bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally Invasive Robotic-assisted Perforator-to-Perforator DIEP Flap Breast Reconstruction
Authors: Kueckelhaus Maximilian
Published: May 2024

Reducing morbidity has been the goal of many reconstructive microsurgery efforts. Several techniques have been described for deep inferior epigastric perforator flap breast reconstruction to minimize abdominal donor-site morbidity. Although these techniques have certain tradeoffs, we designed a minimally invasive robot-assisted perforator-to-perforator approach to achieve minimal donor- and recipient-site morbidity. Simultaneous identification of the deep inferior epigastric artery (DIEA) and internal mammary artery (IMA) perforator was performed, followed by a small fascial incision around the dominant DIEA perforator. The IMA perforator was prepared for a prepectoral anastomosis. The short DIEA pedicle was dissected without further longitudinal fascial incision until an adequate diameter compared with the IMA perforator was reached, and a robot-assisted perforator-to-perforator anastomosis was performed prepectorally. All patients underwent reconstruction performed by a single surgeon. The smallest abdominal incision was 2.5 cm with a DIEP pedicle length of 6 cm. The average IMA perforator diameter was 1.14 mm (1.0 mm–1.2 mm). The average vein diameter was 2.0 mm (1.5–3.0 mm). The incision to closure lasted 330 minutes (313–348 minutes). Flap ischemia was 105 minutes (82–118 minutes), whereas the time for robot-assisted anastomosis was 25 minutes (22–30 minutes). All anastomoses were performed successfully. Our initial experience with robot-assisted perforator-to-perforator anastomosis for DIEP flap breast reconstruction demonstrates promise in achieving minimal patient morbidity. Raising only a very short pedicle can be compensated by adding the prepectoral IMA perforator length and enabling a good size match for small-caliber anastomosis. This technique combines important aspects of most minimally invasive DIEP flap harvests and insets.
“Demodicosis” Mimicking PreSeptal Cellulitis: Severe Periocular and Facial Inflammation Caused by “Normal” Skin Flora
Authors: Desire Galaxy M. , Stagner Anna M. , Lin Li-Wei , Lefebvre Daniel R.
Published: May 2024

Due to their relatively high prevalence and commensalism, the pathogenicity of Demodex mites has been debated. Recent data, however, show Demodex to be associated with skin and ocular surface diseases such as rosacea, blepharitis, and keratitis. Here the authors report the first known case, to the best of the their knowledge, of Demodex infestation mimicking preseptal cellulitis in an adult human. A 29-year-old male bilaterally blind from advanced retinopathy of prematurity presented with a 2-month history of right-greater-than-left upper eyelid and periocular/cheek swelling, redness, and ocular discharge that did not resolve with oral antibiotics or oral steroids. Based on MRI findings, biopsies of the right lacrimal gland, right orbital fat, and right upper eyelid preseptal skin were obtained which revealed marked intrafollicular Demodex mite density and budding yeasts in the upper eyelid skin. This case serves to alert clinicians to this entity that may not otherwise be usually considered in ophthalmic clinical practice.
Presumed Lacrimal Gland Pleomorphic Adenoma With Extensive Ossification and Necrosis
Authors: Hughes Laura , McKelvie Penelope A. , McNab Alan A.
Published: May 2024

Calcification within pleomorphic adenomas of the lacrimal gland is well recognized but uncommon, being seen more readily in lacrimal gland carcinomas. Bony formation, ossification, in pleomorphic adenomas of the lacrimal glands is even rarer. Together with extensive sclerosis, or “coagulative necrosis,” ossification and necrosis should alert the clinician to the risk of malignant transformation. However, both can mimic carcinomatous change, leading to misinterpretation of malignancy in an otherwise benign lacrimal gland neoplasm. We present 2 case reports of patients with clinically presumed pleomorphic adenomas of the lacrimal gland whose histopathology demonstrated lacrimal gland ossification and necrosis without features of malignancy or invasive disease.
Regional Transformation
Authors: McGinnis Juli , Aquino-Maneja Emma , Geloso Kristy , Zaragoza Carrie , Spicer Jerry , Kawar Lina Najib
Published: May 2024

Background:

Synergistic opportunity exists between Magnet-aspiring environments and High Reliability Organization (HRO) cultures to elevate safety, quality, new knowledge, continuous improvement, hierarchical flattening, and frontline empowerment.

Local Problem:

Variation existed across a region’s 15 hospitals regarding Magnet-readiness, leadership engagement, journey strategies, and resource capacity.

Methods:

Quality improvement (QI) methodology and a hybrid-hub-spoke-model (HHSM) were used to support region-wide Magnet designation, improve patient outcomes, and advance nursing research.

Interventions:

HRO strategies were used region-wide to strengthen implementation and enculturation of Magnet excellence infrastructure.

Results:

Nine facilities achieved Magnet recognition. Magnet sites demonstrated significantly lower falls with injury (P = .012), lower health care-associated infections and hospital-acquired pressure injuries than non-Magnet sites. Nursing research studies increased 223%.

Conclusions:

Utilizing a HHSM and HRO strategies represent effective methods for supporting region-wide Magnet designation and continuous QI.
A Narrative Review on the Clinical Relevance of Imaging the Circumventricular Brain Organs and Performing Their Anatomical and Histopathological Examination in Acute and Postacute COVID-19
Authors: Castañeyra-Perdomo Agustin , Gonzalez-Mora Jose Luis , Carmona-Calero Emilia Maria , Makris Nikos , Carrasco-Juan Jose Luis
Published: May 2024

Autopsy followed by histopathological examination is foundational in clinical and forensic medicine for discovering and understanding pathological changes in disease, their underlying processes, and cause of death. Imaging technology has become increasingly important for advancing clinical research and practice, given its noninvasive, in vivo and ex vivo applicability. Medical and forensic autopsy can benefit greatly from advances in imaging technology that lead toward minimally invasive, whole-brain virtual autopsy. Brain autopsy followed by histopathological examination is still the hallmark for understanding disease and a fundamental modus operandi in forensic pathology and forensic medicine, despite the fact that its practice has become progressively less frequent in medical settings. This situation is especially relevant with respect to new diseases such as COVID-19 caused by the SARS-CoV-2 virus, for which our neuroanatomical knowledge is sparse. In this narrative review, we show that ad hoc clinical autopsies and histopathological analyses combined with neuroimaging of the principal circumventricular organs are critical to gaining insight into the reconstruction of the pathophysiological mechanisms and the explanation of cause of death (ie, atrium mortis) related to the cardiovascular effects of SARS-CoV-2 infection in forensic and clinical medicine.
Genital Self-Image and Body Dysmorphic Symptoms in Patients Undergoing Central Wedge or Linear Labiaplasty: A Clinical Trial
Authors: Minikowski Guilherme Campanha , Veiga Daniela Francescato , Felix Gabriel de Almeida Arruda , Pedroso Juan Carlos Montano , Ferreira Lydia Masako , Neto Miguel Sabino
Published: May 2024

Background:

Labiaplasty, a surgical procedure designed to address labia minora hypertrophy, has been closely linked to the improvement of genital self-image and the alleviation of symptoms related to body dysmorphic disorder (BDD). Brazil stands as the global leader in the prevalence of labiaplasty procedures. This study aimed to assess alterations in genital self-image and symptoms of BDD in individuals with labia minora hypertrophy who underwent either wedge or trim labiaplasty.

Methods:

A total of 48 adult women undergoing labiaplasty were enrolled in this randomized clinical trial with 2 parallel groups. The allocation ratio was 1:1. The study group underwent wedge labiaplasty, and the control group underwent trim labiaplasty. Genital self-image and symptoms of BDD were assessed both preoperatively and 6 months postoperatively, using validated tools.

Results:

After a 6-month intervention period, a statistically significant improvement in genital self-image was observed (P < 0.001), alongside a marked decrease in the score of symptoms related to BDD (P < 0.001). There were no significant differences in outcomes between the groups. Furthermore, no statistically significant associations were noted between complications and the specific technique used.

Conclusions:

The study findings underscore the noteworthy improvement in genital self-image and a concurrent reduction in symptoms of BDD, evident in both the wedge and linear labiaplasty groups at the 6-month postoperative assessments. These results suggest that the choice of surgical technique does not significantly impact these outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, I.
Exploring the Mechanisms of Yuanhu Zhitong Oral Liquid for Primary Dysmenorrhea through Network Pharmacology, Molecular Docking, and Molecular Dynamics Simulation
Authors: Zhang Cheng-Rui , Zhang Dai-Yan , Gao Jin , Cao Zhi-Ming , Hu Yuan-Jia
Published: May 2024

Objective:

Primary dysmenorrhea (PD) is a prevalent gynecological disorder. Yuanhu Zhitong oral liquid (YHZT) presents a promising alternative treatment for PD. However, the mechanisms underlying its efficacy remain unclear. This study aims to investigate the potential targets and mechanisms of action of YHZT in treating PD using network pharmacology, molecular docking, and molecular dynamics simulations.

Methods:

Potential compounds from YHZT were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the Traditional Chinese Medicine Information Database (TCMID). The relevant targets of these compounds were identified using the similarity ensemble approach (SEA) and the Swiss Target Prediction database. PD-related targets were retrieved from the Genecards, DrugBank, and Disgenet databases. ClusterProfiler was utilized for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. The compound-target-pathway (CTP) network was constructed to facilitate the identification of key compounds, core targets, and signaling pathways. Finally, molecular docking and molecular dynamics simulations were performed to evaluate the interactions between the targets and compounds.

Results:

A total of 153 putative compounds and 129 targets of YHZT were identified. Network topology analysis revealed eight core targets and six key compounds. The effects of YHZT were mediated by genes associated with hormone and steroid metabolism, as well as pathways involved in steroid hormone biosynthesis and cytochrome P450 enzymes. Docking results showed free-binding energies ranging from -6.06 to -10.85 kcal/mol, indicating strong binding affinity between the compounds and targets. Molecular dynamics simulation results further confirmed the stability of these interactions.

Conclusion:

This study demonstrates that YHZT treats PD by suppressing inflammatory reactions and modulating hormone and cytochrome P450 concentrations. Key compounds such as ferulic acid, (R)-canadine, (S)-canadine, canadine, and asristolone are implicated in this process. These findings offer insights into the mechanisms underlying the action of YHZT and provide a foundation for further research in this area.
A Differential Analysis of Preferred Feminine Facial Contours for Transfeminine Individuals
Authors: Doan Leandra L. , Ives Graham C. , Cordero Justin J. , Lee James C.
Published: May 2024

Background:

Facial feminization surgeries are important gender-affirming procedures for transfeminine individuals. The literature provides guidance on classically feminine facial features but the aesthetic preferences of transgender patients have not been studied. This study aimed to define the preferred feminine facial proportions of transfeminine patients and compare them to a mixed population of US adults.

Methods:

An online survey was designed consisting of virtually modified images with progressive degrees of change in 6 facial features: forehead, nasal dorsum, chin projection, nasolabial angle, mandibular angle, and chin height. It was administered to transfeminine patients in a large-scale health system as well as the general population using an online market research instrument. Respondents ranked each image on a 7-point Likert scale from “very unattractive” to “very attractive” for a feminine face.

Results:

Both groups agreed that a moderately convex forehead without supraorbital ridge prominence, slightly sloped nasal dorsum, ∼105-degree nasolabial angle, and decreased chin height were considered most attractive. In addition, very concave nasal slope and ∼110-degree nasolabial angle were rated significantly higher by transfeminine respondents compared with controls. The most classically masculine versions of each feature were considered significantly more unattractive by transfeminine patients when compared with controls.

Conclusion:

Transfeminine individuals share significant preferences in feminine facial features with control respondents. However, transfeminine patients were more averse to traditionally masculine features on a feminine face and more accepting of the most traditionally feminine versions of nasal contours. Understanding these differences can facilitate surgical planning between surgeons and patients and potentially improve patient satisfaction.
A Novel Design of Computer-Assisted 3D-Printed TMJ Arthrocentesis Guide (Technical Note)
Authors: Sherif Mohammed Malak , Hany Hossam El-Dien , El Fadly Mahmoud Abd El Aziz , Taha Moustafa Mohammed Sayed
Published: May 2024

Attempts of needle relocation and extension of the operation time are the most common cause of postoperative edema and swelling after temporomandibular joint arthrocentesis. To facilitate the placement of needles and decrease patient discomfort, a template-based technique that includes design of patient-specific guide was performed to direct access to the temporomandibular joint space for arthrocentesis.
Quality of Life in Patients Undergoing Endoscopic Thyroidectomy Versus Conventional Open Thyroidectomy: Interim Results From Randomized Trial
Authors: Kataria Kamal , Aggarwal Vaibhav , Dhar Anita , Ranjan Piyush , Rathore Yashwant , Khadgawat Rajesh , Kumar Rakesh , Chirom Amit , Agarwal Shipra , Huzaifa Muhammed
Published: May 2024

Objective:

We determined whether endoscopic thyroidectomy (ET) is associated with better health-related quality of life (QoL) compared with open thyroidectomy.

Methods:

We randomly assigned 28 patients aged older than 18 years, Bethesda IV or less on cytology and gland volume of <40 mL to undergo hemithyroidectomy through either open or endoscopic (axillo-breast approach/bilateral axillo-breast approach) technique. The primary outcome was QoL scores on the Short Form-36 and Thyroid-Specific Questionnaire at 2, 6, and 12 weeks postsurgery. Secondary outcomes were postoperative complications, hospital stay, and pain scores.

Results:

The generic QoL scores based on Short Form-36 were statistically nonsignificant between the two groups. QoL scores based on Thyroid-Specific Questionnaire were statistically significant (P < 0.05) favoring open thyroidectomy in the following domains: (1) numbness at 2, 6, and 12 weeks (P = 0.04, 0.004, and 0.005, respectively), (2) shoulder impairment at 2 weeks (P = 0.017), and (3) favoring ET in cosmesis at 6 and 12 weeks (P = 0.037 and 0.02, respectively). ET has longer operative time (104.6 ± 25.4 vs 123 ± 8.9 min; P = 0.03), longer hospital stays (2.8 ± 0.4 vs 2.4 ± 0.5; P = 0.056) and higher pain scores at 2 and 6 weeks (P = 0.007 and 0.012, respectively) but decreased intraoperative bleeding (33.5 ± 6.4 vs 29.1 ± 3.7 mL; P = 0.037).

Conclusion:

ET has higher cosmetic satisfaction, increased numbness, and shoulder movement impairment during short-term postsurgery follow-up. Both techniques are similar in impacting general physical, mental, and social health-related QoL. (Clinical Trials Registry of India, Reg. No. CTRI/2020/07/026374).
Efficacy of Pancreatic Dissection With a Triple-row Stapler in Laparoscopic Distal Pancreatectomy: A Retrospective Observational Study
Authors: Izumi Hideki , Yoshii Hisamichi , Fujino Rika , Takeo Shigeya , Nomura Eiji , Mukai Masaya , Makuuchi Hiroyasu
Published: May 2024

Background:

Postoperative pancreatic fistulas (POPFs) occur after 20% to 30% of laparoscopic distal pancreatectomies. This study aimed to evaluate the clinical efficacy of laparoscopic distal pancreatectomy using triple-row staplers in preventing POPFs.

Methods:

Between April 2016 and May 2023, 59 patients underwent complete laparoscopic distal pancreatectomies. There were more females (n=34, 57.6%) than males (n=25, 42.4%). The median age of the patients was 68.9 years. The patients were divided into slow-compression (n=19) and no-compression (n=40) groups and examined for pancreatic leakage. Both groups were examined with respect to age, sex, body mass index (BMI), pancreatic thickness at the pancreatic dissection site, pancreatic texture, diagnosis, operative time, blood loss, presence of POPF, date of drain removal, and length of hospital stay. In addition, risk factors for POPF were examined in a multivariate analysis.

Results:

Grade B POPFs were found in 9 patients (15.3%). Using univariate analysis, the operative time, blood loss, postoperative pancreatic fluid leakage, day of drain removal, and hospital stay were shorter in the no-compression group than in the slow-compression group. Using multivariate analysis, the absence of POPFs was significantly more frequent in the no-compression group (odds ratio, 5.69; 95% CI, 1.241-26.109; P=0.025). The no-compression pancreatic dissection method was a simple method for reducing POPF incidence.

Conclusions:

The method of quickly dissecting the pancreas without compression yielded better results than the method of slowly dissecting the pancreas with slow compression. This quick dissection without compression was a simple and safe method that minimized postoperative pancreatic fluid leakage, shortened the operative time and length of hospital stay, and reduced medical costs. Therefore, this method might be a clinically successful option.
Putting the ready in readiness: A post hoc analysis of surgeon performance during a military mass casualty situation in Afghanistan
Authors: Andreatta Pamela B. , Bowyer Mark W. , Renninger Christopher H. , Graybill John Christopher , Gurney Jennifer M. , Elster Eric A.
Published: May 2024

BACKGROUND

All military surgeons must maintain trauma capabilities for expeditionary care contexts, yet most are not trauma specialists. Maintaining clinical readiness for trauma and mass casualty care is a significant challenge for military and civilian surgeons. We examined the effect of a prescribed clinical readiness program for expeditionary trauma care on the surgical performance of 12 surgeons during a 60-patient mass-casualty situation (MASCAL).

METHODS

The sample included orthopedic (four) and general surgeons (eight) who cared for MASCAL victims at Hamad Karzai International Airport, Kabul, Afghanistan, on August 26, 2021. One orthopedic and two general surgeons had prior deployment experience. The prescribed program included three primary measures of clinical readiness: 1, expeditionary knowledge (examination score); 2, procedural skills competencies (performance assessment score); and 3, clinical activity (operative practice profile metric). Data were attained from program records for each surgeon in the sample. Each of the 60 patient cases was reviewed and rated (performance score) by the Joint Trauma System's Performance Improvement Branch, a military-wide performance improvement organization. All scores were normalized to facilitate direct comparisons using effect size calculations between each predeployment measure and MASCAL surgical care.

RESULTS

Predeployment knowledge and clinical activity measures met program benchmarks. Baseline predeployment procedural skills competency scores did not meet program benchmarks; however, those gaps were closed through retraining, ensuring all surgeons met or exceeded the program benchmarks predeployment. There were very large effect sizes (Cohen's d) between all program measures and surgical care score, confirming the relationship between the program measures and MASCAL trauma care provided by the 12 surgeons.

CONCLUSION

The prescribed program measures ensured that all surgeons achieved predeployment performance benchmarks and provided high-quality trauma care to our nation's service members.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level IV.
A clinical metagenomic study of biopsies from Mexican endophthalmitis patients reveals the presence of complex bacterial communities and a diversity of resistance genes
Authors: Vences-Guzmán Miguel Ángel , Jiménez-Rodríguez Martín , Lozano Luis , Rojas-Juárez Sergio , Ramírez-Estudillo Juan Abel , Hernández-Vázquez Ángeles Yahel , Pita Ortiz Ingrid Yazmín , Ramírez-Ceballos Karol Guadalupe , Medina-Medina Silvia , Sohlenkamp Christian
Published: May 2024

Infectious endophthalmitis is a severe ophthalmic emergency. It is known that this infection can be caused by bacteria and fungi. For efficient treatment, the administration of antimicrobial drugs to which the microbes are susceptible is essential. The aim of this study was to identify microorganisms in biopsies of Mexican endophthalmitis patients using metagenomic next-generation sequencing and determine which antibiotic resistance genes were present in the biopsy samples. In this prospective case study, 19 endophthalmitis patients were recruited. Samples of vitreous or aqueous humor were extracted for DNA extraction for metagenomic next-generation sequencing. Analysis of the sequencing results revealed the presence of a wide variety of bacteria in the biopsies. The resistome analysis showed that homologs of antibiotic resistance genes were present in several biopsy samples. Genes possibly conferring resistance to ceftazidime and vancomycin were detected in addition to various genes encoding efflux pumps. Our findings contrast with the widespread opinion that only one or a few bacterial strains are present in the infected tissues of endophthalmitis patients. These diverse communities might host many of the resistance genes that were detected, which can further complicate the infections.
Development of selective isolation media for detecting the genera Actinomyces and Schaalia from oral specimens containing indigenous bacteria
Authors: Aoki Sadao , Yahara Hiroko , Nakao Ryoma , Tsuzukibashi Osamu , Yahara Koji
Published: May 2024

To isolate specific bacteria from samples constituting the microbiota, it is essential to employ selective media that suppress the growth of resident bacteria other than specific target bacteria. Selective media for clinically important Actinomyces (including Schaalia, which was previously taxonomically classified as part of the genus Actinomyces) have been limited because they have been designed for a limited range of species within the genus and require ingredients which are difficult to prepare and handle. This study aimed to develop a selective medium [referred to as Actinomyces and Schaalia Selective Medium (ASSM)] for the isolation of a broad range of Actinomyces and Schaalia species from samples mixed with resident bacteria. The composition of ASSM includes yeast extract, agar, brain heart infusion (BHI), levofloxacin (LVFX), fosfomycin (FOM), colistin (CL) and metronidazole (MNZ). Evaluation of the medium using 24 swab samples serially collected from the roots of the teeth of a healthy individual for whom metagenome sequencing data of a saliva sample are publicly available revealed that ASSM adjusted to concentrations of LVFX 0.5 mg l−1, FOM 5 mg l−1, CL 1 mg l−1 and MNZ 2 mg l−1 and cultured anaerobically at 35 °C for 7 days enabled the isolation of Actinomyces species from 37.5 % of the samples. The inclusion of CL and MNZ in ASSM can also be useful for samples harbouring other bacterial species. The selective isolation medium is expected to contribute to studies investigating the relationship between these bacteria and their pathogenesis or disease.
Using 16s rRNA sequencing to characterize the microbiome of tropical cutaneous ulcer disease: insights into the microbial landscape and implications for diagnosis and treatment
Authors: Handley Becca L. , Sokana Oliver , Addo Kennedy Kwasi , Wagner Josef , Fookes María , Harding-Esch Emma , Marks Michael , Thomson Nicholas R. , Doyle Ronan M.
Published: May 2024

Cutaneous ulcers are common in yaws-endemic areas. Although often attributed to 'Treponema pallidum subsp. pertenue' and Haemophilus ducreyi, quantitative PCR has highlighted a significant proportion of these ulcers are negative for both pathogens and are considered idiopathic. This is a retrospective analysis utilising existing 16S rRNA sequencing data from two independent yaws studies that took place in Ghana and the Solomon Islands. We characterized bacterial diversity in 38 samples to identify potential causative agents for idiopathic cutaneous ulcers. We identified a diverse bacterial profile, including Arcanobacterium haemolyticum, Campylobacter concisus, Corynebacterium diphtheriae, Staphylococcus spp. and Streptococcus pyogenes, consistent with findings from previous cutaneous ulcer microbiome studies. No single bacterial species was universally present across all samples. The most prevalent bacterium, Campylobacter ureolyticus, appeared in 42% of samples, suggesting a multifactorial aetiology for cutaneous ulcers in yaws-endemic areas. This study emphasizes the need for a nuanced understanding of potential causative agents. The findings prompt further exploration into the intricate microbial interactions contributing to idiopathic yaw-like ulcers, guiding future research toward comprehensive diagnostic and therapeutic strategies.
The effectiveness of Evodia rutaecarpa hot compress on the recovery of gastrointestinal function after laparoscopic surgery for colorectal cancer: A propensity score-matched retrospective cohort study
Authors: Huang MiaoXin , Li JunMiao , Huang Wei , Zhou YuLin , Cai Lei , Liu Ming
Published: May 2024

Background

Although the use of hot compresses with the herbal medicine Evodia rutaecarpa (ER) as a complementary and alternative therapy to promote recovery of postoperative gastrointestinal function is gradually increasing in clinical practice, there is still a lack of relevant empirical studies. Particularly, the role of ER hot compress therapy on gastrointestinal recovery post-laparoscopic surgery for colorectal cancer has not been well investigated. The purpose of this study is to evaluate the efficacy and applicability of ER hot compress therapy for the recovery of postoperative gastrointestinal function.

Methods

This is a retrospective cohort study. Patients were divided into two cohorts, the ER group and the non-ER group. Propensity score matching(PSM) was introduced to limit confounding, and independent samples t-tests, non-parametric tests, or Chi-squared tests were used to compare these two cohorts.

Results

A total of 454 patients were included, with 267 (59%) receiving ER hot compress therapy and 187 (41%) not. Following 1:1 PSM, 320 patients were analyzed (160 in each group). Compared to the ER group, patients in the non-ER group had shorter times to return to a semi-liquid diet (p=0.035) and hospital stay (p=0.001), as well as lower hospital costs (p<0.001). Subgroup analyses revealed no statistically significant differences in the length of hospital stay, hospital costs, postoperative time to return to full-liquid diet, or time to return to semi-liquid diet among stage I and II tumor patients, though means and standard deviations were generally lower in the ER group. Complication incidence showed no significant difference between the two cohorts before and after PSM.

Conclusions

The use of ER hot packs after laparoscopic surgery in patients with colorectal cancer has a non-significant effect on the recovery of the gastrointestinal function and, given the results of the study, it is likely that patients with early-stage tumors may benefit more. Therefore, healthcare providers need to consider the individualisation, practicality, and economics of treatment options.
Super Enhancer-driven LncRNA UNC5B-AS1 Inhibits Inflammatory Phenotypic Transition in Smooth Muscle Cells via Lactylation Modification
Authors: Zhu Xiangrui , Pang Xiangming , Wang Xiaoying , Guan Xiaoyu , Wang Zhaosi , Zhang Lixin , Zheng Xiaodong , Li Fei , Mei Jian , Ou Langlin , Liu Yuxiang , Meng Zitong , Chen Yingli , Ma Cui
Published: May 2024

Background

The phenotypic transition of pulmonary artery smooth muscle cells (PASMCs) is a central pathological alteration in pulmonary artery remodeling that contributes to pulmonary hypertension (PH). The specific role of long noncoding RNAs (lncRNAs), especially super enhancer (SE)-driven lncRNAs, in the phenotypic transformation of PASMCs induced by hypoxia remains unclear. The objective of this study is to determine the mechanistic role of the super enhancer-driven LncRNA UNC5B-AS1 in phenotypic transformation of PASMCs and hypoxia-induced vascular remodeling.

Methods

The lncRNA UNC5B-AS1 regulated by super-enhancers was identified in hypoxic human PASMCs through RNA sequencing and H3K27ac ChIP sequencing. Overexpression of lncRNA UNC5B-AS1 in human PASMCs was performed to elucidate its role in the pathogenesis of PH. A conserved functional fragment of lncRNA UNC5B-AS1 was used for the treatment of mouse PH.

Results

In PASMCs, we have identified a SE-driven lncRNA called UNC5B-AS1 that regulates phenotype transition. It is transcriptionally activated by the transcription factor FOXP3. We demonstrate that UNC5B-AS1, as a molecular scaffold in mitochondria, stabilizes the interaction between LRPPRC, which is rich in leucine, and oxidative respiratory chain complex IV. This complex regulates the lactylation modification level of upstream promoter regions of inflammatory genes IL-1β, IL-6, and TNF-α by influencing the glycolytic pathway in PASMCs under hypoxic conditions, ultimately affecting the inflammatory phenotype transition of PASMCs.

Conclusions

Our findings identify the SE-driven lncRNA UNC5B-AS1 as a novel regulatory factor in hypoxia-induced phenotypic switch of PASMCs, and suggest that overexpression of UNC5B-AS1 may represent a promising therapeutic strategy for PH.

Highlights

The long non-coding RNA UNC5B-AS1, regulated by super-enhancers (SE), is downregulated in hypoxic PASMCs, and regulates PASMC phenotype transition through glycolysis.

The super-enhancer region of lncRNA UNC5B-AS1 recruits the transcription factor FOXP3 to its promoter region, forming a chromatin loop to regulate its expression.

The lncRNA UNC5B-AS1 acts as a molecular scaffold stabilizing the interaction between LRPPRC and mitochondrial complex IV.

The lactate generated by glycolysis activation induces lactylation modification of histones at the IL-1β, IL-6, and TNF-α promoters, leading to the inflammatory phenotype transition of PASMCs.

Overexpression of lncRNA UNC5B-AS1 conserved fragment reversed SuHx-induced PH in mice.
Impact of tRNA-induced proline-to-serine mistranslation on the transcriptome ofDrosophila melanogaster
Authors: Isaacson Joshua R. , Berg Matthew D. , Yeung William , Villén Judit , Brandl Christopher J. , Moehring Amanda J.
Published: May 2024

Mistranslation is the misincorporation of an amino acid into a polypeptide. Mistranslation has diverse effects on multicellular eukaryotes and is implicated in several human diseases. InDrosophila melanogaster, a serine transfer RNA (tRNA) that misincorporates serine at proline codons (P→S) affects male and female flies differently. The mechanisms behind this discrepancy are currently unknown. Here, we compare the transcriptional response of male and female flies to P→S mistranslation to identify genes and cellular processes that underlie sex-specific differences. Both males and females downregulate genes associated with various metabolic processes in response to P→S mistranslation. Males downregulate genes associated with extracellular matrix organization and response to negative stimuli such as wounding, whereas females downregulate aerobic respiration and ATP synthesis genes. Both sexes upregulate genes associated with gametogenesis, but females also upregulate cell cycle and DNA repair genes. These observed differences in the transcriptional response of male and female flies to P→S mistranslation have important implications for the sex-specific impact of mistranslation on disease and tRNA therapeutics.

ARTICLE SUMMARY

Proline-to-serine mistranslation affects male and female flies differently, but the mechanisms underlying this discrepancy are unknown. We present a transcriptomic analysis of male and female flies showing that mistranslation disrupts metabolic pathways and gametogenesis in both sexes, whereas processes such as DNA repair and cell cycle regulation are affected only in one sex. This is the first analysis that characterizes sex-specific effects of mistranslation and provides intriguing avenues for future research to understand how mistranslation affects males and females.
Species richness patterns in Fijian bees are explained by constraints in physiological traits
Authors: da Silva Carmen R.B. , Dorey James B. , Matthews Cale S. , Parslow Ben , Tuiwawa Marika , Beaman Julian E. , Congedi Nicholas C. , Barker Sarah J. , Hughes Paris M. , Blumson Rosheen T.E. , Stevens Mark I. , Schwarz Michael P. , Gloag Rosalyn , Kellermann Vanessa
Published: May 2024

Determining the ecological and evolutionary mechanisms that underpin patterns of species richness across elevational gradients is a key question in evolutionary ecology, and can help to understand species extinction risk under changing climates. In the tropical montane islands of Fiji, there are 28 species of endemic bee in the subgenusLasioglossum(Homalictus), where species richness increases with elevation despite decreasing land surface (habitat) areas. We used a combination of spatially explicit phylogenetic diversity analyses and phylogenetic trait analyses to examine the factors shaping species distributions in these bees. We found that species at higher elevations had lower heat tolerance and desiccation resistance than those at lower elevations, consistent with these traits constraining species’ elevational ranges. We also found high species phylogenetic diversity within mountains, and high phylogenetic signal in species’ heat tolerance and minimum elevational ranges, consistent with these traits being evolutionarily conserved among mountain-top taxa following vicariant (allopatric) speciation. We found no evidence to suggest that interspecific competition is shaping species elevational ranges. In all, our findings indicate that phylogenetic conservatism in physiological traits related to climatic niche, such as heat tolerance, can explain why species richness is highest at mountain tops in this system, with species having tracked their climatic niches over time towards ever higher (cooler and wetter) elevations. Because high elevations in this archipelago are extremely limited (∼2.3% of total land area), only miniscule elevational ‘islands in the sky’ remain into which this diverse, but climate-restricted fauna, can retreat as climates warm.
TMEM165 replenishes lysosomal Ca2+stores, protects cells against Ca2+overload, and mediates Ca2+-induced lysosomal H+leakage
Authors: Chen Ran , Liu Bin , Jaślan Dawid , Kucej Lucija , Kudrina Veronika , Warnke Belinda , Klingl Yvonne , Petrauskas Arnas , Maeda Kenji , Grimm Christian , Jäättelä Marja
Published: May 2024

The proper function of lysosomes depends on their ability to store and release calcium. While several lysosomal calcium release channels have been described, how mammalian lysosomes replenish their calcium stores has not been determined. Using genetic depletion and overexpression techniques combined with electrophysiology and visualization of subcellular ion concentrations and their fluxes across the lysosomal membrane, we show here that TMEM165 imports calcium to the lysosomal lumen and mediates calcium-induced lysosomal proton leakage. Accordingly, TMEM165 accelerates the recovery of cells from cytosolic calcium overload thereby enhancing cell survival while causing a significant acidification of the perilysosomal area and the entire cytosol. These data indicate that in addition to its essential role in the glycosylation in the Golgi, a small but significant fraction of TMEM165 localizes on the lysosomal limiting membrane, where it protects cells against cytosolic calcium overload, preserves lysosomal function by refilling lysosomal calcium stores and regulates perilysosomal and lysosomal pH.
Modelling resource-driven movements of livestock herds to predict the impact of climate change on network dynamics
Authors: Sulaimon Tijani A. , Ekwem Divine , Finch Douglas , Palmer Paul I. , Cleaveland Sarah , Enright Jessica , Johnson Paul C. D. , Kao Rowland
Published: May 2024

In East Africa, climate change is likely to profoundly impact livestock management and the potential spread of infectious diseases. Here, we developed a network model to describe livestock movements to grazing and watering sites, fitted it to data from the Serengeti district of Tanzania, and used it to explore how projected changes in resource availability due to climate change could impact future network structures and therefore infectious disease risks, using 2050 and 2080 as exemplar scenarios. Our modelled networks show increased connections between villages in grazing and watering networks, with connectivity increasing further in the future in correspondence with changes in vegetation and water availability. Our analyses show that targeted interventions to efficiently control regional disease spread may become more difficult, as village connectivity increases and disease vulnerability becomes more evenly distributed. This analysis also provides proof of principle for a novel approach applicable to agropastoral settings across many developing countries, where livestock trade plays a crucial role in maintaining local livelihoods but also in spreading disease.
Centromeres are Hotspots for Chromosomal Inversions and Breeding Traits in Mango
Authors: Wilkinson Melanie J. , McLay Kathleen , Kainer David , Elphinstone Cassandra , Dillon Natalie L. , Webb Matthew , Wijesundara Upendra K. , Ali Asjad , Bally Ian S.E. , Munyengwa Norman , Furtado Agnelo , Henry Robert J. , Hardner Craig M. , Ortiz-Barrientos Daniel
Published: May 2024

Chromosomal inversions can preserve combinations of favorable alleles by suppressing recombination. Simultaneously, they reduce the effectiveness of purifying selection enabling deleterious alleles to accumulate. This study explores how areas of low recombination, including centromeric regions and chromosomal inversions, contribute to the accumulation of deleterious and favorable loci in 225Mangifera indicagenomes from the Australian Mango Breeding Program. Here, we identify 17 chromosomal inversions that cover 7.7% (29.7Mb) of theM. indicagenome: eight pericentric (inversion includes the centromere) and nine paracentric (inversion is on one arm of the chromosome). Our results show that these large pericentric inversions are accumulating deleterious loci, while the paracentric inversions show deleterious levels above and below the genome wide average. We find that despite their deleterious load, chromosomal inversions contain small effect loci linked to variation in crucial breeding traits, indicating that chromosomal inversions have likely facilitated their selection. The results from this study have important implications for selective breeding of favorable combinations of alleles in regions of low recombination.

Significance Statement

Chromosomal inversions and other low recombination regions of the genome can drive trait evolution. Fewer recombination events can assist in maintaining favorable combinations of alleles, but it can also make disentangling favorable and deleterious alleles difficult. Understanding whether these low recombination regions contain favorable or deleterious loci could drive our decision to increase or decrease the frequency of these regions in target breeding populations. Breeding for large segments of the genome based on presence or absence of an inversion can rapidly drive large trait differences within few generations. Harnessing the impact of large low recombination regions of the genome could have major implications for future genetic improvement in breeding.
Molecular Matchmakers: Phytoplasma Effector SAP54 Targets MADS-Box Factor SVP to Enhance Attraction of Fecund Female Vectors by Modulating Leaf Responses to Male Presence
Authors: Orlovskis Zigmunds , Singh Archana , Kliot Adi , Huang Weijie , Hogenhout Saskia A.
Published: May 2024

Obligate parasites often trigger significant changes in their hosts to facilitate transmission to new hosts. The molecular mechanisms behind these extended phenotypes - where genetic information of one organism is manifested as traits in another - remain largely unclear. This study explores the role of the virulence protein SAP54, produced by parasitic phytoplasmas, in attracting leafhopper vectors. SAP54 is responsible for the induction of leaf-like flowers in phytoplasma-infected plants. However, we previously demonstrated that the insects were attracted to leaves and the leaf-like flowers were not required. Here we made the surprising discovery that leaf exposure to leafhopper males is required for the attraction phenotype, suggesting a leaf response that distinguishes leafhopper sex in the presence of SAP54. In contrast, this phytoplasma effector alongside leafhopper females discourages further female colonization. We demonstrate that SAP54 effectively suppresses biotic stress response pathways in leaves exposed to the males. Critically, the host plant MADS-box transcription factor SHORT VEGETATIVE PHASE (SVP) emerges as a key element in the female leafhopper preference for plants exposed to males, with SAP54 promoting the degradation of SVP. This preference extends to female colonization of male-exposedsvp nullmutant plants over those not exposed to males. Our research underscores the dual role of the phytoplasma effector SAP54 in host development alteration and vector attraction - integral to the phytoplasma life cycle. Importantly, we clarify how SAP54, by targeting SVP, heightens leaf vulnerability to leafhopper males, thus facilitating female attraction and subsequent plant colonization by the insects. SAP54 essentially acts as a molecular "matchmaker," helping male leafhoppers more easily locate mates by degrading SVP-containing complexes in leaves. This study not only provides insights into the long reach of single parasite genes in extended phenotypes, but also opens avenues for understanding how transcription factors that regulate plant developmental processes intersect with and influence plant-insect interactions.
Channel width modulates the permeability of DNA origami based nuclear pore mimics
Authors: Feng Qingzhou , Saladin Martin , Wu Chunxiang , Cao Eason , Zheng Wei , Zhang Amy , Bhardwaj Pushpanjali , Li Xia , Shen Qi , Kapinos Larisa E. , Mariappan Malaiyalam , Lusk C. Patrick , Xiong Yong , Lim Roderick Y. H. , Lin Chenxiang
Published: May 2024

Nucleoporins (nups) in the central channel of nuclear pore complexes (NPCs) form a selective barrier that suppresses the diffusion of most macromolecules while enabling rapid transport of nuclear transport receptors (NTRs) with bound cargos. The complex molecular interactions between nups and NTRs have been thought to underlie the gatekeeping function of the NPC. Recent studies have shown considerable variation in NPC diameter but how altering NPC diameter might impact the selective barrier properties remains unclear. Here, we build DNA nanopores with programmable diameters and nup arrangement to mimic NPCs of different diameters. We use hepatitis B virus (HBV) capsids as a model for large-size cargos. We find that Nup62 proteins form a dynamic cross-channel meshwork impermeable to HBV capsids when grafted on the interior of 60-nm wide nanopores but not in 79-nm pores, where Nup62 cluster locally. Furthermore, importin-β1 substantially changes the dynamics of Nup62 assemblies and facilitates the passage of HBV capsids through NPC mimics containing Nup62 and Nup153. Our study shows the transport channel width is critical to the permeability of nup barriers and underscores the role of NTRs in dynamically remodeling nup assemblies and mediating the nuclear entry of viruses.
Obscured Complexity: How External Cycles Simplify the Dynamics of the Endogenous Circadian Oscillator–take the time series of body temperature records as an example
Authors: Lin Feng
Published: May 2024

Background

Understanding circadian rhythms is crucial in various fields of biological research, as they play a fundamental role in the regulation of diverse biological processes, ranging from gene expression to physiological functions.

Objective

This study aims to explore the complexity of circadian rhythm signals from a biological system. Without the permission of using experimental data, the mathematical model is utilized to simulate the intricate dynamics of the body temperature’s circadian rhythms and investigate the impact of parameter variation on system behavior.

Methods

The Duffing equation is constructed as the mathematical model for simulating circadian rhythms. A thorough discussion justifies the selection of the Duffing equation and establishes the proper parameter range, ensuring chaotic behavior in the system. Four different values of the driving force parameterγ(0.32, 0.33, 0.34, and 0.35) are chosen to represent specific cases. Fourier analysis is employed to analyze the simulation data, revealing the frequency components present in the circadian rhythm signals. Entropy analysis along the Poincare sections is utilized to measure the system’s behavior and aggregation of points.

Results

The simulations exhibit distinct characteristics in terms of plain visualization, Fourier analysis, and entropy analysis along the Poincare sections. Under normal work sleep conditions (γ= 0.35), the system demonstrates specific resetting at particular times within a total period. In shift work (γ= 0.34) conditions, some of the resetting behaviour diminishes and the initial phase of the time changes. In longterm constant temperature (γ= 0:33) conditions, resembles that of normal work sleep conditions, with a noticeable reset at the beginning of the period. When all external driving forces are eliminated (γ= 0:32), the system undergoes multiple resets within a given period. In such circumstances, the biological clock experiences more frequent resets to adapt to the independent operations of each subsystem. Without relying on external environmental cues for regulation, the biological clock relies on frequent resetting to maintain the stability and coordination of the entire system.

Conclusion

The simulations reveals variations in resetting behavior and the importance of frequent resets in the absence of external cues. The complexity arising from chaos allows the biological system to adapt and adjust to the intricacies of the external environment. The endogenous clock within the system, despite its inherent complexity, can dynamically optimize its entrainment with external cycles. However, the full complexity of the endogenous clock may be concealed within the system and not readily observable. These findings contribute to a better understanding of the complex dynamics of circadian rhythms. Future research should aim to validate these results through comparisons with experimental data.