bluuebunny/crossref_metadata_2025 huggingface dataset:
801. ROBOTIC ASSISTED LAPAROSCOPIC GIANT PARA-OESOPHAGEAL HERNIA REPAIR: 5-YEAR EXPERIENCE
Authors: Siriwardana Priyantha , Sathian Vishnu , Qamruddin Mohammad , Lorenzi Bruno , Kadirkamanathan Sritharan
Published: September 2024

Background

Prior to laparoscopic era, giant paraesophageal hernia repair (GPEHR) was considered a relatively morbid operation requiring thoracotomy or laparotomy or both. GPEHR has been shown to be amenable to laparoscopic approach with low morbidity and mortality. We presented the outcome of over 200 cases of laparoscopic GPEHR (LGPEHR) with long-term follow- up over 20 years at DDW 2022. We have been performing robotic-assisted laparoscopic giant paraesophageal hernia repair (RAL-GPEHR) since 2018 and present our results.

Methods

We did a retrospective analysis of prospectively collected data of RAL- GPEHR using the DaVinci Xi between December 2018 and March 2024. All operating data are electronically recorded automatically by DaVinci Xi system for each surgeon/console user. Demographic data, clinical presentation, pre-operative assessment, and testing including haemoglobin (Hb), respiratory function {Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 Second (FEV1)} as well as quality-of-life (QoL) with SF-36 questioners (including general health, physical, emotional, and social components), length of hospital stay (LOS), morbidity, mortality and follow up outcomes (Clinical, Hb, radiological, respiratory and QoL) were recorded.

Results

Twenty patients underwent RAL-GPEHR with 15(75%) having crural repair plus gastropexy and 5(25%) patients having additional Toupet fundoplication. Fourteen (70%) were females. Data is presented in Table 1. Presenting symptoms were dyspnoea, reflux, post-prandial pain, and dysphagia with 7(35%) anaemic. Eight (40%) were ASA III and 12(60%) ASA II. Thirteen (65%) were Type III-GPEH, 4(20%)-Type IV, one-Type II (5%) and 2(10%) recurrent GPEH. Blood loss was minimal with no intra-operative complications or conversions to open. One (5%) had post-operative chest infection. Symptoms improved in all post-operatively with improvement of Hb, FVC, FEV1 and QoL. Radiological recurrence occurred in one (5%) but remains asymptomatic.

Conclusions

This report represents our initial experience of a small number of patients undergoing RAL-GPEHR which has proved to be feasible and safe. A long-term follow- up with a large series of patients is required to compare long-term outcomes especially symptomatic recurrences and QoL.
812. INTRAOPERATIVE USE OF IMPEDANCE PLANIMETRY FOR RECURRENT ACHALASIA AFTER HELLER-NISSEN
Authors: Milito Pamela , De Maron Roberta , Siboni Stefano , Vico Eleonora , Tonini Federico , Bernardi Daniele , Tartaglia Giuseppe , Asti Emanuele
Published: September 2024

Background

Re-operations after Heller myotomy for esophageal achalasia is a challenging operation due to the fibrotic tissue surrounding the esophago-gastric junction (EGJ). The risk of both undertreatment or, on the other hand, esophageal perforation is significant. The impedance planimetry could guide the operation and assess whether the patients needs further dissection of adhesions, an extension of the previous myotomy and anti-reflux treatment.

Methods

A 70-year-old woman treated with Heller-Nissen in 1983 for type II achalasia was referred to our tertiary care center with absolute dysphagia for three days. In the past 41 years she reported occasional and self-limited episodes of dysphagia, regurgitation and chest pain. Aside from that, her medical history was unremarkable.

An esophagogastroduodenoscopy (EGD) with airway protection was performed, showing retained solid food. A water-soluble swallow study showed a tortuous megaesophagus and a misaligned esophageal gastric junction (EGJ), which did not allow endoscopic dilation. Esophageal wall thickening and focal lesions were ruled out by a CT scan.

Results

A laparoscopy with impedance planimetry technology support was scheduled. The first EGJ distensibility index (EGJ-DI) measurement was 2.1 mm2/mmHg. Esophagus was freed, encircled and released from the hiatus. An EGD confirmed the reposition of the cardia in the abdomen and the previous anterior esophageal myotomy. The Nissen fundoplication was not detectable. At this stage, an EGJ-DI of 4,2 mm2/mmHg was found. To obtain a regular esophageal outflow an anterior myotomy of the EGJ and proximal stomach was carried out and the edge was everted with absorbable barbed suture. A posterior cruroplasty was then performed. The final EGJ-DI was 8,8 mm2/mmHg.

Conclusion

The postoperative course was uneventful and she was discharged on post-operative day 4 eating a soft diet. In conclusion, the intraoperative use of the impedance planimetry technology has been crucial for a correct decision-making process during complex redo operations for esophageal achalasia as it has helped to tailor the surgical treatment.

https://www.dropbox.com/scl/fi/pednopcqnalooidynge3q/ISDE-Definitivo.mov?rlkey=8exx0oe6ompxoex8wqmlsgi0i&st=xgnfnjyt&dl=0
817. ARTERIA LUSORIA: IMPLICATIONS FOR ESOPHAGEAL SURGERY
Authors: Fonseca Filipa , Cabral Francisco , Dias Raquel , Ramos Paulo , Monteiro Cecília , Abecasis Nuno , Casaca Rui
Published: September 2024

Background

The aberrant right subclavian artery, also known as arteria lusoria, is an embryologic abnormality affecting 0.5-1.8% of individuals. Instead of arising from the brachiocephalic artery, the right subclavian artery emerges as the fourth branch of the aortic arch. In most cases (80%), the artery has a retro-esophageal trajectory, while in 20% it runs anteriorly, which may pose difficulties in performing a safe intra-thoracic or cervical anastomosis. This condition is associated with a non-recurrent right inferior laryngeal nerve.

Methods

Following Kurokawa’s publication in 2019, our unit has adopted routine recurrent bilateral laryngeal nerve lymphadenectomy in esophageal and cardia carcinomas with over than 4 cm of esophageal involvement.

We present a video that features a 68-year-old male diagnosed with a squamous cell carcinoma of lower thoracic esophagus, staged as cT3N+M0. He presents with a retro-esophageal arteria lusoria and non-recurrent right inferior laryngeal nerve. Following the CROSS protocol with neoadjuvant chemoradiotherapy, the patient underwent a Mckeown esophagectomy with total thoracic lymphadenectomy.

Results

In this presentation, we explore the anatomical details and surgical considerations associated with the arteria lusoria in esophageal surgery. This video details the essential procedural steps for the identification of the vagus nerve and the identification of the arteria lusoria during upper mediastinal dissection. This case emphases the need for customized surgical strategies and the role of interdisciplinary collaboration, particularly integration of radiological insights. Such cooperation ensures that the surgical team is ready to address the unique challenges presented by these anatomical deviations and minimize the risks.

Conclusion

In conclusion, this presentation aims to highlight the procedural intricacies and the collaborative effort required to manage effectively the arteria lusoria in esophageal surgery.

https://drive.google.com/file/d/1agjPmA6lxPoVVPxvgJCHaDCqs1dJP-xk/view
Bipolar catheter ablation of a left atrial anteroseptal line in a patient with peri-mitral atrial flutter: a case report
Authors: Martins Nadja , Landmesser Ulf , Attanasio Philipp , Huemer Martin
Published: September 2024

Background

Treatment of recurring atrial flutter can be challenging due to anatomical obstacles preventing complete conduction block of linear ablation lesions. Epicardial or bipolar ablation can be used as an alternative to create deeper ablation lesions but is still limitedly used in patients with atrial flutter.

Case summary

We describe a case of a 54-year-old patient with recurring peri-mitral flutter treated with ablation of an anteroseptal line using bipolar ablation to achieve a complete conduction block.

Discussion

As conventional ablation cannot always achieve, complete conduction block in linear ablation lesions alternatives may be used to create deeper lesions. In this, case bipolar ablation was used successfully for an anteroseptal line in a patient with recurring peri-mitral flutter.
Basal inferoseptal segment is highly susceptible to deformation in the clinical spectrum of transthyretin-derived amyloid cardiomyopathy
Authors: Tsuruda Toshihiro , Nakada Hiroshi , Yamamura Yoshimasa , Matsuura Yunosuke , Ogata Miyuki , Tanaka Miyo , Suiko Yosuke , Komaki Soichi , Tanaka Hiroki , Moribayashi Kohei , Ideguchi Takeshi , Terada Tamasa , Ota Tomomi , Yamamoto Keisuke , Nishihira Kensaku , Shibata Yoshisato , Kaikita Koichi
Published: September 2024

Aims

While the prevalence of transthyretin-derived amyloid cardiomyopathy (ATTR-CM) is on the rise, detailed understanding of its morphological and functional characteristics within the left ventricle (LV) across heart failure (HF) remains limited.

Methods and results

Utilizing two-dimensional (2D) speckle-tracking echocardiography, we assessed longitudinal strain (LS) in 63 histology-confirmed ATTR-CM patients. Additionally, cardiac magnetic resonance (CMR) images measured native T1 and extracellular volume (ECV), compared with LS across 18 LV segments. Patients were categorized into three groups based on HF status: Group 1 (no HF symptoms), Group 2 (HF with preserved LV ejection fraction), and Group 3 (HF with reduced LV ejection fraction). LS analysis unveiled susceptibility to deformation in the basal inferoseptal segment, persisting even in asymptomatic cases. CMR demonstrated increasing native T1 deviation, particularly evident in segments distant from the inferoseptal region. Contrastingly, maximal ECV was consistently observed in the basal and mid-ventricular inferior-septum, even in asymptomatic individuals. Segmental LS decline correlated with ECV expansion but not with native T1 values.

Conclusion

Our findings suggest that the inferoseptal segment is highly susceptible to amyloid infiltration, and 2D speckle-tracking echocardiography and CMR may serve as a valuable tool for its early detection.
Bromocriptine treatment and outcomes in peripartum cardiomyopathy: the EORP PPCM registry
Authors: van der Meer Peter , van Essen Bart Johan , Viljoen Charle , Böhm Michael , Jackson Alice , Hilfiker-Kleiner Denise , Hoevelmann Julian , Mebazaa Alexandre , Farhan Hasan Ali , Goland Sorel , Ouwerkerk Wouter , Petrie Mark C , Seferović Petar M , Tromp Jasper , Sliwa Karen , Bauersachs Johann
Published: September 2024

Background and Aims

Peripartum cardiomyopathy (PPCM) remains a serious threat to maternal health around the world. While bromocriptine, in addition to standard treatment for heart failure, presents a promising pathophysiology-based disease-specific treatment option in PPCM, the evidence regarding its efficacy remains limited. This study aimed to determine whether bromocriptine treatment is associated with improved maternal outcomes in PPCM.

Methods

Peripartum cardiomyopathy patients from the EORP PPCM registry with available follow-up were included. The main exposure of this exploratory non-randomized analysis was bromocriptine treatment, and the main outcome was a composite endpoint of maternal outcome [death or hospital readmission within the first 6 months after diagnosis, or persistent severe left ventricular dysfunction (left ventricular ejection fraction < 35%) at 6-month follow-up]. Inverse probability weighting was used to minimize the effects of confounding by indication. Multiple imputation was used to account for the missing data.

Results

Among the 552 patients with PPCM, 85 were treated with bromocriptine (15%). The primary endpoint was available in 491 patients (89%) and occurred in 18 out of 82 patients treated with bromocriptine in addition to standard of care (22%) and in 136 out of 409 patients treated with standard of care (33%) (P = .044). In complete case analysis, bromocriptine treatment was associated with reduced adverse maternal outcome [odds ratio (OR) 0.29, 95% confidence interval (CI) 0.10–0.83, P = .021]. This association remained after applying multiple imputation and methods to correct for confounding by indication (inverse probability weighted model on imputed data: OR 0.47, 95% CI 0.31-0.70, P < 0.001). Thromboembolic events were observed in 6.0% of the patients in the bromocriptine group vs. 5.6% in the standard of care group (P = .900).

Conclusions

Among women with PPCM, bromocriptine treatment in addition to standard of care was associated with better maternal outcomes after 6 months.
Revolutionizing solar water distillation: maximizing efficiency with pyramid solar stills enhanced by fins, evacuated tubes, nanomaterial, and phase change materials—a comprehensive review
Authors: Mehta Vijay Kishorbhai , Panchal Hitesh , Singh Bharat , Kumar Laveet
Published: September 2024

The availability of water and energy is crucial for human survival, yet rising industrialization and population growth have escalated demand, particularly in developing economies. Despite efforts to address water scarcity, contamination persists, leading to widespread diseases. Conventional purification methods like reverse osmosis are effective but expensive and energy-intensive while boiling exacerbates air pollution. In this context, solar still systems present a promising solution, harnessing abundant sunlight to distill seawater into drinkable water. By integrating phase change material (PCM) and sensible heat storage, these systems can enhance efficiency and reduce energy consumption. This article explores the optimization of solar still systems through the selection of suitable PCM and sensible heat storage materials. The primary objectives are to improve distillation efficiency and heat recovery, making the process more eco-friendly and cost-effective. By addressing water scarcity and energy consumption simultaneously, these optimized systems offer a sustainable approach to water production, particularly in regions with ample sunlight. Through a comprehensive review, this research aims to advance the understanding of solar still technology and facilitate its widespread adoption, ultimately contributing to global efforts toward water security and environmental sustainability.
Classification of Solutions to the Anisotropic N-Liouville Equation in ℝN
Authors: Ciraolo Giulio , Li Xiaoliang
Published: September 2024

Given $N\geq 2$, we completely classify solutions to the anisotropic $N$-Liouville equation

$$ \begin{align*} &-\Delta_N^H\,u=e^u \quad\textrm{in}\ \mathbb{R}^N,\end{align*} $$

under the finite mass condition $\int _{\mathbb{R}^{N}} e^{u}\,dx<+\infty $. Here $\Delta _{N}^{H}$ is the so-called Finsler $N$-Laplacian induced by a positively homogeneous function $H$. As a consequence in the planar case $N=2$, we give an affirmative answer to a conjecture made in [ 53].
Elevated Plasma Matrix Metalloproteinases Are Associated With Mycobacterium tuberculosis Bloodstream Infection and Mortality in Human Immunodeficiency Virus–Associated Tuberculosis
Authors: Walker Naomi F , Schutz Charlotte , Ward Amy , Barr David , Opondo Charles , Shey Muki , Elkington Paul T , Wilkinson Katalin A , Wilkinson Robert J , Meintjes Graeme
Published: September 2024

Mortality from human immunodeficiency virus (HIV)–associated tuberculosis (TB) is high, particularly among hospitalized patients. In 433 people with HIV hospitalized with symptoms of TB, we investigated plasma matrix metalloproteinases (MMP) and matrix-derived biomarkers in relation to TB diagnosis, mortality, and Mycobacterium tuberculosis (Mtb) bloodstream infection (BSI). Compared to other diagnoses, MMP-8 was elevated in confirmed TB and in Mtb-BSI, positively correlating with extracellular matrix breakdown products. Baseline MMP-3, -7, -8, -10, and PIIINP were associated with Mtb-BSI and 12-week mortality. These findings implicate MMP dysregulation in pathophysiology of advanced HIV-TB and support MMP inhibition as a host-directed therapeutic strategy for HIV-TB.
Insights into the global genomic features of Salmonella enterica serovar Gallinarum biovars Gallinarum and Pullorum
Authors: Campos Isabela C , Vilela Felipe Pinheiro , Saraiva Mauro de M S , Junior Angelo Berchieri , Falcão Juliana Pfrimer
Published: September 2024

Aims

Characterize global genomic features of 86 genomes of Salmonella Gallinarum (SG) and Pullorum (SP), which are important pathogens causing systemic infections in poultry.

Methods and results

All genomes harbored efflux pump encoding gene mdsA and gold tolerance genes golS and golT. Aminoglycoside (aac(6′)-Ib, aadA5, aph(6)-Id, aph(3′')-Ib, ant(2′')-Ia), beta-lactam (blaTEM-1, blaTEM-135), efflux pump (mdsB), fosfomycin (fosA3), sulfonamide (sul1, sul2), tetracycline [tet(A)], trimethoprim (dfrA17), acid (asr), and disinfectant (qacEdelta1) resistance genes, gyrA, gyrB, and parC quinolone resistance point mutations, and mercury tolerance genes (mer) were found in different frequencies. Additionally, 310 virulence genes, pathogenicity islands (including SPI-1, 2, 3, 4, 5, 6, 9, 10, 12, 13, and 14), plasmids [IncFII(S), ColpVC, IncX1, IncN, IncX2, and IncC], and prophages (Fels-2, ST104, 500465-1, pro483, Gifsy-2, 103 203_sal5, Fels-1, RE-2010, vB_SenS-Ent2, and L-413C) were detected. MLST showed biovar-specific sequence types, and core genome MLST showed country-specific and global-related clusters.

Conclusion

SG and SP global strains carry many virulence factors and important antimicrobial resistance genes. The diverse plasmids and prophages suggest genetic variability. MLST and cgMLST differentiated biovars and showed profiles occurring locally or worldwide.
Selenium suppressed the LPS-induced oxidative stress of bovine endometrial stromal cells through Nrf2 pathway with high cortisol background
Authors: Cui Luying , Zheng Fangling , Zhang Min , Wang Zhihao , Meng Xia , Dong Junsheng , Liu Kangjun , Guo Long , Wang Heng , Li Jianji
Published: September 2024

Stress and infection seriously threaten the reproductive performance and health of dairy cows. Various perinatal stresses increase plasma cortisol concentrations in cows, and chronically high cortisol levels may increase the incidence and severity of the uterine diseases. Selenium (Se) enhances antioxidant capacity of cows. The aim of this study was to explore how Se affects the oxidative stress of primary bovine endometrial stromal cells (BESC) with high cortisol background. The levels of reactive oxygen species (ROS) and other biomarkers of oxidative stress were measured using flow cytometry and assay kits. The changes in nuclear NF-E2-related factor 2 (Nrf2) pathway were detected by Western blot, qPCR, and immunofluorescence. The result showed that lipopolysaccharide (LPS) increased (P < 0.01) ROS and malondialdehyde (MDA) content and reduced (P < 0.01) superoxide dismutase (SOD) concentration, provoking BESC oxidative stress. The elevated levels of cortisol resulted in the accumulation (P < 0.05) of ROS and MDA and inhibition (P < 0.05) of SOD in unstimulated BESC but demonstrated an antioxidative effect in LPS-stimulated cells. Pretreatment with Se reduced (P < 0.01) the levels of ROS and MDA, while increasing (P < 0.05) the antioxidant capacities and the relative abundance of gene transcripts and proteins related to the Nrf2 pathway in BESC. This antioxidant effect was more pronounced in the presence of high cortisol level. In conclusion, cortisol alone induced the oxidative damage but provided an antioxidant protection in the presence of LPS. Se alleviated the LPS-induced cellular oxidative stress, which is probably achieved through activating Nrf2 pathway. At high cortisol levels, Se supplement has a more significant protective effect on BESC oxidative stress. This study provided evidence for the protective role of Se in bovine endometrial oxidative damage of stressed animals and suggested the potential regulatory mechanism in vitro.
Identification of 5-aminometonitazene and 5-acetamidometonitazene in a postmortem case: are nitro-nitazenes unstable?
Authors: Parks Claire , Maskell Peter D , McKeown Denise A , Couchman Lewis
Published: September 2024

In recent years, the use of 2-benzylbenzimidazole opioids (‘nitazenes’) has increased with them becoming one of the most prominent synthetic opioid subclasses of novel psychoactive substances. With the increased prevalence, there is also a concern of the dangers to public health with the use of nitazenes due to their high potency especially with polypharmacy. To aid in the detection of such compounds, it is important that forensic toxicology laboratories maintain up-to-date compound libraries for drug screening methods and that sensitive analytical instrumentation is available to detect the low blood/plasma concentrations of more potent drugs. This includes not only the compounds themselves but also potential metabolites and/or degradation products. Metonitazene is a ‘nitro-nitazene’ with a nitro group at position 5 of the benzimidazole ring. As a nitro-nitazene, there is a potential for bacterial degradation of metonitazene to 5-aminometonitazene, as occurs with nitro-benzodiazepines. In this study, we provide evidence from a postmortem (PM) case of degradation of metonitazene in unpreserved PM blood using liquid chromatography–triple quadrupole mass spectrometry (LC–QQQ-MS), and putative identification of the degradation/metabolic products 5-aminometonitazene and 5-acetamidometonitazene by liquid chromatography–quadrupole time-of-flight mass spectrometry. The results from LC–QQQ-MS analysis indicated that there did not appear to be such degradation in preserved (fluoride/oxalate) blood. These results suggest that nitro-nitazenes may be subject to similar in vitro stability/degradation issues as nitro-benzodiazepines. These breakdown products should be added to instrument libraries to aid in the detection of the use of nitro-nitazenes, and nitro-nitazenes should be quantified in preserved blood samples where available.
Intermittent Versus Daily Trimethoprim/Sulfamethoxazole Regimens for Pneumocystis Pneumonia Prophylaxis: A Systematic Review and Meta-analysis
Authors: Masaki Tetsuhiro , Ishikawa Kazuhiro , Fujino Takahisa , Koyamada Ryosuke , Kawai Fujimi , Ota Erika , Mori Shinichiro
Published: September 2024

Background

In immunocompromised individuals, trimethoprim/sulfamethoxazole (TMP/SMX) for Pneumocystis pneumonia (PCP) prophylaxis has adverse events, and the optimal dosage is unclear. The objective of this study was to assess efficacy and safety of intermittent versus daily TMP/SMX for PCP prophylaxis.

Methods

This systematic review included randomized controlled trials (RCTs) indexed in the Cochrane Central Register of Controlled Trials, PubMed, Ichushi, or Embase databases, published from database inception to September 2023. The inclusion criteria were adults taking intermittent or daily TMP/SMX for PCP prophylaxis. Risk of bias was assessed using the Cochrane risk-of-bias tool. The primary outcomes were PCP incidence, PCP-related mortality, and adverse events requiring temporary or permanent TMP/SMX discontinuation.

Results

Four RCTs (N = 2808 patients) were included. PCP incidence did not differ significantly between the intermittent and daily regimen groups (risk ratio [RR], 1.17 [95% confidence interval {CI}, .89–1.53]; certainty: very low). There was no PCP-related mortality in the 3 RCTs reporting its outcome. Compared with the daily regimen group, the intermittent regimen group experienced significantly fewer adverse events requiring temporary or permanent TMP/SMX discontinuation (RR, 0.51 [95% CI, .42–.61]; certainty: low)

Conclusions

This systematic review and meta-analysis suggests that intermittent TMP/SMX regimens for PCP prophylaxis may be more tolerable than daily regimens and may have similar efficacy. Further RCTs are needed to apply this to current practice.

Clinical Trials Registration. PROSPERO (CRD42022359102).
Repeated glucose oscillations in high cell–density cultures influence stress–related functions of Escherichia coli
Authors: Bafna-Rührer Jonas , Bhutada Yashomangalam D , Orth Jean V , Øzmerih Süleyman , Yang Lei , Zielinski Daniel , Sudarsan Suresh
Published: September 2024

Engineering microbial cells for the commercial production of biomolecules and biochemicals requires understanding how cells respond to dynamically changing substrate (feast–famine) conditions in industrial-scale bioreactors. Scale-down methods that oscillate substrate are commonly applied to predict the industrial-scale behavior of microbes. We followed a compartment modeling approach to design a scale-down method based on the simulation of an industrial-scale bioreactor. This study uses high cell–density scale-down experiments to investigate Escherichia coli knockout strains of five major glucose-sensitive transcription factors (Cra, Crp, FliA, PrpR, and RpoS) to study their regulatory role during glucose oscillations. RNA-sequencing analysis revealed that the glucose oscillations caused the down-regulation of several stress-related functions in E. coli. An in-depth analysis of strain physiology and transcriptome revealed a distinct phenotype of the strains tested under glucose oscillations. Specifically, the knockout strains of Cra, Crp, and RpoS resulted in a more sensitive transcriptional response than the control strain, while the knockouts of FliA and PrpR responded less severely. These findings imply that the regulation orchestrated by Cra, Crp, and RpoS may be essential for robust E. coli production strains. In contrast, the regulation by FliA and PrpR may be undesirable for temporal oscillations in glucose availability.
Sex differences in the role of sleep on cognition in older adults
Authors: Wiranto Yumiko , Siengsukon Catherine , Mazzotti Diego R , Burns Jeffrey M , Watts Amber
Published: September 2024

Study Objectives

The study aimed to investigate sex differences in the relationship between sleep quality (self-report and objective) and cognitive function across three domains (executive function, verbal memory, and attention) in older adults.

Methods

We analyzed cross-sectional data from 207 participants with normal cognition (NC) or mild cognitive impairment (89 males and 118 females) aged over 60 years. The relationship between sleep quality and cognitive performance was estimated using generalized additive models. Objective sleep was measured with the GT9X Link ActiGraph, and self-reported sleep was measured with the Pittsburgh Sleep Quality Index.

Results

We found that females exhibited lower executive function with increased objective total sleep time, with a steeper decline in performance after 400 minutes (p = .015). Additionally, longer objective sleep correlated with lower verbal memory linearly (p = .046). In males, a positive linear relationship emerged between objective sleep efficiency and executive function (p = .036). Self-reported sleep was not associated with cognitive performance in females and males with NC. However, in males with cognitive impairment, there was a nonlinear positive relationship between self-reported sleep and executive function (p < .001).

Conclusions

Our findings suggest that the association between sleep parameters on cognition varies between older males and females, with executive function being most strongly associated with objective sleep for both sexes top of form. Interventions targeting sleep quality to mitigate cognitive decline in older adults may need to be tailored according to sex, with distinct approaches for males and females.
Allostasis as a consequence of high heat load in grain-fed feedlot cattle
Authors: Wijffels Gene , Lees Angela M , Sullivan Megan L , Sammes Stephanie L , Li Yutao , Gaughan John B
Published: September 2024

Heat wave intensity, frequency, and duration are increasing in many regions of the world, including locations where highly productive livestock are raised. There are animal health and welfare, as well as economic impacts from these events. In this study, the physiological responses of grain-fed steers during a high heat load challenge through to recovery in climate-controlled rooms (CCR) were intensively evaluated. Two cohorts of 12 Black Angus steers (BW, 615.4 ± 40.1 kg) sequentially underwent a simulated heatwave event that consisted of 3 phases in the CCR: PreChallenge (5 d duration and temperature humidity index (THI) range of 65 to 71), Challenge (7-d duration and THI 66 to 95 with diurnal cycling), and Recovery (5 d duration and THI 65 to 70). The Challenge period was modeled on a severe heat wave, characterized by 3 very hot days. Individual rumen temperature (RumT, °C) was collected every 10 min, and respiration rate (RR, breaths per minute), panting score (PS), and water usage (L·steer−1·day−1) were obtained at multiple time points daily, by trained observers. Individual animal daily DMI was also determined. Morning (0700 hours) rectal temperature (RecT, °C) was measured on days 3, 5, 7 to 13, 15, and 17. Not unexpectedly, RumT, RecT, RR, and PS rose during Challenge and fell rapidly as conditions eased. Conversely, DMI was reduced during Challenge. During the transition between PreChallenge and Challenge, there were abrupt increases in RumT, and RR. It was also very apparent that during Recovery the steers did not return to the baseline PreChallenge state. Compared to PreChallenge, Recovery was characterized by persistent lowered daily mean RumT (P = 0.0010), RecT (P = 0.0922), RR (P = 0.0257), PS (P ≤ 0.0001), and DMI (P ≤ 0.0001). These results provide evidence that these steers have undergone an allostatic response in response to high heat load, and the new adjusted physiological state post-heat event may not be transient.
Estimate of the Deterministic Neutron RBE for Radiation-induced Pseudo-Pelger Huët Cell Formation
Authors: Goans R. E. , Iddins C. J. , Goans R. E.
Published: September 2024

Using archival peripheral blood slides from radiation accident patients, we have recently described the pseudo-Pelger Huët anomaly (PPHA) in neutrophils as a new radiation-induced biomarker, useful for dosimetry not only immediately after a radiation incident but also potentially helpful as a tool in retrospective dosimetry. In conjunction with the Radiation Accident Registry at the Radiation Emergency Assistance Center/Training Site (REAC/TS), the frequency of PPHA cells has been compared from selected patients in the Y-12 criticality accident in Oak Ridge, TN, in 1958 and from the patient in the 1971 60Co accident at the USAEC Comparative Animal Research Laboratory (CARL), also in Oak Ridge. Patients A, C, and D in the Y-12 accident are described as having an average dose of 2.53 ± 0.14 Gy gamma + 0.90 ± 0.05 Gy neutron, while the patient in the CARL event had 2.6 Gy gamma dose from event reconstruction. Since the average gamma energies are almost identical in these two cohorts, it is possible to estimate the deterministic neutron relative biological effectiveness (RBEd) for PPHA formation in a criticality event. The neutron RBEd calculated in this way is an average value over the neutron fission energy spectrum and is found to be 3.4 ± 0.6, in good agreement with the currently recommended value of 3 for acute neutron dose to red marrow.
Idiopathic unilateral complete oculomotor nerve palsy: a case report of diagnostic quandary
Authors: Ghimire Sagun , Shrestha Shikher , Shrestha Dinuj , Ranabhat Kajan , Bhattarai Suman , Bhandari Kritick , Kc Rikesh
Published: September 2024

Introduction and importance:

When compared to other cranial nerve palsies idiopathic unilateral oculomotor nerve palsy with pupillary sparing is one of the least noted neurological conditions. Moreover, there lies a series of diagnostic dilemmas to come into a final diagnosis resulting in several array of clinical investigations. Hence, there is a delay in prompt management.

Case summary:

An elderly female without any known comorbidities presented with the complaint of headache, dizziness and dropping of left eyelid. Several arrays of diagnostic workups was done to come to a diagnosis, but even with rigorous laboratory investigations and radiological examinations, a common working diagnosis could not be made. Hence with a diagnosis of exclusion after proper neurological and neuro-ophthalmological examination, idiopathic unilateral common oculomotor nerve palsy was identified for which improvement with steroids was noted in the patient.

Discussion:

Idiopathic unilateral complete oculomotor nerve palsy is considered as a diagnosis of exclusion when all the diagnostic parameters fail to signify and positive results. The vague symptomatic presentation of the disease condition further compels the treating physician to carry out several panels of laboratory to radiological investigations. But if identified in time the treatment modality is straightforward.

Conclusion:

The diagnostic quandary in timely identification of such disease conditions needs a pertinent diagnostic guideline so as to avoid the unwanted panel of investigations.
Percutaneous Balloon Compression Guided by a Compression-Time Effect in Trigeminal Nerve Branches
Authors: Chang Bowen , Mei Jiaming
Published: September 2024

Background:

Percutaneous balloon compression (PBC) is an important treatment for trigeminal neuralgia (TN). Establishing the duration of balloon compression involves a tradeoff between outcome and postoperative complications. We aimed to explore the effect of the duration of balloon compression on the numbness response in areas innervated by the branches of the trigeminal nerve.

Methods:

Thirty-three patients with TN were included as an exploratory cohort, and the response area and compression time to the onset of facial numbness were recorded intraoperatively. Seventy-six patients with TN were then randomly divided into experimental (EG) and control groups (CG) for validation. The EG was treated with balloon compression times adjusted to reflect the compression-time effect observed in the initial investigation, whereas the CG was treated with a standardized compression time of 180 s. Patients were followed up postoperatively for pain relief and facials to verify the reliability of the effect.

Results:

We found that the mean compression time to numbness in the region innervated by the ophthalmic meridian (V1) was 89.09 ± 8.99 s; by V1 and the maxillary nerve (V2), 123.52 ± 7.97 s; and by V1, V2, and the mandibular nerve (V3), 181.33 ± 10.29 s. All 76 patients used to verify the effect had complete relief of pain, and the EG had significantly less numbness than the CG.

Conclusion:

In PBC, with the extension of balloon compression time, the numbness response of each branch of the trigeminal nerve appears in a certain order. This effect can guide PBC in mitigating complications while ensuring efficacy.
Analysis of the Dynamic Expression of the SMAD Family in the Periosteum During Guided Bone Regeneration
Authors: Yu Bao-Fu , Li Xiao-Qing , Chen Xiao-Xue , Dai Chuan-Chang , He Jin-Guang , Wei Jiao
Published: September 2024

Objective:

The aim of this study was to investigate the dynamic expression of the SMAD family during guided bone regeneration for the reconstruction of cranio-maxillofacial bone defects.

Methods:

A swine model of guided bone regeneration was established with one side of the rib as the trauma group and the contralateral as control group. Periosteal and regenerative tissue specimens were harvested at 9 time points in the early, middle, and late phases, and were subjected to gene sequencing and tissue staining. Expression data of each SMAD family were extracted for further analysis, in which the correlation of the expression of the respective members within and between groups and at different time points was analyzed.

Results:

The expression of individual members of the SMAD family fluctuates greatly, especially during the first month. The SMAD3 and SMAD4 genes were the most highly expressed. The foldchange value of SMAD6 was the largest and remained above 1.5 throughout the process. The dynamic expression levels of SMAD2, SMAD4, SMAD5, SMAD6, and SMAD9 showed a significant positive correlation in both groups. The expression levels of each gene showed a positive correlation with other SMAD genes. Tissue staining showed that the overall contour of the regenerated bone tissue was basically formed within the first 1 month.

Conclusion:

The first month of guided bone regeneration is a critical period for bone regeneration and is an important period for the SMAD family to play a role. The SMAD6 may play an important role in the whole process of guided bone regeneration.
Noninvasive brain stimulation to improve motor outcomes after stroke
Authors: Savelon Emma C.J. , Jordan Harry T. , Stinear Cathy M. , Byblow Winston D.
Published: September 2024

Purpose of review

This review highlights recent developments in noninvasive brain stimulation (NIBS) techniques and applications for improving motor outcomes after stroke. Two promising areas of development relate to deep brain neuromodulation and the use of single-pulse transcranial magnetic stimulation (TMS) within a prediction tool for predicting upper limb outcome for individual patients.

Recent findings

Systematic reviews highlight the inconsistent effect sizes of interventional NIBS for motor outcome after stroke, as well as limited evidence supporting the interhemispheric competition model. To improve the therapeutic efficacy of NIBS, studies have leveraged metaplasticity and priming approaches. Transcranial temporal interference stimulation (tTIS) and low-intensity focused ultrasound stimulation (LIFUS) are emerging NIBS techniques with potential for modulating deeper brain structures, which may hold promise for stroke neurorehabilitation. Additionally, motor evoked potential (MEP) status obtained with single-pulse TMS is a prognostic biomarker that could be used to tailor NIBS for individual patients.

Trials of interventional NIBS to improve stroke outcomes may be improved by applying NIBS in a more targeted manner. This could be achieved by taking advantage of NIBS techniques that can be targeted to deeper brain structures, using biomarkers of structural and functional reserve to stratify patients, and recruiting patients in more homogeneous time windows.
pQEB1: a hospital outbreak plasmid lineage carrying bla
KPC-2
Authors: Moran Robert A. , Behruznia Mahboobeh , Holden Elisabeth , Garvey Mark I. , McNally Alan
Published: September 2024

While conducting genomic surveillance of carbapenemase-producing Enterobacteriaceae (CPE) from patient colonisation and clinical infections at Birmingham’s Queen Elizabeth Hospital (QE), we identified an N-type plasmid lineage, pQEB1, carrying several antibiotic resistance genes, including the carbapenemase gene bla
KPC-2. The pQEB1 lineage is concerning due to its conferral of multidrug resistance, its host range and apparent transmissibility, and its potential for acquiring further resistance genes. Representatives of pQEB1 were found in three sequence types (STs) of Citrobacter freundii, two STs of Enterobacter cloacae, and three species of Klebsiella. Hosts of pQEB1 were isolated from 11 different patients who stayed in various wards throughout the hospital complex over a 13 month period from January 2023 to February 2024. At present, the only representatives of the pQEB1 lineage in GenBank were carried by an Enterobacter hormaechei isolated from a blood sample at the QE in 2016 and a Klebsiella pneumoniae isolated from a urine sample at University Hospitals Coventry and Warwickshire (UHCW) in May 2023. The UHCW patient had been treated at the QE. Long-read whole-genome sequencing was performed on Oxford Nanopore R10.4.1 flow cells, facilitating comparison of complete plasmid sequences. We identified structural variants of pQEB1 and defined the molecular events responsible for them. These have included IS26-mediated inversions and acquisitions of multiple insertion sequences and transposons, including carriers of mercury or arsenic resistance genes. We found that a particular inversion variant of pQEB1 was strongly associated with the QE Liver speciality after appearing in November 2023, but was found in different specialities and wards in January/February 2024. That variant has so far been seen in five different bacterial hosts from six patients, consistent with recent and ongoing inter-host and inter-patient transmission of pQEB1 in this hospital setting.
Regulatory architecture of disease resistance in maize revealed by multi-omic systems genetics
Authors: Clark Natalie M , Song Gaoyuan , Kabahuma Mercy K. , Kolkman Judith M , Christensen Shawn A , Montes Christian , Malik Shikha , Nelson Rebecca J , Walley Justin W
Published: September 2024

Complex traits such as disease resistance have been traditionally studied using quantitative genetics. Here, we use systems genetics to integrate disease severity and multi-omic quantitate trait loci (QTL) to uncover biological networks underlying interaction with northern leaf blight (NLB), a yield-limiting disease of corn. Specifically, we integrated transcriptome, (phospho)proteome, and metabolome measurements to map molecular QTL and build predictive regulatory networks following NLB infection. These inferred networks identified a critical signaling module that was genetically validated comprised of a kinase termedNLBSUSCEPTIBLEKINASE 1, a bHLH transcription factor, and the lignin biosynthesis enzyme BROWN MIDRIB 2. Our results demonstrate the feasibility of high-throughput mapping of genetic determinants of gene- product levels and demonstrates the power of systems genetics to identify upstream regulatory genes that confer resistance to NLB that can inform future strategies for crop protection.
A nuclear hormone receptornhr-76programs age-dependent chemotaxis decline inC. elegans
Authors: Yokosawa Rikuou , Noma Kentaro
Published: September 2024

A decline in food-searching behavior of post-reproductive animals can be beneficial for the population and possibly programmed by the genome. We investigated the genetic program of age-dependent decline in chemotaxis behavior toward an odorant secreted from bacterial food inC. elegans. Through a forward genetic screen, we identified a nuclear hormone receptor,nhr-76, whose mutants ameliorate the age-dependent chemotaxis decline. We found thatnhr-76downregulates the expression of the odorant receptor during aging. Because NHR-76 expression and localization did not change during aging, secretion of its hydrophobic ligands might alter the activity of NHR-76 to cause age-dependent chemotaxis decline. Our findings imply that post-reproductive behavioral decline can be genetically programmed.
Evolutionary feedbacks for Drosophila aggression revealed through experimental evolution
Authors: Girardeau Anna R. , Enochs Grace E. , Saltz Julia B.
Published: September 2024

Evolutionary feedbacks occur when evolution in one generation alters the environment experienced by subsequent generations. Despite longstanding hypotheses that feedbacks should be nearly ubiquitous for social behaviors, we still know little about how feedbacks influence evolution. Using experimental evolution, we manipulated the social environment in which aggression was expressed and selected in fruit fly (Drosophila melanogaster) populations to allow or limit feedbacks. We selected for increased male-male aggression while allowing either positive, negative, or no feedbacks, alongside unselected controls. Populations undergoing negative feedbacks showed the weakest responses to selection, while populations undergoing positive evolutionary feedbacks evolved supernormal aggression. Further, the underlying social dynamics evolved only in the negative feedbacks treatment. Our results demonstrate that evolutionary feedbacks can alter the rate and pattern of behavioral evolution.
Discerning Specific Thrombolytic Activities and Blood Clot Degradomes of Diverse Snake Venoms with Untargeted Peptidomics
Authors: Smith Cara F. , Baldé Mamadou Alpha , Bahrabadi Lilyrose , Amponsah-Asamoah Merilyn , Larson Keira Y. , Maroney Sean P. , Ceja-Galindo David , Millimouno Martin , Camara Naby , Benjamin Jordan , Brandehoff Nicklaus P. , Modahl Cassandra M. , McCabe Maxwell C. , Cohen Mitchell J. , Castoe Todd A. , Baldé Cellou , Jackson Kate , Mackessy Stephen P. , Hansen Kirk C. , Saviola Anthony J.
Published: September 2024

Identification and characterization of snake venom toxins that interfere with hemostasis have important implications for the treatment of snake envenomation, the bioprospecting of therapeutically useful molecules, and the development of research tools for investigating hematologic disorders. Many venoms have been shown to possess thrombolytic activity. However, it remains unclear if actions on other clot-stabilizing proteins beyond fibrin chains contribute significantly to venom-induced thrombolysis because the clot-wide targets of venom proteases and the mechanisms responsible for thrombolysis are not well understood. Here, we utilize a high-throughput time-based thrombolysis assay in combination with untargeted peptidomics to provide comprehensive insight into the effects of venom from six snake species on blood clot degradation. We compare thrombolytic profiles across venoms with variable levels of proteases and generate venom-specific fingerprints of cleavage specificity. We also compare the specific effects of venoms that possess a range of thrombolytic activity on fibrin subunits and other clot-bound proteins involved in clot structure. Venoms with higher thrombolytic activity demonstrated an enhanced ability to target multiple sites across fibrin chains critical to clot stability and structure, as well as clot-stabilizing proteins including fibronectin and vitronectin. Collectively, this study significantly expands our understanding of the thrombolytic and fibrinolytic effects of snake venom by determining the full suite of clot-specific venom targets that are involved in clot formation and stability.
Contrasting dynamics of soil fungal functional groups in the plant rhizosphere
Authors: Wei Na , Nakaji-Conley Madelynn
Published: September 2024

Background and aims

Soil microbiomes, critical for plant productivity and ecosystem functioning, mediate essential functions such as pathogenesis, mutualism, and decomposition through different fungal functional groups. Yet, our understanding of the dynamics of co-existing soil fungal functional groups in the plant rhizosphere remains limited.

Methods

By leveraging a ‘natural’ experiment in urban farming with fields of different ages and multiple plant genotypes, we tracked the relative abundance, richness, and microbial networks of plant pathogens, mycorrhizal fungi, and saprotrophic fungi across fields over two years.

Results

We observed an increase in the relative abundance of plant pathogens in older fields relative to younger fields, supporting the prediction of pathogen accumulation over time. In contrast, there was a decrease in the relative abundance of mycorrhizal fungi in older fields. Unlike plant pathogens and mycorrhizal fungi, the relative abundance of saprotrophic fungi remained similar among fields. While the richness of plant pathogens and saprotrophic fungi were similar across fields, the community structure of both groups differed between younger and older fields. For mycorrhizal fungi, the richness declined in older fields and over the two years. These dynamics led to distinct microbial networks, with decreased network links for mycorrhizal fungi and increased links for saprotrophic fungi in older fields, whereas the links for plant pathogens remained similar across fields.

Conclusion

Our study reveals contrasting dynamics of essential soil fungal functional groups in the plant rhizosphere, and provides a predictive insight into the potential shifts in soil function and their impact on plant productivity.