bluuebunny/crossref_metadata_2025 huggingface dataset:
Multimodal protein representation learning and target-aware variational auto-encoders for protein-binding ligand generation
Authors: Khang Ngo Nhat , Son Hy Truong
Published: April 2024

Without knowledge of specific pockets, generating ligands based on the global structure of a protein target plays a crucial role in drug discovery as it helps reduce the search space for potential drug-like candidates in the pipeline. However, contemporary methods require optimizing tailored networks for each protein, which is arduous and costly. To address this issue, we introduce TargetVAE, a target-aware variational auto-encoder that generates ligands with desirable properties including high binding affinity and high synthesizability to arbitrary target proteins, guided by a multimodal deep neural network built based on geometric and sequence models, named Protein Multimodal Network (PMN), as the prior for the generative model. PMN unifies different representations of proteins (e.g. primary structure—sequence of amino acids, 3D tertiary structure, and residue-level graph) into a single representation. Our multimodal architecture learns from the entire protein structure and is able to capture their sequential, topological, and geometrical information by utilizing language modeling, graph neural networks, and geometric deep learning. We showcase the superiority of our approach by conducting extensive experiments and evaluations, including predicting protein-ligand binding affinity in the PBDBind v2020 dataset as well as the assessment of generative model quality, ligand generation for unseen targets, and docking score computation. Empirical results demonstrate the promising and competitive performance of our proposed approach. Our software package is publicly available at https://github.com/HySonLab/Ligand_Generation.
Atomic force microscopy simulations for CO-functionalized tips with deep learning
Authors: Carracedo-Cosme Jaime , Hapala Prokop , Pérez Rubén
Published: April 2024

Atomic force microscopy (AFM) operating in the frequency modulation mode with a metal tip functionalized with a CO molecule is able to image the internal structure of molecules with an unprecedented resolution. The interpretation of these images is often difficult, making the support of theoretical simulations important. Current simulation methods, particularly the most accurate ones, require expertise and resources to perform ab initio calculations for the necessary inputs (i.e charge density and electrostatic potential of the molecule). Here, we propose a computationally inexpensive and fast alternative to the physical simulation of these AFM images based on a conditional generative adversarial network (CGAN), that avoids all force calculations, and uses as the only input a 2D ball–and–stick depiction of the molecule. We discuss the performance of the model when trained with different subsets extracted from the previously published QUAM-AFM database. Our CGAN reproduces accurately the intramolecular contrast observed in the simulated images for quasi–planar molecules, but has limitations for molecules with a substantial internal corrugation, due to the strictly 2D character of the input.
Subtitled speech: the neural mechanisms of ticker-tape synaesthesia
Authors: Hauw Fabien , Béranger Benoît , Cohen Laurent
Published: April 2024

The acquisition of reading modifies areas of the brain associated with vision and with language, in addition to their connections. These changes enable reciprocal translation between orthography and the sounds and meaning of words. Individual variability in the pre-existing cerebral substrate contributes to the range of eventual reading abilities, extending to atypical developmental patterns, including dyslexia and reading-related synaesthesias. The present study is devoted to the little-studied but highly informative ticker-tape synaesthesia, in which speech perception triggers the vivid and irrepressible perception of words in their written form in the mind’s eye.

We scanned a group of 17 synaesthetes and 17 matched controls with functional MRI, while they listened to spoken sentences, words, numbers or pseudowords (Experiment 1), viewed images and written words (Experiment 2) or were at rest (Experiment 3).

First, we found direct correlates of the ticker-tape synaesthesia phenomenon: during speech perception, as ticker-tape synaesthesia was active, synaesthetes showed over-activation of left perisylvian regions supporting phonology and of the occipitotemporal visual word form area, where orthography is represented. Second, we provided support to the hypothesis that ticker-tape synaesthesia results from atypical relationships between spoken and written language processing: the ticker-tape synaesthesia-related regions overlap closely with cortices activated during reading, and the overlap of speech-related and reading-related areas is larger in synaesthetes than in controls. Furthermore, the regions over-activated in ticker-tape synaesthesia overlap with regions under-activated in dyslexia. Third, during the resting state (i.e. in the absence of current ticker-tape synaesthesia), synaesthetes showed increased functional connectivity between left prefrontal and bilateral occipital regions. This pattern might reflect a lowered threshold for conscious access to visual mental contents and might imply a non-specific predisposition to all synaesthesias with a visual content.

These data provide a rich and coherent account of ticker-tape synaesthesia as a non-detrimental developmental condition created by the interaction of reading acquisition with an atypical cerebral substrate.
Nursing home finances associated with real estate investment trust and private equity investments
Authors: Williams Dunc , Fernandez Rahul , Stevenson David , Unruh Mark , Braun Robert Tyler
Published: April 2024

In 2021, real estate investment trusts (REITs) and private equity (PE) held investments in 1915 (16%) and 1569 (13%) US nursing homes (NHs), respectively. We created a database of REIT and PE investments in NHs, merged it with Medicare Cost Report data (2011–2019), and used a difference-in-differences approach within an event-study framework to compare NH spending and financial performance before and after REIT or PE investment to NHs that did not receive REIT or PE investment. REIT investments were associated with higher total wages (3%), total nursing wages (3%; both logged, per resident day [PRD]), and current ratio (81%). PE investments were associated with lower net patient service revenue (7%), total expenses (7%), and total wages (8%; all logged, PRD). The impact of REIT and PE investments in NHs may vary in different market conditions, as may occur in the current environment of low, falling NH profits, potentially higher minimum staffing requirements, and rising interest rates. Therefore, it is important for stakeholders to understand the impact of these large, growing investments on the financial performance of NHs.
Mitochondrial abnormalities contribute to muscle weakness in a Dnajb6 deficient zebrafish model
Authors: McKaige Emily A , Lee Clara , Calcinotto Vanessa , Giri Saveen , Crawford Simon , McGrath Meagan J , Ramm Georg , Bryson-Richardson Robert J
Published: April 2024

Mutations in DNAJB6 are a well-established cause of limb girdle muscular dystrophy type D1 (LGMD D1). Patients with LGMD D1 develop progressive muscle weakness with histology showing fibre damage, autophagic vacuoles, and aggregates. Whilst there are many reports of LGMD D1 patients, the role of DNAJB6 in the muscle is still unclear. In this study, we developed a loss of function zebrafish model in order to investigate the role of Dnajb6. Using a double dnajb6a and dnajb6b mutant model, we show that loss of Dnajb6 leads to a late onset muscle weakness. Interestingly, we find that adult fish lacking Dnajb6 do not have autophagy or myofibril defects, however, they do show mitochondrial changes and damage. This study demonstrates that loss of Dnajb6 causes mitochondrial defects and suggests that this contributes to muscle weakness in LGMD D1. These findings expand our knowledge of the role of Dnajb6 in the muscle and provides a model to screen novel therapies for LGMD D1.
Chlamydiae in corals: shared functional potential despite broad taxonomic diversity
Authors: Maire Justin , Collingro Astrid , Horn Matthias , van Oppen Madeleine J H
Published: April 2024

Cnidarians, such as corals and sea anemones, associate with a wide range of bacteria that have essential functions, including nutrient cycling and the production of antimicrobial compounds. Within cnidarians, bacteria can colonize all microhabitats including the tissues. Among them are obligate intracellular bacteria of the phylum Chlamydiota (chlamydiae) whose impact on cnidarian hosts and holobionts, especially corals, remain unknown. Here, we conducted a meta-analysis of previously published 16S rRNA gene metabarcoding data from cnidarians (e.g. coral, jellyfish, and anemones), eight metagenome-assembled genomes (MAGs) of coral-associated chlamydiae, and one MAG of jellyfish-associated chlamydiae to decipher their diversity and functional potential. While the metabarcoding dataset showed an enormous diversity of cnidarian-associated chlamydiae, six out of nine MAGs were affiliated with the Simkaniaceae family. The other three MAGs were assigned to the Parasimkaniaceae, Rhabdochlamydiaceae, and Anoxychlamydiaceae, respectively. All MAGs lacked the genes necessary for an independent existence, lacking any nucleotide or vitamin and most amino acid biosynthesis pathways. Hallmark chlamydial genes, such as a type III secretion system, nucleotide transporters, and genes for host interaction, were encoded in all MAGs. Together these observations suggest an obligate intracellular lifestyle of coral-associated chlamydiae. No unique genes were found in coral-associated chlamydiae, suggesting a lack of host specificity. Additional studies are needed to understand how chlamydiae interact with their coral host, and other microbes in coral holobionts. This first study of the diversity and functional potential of coral-associated chlamydiae improves our understanding of both the coral microbiome and the chlamydial lifestyle and host range.
The Effect of Terrorism on Income Inequality
Authors: McGauvran Ronald J , Biglaiser Glen , Hunter Lance Y , Lee Hoon
Published: April 2024

Conflict research has recently found that increased inequality weakens institutional conditions, opening the door for terrorism. While this research often accounts for endogeneity, or the possibility of a reverse causal relationship, there has yet to be an empirical investigation of the impact of terrorism on income inequality. Using a sample of 139 countries between 1994 and 2018, we show that both domestic and transnational terrorism result in higher levels of income inequality. Our results are consistent for both pre- and post-tax and transfer inequality as well as multiple model specifications. Additionally, we explore multiple potential causal mechanisms that link terrorism and income inequality finding that the effect is, in part, due to terrorism’s negative effects on institutional stability, increased military expenditure, possibly to fund counterterrorism operations, and reduced foreign capital, especially for greenfield investment. Our analysis indicates a positive relationship between terrorism and inequality and the mechanisms that produce the effect, contributing to the terrorism and inequality literatures.
A Meta-Analysis of the Mortality and the Prevalence of Burn Complications in Western Populations
Authors: Foppiani Jose A , Weidman Allan , Hernandez Alvarez Angelica , Valentine Lauren , Bustos Valeria P , Galinaud Cécilia , Hrdina Radim , Hrdina Radim , Musil Zdenek , Lee Bernard T , Lin Samuel J
Published: April 2024

Management of burn injuries is complex, with highly variable outcomes occurring among different populations. This meta-analysis aims to assess the outcomes of burn therapy in North American and European adults, specifically mortality and complications, to guide further therapeutic advances. A systematic review of PubMed, Web of Science, and Cochrane was performed. Random-effect meta-analysis of proportions was conducted to assess the overall prevalence of the defined outcomes. In total, 54 studies were included, pooling 60 269 adult patients. A total of 53 896 patients were in North America (NA, 89.4%), and 6373 were in Europe (10.6%). Both populations experienced similar outcomes. The overall pooled prevalence of mortality was 13% (95% CI, 8%-19%) for moderate burns, 20% (95% CI, 12%-29%) for severe burns in the NA region, and 22% (95% CI, 16%-28%) for severe burns in Europe. Infectious complications were the most common across both regions. European studies showed an infection rate for patients with moderate and severe burns at 8% and 76%, respectively, while NA studies had rates of 35% and 54%. Acute kidney injury (39% vs 37%) and shock (29% vs 35%) were the next most common complications in European and NA studies, respectively. The length of stay was 27.52 days for patients with severe burns in Europe and 31.02 days for patients with severe burns in NA. Burn outcomes are similar between Western populations. While outcomes are reasonably good overall, infectious complications remain high. These findings encourage the development of further therapeutic strategies disclosing respective costs to enable cost/efficiency evaluations in burn management.
Development of a Wound Epithelialization Healing Model: Reducing the Impact of Contraction Healing on the Wound Surface
Authors: Chang Fei , Yan Lei , Zha Yuanyuan , Hong Xudong , Zhu Kaisi , Fei Yanghonghong , Si Tingting , Ding Yinjia , Chen Aifen , Zhang Xudong , Chen Zhengli , Li Huatao , Jin Jian
Published: April 2024

Animal experiments are important in trauma-related studies because they simulate in vivo effects. Rodents are a good choice for preparing trauma models; however, contractile healing in rodents results in a healing pattern that differs considerably from that in humans. Therefore, this study developed a new rodent model that avoids contractile healing of the skin around the wound using an anticontraction ring, and the skin in the wound’s center remains intact and acts as a source for epithelialized diffusion healing. Cell proliferation, migration, revascularization, and collagen secretion did not differ between the novel and conventional full-skin defect trauma models. However, the healing rate at various stages significantly differed between the 2 groups owing to differences in the healing patterns. And without effective treatment, the experimental group cannot heal. The stabilities of the novel and conventional methods were good regardless of operator or batch. In summary, this new animal trauma model provides a stable experimental environment similar to that in humans, which may promote trauma-related research.
Dissecting the causal polymorphism of the Lr67res multipathogen resistance gene
Authors: Milne Ricky J , Dibley Katherine E , Bose Jayakumar , Riaz Adnan , Zhang Jianping , Schnippenkoetter Wendelin , Ashton Anthony R , Ryan Peter R , Tyerman Stephen D , Lagudah Evans S
Published: April 2024

Partial resistance to multiple biotrophic fungal pathogens in wheat (Triticum aestivum L.) is conferred by a variant of the Lr67 gene, which encodes a hexose–proton symporter. Two mutations (G144R and V387L) differentiate the resistant and susceptible protein variants (Lr67res and Lr67sus). Lr67res lacks sugar transport capability and was associated with anion transporter-like properties when expressed in Xenopus laevis oocytes. Here, we extended this functional characterization to include yeast and in planta studies. The Lr67res allele, but not Lr67sus, induced sensitivity to ions in yeast (including NaCl, LiCl, and KI), which is consistent with our previous observations that Lr67res expression in oocytes induces novel ion fluxes. We demonstrate that another naturally occurring single amino acid variant in wheat, containing only the Lr67G144R mutation, confers rust resistance. Transgenic barley plants expressing the orthologous HvSTP13 gene carrying the G144R and V387L mutations were also more resistant to Puccinia hordei infection. NaCl treatment of pot-grown adult wheat plants with the Lr67res allele induced leaf tip necrosis and partial leaf rust resistance. An Lr67res-like function can be introduced into orthologous plant hexose transporters via single amino acid mutation, highlighting the strong possibility of generating disease resistance in other crops, especially with gene editing.
Fourteen years of cellular deconvolution: methodology, applications, technical evaluation and outstanding challenges
Authors: Nguyen Hung , Nguyen Ha , Tran Duc , Draghici Sorin , Nguyen Tin
Published: April 2024

Single-cell RNA sequencing (scRNA-Seq) is a recent technology that allows for the measurement of the expression of all genes in each individual cell contained in a sample. Information at the single-cell level has been shown to be extremely useful in many areas. However, performing single-cell experiments is expensive. Although cellular deconvolution cannot provide the same comprehensive information as single-cell experiments, it can extract cell-type information from bulk RNA data, and therefore it allows researchers to conduct studies at cell-type resolution from existing bulk datasets. For these reasons, a great effort has been made to develop such methods for cellular deconvolution. The large number of methods available, the requirement of coding skills, inadequate documentation, and lack of performance assessment all make it extremely difficult for life scientists to choose a suitable method for their experiment. This paper aims to fill this gap by providing a comprehensive review of 53 deconvolution methods regarding their methodology, applications, performance, and outstanding challenges. More importantly, the article presents a benchmarking of all these 53 methods using 283 cell types from 30 tissues of 63 individuals. We also provide an R package named DeconBenchmark that allows readers to execute and benchmark the reviewed methods (https://github.com/tinnlab/DeconBenchmark).
Discrimination as a Public Wrong
Authors: Goldiner Adi
Published: April 2024

The enforcement mechanisms of anti-discrimination law manifest a puzzle: while the dominant view is that discrimination is a wrongdoing against individuals, which suggests that discriminatees should have the power to vindicate their rights, legal provisions sometimes authorise public officials to file claims against alleged discriminators, regardless of discriminatees’ preferences. Seeking to make sense of this puzzle, this article draws on theories of state enforcement under criminal law to explore the justification of public enforcement under anti-discrimination law and reflect on the nature of discrimination more broadly. It claims that an instrumental justification of public enforcement of anti-discrimination law is left wanting. Instead, it argues that public enforcement in this domain is warranted because discrimination is not only a private wrong against individuals, but is also a public wrong, namely a wrong against the community as a whole.
Thermal, water, and land cover factors led to contrasting urban and rural vegetation resilience to extreme hot months
Authors: Wang Yaoping , Mao Jiafu , Brelsford Christa M , Ricciuto Daniel M , Yuan Fengming , Shi Xiaoying , Rastogi Deeksha , Mayes Melanie M , Kao Shih-Chieh , Warren Jeffrey M , Griffiths Natalie A , Cheng Xinghua , Weston David J , Zhou Yuyu , Gu Lianhong , Thornton Peter E
Published: April 2024

With continuing global warming and urbanization, it is increasingly important to understand the resilience of urban vegetation to extreme high temperatures, but few studies have examined urban vegetation at large scale or both concurrent and delayed responses. In this study, we performed an urban–rural comparison using the Enhanced Vegetation Index and months that exceed the historical 90th percentile in mean temperature (referred to as “hot months”) across 85 major cities in the contiguous United States. We found that hot months initially enhanced vegetation greenness but could cause a decline afterwards, especially for persistent (≥4 months) and intense (≥+2 °C) episodes in summer. The urban responses were more positive than rural in the western United States or in winter, but more negative during spring–autumn in the eastern United States. The east–west difference can be attributed to the higher optimal growth temperatures and lower water stress levels of the western urban vegetation than the rural. The urban responses also had smaller magnitudes than the rural responses, especially in deciduous forest biomes, and least in evergreen forest biomes. Within each biome, analysis at 1 km pixel level showed that impervious fraction and vegetation cover, local urban heat island intensity, and water stress were the key drivers of urban–rural differences. These findings advance our understanding of how prolonged exposure to warm extremes, particularly within urban environments, affects vegetation greenness and vitality. Urban planners and ecosystem managers should prioritize the long and intense events and the key drivers in fostering urban vegetation resilience to heat waves.
Different responses of oxygen and hydrogen isotopes in leaf and tree-ring organic matter to lethal soil drought
Authors: Lehmann Marco M , Diao Haoyu , Ouyang Shengnan , Gessler Arthur
Published: April 2024

The oxygen and hydrogen isotopic composition (δ18O, δ2H) of plant tissues are key tools for the reconstruction of hydrological and plant physiological processes and may therefore be used to disentangle the reasons for tree mortality. However, how both elements respond to soil drought conditions before death has rarely been investigated. To test this, we performed a greenhouse study and determined predisposing fertilization and lethal soil drought effects on δ18O and δ2H values of organic matter in leaves and tree rings of living and dead saplings of five European tree species. For mechanistic insights, we additionally measured isotopic (i.e. δ18O and δ2H values of leaf and twig water), physiological (i.e. leaf water potential and gas-exchange) and metabolic traits (i.e. leaf and stem non-structural carbohydrate concentration, carbon-to-nitrogen ratios). Across all species, lethal soil drought generally caused a homogenous 2H-enrichment in leaf and tree-ring organic matter, but a low and heterogenous δ18O response in the same tissues. Unlike δ18O values, δ2H values of tree-ring organic matter were correlated with those of leaf and twig water and with plant physiological traits across treatments and species. The 2H-enrichment in plant organic matter also went along with a decrease in stem starch concentrations under soil drought compared with well-watered conditions. In contrast, the predisposing fertilization had generally no significant effect on any tested isotopic, physiological and metabolic traits. We propose that the 2H-enrichment in the dead trees is related to (i) the plant water isotopic composition, (ii) metabolic processes shaping leaf non-structural carbohydrates, (iii) the use of carbon reserves for growth and (iv) species-specific physiological adjustments. The homogenous stress imprint on δ2H but not on δ18O suggests that the former could be used as a proxy to reconstruct soil droughts and underlying processes of tree mortality.
Evaluation of the Genetic Diversity, Haplotype, and Virulence of Fusarium oxysporum f. sp. vasinfectum Field Isolates from Alabama
Authors: Otero Miranda , Pokhrel Ambika , Seo Seungyeon , Wendell Laura , Luangkhot Amber S. , Lawrence Kathy S. , Coleman Jeffrey J.
Published: April 2024

The United States is the third largest producer of cotton and the largest exporter of cotton globally. Fusarium wilt, caused by the soilborne fungal pathogen Fusarium oxysporum f. sp. vasinfectum ( Fov), was estimated to cause a $21 million cotton yield loss in 2022. Historically, Alabama was an important producer of cotton in the Southeastern United States and was the first state in which Fusarium wilt on cotton was described. To assess the genetic diversity of Fov field isolates in Alabama, 118 field isolates were collected from six counties across the state from 2014 to 2016. Phylogenetic analysis using TEF1 and RPB2 placed the Fov field isolates into 18 haplotypes. Upon profiling the Tfo1 transposon insertion in the NAT gene, it was determined that no race 4 isolates were recovered in Alabama. Representatives of all field isolate haplotypes caused disease on Upland cotton variety Rowden in a hydroponic test tube assay. Two haplotype A isolates were the most aggressive isolates recovered, and haplotype A isolate TF1 was more aggressive than the race 4 isolate 89-1A on Upland cotton and had similar symptom severity on Pima cotton. Karyotype profiling indicted an abundance of small chromosomes characteristic of karyotypes that include accessory chromosomes, with considerable variability between isolates. Collectively, our study indicates that Fov isolates from Alabama are genetically diverse, which may have been promoted by its persistence in cotton fields.
Age-dependent Sagittal Plane Remodeling of Pediatric Supracondylar Fractures
Authors: Kim Yun Ki , Lee Seung Hoo
Published: April 2024

Background:

Current treatment guidelines for pediatric supracondylar fractures have not fully accounted for age-related variations in the remodeling potential. This study aimed to explore age-dependent sagittal plane remodeling in supracondylar fractures by assessing cases with residual deformities after treatment.

Methods:

This study included 62 patients under 16 years of age treated for supracondylar fractures at our institution from 2002 to 2022. The distance between the posterior and anterior aspects of the capitellar ossific nucleus (CON) was defined as the CON size, while the distance from the anterior humeral line to the posterior aspect of CON was termed DAP-CON. The value obtained by subtracting the DAP-CON on the unfractured side from the DAP-CON on the fractured side was divided by the CON size and multiplied by 100 and termed the displacement of CON (d-CON). The absolute value of the difference between d-CON after intervention and d-CON at the last follow-up was denoted as sagittal plane remodeling.

Results:

For this patient cohort, the mean age was 5.5 years (range, 1.4 to 14.6 years), and the mean follow-up period was 30.4 months (range, 12.0 to 137.1 months). Sagittal plane remodeling was more pronounced in children younger than 5 years (group I) compared with those older (group II) (P<0.001). In multiple regression analysis, only age at the time of injury was found to be a significant variable (P<0.001). The receiver operating characteristic curve analysis identified 4.2 years as the cutoff age for predicting >33% sagittal plane remodeling, with an area under the curve of 0.975.

Conclusions:

Children below the age of 5 years exhibit sagittal plane remodeling, with a cutoff age identified at 4.2 years for achieving >33% of d-CON. This indicates that mild deformities (16.5%<d-CON ≤ 33%) can be expected to be fully remodeled before the age of 4.2 years, suggesting that the patient’s age needs to be considered in the treatment guidelines.

Level of Evidence:

Level IV—retrospective study.
Impact and Feasibility of Mechanical Ventilation at a Surgical Center in Sierra Leone: Experience From EMERGENCY’s Hospital in Goderich*
Authors: Spagnolello Ornella , Cole Richmond Dixon , Unisa Jalloh , Vandi Hawa , Macarthy Marian , Gatti Sofia , Cormio Manuela , Portella Gina , Baiardo Redaelli Martina
Published: April 2024

OBJECTIVES:

Despite the large burden of critically ill patients in developing countries, mechanical ventilation (MV) is scarce in these low-resource settings. In the absence of data, issues like costs and lack of training are often felt to outweigh the benefits of potential MV implementation in such places. We aimed to investigate the impact and feasibility of MV in a surgical ICU in West Africa.

DESIGN:

This is a 7-month retrospective observational study (from October 25, 2022, to May 25, 2023), covering all patients consecutively admitted to ICU.

SETTING:

The NGO EMERGENCY’s hospital in Goderich, Freetown, Sierra Leone. The hospital is a referral center for acute care surgery.

PATIENTS:

Critical patients admitted to the hospital’s ICU.

INTERVENTIONS:

Following brief, practical training of the nursing staff, one basic mechanical ventilator was installed at the hospital’s ICU, under the supervision of two intensivists. Only patients with a body weight of over 15 kg and who met the “extreme criteria” for MV received this life-saving therapy.

MEASUREMENTS AND MAIN RESULTS:

Of the 195 files of patients admitted to ICU during the study period, 162 were analyzed. The median age was 16 (interquartile range 7–27) and 48.1% of the population were under 14 years. The most common cause of admission was trauma (58.6%), followed by acute abdomen (33.3%), caustic soda ingestion (6.2%), and burns (1.9%). Of the overall population, 26 patients (16%) underwent MV (88.5% trauma cases vs. 11.5% acute abdomen). Median time on MV was 24 hours (12–64). The mortality rate in the MV group was 30.8% (8/26), while in the overall study population, it was 11.7% (19/162). One potentially life-threatening event of tube obstruction was handled appropriately.

CONCLUSIONS:

This study strongly supports the implementation of MV in low-resource settings. In our experience, the consistent benefit of reduced mortality among critical patients largely outweighs the associated challenges.
Increased vascular stiffness in children exposed in utero but not children exposed postnatally to emissions from a coal mine fire
Authors: Hemstock Emily J. , Bigaran Ashley , Allgood Shantelle , Wheeler Amanda J. , Dalton Marita , Williamson Grant J. , Gao Caroline X. , Abramson Michael J. , Negishi Kazuaki , Johnston Fay H. , Zosky Graeme R.
Published: April 2024

Background:

Chronic, low-intensity air pollution exposure has been consistently associated with increased atherosclerosis in adults. However, there was limited research regarding the implications of acute, high-intensity air pollution exposure during childhood. We aimed to determine whether there were any associations between early-life exposure to such an episode and early-life vascular function changes.

Methods:

We conducted a prospective cohort study of children (<9 years old) who lived in the vicinity of the Hazelwood coal mine fire (n = 206). Vascular function was measured using noninvasive diagnostic methods including carotid intima-media thickness and pulse wave velocity (PWV). Exposure estimates were calculated from prognostic models and location diaries during the exposure period completed by each participant’s parent. Linear mixed-effects models were used to determine whether there were any associations between exposure and changes in vascular outcomes at the 3- and 7-year follow-ups and over time.

Results:

At the 7-year follow-up, each 10 μg/m3 increase in daily PM2.5 in utero was associated with increased PWV (β = 0.13 m/s; 95% confidence interval [CI] = 0.02, 0.24; P = 0.02). The association between in utero exposure to daily PM2.5 was not altered by adjustment for covariates, body mass index, and maternal fire stress. Each 1 µg/m3 increase in background PM2.5 was associated with increased PWV (β = 0.68 m/s; 95% CI = 0.10, 1.26; P = 0.025), in children from the in utero exposure group. There was a trend toward smaller PWV (β = −0.17 m/s; 95% CI = −0.366, 0.02) from the 3- to 7-year follow-up clinic suggesting that the deficits observed previously in children exposed postnatally did not persist.

Conclusion:

There was a moderate improvement in vascular stiffness of children exposed to PM2.5 from a local coal mine fire in infancy. There was a mild increase in vascular stiffness in children exposed to PM2.5 from a local coal mine fire while their mothers were pregnant.
Diagnosis and Treatment of Perioperative Allergic Complications: A Practical Review
Authors: Schroeder Michael J. , Kraft Casey T. , Janis Jeffrey E. , Kraft Monica T.
Published: April 2024

Background:

Reported drug allergies are commonly encountered by surgeons and can lead to uncertainty in selecting an appropriate agent due to concerns of associated risks with related and cross-reactive drugs. This uncertainty can ultimately lead to increased infection rates.

Methods:

A literature review was conducted in PubMed using a combination of the terms “allergy,” “allergic reaction,” “anaphylaxis,” and “surgery,” “surgical,” or “operating room” for articles published within the last 10 years. Publications identified with these search terms were then filtered for review articles, sorted by “best match,” and a maximum of 100 articles were manually reviewed for each combination of search terms.

Results:

Search results yielded 46,484 articles, 676 of which were ultimately included for manual review, based on selection criteria. Specifically, articles selected for inclusion focused on surgical allergic reactions that were either related to mechanism of action, causative agent for the allergic reaction, timing of allergic reaction, or recommendations for appropriate management.

Conclusions:

Allergic reactions can be a common occurrence in the operative room. Knowledge of likely causative agents, timing of a reaction to various agents, and appropriate management in the immediate and delayed setting can improve outcomes and safety for plastic surgery patients.
Reconstruction after Resection of Undifferentiated Pleomorphic Sarcoma and Invasive Ductal Carcinoma in a Patient with Li-Fraumeni Syndrome
Authors: Lue Melinda , Harrah Payden , Shrestha Sabi , Wang Howard T.
Published: April 2024

This case exhibits a presentation of multiple primary malignancies in a patient with Li-Fraumeni syndrome, necessitating surgical excision and multistaged reconstruction. Due to Li-Fraumeni syndrome patients’ predisposition to developing malignancies, management includes lifelong surveillance and aggressive treatment of cancers. Plastic surgeons can minimize damage to patient’s quality of life by carrying out reconstruction in a thoughtful manner that maximizes function and considers a potential lifetime of future reconstructive needs.
Superficial Intramuscular Gluteal Lipograft by Doppler Ultrasound: A Report of 24 Patients
Authors: Roblero Rivera Carlos Alexander , Manzaneda Cipriani Raul , Flores Gonzáles Emmanuel Armando , Scheneider Salomone Viaro Mauricio
Published: April 2024

Background:

Gluteal fat grafting is a common procedure in liposculpture. This study proposes a Doppler ultrasound–guided intramuscular and subcutaneous gluteal lipotransfer technique that allows for visualization of the location of the gluteal vessels, avoiding approaching them during lipotransfer by having the cannula localized during fat infiltration.

Methods:

This new technique was applied to 24 women after obtaining informed consent and providing them with a clear explanation of potential risks and complications. Doppler ultrasound was used to locate the site and depth of blood vessels, and for quadrant scanning of vessels and superficial intramuscular visualization of the cannula’s location. Intramuscular lipotransfer was performed with a volume of 400 mL per gluteus (or less), and 12 patients underwent magnetic resonance imaging before and 3 months after surgery.

Results:

This technique allowed for visualizing the location of the gluteal vessels, and infiltration could be easily performed in patients. In the 24 glutei reviewed postsurgery, from 12 patients who underwent pre- and postsurgery magnetic resonance imaging, intramuscular fat was found; however, there was no migration outside the gluteus maximus muscle.

Conclusions:

No local or systemic complications were observed. The results of our report show that fat filtration did not migrate outside the gluteus maximus muscle. This finding seeks to promote new research to create theoretical/practical precedents for the intervention of plastic surgeons and, from there, promote the standardization of a new and safe technique.
Diagnostic Accuracy of Blind Bronchial Sample Testing by BioFire Pneumonia plus Panel in Pediatric Intensive Care Unit Patients and Its Impact in Early Adaptation of Antimicrobial Therapy: A Prospective Observational Study
Authors: Geslain Guillaume , Cointe Aurélie , Naudin Jérôme , Dauger Stéphane , Poey Nora , Pages Justine , Le Roux Enora , Bonacorsi Stéphane
Published: April 2024

Background:

Community-acquired and nosocomial lower-respiratory-tract infections in critically ill pediatric patients require early appropriate antibiotic therapy to optimize outcomes. Using blind bronchial samples, we assessed the diagnostic performance of the rapid-multiplex polymerase chain reaction (PCR) assay BioFire Pneumonia plus Panel vs. reference standard culturing with antimicrobial susceptibility testing.

Methods:

For this prospective observational study in a single pediatric intensive care unit, we included consecutive patients younger than 18 years admitted for suspected community-, hospital- or ventilator-associated pneumonia in 2021–2022. Sensitivity, specificity, positive predictive value and negative predictive value of the multiplex PCR assay were determined. The kappa coefficient was computed to assess agreement, and univariate analyses were done to identify factors associated with discrepancies between the 2 diagnostic methods.

Results:

Of the 36 included patients (median age, 1.4 years; interquartile range, 0.2–9.2), 41.7%, 27.8%, and 30.5% had community-, hospital- and ventilator-associated pneumonia, respectively. The overall κ was 0.74, indicating good agreement. Overall, the sensitivity of the multiplex PCR assay was 92% (95% CI: 77%–98%) and specificity 95% (95% CI: 92%–97%), with variations across microorganisms. The median time from sample collection to antimicrobial susceptibility test results was 3.9 (2.5–15) hours with the multiplex PCR assay and 60.5 (47.6–72.2) hours with the reference technique.

Conclusion:

The BioFire Pneumonia plus Panel used to test blind bronchial samples had satisfactory diagnostic performance in critically ill pediatric patients. The rapid results provided by this test may improve the appropriateness of antimicrobial therapy and help minimize the use of antibiotics.
Hepatitis C Exposure Diagnosis and Testing in Infants Born to Hepatitis C Virus-infected Mothers
Authors: Morris Natalie , Hunter Krystal , Bhat Vishwanath , Kushnir Alla
Published: April 2024

Background:

There has been a 5-fold increase in the number of cases of hepatitis C virus (HCV) infection among pregnant women, which is potentially associated with the increase in opioid use.

Methods:

This study was a retrospective review of infants born at a tertiary urban hospital in New Jersey, from January 1, 2011 to January 1, 2021, who were born to mothers with a prenatal diagnosis of HCV.

Results:

Of the 142 mothers with a prenatal diagnosis of HCV, 114 (80%) infants had a diagnosis of HCV exposure in the electronic health records. Of the HCV-exposed infants with follow-up data at 24 months of age, 52 (46%) were tested, with 34 of 52 (65%) receiving adequate testing. Infants documented as HCV exposed were more likely to be born to a mother with nonopioid drug use in pregnancy (P = 0.01) and have a higher birth weight (P = 0.03). Of tested infants, those with a higher number of well-child pediatrician visits (P = 0.01) were more likely to receive adequate testing. Trends showed more polymerase chain reaction testing than antibody testing for those who were inadequately tested.

Conclusions:

A significant proportion of infants born to HCV-infected mothers were either not identified at birth (20%) or did not receive adequate testing on follow-up (35%). Further work needs to be done to improve documentation of HCV exposure at birth and follow-up testing to avoid missing congenitally acquired HCV.
Changing Landscape of Antimicrobial Resistance in Neonatal Sepsis: An in silico Analyses of Multidrug Resistance in Klebsiella pneumoniae
Authors: Vijayakumar Santhiya , Kumar Hithesh , Basu Soumya , Chandy Sara , Anbarasu Anand , Manoharan Anand , Ramaiah Sudha
Published: April 2024

Background:

Neonatal sepsis poses a critical healthcare concern, as multidrug-resistant Klebsiella pneumoniae (K. pneumoniae) infections are on the rise. Understanding the antimicrobial susceptibility patterns and underlying resistance mechanism is crucial for effective treatment.

Objectives:

This study aimed to comprehensively investigate the antimicrobial susceptibility patterns of K. pneumoniae strains responsible for neonatal sepsis using in silico tools. We sought to identify trends and explore reasons for varying resistance levels, particularly for β-lactams and fluoroquinolone.

Methods:

K. pneumoniae isolated from neonates at Kanchi Kamakoti CHILDS Trust Hospital (2017–2020) were analyzed for antimicrobial resistance. Elevated resistance to β-lactam and fluoroquinolone antibiotics was further investigated through molecular docking and interaction analysis. β-lactam affinity with penicillin-binding proteins and β-lactamases was examined. Mutations in ParC and GyrA responsible for quinolone resistance were introduced to investigate ciprofloxacin interactions.

Results:

Of 111 K. pneumoniae blood sepsis isolates in neonates, high resistance was detected to β-lactams such as cefixime (85.91%, n = 71), ceftriaxone (84.9%, n = 106), cefotaxime (84.9%, n = 82) and fluoroquinolone (ciprofloxacin- 79.44%, n = 107). Molecular docking revealed low β-lactam binding toward penicillin-binding proteins and higher affinities for β-lactamases, attributing to the reduced β-lactam efficiency. Additionally, ciprofloxacin showed decreased affinity toward mutant ParC and GyrA in comparison to their corresponding wild-type proteins.

Conclusion:

Our study elucidates altered resistance profiles in neonatal sepsis caused by K. pneumoniae, highlighting mechanisms of β-lactam and fluoroquinolone resistance. It underscores the urgent need for the development of sustainable therapeutic alternatives to address the rising antimicrobial resistance in neonatal sepsis.
Epidemiology of Adenovirus Infection in Hospitalized Children in the United States From 1997 to 2019
Authors: Totapally Balagangadhar R. , Totapalli Seevitha , Sendi Prithvi , Martinez Paul A.
Published: April 2024

Objective:

The study aimed to explore the prevalence, clinical features, resource utilization, temporal trends and outcomes associated with adenoviral infections in hospitalized children.

Methods:

A retrospective analysis using the Healthcare Cost and Utilization Project’s Kids’ Inpatient Database from 1997 to 2019 was performed. Children 29 days to 17 years of age with adenoviral infection were selected. Chi-square, Kruskal-Wallis tests, linear trend analysis and multivariable analysis were used for data analysis.

Results:

A total of 40,135 children under 18 years of age with adenoviral infection were discharged in the United States with an overall prevalence of 18.9 per 10,000 discharges and 6.9 children per 100,000 population. By linear trend analysis, the hospitalization rate has significantly increased with the highest prevalence in 2019. Adenoviral infection was more prevalent in Black children, in winter months, in the Midwest region, in children with government insurance and in the lowest income quartile. The majority (85%) of adenovirus-related hospitalizations occurred under 6 years of age. Mechanical ventilation, extracorporeal membrane oxygenation support, acute kidney injury and liver failure were documented in 11.9%, 0.4%, 2.7% and 0.4%, respectively. The overall case fatality rate was 1.4%, which decreased from 1997 to 2019 (P < 0.05). By regression analysis, an increased mortality rate was associated with the need for mechanical ventilation, the presence of complex chronic conditions, immune deficiency, central nervous system infection and pneumonia/bronchiolitis.

Conclusions:

Most human adenovirus infections occur in children under 6 years of age and cause mild illness. Human adenovirus can lead to serious illness in children with complex chronic conditions and immune deficiency conditions.
Eruptive Pseudoangiomatosis and Parvovirus: Exclusive Findings in Clinical Manifestation from a Report of Four Cases
Authors: Gaudiello Francesca , Spennato Serena , Cillo Francesco , Cantelli Maria Teresa , Vastarella Maria , Scalvenzi Massimiliano
Published: April 2024

Introduction:

Eruptive pseudoangiomatosis (EP) is a rare type of cutaneous exanthema characterized by red angioma-like papules. An association of EP with viral infection has been reported.

 We herein describe 4 pediatric patients who showed a new variant of EP-associated rash with atypical clinical features and positivity for parvovirus B19 infection.

Case presentation:

Pediatric patients showed a new variant of EP-associated rash with atypical clinical features by dermoscopy and reflectance confocal microscopy. The papules were localized to the face (cheeks, forehead, and eyelids).

 Dermoscopy showed multiple red dots suggesting dilated capillaries surrounded by reddish structureless areas; and in vivo reflectance confocal microscopy (RCM) showed perivascular inflammation around the dermal papillae. However, characteristic perilesional halo was absent. In all patients, serology revealed evidence of active infection by parvovirus B19.

Discussion:

Few cases of a facial pseudoangiomatous rash that is related to parvovirus B19 infection and lacks the typical anemic halo have been reported in the literature.

Conclusion:

These cases provide new information on the clinical spectrum of EP and its association with parvovirus.
Professional Quality of Life and Turnover Intention in Forensic Nurse Program Coordinators: Implications to Forensic Nurse Workforce Development
Authors: Meyer Leigh Anne
Published: April 2024

Background

Significant barriers to forensic nurse workforce development exist, affecting patient care access. Retention of forensic nurses is a persistent problem, and turnover of forensic nurses can be attributed to many factors related to professional quality of life, including compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS).

Purpose

The aim of this study was to identify the effect of an educational session on the topic of professional quality of life and strategies for mitigating the impact of stressors within the forensic nurse role on Professional Quality of Life Scale-5 and Turnover Intention Scale-6.

Methods

A convenience sample of forensic nurse program coordinators was surveyed using a pretest–posttest quasi-experimental survey design. Correlation between professional quality of life indicators and turnover intention was explored.

Results

Cohort (n= 38) preintervention CS levels were average to high (mean = 41.42), BO levels were average to low (mean = 22.53), and STS levels were average to low (mean = 22.89). Statistically significant positive correlations were noted between each Professional Quality of Life Scale indicator and turnover intention (CS:r= 0.59,p< 0.0001; BO:r= 0.98,p< 0.0000; STS:r= 0.67,p< 0.0000). A statistically significant decrease in BO level (α = 0.05,p= 0.0454) was noted postintervention.

Implications

BO and STS had a strong positive correlation to turnover intention. BO levels decreased to a significant degree when reassessed 3 months after the educational intervention. Increased awareness of the impact of CS, BO, and STS could decrease BO in forensic nurses with potential reduction in turnover.