bluuebunny/crossref_metadata_2025 huggingface dataset:
A comprehensive analysis of the floral transition in ma bamboo (Dendrocalamus latiflorus) reveals the roles of DlFTs involved in flowering
Authors: Fan Huijin , Zhuo Renying , Wang Huiyuan , Xu Jing , Jin Kangming , Huang Biyun , Qiao Guirong
Published: April 2022

Bamboo has a unique flowering characteristics of long and unpredictable vegetative period, which differs from annual herbs and perennial woody plants. In order to understand the molecular regulatory mechanism of bamboo flowering, a comprehensive study was conducted in ma bamboo (Dendrocalamus latiflorus Munro), including morphological, physiological and transcriptiome analyses. Differentially expressed genes related to the flowering pathway were identified by comparative transcriptome analysis. DlFT1, a homologous gene of FT/Hd3a, was significantly upregulated in flowering bamboo. Direct differentiation of spikelets from calli occurred and the downstream gene AP1 was upregulated in the transgenic bamboo overexpressing DlFT1. Transgenic rice overexpressing DlFT1 showed a strong early flowering phenotype. DlFT1 and DlTFL1 could interact with DlFD, and DlTFL1 delayed flowering. It is presumed that DlTFL1 plays an antagonistic role with DlFT1 in ma bamboo. In addition, the expression of DlFT1 was regulated by DlCO1, indicating that a CO-FT regulatory module might exist in ma bamboo. These results suggest that DlFT1 is a florigen candidate gene with conservative function in promoting flowering. Interestingly, the results have shown for the first time that DlFT2 can specifically interact with E3 ubiquitin ligase WAV3, while DlFT3 transcripts are mainly nonsense splicing. These findings provide better understanding of the roles of the florigen gene in bamboo and lay a theoretical basis for regulating bamboo flowering in the future.
Disseminated Congenital Tuberculosis in Neonates: A Case Series
Authors: Mane Sushant , Chopade Rajratna , Patil Aishwarya , Charania Kaif , Ganapathi Deepa , Pustake Manas
Published: April 2022

Congenital tuberculosis (CTB) is an uncommon yet, well-defined condition. CTB has a non-specific clinical presentation, making the diagnosis difficult. The rarity of CTB in neonates is due to the difficulty in distinguishing between congenital and postnatally acquired infection, and non-specific symptoms in the newborn, which are often misdiagnosed. Though it has a low incidence, it has significant mortality if the diagnosis is delayed. We are presenting two cases of CTB in newborns who showed signs of disease in the first few days of life. The diagnosis was suspected based on chest computed tomography, magnetic resonance imaging brain, cerebrospinal fluid studies, intrauterine growth restriction, non-response to standard treatment and a maternal history of active tuberculosis. These cases highlight the significance of having a high suspicion of CTB and timely treatment for better outcomes.
Integrative taxonomy of eared nightjars (Aves:Lyncornis) underscores the complementarity of morphology, vocalizations and DNA evidence
Authors: Sangster George , King Ben F , Irestedt Martin , Ericson Per G P
Published: April 2022

The eared nightjars (Lyncornis, formerly Eurostopodus) comprise six taxa distributed from southern India and Southeast Asia to Sulawesi. Species limits in this group have not been evaluated since 1940. In this study, we use three datasets (morphology, acoustics and mitochondrial DNA) to assess the taxonomic status of taxa in this genus. Multivariate analyses of vocalizations and phylogenetic analysis of mitochondrial DNA both revealed the presence of four major groups. Morphological analyses also revealed four major groups, but these agreed only in part with those identified by vocalizations and DNA. Lyncornis macrotis cerviniceps from mainland Southeast Asia and the isolated Lyncornis macrotis jacobsoni on Simeulue Island, off north-west Sumatra, differed by six diagnostic plumage characters, but could not be distinguished by their vocalizations or mitochondrial DNA. Conversely, Lyncornis macrotis macrotis from the Philippines and Lyncornis macrotis macropterus from Sulawesi differed diagnosably in song and by 5% sequence divergence but could not be diagnosed by plumage. We adopt an integrative approach and propose to recognize five monotypic species: Lyncornis temminckii, Lyncornis cerviniceps (synonym: Lyncornis bourdilloni), Lyncornis jacobsoni, Lyncornis macrotis and Lyncornis macropterus. Our study illustrates that taxonomic revisions based on single lines of evidence can underestimate diversity and underscores the importance of using multiple datasets in species-level taxonomy.
Towards completing the crocodile newts’ puzzle with all-inclusive phylogeographic resources
Authors: Dufresnes Christophe , Hernandez Axel
Published: April 2022

Crocodile newts (Echinotriton and Tylototriton) are emblematic of the biodiversity of South-East Asia. In this study, we provide an account of their evolution, diversity and phylogeography based on mitochondrial (16.2 kb) and nuclear sequences (3.2 kb), combining barcoding data from nearly 1200 specimens collected over ~180 localities, representative of all lineages known to date. While phylogenies of nuclear data lacked resolution, the mitochondrial tree showed dynamic allopatric speciation that followed climate cooling during the last 10 million years, a pattern shared with many other tropical and subtropical amphibians. In crocodile newts, this implies weak dispersal and local adaptation as contributing factors of isolation, and was accompanied by macro- and micro-evolutionary changes in reproductive behaviours. Specifically, our resolved phylogeny of Tylototriton allowed the tracing of a major shift from conserved habits of terrestrial clutch-spawning towards more plastic strategies involving both aquatic and land spawning of single eggs. Using this framework, we then revised the taxonomy of crocodile newts by describing a new subgenus and two new species. Our study provides a basis to guide future phylogeographic, speciation and conservation research on these iconic amphibians.
Interdisciplinary and Innovative: A Nursing and Computer Science Collaboration to Create a Barcode Medication Administration System
Authors: Berndt Jodi , Ohmann Peter , Rahal Imad , Hoeschen Lindsey , Rothstein Andrew
Published: April 2022

Preventing medication errors remains a priority in nursing education. The implementation of Barcode Medication Administration (BCMA) systems is one strategy that has been used to reduce medication errors. Practice using BCMA in simulated settings may enhance the transfer of these skills to the clinical practice setting. However, the purchase of BCMA educational products available for nursing students can be cost prohibitive for many nursing programs. To overcome the barrier of cost, an interdisciplinary and innovative collaborative approach was used to create a fully functional low-cost BCMA system.
Improving Consistency in the Use of Sucrose With Comfort Measures During Minor Painful Procedures
Authors: Vykol Victoria , Wilson Janice , Goodwin Jana
Published: April 2022

Background:

Inconsistent pain management practices can have negative physiologic and neurodevelopmental consequences in the neonate. Low rates of oral sucrose use with comfort measures for pain management during minor painful procedures were identified at a level III neonatal intensive care unit. Underutilization of pain management resources occurs despite the availability of evidence-based pain management interventions.

Purpose:

To improve consistency in the use of oral sucrose solution with comfort measures during peripheral intravenous catheter insertion attempts in the neonatal intensive care unit in patients greater than or equal to 32 0/7th weeks postmenstrual age.

Methods:

Quality improvement methods were used to implement an evidence-based procedural pain algorithm for minor painful procedures and optimize pain management processes over a 15-week period in a 26-bed, level III neonatal intensive care unit.

Results:

There was an increase in the average percentage of documented use of sucrose with comfort measures during peripheral intravenous catheter insertion attempts from 20% to 27%. There was a 41% increase in the average presence of a sucrose order indicated for procedural pain. There were improvements in staff knowledge of sucrose dosing and perceived behavior of staff after completing the education.

Implications for Practice and Research:

Procedural pain management should be used as a quality indicator and guidelines should be established with the support of key stakeholders in neonatal intensive care settings. Future projects should address barriers related to workflow and accessibility of sucrose, include other common needlestick procedures, and expand the role of parent participation in pain management practices.

Video Abstract available at:
https://journals.lww.com/advancesinneonatalcare/pages/video.aspx?v=60.
Treatment of VPI with Customized Pharyngeal Flaps: One Size Does Not Fit All
Authors: Boudiab Elizabeth M. , Peshel Emanuela C. , Ibrahim Yousef , Gupta Rohun , Chaiyasate Kongkrit , Shaheen Kenneth , Rontal Matthew , Thottam Prasad , Antonio Ysunza Pablo
Published: April 2022

Background:

Failure of complete closure of the velopharyngeal sphincter results in velopharyngeal insufficiency (VPI), which may severely interfere with speech. The pharyngeal flap remains a common procedure for correcting VPI. We aimed to study whether customization of pharyngeal flaps using a dynamic preprocedural assessment can result in successful outcomes in the surgical treatment of VPI, despite variations in surgical technique.

Methods:

This is a retrospective review of patients between the ages 4 and 18 years old with VPI who underwent surgical correction by one of four surgeons at our institution. All four surgeons used a superiorly based pharyngeal flap (SBPF) with slight variations in operative technique. All patients also received an evaluation by the speech and language pathologist that included nasometry, multiplanar videofluoroscopy, and flexible videonasopharyngoscopy. Individualized preoperative planning was performed based on the findings.

Results:

In total, 158 patients (92%) demonstrated overall successful correction of VPI, defined by a normal post-operative mean nasalance. Thirteen patients (8%) presented with resonance improvement but persistent abnormal mean nasalance. The most common causes of failed VPI correction were inferior migration and/or shrinking of the pharyngeal flap. There was a nonsignificant association between surgical technique and unsuccessful corrections.

Conclusions:

The optimal surgical approach for performing pharyngeal flaps to correct VPI is individualized, customizing the procedure based on preoperative imaging. This study demonstrates that despite variations in surgical techniques for performing SBPF, high rates of success can be achieved when adequate surgical planning is based on imaging findings.
Otologic Examination Findings In Afebrile Young Infants Clinically Diagnosed With Acute Otitis Media
Authors: McLaren Son H. , Shah Nipam , Schmidt Suzanne M. , Wang Aijin , Thompson Julia , Dayan Peter S. , Pruitt Christopher M. ,   on behalf of the Pediatric Emergency Medicine Collaborative Research Committee
Published: April 2022

There are limited data on examination criteria for diagnosing acute otitis media in young infants. In this 33-site retrospective study of afebrile infants ≤90 days, clinicians typically documented tympanic membrane erythema with ≥1 other otologic abnormalities (64.1%) to diagnose acute otitis media. Notable differences in ear examination findings used for diagnosis existed across age subgroups.
Correlation between bone mineral density of different sites and lumbar disc degeneration in postmenopausal women
Authors: Zhou Lin , Li Cheng , Zhang Hao
Published: April 2022

Osteoporosis and lumbar disc degeneration (LDD) have been common causes that make increasing patients suffer from different degrees of low back pain. At present, whether osteoporosis degenerates or protects disc is still controversial, and the correlation between hip bone mineral density (BMD) and LDD still remains unclear. Our study aims to analyze the correlation between BMD of different sites and LDD in postmenopausal women, and explore the potential pathophysiological mechanism of them.

One hundred ninety-five postmenopausal female patients were enrolled and divided into osteoporosis, osteopenia, and normal bone mass groups. Their BMD and lumbar spine magnetic resonance imaging were retrospectively analyzed. Two spine surgeons were selected to assess LDD according to Pfirrmann grading system.

Based on lumbar BMD, LDD of normal bone mass group was more severe than the other 2 groups in L1/2 and L2/3 segments (P < .05). Based on hip BMD, LDD of each disc from L1/2 to L5/S1 had no significant difference among the 3 groups (P > .05). Lumbar BMD (L1-L4) was positively correlated with corresponding degree of LDD (L1/2-L4/5) (P < .05), whereas there was no correlation between hip BMD and degree of LDD (P = .328).

There is a positive correlation between lumbar BMD and LDD in postmenopausal women, which is more obvious in the upper lumbar spinal segments (L1, L2). However, there is no correlation between hip BMD and LDD, suggesting that in postmenopausal women with lumbar degenerative disease, hip BMD is more suitable for the diagnosis of osteoporosis.
The efficacy and safety of massage therapy as an adjuvant in the treatment of hypoxic ischemic encephalopathy in neonates
Authors: Meizhuang Wang , Xu Haizhu , Chen Youhong
Published: April 2022

Background:

Neonatal hypoxic-ischemic encephalopathy (HIE) has become a major problem that endangers the life and health of newborns. It is the most serious complication after neonatal asphyxia with a high mortality rate. Even survivors of HIE would suffer permanent neurological developmental impairment that seriously affects the growth and development in the future. Previous studies have shown that massage therapy can improve the prognosis of neonatal HIE. However, the efficacy of massage therapy on the growth, development, and sleep in neonates with HIE reported by various studies is inconsistent, which will be thoroughly assessed in this meta-analysis.

Methods:

Randomized controlled trials of massage therapy on the growth, development, and sleep neonates with HIE published before February 2022 will be retrieved from the PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wan Fang Database, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Clinical Trial Register. Literature selection, data extraction, risk of bias assessment, and meta-analyses will be independently completed by 2 researchers. Meta-analysis will be performed by using RevMan5.4.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This systematic review provides a high-quality synthesis to assess the effect of massage therapy on growth, development, and sleep in neonates with HIE.

OSF registration number:

DOI 10.17605/OSF.IO/G9WXN.
Blood Component Requirements and Erythrocyte Transfusion and Mortality Related to Hemoglobin Deficit in Phase III Trial of Hemoglobin-Based Oxygen Carrier: HBOC-201
Authors: Jahr Jonathan S. , Williams John P.
Published: April 2022

Background:

Hemoglobin-based oxygen carriers (HBOCs) may cause coagulopathy, changes in total hemoglobin (THb), and affect mortality. Low total hemoglobin concentrations [THb] during hemorrhage may worsen outcomes.

Study Question:

The database of the Hemopure HEM-0115 phase III trial was queried to determine the use of platelets, plasma, or cryoprecipitate and compare transfusion requirements and coagulation studies between patients randomized to erythrocyte transfusion or HBOC-201 infusion. Modeling of hemoglobin (Hb) changes produced by HBOC-201, erythrocyte, and blood product administration were related to [THb], coagulopathy, and mortality.

Data Sources:

Hemopure HEM-0115 phase III trial database.

Study Design:

Retrospective and Novel Hemoglobin Deficit Formulas Tested Against Existing Database.

Results:

The HBOC-201 database (n = 688) demonstrated less than 6% of subjects in both groups were administered non-Hb containing blood products (fresh frozen plasma, platelets, or cryoprecipitate) and low rates of coagulopathies in both erythrocyte and HBOC-201 arms. There were no differences in mortality in elective orthopedic patients administered up to 10 bags HBOC-201 (equivalent to 3 units erythrocytes). Low total [Hb] and lack of adequate oxygen carrying capacity was found to be an independent predictor of morbidity/mortality.

Conclusions:

The elective use of HBOC-201 for orthopedics versus erythrocytes demonstrated low incidence of blood product requirements in both cohorts and no differences in mortality up to the HBOC-201 equivalent of 3 units erythrocytes. High total Hb may be important to maintain in acute hemorrhage and [Hb] deficit, whereas later in recovery might not be as crucial. Future trauma trials may benefit from the use of HBOC-201 containing 13 g/dL in prehospital management, when erythrocytes are commonly not available.
Chief Nursing Officers
Authors: Monroe Martha , Davies Claire C. , Beckman Dee , Cantrell Donita , Brockopp Dorothy
Published: April 2022

OBJECTIVE

The purpose of this study was to describe the experience of chief nursing officers (CNOs), including leadership strategies that they developed as they encountered the administrative challenges posed by COVID-19.

BACKGROUND

The COVID-19 pandemic required CNOs to make difficult decisions and to support nursing staff as they cared for critically ill and dying patients, and therefore, they experienced intense stress during a pandemic of a highly infectious disease. Understanding the challenges that CNOs faced in this crisis will help hospitals and CNOs to better prepare for the future.

METHODS

Using a descriptive qualitative approach, we conducted interviews with 9 CNOs from hospitals across the United States. The goal of the interviews was to develop an understanding of the difficulties that these CNOs encountered during the COVID-19 pandemic and their emotional response to the challenging situations.

RESULTS

Themes of frustration, heartbreak, and feeling overwhelmed, exhausted, and helpless were revealed. In addition, pride in being a nurse was expressed.

CONCLUSION

Themes revealed in this study suggested intentional leadership strategies that would be useful in future healthcare crises.
Leadership Implications Related to Bullying and Intent to Leave Among Licensed Practical Nurses
Authors: Filipova Anna A.
Published: April 2022

OBJECTIVE

This study examines the relationship between bullying and intent to leave among a sample of LPNs as mediated by exhaustion, job satisfaction, and organizational commitment.

BACKGROUND

Bullying incidents may negatively impact the well-being, commitment, and retention for LPNs.

METHODS

A cross-sectional survey design was used. A total of 168 questionnaires (19.65% response rate) were analyzed, performing Pearson correlation, mediation, and hierarchical regression tests.

RESULTS

LPNs reported a relatively high score on exhaustion and were somewhat committed to their organization. They were fairly satisfied with the job and unlikely to leave it. The model explained 72% of the variance in intent to leave, with commitment, exhaustion, and bullying being the strongest correlates.

CONCLUSIONS

Nursing leadership needs to implement antibullying language in policies, institute communication and self-leadership trainings, model authentic leadership, and foster ethical climates to support the retention of LPNs.
Using Gamification to Engage Clinical Nurses in Quality Improvement
Authors: Bonn Jennifer , Mulkey David , Goers Jama
Published: April 2022

Engaging clinical nurses in quality improvement is essential to achieve improved patient outcomes. By using gamification, nursing professional development specialists can increase motivation and improve attitudes toward quality improvement. This project was designed to create and implement a virtual escape room to engage clinical nurses in nursing-sensitive quality improvement. Results revealed that gamification was a valuable active learning strategy that allowed participants to be more immersed in the learning experience.
An observational study of centrally facilitated pain in individuals with chronic low back pain
Authors: Georgopoulos Vasileios , Akin-Akinyosoye Kehinde , Smith Stephanie , McWilliams Daniel F. , Hendrick Paul , Walsh David A.
Published: April 2022

Introduction:

Central pain facilitation can hinder recovery in people with chronic low back pain (CLBP).

Objectives:

The objective of this observational study was to investigate whether indices of centrally facilitated pain are associated with pain outcomes in a hospital-based cohort of individuals with CLBP undertaking a pain management programme.

Methods:

Participants provided self-report and pain sensitivity data at baseline (n = 97) and again 3 months (n = 87) after a cognitive behavioural therapy–based group intervention including physiotherapy. Indices of centrally facilitated pain were pressure pain detection threshold, temporal summation and conditioned pain modulation at the forearm, Widespread Pain Index (WPI) classified using a body manikin, and a Central Mechanisms Trait (CMT) factor derived from 8 self-reported characteristics of anxiety, depression, neuropathic pain, fatigue, cognitive dysfunction, pain distribution, catastrophizing, and sleep. Pain severity was a composite factor derived from Numerical Rating Scales. Cross-sectional and longitudinal regression models were adjusted for age and sex.

Results:

Baseline CMT and WPI each was associated with higher pain severity (CMT: r = 0.50, P < 0.001; WPI: r = 0.21, P = 0.04) at baseline and at 3 months (CMT: r = 0.38, P < 0.001; WPI: r = 0.24, P = 0.02). High baseline CMT remained significantly associated with pain at 3 months after additional adjustment for baseline pain (β = 2.45, P = 0.04, R
2 = 0.25, P < 0.0001). Quantitative sensory testing indices of pain hypersensitivity were not significantly associated with pain outcomes at baseline or at 3 months.

Conclusion:

Central mechanisms beyond those captured by quantitative sensory testing are associated with poor CLBP outcome and might be targets for improved therapy.
The Sonographic Features of Malformation in Fetal Echogenic Bowel and Its Relationship With Chromosome Abnormalities
Authors: Yang Lin , Chen Huie , Li Feifei , Liao Jianmei , Lin Xiangbo
Published: April 2022

The aims of this study were to analyze the sonographic features and clinical prognosis of fetal echogenic bowel (FEB) and to evaluate the value of FEB in the prediction of fetal chromosomal abnormalities. Eight hundred eighty-two fetuses with FEB were selected. The ultrasonographic features and the chromosomal examination were retrospectively analyzed. Among the 882 FEB, 272 (30.8%) cases had malformation. The most common malformation was cardiovascular malformation (21.6%), followed by urinary malformation (9.0%), craniocerebral malformation (6.8%), and gastrointestinal malformations (5.6%). According to other combined ultrasound abnormalities, the FEBs were divided into 4 groups: isolated FEB group (490 cases), ultrasound soft indicators group (130 cases), single malformation group (117 cases), and multiple malformation group (145 cases). A total of 45 cases (5.1%) were detected with chromosomal abnormalities. Compared with isolated FEB group, the rate of chromosomal abnormality in other 3 groups was significantly higher. Among 490 cases of isolated FEB, 114 cases of isolated FEB group with adverse pregnancy outcomes were selected as the experimental group, and 376 cases of FEB group with good prognosis were selected as the control group. There were significant differences of the location, shape, intensity, and progression between the 2 groups. Multivariate logistic regression analysis showed that central location and progression of FEB were independent risk predictors of poor prognosis. The combined malformation rate is high for FEB fetuses. The fetal systems should be carefully examined when FEB is found in prenatal ultrasound.
Factors Associated With a Positive Urine Culture in Women Seeking Urogynecologic Care for Urinary Tract Infection Symptoms
Authors: Meckes Nicole A. , Melnyk Alexandra I. , Guirguis Marina , Zyczynski Halina , Bradley Megan S.
Published: April 2022

Importance

Urinary tract infections (UTIs) are one of the most common bacterial infections and more frequently affect women than men.

Objectives

Our objective was to determine clinical characteristics associated with a positive urine culture in women seeking treatment for symptoms of UTI.

Study Design

In this prospective cohort study, women seeking treatment for UTI symptoms were administered the Urinary Tract Infection Symptom Assessment questionnaire at baseline and at the time of culture results. Participants were grouped by history of recurrent UTI (rUTI) based on chart review. Our primary outcome was the proportion of “positive” urine cultures (≥103 colony-forming units) compared between rUTI groups. Characteristics were compared and the relative odds of a positive culture were calculated with a logistic regression model.

Results

Analyses included 152 women, 79 (52%) with rUTI and 73 (48%) with no history of rUTI. Overall, 90 (59.2%) had a positive culture. Participants with a positive culture were more likely to report history of rUTI (P = 0.01). There was a 2.45-fold increased adjusted odds of a positive culture in those with a history of rUTI (adjusted odds ratio [aOR], 2.45; 95% confidence interval [CI], 1.34–5.03; P = 0.01) when controlling for confounding variables, including scores on the Urinary Tract Infection Symptom Assessment for frequency (aOR, 0.59; 95% CI, 0.40–0.91), dysuria (aOR, 1.53; 95% CI, 1.10–2.12), and age (aOR, 1.02; 95% CI, 1.01–1.05).

Conclusions

In a cohort of women seeking care for UTI symptoms, older women, those with a history of rUTI and those presenting with dysuria are more likely to have a positive urine culture compared with those with urinary frequency.
Manufacturer and User Facility Device Experience Reporting of Events Related to Transvaginal Mesh: Understanding the Data
Authors: Dallas Kai , Souders Colby P. , Caron Ashley , Clark Khasiah , Obi Ndidiamaka , McClelland Lynn , Chughtai Bilal , Eilber Karyn S. , Anger Jennifer T.
Published: April 2022

Objective

The aim of this study was to examine potential bias in reports to the Manufacturer and User Facility Device Experience (MAUDE) database involving vaginal mesh by identifying the party submitting the report, the nature of the complaints, and whether the reports were edited.

Methods

All reports submitted to the MAUDE database involving synthetic transvaginal mesh from January 2000 through December 2017 (40,266 safety reports) were identified. A random 2% sample (900) of these reports was reviewed in depth to determine the specific relevant details, including reporter type (patient, manufacturer, lawyer) and details of the complaint/injury.

Results

Of the 40,226 reports to MAUDE identified, 28,473 (70.7%) were sling reports, and 11,793 (29.3%) described mesh products augmenting pelvic organ prolapse repair. Of the 900 reports reviewed in depth, 46%, 41%, 10%, and 2% of entries were reported by the manufacturer, attorney, health care provider, and patients, respectively. In the 4 years after submission, 18.6% of reports were modified at least once.

Conclusions

The MAUDE database allows physicians, manufacturers, and patients to immediately report adverse events experienced due to medical devices. While this database is an important means to identify potential danger to patients, any individual can file a report and, thus, it should not be the sole source of evidence to consider when assessing device safety. Further, the MAUDE database provides no information into the total number of cases performed without complication.
Is Same-Day Discharge Following Minimally Invasive Sacrocolpopexy Safe and Feasible? A National Contemporary Database Analysis
Authors: Raju Rubin , Hanson Kristine T. , Habermann Elizabeth B. , Occhino John A. , Linder Brian J.
Published: April 2022

Objective

The aim of this study was to investigate trends and outcomes of ambulatory minimally invasive sacrocolpopexy (MISC) using data from a contemporary multicenter nationwide cohort.

Methods

We used the American College of Surgeons National Surgical Quality Improvement Program database to identify women who underwent nonemergent MISC (laparoscopic and robotic) from 2012 to 2018. Exclusion criteria were age <18 or ≥90 years, rectal prolapse, postoperative discharge day ≥3, and concomitant hysterectomy, transvaginal mesh repair, colpocleisis, and/or colorectal surgery. Baseline demographics and 30-day outcomes were compared between patients who underwent same-day discharge (SDD; discharge on postoperative day [POD] 0) and those discharged on POD 1–2 using Kruskal-Wallis, Fisher exact, and Pearson χ
2 tests. A 2-sided Cochran-Armitage trend test assessed SDD over time, and person-years methodology was used to assess readmission rates. Multivariable logistic regression and Cox proportional hazards modeling evaluated associations between SDD and postoperative outcomes. We hypothesized that SDD increased over the study time frame and is not associated with adverse outcomes.

Results

Of 2,928 women, 362 (12.4%) were SDD, and 2,566 (87.6%) were discharged POD 1–2. The proportion of SDD nearly quadrupled over time (5.6% [2012], 20.6% [2018]; P < 0.001). The SDD group was younger (mean age, 61.9 vs 63.6; P = 0.04), with lower proportion of American Society of Anesthesiologists class III or higher (21.8% vs 27.5%; P = 0.02) and hypertension (37.3% vs.46.5%; P < 0.001), shorter total operation time (median, 142 vs 172 minutes; P < 0.001), and fewer concomitant slings (21.5% vs 33.0%; P < 0.001). Outcomes were similar for SDD: 30-day overall complications (3.0% vs 4.4%; P = 0.23), readmissions (1.1% vs 2.0%; P = 0.28), and reoperations (1.1% vs 0.9%; P = 0.55) and persisted with multivariable analysis.

Conclusion

Ambulatory MISC significantly increased during the study period and appears safe and feasible in select patients.
Brexpiprazole-Associated Pisa Syndrome (Pleurothotonus) in a Patient With Dementia
Authors: Nagai Yasuhito , Yamazaki Takahiro , Sugita Tomoyuki , Shibata Nobuto
Published: April 2022

Objectives

The aims of the study were to report brexpiprazole-induced Pisa syndrome (PS) in a patient with Alzheimer disease and to discuss the pathophysiology and the treatment of PS.

Methods

We report a 71-year-old female patient with Alzheimer disease. After 2 months medication of brexpiprazole, she presented PS. By switching to quetiapine, the symptom was ameliorated; however, transient acute dystonia was occurred.

Conclusions

Drug-induced PS may be associated with dopamine-acetylcholine imbalance. This imbalance causes the dysfunction of the cortex and basal ganglia and the dysfunction of sensory and somatosensory system. Stopping the offending drugs is a choice for the treatment of PS. This is the first report of PS-induced brexpiprazole.
Low Intensity Vibration Protects the Weight Bearing Skeleton and Suppresses Fracture Incidence in Boys with Duchenne Muscular Dystrophy
Authors: Bianchi ML , Vai S , Baranello G , Broggi F , Judex S , Hangartner TN , Rubin CT
Published: April 2022

Introduction/Aims

The ability of low intensity vibration (LIV) to combat skeletal decline in Duchenne Muscular Dystrophy (DMD) was evaluated in a randomized controlled trial.

Methods

Twenty DMD boys were enrolled, all ambulant and treated with glucocorticoids (mean age 7.6, height-adjusted Z-scores (HAZ) of hip BMD −2.3). Ten DMD boys were assigned to stand for 10min/d on an Active LIV platform (0.4g @ 30Hz), while 10 stood on a Placebo device. Baseline and 14-month BMC and BMD of spine, hip and total body were measured with DXA, and trabecular bone density (TBD) of tibia with QCT.

Results

All children tolerated the LIV intervention well, with daily compliance averaging 78%. At 14 months, TBD in the proximal and distal tibia remained unchanged in Placebo (−0.7% & −0.8%), while rising 4.1% and 4.5% in LIV. HAZ for hip BMD and BMC in Placebo declined 22% and 13% respectively, contrasting with no change from baseline (0.9% and 1.4%) in LIV. Fat mass in the leg increased 33% in Placebo, contrasting with 20% in LIV subjects. Across the 14-month study, there were four incident fractures in three placebo patients (30%), with no new fractures identified in LIV subjects.

Conclusions

These data suggest that non-invasive LIV can help protect the skeleton of DMD children against the disease progression, the consequences of diminished load bearing, and the complications of chronic steroid use.
Quantitative longitudinal natural history of eight gangliosidoses – conceptual framework and baseline data of the German 8-in-1 disease registry. A cross-sectional analysis
Authors: Ries Markus , Mendoza Grecia , Arash-Kaps Laila , Amraoui Yasmina , Quack Folker , Hardt Brigitte , Diederich Stefan , Beck Michael , Mengel Eugen
Published: April 2022

Purpose

Gangliosidoses are a group of inherited neurogenetic autosomal recessive lysosomal storage disorders usually presenting with progressive macrocephaly, developmental delay and regression, leading to significant morbidity, and premature death. A quantitative definition of the natural history would support and enable clinical development of specific therapies.

Methods

Single disease registry of eight gangliosidoses (NCT04624789).

Cross-sectional analysis of baseline data in N= 26 patients.

Primary endpoint: disease severity assessed by the 8-in-1 score.

Secondary endpoints: first neurological sign or symptom observed a. by parents and b. by physicians, diagnostic delay, as well as phenotypical characterization.

Tertiary endpoints: Neurological outcomes (development, ataxia, dexterity) and disability.

Results

The 8-in-1 score quantitatively captured severity of disease. Parents recognized initial manifestations (startle reactions) earlier than physicians (motor developmental delay and hypotonia). Median diagnostic delay was 3.16 [IQR 0.69 … 6.25] years. Eight patients presented with late-infantile phenotypes.

Conclusion

Data in this registry raise awareness of these rare and fatal conditions in order to accelerate diagnosis, inform counselling of afflicted families, define quantitative endpoints for clinical trials, and can serve as historical controls for future therapeutic studies. The characterization of a late-infantile phenotype is novel. Longitudinal follow-up is planned.
The Co-production of the Roots Framework: A Reflective Framework for Mapping the Implementation Journey of Trauma-informed Care
Authors: Thirkle Steven Anthony , Kennedy Angela , Sice Petia , Patel Paras
Published: April 2022

Background

The trauma-informed care programme at the Tees, Esk and Wear Valleys Foundation NHS Trust identified a need to evaluate the ongoing service-wide trauma-informed care implementation effort. An absence of staff, service user and system-related outcomes specific to trauma-informed care presented barriers to monitoring the adoption of trauma-informed approaches and progress over time across the Tees, Esk and Wear Valleys Foundation NHS Trust. This paper describes the co-production of a new self-assessment tool, Roots, a discussion-based framework that facilitates learning and improvement by reflecting on positive or negative examples of trauma-informed services.

Methods

Using secondary data obtained from an affiliated national trauma summit and instruments found in literature, domains and items were co-produced with the help of trauma-informed care leads, NHS staff and service users. The research design consisted of community-based co-production methods such as surveys, focus groups, and expert consultations.

Results

Adopting trauma-informed care requires enthusiasm and commitment from all members of the organisation. Services must adapt to meet the dynamic needs of staff and service users to ensure they remain trauma-informed; this must be done as a community.

Conclusions

Following an extensive co-production process, the Roots framework was published open-access and accompanied by a user manual. Roots can provide both qualitative and quantitative insights on trauma-informed care implementation by provoking the sharing of experience across services.
A Novel and Prevalent Pathway in Microbial Selenium Metabolism
Authors: Kayrouz Chase M. , Seyedsayamdost Mohammad R.
Published: April 2022

Selenium is an essential micronutrient in diverse organisms. Two routes are known for its insertion into proteins and nucleic acids via selenocysteine and 2-selenouridine, respectively1. However, despite its importance, pathways for specific incorporation of selenium into small molecules have remained elusive. We herein use a genome mining strategy to uncover a widespread three-gene cluster in varied microorganisms that encodes a dedicated pathway for producing selenoneine, the selenium-analog of the multifunctional molecule ergothioneine2,3. We elucidate the reactions of all three proteins and uncover two novel selenium-carbon bond-forming enzymes and the first biosynthetic pathway for production of a selenosugar, an unexpected intermediate on route to the final product. Our findings expand the scope of biological selenium utilization, suggest that the selenometabolome is more diverse than previously thought, and set the stage for the discovery of other selenium-containing natural products.
Multi-omics analyses cannot identify true-positive novel associations from underpowered genome-wide association studies of four brain-related traits
Authors: Baranger David A.A. , Hatoum Alexander S. , Polimanti Renato , Gelernter Joel , Edenberg Howard J. , Bogdan Ryan , Agrawal Arpana
Published: April 2022

Background

The integration of multi-omics information (e.g., epigenetics and transcriptomics) can be useful for interpreting findings from genome-wide association studies (GWAS). It has additionally been suggested that multi-omics may aid in novel variant discovery, thus circumventing the need to increase GWAS sample sizes. We tested whether incorporating multi-omics information in earlier and smaller sized GWAS boosts true-positive discovery of genes that were later revealed by larger GWAS of the same/similar traits.

Methods

We applied ten different analytic approaches to integrating multi-omics data from twelve sources (e.g., Genotype-Tissue Expression project) to test whether earlier and smaller GWAS of 4 brain-related traits (i.e., alcohol use disorder/problematic alcohol use [AUD/PAU], major depression [MDD], schizophrenia [SCZ], and intracranial volume [ICV]) could detect genes that were revealed by a later and larger GWAS.

Results

Multi-omics data did not reliably identify novel genes in earlier less powered GWAS (PPV<0.2; 80% false-positive associations). Machine learning predictions marginally increased the number of identified novel genes, correctly identifying 1-8 additional genes, but only for well-powered early GWAS of highly heritable traits (i.e., ICV and SCZ). Multi-omics, particularly positional mapping (i.e., fastBAT, MAGMA, and H-MAGMA), was useful for prioritizing genes within genome-wide significant loci (PPVs = 0.5 – 1.0).

Conclusions

Although the integration of multi-omics information, particularly when multiple methods agree, helps prioritize GWAS findings and translate them into information about disease biology, it does not substantively increase novel gene discovery in brain-related GWAS. To increase power for discovery of novel genes and loci, increasing sample size is a requirement.
Shell Microelectrode Arrays (MEAs) for brain organoids
Authors: Huang Qi , Tang Bohao , Romero July Carolina , Yang Yuqian , Elsayed Saifeldeen Khalil , Pahapale Gayatri , Lee Tien-Jung , Pantoja Itzy Erin Morales , Han Fang , Berlinicke Cynthia , Xiang Terry , Solazzo Mallory , Hartung Thomas , Qin Zhao , Caffo Brian S. , Smirnova Lena , Gracias David H.
Published: April 2022

Brain organoids are important models for mimicking some three-dimensional (3D) cytoarchitectural and functional aspects of the brain. Multielectrode arrays (MEAs) that enable recording and stimulation of activity from electrogenic cells are widely utilized in biomedical engineering. However, conventional MEAs, initially designed for monolayer cultures, offer limited recording contact area restricted to the bottom of the 3D organoids. Inspired by the shape of electroencephalography (EEG) caps, we developed miniaturized chip-integrated MEA caps for organoids. The optically transparent shells are composed of self-folding polymer leaflets with conductive polymer-coated metal electrodes. Tunable folding of the minicaps’ polymer leaflets guided by mechanics simulations enables versatile recording from organoids of different sizes and we validate the feasibility of electrophysiology recording from 400-600 µm sized organoids for up to four weeks and in response to glutamate stimulation. Our studies suggest that 3D shell MEAs offer significant potential for high signal-to-noise and 3D spatiotemporal brain organoid recording.
The Omicron (B.1.1.529) SARS-CoV-2 variant of concern also affects companion animals
Authors: Sánchez-Morales Lidia , Sánchez-Vizcaíno José M. , Pérez-Sancho Marta , Domínguez Lucas , Barroso-Arévalo Sandra
Published: April 2022

The recent emergence of the Omicron variant (B.1.1.529) has brought with it a large increase in the incidence of SARS-CoV-2 disease worldwide. However, there is hardly any data on the incidence of this new variant in companion animals. In this study, we have detected the presence of this new variant in domestic animals such as dogs and cats living with owners with COVID19 in Spain that have been sampled at the most optimal time for the detection of the disease. None of the RT-qPCR positive animals (10.13%) presented any clinical signs and the viral loads detected were very low. In addition, the shedding of viral RNA lasted a short period of time in the positive animals. Infection with the Omicron variant of concern (VOC) was confirmed by a specific RT-qPCR for the detection of this variant and by sequencing. These outcomes suggest a lower virulence of this variant in infected cats and dogs. This study demonstrates the transmission of this new variant from infected humans to domestic animals and highlights the importance of doing active surveillance as well as genomic research to detect the presence of VOCs or mutations associated with animal hosts.
MoDLE: High-performance stochastic modeling of DNA loop extrusion interactions
Authors: Rossini Roberto , Kumar Vipin , Mathelier Anthony , Rognes Torbjørn , Paulsen Jonas
Published: April 2022

DNA loop extrusion emerges as a key process establishing genome structure and function. We introduce MoDLE, a computational tool for fast, stochastic modeling of molecular contacts from DNA loop extrusion capable of simulating realistic contact patterns genome wide in a few minutes. MoDLE accurately simulates contact maps in concordance with existing molecular dynamics approaches and with Micro-C data, and does so orders of magnitude faster than existing approaches. MoDLE runs efficiently on machines ranging from laptops to high performance computing clusters, and opens up for exploratory and predictive modeling of 3D genome structure in a wide range of settings.
Form follows function: Variable microtubule architecture in the malaria parasite
Authors: Ferreira Josie L , Pražák Vojtěch , Vasishtan Daven , Siggel Marc , Hentzschel Franziska , Pietsch Emma , Kosinski Jan , Frischknecht Friedrich , Gilberger Tim W. , Grünewald Kay
Published: April 2022

The malaria parasite undergoes a series of extensive morphological changes within its human host and mosquito vector. A scaffold of microtubules beneath a peripheral double membrane establishes and maintains the distinct shapes of all infectious forms, but the underlying structural basis remains unknown. Here we appliedin situelectron cryo-tomography after focused ion beam milling to follow changes in the microtubule cytoskeleton throughout thePlasmodiumlife cycle. This revealed an unexpected level of structural and architectural diversity so far not observed in other organisms. Microtubules in migrating mosquito forms consist of 13 protofilaments reinforced by interrupted luminal helices. Conversely, gametocyte microtubules consist of 13 to 18 protofilaments with doublets, triplets and quadruplets of varying arrangements. We show the microtubule cytoskeleton within the native cellular context, highlighting structurally diverse apical rings which act as microtubule organising centres. This provides a unique view into a relevant human pathogen with an unusual microtubule cytoskeleton.
Control of N2 fixation and NH3 excretion in Azorhizobium caulinodans ORS571
Authors: Haskett Timothy L , Karunakaran Ramakrishnan , Batista Marcelo Bueno , Dixon Ray , Poole Philip S
Published: April 2022

Due to the costly energy demands of N2 fixation, diazotrophic bacteria have evolved complex regulatory networks that permit expression of the N2-fixing catalyst nitrogenase only under conditions of N starvation, whereas the same condition stimulates upregulation of high-affinity NH3 assimilation by glutamine synthetase (GS), preventing excess release of excess NH3 for plants. Diazotrophic bacteria can be engineered to excrete NH3 by interference with GS, however control is required to minimise growth penalties and prevent unintended provision of NH3 to non-target plants. Here, we attempted two strategies to control GS regulation and NH3 excretion in our model cereal symbiont Azorhizobium caulinodans AcLP, a derivative of ORS571. We first attempted to recapitulate previous work where mutation of both PII homologues glnB and glnK stimulated GS shutdown but found that one of these genes was essential for growth. Secondly, we expressed unidirectional adenylyltransferases (uATs) in a ΔglnE mutant of AcLP which permitted strong GS shutdown and excretion of NH3 derived from N2 fixation and completely alleviated negative feedback regulation on nitrogenase expression. We placed a uAT allele under control of the NifA-dependent promoter PnifH, permitting GS shutdown and NH3 excretion specifically under microaerobic conditions, the same cue that initiates N2 fixation, then deleted nifA and transferred a rhizopine-inducible nifAL94Q/D95Q-rpoN controller plasmid into this strain, permitting coupled rhizopine-dependent activation of N2 fixation with NH3 excretion. In future, this highly sophisticated and multi-layered control circuitry could be used to activate N2 fixation and NH3 excretion specifically by AcLP colonising transgenic rhizopine producing cereals, targeting delivery of fixed N to the crop, and preventing interaction with non-target plants.

Author Summary

Inoculation of cereal crops with associative “diazotrophic” bacteria that convert atmospheric N2 to NH3 could be used to sustainably improve delivery of nitrogen in agriculture. However, due to the costly energy demands of N2 fixation, natural diazotrophic bacteria have evolved to conserve energy by preventing excess production of NH3 and release to the plants. Diazotrophs can be engineered for excess NH3 production and release, however genetic control is required to minimise growth penalties and prevent unintended provision of NH3 to non-target weed species. Here, we engineer control of N2 fixation and NH3 excretion in response to the signalling molecule rhizopine which is produced by transgenic barley. This control could be used to establish plant host-specific activation of N2 fixation and NH3 release following root colonisation in the field, minimising bacterial energy requirements in the bulk soil and preventing provision of NH3 to non-target plants.