bluuebunny/crossref_metadata_2025 huggingface dataset:
Marine pasture monitoring system based on edge computing
Authors: Qin JieLi
Published: December 2023

With the continuous optimization and upgrading of Marine development, it is particularly important to build Marine pastures that play a pivotal role in the Marine economy. This study discusses the problems and key technologies faced by the construction of Marine pastures. It uses the underwater Internet of Things technology to propose a smart ocean pasture solution based on edge computing and designs a three-level and six-layer system architecture from top to bottom. Taking the target object of the perception layer, fish, for example, is processed and analyzed from the environmental elements and biological characteristics. The watercolor, species, and quantity are monitored. This realizes the purpose of systematic monitoring and early warning of Marine pasture and provides a technical reference for realizing intelligent ocean engineering with high performance and low power consumption.
Networked Radar Mission Planning Algorithm Based on Pulse Interleaving and Cross-Scheduling Interval
Authors: Luo Meng , Jiang Bing , Xing Wen-ge
Published: December 2023

Aiming at the problem of networked radar task planning, this paper proposes a task scheduling algorithm based on pulse interleaving and cross-scheduling interval from the perspective of rationally arranging communication and detection tasks, improving the utilization rate of radar system time resources and the success rate of task scheduling. The waiting period of tracking tasks is fully utilized to sort the tasks by pulse interleaving. On the other hand, taking advantage of the characteristics of large search task cycle and long timeliness, when there are still idle time slices in the current scheduling cycle that are not used, the time axis can be opened, and the subsequent scheduling interval can be The search tasks in the interval are advanced to be executed within the current scheduling cycle. The simulation results show that the algorithm can effectively improve the time resource utilization rate and task scheduling success rate of the system.
Permafrost degradation and soil erosion as drivers of greenhouse gas emissions from tundra ponds
Authors: Prėskienis Vilmantas , Fortier Daniel , Douglas Peter M J , Rautio Milla , Laurion Isabelle
Published: December 2023

Climate change poses a serious threat to permafrost integrity, with expected warmer winters and increased precipitation, both raising permafrost temperatures and active layer thickness. Under ice-rich conditions, this can lead to increased thermokarst activity and a consequential transfer of soil organic matter to tundra ponds. Although these ponds are known as hotspots for CO2 and CH4 emissions, the dominant carbon sources for the production of greenhouse gases (GHGs) are still poorly studied, leading to uncertainty about their positive feedback to climate warming. This study investigates the potential for lateral thermo-erosion to cause increased GHG emissions from small and shallow tundra ponds found in Arctic ice-wedge polygonal landscapes. Detailed mapping of fine-scale erosive features revealed their strong impact on pond limnological characteristics. In addition to increasing organic matter inputs, providing carbon to heterotrophic microorganisms responsible for GHG production, thermokarst soil erosion also increases shore instability and water turbidity, limiting the establishment of aquatic vegetation—conditions that greatly increase GHG emissions from these aquatic systems. Ponds with more than 40% of the shoreline affected by lateral erosion experienced significantly higher rates of GHG emissions (∼1200 mmol CO2 m−2 yr−1 and ∼250 mmol CH4 m−2 yr−1) compared to ponds with no active shore erosion (∼30 mmol m−2 yr−1 for both GHG). Although most GHGs emitted as CO2 and CH4 had a modern radiocarbon signature, source apportionment models implied an increased importance of terrestrial carbon being emitted from ponds with erosive shorelines. If primary producers are unable to overcome the limitations associated with permafrost disturbances, this contribution of older carbon stocks may become more significant with rising permafrost temperatures.
Hereditary Alpha Tryptasemia: Validation of a Single-Well Multiplex Digital Droplet PCR Assay in a Cohort of Symptomatic Patients
Authors: Alheraky Abdulrazzaq , Wierenga Albertus T J , Simpelaar Arjan , Hesp Lucy B , Minovic Isidor , Bagheri Niusha , Roozendaal Caroline , Span Lambert F R , Oude Elberink Hanneke N G , Kema Ido P , Mulder André B
Published: December 2023

Background

Hereditary alpha tryptasemia (HαT) has significant prevalence and potential morbidity in the general population. However, it remains largely undiagnosed in routine clinical diagnostics due to low availability of efficient assessment methods. To address this issue, we developed a reliable and efficient single-well multiplex digital droplet PCR assay.

Methods

The assay was based on the reconstruction of the TPSAB1 gene through quantification of the ratio of α- and β-tryptase copy number variants (CNV) in a single-well measurement. We performed analytical validation by determining CNV measurement clustering around the expected copy numbers in 281 cases and determined the diagnostic accuracy of basal serum tryptase (BST) to predict HαT and HαT subtypes in 141 symptomatic patients.

Results

The assay determined α- and β-tryptase CNVs with an overall accuracy, expressed as a 99% prediction interval, of 0.03 ± 0.27 copy numbers. The optimal BST cutoff level to predict HαT in symptomatic patients, who had no other explanation for relatively high tryptase levels (i.e., no diagnosis of systemic mastocytosis, myeloid neoplasm, or end-stage renal failure), was 9.2 ng/mL (sensitivity: 98.1%; specificity: 96.6%). HαT showed a linear gene–dose effect, with an average gene–dose increase of 7.5 ng/mL per extra α-tryptase gene.

Conclusion

Our single-well multiplex digital droplet PCR assay accurately determined HαT and could be implemented as a state-of-the-art routine diagnostic test. The assay demonstrated a strong correlation with BST and the optimal threshold for identifying HαT in symptomatic patients with unexplained high tryptase concentrations was at a BST level of 9.2 ng/mL.
Sign language usage of deaf or hard of hearing Sri Lankans
Authors: Udugama Leeljanaka S K , Nethsinghe Rohan , Southcott Jane , Kularathna Sampath , Dhanapala T D T Leslie , Alwis K Anoma C
Published: December 2023

In Sri Lanka, about 300,000 Sinhala speaking people are either deaf or hard of hearing (DHH) and would benefit from a common Sinhala sign language, technological resources such as captioning, and educational and social support. There is no fully developed common sign language for members of the Sinhalese community, a severe shortage of sign language interpreters, and few resources for teachers. This exploratory study was undertaken in all nine provinces of Sri Lanka into the use of sign language, access to education for people with disabilities, and the availability of trained or qualified educators to work with the DHH people. Data were gathered via interviews and focus groups with Special Education Assistant Directors, Principals and Teachers in Deaf Schools, and Teachers of Special Education Deaf Units in mainstream schools. The DHH members of Sri Lankan society are marginalized, under-supported, and require urgent attention to their educational and social needs. This study provides a basis for much needed attention and reform.
Effect of heat treatment and nitrogen atmosphere during post-curing on mechanical properties of 3D-printed orthodontic aligners
Authors: Mattle Mélanie , Zinelis Spiros , Polychronis Georgios , Makou Olga , Panayi Nearchos , Papageorgiou Spyridon N , Eliades Theodore
Published: December 2023

Objectives

Three-dimensional (3D)-printed aligners present a promising orthodontic treatment modality, whose clinical success largely depends on the material’s mechanical properties. The aim of this study was to evaluate the mechanical properties of resin-made 3D-printed aligners and assess the effect of two different post-curing conditions.

Materials and methods

Forty dumbbell-shaped specimens and 40 resin aligners were 3D-printed and divided into four equal groups according to post-curing conditions: presence or absence of oxygen during post-curing and water heat treatment at 85°C for 15 s or none. Samples from the central incisor of the aligner (n = 5/group) were studied by Attenuated Total Reflection Fourier-transform infrared spectroscopy (ATR-FTIR). The dumbbell-shaped specimens were loaded up to fracture under tensile mode and yield strength, ultimate tensile strength, elastic and plastic strain were calculated. The first mandibular molar area from 3D-printed aligners (n = 10/group) was cut and embedded in acrylic resin and then underwent metallographic grinding and polishing followed by instrumented indentation testing to determine the following mechanical properties: Martens hardness, indentation modulus, elastic index, and indentation relaxation. After descriptive statistics, differences according to each post-curing protocol, as well as their combination, were analyzed with linear regression modeling at a 5% significance level.

Results

All groups showed identical ATR-FTIR spectra, while no statistically significant effects were seen for either post-curing protocol (N2 presence and heat treatment) or their combination (P > .05 in all instances).

Conclusions

The mechanical properties of 3D-printed resin aligners were not considerably affected either by post-curing in N2 atmosphere or heat treatment.
Long term peripheral AAV9-SMN gene therapy promotes survival in a mouse model of spinal muscular atrophy
Authors: Reilly Aoife , Yaworski Rebecca , Beauvais Ariane , Schneider Bernard L , Kothary Rashmi
Published: December 2023

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by motor neuron loss and skeletal muscle atrophy. SMA is caused by the loss of the SMN1 gene and low SMN protein levels. Current SMA therapies work by increasing SMN protein in the body. Although SMA is regarded as a motor neuron disorder, growing evidence shows that several peripheral organs contribute to SMA pathology. A gene therapy treatment, onasemnogene abeparvovec, is being explored in clinical trials via both systemic and central nervous system (CNS) specific delivery, but the ideal route of delivery as well as the long-term effectiveness is unclear. To investigate the impact of gene therapy long term, we assessed SMA mice at 6 months after treatment of either intravenous (IV) or intracerebroventricular (ICV) delivery of scAAV9-cba-SMN. Interestingly, we observed that SMN protein levels were restored in the peripheral tissues but not in the spinal cord at 6 months of age. However, ICV injections provided better motor neuron and motor function protection than IV injection, while IV-injected mice demonstrated better protection of neuromuscular junctions and muscle fiber size. Surprisingly, both delivery routes resulted in an equal rescue on survival, weight, and liver and pancreatic defects. These results demonstrate that continued peripheral AAV9-SMN gene therapy is beneficial for disease improvement even in the absence of SMN restoration in the spinal cord.
The burden and impact of COVID-19 among newborns in African countries: a study protocol for a systematic review and meta-analysis
Authors: Haile Teklehaimanot Gereziher , Getachew Tamirat , Negash Assefa Iyasu
Published: December 2023

The WHO, on 30 January 2020, declared the Chinese outbreak of coronavirus disease 2019 (COVID-19) a global community health emergency that poses a serious threat to vulnerable healthcare systems. This review protocol will be conducted to systematically review and to perform a meta-analysis on the impact of COVID-19 among newborns in Africa. All observational studies on the impact of COVID-19 among newborns in Africa will be included. A standard quest strategy to retrieve studies was conducted on several databases (Google Scholar, PubMed/MEDLINE, EMBASE, HINARI, Cochrane Library, WHO COVID-19 database, Africa Wide Knowledge and Web of Science). Two independent authors were tasked to extract key data and to assess the risk of bias. To assess possible publication bias, funnel plot test and Egger's test methods will be used. The description will be used to show the COVID-19 distribution data by interest variables such as residence, setting and person-level characteristics. The findings of this review will notify healthcare professionals about the burden and impact of COVID-19 and provide evidence to bring about the requisite improvements in clinical practice.
ExoMol line lists – LIV. Empirical line lists for AlH and AlD and experimental emission spectroscopy of AlD in A1Π (v = 0, 1, 2)
Authors: Yurchenko Sergei N , Szajna Wojciech , Hakalla Rafał , Semenov Mikhail , Sokolov Andrei , Tennyson Jonathan , Gamache Robert R , Pavlenko Yakiv , Schmidt Mirek R
Published: December 2023

New ExoMol line lists AloHa for aluminium hydride (AlH and AlD) are presented improving the previous line lists WYLLoT. The revision is motivated by the recent experimental measurements and astrophysical findings involving the highly excited rotational states of AlH in its A 1Π − X 1Σ+ system. A new high-resolution emission spectrum of 10 bands from the A 1Π − X 1Σ+ system of AlD, in the region 17 300–32 000 cm−1 was recorded with a Fourier transform spectrometer, which probes the predissociative A 1Π v = 2 state. The AlD new line positions are combined with all available experimental data on AlH and AlD to construct a comprehensive set of empirical rovibronic energies of AlH and AlD covering the X 1Σ+ and A 1Π electronic states using the MARVEL approach. We then refine the spectroscopic model WYLLoT to our experimentally derived energies using the nuclear-motion code Duo and use this fit to produce improved line lists for 27AlH, 27AlD, and 26AlH with a better coverage of the rotationally excited states of A 1Π in the predissociative energy region. The lifetimes of the predissociative states are estimated and are included in the line list using the new ExoMol data structure, alongside the temperature-dependent continuum contribution to the photoabsorption spectra of AlH. The new line lists are shown to reproduce the experimental spectra of both AlH and AlD well, and to describe the AlH absorption in the recently reported Proxima Cen spectrum, including the strong predissociative line broadening. The line lists are included into the ExoMol data base www.exomol.com.
Rights and the Good
Authors: Zylberman Ariel
Published: December 2023

What is the connection between moral rights and the good? While familiar normative theories give justificatory precedence to one notion over the other, this paper explores a neglected alternative: when properly specified, the notion of moral rights and of the good conceptually depend on each other.1
Priorities in research portfolios: exploring the need for upstream research in cardiometabolic and mental health
Authors: van de Klippe Wouter , Yegros-Yegros Alfredo , Willemse Tim , Rafols Ismael
Published: December 2023

A current issue in mission-oriented research policy is the balance of priorities in research portfolios. In parallel, in health policies, there is a debate on shifting research away from biomedical treatments towards health promotion and well-being. In this study, we examine if research agendas are responsive to these demands in cardiometabolic and mental health. First, we conducted bibliometric analyses which showed that most research remains focused on biomedical and clinical approaches. In contrast, focus groups and interviews suggested that more research is needed upstream, i.e. on broader determinants of health, public health, and health systems. Most experts also saw a need for more intervention-oriented research. Furthermore, comparisons between cardiometabolic and mental health suggested that they require similar upstream knowledge in issues such as health systems, nutrition, labour, or economic conditions. We discuss the reasons for the persistence of current priorities and the implications in the context of funding strategies.
Clinical characteristics of snakebite patients attending a tertiary hospital in Hangzhou, southeast China
Authors: Shen Yuchen , Hu Sipin , Bao Shuhua , Tu Mengyun
Published: December 2023

Background

Venomous snakebite is a neglected yet an important public health problem in China, and few studies have focused on them so far. The aim of this study is to investigate clinical characteristics of snakebites patients in a tertiary hospital in Hangzhou, southeast China.

Methods

A total of 416 snakebite cases were included in this retrospective study. The data were collected from the medical records including demographics, clinical manifestations, management and outcomes.

Results

Of the 416 patients with venomous snakebites, 248 were male, and the average age was 54.6 years. The majority of cases occurred in rural in May to September. Out of all the venomous bites, Gloydius brevicaudus accounted for the highest percentage (55.3%). Hands were the most vulnerable site to snakebites (47.4%). Patients had clinical manifestations of pain (100%), swelling (100%), wound necrosis (25.7%), hemorrhagic blister (18.3%), and blister (8.7%). Three hundred and ninety-two patients received antivenom administration, and most were treated within six hours after bites. Twenty-six patients received surgical treatments, and 90 patients developed venom-induced consumption coagulopathy. No deaths have occurred in this study.

Conclusion

Hangzhou is one of the regions with high affecting of snakebites in China. The results of this study will increase the understanding of the clinical characteristics of venomous snakebites in Hangzhou area.
Genome-Wide Association Study of Fungicide Sensitivity in a Fusarium graminearum Population Collected from North Dakota
Authors: Poudel Bikash , Mullins Joseph , Fiedler Jason D. , Zhong Shaobin
Published: December 2023

Fusarium head blight is a destructive disease of small grains. The disease is predominantly caused by the haploid ascomycete fungus Fusarium graminearum in North America. To understand the genetics of quantitative traits for sensitivity to fungicides in this fungal pathogen, we conducted a genome-wide association study of sensitivity to two demethylation inhibition class fungicides, tebuconazole and prothioconazole, using an F. graminearum population of 183 isolates collected between 1981 and 2013 from North Dakota. Baseline sensitivity to tebuconazole and prothioconazole was established using 21 isolates collected between 1981 and 1994. Most fungal isolates were sensitive to both tebuconazole and prothioconazole; however, five isolates showed significantly reduced sensitivity to prothioconazole. The genome-wide association study identified one significant marker-trait association on chromosome 3 for tebuconazole resistance, whereas six significant marker-trait associations, one on chromosome 1, three on chromosome 2, and two on chromosome 4, were detected for prothioconazole resistance. Functional annotation of the marker-trait association for tebuconazole revealed a candidate gene encoding a basic helix-loop-helix domain-containing protein that reinforces sterol in the fungal membrane. Putative genes for prothioconazole resistance were also identified, which are involved in RNA interference, the detoxification by ubiquitin-proteasome pathway, and membrane integrity reinforcement. Considering the potential of the pathogen toward overcoming chemical control, continued monitoring of fungal sensitivities to commercially applied fungicides, especially those containing prothioconazole, is warranted to reduce risks of fungicide resistance in the pathogen populations.
Identification of an Isolate of Citrus Tristeza Virus by Nanopore Sequencing in Korea and Development of a CRISPR/Cas12a-Based Assay for Rapid Visual Detection of the Virus
Authors: Kim Hae-Jun , Cho In-Sook , Choi Se-Ryung , Jeong Rae-Dong
Published: December 2023

Citrus tristeza virus (CTV) is a highly destructive viral pathogen posing a significant threat to citrus crops worldwide. Disease management and crop protection strategies necessitate the development of rapid and accurate detection methods. In this study, we employed Oxford Nanopore sequencing to detect CTV in Citrus unshiu samples. Subsequently, we developed a specific and sensitive detection assay combining CRISPR/Cas12a with reverse transcription-recombinase polymerase amplification. The CRISPR-Cas12a assay exhibited exceptional specificity for CTV, surpassing conventional RT-PCR by at least 10-fold in sensitivity. Remarkably, the developed assay detected CTV in field samples, with zero false negatives. This diagnostic approach is user-friendly, cost-effective, and offers tremendous potential for rapid onsite detection of CTV. Therefore, the CRISPR-Cas12a assay plays a significant role in managing and preserving citrus trees that are free from viruses in the industry.
Primary Screw Fixation of the Medial Malleolus in Highly Unstable Ankle Fracture-dislocations as an Alternative to Temporary Ankle-spanning External Fixation
Authors: Zimmermann Julian B. F. , Leucht Anna-Kathrin , Meier Christoph
Published: December 2023

Closed reduction combined with temporary ankle-spanning external fixation is the gold standard if immediate open reduction and internal fixation is not feasible or closed reduction may not be maintained in highly unstable fracture-dislocations of the ankle. Although external fixation is a quick and technically simple procedure, considerable operation-related complications have been reported in the literature. As an alternative, primary reduction and screw fixation of the medial malleolus may provide sufficient stability to maintain adequate reduction of the ankle joint. With this approach, potential problems of external fixation may be avoided, and the operating time of definitive open reduction and internal fixation is shortened.

Level of Evidence: Level V.
Leveraging External Validation Data: The Challenges of Transporting Measurement Error Parameters
Authors: Ross Rachael K. , Cole Stephen R. , Edwards Jessie K. , Zivich Paul N. , Westreich Daniel , Daniels Julie L. , Price Joan T. , Stringer Jeffrey S. A.
Published: December 2023

Approaches to address measurement error frequently rely on validation data to estimate measurement error parameters (e.g., sensitivity and specificity). Acquisition of validation data can be costly, thus secondary use of existing data for validation is attractive. To use these external validation data, however, we may need to address systematic differences between these data and the main study sample. Here, we derive estimators of the risk and the risk difference that leverage external validation data to account for outcome misclassification. If misclassification is differential with respect to covariates that themselves are differentially distributed in the validation and study samples, the misclassification parameters are not immediately transportable. We introduce two ways to account for such covariates: (1) standardize by these covariates or (2) iteratively model the outcome. If conditioning on a covariate for transporting the misclassification parameters induces bias of the causal effect (e.g., M-bias), the former but not the latter approach is biased. We provide proof of identification, describe estimation using parametric models, and assess performance in simulations. We also illustrate implementation to estimate the risk of preterm birth and the effect of maternal HIV infection on preterm birth. Measurement error should not be ignored and it can be addressed using external validation data via transportability methods.
Salt restriction for treatment of hypertension – current state and future directions
Authors: Nolan Philip , McEvoy John W.
Published: December 2023

Purpose of review

Given the adverse effects of excess dietary sodium chloride (also known as table salt) on blood pressure (BP) and cardiovascular disease (CVD), restriction of dietary sodium is recommended by numerous guidelines. The strictest of these recommend no more than 1.5 g/day of dietary sodium among hypertensive persons. However, average dietary sodium intake in the population is closer to 5 g/day and there is debate about whether too much sodium restriction may be associated with increased CVD risk. Herein, we aim to provide a balanced update on this topic.

Recent findings

In 2021, the Salt Substitute and Stroke Study (SSaSS) demonstrated a significant reduction in BP, CVD, and death among Chinese adults randomized to a low sodium salt-substitute supplemented with potassium. This trial largely puts to rest any remaining debate about the benefits of dietary sodium restriction among persons with excess baseline intake (dietary sodium intake fell from approximately 5 down to 4 g/day in the active arm of SSaSS). However, whether achieving and maintaining a dietary sodium of less than1.5 g/day is feasible in real-world settings and whether this low an intake is harmful remain open questions.

Aiming for sodium intakes of 2--3 g/day in the general population and as low as 2 g/day in persons with hypertension or CVD seems most reasonable, but there is some uncertainty around lower targets.
Advances in hydrogel materials applied to pancreatic-related diseases
Authors: Zhou Yuan , Pan Maoen , Lin Ronggui , Huang Heguang
Published: December 2023

The pancreas is a glandular organ that maintains internal homeostasis through its endocrine and exocrine functions. These functions are vital for overall well-being. However, environmental and lifestyle changes have led to an increasing incidence of pancreatic diseases, including pancreatic cancer, pancreatitis, and pancreatic neuroendocrine tumors. These conditions profoundly impact the health and quality of life of affected individuals. The existing diagnostic and treatment approaches for pancreatic diseases exhibit limitations and shortcomings, necessitating exploring novel strategies. In recent years, advancements in medicine and bioengineering have fostered multidisciplinary and interdisciplinary innovations, introducing fresh avenues for diagnosing and treating pancreatic diseases. Hydrogels, emerging as a biomaterial, represent highly hydrated cross-linked hydrophilic polymer networks. Their exceptional biodegradability and biocompatibility have rendered them instrumental in various medical applications. Hydrogels, with their macromolecular porous structures, are efficient carriers for drug delivery and controlled release. Hydrogel materials have garnered substantial attention for their unique properties and diverse applications in the context of pancreatic diseases. This article aims to provide an overview of the current limitations in diagnosing and treating pancreatic diseases while highlighting the latest trends and advancements in developing hydrogel carrier materials tailored for these conditions, primarily focusing on strategies for pancreatitis, pancreatic cancer, and pancreatic neuroendocrine tumors. The article endeavors to give researchers and clinicians a comprehensive grasp of this field, offering valuable insights into prospective research directions and emerging trends.
Prognostic value of para-aortic lymph node metastasis and dissection for pancreatic head ductal adenocarcinoma: a retrospective cohort study
Authors: Xu Yecheng , Yang Feng , Fu Deliang
Published: December 2023

Background:

Para-aortic lymph node (PALN) metastasis affects approximately 20% of patients with pancreatic ductal adenocarcinoma (PDAC). However, the prognostic significance of PALN metastases and dissection remains unclear.

Methods:

This retrospective cohort study included patients with PDAC of the pancreatic head who had undergone pancreaticoduodenectomy (PD) at our center between January 2017 and December 2020.

Results:

A total of 234 patients were included in the study. PALN dissection improved the median overall survival (OS) without statistical significance (24.1 vs 18.1 months, P = .156). The median recurrence-free survival was significantly longer in the PALN-dissection group than the group without PALN dissection (18.2 vs 11.6 months, P = .040). Conversely, there were no significant differences in the long-term prognosis between the PALN-positive and PALN-negative subgroups in the PALN-dissection group. Multivariate analysis showed that PALN metastasis was not an independent risk factor for OS (hazard ratio: 0.831, 95% confidence interval: 0.538–1.285, P = .406).

Conclusions:

For patients with pancreatic head ductal adenocarcinoma, PD with PALN dissection may achieve survival prolongation and bridge the survival gap between patients with and without PALN metastasis without significantly increasing the perioperative risks.
Diagnosis and management of acute lower gastrointestinal bleeding
Authors: Elimeleh Yotam , Gralnek Ian M.
Published: December 2023

Purpose of review

We review and summarize the most recent literature, including evidence-based guidelines, on the evaluation and management of acute lower gastrointestinal bleeding (LGIB).

Recent findings

LGIB primarily presents in the elderly, often on the background of comorbidities, and constitutes a significant healthcare and economic burden worldwide. Therefore, acute LGIB requires rapid evaluation, informed decision-making, and evidence-based management decisions. LGIB management involves withholding and possibly reversing precipitating medications and concurrently addressing risk factors, with definitive diagnosis and therapy for the source of bleeding usually performed by endoscopic or radiological means. Recent advancements in LGIB diagnosis and management, including risk stratification tools and novel endoscopic therapeutic techniques have improved LGIB management and patient outcomes. In recent years, the various society guidelines on acute lower gastrointestinal bleeding have been revised and updated accordingly.

By integrating the most recently published high-quality clinical studies and society guidelines, we provide clinicians with an up-to-date and comprehensive overview on acute LGIB diagnosis and management.
Neonatal sepsis and its predictors in Ethiopia: umbrella reviews of a systematic review and meta-analysis, 2023
Authors: Eyeberu Addis , Musa Ibsa , Debella Adera
Published: December 2023

Background:

Although neonatal sepsis is acknowledged as the primary cause of newborn death in Ethiopia, data on its impact at the national level are limited. Strong supporting data are required to demonstrate how this affects neonatal health. This umbrella study was conducted to determine the overall prevalence of newborn sepsis and its relationship with maternal and neonatal factors.

Methods:

This umbrella review included five articles from various databases. The AMSTAR-2 method was used to assess the quality of included systematic review and meta-analysis studies. STATA Version 18 software was used for statistical analysis. A random-effects model was used to estimate the overall effects.

Results:

In this umbrella review, 9032 neonates with an outcome of interest were included. The overall pooled prevalence of neonatal sepsis was 45% (95% CI: 39–51%; I2=99.34). The overall pooled effect size showed that prematurity was significantly associated with neonatal sepsis [odds ratio=3.11 (95% CI: 2.22–3.99)]. Furthermore, maternal factors are strongly associated with neonatal sepsis.

Conclusions:

Nearly half of Ethiopian neonates are affected by neonatal sepsis. It is critical to reduce premature birth, low birth weight, and preterm membrane rupture to reduce the incidence of neonatal sepsis. Furthermore, it is preferable to design and strengthen policies and programs aimed at improving maternal nutritional status and treating maternal infections, which all contribute to lowering the burden of neonatal sepsis.
Academic Leadership for Advancing Diversity, Equity, and Inclusion
Authors: Bowen Felesia , Harper Doreen C. , gossom joyce gillie , Sample Nevette S. , Shirey Maria R.
Published: December 2023

Academic nursing prepares nurses for the future to deliver, improve, and innovate health care. Moving forward on this imperative requires nurse leaders to support diversity, equity, and inclusion efforts thus partnering with individuals, families, communities, and other sectors to advance health equity, reduce health disparities, and improve care. The purpose of this article is to describe the creation, launch, and evaluation of an Office of Diversity, Equity, and Inclusion (DEI) in an academic nursing institution. Lessons learned are shared to assist others in their own journey to establish a DEI structure within an academic setting, especially one with a robust academic-practice partnership. The ideas shared are easily transferable to nonacademic settings.
Rapid Immunohistochemistry Based on Ultrasonic Thermal Steam Heating for Improvement of Intraoperative Diagnosis
Authors: Yu Guangyin , Tao Lili , Liao Mengying , Huang ChuQiang , Chen Cuimin , Yin Xiaomin
Published: December 2023

Objectives:

To evaluate the role of rapid immunohistochemistry (RIHC) based on ultrasonic thermal steam heating in improving diagnostic accuracy of intraoperative frozen section diagnosis and to recommend RIHC antibody panels for pathologic differential diagnosis.

Materials and Methods:

RIHC based on ultrasonic thermal steam heating was tested for intraoperative frozen diagnosis with difficulty in diagnosis, and all slides were reviewed and compared with the final diagnosis. Ninety-three cases of surgical specimens involving RIHC examination were studied. Discordance rates with paraffin immunohistochemistry were calculated.

Results:

In 93 cases where RIHC was performed, 85 cases (91%) were proven to be helpful for the diagnosis. A total of 58 antibodies were used for RIHC 276 times, of which 19 antibodies were not effective 25 times. Fifteen RIHC antibody panels are recommended based on staining stability and utilization frequency.

Conclusion:

After improving the staining method, ultrasonic thermal steam heating RIHC is practical, convenient, and cost-effective, making it suitable for use in any pathology department with routine immunohistochemistry reagents. It plays an important auxiliary role in improving the accuracy of intraoperative rapid pathologic diagnosis.
Clinical Efficacy, Safety, and Complications of the Arthroscopic Cartilage Shaving Procedure for Secondary Osmidrosis Treatment
Authors: Chang Juo-Mei , Hsiao Yen-Chang
Published: December 2023

Background

Axillary osmidrosis is a common disease with negative psychosocial impact on patients. Further, many treatment modalities are not sufficient and result in recurrence.

Objective

We aimed to evaluate the effectiveness and safety of using a cartilage shaver in patients with recurrent osmidrosis to remove tightly attached apocrine glands and subdermal scars.

Methods

We retrospectively evaluated 24 patients with secondary axillary osmidrosis who underwent cartilage shaving surgery between January 2013 and May 2022. We analyzed the incidence of complications, including seroma, infection, pigmentation, wound dehiscence, skin necrosis, scarring, shoulder movement limitation, comedones/sebaceous cysts, and nerve injury. Clinical effectiveness was also evaluated.

Results

Excellent or good efficacy with improved malodor was achieved in 24 patients (47 axillae [100%]). Complications were observed in 16 (36.17%) axillae, including hematomas (n = 2), pigmentation (n = 7), skin necrosis (n = 3), and comedones/sebaceous cysts (n = 4); one patient (2.13%) required local debridement. Mean Vancouver Scar Scale scores were markedly low (5.41 to 4.67). Scar tissue did not interfere with the shaving surgery, allowing for successful removal of the apocrine glands.

Conclusions

Secondary osmidrosis treatment using a cartilage shaver system yielded satisfactory and better scar results than the patients' previous treatments.
Genetic ancestry-specific Molecular and Survival Differences in Admixed Breast Cancer Patients
Authors: Telonis Aristeidis G. , Rodriguez Daniel A. , Spanheimer Philip M. , Figueroa Maria E. , Goel Neha
Published: December 2023

Objective:

We aim to determine whether incremental changes in genetic ancestry percentages influence molecular and clinical outcome characteristics of breast cancer in an admixed population.

Summary Background Data:

Breast cancer patients are predominantly characterized as “Black” or “White” based on self-identified race/ethnicity or arbitrary genetic ancestry cutoffs. This limits scientific discovery in populations that are admixed or of mixed race/ethnicity as they cannot be classified based on historical race/ethnicity boxes or genetic ancestry cutoffs.

Methods:

We used the TCGA cohort and focused on genetically admixed patients that had less than 90% European, African, Asian, or Native American ancestry.

Results:

Genetically admixed breast cancer patients exhibited improved 10-year overall survival relative to those with>90% European ancestry. Within the luminal A subtype, patients with lower African ancestry had longer 10-year overall survival compared to those with higher African ancestry. Correlation of genetic ancestry with gene expression and DNA methylation in the admixed cohort revealed novel ancestry-specific intrinsic PAM50 subtype patterns. In luminal A tumors, genetic ancestry was correlated with both the expression and methylation of signaling genes, while in basal-like tumors, genetic ancestry was correlated with stemness genes. In addition, we took a machine-learning approach to estimate genetic ancestry from gene expression or DNA methylation, and were able to accurately calculate ancestry values from a reduced set of 10 genes or 50 methylation sites that were specific for each molecular subtype.

Conclusions:

Our results suggest that incremental changes in genetic ancestry percentages result in ancestry-specific molecular differences even between well-established PAM50 subtypes which may influence disparities in breast cancer survival outcomes. Accounting for incremental changes in ancestry will be important in future research, prognostication, and risk-stratification, particularly in ancestrally diverse populations.
Innate Allorecognition in Transplantation: Ancient Mechanisms With Modern Impact
Authors: Gui Zeping , Al Moussawy Mouhamad , Sanders Steven M. , Abou-Daya Khodor I.
Published: December 2023

Through the effective targeting of the adaptive immune system, solid organ transplantation became a life-saving therapy for organ failure. However, beyond 1 y of transplantation, there is little improvement in transplant outcomes. The adaptive immune response requires the activation of the innate immune system. There are no modalities for the specific targeting of the innate immune system involvement in transplant rejection. However, the recent discovery of innate allorecognition and innate immune memory presents novel targets in transplantation that will increase our understanding of organ rejection and might aid in improving transplant outcomes. In this review, we look at the latest developments in the study of innate allorecognition and innate immune memory in transplantation.
Surveillance Endoscopy in Pediatric Esophageal Atresia: Toward an Evidence-Based Algorithm
Authors: Yasuda Jessica L , Kamran Ali , Servin Rojas Maximiliano , Hayes Cameron , Staffa Steven J , Ngo Peter D , Chang Denis , Hamilton Thomas E , Demehri Farokh , Mohammed Somala , Zendejas Benjamin , Manfredi Michael A
Published: December 2023

BACKGROUND:

Individuals with esophageal atresia (EA) have lifelong increased risk for mucosal and structural pathology of the esophagus. The use of surveillance endoscopy to detect clinically meaningful pathology has been underexplored in pediatric EA. We hypothesized that surveillance endoscopy in pediatric EA has high clinical yield, even in the absence of symptoms.

STUDY DESIGN:

The medical records of all patients with EA who underwent at least 1 surveillance endoscopy between March 2004 and March 2023 at an international EA referral center were retrospectively reviewed. The primary outcomes were endoscopic identification of pathology leading to an escalation in medical, endoscopic, or surgical management. Logistic regression analysis examined predictors of actionable findings. Nelson-Aalen analysis estimated optimal endoscopic surveillance intervals.

RESULTS:

Five hundred forty-six children with EA underwent 1,473 surveillance endoscopies spanning 3,687 person-years of follow-up time. A total of 770 endoscopies (52.2%) in 394 unique patients (72.2%) had actionable pathology. Esophagitis leading to escalation of therapy was the most frequently encountered finding (484 endoscopies, 32.9%), with most esophagitis attributed to acid reflux. Barrett’s esophagus (intestinal metaplasia) was identified in 7 unique patients (1.3%) at a median age of 11.3 years. No dysplastic lesions were identified. Actionable findings leading to surgical intervention were found in 55 children (30 refractory reflux and 25 tracheoesophageal fistulas). Significant predictors of actionable pathology included increasing age, long gap atresia, and hiatal hernia. Symptoms were not predictive of actionable findings, except dysphagia, which was associated with stricture. Nelson-Aalen analysis predicted occurrence of an actionable finding every 5 years.

CONCLUSIONS:

Surveillance endoscopy uncovers high rates of actionable pathology even in asymptomatic children with EA. Based on the findings of the current study, a pediatric EA surveillance endoscopy algorithm is proposed.
Placental transfer dynamics and durability of maternal COVID-19 vaccine-induced antibodies in infants
Authors: Lopez Paola A. , Nziza Nadège , Chen Tina , Shook Lydia L. , Burns Madeleine D. , Demidkin Stepan , Jasset Olyvia , Akinwunmi Babatunde , Yonker Lael M. , Gray Kathryn J. , Elovitz Michal A. , Lauffenburger Douglas A. , Julg Boris D. , Edlow Andrea G.
Published: December 2023

Completion of a COVID-19 vaccination series during pregnancy effectively reduces COVID-19 hospitalization among infants less than 6 months of age. Elucidating the dynamics of transplacental transfer of maternal vaccine-induced antibodies, and their persistence in infants at 2, 6, 9 and 12 months, has implications for new vaccine development and timing of vaccine administration in pregnancy to optimize protection of the mother-infant dyad. We evaluated anti-COVID antibody IgG subclass, Fc-receptor binding profile, and activity against wild-type Spike and RBD, and five variants of concern (VOCs) in 153 serum samples from 100 unique infants. Maternal IgG1 and IgG3 responses persisted in 2- and 6-month infants to a greater extent than the other IgG subclasses, with highest persistence of antibodies that bind placental neonatal Fc-receptor as well as FcψR3A. Timing of maternal vaccination and fetal sex were drivers of antibody persistence in infants. Lowest persistence at 2 and 6 months was observed against the Omicron RBD-specific region. Maternal vaccine timing, placental Fc-receptor binding capabilities, antibody subclass, fetal sex, and VOC all impact the persistence of maternal vaccine-induced antibodies in infants up to 12 months.
Autonomous and policy-induced behavior change during the COVID-19 pandemic: Towards understanding and modeling the interplay of behavioral adaptation
Authors: Zozmann Heinrich , Schüler Lennart , Fu Xiaoming , Gawel Erik
Published: December 2023

Changes in human behaviors, such as reductions of physical contacts and the adoption of preventive measures, impact the transmission of infectious diseases considerably. Behavioral adaptations may be the result of individuals aiming to protect themselves or mere responses to public containment measures, or a combination of both. What drives autonomous and policy-induced adaptation, how they are related and change over time is insufficiently understood. Here, we develop a framework for more precise analysis of behavioral adaptation, focusing on confluence, interactions and time variance of autonomous and policy-induced adaptation. We carry out an empirical analysis of Germany during the fall of 2020 and beyond. Subsequently, we discuss how behavioral adaptation processes can be better represented in behavioral-epidemiological models. We find that our framework is useful to understand the interplay of autonomous and policy-induced adaptation as a “moving target”. Our empirical analysis suggests that mobility patterns in Germany changed significantly due to both autonomous and policy-induced adaption, with potentially weaker effects over time due to decreasing risk signals, diminishing risk perceptions and an erosion of trust in the government. We find that while a number of simulation and prediction models have made great efforts to represent behavioral adaptation, the interplay of autonomous and policy-induced adaption needs to be better understood to construct convincing counterfactual scenarios for policy analysis. The insights presented here are of interest to modelers and policy makers aiming to understand and account for behaviors during a pandemic response more accurately.
Seasonal fluctuations in the bone microstructure ofSciurus vulgaris fuscoaterhumeri: a case study using phenomics on µCT-scans
Authors: van Heteren AH , Luft AS , Toth M , Dewanckele J , Marsh M , De Beenhouwer J
Published: December 2023

Sciurus vulgarisLinnaeus, 1758, the red squirrel, is a small, mostly arboreally living rodent, spread across the Palearctic. It is mostly vegetarian, feeding on plants, fungi and seeds, and is less active in the winter months, but does not hibernate. In this lateral study, the humeri of the subspeciesSciurus vulgaris fuscoater, the Central European red squirrel, were analysed to uncover potential intraspecific variation between individuals found in different seasons.

The µCT-scans were obtained with a resolution of 26 microns. Five bone parameters were calculated and statistically evaluated with regards to seasonal variations: total volume, bone volume, endocortical surface, cortical thickness, and average trabecular thickness.

Bone volume, trabecular thickness and endocortical thickness correlate with bone size, whereas cortical thickness does not. Seasonal differences were observed between the warmer summer and autumn months versus the colder winter and spring months for all parameters. We, speculatively, relate the observed seasonal variation to nutrient intake, notably calcium. These results offer a deeper understanding of intraindividual variation in red squirrels, that may be useful in further ecological, taxonomic, and paleontological research.