bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review of Three Recent Dictionaries of Indigenous Languages Spoken in South America
Authors: Turin Mark , Zamudio Ana Laura Arrieta
Published: April 2023

In this review essay, we compare three recent dictionaries of Indigenous languages spoken in South America. The review covers two print dictionaries—one of which is trilingual (Quechua, Spanish and English) and the other the second edition of a bilingual Q’eqchi’-English dictionary—and a bilingual, digital dictionary hosted online (Wichí-Spanish). The structure of this review essay is as follows: first, we offer a brief introduction to each of the languages covered in the dictionaries. Following the introduction, we offer sections in which we compare the orthographic choices made by the compilers, entry design and ordering within the publications. We also address the overarching structure of each dictionary, questions of language production and reception, as well as editorial decisions relating to the incorporation of neologisms. In addition, we include an analysis of the intended audience and accessibility of each dictionary, supplemented by a reflection about ownership and control of language data, community investment and how these resources address dialectal variation within the language, if indeed any exists.
Appropriateness of lumbar spine radiography and factors influencing imaging ordering patterns: paving the path toward value-driven health care
Authors: Tay Yi Xiang , Chan Ling Ling , Than Shin Ru , Lim Gek Hsiang , Tan Mark Bangwei , Mak May San , Hou Wenlu , Wee Jeremy Choon Peng , Ng Yeong Huei , Chen Robert Chun
Published: April 2023

The demand for diagnostic imaging continues to rise. Against the backdrop of rising health care costs and finite resources, this has prompted a paradigm shift toward value-driven patient care. Inappropriate imaging is a barrier toward achieving this goal, which runs counter to prevailing evidence-based guidelines and contributes to rising healthcare costs. Our objective was to evaluate the appropriateness of lumbar spine X-rays in a tertiary referral Emergency Department (ED) and assess whether physicians’ specialization and years of experience influence appropriateness. A total of 1030 lumbar spine radiographs performed in the ED of an academic medical center over a consecutive 3-month period were reviewed retrospectively. Referral indications were reviewed for adherence to 2021 American College of Radiology appropriateness guidelines for lower back pain, and referral patterns were evaluated among physician groups based on specialists’ training and years in practice. 63.8% of lumbar spine radiographs were appropriate, with trauma being the most common indication. 36.2% of orders were inappropriate, with lower back pain of <6 weeks duration being the most common indication. Significant differences in inappropriate orders were found (P < .001) across physician groups: qualified Emergency Medicine specialists (20.9% inappropriate orders), specialists in training (27.8%), and non-specialists with ≥3 (60.0%) and <3 (36.9%) years in practice, respectively. Approximately one-third of lumbar spine radiographs performed in the ED were inappropriately ordered by American College of Radiology guidelines; specialists training and years in practice affected referral patterns. Integrating evidence-based appropriateness guidelines into the physician order workflow and targeting older non-specialists may promote more judicious imaging and reduce health care costs.
A multifaceted strategy to optimize pharmacokinetics of antimicrobial therapy in patients with hospital-acquired infections—a monocentre quality improvement project
Authors: Lagarde Cecile , Bouras Marwan , Le Floch Ronan , Hourmant Yannick , Grillot Nicolas , Bourdiol Alexandre , Mahe Pierre Joachim , Demeure Dit Latte Dominique , Gregoire Matthieu , Dailly Eric , Bellouard Ronan , Asehnoune Karim , Cinotti Raphael , Roquilly Antoine
Published: April 2023

Objective

We assessed the efficacy of a quality improvement programme to optimize the delivery of antimicrobial therapy in critically ill patients with hospital-acquired infections (HAI).

Patients and methods

Before–after trial in a university hospital in France. Consecutive adults receiving systemic antimicrobial therapy for HAI were included. Patients received standard care during the pre-intervention period (June 2017 to November 2017). The quality improvement programme was implemented in December 2017. During the intervention period (January 2018 to June 2019), clinicians were trained to dose adjustment based on therapeutic drug monitoring and continuous infusion of β-lactam antibiotics. The primary endpoint was the mortality rate at day 90.

Results

A total of 198 patients were included (58 pre-intervention, 140 intervention). The compliance with the therapeutic drug monitoring-dose adaptation increased from 20.3% to 59.3% after the intervention (P < 0.0001). The 90-day mortality rate was 27.6% in the pre-intervention period and 17.3% in the intervention group (adjusted relative risk 0.53, 95%CI 0.27–1.07, P = 0.08). Treatment failures were observed in 22 (37.9%) patients before and 36 (25.7%) patients after the intervention (P = 0.07).

Conclusions

Recommendations for therapeutic drug monitoring-dose adaptation and continuous infusion of β-lactam antibiotics were not associated with a reduction in the 90-day mortality rate in patients with HAI.
In vitro activity of sulopenem and comparator agents against Enterobacterales and anaerobic clinical isolates collected during the SENTRY Antimicrobial Surveillance Program
Authors: Maher Joshua M , Huband Michael D , Blankers Christopher G , Puttagunta Sailaja , Aronin Steven I , Castanheira Mariana
Published: April 2023

Objectives

Physicians must leverage several factors when making antibiotic therapy decisions, including route of administration and duration of therapy. Oral administration provides several potential advantages including increased accessibility, prevention of hospitalizations and earlier discharges. Sulopenem—a broad-spectrum, synthetic penem β-lactam agent—uniquely possesses both oral and IV formulations along with noted stability among antimicrobial-resistant subsets. This study evaluated the in vitro activity of sulopenem and comparator agents against contemporary Enterobacterales and anaerobic clinical isolates predominantly from patients with bloodstream, intra-abdominal and urinary tract infections.

Methods

A contemporary collection of 1647 Enterobacterales and 559 anaerobic isolates was assembled from medical centres in Europe and the USA. Isolates were susceptibility tested using the CLSI reference methods: broth microdilution for Enterobacterales and agar dilution for anaerobes.

Results

Sulopenem demonstrated potent in vitro antimicrobial activity (MIC50/90, 0.03/0.25 mg/L) against Enterobacterales isolates regardless of infection type, inhibiting 99.2% of isolates at ≤1 mg/L. This activity was conserved against resistant phenotypes including ESBL-phenotype Escherichia coli (MIC50/90, 0.03/0.06 mg/L) and ESBL-phenotype Klebsiella pneumoniae (MIC50/90, 0.06/1 mg/L). Sulopenem maintained activity against ciprofloxacin-, nitrofurantoin- and trimethoprim/sulfamethoxazole-non-susceptible subsets (MIC50/90, 0.03–0.06/0.12–0.5 mg/L). Against anaerobic isolates, sulopenem (98.9% inhibited at ≤4 mg/L) and meropenem [98.4% susceptible (CLSI)] were the most active compounds tested.

Conclusions

The potent in vitro activity of sulopenem against this large collection of recent Enterobacterales and anaerobic clinical isolates from multiple infection types supports its further clinical evaluation in the treatment of intra-abdominal and urinary tract infections.
Validation of the CompactDry “Nissui” BC for Enumeration of Bacillus cereus in a Variety of Foods: AOAC Performance Tested MethodSM 092201
Authors: Koyanagi Yusuke , Yamazaki Tomoki , Betts Gail
Published: April 2023

Background

The CompactDry “Nissui” BC is a ready-to-use dry media sheet using a chromogenic medium with selective agents for the detection and enumeration of Bacillus cereus in products after incubation at 30 ± 1°C for 24 ± 2 h.

Objective

The CompactDry “Nissui” BC method was validated to achieve AOAC Performance Tested MethodsSM certification.

Method

The performance of the CompactDry “Nissui” BC was compared to that of ISO 7932:2004 for 10 matrixes, including panna cotta, double cream, dried baby food, dried vegetable soup mix, seafood sticks, salmon pâté, sliced ham, pork liver pâté, ham and cheese sandwich, and Caesar pasta salad with chicken and bacon. Performance indicators included repeatability, difference of means (DOM), and inclusivity/exclusivity.

Results

After log10 transformation of the data, the relative standard deviation of repeatability (RSDr) was ≤9.2% for 28 of the 30 materials (10 matrixes each at three contamination levels) analyzed by the CompactDry “Nissui” BC method and ≤13% for 27 of the 30 matrix/level combinations analyzed by the reference method. Method equivalence was demonstrated in 28 of the 30 matrix/level combinations based on the 90% confidence interval of the DOM being within (-0.5, 0.5). For inclusivity, 47 of 50 strains tested showed typical colonies and confirmed positive. For exclusivity, 28 of 33 strains tested resulted in no growth or were negative, and five were positive. Inclusivity and exclusivity results were similar on the reference method agar. The method was shown to be robust to changes in sample volume, incubation temperature, and incubation time, and data are presented supporting product consistency and 18-month shelf life.

Conclusions

The CompactDry “Nissui” BC method is validated for the determination of Bacillus cereus in a variety of matrixes.

Highlights

The CompactDry “Nissui” BC method is equivalent to the ISO 7932:2004 reference method and is suitable for Performance Tested MethodsSM certification for the matrixes tested.
Effects of lasalocid, narasin, or virginiamycin supplementation on rumen parameters and performance of beef cattle fed forage-based diet
Authors: Miszura Alexandre Arantes , Marques Rodrigo S , Polizel Daniel Montanher , Cappellozza Bruno Ieda , Cruz Vinicius Alves , Ogg Makayla Anne , Barroso José Paulo Roman , Oliveira Gabriela Bagio , Martins André Storti , Limede Arnaldo Cintra , Ferreira Evandro Maia , Gouvêa Vinícius N , Pires Alexandre Vaz
Published: April 2023

Two experiments were designed to evaluate the impacts of supplementing lasalocid (LAS), narasin (NAR), or virginiamycin (VRM) on rumen fermentation parameters, apparent nutrient digestibility, and blood parameters (Exp. 1), as well as feed intake and performance (Exp. 2) of Nellore cattle consuming a forage-based diet. In Exp. 1, 32 rumen-fistulated Nellore steers (initial shrunk body weight [BW] = 355 ± 4.4 kg) were assigned to a randomized complete block design. Within block, animals were randomly assigned to one of four treatments: 1) forage-based diet without feed additives (CON), 2) CON diet plus 13 mg/kg of dry matter (DM) of NAR, 3) CON diet plus 20 mg/kg of DM of sodium LAS, or 4) CON diet plus 20 mg/kg of DM of VRM. No treatment effects were detected (P ≥ 0.32) for intake and apparent digestibility of nutrients. Steers fed NAR had the lowest (P ≤ 0.01) molar proportion of acetate on day 28, 56, and 112 vs. CON, LAS, and VRM steers, whereas acetate did not differ (P ≥ 0.25) between LAS, VRM, and CON steers from day 28 to 84. On day 112, steers fed LAS had a lower (P < 0.02) molar proportion of acetate vs. VRM and CON, whereas it did not differ between CON and VRM (P > 0.33). Steers receiving NAR had a greater (P ≤ 0.04) ruminal propionate vs. CON, LAS, and VRM, whereas LAS steers had greater (P < 0.04) propionate vs. CON and VRM steers on day 28 and 112, and it did not differ (P > 0.22) between CON and VRM. In Exp. 2, 160 Nellore bulls were blocked by initial shrunk BW (212 ± 3.1 kg) in a 140-d feedlot trial. Diets contained the same treatments used in Exp. 1. Bulls fed NAR had greater (P < 0.02) average daily gain (ADG) vs. CON and VRM, and similar (P = 0.17) ADG between NAR and LAS, whereas ADG did not differ (P > 0.28) between LAS, VRM, and CON bulls. A treatment effect was detected (P = 0.03) for dry matter intake, being greater in NAR vs. CON, LAS, and VRM bulls, and similar (P > 0.48) between CON, LAS, and VRM bulls. A tendency was detected (P = 0.09) for feed efficiency, which was greater (P < 0.02) in NAR bulls vs. CON and VRM, and similar (P = 0.36) between NAR and LAS bulls. From day 112 to 140, bulls receiving NAR were heavier (P < 0.03) vs. CON, LAS, and VRM bulls, but no differences were observed (P > 0.51) between CON, LAS, and VRM bulls. Collectively, ruminal fermentation profile and intake were impacted by NAR supplementation, which partially contributed to the enhanced performance of Nellore bulls receiving a forage-based diet.
Managing Externalities in the WTO: The Agreement On Fisheries Subsidies
Authors: Hoekman Bernard M , Mavroidis Petros C , Sasmal Sunayana
Published: April 2023

By prohibiting subsidies that support illegal, unregulated, or unreported fishing activities and contribute to the unsustainable depletion of marine resources, the 2022 Agreement on Fisheries Subsidies (AFS) is the first World Trade Organization (WTO) treaty to recognize that a specific trade policy instrument can have adverse consequences for the global commons. We assess the AFS as such and through the lens of the broader challenge confronting WTO members in determining how to address subsidy spillovers and adapt trade policy rules to protect the global commons. While the AFS is a step forward for the WTO, definitions of what constitutes a subsidy and the approach taken to ensure transparency are those that have been part of the WTO since 1995 and have become the cause for contestation and calls for reform. We suggest ways in which birth defects can be addressed while implementing and expanding the coverage of the agreement.
T cells go with the flow: aquaporin 4 is required for full T-cell activation
Authors: Morley Sharon Celeste
Published: April 2023

Proximal T-cell receptor signaling and subsequent T-cell activation were reduced downstream of anti-CD3/CD28 ligation through small-molecule inhibition of the water channel aquaporin 4.
Immune profiling in Puerto Rican injection drug users with and without HIV-1 infection
Authors: Bennett Sydney J , Davila Carmen Ana , Reyes Zahiraliz , Valentín-Acevedo Aníbal , Gocchi Carrasco Kim , Abadie Roberto , Marlin M Caleb , Beel Marci , Chapple Andrew G , Fernando Samodha , Guthridge Joel M , Chiou Kathy S , Dombrowski Kirk , West John T , Wood Charles
Published: April 2023

Antiretroviral therapy has been effective in suppressing HIV viral load and enabling people living with HIV to experience longer, more conventional lives. However, as people living with HIV are living longer, they are developing aging-related diseases prematurely and are more susceptible to comorbidities that have been linked to chronic inflammation. Coincident with HIV infection and aging, drug abuse has also been independently associated with gut dysbiosis, microbial translocation, and inflammation. Here, we hypothesized that injection drug use would exacerbate HIV-induced immune activation and inflammation, thereby intensifying immune dysfunction. We recruited 50 individuals not using injection drugs (36/50 HIV+) and 47 people who inject drugs (PWID, 12/47 HIV+). All but 3 of the HIV+ subjects were on antiretroviral therapy. Plasma immune profiles were characterized by immunoproteomics, and cellular immunophenotypes were assessed using mass cytometry. The immune profiles of HIV+/PWID−, HIV−/PWID+, and HIV+/PWID+ were each significantly different from controls; however, few differences between these groups were detected, and only 3 inflammatory mediators and 2 immune cell populations demonstrated a combinatorial effect of injection drug use and HIV infection. In conclusion, a comprehensive analysis of inflammatory mediators and cell immunophenotypes revealed remarkably similar patterns of immune dysfunction in HIV-infected individuals and in people who inject drugs with and without HIV-1 infection.
Rickettsioses imported by travellers and migrants to Spain attended in the +Redivi network, 2009–2020
Authors: Llenas-García Jara , Cañaveral Ramiro , Arsuaga Marta , Monge-Maillo Begoña , Oliveira-Souto Inés , Torrús-Tendero Diego , Rodríguez Guardado Azucena , Calabuig Eva , Sánchez-Montalvá Adrián , Domínguez-Castellano Ángel , de la Calle-Prieto Fernando , Pérez-Molina José A
Published: April 2023

Background

Rickettsioses are emerging zoonotic diseases with worldwide prevalence, recognized as a cause of imported fever in travellers and migrants. Our objective is to describe the microbiological, clinical and epidemiological characteristics of imported rickettsioses in travellers and migrants included in a Spanish collaborative network database.

Methods

This multicentre retrospective observational study was nested in +Redivi, the Cooperative Network for the Study of Infections Imported by Immigrants and Travellers. We asked collaborating centres for microbiological, clinical and epidemiological data on the rickettsiosis cases from the inception of the network in 2009 to December 2020.

Results

Fifty-four cases of imported rickettsioses were included; 35 (64.8%) patients were men, and the median age was 37 years (interquartile range 26, 51.2). Only 7.4% of patients were travellers visiting friends and relatives, and 5.6% were migrants. The most frequent travel destination (38.9%) was South Africa, and 90.7% engaged in a high-risk activity. Twenty-seven patients (50.0%) started presenting symptoms after their return to Spain. The most frequent symptoms were febrile syndrome (55.6%) and cutaneous manifestations (27.8%). Most diagnoses (63.0%) were confirmed by serology. Only a few cases (9.3%) required hospitalization. All participants had a full recovery.

Conclusions

Clinicians should suspect rickettsial diseases in travellers coming from high-risk areas, especially Southern Africa, who have engaged in activities in rural areas and natural parks. Doxycycline should be considered in the empiric treatment of imported fever of travellers coming from those areas or who have engaged in high-risk activities. There is a need to improve access to molecular diagnosis of rickettsiosis in Spain.
Scheduling pre-operative assessment clinic with answer set programming
Authors: Caruso Simone , Galatà Giuseppe , Maratea Marco , Mochi Marco , Porro Ivan
Published: April 2023

The problem of scheduling pre-operative assessment clinic (PAC) consists of assigning patients to a day for the exams needed before a surgical procedure, taking into account patients with different priority levels, due dates and operators availability. Realizing a satisfying schedule is of upmost importance for a hospital, since delay in PAC can cause delay in the subsequent phases, thus lowering patients’ satisfaction. In this paper, we propose a two-phase solution to the PAC problem: in the first phase, patients are assigned to a day taking into account a default list of exams; then, in the second phase, having the actual list of exams needed by each patient, we use the results of the first phase to assign a starting time to each exam. We first present a mathematical formulation for both problems. Further, we present a solution where modeling and solving are done via answer set programming. We then introduce a rescheduling solution that may come into play when the scheduling solution cannot be applied fully. Experiments employing synthetic benchmarks on both scheduling and rescheduling show that both solutions provide satisfying results in short time. We finally show the implementation and usage of a web application that allows to run our scheduling solution and analyze the results graphically in a transparent way.
In Vivo Wound-Healing Effect of Chemical and Green Synthesized Chitosan Nanoparticles Using Lawsonia inermis Ethanolic Extract
Authors: Metwally Asmaa A , Soliman Ahmed S , Abdel-Hady Abdel-Nasser A A , Ebnalwaled Khaled , Mohamedien Dalia , Abdelhameed Abeer A , Saied AbdulRahman A
Published: April 2023

Wounds can be a result of surgery, an accident, or other factors. There is still a challenge to find effective topical wound-healing agents. This study aims to investigate the wound-healing activity of chemical and green synthesized chitosan nanoparticles (Ch-NPs) using Lawsonia inermis leaves extract. The nanoparticles were morphologically and chemically characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and high-resolution transmission electron microscopy (HRTEM). Forty-five adult female albino rats were randomly divided into three groups. The cutaneous surgical wounds were topically treated with 0.9% normal saline (control group), green Ch-NPs (second group), and chemical Ch-NPs gels (third group), respectively. The clinical picture of wounds and histopathological changes were assessed on the 3rd, 7th, 14th, and 21st days post-treatment. X-ray diffraction analysis revealed great crystallinity and purity of nanoparticles. The studied nanoparticles increased the wound contraction percent (WC%), reduced healing time and wound surface area (WSA), and these results were backed up by histological findings that indicated improved epithelialization, dermal differentiation, collagen deposition, and angiogenesis in treated rats compared with control rats (p < 0.05). We concluded that the wound-healing effects of the studied nanoparticles are encouraging, and further studies for complete assessment are still needed.
From STEM to 4D STEM: Ultrafast Diffraction Mapping with a Hybrid-Pixel Detector
Authors: Stroppa Daniel G , Meffert Matthias , Hoermann Christoph , Zambon Pietro , Bachevskaya Darya  , Remigy Hervé , Schulze-Briese Clemens , Piazza Luca
Published: April 2023

4D scanning transmission electron microscope (STEM) techniques have been increasingly featured among the electron microscopy characterization approaches, as they provide a perspective of improved information retrieval from samples overall. To make 4D STEM experiments as viable as conventional STEM image acquisition, the recording of diffraction patterns with a pixelated detector at fast frame rates, sufficient sensitivity to capture single electron hits, and high dynamic range is necessary. This paper addresses the recent development in hybrid-pixel detector technology that now allows 4D STEM experiments with a similar setup to conventional STEM imaging with pixel collection time under 10 µs. Application examples on virtual STEM detectors and crystal phase-orientation mapping are presented.
Scanning Transmission Electron Microscopy Done Right
Authors: Van Der Wal Dirk
Published: April 2023

Performance, usability, and even availability of 4D-scanning transmission electron microscopy (STEM) measurements have historically been compromised by the lack of integration of 4D-STEM components on (S)TEM columns that were not originally designed for this purpose. This article introduces TESCAN TENSOR, the world’s first dedicated 4D-STEM instrument for multimodal characterization of nanoscale morphological, chemical, and structural properties of functional materials, thin films, and natural and synthetic crystals with stand-out 4D-STEM performance and unprecedented usability. 4D-STEM is the microscopy method of choice for nanoscale, multimodal characterization of material properties such as morphology, chemistry, and structure. At each pixel in the STEM dataset, the TENSOR rapidly acquires a diffraction pattern and an energy dispersive spectroscopy (EDS) spectrum that are perfectly synchronized. Together, diffraction and spectroscopy data encapsulate the full picture of electron beam–specimen interaction, from which a wide range of material properties can be derived. This article will review analytical 4D-STEM applications and discuss how the new 4D-STEM meets these requirements.
FAUST – VIII. The protostellar disc of VLA 1623–2417W and its streamers imaged by ALMA
Authors: Mercimek S , Podio L , Codella C , Chahine L , López-Sepulcre A , Ohashi S , Loinard L , Johnstone D , Menard F , Cuello N , Caselli P , Zamponi J , Aikawa Y , Bianchi E , Busquet G , Pineda J E , Bouvier M , De Simone M , Zhang Y , Sakai N , Chandler C J , Ceccarelli C , Alves F , Durán A , Fedele D , Murillo N , Jiménez-Serra I , Yamamoto S
Published: April 2023

More than 50 per cent of solar-mass stars form in multiple systems. It is therefore crucial to investigate how multiplicity affects the star and planet formation processes at the protostellar stage. We report continuum and C18O (2–1) observations of the VLA 1623–2417 protostellar system at 50 au angular resolution as part of the ALMA (Atacama Large Millimeter/submillimeter Array) Large Program FAUST. The 1.3 mm continuum probes the discs of VLA 1623A, B, and W, and the circumbinary disc of the A1 + A2 binary. The C18O emission reveals, for the first time, the gas in the disc envelope of VLA 1623W. We estimate the dynamical mass of VLA 1623W, Mdyn = 0.45 ± 0.08 M⊙, and the mass of its disc, Mdisc ∼ 6 × 10−3 M⊙. C18O also reveals streamers that extend up to 1000 au, spatially and kinematically connecting the envelope and outflow cavities of the A1 + A2 + B system with the disc of VLA 1623W. The presence of the streamers, as well as the spatial (∼1300 au) and velocity (∼2.2 km s−1) offsets of VLA 1623W, suggests that either sources W and A + B formed in different cores, interacting between them, or source W has been ejected from the VLA 1623 multiple system during its formation. In the latter case, the streamers may funnel material from the envelope and cavities of VLA 1623AB on to VLA 1623W, thus concurring to set its final mass and chemical content.
The Origin of Floral Quartet Formation—Ancient Exon Duplications Shaped the Evolution of MIKC-type MADS-domain Transcription Factor Interactions
Authors: Rümpler Florian , Tessari Chiara , Gramzow Lydia , Gafert Christian , Blohs Marcus , Theißen Günter
Published: April 2023

During development of flowering plants, some MIKC-type MADS-domain transcription factors (MTFs) exert their regulatory function as heterotetrameric complexes bound to two sites on the DNA of target genes. This way they constitute “floral quartets” or related “floral quartet-like complexes” (FQCs), involving a unique multimeric system of paralogous protein interactions. Tetramerization of MTFs is brought about mainly by interactions of keratin-like (K) domains. The K-domain associated with the more ancient DNA-binding MADS-domain during evolution in the stem group of extant streptophytes (charophyte green algae + land plants). However, whether this was sufficient for MTF tetramerization and FQC formation to occur, remains unknown. Here, we provide biophysical and bioinformatic data indicating that FQC formation likely originated in the stem group of land plants in a sublineage of MIKC-type genes termed MIKCC-type genes. In the stem group of this gene lineage, the duplication of the most downstream exon encoding the K-domain led to a C-terminal elongation of the second K-domain helix, thus, generating the tetramerization interface found in extant MIKCC-type proteins. In the stem group of the sister lineage of the MIKCC-type genes, termed MIKC*-type genes, the duplication of two other K-domain exons occurred, extending the K-domain at its N-terminal end. Our data indicate that this structural change prevents heterodimerization between MIKCC-type and MIKC*-type proteins. This way, two largely independent gene regulatory networks could be established, featuring MIKCC-type or MIKC*-type proteins, respectively, that control different aspects of plant development.
Analysis of the saliva microbiome in patients with immunoglobulin G4–related disease
Authors: Yamamoto Motohisa , Aochi Satsuki , Uehara Masaaki
Published: April 2023

Objectives

This article aims to investigate the saliva microbiome in patients with immunoglobulin G4–related disease (IgG4RD) compared with primary Sjögren’s syndrome (SS).

Methods

Saliva samples were collected from 11 IgG4RD and 11 SS patients who visited IMSUT Hospital, The Institute of Medical Science, The University of Tokyo. Deoxyribonucleic acid (DNA) was extracted from the samples, and primers were used to amplify the V3–V4 regions of bacterial and archaeal 16S ribosomal RNA (rRNA) genes, which was then analysed by paired-end sequencing. Amplicon reads were processed using QIIME2 to generate representative sequences. The Greengenes database was used to identify the bacterial flora in each sample and compare them between groups.

Results

The IgG4RD and SS groups exhibited differences in bacterial diversity. Cluster analyses of attributed classification groups by species and disease showed that IgG4RD and SS cases formed individual clusters. Significant differences in relative abundance between IgG4RD and SS were observed for the following organisms: Mogibacterium (P = .0051), Solobacterium moorei (P = .0195), Slackia (P = .0356), and Moryella (P = .0455).

Conclusions

Salivary microbiome analysis of IgG4RD and SS patients revealed significantly higher relative proportions of Mogibacterium, S. moorei, Slackia, and Moryella bacteria in IgG4RD compared with SS.
The Association Between Tobacco and Cannabis Use and the Age of Onset of Depression and Anxiety Symptoms: Among Adolescents and Young Adults
Authors: Bataineh Bara S , Wilkinson Anna V , Sumbe Aslesha , Clendennen Stephanie L , Chen Baojiang , Messiah Sarah E , Harrell Melissa B
Published: April 2023

Introduction

No studies have prospectively explored the association between the use of tobacco or cannabis use and the age of onset of depressive or anxiety symptoms, and no studies have identified the peak ages and ranges of onset of these symptoms among tobacco and/or cannabis users.

Aims and Methods

This is a secondary analysis of Texas Adolescent Tobacco and Marketing Surveillance System data, waves 9–14 (2019–20121). Participants were in 10th grade, 12th grade, and 2 years post-high school (HS) at baseline (wave 9). Interval-censoring multivariable Cox proportional hazards models were fit to assess differences in the estimated age of onset of depression and anxiety by tobacco and cannabis use while adjusting for covariates.

Results

We found that lifetime or ever cigarette, e-cigarette, and cannabis use had an increased risk of an earlier age of onset of depressive and anxiety symptoms across the three cohorts, and the youngest cohort was the most differentially impacted by substance use. Between ages 18 to 19 years in the 10th-grade cohort, between ages 20 to 21 years in the 12th-grade cohort, and between ages 22 to 23 years in the post-HS cohort, the estimated hazard function (or cumulative incidence) for reporting depressive and anxiety symptoms almost doubled among lifetime cigarette, e-cigarette, and cannabis users.

Conclusions

Tobacco and cannabis users should be screened for mental health problems at an earlier age, especially those aged 18 years and younger, and provided with age- and culturally appropriate resources to prevent or delay the onset of anxiety and/or depression symptoms.

Implications

The study’s findings indicate that tobacco and cannabis use is directly linked to the early onset of depressive and anxiety symptoms among youth. This highlights the significance of early screening and substance use interventions, particularly for youth aged 18 years and younger, as they are disproportionately affected by both substance use and mental health problems. School-based interventions that are age- and culturally appropriate hold promise as they enable youth to seek professional help early, and in a supportive environment. Intervening early in substance shows promise in reducing the likelihood of developing mental health problems at a young age.
Effects of intermittent fasting on cognitive health and Alzheimer’s disease
Authors: Elias Alby , Padinjakara Noushad , Lautenschlager Nicola T
Published: April 2023

Objective

Caloric restriction by intermittent fasting produces several metabolic changes, such as increased insulin sensitivity and use of ketone bodies as energy sources. In humans, intermittent fasting has been studied in hypertension, diabetes, and related conditions, but, to date, not as a strategy to reduce the risk of emergent dementia. In this scoping review, the relevance of intermittent fasting as a potential preventive intervention for Alzheimer’s dementia is explored.

Background

The beneficial effects of calorie restriction have been documented in animals and humans. Decreased oxidative stress damage and attenuated inflammatory responses are associated with intermittent fasting. These changes have a favorable impact on the vascular endothelium and stress-induced cellular adaptation.

Results

Physiological alterations associated with fasting have profound implications for pathological mechanisms associated with dementias, particularly Alzheimer’s disease. Compared with ad libitum feeding, caloric restriction in animals was associated with a reduction in β-amyloid accumulation, which is the cardinal pathological marker of Alzheimer’s disease. Animal studies have demonstrated synaptic adaptations in the hippocampus and enhanced cognitive function after fasting, consistent with these theoretical frameworks. Furthermore, vascular dysfunction plays a crucial role in Alzheimer’s disease pathology, and intermittent fasting promotes vascular health.

Conclusions

These observations lead to a hypothesis that intermittent fasting over the years will potentially reverse or delay the pathological process in Alzheimer’s disease.
Anaplasmosis in Pennsylvania: Clinical Features, Diagnosis, and Outcomes of Patients Diagnosed With Anaplasma phagocytophilum Infection at Hershey Medical Center From 2008 to 2021
Authors: Ingram David , Joseph Betsy , Hawkins Stephanie , Spain James
Published: April 2023

Anaplasmosis is an emerging infection in the United States and in particular, Pennsylvania. We highlight the abrupt rise in cases of anaplasmosis in the past decade in the state of Pennsylvania with the hope of increasing clinician awareness. We identified a cohort of 61 patients diagnosed with anaplasmosis at our institution as well as cases reported to the Department of Health. From our review, we identified not only an increase in cases over time but what appears to be an expansion further into central and western Pennsylvania over time.
Petrogenesis of Mantle-Hosted Granitoids from the Samail Ophiolite
Authors: Angelo Tiago Valim , Spencer Christopher J , Cavosie Aaron J , Thomas Robert , Li Hong-Yan
Published: April 2023

Granitoids with evolved chemical signatures, intruding both oceanic crustal rocks and mantle peridotite, are well known in the Samail supra-subduction ophiolite of Oman and United Arab Emirates. The former are metaluminous tonalites and trondhjemites have positive εNd, relatively low δ18O values, resemble ridge ‘tholeiitic’ granitoids with MORB-like affinity, and formed by fractionation of basalt/gabbro or anatexis of oceanic crust. In contrast, the mantle-hosted granitoids are peraluminous, with negative εNd and high δ18O values. They can be modeled as having formed by mixing between partial melts of metabasalt and metasedimentary rocks with minimal mantle contribution. The mantle-hosted granitoids resemble typical peraluminous S-type granitoids (e.g. Himalaya, Variscan, Lachlan) but are compositionally distinct in having notably scattered data values of K2O, Na2O, CaO, Rb/Sr, relatively higher silica and, lower (Al2O3 + FeO + MgO + TiO2 wt%) and Th/Yb as compared to typical S-types. The mantle-hosted granitoids mainly originate from the subducted slab, and mostly intruded mantle peridotite in the lithospheric mantle, with no apparent association with the overriding oceanic plate and little interaction (e.g. assimilation) with the mantle. While the specific controls on geochemical variations remain speculative, results from this study show that the Samail mantle-hosted S-type granitoids are compositionally distinct from classic S-type granitoids formed in orogenic belts. While global S-type granitoids may be mineralogically similar, the Samail mantle-hosted granitoids preserve different geochemical signatures, reflecting their formation in distinct tectonic setting, including the mantle.
Sidestepping the Frege–Geach Problem
Authors: Bex-Priestley Graham , Gamester Will
Published: April 2023

Hybrid expressivists claim to solve the Frege–Geach problem by offloading the explanation of the logico-semantic properties of moral sentences onto the belief-components of hybrid states they express. We argue that this strategy is undermined by one of hybrid expressivism's own commitments: That the truth of the belief-component is neither necessary nor sufficient for the truth of the hybrid state it composes. We articulate a new approach. Instead of explaining head-on what it is for, say, a pair of moral sentences to be inconsistent, expressivists should ‘sidestep’ and explain what it is to think that a pair of moral sentences is inconsistent. To think so is to think they cannot both be true—a modal notion. Since expressivists have given accounts of such modals, we illustrate how sentences like ‘‘‘lying is wrong’’ and ‘‘lying is not wrong’’ are inconsistent’ express sensible—and rationally compelling—states of mind.
Two Neuroanatomical Signatures in Schizophrenia: Expression Strengths Over the First 2 Years of Treatment and Their Relationships to Neurodevelopmental Compromise and Antipsychotic Treatment
Authors: du Plessis Stefan , Chand Ganesh B , Erus Guray , Phahladira Lebogang , Luckhoff Hilmar K , Smit Retha , Asmal Laila , Wolf Daniel H , Davatzikos Christos , Emsley Robin
Published: April 2023

Background and Hypothesis

Two machine learning derived neuroanatomical signatures were recently described. Signature 1 is associated with widespread grey matter volume reductions and signature 2 with larger basal ganglia and internal capsule volumes. We hypothesized that they represent the neurodevelopmental and treatment-responsive components of schizophrenia respectively.

Study Design

We assessed the expression strength trajectories of these signatures and evaluated their relationships with indicators of neurodevelopmental compromise and with antipsychotic treatment effects in 83 previously minimally treated individuals with a first episode of a schizophrenia spectrum disorder who received standardized treatment and underwent comprehensive clinical, cognitive and neuroimaging assessments over 24 months. Ninety-six matched healthy case–controls were included.

Study Results

Linear mixed effect repeated measures models indicated that the patients had stronger expression of signature 1 than controls that remained stable over time and was not related to treatment. Stronger signature 1 expression showed trend associations with lower educational attainment, poorer sensory integration, and worse cognitive performance for working memory, verbal learning and reasoning and problem solving. The most striking finding was that signature 2 expression was similar for patients and controls at baseline but increased significantly with treatment in the patients. Greater increase in signature 2 expression was associated with larger reductions in PANSS total score and increases in BMI and not associated with neurodevelopmental indices.

Conclusions

These findings provide supporting evidence for two distinct neuroanatomical signatures representing the neurodevelopmental and treatment-responsive components of schizophrenia.
Paired analysis of ED efficiency for low-acuity children treated by PAs and pediatricians
Authors: McKinley Kenneth W. , Tran Jennifer Q. , Chamberlain James M. , Berkowitz Deena D.
Published: April 2023

Objective:

To determine if there was a clinically important difference (15 minutes or more) in length of stay (LOS) for low-acuity pediatric ED patients treated by PAs compared with those treated by pediatricians.

Methods:

Between July 2017 and February 2020, shifts were identified that had shared PA and pediatrician staffing in the low-acuity care area for a large, urban ED. LOS was collected for every patient during the 6 hours of overlap for each shift. Using a paired analysis, we calculated the difference in mean LOS for these shifts.

Results:

Mean shift LOS for children seen by PAs (160.1 minutes, SD: 48.6) was 10.1 minutes longer (95% CI: 6.1, 14.1) than mean shift LOS for children seen by pediatricians (150 minutes, SD: 47.3).

Conclusions:

No clinically important difference in LOS was found for low-acuity children treated by PAs compared with those treated by pediatricians in a large, urban ED.
A Faculty Toolkit to Pilot Next Generation NCLEX-Style Exam Items in a Prelicensure Curriculum
Authors: Davis Rebecca G.
Published: April 2023

With the implementation of Next Generation NCLEX (NGN), many prelicensure nurse faculty feel unprepared to create examination items in the formats proposed. These formats are designed to meaningfully evaluate clinical judgment while providing learners experience with the NGN assessment format prior to their sitting for the licensure examination. This article presents one program’s pilot of NGN-style exam items in three clinical courses. Resources created for faculty to successfully implement the pilot items, outcomes of the pilot, and future plans for full implementation are discussed.
Implementing the AAOS Guidelines for Screening of Developmental Dysplasia of the Hip Before the Age of 6 Months in Taiwan
Authors: Hsu Kuei-Hsiang , Chang Wen-Chieh , Feng Chi-Kuang , Su Yu-Ping
Published: April 2023

Background:

The prevalence of developmental dysplasia of the hip (DDH) has been considered to be low in East Asia, but this may be incorrect because of inconsistent diagnostic definitions and testing criteria. In 2015, the AAOS released guidelines for systematic screening for DDH in newborns. We implemented these guidelines and compared DDH incidence and outcomes before and after their implementation.

Methods:

We used a historic comparison cohort of newborns with DDH between July 2015 and May 2017 before guideline implementation (the preguideline group); their data were retrieved using electronic medical records. In this group, the newborns received general hip screening without systemic follow-up. The postguideline group included newborns who were screened for hip dysplasia and followed up per the AAOS guidelines between July 2017 and May 2019. Their data were prospectively collected. The primary outcome in the postguideline group was DDH incidence. Other outcomes included rates of referral, surgery, and complications, and DDH prognosis.

Results:

The preguideline and postguideline groups included 3534 and 2663 newborns, respectively, of whom 49 (1.1%) and 225 (8.4%), respectively, were referred to the pediatric orthopaedic clinic enrolled. In the postguideline group, 35 patients were diagnosed as having DDH (incidence: 1.3%, 95% CI: 0.8%–1.9%). Both the incidence and referral rates were significantly higher in the postguideline group than in the preguideline group. Furthermore, the mean age at referral was 6.7±10.06 months and 0.9±0.25 months in the preguideline and postguideline groups, respectively, indicating a potential for early treatment in the postguideline group. Finally, the female sex was identified as a risk factor for residual hip dysplasia at 6 months of age.

Conclusion:

DDH incidence in East Asia seems comparable to that in Western countries. Implementing the AAOS guidelines increased the diagnosis rate and opportunity for early treatment initiation, thus potentially avoiding surgical intervention. Nevertheless, residual DDH may be detected in some patients at 6 months of age, particularly in female infants.

Level of Evidence:

Level IV.
Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy
Authors: Dearborn Logan C , Hazlehurst Marnie F , Loftus Christine T , Szpiro Adam A , Carroll Kecia N , Moore Paul E , Adgent Margaret A , Barrett Emily S , Nguyen Ruby HN , Sathyanarayana Sheela , LeWinn Kaja Z , Bush Nicole R , Kaufman Joel D , Karr Catherine J
Published: April 2023

Background:

Infants experiencing bronchiolitis are at increased risk for asthma, but few studies have identified modifiable risk factors. We assessed whether early life air pollution influenced child asthma and wheeze at age 4–6 years among children with a history of bronchiolitis in the first postnatal year.

Methods:

Children with caregiver-reported physician-diagnosed bronchiolitis were drawn from ECHO-PATHWAYS, a pooled longitudinal cohort from six US cities. We estimated their air pollution exposure from age 1 to 3 years from validated spatiotemporal models of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3). Caregivers reported children’s current wheeze and asthma at age 4–6 years. We used modified Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for child, maternal, and home environmental factors. We assessed effect modification by child sex and maternal history of asthma with interaction models.

Results:

A total of 224 children had caregiver-reported bronchiolitis. Median (interquartile range) 2-year pollutant concentrations were 9.3 (7.8–9.9) µg/m3 PM2.5, 8.5 (6.4–9.9) ppb NO2, and 26.6 (25.6–27.7) ppb O3. RRs (CI) for current wheeze per 2-ppb higher O3 were 1.3 (1.0–1.7) and 1.4 (1.1–1.8) for asthma. NO2 was inversely associated with wheeze and asthma whereas associations with PM2.5 were null. We observed interactions between NO2 and PM2.5 and maternal history of asthma, with lower risks observed among children with a maternal history of asthma.

Conclusion:

Our results are consistent with the hypothesis that exposure to modest postnatal O3 concentrations increases the risk of asthma and wheeze among the vulnerable subpopulation of infants experiencing bronchiolitis.
Prevalence and Factors Associated With Delayed Puberty Among Adolescents on Boosted Protease Inhibitor–based Second-line Antiretroviral Therapy: A Cross-sectional Study at a Pediatric Infectious Diseases Clinic in Uganda
Authors: Nakiddu Nana Jacqueline , Bakeera-Kitaka Sabrina , Musoke Philippa
Published: April 2023

Background:

Delayed puberty is a recognized phenomenon among children living with HIV type 1 infection but has not been widely reported among adolescents on second-line or newer treatments in high burden settings. The study aimed to determine the prevalence of, and factors associated with delayed puberty among adolescents on boosted protease inhibitor-based second-line antiretroviral therapy (ART) in Uganda.

Methods:

Between December 2017 and May 2018, we conducted a cross-sectional study among adolescents living with HIV (ALWHIV) 10–19 years of age on atazanavir- and lopinavir-based regimens at the Paediatric Infectious Diseases Clinic, Kampala. Participants were on ART for at least 3 months and had a recent viral load. Sociodemographics, clinical measurements: body mass index for age Z score, height for age Z score, Tanner staging were collected. ART history was extracted from medical records. The outcome was delayed puberty defined as absence of signs of breast development in a girl 13 years of age or a testicular volume of less than 4 mL in a boy 14 years of age by Tanner staging, or an age for Tanner staging which was at least 2 standard deviations above the expected mean.

Results:

Among 230 perinatally infected ALWHIV participants, 14.7 ± 3.1 years of age were included, 54.9% were female, 5.2% were wasted and the median duration on ART was 9.5 years (interquartile range 7.3–11.7). The prevalence of delayed puberty was 8.7% (10.4% females, 6.7% males). Overall mean age estimates at different Tanner stages by sex were significantly higher than reference populations. Age at ART initiation (adjusted odds ratio 1.37, 95% confidence interval: 1.06–1.77) and body mass index for age Z score (adjusted odds ratio: 7.63, 95% confidence interval: 1.80–32.38) were associated with delayed puberty.

Conclusions:

Timely initiation of ART and nutritional monitoring could optimize body weight and consequently, normal puberty for ALWHIV. Longitudinal studies could establish biological diagnoses and guide treatment of delayed puberty in this population.