyi , Chi Zhaocheng , Tan Ke , Wang Bo , Lie Chunxiao , Wang Quan
Published: January 2024

Background:

Robotic-assisted total mesorectal excision (RaTME) may be associated with reduced conversion to an open approach and a higher rate of complete total mesorectal excision (TME); however, studies on its advantages in intersphincteric resection (ISR) are inadequate.

Materials and methods:

This retrospective multicenter cohort study enroled consecutive patients who underwent RaTME and laparoscopy-assisted total mesorectal excision (LaTME) at four medical centres between January 2020 and March 2023. Propensity score matching (PSM), inverse probability of treatment weight (IPTW), and multivariate logistic regression analyses were performed. The primary outcome was the ISR rate. Secondary outcomes were coloanal anastomosis (CAA), conversion to open surgery, conversion to transanal TME, abdominoperineal resection, postoperative morbidity and mortality within 30 days, and pathological outcomes.

Results:

Among the 1571 patients, 1211 and 450 underwent LaTME and RaTME, respectively, with corresponding ISR incidences of 5.3% and 8.4% (P=0.024). After PSM and IPTW, RaTME remained associated with higher ISR rates (4.5% versus 9.4%, P=0.022 after PSM; 4.9% versus 9.2, P=0.005 after IPTW). This association remained in multivariate analysis after adjusting for other confounding factors. RaTME was further associated with a higher CAA rate, longer operating time, and higher hospitalization expenses.

Conclusions:

RaTME may facilitate ISR in middle and low rectal cancers, showing an independent association with a higher ISR incidence, with pathological outcomes and complications comparable to those of LaTME. However, it may also require a longer operating time and incur higher hospitalization expenses.
SKA3 targeted therapies in cancer precision surgery: bridging bench discoveries to clinical applications – review article
Authors: Feng Dechao , Wang Jie , Xiao Yuhan , Wu Ruicheng , Li Dengxiong , Tuo Zhouting , Yu Qingxin , Ye Luxia , MIYAMOTO Akira , Yoo Koo Han , Wei Wuran , Ye Xing , Zhang Chi , Han Ping
Published: January 2024

Spindle and kinetochore-associated complex subunit 3 (SKA3) is a microtubule-binding subcomplex of the outer kinetochore, which plays a vital role in proper chromosomal segregation and cell division. Recently, SKA3 have been demonstrated its oncogenic role of tumorigenesis and development in cancers. In this review, the authors comprehensively deciphered SKA3 in human cancer from various aspects, including bibliometrics, pan-cancer analysis, and narrative summary. The authors also provided the top 10 predicted drugs targeting SKA3. The authors proposed that SKA3 was a potential target and brought new therapeutic opportunities for cancer patients.
Prevalence, Incidence, and Determinants of Kidney Stones in a Nationally Representative Sample of US Adults
Authors: Chew Ben H. , Miller Larry E. , Eisner Brian , Bhattacharyya Samir , Bhojani Naeem
Published: January 2024

Purpose:

To determine the prevalence, incidence, and determinants of kidney stones among adults in the United States.

Materials and Methods:

This cross-sectional observational study evaluated the lifetime prevalence of kidney stones and the 12-month incidence of kidney stone passage from the 2017 to 2020 National Health and Nutrition Examination Survey. Survey statistical methods were used to estimate kidney stone prevalence and incidence and the association of patient characteristics with these outcomes using logistic regression.

Results:

The analysis included 9208 participants with prevalence data and 9193 with incidence data. The mean age of the sample was 51 ± 17 years, 49% were male, and the mean body mass index was 30 ± 8 kg/m2. The prevalence of kidney stones was 9.9% (95% confidence interval (CI): 8.7%-11.3%), and the incidence of stone passage was 1.8% (95% CI: 1.4%-2.4%). The most important covariates predicting kidney stone prevalence were a history of gallstones (OR = 2.89: 95% CI: 2.16-3.89, P < .001), hypertension (OR = 1.73: 95% CI: 1.06-2.83, P = .03), and chronic kidney disease (OR = 1.99: 95% CI: 1.01-3.90, P = .046). The same variables were most important in predicting the incidence of kidney stone passage: history of gallstones (OR = 2.66: 95% CI: 1.47-4.81, P = .002), chronic kidney disease (OR = 3.34: 95% CI: 1.01-11.01, P = .048), and hypertension (OR = 2.24: 95% CI: 1.17-4.27, P = .02).

Conclusions:

The self-reported prevalence and incidence of kidney stones in the US adult population between 2017 and 2020 were 9.9% and 1.8%, respectively. History of gallstones, hypertension, and chronic kidney disease were important predictors of both outcomes. Individuals with these risk factors may require more frequent monitoring or targeted preventative lifestyle interventions.
Proceedings of the 28th Annual Congress of the International Liver Transplantation Society
Authors: Shaji Mathew Johns , Shingina Alexandra , Khan Mohammad Qasim , Wilson Elizabeth , Syn Nicholas , Rammohan Ashwin , Alconchel Felipe , Hakeem Abdul Rahman , Shankar Sadhana , Patel Dhupal , Keskin Onur , Liu Jiang , Nasralla David , Mazzola Alessandra , Patel Madhukar S. , Tanaka Tomohiro , Victor David , Yoon Uzung , Yoon Young-in , Vinaixa Carmen , Kirchner Varvara , De Martin Eleonora , Ghobrial R. Mark , Chadha Ryan
Published: January 2024

The 2023 Joint International Congress of the International Liver Transplantation Society (ILTS), the European Liver and Intestine Transplant Association (ELITA), and the Liver Intensive Care Group of Europe (LICAGE) held in Rotterdam, the Netherlands, marked a significant recovery milestone for the liver transplant community after COVID-19. With 1159 participants and a surge in abstract submissions, the event focused on “Liver Disorders and Transplantation: Innovations and Evolving Indications.” This conference report provides a comprehensive overview of the key themes discussed during the event, encompassing Hepatology, Anesthesia and Critical Care, Acute Liver Failure, Infectious Disease, Immunosuppression, Pediatric Liver Transplantation, Living Donor Liver Transplantation, Transplant Oncology, Surgical Approaches, and Machine Perfusion. The congress provided a platform for extensive discussions on a wide range of topics, reflecting the continuous advancements and collaborative efforts within the liver transplant community.
Recurrent events after acute ST-segment elevation myocardial infarction: predictors and features of plaque progression and stent failure
Authors: Di Vito Luca , Di Giusto Federico , Bruscoli Filippo , Scalone Giancarla , Silenzi Simona , Mariani Luca , Selimi Adelina , Delfino Domenico , Grossi Pierfrancesco
Published: January 2024

Objectives

Patients with acute ST-segment elevation myocardial infarction (STEMI) are at high risk for recurrent coronary events (RCE). Non-culprit plaque progression and stent failure are the main causes of RCEs. We sought to identify the incidence and predictors of RCEs.

Methods

Eight hundred thirty patients with STEMI were enrolled and followed up for 5 years. All patients underwent blood test analysis at hospital admission, at 1-month and at 12-month follow-up times. Patients were divided into RCE group and control group. RCE group was further categorized into non-culprit plaque progression and stent failure subgroups.

Results

Among 830 patients with STEMI, 63 patients had a RCE (7.6%). At hospital admission, HDL was numerically lower in RCE group, while LDL at both 1-month and 12-month follow-up times were significantly higher in RCE group. Both HDL at hospital admission and LDL at 12-month follow-up were independently associated with RCEs (OR 0.90, 95% CI 0.81–0.99 and OR 1.041, 95% CI 1.01–1.07, respectively). RCEs were due to non-culprit plaque progression in 47.6% of cases, while in 36.5% due to stent failure. The mean time frame between pPCI and RCE was significantly greater for non-culprit plaque progression subgroup as compared to stent failure subgroup (27 ± 18 months and 16 ± 14 months, P = 0.032).

Conclusion

RCEs still affect patients after pPCI. Low levels of HDL at admission and high levels of LDL at 12 months after pPCI significantly predicted RCEs. A RCE results in non-culprit plaque progression presents much later than an event due to stent failure.