bluuebunny/crossref_metadata_2025 huggingface dataset:
Reference genome for the American rubyspot damselfly, Hetaerina americana
Authors: Grether Gregory F , Beninde Joscha , Beraut Eric , Chumchim Noravit , Escalona Merly , MacDonald Zachary G , Miller Courtney , Sahasrabudhe Ruta , Shedlock Andrew M , Toffelmier Erin , Shaffer H Bradley
Published: May 2023

Damselflies and dragonflies (Order: Odonata) play important roles in both aquatic and terrestrial food webs and can serve as sentinels of ecosystem health and predictors of population trends in other taxa. The habitat requirements and limited dispersal of lotic damselflies make them especially sensitive to habitat loss and fragmentation. As such, landscape genomic studies of these taxa can help focus conservation efforts on watersheds with high levels of genetic diversity, local adaptation, and even cryptic endemism. Here, as part of the California Conservation Genomics Project (CCGP), we report the first reference genome for the American rubyspot damselfly, Hetaerina americana, a species associated with springs, streams and rivers throughout California. Following the CCGP assembly pipeline, we produced two de novo genome assemblies. The primary assembly includes 1,630,044,487 base pairs, with a contig N50 of 5.4 Mb, a scaffold N50 of 86.2 Mb, and a BUSCO completeness score of 97.6%. This is the seventh Odonata genome to be made publicly available and the first for the subfamily Hetaerininae. This reference genome fills an important phylogenetic gap in our understanding of Odonata genome evolution, and provides a genomic resource for a host of interesting ecological, evolutionary, and conservation questions for which the rubyspot damselfly genus Hetaerina is an important model system.
Conscription to Fight a War of Aggression under International Criminal Law
Authors: Boister Neil
Published: May 2023

The criminalization of the unlawful use of force in international relations is not usually linked to conscription of an army to fight such a war. However, historical precedent in the Nuremberg and Tokyo International Military Tribunals established that conscription was part of the common plan to wage a war of aggression. After a brief history of conscription and its justifications, this article examines that precedent and then analyses how it could be put to use in a prosecution of the crime of aggression under the Rome Statute of the International Criminal Court. Finally, it argues that there is a normative case for the inclusion of conscription within the scope of the crime of aggression because of the harm done to both the conscripts and the state and people of the place they invade.
Equivalence between simple multilayered and homogeneous laboratory-based rheological models in planetary science
Authors: Gevorgyan Yeva , Matsuyama Isamu , Ragazzo Clodoaldo
Published: May 2023

The goal of this work is to investigate under which circumstances the tidal response of a stratified body can be approximated by that of a homogeneous body. We show that any multilayered planet model can be approximated by a homogeneous body, with the same dissipation of tidal energy as a function of the excitation frequency, as long as the rheology of the homogeneous model is sufficiently complex. Moreover we provide two straightforward methods for finding the parameters of the homogeneous rheology that would exhibit the same tidal response as the layered body. These results highlight the fact that the two models cannot be distinguished from each other only by the measurement of the second degree tidal Love number and quality factor, and that we do not need the complexity of the multilayer planet model in order to estimate its tidal dissipation. The methodology promises a great simplification of the treatment of multilayered bodies in numerical simulations because the treatment of a homogeneous body – even with a complex rheological model – can be computationally better handled than that of a multilayered planet.
Chemical-genomic profiling identifies genes that protect yeast from aluminium, gallium, and indium toxicity
Authors: Schulze Yves , Ghiaci Payam , Zhao Liqian , Biver Marc , Warringer Jonas , Filella Montserrat , Tamás Markus J
Published: May 2023

Aluminium, gallium, and indium are group 13 metals with similar chemical and physical properties. While aluminium is one of the most abundant elements in the Earth's crust, gallium and indium are present only in trace amounts. However, the increased use of the latter metals in novel technologies may result in increased human and environmental exposure. There is mounting evidence that these metals are toxic, but the underlying mechanisms remain poorly understood. Likewise, little is known about how cells protect themselves from these metals. Aluminium, gallium, and indium are relatively insoluble at neutral pH, and here we show that they precipitate in yeast culture medium at acidic pH as metal-phosphate species. Despite this, the dissolved metal concentrations are sufficient to induce toxicity in the yeast Saccharomyces cerevisiae. By chemical-genomic profiling of the S. cerevisiae gene deletion collection, we identified genes that maintain growth in the presence of the three metals. We found both shared and metal-specific genes that confer resistance. The shared gene products included functions related to calcium metabolism and Ire1/Hac1-mediated protection. Metal-specific gene products included functions in vesicle-mediated transport and autophagy for aluminium, protein folding and phospholipid metabolism for gallium, and chorismate metabolic processes for indium. Many of the identified yeast genes have human orthologues involved in disease processes. Thus, similar protective mechanisms may act in yeast and humans. The protective functions identified in this study provide a basis for further investigations into toxicity and resistance mechanisms in yeast, plants, and humans.
On the prediction of non-CG DNA methylation using machine learning
Authors: Sereshki Saleh , Lee Nathan , Omirou Michalis , Fasoula Dionysia , Lonardi Stefano
Published: May 2023

DNA methylation can be detected and measured using sequencing instruments after sodium bisulfite conversion, but experiments can be expensive for large eukaryotic genomes. Sequencing nonuniformity and mapping biases can leave parts of the genome with low or no coverage, thus hampering the ability of obtaining DNA methylation levels for all cytosines. To address these limitations, several computational methods have been proposed that can predict DNA methylation from the DNA sequence around the cytosine or from the methylation level of nearby cytosines. However, most of these methods are entirely focused on CG methylation in humans and other mammals. In this work, we study, for the first time, the problem of predicting cytosine methylation for CG, CHG and CHH contexts on six plant species, either from the DNA primary sequence around the cytosine or from the methylation levels of neighboring cytosines. In this framework, we also study the cross-species prediction problem and the cross-context prediction problem (within the same species). Finally, we show that providing gene and repeat annotations allows existing classifiers to significantly improve their prediction accuracy. We introduce a new classifier called AMPS (annotation-based methylation prediction from sequence) that takes advantage of genomic annotations to achieve higher accuracy.
Observational Study Evaluating the Seroprotection of HepB-alum Vaccine and HepB-CpG Vaccine in People With HIV
Authors: Reilly-Evans Brenna , Dudzik Beatrix , Costlow David J , Hartmann Carlos , Khalsa Ann M , Kassis Christelle , Zmarlicka Monika T
Published: May 2023

Background

Hepatitis B virus (HBV) vaccine seroprotection rates with conventional aluminum adjuvanted recombinant HBV vaccines, Engerix-B (HepB-alum) vaccine, among people with HIV (PWH) are varied. Heplisav-B (HepB-CpG) vaccine, a novel adjuvanted recombinant HBV vaccine, has shown higher seroprotection rates in immunocompetent patients but is not well studied in PWH. There are no published studies comparing seroprotection rates between HepB-alum and HepB-CpG in PWH. This study aims to evaluate and compare the seroprotection incidence of HepB-alum vs HepB-CpG in PWH at least 18 years of age.

Methods

This retrospective, observational cohort study included adults diagnosed with HIV who received a complete series of HepB-alum or HepB-CpG at a community health center in Phoenix, Arizona. Patients had a hepatitis B surface antibody <10 IU/L at the time of the first vaccine dose. The primary outcome was a comparison of seroconversion incidence between HepB-CpG and HepB-alum. Secondary outcomes included identifying factors associated with likelihood of response to HBV vaccination.

Results

A total of 120 patients were included in this study, 59 in the HepB-alum cohort and 61 in the HepB-CpG cohort. In the HepB-alum cohort, 57.6% achieved seroconversion, compared with 93.4% in the HepB-CpG cohort (P < .001). Those without diabetes were more likely to have response to a vaccine.

Conclusions

Among PWH at a single community health center, HepB-CpG provided a statistically higher incidence of seroprotection against HBV compared with HepB-alum.
The Comparison of Surgical Margins and Type of Hepatic Resection for Hepatocellular Carcinoma With Microvascular Invasion
Authors: Liu Jianwei , Zhuang Guokun , Bai Shilei , Hu Zhiliang , Xia Yong , Lu Caixia , Wang Jie , Wang Chunyan , Liu Liu , Li Fengwei , Wu Yeye , Shen Feng , Wang Kui
Published: May 2023

Objective

The objective of this study was to investigate the impact of surgical margin and hepatic resection on prognosis and compare their importance on prognosis in patients with hepatocellular carcinoma (HCC).

Methods

The clinical data of 906 patients with HCC who underwent hepatic resection in our hospital from January 2013 to January 2015 were collected retrospectively. All patients were divided into anatomical resection (AR) (n = 234) and nonanatomical resection (NAR) group (n = 672) according to type of hepatic resection. The effects of AR and NAR and wide and narrow margins on overall survival (OS) and time to recurrence (TTR) were analyzed.

Results

In all patients, narrow margin (1.560, 1.278-1.904; 1.387, 1.174-1.639) is an independent risk factor for OS and TTR, and NAR is not. Subgroup analysis showed that narrow margins (2.307, 1.699-3.132; 1.884, 1.439-2.468), and NAR (1.481, 1.047-2.095; 1.372, 1.012-1.860) are independent risk factors for OS and TTR in patients with microvascular invasion (MVI)-positive. Further analysis showed that for patients with MVI-positive HCC, NAR with wide margins was a protective factor for OS and TTR compared to AR with narrow margins (0.618, 0.396-0.965; 0.662, 0.448-0.978). The 1, 3, and 5 years OS and TTR rate of the two group were 81%, 49%, 29% versus 89%, 64%, 49% (P = .008) and 42%, 79%, 89% versus 32%, 58%, 74% (P = .024), respectively.

Conclusions

For patients with MVI-positive HCC, AR and wide margins were protective factors for prognosis. However, wide margins are more important than AR on prognosis. In the clinical setting, if the wide margins and AR cannot be ensured at the same time, the wide margins should be ensured first.
Transcriptionally linked simultaneous overexpression of P450 genes for broad-spectrum herbicide resistance
Authors: Suda Hiroe , Kubo Tomomi , Yoshimoto Yusuke , Tanaka Keisuke , Tanaka Satoru , Uchino Akira , Azuma Satoshi , Hattori Makoto , Yamaguchi Takuya , Miyashita Masahiro , Tominaga Tohru , Iwakami Satoshi
Published: May 2023

Broad-spectrum herbicide resistance (BSHR), often linked to weeds with metabolism-based herbicide resistance, poses a threat to food production. Past studies have revealed that overexpression of catalytically promiscuous enzymes explains BSHR in some weeds; however, the mechanism of BSHR expression remains poorly understood. Here, we investigated the molecular basis of high-level resistance to diclofop-methyl in BSHR late watergrass (Echinochloa phyllopogon) found in the United States, which cannot be solely explained by the overexpression of promiscuous cytochrome P450 monooxygenases CYP81A12/21. The BSHR late watergrass line rapidly produced 2 distinct hydroxylated diclofop acids, only 1 of which was the major metabolite produced by CYP81A12/21. RNA-seq and subsequent reverse transcription quantitative PCR (RT-qPCR)-based segregation screening identified the transcriptionally linked overexpression of a gene, CYP709C69, with CYP81A12/21 in the BSHR line. The gene conferred diclofop-methyl resistance in plants and produced another hydroxylated diclofop acid in yeast (Saccharomyces cerevisiae). Unlike CYP81A12/21, CYP709C69 showed no other herbicide-metabolizing function except for a presumed clomazone-activating function. The overexpression of the 3 herbicide-metabolizing genes was also identified in another BSHR late watergrass in Japan, suggesting a convergence of BSHR evolution at the molecular level. Synteny analysis of the P450 genes implied that they are located at mutually independent loci, which supports the idea that a single trans-element regulates the 3 genes. We propose that transcriptionally linked simultaneous overexpression of herbicide-metabolizing genes enhances and broadens the metabolic resistance in weeds. The convergence of the complex mechanism in BSHR late watergrass from 2 countries suggests that BSHR evolved through co-opting a conserved gene regulatory system in late watergrass.
Arabidopsis AUTOPHAGY-RELATED2 is essential for ATG18a and ATG9 trafficking during autophagosome closure
Authors: Luo Mengqian , Law Kai Ching , He Yilin , Chung Ka Kit , Po Muk Kuen , Feng Lanlan , Chung Kin Pan , Gao Caiji , Zhuang Xiaohong , Jiang Liwen
Published: May 2023

As a fundamental metabolic pathway, autophagy plays important roles in plant growth and development, particularly under stress conditions. A set of autophagy-related (ATG) proteins is recruited for the formation of a double-membrane autophagosome. Among them, the essential roles of ATG2, ATG18, and ATG9 have been well established in plant autophagy via genetic analysis; however, the underlying molecular mechanism for ATG2 in plant autophagosome formation remains poorly understood. In this study, we focused on the specific role of ATG2 in the trafficking of ATG18a and ATG9 during autophagy in Arabidopsis (Arabidopsis thaliana). Under normal conditions, YFP-ATG18a proteins are partially localized on late endosomes and translocated to ATG8e-labeled autophagosomes upon autophagic induction. Real-time imaging analysis revealed sequential recruitment of ATG18a on the phagophore membrane, showing that ATG18a specifically decorated the closing edges and finally disassociated from the completed autophagosome. However, in the absence of ATG2, most of the YFP-ATG18a proteins are arrested on autophagosomal membranes. Ultrastructural and 3D tomography analysis showed that unclosed autophagosome structures are accumulated in the atg2 mutant, displaying direct connections with the endoplasmic reticulum membrane and vesicular structures. Dynamic analysis of ATG9 vesicles suggested that ATG2 depletion also affects the association between ATG9 vesicles and the autophagosomal membrane. Furthermore, using interaction and recruitment analysis, we mapped the interaction relationship between ATG2 and ATG18a, implying a possible role of ATG18a in recruiting ATG2 and ATG9 to the membrane. Our findings unveil a specific role of ATG2 in coordinating ATG18a and ATG9 trafficking to mediate autophagosome closure in Arabidopsis.
Membrane nanodomains: Dynamic nanobuilding blocks of polarized cell growth
Authors: Pan Xue , Pérez-Henríquez Patricio , Van Norman Jaimie M , Yang Zhenbiao
Published: May 2023

Cell polarity is intimately linked to numerous biological processes, such as oriented plant cell division, particular asymmetric division, cell differentiation, cell and tissue morphogenesis, and transport of hormones and nutrients. Cell polarity is typically initiated by a polarizing cue that regulates the spatiotemporal dynamic of polarity molecules, leading to the establishment and maintenance of polar domains at the plasma membrane. Despite considerable progress in identifying key polarity regulators in plants, the molecular and cellular mechanisms underlying cell polarity formation have yet to be fully elucidated. Recent work suggests a critical role for membrane protein/lipid nanodomains in polarized morphogenesis in plants. One outstanding question is how the spatiotemporal dynamics of signaling nanodomains are controlled to achieve robust cell polarization. In this review, we first summarize the current state of knowledge on potential regulatory mechanisms of nanodomain dynamics, with a special focus on Rho-like GTPases from plants. We then discuss the pavement cell system as an example of how cells may integrate multiple signals and nanodomain-involved feedback mechanisms to achieve robust polarity. A mechanistic understanding of nanodomains’ roles in plant cell polarity is still in the early stages and will remain an exciting area for future investigations.
Assortative Mating and Wealth Inequalities Between and Within Households
Authors: Lersch Philipp M , Schunck Reinhard
Published: May 2023

Positive assortative mating may be a driver of wealth inequalities, but this relationship has not yet been examined. We investigate the association between assortative mating and wealth inequality within and between households drawing on data from the United States Survey of Income and Program Participation and measuring current, individual-level wealth for newly formed couples (N = 3936 couples). We find that partners positively sort according to wealth over and above sorting by age, race, education, and income. In the absence of assortative mating according to wealth, the Gini coefficient for between-household wealth inequality would be 7 percent lower. Wealth inequalities would thus remain high if couples did not match by wealth. We find a within-household wealth gap of about USD 23,000 to the disadvantage of women. Whereas the within-household wealth gap would be markedly greater for women at the bottom and in the middle of the female wealth distribution without assortative mating, we also find that women would have a substantial wealth advantage under random matching at the top of the female wealth distribution.
Exemption clauses: a comparative review of the Unidroit Principles and the Qatar Civil Code
Authors: Dawwas Amin
Published: May 2023

This article deals with exemption clauses and specifically with respect to their definition, types, and validity. It tackles clauses that exempt the obligor from liability for his or his employees’ non-performance. The article presents and analyses the legal provisions on exemption clauses under the Unidroit Principles and the Qatar Civil Code and discusses the case law made under these legislative instruments. In addition, the article draws a comparison between the legal texts at issue in order to conclude with a solution that best serves the parties’ interests.
Reported Reasons for Cannabis Use Before and After Pregnancy Recognition
Authors: Besse Margaret , Parikh Kajal , Mark Katrina
Published: May 2023

Objectives

Cannabis use is cautioned against during pregnancy, yet many pregnant people continue to use. This study aimed to evaluate the patterns and reasons for cannabis use before and after conception in pregnant people who screened positive for cannabis use at initiation of prenatal care.

Methods

Pregnant patients at 1 prenatal practice in Baltimore, MD, who either self-reported cannabis use or tested positive on urine toxicology were approached for enrollment. Those who consented were given an anonymous survey with multiple choice questions regarding frequency and reasons for use before and after pregnancy recognition. Fisher exact, χ2 test, and analysis of variance were used for analysis.

Results

Of 117 pregnant people approached, 105 enrolled in the study. Of the 105 respondents, 40 (38.1%) reported complete abstinence after pregnancy recognition, whereas 65 (61.9%) reported continued use. Of the respondents who continued cannabis use, 35 (53.8%) had decreased frequency of use or quit, 26 (40%) reported no change in frequency of use, and 4 (6.2%) reported increase in frequency of use. Those who considered their use medical or mixed before pregnancy were 4 times as likely to continue use compared with those who considered their use nonmedical (66.7% vs 33.3%; odds ratio, 4.0; 95% confidence interval, 1.3–12.8). Respondents who continued use after pregnancy recognition were significantly more likely to discuss their use with their obstetrician (89.2% vs 50%, P < 0.001).

Conclusions

Reasons for use frequently changed after recognition of pregnancy. Most people who continued use during pregnancy reported that their reasons were for symptom control.
Median Nerve Palsy in Pediatric Supracondylar Humerus Fractures Recovers Faster With Open Than Closed Reduction
Authors: Wilks Daniel J. , Ye Xuan , Biggins Rose , Wang Kemble K. , Wade Ryckie G. , McCombe David
Published: May 2023

Background:

Management of supracondylar humerus fractures (SCHF) with coexisting median nerve injury is controversial. Although many nerve injuries improve with the reduction and stabilization of the fracture, the speed and completeness of recovery are unclear. This study investigates median nerve recovery time using the serial examination.

Methods:

A prospectively maintained database of SCHF-related nerve injuries referred to a tertiary hand therapy unit between 2017 and 2021 was interrogated. Factors related to the injury (vascularity, Gartland grade, open vs. closed fracture) and treatment (fixation modality, adequacy, timing of reduction, vascular and nerve intervention, and secondary procedures) were assessed.

Primary outcomes were the motor recovery of Medical Research Council (MRC) grade 4 or 5 in flexor pollicis longus or flexor digitorum profundus (index) and detection of the 2.83 Semmes Weinstein monofilament.

A retrospective clinical note review of all SCHF presenting during the same period was also conducted.

Results:

Of 1096 SCHF, 74 (7%) had an associated median nerve palsy. Twenty-one patients [mean age 7 years (SD 1.6)] with SCHF-related median nerve injuries underwent serial examination. Nineteen (90%) were modified Gartland III or IV, and 10 (48%) were pulseless on presentation. The mean follow-up was 324 days.

The mean motor recovery time was 120 days (SD 71). Four (27%) and 2 (13%) patients had not achieved MRC grade 4 by 6 months and 2 years, respectively. Only 50% attained MRC grade 5 at 2 years.

When compared with closed reduction, those who underwent open reduction recovered motor function 80 days faster (mean 71 vs. 151 d,P=0.03) and sensory function 110 days faster (52 vs. 162,P=0.02). Fewer patients recovered after closed reduction (8 of 10) than open (5 of 5).

Modified Gartland grade, vascular status, adequacy of reduction, and secondary surgery were not associated with recovery time.

Conclusions:

Median nerve recovery seems to occur slower than previously thought, is often incomplete, and is affected by treatment decisions (open vs. closed reduction). Retrospective reporting methods may overestimate median nerve recovery.

Level of Evidence:

Level III—therapeutic.
Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients
Authors: Turner Henry , Hayes Sarah , McManus Robin , O’Kelly Patrick , Kennedy Jim , Noel Jacques , Kiely Pat
Published: May 2023

Background:

Early-onset scoliosis (EOS) is frequently associated with complex spine and chest wall deformities that may lead to severe cardiopulmonary impairment and malnutrition. The aim of this study is to evaluate the change in the nutritional status of EOS patients after treatment with magnetically controlled growing rod instrumentation (MCGR) in a single center.

Methods:

We prospectively collected data of patients treated with MCGR for EOS in a single center. Exclusion criteria were <2 years’ follow-up and incomplete weight-for-age Z-scores (WAZ) data. Preoperative and postoperative WAZ, radiographic parameters, including major coronal curve, kyphosis angle, space available for lung ratios, thoracic height, and unplanned returns to the operating room (UPROR), were analyzed. SD and 95% Confidence intervals (CI) are presented with means.

Results:

Sixty-eight patients (37 males/31 females) were included. The mean age at surgery was 8.2 years (SD 2.8, range 1.8–14.2), and the mean follow-up time was 3.8 years (SD 1.0, range 2.1–6.8). The study population was categorized by the primary diagnosis as follows: 23 neuromuscular, 18 idiopathic, 15 congenital, and 12 syndromic patients. The major coronal curve improved between the preoperative and latest visits by 40% (P<0.005, SD 27, CI 33–47), while the space available for lung ratios improved by 8% (P<0.005, SD 13, CI 5–12). Thoracic height increased by 25% (P<0.005, SD 13, CI 22–28), and kyphosis angle decreased by 25% (P<0.005, SD 26, CI 9–39). Eighteen patients (27%) required a total of 53 UPRORs. WAZ improved significantly between the preoperative and the latest follow-up (P=0.005). Regression analysis showed WAZ improvements were most significant in the underweight patients and the Idiopathic or Syndromic EOS patients. UPROR was not associated with deterioration in WAZ.

Conclusions:

Treatment of EOS patients with MCGR resulted in an improvement in nutritional status, as evidenced by the significant increase in WAZ. Underweight, Idiopathic and Syndromic EOS patients, and those who required UPROR all had significant improvement in their WAZ with MCGR treatment.

Level of Evidence:

Therapeutic Study—Level II.
Understanding the next circulation: lymphatics and what the future holds
Authors: Tomasulo Catherine E. , Dori Yoav , Smith Christopher L.
Published: May 2023

Purpose of review

The lymphatic system was previously considered the forgotten circulation because of an absence of adequate options for imaging and intervention. However, recent advances over the last decade have improved management strategies for patients with lymphatic disease, including chylothorax, plastic bronchitis, ascites, and protein-losing enteropathy.

Recent findings

New imaging modalities have enabled detailed visualization of lymphatic vessels to allow for a better understanding of the cause of lymphatic dysfunction in a variety of patient subsets. This sparked the development of multiple transcatheter and surgery-based techniques tailored to each patient based on imaging findings. In addition, the new field of precision lymphology has added medical management options for patients with genetic syndromes, who have global lymphatic dysfunction and typically do not respond as well to the more standard lymphatic interventions.

Recent developments in lymphatic imaging have given insight into disease processes and changed the way patients are managed. Medical management has been enhanced and new procedures have given patients more options, leading to better long-term results.
Ups and downs of conducting a national representative survey on hypertension during pandemic time: main results of SEPHAR IV
Authors: Dorobantu Maria , Cojocaru Cosmin , Stanciulescu Laura , Pop Calin , Bala Cornelia , Benedek Theodora , Parepa Irinel , Lighezan Daniel , Darabont Roxana , Darabantiu Dan , Mitu Florin , Gheorghita Valeriu , Scafa-Udriste Alexandru , Gheorghe-Fronea Oana-Florentina
Published: May 2023

Objectives:

This national representative survey sought to assess hypertension's prevalence, awareness, treatment and control in Romania.

Methods:

A representative sample (by age, sex and residence) of 1477 Romanian adults (51.19 ± 16.61 years, range 18–80 years, 59.9% women) was multimodally evaluated during two study visits. Hypertension was defined as SBP at least 140 mmHg and/or DBP at least 90 mmHg or previously diagnosed hypertension, regardless of BP. Awareness was defined by knowledge of previous hypertension diagnosis or of current use of antihypertensive treatment. Treatment was defined by antihypertensive medication taken at least 2 weeks prior to enrolment. Control was defined as SBP less than 140 mmHg and DBP less than 90 mmHg at both visits in treated hypertensive patients.

Results:

Hypertension prevalence was 46% (n = 680) consisting of 81.02% (n = 551) known hypertensive patients and 18.98% (n = 129) newly diagnosed hypertensive patients. Awareness, treatment and control of hypertension were: 81% (n = 551), 83.8% (n = 462) and 39.2% (n = 181).

Conclusion:

Despite numerous pandemic-related obstacles in conducting a national survey, SEPHAR IV updates hypertension epidemiological data of a high-cardiovascular-risk Eastern-European population. This study confirms previous predictions of hypertension prevalence, treatment and control, which remain unfavourable because of unsatisfactory control of promoting factors.
Impaired Dermatoscopic Visualization in a Patient With Ichthyosis Vulgaris Undergoing Complete Skin Examination
Authors: Kelly Brenna G. , Herold Mitch , Curiel-Lewandrowski Clara
Published: May 2023

Ichthyosis vulgaris is an inherited disease caused by loss of function mutations in the filaggrin encoding gene. This mutation results in decreased skin hydration, elevated skin surface pH, and increased transepidermal water loss. This leads to the characteristic xerosis and scaling seen with the disease. Patients with ichthyosis vulgaris may be at a greater risk for skin cancer, which emphasizes the importance of complete skin examinations in this patient population. Prior literature has not addressed potential challenges that arise when performing complete skin examinations in patients with ichthyosis vulgaris—primarily, that dermatoscopic visualization can be obscured by hyperkeratosis. This case highlights the importance of keratolytic use before skin examinations in patients with ichthyosis vulgaris.
MSMO1 deficiency: a potentially partially treatable, ultrarare neurodevelopmental disorder with psoriasiform dermatitis, alopecia and polydactyly
Authors: Tkemaladze Tinatin , Bratland Eirik , Bregvadze Kakha , Shatirishvili Teona , Tatishvili Nino , Abzianidze Elene , Houge Gunnar , Douzgou Sofia
Published: May 2023

MSMO1 deficiency (OMIM #616834) is an ultrarare autosomal recessive disorder of distal cholesterol metabolism with only five cases reported to date. The disorder is caused by missense variants in the MSMO1 gene encoding methylsterol monooxygenase 1, leading to the accumulation of methylsterols. Clinically, MSMO1 deficiency is characterized by growth and developmental delay, often in association with congenital cataracts, microcephaly, psoriasiform dermatitis and immune dysfunction. Treatment with oral and topical cholesterol supplements and statins was reported to improve the biochemical, immunological, and cutaneous findings, supporting a potential treatment following the precision diagnosis of MSMO1 deficiency. We describe two siblings from a consanguineous family presenting with novel clinical features of polydactyly, alopecia and spasticity. Whole-exome sequencing revealed a novel, homozygous c.548A > C, p.(Glu183Ala) variant. Based on previously published treatment algorithms, we initiated a modified dosage regime with systemic cholesterol supplementation, statins and bile acid along with topical application of a cholesterol/statin formulation. This resulted in a marked improvement of psoriasiform dermatitis and some hair growth.
Kidney health and function with left ventricular assist devices
Authors: Garcia Leonardo Pozo , Walther Carl P.
Published: May 2023

Purpose of review

Mechanical circulatory support (MCS) is a group of evolving therapies used for indications ranging from temporary support during a cardiac procedure to permanent treatment of advanced heart failure. MCS is primarily used to support left ventricle function, in which case the devices are termed left ventricular assist devices (LVADs). Kidney dysfunction is common in patients requiring these devices, yet the impact of MCS itself on kidney health in many settings remains uncertain.

Recent findings

Kidney dysfunction can manifest in many different forms in patients requiring MCS. It can be because of preexisting systemic disorders, acute illness, procedural complications, device complications, and long-term LVAD support. After durable LVAD implantation, most persons have improvement in kidney function; however, individuals can have markedly different kidney outcomes, and novel phenotypes of kidney outcomes have been identified.

MCS is a rapidly evolving field. Kidney health and function before, during, and after MCS is relevant to outcomes from an epidemiologic perspective, yet the pathophysiology underlying this is uncertain. Improved understanding of the relationship between MCS use and kidney health is important to improving patient outcomes.
The Deepest Extent of Acellular Mucin Pools in Resected Locally Advanced Rectal Cancer With Pathological Complete Response After Preoperative Chemoradiotherapy
Authors: Chen Mian , Wang Chao , Liu Huashan , Liang Zhenxing , Ye Fujin , Luo Shuangling , Liu Zhanzhen , Hu Huanxin , Lai Sicong , Hou Yujie , Kang Liang , Huang Liang
Published: May 2023

For patients with locally advanced rectal cancer (LARC) with pathological complete response (pCR), the clinical significance of the distribution extent of acellular mucin pools (AMP) distribution remains unclear, so this study was conducted to address key unanswered questions. We performed a retrospective analysis of 317 patients with LARC with pCR after preoperative chemoradiotherapy and total mesorectal resection from January 2011 to June 2020. Based on AMP existence and the deepest tissue layer of distribution, patients were assigned new stages. The patient information was recorded, and the main outcome measures included 5-year disease-free survival (DFS) and 5-year overall survival (OS). A total of 83/317 (26.2%) patients exhibited AMP, and disease recurrence occurred in 46/317 (14.5%) patients. Over the 5-year median follow-up period, the patients with AMP showed 5-year DFS rates (75.9% vs. 88.9%, P=0.004) and 5-year OS rates (85.5% vs. 95.7%, P=0.002) statistically lower than those of patients without AMP. Disease recurrence was seen in 15/54 (27.8%) patients with AMP within the subserosa and/or the serosa, or adipose tissue. Univariate and multivariate analysis showed that the existence of AMP within the subserosa and/or the serosa, or adipose tissue was an independent risk factor for DFS [hazard ratio (HR): 2.344; 95% confidence interval (CI): 1.256–4.376; P=0.007] and OS [HR: 3.374; 95% CI: 1.438–7.917; P=0.005]. The new stages based on the deepest extent of AMP were related to worse DFS (P=0.004) and OS (P=0.003) rates among patients with pCR. In conclusion, the presence of AMP might reduce the prognosis of LARC patients with pCR after chemoradiotherapy, especially in patients with AMP in deeper tissue layers. Therefore, the influence of the deepest AMP extent might be worth considering in staging. Moreover, the revised staging of patients with pCR according to the deepest extent of AMP, which is unrelated to the clinical T stage, might facilitate postoperative management.
Impact of an Emergency Department Saturation Tool on a Pediatric Hospital's Capacity Management Policy
Authors: Kane Ann , Tackett Sean , Ngo Thuy , Burkett Gregory S. , Wilson Mary Ellen , Ryan Leticia M. , Klein Bruce L.
Published: May 2023

Evidence-based general emergency department saturation assessment tools to estimate and/or predict crowding are rarely used by pediatric emergency departments (PEDs) to devise responses to overcrowding.

Objective

We sought to describe how the Emergency Department Work Index (EDWIN) saturation tool (1) correlates with PED overcrowding during a capacity management activation policy, known internally as Purple Alert and (2) compare overall hospital-wide capacity metrics on days in which the alert was instituted versus days it was not.

Methods

This study was conducted between January 1, 2017 and December 31, 2019 in a 30-bed academic quaternary care, urban PED within a university hospital. The EDWIN tool was implemented in January 2019 and objectively measured the busyness of the PED. To determine correlation with overcrowding, EDWIN scores were calculated at alert initiation. Mean alert hours per month were plotted on a control chart before and after EDWIN implementation. We also compared daily numbers of PED visits, inpatient admissions, and patients left without being seen (LWBS) for days with and without alert initiation to assess whether or not Purple Alert correlated with high PED usage.

Results

During the study period, the alert was activated a total of 146 times; 43 times after EDWIN implementation. Mean EDWIN score was 2.5 (SD 0.5, min 1.5, max 3.8) at alert initiation. There were no alert occurrences for EDWIN scores less than 1.5 (not overcrowded). There was no statistically significant difference for mean alert hours per month before and after EDWIN was instituted (21.4 vs 20.2,P= 0.08). Mean numbers of PED visits, inpatient admissions, and patients left without being seen were higher on days with alert activation (P< 0.001 for all).

Conclusions

The EDWIN score correlated with PED busyness and overcrowding during alert activation and correlated with high PED usage. Future studies could include implementing a real-time Web-based EDWIN score as a prediction tool to prevent overcrowding and verifying EDWIN generalizability at other PED sites.
Mixed Methods, Implementation Science Evaluation of a Community Health Worker Strategy for HIV Service Engagement in Uganda
Authors: Chang Larry W. , Pollard Rose , Mbabali Ismail , Anok Aggrey , Hutton Heidi , Amico K. Rivet , Kong Xiangrong , Mulamba Jeremiah , Ssekasanvu Joseph , Long Amanda , Thomas Alvin G. , Thomas Kristin , Bugos Eva , van Wickle Kimiko , Kennedy Caitlin E. , Nalugoda Fred , Beres Laura K. , Bollinger Robert C. , Quinn Thomas C. , Serwadda David , Gray Ronald H. , Wawer Maria J. , Reynolds Steven J. , Nakigozi Gertrude
Published: May 2023

Background:

A trial found that a community health worker (CHW) strategy using “Health Scouts” improved HIV care uptake and ART coverage. To better understand outcomes and areas for improvement, we conducted an implementation science evaluation.

Methods:

Using the RE-AIM framework, quantitative methods included analyses of a community-wide survey (n = 1903), CHW log books, and phone application data. Qualitative methods included in-depth interviews (n = 72) with CHWs, clients, staff, and community leaders.

Results:

Thirteen Health Scouts logged 11,221 counseling sessions; 2532 unique clients were counseled. 95.7% (1789 of 1891) of residents reported awareness of the Health Scouts. Overall, reach (self-reported receipt of counseling) was 30.7% (580 of 1891). Unreached residents were more likely to be male and HIV seronegative (P < 0.05). Qualitative themes included the following: (1) reach was promoted by perceived usefulness but deterred by busy client lifestyles and stigma, (2) effectiveness was enabled through good acceptability and consistency with the conceptual framework, (3) adoption was facilitated by positive impacts on HIV service engagement, and (4) implementation fidelity was initially promoted by the CHW phone application but deterred by mobility. Maintenance showed consistent counseling sessions over time. The findings suggested the strategy was fundamentally sound but had suboptimal reach. Future iterations could consider adaptations to improve reach to priority populations, testing the need for mobile health support, and additional community sensitization to reduce stigma.

Conclusions:

A CHW strategy to promote HIV services was implemented with moderate success in an HIV hyperendemic setting and should be considered for adoption and scale-up in other communities as part of comprehensive HIV epidemic control efforts.

Trial registration:

ClinicalTrials.gov Trial Number NCT02556957.
Novel Latent Profile Analysis of a Test of Concept, Stigma Intervention to Increase PrEP Uptake Among Black Sexual Minority Men
Authors: Eaton Lisa A. , Layland Eric K. , Driver Redd , Kalichman Seth C. , Kalichman Moira O. , Watson Ryan J. , Kalinowski Jolaade , Chandler Cristian J. , Earnshaw Valerie A.
Published: May 2023

Background:

Pre-exposure prophylaxis (PrEP) has demonstrated efficacy for HIV prevention, yet uptake of PrEP among populations in urgent need of prevention tools (eg, Black sexual minority men) is limited, and stigma and medical mistrust remain strong barriers to accessing PrEP.

Purpose:

To evaluate a test of concept brief intervention to address stigma and medical mistrust as barriers to PrEP uptake using novel latent profile analysis.

Methods:

Participants (N = 177) residing in the southeastern US were randomized to 1 of 4 arms to establish the potential impact of a brief, stigma focused counseling intervention (referred to as Jumpstart) to increase PrEP uptake. We estimated intervention effect size (Cramer's V) for PrEP uptake and then explored differential intervention effects across latent profiles of psychosocial barriers to PrEP use.

Results:

The intervention resulted in small, but meaningful effect size, with self-reported PrEP uptake increasing across Jumpstart conditions with the control condition reporting 24% uptake and Jumpstart plus text/phone calls (the most intensive intervention arm) reporting 37% uptake, and a similar pattern emerging for biologically confirmed PrEP use. Among participants 30 and older, Jumpstart participants were more likely to move to a postintervention profile with fewer barriers than control participants and reported the highest uptake of PrEP.

Conclusions:

Addressing social/emotional barriers to PrEP uptake is an essential component of bridging the gap between advances being made in biomedical forms of HIV prevention, and establishing and supporting access to those advances.
Hungarian Women’s Health Care Seeking Behavior and Knowledge of Urinary Incontinence and Pelvic Organ Prolapse: A Cross-Sectional Study
Authors: Szatmári Éva , Makai Alexandra , Prémusz Viktória , Balla Béla József , Ambrus Eszter , Boros-Balint Iuliana , Ács Pongrác , Hock Márta
Published: May 2023

Importance

Adequate knowledge about pelvic floor disorders could lead to increased health care-seeking behavior, improved symptoms, and quality of life.

Objectives

The aims of the present study were to evaluate Hungarian women’s knowledge about pelvic floor disorders and to assess health care-seeking behavior.

Study Design

We conducted a cross-sectional survey from March to October 2022 using self-administered questionnaires. The Prolapse and Incontinence Knowledge Questionnaire was used to assess Hungarian women’s knowledge about pelvic floor disorders. The International Consultation of Incontinence Questionnaire–Short Form was used to gather information about the symptoms of urinary incontinence.

Results

Five hundred ninety-six women were included in the study. Urinary incontinence knowledge was deemed proficient in 27.7% of participants, while pelvic organ prolapse knowledge was deemed proficient in 40.4% of participants. Greater urinary incontinence knowledge was significantly associated (P < 0.001) with higher level of education (P = 0.016), work in a medical field (P < 0.001), and ever practiced pelvic floor muscle training (P < 0.001), whereas greater pelvic organ prolapse knowledge was significantly associated (P < 0.001) with higher level of education (P = 0.032), work in a medical field (P < 0.001), ever practiced pelvic floor muscle training (P = 0.017), and ever had pelvic organ prolapse (P = 0.022). Of the 248 participants who reported a history of urinary incontinence, only 42 (16.93%) women sought care. Care seeking was higher among women who were more knowledgeable about urinary incontinence and among women with more severe symptoms.

Conclusions

Hungarian women had limited knowledge about urinary incontinence and pelvic organ prolapse. Health care seeking among women with urinary incontinence was low.
Quantitative Electroencephalographic Changes Associated With Brain Tissue Hypoxia After Pediatric Traumatic Brain Injury: A Retrospective Exploratory Analysis
Authors: Appavu Brian L. , Temkit M′Hamed , Hanalioglu Damla , Burrows Brian T. , Adelson P. David
Published: May 2023

Purpose:

Brain tissue hypoxia is associated with poor outcomes after pediatric traumatic brain injury. Although invasive brain oxygenation (PbtO2) monitoring is available, noninvasive methods assessing correlates to brain tissue hypoxia are needed. We investigated EEG characteristics associated with brain tissue hypoxia.

Methods:

We performed a retrospective analysis of 19 pediatric traumatic brain injury patients undergoing multimodality neuromonitoring that included PbtO2 and quantitative electroencephalography(QEEG). Quantitative electroencephalography characteristics were analyzed over electrodes adjacent to PbtO2 monitoring and over the entire scalp, and included power in alpha and beta frequencies and the alpha-delta power ratio. To investigate relationships of PbtO2 to quantitative electroencephalography features using time series data, we fit linear mixed effects models with a random intercept for each subject and one fixed effect, and an auto-regressive order of 1 to model between-subject variation and correlation for within-subject observations. Least squares (LS) means were used to investigate for fixed effects of quantitative electroencephalography features to changes in PbtO2 across thresholds of 10, 15, 20, and 25 mm Hg.

Results:

Within the region of PbtO2 monitoring, changes in PbtO2 < 10 mm Hg were associated with reductions of alpha-delta power ratio (LS mean difference −0.01, 95% confidence interval (CI) [−0.02, −0.00], p = 0.0362). Changes in PbtO2 < 25 mm Hg were associated with increases in alpha power (LS mean difference 0.04, 95% CI [0.01, 0.07], p = 0.0222).

Conclusions:

Alpha–delta power ratio changes are observed across a PbtO2 threshold of 10 mm Hg within regions of PbtO2 monitoring, which may reflect an EEG signature of brain tissue hypoxia after pediatric traumatic brain injury.
Dopamine mediates the pea aphid wing plasticity
Authors: Liu Xiaomi , Brisson Jennifer A.
Published: May 2023

Many organisms exhibit phenotypic plasticity, in which developmental processes result in different phenotypes depending on their environmental context. Here we focus on the molecular mechanisms underlying that environmental response. Pea aphids (
Acyrthosiphon pisum
) exhibit a wing dimorphism, in which pea aphid mothers produce winged or wingless daughters when exposed to a crowded or low-density environment, respectively. We investigated the role of dopamine in mediating this wing plasticity, motivated by a previous study that found higher dopamine titres in wingless- versus winged-producing aphid mothers. In this study, we found that manipulating dopamine levels in aphid mothers affected the numbers of winged offspring they produced. Specifically, asexual female adults injected with a dopamine agonist produced a lower percentage of winged offspring, while asexual females injected with a dopamine antagonist produced a higher percentage of winged offspring, matching expectations based on the titre difference. We also found that genes involved in dopamine synthesis, degradation and signalling were not differentially expressed between wingless- and winged-producing aphids. This result indicates that titre regulation possibly happens in a non-transcriptional manner or that sampling of additional timepoints or tissues is necessary. Overall, our work emphasizes that dopamine is an important component of how organisms process information about their environments.