bluuebunny/crossref_metadata_2025 huggingface dataset:
Improved spectrometry of semi-insulating GaAs detectors by chemically thinning detector thickness
Authors: Sagatova A. , Kovacova E. , Gregusova D. , Zatko B.
Published: February 2025

The spectrometric properties of a semiconductor detector depend on both, the base material quality and the electric collection field distribution. In the case of single pad semi-insulating (SI) bulk GaAs detectors with a circular electrode the electric field collecting the charge generated by the radiation is affected by electrode area, detector thickness and applied bias. Thinner and smaller detectors under higher bias obtain better spectrometric properties such as charge collection efficiency (CCE) and energy resolution (FWHM) due to a more intense electric collection field and fewer volume defects. However, the bulk SI GaAs substrate fabrication limits the lowest achievable wafer thickness to about 200 μm due to crystal fragility. We have developed the SI GaAs detectors of 60, 110, 155 and 200 μm thickness by wet chemical etching of 250 μm thick GaAs substrate. The samples were evaluated from point of view of electrical and spectrometric properties. The CCE and FWHM were evaluated with respect to detector thickness and applied bias. The highest achieved CCE increased with thinning detector material from 72% to 92%. The best energy resolution of about 80 keV for 5.5 MeV alpha particles was reached with the 60 μm thick detector.
Design of the movable collimator for background suppression for the CEPC
Authors: Zhang P. , Wang H. , Bai S. , Liu Y. , Qu H.
Published: February 2025

The Circular Electron Positron Collider (CEPC) is a proposed
electron-positron collider to be operated at unprecedented high
energy and luminosity. To reduce background noise from spent
particles, a movable collimator system has been devised. This study
presents a comprehensive design of the movable collimator for the
CEPC, addressing the challenges posed by its high energy and
luminosity. The interaction between synchrotron radiation,
background particles, and the collimator was thoroughly
investigated. Several aspects, including optimization of synchrotron
radiation load, thermodynamic design, and structural impedance of
the collimator, are considered. Additionally, the study examines the
impact of key geometric parameters on the collimator's performance,
providing valuable guidance for optimizing its performance with
different requirement.
Projected increases in tropical cyclone-induced U.S. electric power outage risk
Authors: Rice Julian R , Balaguru Karthik , Staid Andrea , Xu Wenwei , Judi David
Published: February 2025

While power outages caused by tropical cyclones (TCs) already pose a great threat to coastal communities, how—and why—these risks will change in a warming climate is poorly understood. To address this need, we develop a robust machine learning model to capture TC-induced power outage risk. When applied to 900 000 synthetic TCs downscaled from simulated historical and future climate conditions under a strong warming scenario, we find outage risk in the United States and Puerto Rico is expected to increase broadly by the end of the century, with some states seeing increases of 60% and higher. Further, we discover that rising rainfall rates will play an increasingly important role in TC-induced power outage risk as the climate changes, explaining more than 50% of the projected change in risk in some regions. These insights are important for guiding decision-makers in their future outage risk investment and mitigation plans.
Introduction and overview
Authors: Aidt Toke S , Franck Raphaël
Published: February 2025

This chapter introduces the new process-based approach to the study of democratisation which focuses on one reform and its components. It explains how this approach can help us understand the relevance of different theories of democratisation. It provides an overview of the book and explains how its structure relates to the reform process that culminated with the Great Reform Act of 1832.
From the Unreformed Parliament to the Great Reform Act
Authors: Aidt Toke S , Franck Raphaël
Published: February 2025

This chapter sets the stage for the constitutional drama that unfolded between November 1830 and June 1832 and resulted in the Great Reform Act of 1832. It surveys the main features of the Unreformed Parliament and brings its salient features to life with rich micro-political data. It also provides a step-by-step guide to the events between November 1830 and June 1832 that subsequent chapters will focus on, and it highlights five significant roadblocks that had to be overcome on the bill’s bumpy journey to the statute books. The chapter concludes with an evaluation of the economic and political consequences of the Great Reform Act.
Conclusion
Authors: Aidt Toke S , Franck Raphaël
Published: February 2025

This book emphasises the process aspect of democratic reform. Rather than treating a reform as one discrete event, it argues that much can be learned about the causes of democratisation by focusing on sub-events within the reform process. In the case of the Great Reform Act of 1832, this perspective shows that different causal forces played pivotal roles at different points in the Reform Bill’s journey through the Unreformed British Parliament. The book offers new insights into the root causes of democratisation and shows, through detailed econometric analysis of rich micro-political data, how theoretically relevant factors play a crucial role in particular instances and not in others.
Phenotypic clustering in tuberous sclerosis complex reveals four distinct disease trajectories
Authors: Dhawan Andrew , Kumar Harshita , Huang Honglian , Gupta Ajay
Published: February 2025

Tuberous sclerosis complex (TSC) is a phenotypically heterogeneous autosomal dominant epilepsy, neuropsychiatric, and tumoral predisposition disease, occurring due to germline variants in the TSC1 or TSC2 genes. Despite an improving understanding of the varied phenotypes TSC may present with, there remains an incomplete understanding of the disease trajectory and genotype-phenotype relationship in this disorder. We sought to examine whether an unbiased clustering approach could uncover subgroups of disease trajectories in TSC and enhance understanding of genotype-phenotype correlation.

In this observational, prospective, multicentre natural history cohort of patients with confirmed diagnosis of TSC (TSC Alliance Natural History Database), data collected from 2006 - 2022 was used to identify groups of co-occurring phenotypes. This was a multicentre study involving 18 TSC clinical network centres in the US. 947 individuals were included, all of whom had a clinical diagnosis of tuberous sclerosis complex. Each patient was required to have complete characterization of 29 phenotype features associated with TSC. The primary outcomes were consensus clusters of clinical features defining subgroups of patients with TSC and their association with genotype.

947 individuals (50% male) across the TSC Alliance Natural History Database were included in this study, and 29 clinical features were used to define clusters of phenotypes to define disease trajectories. Four reproducible and distinct disease subgroups were identified: angiomyolipoma-predominant TSC (cluster 1), TSC with infantile spasms (cluster 2), neuropsychiatric TSC (cluster 3), and a milder phenotype of TSC (cluster 4). Variants in the rho domain of hamartin and the TSC1 binding domain of tuberin preferentially associated with cluster 1, with increased likelihood of angiomyolipomas, dermatologic findings, and subependymal giant cell astrocytoma.

Four distinct disease subgroups exist in TSC and differentially associate with variant location, informing deep genotype-phenotype correlation in TSC with potential impact in personalizing disease surveillance, treatment, and clinical trial endpoint choice. Additional prospective data are needed to confirm these findings.
Marshall’s economics of work: a reassessment
Authors: Spencer David A
Published: February 2025

This article reassesses some key aspects of Alfred Marshall’s economics of work, showing their value, limitations and enduring relevance for modern economic enquiry. It establishes that, for Marshall, work mattered not just because of the income it gave to workers, but also because of the kind of lives that it enabled workers to lead. Based on a wide conception of work, Marshall supported the reform of work, including the reduction of working hours, in order to improve workers’ quality of life. The article argues that some of Marshall’s core ideas on work and work reform can offer help in rethinking how modern economics conceptualises work and how it approaches issues of progress in workers’ well-being.
Nested likelihood-ratio testing of the nonsynonymous:synonymous ratio suggests greater adaptation in the piRNA machinery of Drosophila melanogaster compared with Drosophila ananassae and Drosophila willistoni, two species with higher repeat content
Authors: Blumenstiel Justin P , Kingan Sarah B , Garrigan Daniel , Hill Tom , Vedanayagam Jeffrey
Published: February 2025

Numerous studies have revealed a signature of strong adaptive evolution in the piwi-interacting RNA (piRNA) machinery of Drosophila melanogaster, but the cause of this pattern is not understood. Several hypotheses have been proposed. One hypothesis is that transposable element (TE) families and the piRNA machinery are co-evolving under an evolutionary arms race, perhaps due to antagonism by TEs against the piRNA machinery. A related, though not co-evolutionary, hypothesis is that recurrent TE invasion drives the piRNA machinery to adapt to novel TE strategies. A third hypothesis is that ongoing fluctuation in TE abundance leads to adaptation in the piRNA machinery that must constantly adjust between sensitivity for detecting new elements and specificity to avoid the cost of off-target gene silencing. Rapid evolution of the piRNA machinery may also be driven independently of TEs, and instead from other functions such as the role of piRNAs in suppressing sex-chromosome meiotic drive. We sought to evaluate the impact of TE abundance on adaptive evolution of the piRNA machinery in D. melanogaster and 2 species with higher repeat content—Drosophila ananassae and Drosophila willistoni. This comparison was achieved by employing a likelihood-based hypothesis testing framework based on the McDonald–Kreitman test. We show that we can reject a faster rate of adaptive evolution in the piRNA machinery of these 2 species. We propose that the high rate of adaptation in D. melanogaster is either driven by a recent influx of TEs that have occurred during range expansion or selection on other functions of the piRNA machinery.
Analysis of Ga2 genome structure and activity reveals widespread distribution of functional alleles in modern maize germplasm
Authors: Moran Lauter Adrienne N , Holland James B , Scott M Paul
Published: February 2025

The Ga2 locus controls unilateral cross incompatibility in Zea species. Molecular characterization of this locus indicates that fully functional loci contain two components that function in male and female reproductive tissues, Ga2P and Ga2F respectively. Some Zea mays varieties have been reported to be capable of overcoming the Ga2 reproductive barrier including the widely used inbred line Mo17. Our objective was to better understand the structure, function and distribution of the Ga2 locus in Zea species. To do this, we first examined the ability to overcome the Ga2 reproductive barrier across a diverse sample of Zea mays inbred lines. The ability of Mo17 to overcome the Ga2 reproductive barrier was mapped to the Ga2 locus. We next examined the structure of the Ga2 locus. Like the Ga1 locus, the Ga2 locus in Zea mays sp. contains multiple repeated functional genes and pseudogenes encoding the Ga2P and Ga2F pectin methylesterase enzymes. The organization of these repeat units is similar in the three sweet corn lines examined, and all are capable of overcoming the reproductive barrier. The non-sweet corn lines have a variety of genome structures, but these structures do not correlate well with the ability to overcome the Ga2 reproductive barrier. Levels of transcripts derived from Ga2P and the ability to overcome the reproductive barrier in sweet corn are higher in sweet corn lines than the other lines tested. The role of Ga2P in Zea mays in the apparent absence of a functional female factor remains unclear and may be evidence for an additional role in reproductive tissues.
Humanized Saccharomyces cerevisiae provides a facile and effective tool to identify damaging human variants that cause exosomopathies
Authors: Ahammed Khondakar Sayef , Fasken Milo B , Corbett Anita H , van Hoof Ambro
Published: February 2025

The RNA exosome is an evolutionarily conserved, multiprotein complex that is the major RNase in 3’ processing and degradation of a wide range of RNAs in eukaryotes. Single amino acid changes in RNA exosome subunits cause rare genetic diseases collectively called exosomopathies. However, distinguishing disease-causing variants from non-pathogenic ones remains challenging, and the mechanism by which these variants cause disease is largely unknown. Previous studies have employed a budding yeast model of RNA exosome-linked diseases that relies on mutating the orthologous yeast genes. Here, we develop a humanized yeast model of exosomopathies that allows us to unambiguously assess damaging effects of the exact patient variant in budding yeast. Individual replacement of the yeast subunits with corresponding mammalian orthologs identified six out of nine non-catalytic core subunits of the budding yeast RNA exosome that can be replaced by a mammalian subunit, with three of the replacements supporting close to normal growth. Further analysis of the disease-associated variants utilizing the hybrid yeast/mammalian RNA exosome revealed functional defects caused by both previously characterized and uncharacterized variants of EXOSC2, EXOSC4, EXOSC7, and EXOSC9. Analysis of the protein levels of these variants indicates that a subset of the patient-derived variants causes reduced protein levels, while other variants are defective but are expressed as well as the reference allele, suggesting a more direct contribution of these residues to RNA exosome function. This humanized yeast model of exosomopathies provides a convenient and sensitive genetic tool to help distinguish damaging RNA exosome variants from benign variants. This disease model can be further exploited to uncover the underpinning mechanism of RNA exosome defects.
Tudor domain containing protein 5-like (Tdrd5l) identifies a novel germline body and regulates maternal RNAs during oogenesis in Drosophila
Authors: Pozmanter Caitlin , Benner Leif , Kelly Sydney E , Curnutte Harrison , Emilfork Laura , Van Doren Mark
Published: February 2025

Tudor domain-containing proteins are conserved across the animal kingdom for their function in germline development and fertility. Previously, we demonstrated that Tudor domain-containing protein 5-like (Tdrd5l) plays an important role in the germline where it promotes male identity. However, Tdrd5l is also expressed in both the ovary and testis during later stages of germline development, suggesting that it plays a role in germline differentiation in both sexes. We found that Tdrd5l localizes to a potentially novel germline body and plays a role in post-transcriptional gene regulation. Additionally, embryos laid by Tdrd5l-mutant females exhibited reduced viability and displayed dorsal appendage defects suggesting a failure of proper dorsal-ventral (D/V) patterning. As D/V patterning is dependent on gurken (grk), we examined Grk expression during oogenesis. We observed premature accumulation of Grk protein in nurse cells indicating that translation is no longer properly repressed during mRNA transport to the oocyte. We also observed increased nurse cell accumulation of the cytoplasmic polyadenylation element binding protein Oo18 RNA-Binding Protein (Orb or CPEB), a translational activator of grk. Decreasing orb function was able to partially rescue the Tdrd5l-mutant phenotype, and so defects in Orb are likely a primary cause of the defects in Tdrd5l mutants. Our data indicate that Tdrd5l is important for translational repression of maternal mRNAs such as orb, and possibly others, following their synthesis in the nurse cells and during their transport to the oocyte.
From data to artificial intelligence: evaluating the readiness of gastrointestinal endoscopy datasets
Authors: Elamin Sami , Johri Shreya , Rajpurkar Pranav , Geisler Enrik , Berzin Tyler M
Published: February 2025

The incorporation of artificial intelligence (AI) into gastrointestinal (GI) endoscopy represents a promising advancement in gastroenterology. With over 40 published randomized controlled trials and numerous ongoing clinical trials, gastroenterology leads other medical disciplines in AI research. Computer-aided detection algorithms for identifying colorectal polyps have achieved regulatory approval and are in routine clinical use, while other AI applications for GI endoscopy are in advanced development stages. Near-term opportunities include the potential for computer-aided diagnosis to replace conventional histopathology for diagnosing small colon polyps and increased AI automation in capsule endoscopy. Despite significant development in research settings, the generalizability and robustness of AI models in real clinical practice remain inconsistent. The GI field lags behind other medical disciplines in the breadth of novel AI algorithms, with only 13 out of 882 Food and Drug Administration (FDA)-approved AI models focussed on GI endoscopy as of June 2024. Additionally, existing GI endoscopy image databases are disproportionately focussed on colon polyps, lacking representation of the diversity of other endoscopic findings. High-quality datasets, encompassing a wide range of patient demographics, endoscopic equipment types, and disease states, are crucial for developing effective AI models for GI endoscopy. This article reviews the current state of GI endoscopy datasets, barriers to progress, including dataset size, data diversity, annotation quality, and ethical issues in data collection and usage, and future needs for advancing AI in GI endoscopy.
First report of the deer ked, Lipoptena cervi, and associated pathogens in southern Québec, Canada
Authors: Bouchard Catherine , Dumas Ariane , Dyer Elizabeth , Desrochers-Plourde Carol-Ann , Audet-Legault Raphaëlle , Hubert Marine , Aenishaenslin Cécile , Rocheleau Jean-Philippe , Leighton Patrick , Gasse Anaïs , Iranpour Mahmood , Smid Joel , Waitt Brooks , Savage Jade , Coatsworth Heather
Published: February 2025

Deer keds (Lipoptena cervi), an introduced European species, are expanding their geographic range in North America. We document their first recorded presence in Québec, Canada, map their distribution, and highlight the detection of pathogens of potential public health relevance. In the Estrie region of southern Québec, 47 deer keds (L. cervi) were collected from 14 (5.5%) of 254 harvested white-tailed deer (Odocoileus virginianus). Borrelia spp. and Anaplasma phagocytophilum were detected in the body of 1/44 and 8/44 L. cervi specimens, respectively. A statistically significant spatial cluster of white-tailed deer infested by L. cervi was found in southern Estrie using the Bernoulli-based spatial scan statistic.
Evaluating vector mosquito occurrence in residential rain barrels in central Illinois
Authors: Cloud Rebecca E , Mackay Andrew J , Sanchez Maeli C , Wangen Catherine E , Allan Brian F
Published: February 2025

Several species of vector mosquitoes (eg Culex pipiens (Linnaeus, 1758), Aedes albopictus (Skuse, 1895)) complete juvenile development in artificial containers. Rain barrels are green infrastructure tools used to conserve rainwater for outdoor use, though they may also serve as a source of mosquito habitat in residential neighborhoods. To identify rain barrel features, maintenance habits, and other conditions associated with the presence of juvenile mosquitoes (ie month), we conducted periodic inspections of rain barrels at 53 households in central Illinois, USA between June and September 2016. Additionally, we administered a questionnaire to the household study participants. In the first month of the study, a diversity of mosquito species was detected in household rain barrels, but from July to September juveniles of Ae. albopictus were predominant. More than half of inspected households contained at least one mosquito-positive rain barrel within the study period. Using stepwise model selection, the strongest predictors of whether or not mosquito juveniles were detected in rain barrels were the use of a preventative measure (eg Bti, chlorine, goldfish), the presence of a mesh covering on the lid of the barrel, and the month of the year. Additionally, the participant questionnaire revealed that the majority of respondents were aware of immediate elimination methods, but few were aware of the need for long-term preventative maintenance of rain barrels against larval mosquito colonization. These findings provide valuable insight into best practices for mosquito prevention in green infrastructure and highlight the importance of proper maintenance and education to minimize juvenile mosquito habitat.
Surgical management of bilateral axillary severe hidradenitis suppurativa with thoracodorsal artery perforator V-Y advancement flaps: a case report
Authors: Le Phuc H , Tran Tien N , Phung Nguyen , Le Nhan N T
Published: February 2025

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder caused by follicular occlusion and rupture, leading to recurrent abscesses and dermal destruction. Severe cases, classified as Hurley Stage III, often require surgical intervention. This report presents a 27-year-old male with bilateral axillary Stage III HS persisting for 2 years. Despite a 10-week Adalimumab regimen, recurrent lesions necessitated surgical excision with bilateral thoracodorsal artery perforator (TDAP) V-Y advancement flaps. The patient exhibited successful wound healing and cicatrization and preserved functionality postoperatively. TDAP flaps present several advantages over skin grafts, including reliable vascularity, minimal donor site morbidity, and improved aesthetic results. This case demonstrates the effectiveness of TDAP V-Y advancement flaps in reconstructing axillary defects, significantly reducing the risk of recurrence. The patient’s positive recovery and absence of procedure-related complications show that TDAP V-Y advancement flaps offer a superior, functional, and aesthetically pleasing option for managing severe HS.
Meningitis due to inflammatory reaction to Echinococcus antigen after the resection of cerebral alveolar hydatid cyst
Authors: Yoshida Taishin , Yamamoto Shota , Yuzawa Sayaka , Takano Takuma , Sanada Takahiro , Saito Masato , Tanino Mishie , Kinoshita Manabu
Published: February 2025

Meningitis after resection of a cerebral alveolar hydatid cyst (CAHC) is rare. Although several etiologies are proposed for meningitis, including recurrence or inflammatory reaction to dead echinococcal antigens, the effectiveness of treatment strategies specifically targeting the inflammatory reaction has not been reported. A 72-year-old patient presented with a brain cyst suggestive of CAHC. The cyst ruptured during resection, which was immediately replaced with 95% ethanol to obliterate the viable larvae, followed by cyst removal. One-month post-surgery, the patient showed signs of meningitis suggestive of a recurrence of cerebral hydatidosis. However, the negative sign of the recurrence on the brain and whole spine MRI suggested an inflammatory reaction to the obliterated Echinococcus antigen. An increased dose of prednisone resulted in the patient’s complete recovery without recurrence for 1.8 years. Adding steroids to the anthelmintic maintenance treatment could be reasonable if the inflammatory reaction is more likely to be the cause.
Small bowel obstruction unmasking an internal hernia through a broad ligament defect: a case report
Authors: Slimi Youness , Frikal Mohammed , Mahmoudi Mohammed , Haddar Karim , Boukabous Houssam , Guellil Abdelali , Jabi Rachid , Skiker Imane , Bouziane Mohammed
Published: February 2025

Internal hernias are rare occurrences in which abdominal organs protrude through a mesenteric defect. Among these, herniation through the broad ligament is an especially uncommon type, comprising only 4% of all internal hernias. This condition can present with a wide spectrum of symptoms, ranging from abdominal pain to acute small bowel obstruction. Diagnosis is often difficult due to nonspecific clinical and radiological signs, making the condition a challenge to detect preoperatively. We present the case of a 30-year-old woman who developed an acute small bowel obstruction, identified through a CT scan. Surgical exploration revealed an incarcerated internal hernia passing through a defect in the broad ligament. After releasing the incarcerated bowel and closing the hernial orifice, the patient made a full recovery. This case provides additional insight into broad ligament hernias and the surgical approach to this rare condition.
Potential unrecognized redox-active atypical thioredoxins in eukaryote photosynthetic organisms
Authors: de Bont Linda , Donnay Natacha , Favier Frédérique , Couturier Jérémy , Didierjean Claude , Rouhier Nicolas
Published: February 2025

Photosynthetic organisms have a high diversity of proteins belonging to the thioredoxin (TRX) superfamily. It comprises more than 150 proteins distributed in different families and classes, including in particular thioredoxins, glutaredoxins, protein disulfide isomerases, thiol peroxidases or glutathione transferases, which share the thioredoxin structural fold. Many of them have one or two redox-active cysteines and a characteristic cis-proline at specific positions, but also additional domains or secondary structures at either end or inserted into the protein core. With the aim of further describing the TRX family in plants, we identified a set of 17 atypical TRX-like proteins from Arabidopsis thaliana, which have not been considered before despite having both a TRX fold and the CxxC/S signature typical of redox-active TRX. The in silico sequence and structure analyses revealed that they are distributed in eight distinct classes with unique active site signatures and structures, some with DsbA and peroxiredoxin-like folds. The distinct subcellular localizations (plastids, mitochondria, extracellular space) and gene expression profiles suggest that these proteins are involved in diverse cellular processes, further expanding the set of proteins involved in redox regulation and/or stress adaptation. These results further reveal the diversity in structure and function of atypical TRXs in plants.
Postural Sway Measurement Using a Body-Worn Movement Sensor in Clinical Stroke Rehabilitation: Exploring Sensitivity to Change and Responsiveness
Authors: Geerars Marieke , Wouda Natasja C , Felius Richard A W , Visser-Meily Johanna M A , Pisters Martijn F , Punt Michiel
Published: February 2025

Importance

During rehabilitation, stroke survivor’s balance is commonly monitored using the Berg Balance Scale (BBS) and Mini-BESTest. These tests evaluate the ability to maintain balance in an upright position while performing tasks. Currently, clinical practice lacks an adequate assessment of balance impairments like the increased postural sway post-stroke. Integrating postural sway measurement with a body-worn Inertial Measurement Unit (IMU) could offer clinicians an objective, and rapid measurement method.

Objective

Sensitivity to change and responsiveness of postural sway measurement during stroke rehabilitation were explored.

Design

A longitudinal study was conducted.

Setting

Data were collected in five rehabilitation centers.

Participants

Ninety-four stroke survivors were included in the study.

Intervention

Sensitivity to change was evaluated by comparing the percentages of participants who exceeded the Minimal Detectable Change (MDC) for both the conventional and IMU tests. Responsiveness was assessed through hypotheses testing, utilizing both a criterion approach (external criterion: a 5-point retrospective Global Rating of Change score) and a construct approach.

Results

At discharge, only 3.2% to 23.9% of the participants showed genuine improvement (ie, had a lower postural sway) on the IMU test, compared to 33% to 60% on the conventional tests. In total, 67.4% of the hypotheses were rejected.

Conclusions

The sensitivity to change and responsiveness of postural sway measurement in stroke survivors are limited. Restoring balance to achieve functional independence is not necessarily dependent on, or associated with, the level of postural sway. At present, integrating postural sway measurement into clinical stroke rehabilitation seems to provide no added value for monitoring balance.

Relevance

A novel approach to balance assessment in clinical stroke rehabilitation was investigated. It was found that while most participants improved in terms of functionality and independence, only a small percentage exhibited a significant change in postural sway. Therefore, postural sway may not effectively serve as an indicator of improved movement quality. This insight is crucial for both researchers and clinicians involved in neurorehabilitation.
Bacterial Leaf Spot of Hydrangea: On a “New Old” Disease and the Importance of Diagnostics Specificity to Reduce Cross-Reactivity and Improve Surveillance
Authors: Dia Nay C. , Cottyn Bart , Aspin Andrew , Studer Bruno , Smits Theo H. M. , Pothier Joël F.
Published: February 2025

The causal organism of bacterial leaf spot of Hydrangea L., Xanthomonas hydrangeae, was the subject of a disease report and a new bacterial species description in 2021. These publications, along with the development of a specific isothermal diagnostic assay for X. hydrangeae, and the recent awareness of this pathogenic bacterium, combined with the wet weather conditions during the summer of 2021 in Europe, have revealed a broader historical and current prevalence of this disease. Global trade of plants appeared to play an important role in the dissemination of this pathogen. Furthermore, scouring the literature revealed multiple instances, mainly in the USA, of bacterial leaf spot of Hydrangea, previously attributed to other Xanthomonas species (e.g., Xanthomonas campestris, Xanthomonas hortorum). The first known indication of bacterial leaf spot of Hydrangea dates to 1995 in Georgia (USA). However, these 1995 isolates are no longer available and their identity as X. hydrangeae cannot be confirmed. This mini-review outlines the challenges encountered when studying X. hydrangeae, as related to 1) the development of a diagnostics assay targeting X. hydrangeae, especially given its phylogenetic similarity to X. hortorum, and 2) the information discontinuity regarding historical and current incidence of bacterial leaf spot of Hydrangea.
The top 50 most cited articles in carpometacarpal arthritis: A bibliometric analysis
Authors: Zieminski Colin , Pottanat Paul , Allen J. Ryan , Daly Charles
Published: February 2025

Background:

Carpometacarpal (CMC) arthritis is common and can be debilitating and disabling for patients. While a common pathology, treatment may vary. Understanding the current literature and evidence regarding therapy is paramount. This study analyzed the most prolific studies, authors, and journals regarding CMC arthritis. We predict they will be in hand journals from academic institutions in the U.S. by fellowshiptrained hand surgeons.

Methods:

The Elsevier Scopus database was queried for articles related to carpometacarpal arthritis. Search results were filtered by citations. The top 50 articles were reviewed, and multiple data points were collected. Citation density and h-index were identified for the articles and high producing authors.

Results:

The search yielded 1,288 articles from 1920-2024. The articles ranged from years 1968 to 2017. These papers were cited 6,608 times, ranging from 69 to 706 and averaged 132 citations. The average citation density was 5.3. The most prolific institution was Columbia University (n=6). Authors with the most publications were R.G Eaton (n=8), R.I Burton (n=5) and V.D Pellegrini (n=5). The U.S. produced the most articles (n=36). The Journal of Hand Surgery published the most articles with 20. The most common level of evidence was IV and case series was the most used type of study.

Conclusion:

Highly cited papers on carpometacarpal arthritis were most likely case series produced in the United States from a few institutions that evaluated postoperative outcomes of surgical techniques. The list provides a group of highly impactful papers that can be included in a curriculum for surgical trainees.
Society of Critical Care Medicine 2024 Guidelines on Adult ICU Design
Authors: Hamilton D. Kirk , Gary Jodie C. , Scruth Elizabeth , Anderson Harry L. , Cadenhead Charles D. , Oczkowski Simon J. , Lau Vincent I. , Adler Jason , Bassily-Marcus Adel , Bassin Benjamin S. , Boyd Joel , Busl Katharina M. , Crabb James R. , Harvey Clifford , Hecht Jason P. , Herweijer Milee , Gunnerson Kyle J. , Ibrahim Abdullahi S. , Jabaley Craig S. , Kaplan Lewis J. , Monchar Sarah , Moody Andrew , Read Julie Lindeman , Renne B. Christian , Sarosi Michael G. , Swoboda Sandra M. , Thompson-Brazill Kelly A. , Wells Chris L. , Anderson Diana C.
Published: February 2025

Rationale:

Advances in technology, infection control challenges—as with the COVID-19 pandemic—and evolutions in patient- and family-centered care highlight ideal aspects of ICU design and opportunities for enhancement.

Objectives:

To provide evidence-based recommendations for clinicians, administrators, and healthcare architects to optimize design strategies in new or renovation projects.

Panel Design:

A guidelines panel of 27 members with experience in ICU design met virtually from the panel’s inception in 2019 to 2024. The panel represented clinical professionals, architects, engineers, and clinician methodologists with expertise in developing evidence-based clinical practice guidelines. A formal conflict of interest policy was followed throughout the guidelines-development process.

Methods:

Embase, Medline, CINAHL, Central, and Proquest were searched from database inception to September 2023. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to determine certainty in the evidence and to formulate recommendations, suggestions, and practice statements for each Population, Intervention, Control, and Outcomes (PICO) question based on quality of evidence and panel consensus. Recommendations were provided when evidence was actionable; suggestions, when evidence was equivocal; and practice statements when the benefits of the intervention appeared to outweigh the risks, but direct evidence to support the intervention did not exist.

Results:

The ICU Guidelines panel issued 17 recommendations based on 15 PICO questions relating to ICU architecture and design. The panel strongly recommends high-visibility ICU layouts, windows and natural lighting in all patient rooms to enhance sleep and recovery. The panel suggests integrated staff break/respite spaces, advanced infection prevention features, and flexible surge capacity. Because of insufficient evidence, the panel could not make a recommendation around in-room supplies, decentralized charting, and advanced heating, ventilation, and air conditioning systems.

Conclusions:

This ICU design guidelines is intended to provide expert guidance for clinicians, administrators, and healthcare architects considering erecting a new ICU or revising an existing structure.
The Definition of the Intensivist in the Era of Global Healthcare: 2024 Consensus Statement From the Society of Critical Care Medicine Defining Intensivist Task Force
Authors: Wu Daniel , Dzierba Amy L. , Ablordeppey Enyo A. , Dorman Todd , Du Bin , Dulu Alina O. , Gunnerson Kyle , Holly Pamela B. , Jansen van Rensburg Johannes , Kortz Teresa B. , Livesay Sarah L. , Lorenzo Javier , Madden Maureen A. , Mathur Piyush , Myatra Sheila Nainan , Roberts Kathryn E. , Rodríguez-Vega Gloria M. , Szakmany Tamas , Taha Ahmed , Tisherman Samuel A.
Published: February 2025

Objectives:

The goal of this task force was to examine the 1992 definition of the intensivist, identify gaps, and initiate a path forward to define a concise and practical definition that could be applied globally.

Design:

A modified Delphi technique was used to develop a revised definition and roles of the intensivist. We determined a priori that 75% or greater participant agreement for the definition and essential roles of the intensivist was required.

Setting:

A task force consisting of physicians, a respiratory therapist, advanced practice providers, and a pharmacist that practice in critical/intensive care medicine, in various settings, was established with the goal of evaluating and revising the previous definition considering evolving healthcare.

Subjects:

The task force participated in online questionnaires related to the definition and roles of the intensivist.

Interventions:

None.

Measurements and Main Results:

The task force agreed on the following definition of an intensivist: “A physician who has successfully completed an accredited program or equivalent critical care/intensive care medicine training and maintains advanced certification (if available); and shows dedication to the area of critical/intensive care medicine in the way of professional work.” Additionally, the task force determined a list of essential roles of the intensivist categorized into Direct Clinical Care, Unit Management/Unit Involvement, Responsibility to the Community, and Administration and Leadership.

Conclusions:

The revised definition of the intensivist seeks to integrate the intensivist in the current realm of team-based healthcare. The intensivist is a physician who provides care to critically ill patients in collaboration with an interprofessional team. Establishment of a single, revised definition is intended to render clarity of an intensivist’s role and responsibilities for patients, families, and the interprofessional team.
The burden of prostate cancer and metastatic prostate cancer in Italy in 2024
Authors: Crocetti Emanuele , Ravaioli Alessandra , Falcini Fabio , Vattiato Rosa , Mancini Silvia , Baldacchini Flavia , Zamagni Federica , Vitali Benedetta , Balducci Chiara , Bucchi Lauro , Giuliani Orietta
Published: February 2025

Objective

The epidemiologic scenario of prostate cancer (PC) is changing rapidly. The present study updates to 2024 the estimates of PC in Italy, including incident and prevalent cases, deaths, and metastatic PC (mPC), which is further subdivided into de novo mPC (metastasis detected at diagnosis) and recurrent mPC (metachronous metastasis).

Methods

The study was based on updated data from the Italian Network of Cancer Registries and the National Institute of Statistics and the age-specific short-term PC projections made available by the International Agency for Cancer Research. For mPC, we applied the age-specific ratios between deaths and estimated de novo and recurrent mPCs for the USA to the Italian age-specific deaths.

Results

In Italy, in 2024, we expect 8400 PC deaths, approximately 39 000 new diagnoses, 4900 of whom are diagnoses of mPC, and almost 670 000 prevalent cases, about 36 000 of whom are mPCs.

Conclusion

These estimates provide updated and realistic information to policy makers, clinicians, and the community to properly address the needs of patients with PC in Italy from diagnosis to end-of-life care.
Safety and Performance of RHA4 in the Midface Using the Multilayering Technique: Preclinical and Clinical Evidence
Authors: Flégeau Killian , Ballarini Stefania , Brusini Romain , Vantou Camille , Liao Zhifeng , Hirt-Burri Nathalie , Bourdon François , Tseng Fang-Wen , Faivre Jimmy
Published: February 2025

Background:

Resilient hyaluronic acid (RHA) fillers are used to treat dynamic wrinkles or provide tissue lifting in facial aesthetics. This study explored the biological, biomechanical, and clinical safety and performance of RHA4, a volumizing hyaluronic acid filler tailored for tissue support in dynamic facial areas, upon interaction with human subcutaneous adipose tissue (AT).

Methods:

RHA4 underwent cytocompatibility testing with human fibroblasts and adipose stem cells. A 1-year rat in vivo implantation study tracked tissue integration, local effects, and filler degradation. Biomechanical tests assessed RHA4’s impact on subcutaneous AT mechanics. Clinical outcomes, safety, injection volumes, and techniques were evaluated in 35 patients, treated in midface deep and superficial fat compartments via a multilayering methodology. Dynamic outcomes and 2-year follow-up of RHA4 in the midface using multilayer treatments were described.

Results:

RHA4 demonstrated excellent biocompatibility and tissue integration both in vitro and in vivo, exhibiting minimal local inflammation and rapid collagen bundle formation within the filler. It integrated gradually over time and was well tolerated, allowing for increased extracellular matrix presence, neovascularization, denser collagen deposition, and AT growth. Ex vivo, RHA4 did not impede fat motion biomechanics but visibly lifted the tissue. Clinically, RHA4 proved safe and effective for lifting both deep and superficial fat compartments in the midface without affecting facial expressiveness.

Conclusions:

Preclinical and clinical evidence confirmed that RHA4 is a versatile filler capable of lifting tissue efficiently, whether deep or superficial, particularly through the multilayering treatment approach. Importantly, RHA4 preserves AT biomechanics, adapts to the dynamism of the face, and ensures natural-looking outcomes.
Emergency Department and Critical Care Use of Clevidipine for Treatment of Hypertension in Patients With Acute Stroke
Authors: Brehaut Scott S. , Roche Angelina M.
Published: February 2025

Background and Purpose:

Clevidipine is a parenteral dihydropyridine calcium channel blocker that received Food and Drug Administration approval in 2008 for the reduction of blood pressure (BP) when oral therapy is not feasible or not desirable. Soon after approval, our institution incorporated clevidipine into protocols for the management of hypertension among acute stroke patients, based on the drug’s rapid onset of action and straightforward titration to goal. A subsequent retrospective review of its use in otherwise alteplase-eligible ischemic stroke patients with BP greater than 185/110 mm Hg (n = 32, in 2014) revealed that clevidipine in that setting demonstrated the shortest median time to BP control, the shortest median door-to-alteplase administration time, and the lowest administered volume of any parenteral antihypertensive used. As a result, clinical protocols in our institution were modified to make clevidipine first-line antihypertensive in both ischemic and hemorrhagic acute stroke. In this study, we report our institution’s experience with clevidipine in acute stroke, comprising the largest such report to date.

Methods:

We conducted a retrospective chart review of all acute stroke patients who received clevidipine in the emergency department (ED) or intensive care unit (ICU) (n = 295) for the management of clinically significant hypertension between January 1, 2015, and December 31, 2017. Metrics analyzed included target (goal) BP for thrombolysis eligibility among patients intended for lytic therapy according to stroke management guidelines in effect at the time of care.

Results:

The median time for initial parenteral antihypertensive dose to goal (DTG) BP for all ischemic stroke patients (both those intended for and those not intended for lytic therapy) with complete data (n = 71 of 204) was 15 minutes; median time for door-to-IV-alteplase administration for ischemic stroke patients with complete data (n = 14 of 34 treated patients) was 59 minutes. The median time for initial parenteral antihypertensive DTG BP for all hemorrhagic stroke patients with complete data (n = 33 of 91 treated patients) was 39 minutes.

Conclusions:

We conclude that the salutary findings of the initial small study are valid across a larger patient sample of all acute stroke types. Based on these data, clevidipine is shown to be safe, consistent, and effective in the treatment of acute hypertension in ischemic and hemorrhagic stroke events, and is a reasonable first-line treatment option for acute hypertension in this setting.
Unveiling emerging threats: Langya and Mojiang—A dance with unfamiliar foes
Authors: Nayak Snehasis
Published: February 2025

Langya henipavirus (LayV) and Mojiang henipavirus (MojV) are emerging zoonotic pathogens that were first identified in China in 2018 and 2012 respectively, and are classified within the Henipavirus genus. This article presents an in-depth review of LayV and MojV, focusing on their structural properties, viral entrance, and consequences for human health. The pathogenic potential of these viruses is investigated in depth as well as the current diagnostic methods for identifying LayV and MojV. Furthermore, treatment methods for controlling LayV and MojV infections are assessed, with a particular emphasis on the critical need for tailored antiviral research. This review serves as a critical resource for researchers and healthcare professionals, offering an up-to-date synthesis of knowledge on LayV and MojV while underscoring their significance in public health.
Enhancing supportive medication patient education for oncology nurses
Authors: Prosdocimo Brittni
Published: February 2025

This article discusses a quality improvement project that developed and implemented supportive care medication cards to enhance patient education in outpatient oncology settings. Recognizing the challenges oncology nurses face in delivering effective education amidst the complexities of cancer treatment, the project evaluates the impact of these cards on patient understanding and adherence to prescribed therapies. Results from a trial period indicate significant improvements in both nurse workflow and patient comprehension, ultimately contributing to safer and more effective oncology care.
Breast cancer in males
Authors: Pullen Richard L.
Published: February 2025

Male breast cancer (BC) is a rare but clinically significant disease, accounting for approximately 1% of all BC diagnoses. This article examines the unique risk factors, including genetic mutations (such as BRCA2), hormonal influences, and social determinants of health that contribute to the incidence of BC in males. In addition, this article highlights the need for improved awareness, targeted screening, and tailored treatment strategies to address the distinct challenges faced by male patients with BC.