bluuebunny/crossref_metadata_2025 huggingface dataset:
Compact object populations over cosmic time – I. bossa: a binary object environment-sensitive sampling algorithm
Authors: de Sá Lucas M , Bernardo Antônio , Rocha Lívia S , Bachega Riis R A , Horvath Jorge E
Published: October 2024

Binary population synthesis (BPS) is an essential tool for extracting information about massive binary evolution from gravitational-wave detections of compact object mergers. It has been successfully used to constrain the most likely permutations of evolution models among hundreds of alternatives, while initial condition models, in contrast, have not yet received the same level of attention. Here, we introduce bossa, a detailed initial sampling code including a set of 192 initial condition permutations for BPS, that captures both ‘invariant’ and ‘varying’ models, the latter accounting for a possible metallicity- and star formation rate-dependence of the initial mass function (IMF), as well as correlations between the initial primary mass, orbital period, mass ratio, and eccentricity of binaries. We include 24 metallicity-specific cosmic star formation history models and propose two alternate models for the mass-dependent binary fraction. We build a detailed pipeline for time-evolving BPS, such that each binary has well-defined initial conditions, and we are able to distinguish the contributions from populations of different ages. We discuss the meaning of the IMF for binaries and introduce a refined initial sampling procedure for component masses. We also discuss the treatment of higher order multiple systems when normalizing a binary sample. In particular, we argue for how a consistent interpretation of the IMF implies that this is not the distribution from which any set of component masses should be independently drawn, and show how the individual IMF of primaries and companions is expected to deviate from the full IMF.
Low-resolution transit spectroscopy of three hot Jupiters using the 2 m Himalayan Chandra Telescope
Authors: Unni Athira , Sivarani Thirupathi , Goyal Jayesh , Joshi Yogesh C , Oza Apurva V , Banyal Ravinder K
Published: October 2024

Here, we present the low-resolution transmission spectroscopy of three giant planets using the Himalayan Faint Object Spectrograph Camera (HFOSC) on the 2 m Himalayan Chandra Telescope (HCT) in Hanle, India. It is the first application of transmission spectroscopy with HCT. This study presents results from a single transit, each for three planets: HAT-P-1b, KELT-18b, and WASP-127b. The selection of suitable reference stars assisted in accurately tracking slit losses for the long cadence observations that are needed to achieve the required signal-to-noise ratio (SNR). We employ the common mode correction technique, utilizing a white light transit curve to minimize time-dependent systematic errors. The observed spectra for WASP-127b and HAT-P-1b agree with previous low-resolution transit spectroscopic observations using other observing facilities. We confirm the presence of Rayleigh scattering in the atmosphere of WASP-127b. In addition, we provide the first low-resolution transmission spectrum for KELT-18b. Modelling the exoplanet atmosphere with HFOSC and available IR observations from HST and Spitzer for WASP-127b and HAT-P-1b shows that HFOSC can be an alternative optical instrument to use in conjunction with IR observations to constrain the atmospheric parameters better.
E-cigarette Retail Outlets in Mexico: A Country That Bans the Sale
Authors: Zepeta Hernández David , López Arellano Angelica Susana , del Angel Salazar Erika Mayte , Martínez Díaz Nazaria
Published: October 2024

Introduction

Restrictive e-cigarette policies have not allowed for the characterization of the sale of these tobacco products in the countries where they are implemented. This is because it is believed that there are no stores. However, the use of e-cigarettes persists in these countries.

Aims and Methods

A content analysis of electronic cigarette points of sale through the Internet in Mexico was conducted. Cross-sectional study. Structured searches were performed in the Google Maps search engine with the terms “electronic cigarette store” and “vape store” in combination with the name of each state of Mexico, in the period from October 2021 to February 2022.

Results

A total of 695 e-cigarette stores were located, of which 481 (69.2%) were physical stores, 207 hybrid stores (29.8%), 4 online stores (0.6%), and 3 (0.4%) vending machines. A total of 316 e-cigarette brands and 578 vape liquid brands were identified. The sales attraction strategy they used the most was free shipping of products (85.8%). Stores used WhatsApp (92.5%), Facebook (86.3%), and Instagram (74.4%) to promote their products. Only 35.1% of stores checked the age of their customers, of which, 95.9% asked if the customer was of legal age and 4.1% asked for the date of birth. In addition, 25.6% of the stores warned about nicotine addiction and 24.2% specifically about the ingredients of the liquids.

Conclusions

E-cigarettes are widely available and marketed in a variety of retail outlets in Mexico. The high number of stores, brands of liquids, and e-cigarettes indicates noncompliance with existing regulations.

Implications

E-cigarette consumption has increased globally, even in countries with restrictive regulations. However, there is limited data on the density and characteristics of vape stores in low- and middle-income countries with restrictive regulations. This study found no significant differences in e-cigarette sales between countries with permissive and restrictive regulations. Therefore, it is suggested that, in addition to establishing restrictive policies on the sale of e-cigarettes, their enforcement should also be monitored. Countries with restrictive measures should regulate Internet sales and promotion of e-cigarettes with greater emphasis.
ANA-positive versus ANA-negative Antiphospholipid Antibody-positive Patients: Results from the Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) Clinical Database and Repository (“Registry”)
Authors: Cecchi Irene , Radin Massimo , Foddai Silvia Grazietta , Barinotti Alice , Andrade Danieli , Tektonidou Maria G , Pengo Vittorio , Ruiz-Irastorza Guillermo , Belmont H Michael , Lopez Pedrera Chary , Fortin Paul R , Gerosa Maria , de Jesús Guilherme , Atsumi Tatsuya , Ji Lanlan , Efthymiou Maria , Branch D Ware , Nalli Cecilia , Rodriguez-Almaraz Esther , Petri Michelle , Cervera Ricard , Knight Jason S , Artim-Esen Bahar , Willis Rohan , Bertolaccini Maria Laura , Cohen Hannah , Erkan Doruk , Sciascia Savino
Published: October 2024

Objectives

This study focused on the prevalence and impact of ANA in aPL-positive patients without concomitant systemic autoimmune rheumatic diseases (SARDs).

Methods

Data from aPL-positive patients with or without Revised Sapporo APS classification criteria were retrieved from the Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) Registry. Patients with concomitant SARDs were excluded.

Results

A total of 430 aPL-positive patients were included in the analysis, 56% ANA-positive (ANA+) and 44% ANA-negative (ANA−). ANA positivity was significantly associated with history of haematologic manifestations (persistent autoimmune haemolytic anaemia, thrombocytopenia, leukopenia and/or lymphopenia) (16% of ANA+ vs 7% of ANA−, P = 0.006). Triple aPL-positivity was more frequent in the ANA+ subgroup (P = 0.02), along with low baseline C3 and C4 levels (P = 0.05 and P = 0.009, respectively), and higher frequency for ENA. Among aPL-positive patients with no APS classification, ANA+ patients showed a higher rate of arthritis (P = 0.006). Among female patients who have experienced at least one pregnancy, 113 were ANA+ and 96 were ANA−; ANA− patients had a higher number of pregnancies (P = 0.018), and number of live births (P = 0.014). A wider proportion of ANA+ patients were treated with HCQ (P < 0.001).

Conclusion

When we analysed aPL-positive patients with no other SARDs, ANA status was not associated with thrombosis or pregnancy morbidity. Interestingly, ANA+ patients showed higher rates of systemic autoimmune features, including haematologic manifestations, multiple aPL positivity, lower complement levels, ENA positivity, and joint involvement, and were more often treated with HCQ. Finally, aPL-positive subjects who were ANA− had a higher rate of pregnancies and live births.
Anti-Gender Politics, Economic Insecurity, and Right-Wing Populism: The Rise of Modern Sexism among Young Men in South Korea
Authors: Lee Soohyun Christine
Published: October 2024

The 2022 presidential election in Korea saw a huge swing of young men toward the conservative candidate Yoon Suk-yeol, which was decisive for his electoral victory. This unprecedented electoral volatility created a gendered division among young voters, who had been a solid progressive voting block supporting the center-left party. The article shows how the conservatives’ anti-feminist campaign drove a wedge between young men and women, and it investigates the sources of modern sexism that allowed the successful mobilization of young men. In doing so, it points to the socioeconomic foundations of anti-gender politics: economic insecurity caught up with traditional familism and marital norms produced toxic anxiety among young men because leading a “normal life” of marriage and family is deemed beyond their reach. This anxiety made them vulnerable to the right-wing populism that was at the heart of the conservatives’ anti-feminist campaign.
Stranger things: on the novel buccopharyngeal anatomy and functional morphology of ‘sand-eating’ Malagasy tadpoles (Anura: Mantellidae: Mantidactylus)
Authors: dos Santos Dias Pedro Henrique , Vera Candioti Florencia , Wassersug Richard , Lukas Paul , Targino Mariane , Glos Julian , Wheeler Ward C , Hertwig Stefan , Crottini Angelica , Haas Alexander
Published: October 2024

Anuran larvae are characterized by an extensive array of specialized oral structures that allow them to both graze on substrates and suspension feed with great efficiency. Diversity in these feeding structures accounts for significant diversity of anurans. Herein we describe an astonishing novel buccopharyngeal morphology in six larvae of ‘sand-eating’ tadpoles of the Mantellidae genus Mantidactylus. The buccopharyngeal cavity of these tadpoles is characterized by the presence of ruffled ridges not seen previously in any other anuran larva. Extensive review of the literature and of new empirical data demonstrates the uniqueness of this morphology. We present both CT scans and ergonomic arguments in support of the hypothesis that the ruffled ridges are employed as scrubbing pads, allowing these tadpoles to remove food particles from sand grains. In addition, we explore how the ridges may have developed and evolved.
Evaluation of an Orientation Program for Adjunct Clinical Instructors in Nursing
Authors: Gravis Esther , Dolansky Mary A.
Published: October 2024

Part-time clinical nurse instructors teach students in many nursing schools in the United States. They are often unprepared for this role and require instruction in teaching methods. We developed and evaluated an online orientation program to provide the knowledge and skills necessary for nurses to become confident clinical instructors. For this project, 55 nurses completed the program; 28 were part-time faculty. Significant statistical differences were noted after completing the orientation program. Part-time faculty notably benefited from the online program and felt more confident in their ability to work with students.
Optimum Frequency for Physical Therapy Intervention in Pediatric Patients Undergoing Bone Marrow Transplantation in Acute Care Settings: A Systematic Review
Authors: Myers Abigail , Lenker Hallie , Reoli Rachel
Published: October 2024

Background:

Bone marrow transplantation (BMT) is frequently indicated for management of multiple pathologies requiring an extensive hospitalization, which can result in immobility. The implications of immobility are well documented and lead to a loss of function which physical therapy (PT) aims to prevent or restore. The purpose of this review is to investigate the reported frequency of acute PT intervention for pediatric patients undergoing BMT during hospitalization.

Methods:

A preliminary search on the Johns Hopkins Welch Library was conducted. Experimental, quasi-experimental, and analytical observational studies were included, which consisted of children and adolescents, under 25 years old, post-BMT, and received PT or exercise during their hospitalization. One reviewer assessed the studies that met the inclusion criteria. Two additional reviewers assessed for quality.

Results:

A total of 272 articles were found, 16 met the inclusion criteria. Exercise intervention during hospitalization was found to be safe and feasible. The most reported frequency was found to be 4 to 5 times a week. Factors to be considered for frequency dosing were identified to be the patient’s autonomy, level of support, fatigue, hospital stay characteristics, prior level of function, developmental state, and anthropometrics.

Conclusion:

Our review showed that 4 to 5 sessions per week was the most reported frequency. This frequency can be prescribed to this population when patient factors are considered. Patient factors should be considered for prognosis and outcomes across a wide variety of patients.
STAT1 and STAT3 gain of function: clinically heterogenous immune regulatory disorders
Authors: Olbrich Peter , Freeman Alexandra F.
Published: October 2024

Purpose of review

The identification of STAT1 gain-of-function (GOF) in 2011 and STAT3 GOF in 2014 has advanced our understanding of the host immunity along the JAK/STAT pathway and allowed targeted treatment approaches. We review the clinical features and pathogenesis of STAT1 and STAT3 GOF and how this has shaped new approaches to therapy.

Recent findings

STAT1 GOF, initially described in patients with chronic mucocutaneous candidiasis (CMC) and autoimmune thyroid disease, is now recognized to cause early-onset multisystem autoimmunity and a range of infections. STAT3 GOF comprises mostly lymphoproliferation and autoimmunity but also with varying severity, including some with life threatening organ dysfunction. Treatment has evolved along with the understanding of the pathogenesis, with patients now receiving JAK inhibition to block upstream of the STAT defect with good response in autoimmunity and CMC in STAT1 GOF. Blockade of IL-6 signaling has also been used in STAT3 GOF. Hematopoietic cell transplantation had initial poor outcomes, but outcomes are now improving with focus on the control of inflammation pretransplant.

Understanding the pathogenesis of STAT1 and STAT3 GOF has allowed great recent advancements in therapy, but many questions remain as to the best approach to therapy for each patient's clinical presentation as well as the durability of these therapies.
Resident Unions: Why Now and Will They Change Medical Education and Health Care?
Authors: Sklar David , Javed Britani
Published: October 2024

During the COVID-19 pandemic, resident unions proliferated. While unionization resulted in increased compensation and benefits, the process of union negotiations may have created adversarial relationships between residents and their institutions’ leadership, whom residents depend on for supervision and the development of clinical expertise. Such adversarial relationships could affect the learning environment, which is critical to the delivery of high-quality care. In this commentary, the authors suggest that academic medical centers should offer residents an authentic seat at the institutional care delivery leadership table, ensuring residents’ full participation in key organizational decisions. Doing so represents an alternative to unionization, with its potentially adversarial relationships, while still achieving a key goal of residents—to be included in the decisions that affect them and the care they provide. In this way, residents can use their unique understanding of the institutions’ strengths and weaknesses to improve the quality of patient care and the learning environment. Such engagement can also help residents achieve competence in systems-based practice and provide a vital link between institutions and the patients and community they serve through health policy and advocacy activities.
Pregnancy-related hormonal changes and thyroid growth: do they have an impact on the higher incidence of differentiated thyroid cancer in women?
Authors: Poppe Kris G. , Kyrilli Aglaia , Costante Giuseppe
Published: October 2024

Purpose of review

To analyze whether pregnancy could play a role in the higher prevalence of differentiated thyroid carcinoma (DTC) in women. Estrogens strongly modify thyroid economy by increasing iodine clearance, thyroid hormone requirement and production. Human chorionic gonadotropin (hCG) contributes to the increased thyroid hormone synthesis. Both estrogens and hCG can interfere with the regulation of thyroid volume and with thyroid nodule development and progression. The potential effect of hCG is exclusively related to its weak agonistic activity on TSH receptor. Estrogen implication on normal and nodule-derived thyrocyte growth has been demonstrated in vitro and in animal models. Furthermore, there is solid clinical evidence showing a promoting effect of pregnancy on thyroid volume and nodule development. Two metaanalyses, one including retrospective and another prospective observational studies, failed to show an association between pregnancy and DTC.

Recent findings

A large pooled prospective analysis using multivariable-adjusted Cox proportional hazard models did not demonstrate an association between DTC and parity. Similarly, no association between PTC occurrence and parity was observed in a prospective cohort analysis by linkage to the statewide Surveillance, Epidemiology, and End Results (SEER).

The presently available evidence does not support an involvement of pregnancy in DTC etiology.
Cataract surgery with endothelial keratoplasty
Authors: Ahad Muhammad A. , AlHilali Sara M. , Jomar Deema E.
Published: October 2024

Purpose of review

This review aims to provide an updated summary of the combined approach of cataract surgery with endothelial keratoplasty (EK), addressing key considerations, including intraocular lens (IOL) choice and calculation, decision between sequential and triple EK, and modifications in surgical techniques and postoperative management.

Recent findings

Advances in imaging techniques (Scheimpflug tomography and anterior segment optical coherence tomography) have improved the ability to detect subclinical corneal edema, aiding in surgical decision-making for EK. Recent studies comparing sequential and triple-EK indicate that both methods yield similar visual outcomes. Though triple-EK offers quicker recovery, it may have higher complication rates. The use of gases like SF6 and C3F8 for anterior chamber tamponade is evolving, with conflicting findings on their efficacy in preventing graft detachment. Furthermore, IOL selection remains crucial, as hyperopic refractive surprises are common, and hydrophilic lenses should be avoided owing to the risk of opacification after EK.

The combination of cataract surgery with EK has emerged as an effective treatment for patients with corneal endothelial diseases and cataract. Careful preoperative evaluation, appropriate IOL selection, and advances in surgical techniques contribute to better outcomes, although patient-specific factors must guide the choice between sequential and triple-EK procedures.
Relationships Between Working From Home, Sitting Postures, and Low Back Pain During COVID-19
Authors: Snodgrass Suzanne J. , Kang Chris J. W. , Edwards Suzi , Heneghan Nicola R. , Puentedura Emilio J. , James Carole
Published: October 2024

Objective

The aim of the study is to investigate the effects of working from home on musculoskeletal pain.

Methods

An e-survey of computer workers was conducted. Multinomial logistic regression modeling examined relationships between work location (work or home office desk, dining table, other), sitting posture (diagrams with descriptors), depressive symptoms (Center for Epidemiologic Studies Short Depression Scale), sleep quality (good/average vs poor) and pain (low back pain [LBP]), and other pain without LBP (asymptomatic).

Results

Of 634 respondents, most (91%, n = 578) worked partially at home and had pain (91%, n = 576; 342 LBP, 234 other pain, 58 asymptomatic). Sitting posture (“trunk a little bent forward” vs “straight up, back against back rest”: odds ratio = 2.9; 95% confidence interval = 1.3–6.5, P = 0.008), being female (2.2; 1.2–4.1, P = 0.008), and depressive symptoms (3.4; 1.7–6.6; P < 0.001) were associated with LBP. Poor sleep quality related to LBP but correlated with depressive symptoms. Working from home and location were not associated with pain.

Conclusions

Sitting postures, but not working from home, are associated with LBP.
Developing a Job-Exposure Matrix for Sedentary Behavior
Authors: Fukai Kota , Sano Kei , Terauchi Ryo , Furuya Yuko , Nakazawa Shoko , Kojimahara Noriko , Hoshi Keika , Nakano Tadashi , Toyota Akihiro , Tatemichi Masayuki
Published: October 2024

Objective

The aim of the study is to develop a job-exposure matrix for sedentary behavior and assess its relationship with noncommunicable diseases.

Methods

We constructed a job-exposure matrix using occupational and industry classifications combined with data on daily average sitting durations from 41,718 individuals. This matrix was then applied to a cohort of 706,939 participants in a case-control study to explore the link between sedentary behavior and noncommunicable disease risks.

Results

The matrix effectively identified sedentary behavior across different occupational groups. Using the matrix to assess sedentary behavior, associations were found between increased sedentary activity and heightened risks of diabetes, acute myocardial infarction, and endometrial cancer, while a reduced risk was observed for stroke.

Conclusions

The job-exposure matrix provides valuable insights into the health impacts of sedentary behavior in the workplace, underscoring significant disease risks associated with prolonged inactivity.
Effectiveness of Using Checklist in Preventing Facial, Nasal and Head Pressure Injuries in Preterm Infants in Nasal Noninvasive Mechanic Ventilation
Authors: Güner Başara Sultan , Çalışır Hüsniye , Kaynak Türkmen Münevver
Published: October 2024

Background:

Noninvasive mechanical ventilation (NIMV), when in synchronized intermittent mandatory ventilation, continuous positive airway pressure, or patient-triggered ventilation modes, is known to be a cause of facial, nasal, head, and skin pressure injuries in preterm infants.

Objective:

The objective of this study is to examine the efficacy of using a checklist with preterm infants under nasal NIMV in preventing facial, nasal, and head pressure injuries.

Method:

The study was conducted quasi-experimentally on preterm infants under NIMV. The sampling comprised a total of 104 infants, an intervention group of n = 52 and a control group of n = 52. All procedural steps of NIMV of the infants in the intervention group were performed in accordance with a checklist. The checklist covered: (1) preparation of the ventilation device and cannula placement; (2) care; and (3) monitoring and assessment.

Result:

There was a statistically significant difference in nasal tip, septal, intranasal, upper lip, and right-left cheek pressure injury scores between the intervention and control groups (P < .05).

Conclusion:

Performing all procedural steps of nasal NIMV in accordance with a checklist is effective in preventing pressure injuries on the face, nose, and head of preterm infants, reducing the severity of pressure injuries.

Implications for Practice:

It is recommended to use a checklist covering the ventilation device preparation, cannula placement, care, observation, and assessment steps to prevent any pressure injuries in the face, nose, and head, as well as to reduce the severity of pressure injuries and improve the skin condition of preterm infants under nasal NIMV support.
Comorbid Diabetes Is Associated With Dyspnea Severity and Cardiometabolic Biomarkers in Black Adults With Heart Failure
Authors: Butts Brittany , Kamara Julia , Morris Alanna A. , Davis Erica , Higgins Melinda K. , Dunbar Sandra B.
Published: October 2024

Background

Comorbidities such as Type 2 diabetes mellitus significantly and adversely influence heart failure outcomes, especially in Black adult populations. Likewise, heart failure has a negative effect on diabetes and cardiometabolic outcomes. Dyspnea, a common symptom of heart failure, often correlates with disease severity and prognosis. However, the relationship between comorbid diabetes, dyspnea severity, and cardiometabolic biomarkers in Black adults with heart failure remains understudied.

Objectives

The purpose of this pilot study was to examine differences in the distressing heart failure symptom of dyspnea and in cardiometabolic and inflammatory biomarkers in Black adults living with heart failure with and without diabetes.

Methods

Black adults with heart failure were enrolled in this cross-sectional pilot study. Cardiometabolic and inflammatory biomarkers were measured via multiplex immunoassay. Univariate general liner models were used to identify group differences between persons with heart failure with comorbid diabetes and those without, controlling for age, sex, and comorbid burden.

Results

Participants were mostly female with a mean age of 55 years and mean left ventricular ejection fraction of 33%. Participants with diabetes exhibited higher dyspnea scores compared to those without diabetes, indicating greater symptom burden. Moreover, individuals with comorbid diabetes demonstrated higher levels of cardiometabolic and inflammatory markers.

Discussion

Comorbid diabetes was associated with higher dyspnea severity and adverse cardiometabolic profiles in Black adults with heart failure. These findings underscore the importance of targeted interventions addressing diabetes management and cardiometabolic risk factors to improve symptom control and outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and develop tailored therapeutic strategies for managing comorbidities in persons with heart failure, particularly in minoritized communities.
Poorer Nurse Staffing in Black-Serving Hospitals
Authors: Lake Eileen T. , Iroegbu Christin , Smith Jessica G. , Staiger Douglas O. , Li Kimi , Chen Hal , Weldeab Nehemiah , Rogowski Jeannette A.
Published: October 2024

Background

Patients in hospitals that serve disproportionately patients of Black race have worse outcomes than patients in other hospitals, but the modifiable nursing factors that may contribute to such disparities have not been explored.

Objective

The study objective was to examine whether nurse staffing differs in hospitals that serve predominantly patients of Black race (Black-serving hospitals) as compared to other hospitals.

Methods

A cross-sectional correlational design using a nurse survey in a national hospital sample was used to fulfill the study objective. Nurse staffing was measured as the maximum number of patients cared for on the last shift from the 2015 annual registered nurse survey conducted in National Database of Nursing Quality Indicators hospitals. Hospitals were classified into subgroups of low, medium, and high percentages of patients of Black race using the 2019 Medicare Provider Analysis and Review database.

Results

In survey data from 179,336 registered nurses in 574 hospitals, nurse staffing was significantly worse in high-Black-serving hospitals as compared to medium- and low-Black-serving hospitals. In Poisson regression models that adjusted for nursing unit type and hospital characteristics, nurses in high-Black-serving hospitals and medium-Black-serving hospitals had more patients-per-nurse than did nurses in low-Black-serving hospitals.

Discussion

Small, statistically significant differences in nurse staffing that are worse in hospitals where Black patients disproportionately access their care were found using nurse survey data accounting for nursing unit type. The poorer nurse staffing in Black-serving hospitals may compromise the care and outcomes of the seven in 10 hospitalized Black older adults who receive care in Black-serving hospitals. The consequences for patient outcome disparities of poorer nurse staffing in Black-serving hospitals deserve investigation. Policies to increase nurse staffing in hospitals serving a higher proportion of patients of Black race are needed to contribute to efforts to reduce health disparities.
Acid suppressive therapy for gastroesophageal reflux disease
Authors: Ballinger Avery , Letsa Victor , Sheridan Dan
Published: October 2024

Gastrointestinal (GI) disorders range from intermittent heartburn to life-threatening GI hemorrhage. One of the most common GI disorders is gastroesophageal reflux disease (GERD), which affects an estimated 19% of adults in North America. This article discusses the advantages and disadvantages of acid-suppressive therapy for patients with GERD as well as relevant nursing considerations.
Aquatic envenomation
Authors: Wofford Kenneth A.
Published: October 2024

Envenomation by an aquatic animal can produce distressing and occasionally life-threatening signs and symptoms. Common vectors of exposure in the US are cnidaria and venomous fish. Prompt recognition and treatment may help manage distressing symptoms, limit subsequent tissue destruction, and minimize the risk of more serious complications.
Low-grade Nasopharyngeal Papillary Adenocarcinoma
Authors: Jin Zhe , Ye Min , Sheng Yaru , Sun Ji , Zhang Jiahao , Chen Yueying , Lin Lan , Bai Qianming , Hu Chunyan
Published: October 2024

Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is a rare neoplasm originating from the surface mucosal epithelium in the nasopharynx. To clarify its clinicopathologic, immunohistochemical, and molecular features, we retrospectively enrolled 35 patients diagnosed with LGNPPA between May 2016 and March 2024. Our cohort consisted of 14 male and 21 female patients aged 11 to 71 years (median: 37 y). The most common symptoms were rhinorrhea and nasal obstruction. Most tumors originated from the roof of the nasopharynx and were clinically staged as T1N0M0. None of the patients had a history of thyroid tumors. Microscopically, most of the LGNPPA were composed of irregular papillary structures covered with single-layer columnar or cuboidal epithelium. Eighteen cases (18/35, 51.4%) showed squamous epithelium coverage, and 9 cases (9/35, 25.7%) showed the characteristic transformation of squamous epithelium into neoplasm. Squamous differentiation and a significant spindle cell component were noted in 9 cases (9/35, 25.7%) and 26 cases (26/35, 74.3%), respectively. All cases were positive for thyroid transcription factor-1 protein, CK7, EMA, and Galectin-3 but negative for thyroglobulin, PAX8, and Napsin A. Ki-67 labeling was low and ranged from 2% to 5%. The Epstein-Barr virus or human papilloma virus infection and BRAF V600E mutation were not detected in any of the cases. All patients underwent endoscopic surgical resection, and 4 patients received radiotherapy followed by endoscopic surgery. Complete follow-up data were available for 33 patients. All patients had no recurrent or metastatic disease in the last follow-up (3 to 88 mo). A definitive diagnosis depends on histopathology and immunohistochemistry studies. The optimal treatment for patients with LGNPPA is total excision. Given the extremely indolent biological behavior of LGNPPA, it may be more appropriate to classify it as a primary papillary epithelial tumor rather than an adenocarcinoma of the nasopharynx.
Computer-Aided Design and Manufacturing in Free Fibula Reconstruction of the Mandible: Comparison of Long-Term Outcomes with the Conventional Technique
Authors: Bengur Fuat Baris , Humar Pooja , Saadoun Rakan , Khan Nayel , Anstadt Erin , Dang Sophia , Fadia Neil , Moroni Elizabeth A. , Bottegal Matthew T. , Acarturk Tahsin Oguz , Sridharan Shaum , Kubik Mark , Solari Mario G.
Published: October 2024

Background:

Pre-operative computer-aided design and manufacturing (CAD/CAM) revolutionized head and neck reconstruction after extirpative surgery. However, studies performing head-to-head comparison to the conventional technique have limited long-term follow-up. We aimed to compare short and long-term outcomes between conventional and CAD/CAM approaches for mandibular reconstruction with free fibula flaps.

Methods:

Patients undergoing free flap reconstruction from 2012 to 2021 were included. Data regarding patient demographics, past medical history, surgical details, complications, and reconstructive outcomes were collected. Patients who had CAD/CAM were compared with the patients who underwent reconstruction with the conventional technique. The cumulative incidence of hardware maintenance was displayed using the Kaplan-Meier method.

Results:

A total of 215 patients (n=79 conventional, n=136 CAD/CAM) were included. Both cohorts had similar demographics except the CAD/CAM cohort was younger (p=0.043). The mean operative duration was 54 minutes shorter with the use of CAD/CAM (p=0.014). Total and partial flap loss rates were similar. Patients with CAD/CAM had significantly lower rates of early wound dehiscence (p=0.037). Median [interquartile range] follow-up duration was similar (931 [1854] days in conventional vs 728 [841] days in CAD/CAM, p=0.084). After excluding patients with major surgical complications in the first 30-days, CAD/CAM cohort had a lower hardware removal rate (28.8% vs 13.9%, p=0.011). The significance persisted after including only the patients with more than 2 years of follow-up.

Conclusion:

The use of preoperative CAD/CAM may reduce operative duration, while allowing for longer maintenance of hardware with reduced removal rates due to complications.
The Effect of Medicaid Expansion on Access to Anti-incontinence Surgery
Authors: Roberts Brittany , Ata Ashar , Deverdis Erin C. , Randle Helena , Husk Katherine , Jacobs Bradley , Wolff Gillian , Rogers Rebecca
Published: October 2024

Importance

Medicaid expansion broadened access to care; however, limited data about the effect on access to anti-incontinence surgical procedures exist.

Objective

Since the Affordable Care Act (ACA) Medicaid expansion in 2014, some regions have had more states adopt expansion (NE—Northeast, W—West) than other regions (S—South, MW—Midwest). We aimed to determine if the proportion of Medicaid funded anti-incontinence procedures increased after Medicaid expansion and whether increases were different by U.S. region.

Study Design

This was a retrospective cohort study.

Results

The 2012–2018 Healthcare Cost and Utilization Project National Inpatient Sample was reviewed for anti-incontinence surgical procedures. Medicaid supported surgical procedures were compared by region and year, and among marginalized populations. During the study period 66,510 surgical procedures were performed. Medicaid as a primary payer for anti-incontinence procedures increased from 10% to 12% (P = <0.001) between 2012 and 2018. The percentage of Medicaid supported procedures performed in the NE (13%) and W (17%) were greater than MW (9%) and S (8%). Procedures among Black, Hispanic or lowest income quartile patients were lowest in the S and did not increase after expansion during the study period (2012 vs 2018, all P = NS). When controlling for confounders, the MW (odds ratio [OR] 0.58; 95% CI 0.46–0.74) and S (OR 0.33; 95% CI 0.26–0.42) were less likely to have Medicaid covered surgical procedures compared to the NE and W (OR 1.04; 95% CI 0.84–1.29).

Conclusions

Nationally, the percentage of Medicaid-supported anti-incontinence procedures increased after expansion. Northeast and W access to procedures increased, and access by marginalized populations broadened, while the S and MW had the most limited proportion of anti-incontinence surgical procedures covered by Medicaid.
Long-term hypothermia amplified neuroprotection by antagonizing intracranial pressure rebound after severe traumatic brain injury in rats
Authors: Sun Xiaopeng , Xu Shugang , Wang Jingjing , Li Xiaohong , Sun Hongtao , Zhao Wanyong
Published: October 2024

Long-term hypothermia has been reported to prevent intracranial pressure (ICP) rebound in clinical patients, but the duration for hypothermia and the corresponding ICP data are not available. This study investigated the optimal duration of long-term hypothermia in traumatic brain injury (TBI) rats, and observed the effect on ICP and neurological function. In this study, we established a rat severe TBI model with electronic Controlled Cortical Injury device, and implemented hypothermia (33 °C) for different durations. The motor function of the rats in each group was evaluated by beam walking test and inclined-grid climbing test, brain water content was calculated by the wet-dry weight method, Evan’s blue staining was used to measure the blood–brain barrier (BBB) permeability, the change of hippocampal neurons was observed by Nissl staining, the expressions of BrdU, NeuN, and CD86 positive cells were detected by immunofluorescence staining, and the expressions of Bcl-2, Bax, iNOS, IL-10, and Arg-1 were detected by Western blot. We found that therapeutic hypothermia improved neurological recovery after TBI with declining ICP, reducing brain edema, decreasing BBB permeability, promoting neurogenesis, inhibiting apoptosis, and regulating inflammation. Moreover, 48 h hypothermia amplified the neuroprotective effect after injury on the basis of 4 or 24 h hypothermic treatment. Both 4 and 24 h hypothermia led to ICP rebound during or after rewarming, whereas 48 h hypothermia completely abolished ICP rebound. Our study suggests that long-term hypothermia amplifies neuroprotection after TBI by antagonizing ICP rebound.
Rapid promoter evolution of male accessory gland genes is accompanied by divergent expression in closely relatedDrosophilaspecies
Authors: McQuarrie David W. J. , Stephens Frannie H. S. , Ferguson Alexander D. , Arnold Roland , Civetta Alberto , Soller Matthias
Published: October 2024

Seminal fluid proteins (Sfps) are essential for reproductive success and evolve fast, possibly driven by post-copulatory sexual selection (PCSS) originating from sperm competition and cryptic female choice. Counterintuitively, however, the coding region only in few Sfps evolves adaptively. Hence, additional genomic and functional factors must play a role in Sfp evolution independent of the protein coding region. To shed light on drivers of Sfp evolution we focus on those Sfps predominantly expressed in male accessory glands, because this allows examination of their evolution in the tissue which produces the majority of Sfps. Moreover, accessory glands develop normally in hybrids in contrast to testis allowing to control for changes in cellular environment arising during speciation. Here, we discover that Acp promoters contain hot spots for rapid evolution from accumulation of sequence changes and insertions/deletions (indels). We further show that changes in promoter sequences are accompanied by gene expression divergence among closely relatedDrosophilaspecies. We then validate these observations inDrosophilahybrids to show that species-specific expression divergence of Acps with rapidly evolving promoters are maintained in hybrids for some Acps, while others show dominance of one allele, a phenomenon termed transvection. These results indicate thatcis-regulatory evolution, rather than genome background variation, drives Acp expression changes and promotes their rapid evolution.
Fluor NMR study of amino acid derived ligand to study TSPO
Authors: Duma Luminita , Schneider Severine , Martinez Agathe , Hachet Cathy , Bihel Frederic , Lacapere Jean-Jacques
Published: October 2024

Translocator protein (TSPO, 18 kDa), previously known as peripheral-type benzodiazepine receptor, is an evolutionarily conserved membrane protein involved in various physiological processes and patho-physiological conditions. The endogeneous TSPO ligand is a polypeptide of 9 kDa, but dipeptides with biological activity have been previously synthesized and characterized. Herein, we synthesized a phenyl alanine derived ligand with a19F labelling which opens prospective for19F-MRI and potential18F-PET applications. We characterized the coexistence of two conformers that are not equally sensitive to the media used for membrane protein studies. Interaction studies with the recombinant mouse TSPO (mTSPO) in different membrane-mimicking environments are presented using19F NMR enabling structure/function characterizations. A change in the mTSPO environment from pure detergent to lipid/detergent mixture reveals different exchange rates between bound and free ligand forms. Competition experiments with the high-affinity drug ligand (R)-PK 11195 suggests that phenyl alanine derived ligand binds in the same protein cavity.

Highlights

Fluor labelling of ligands easily reveals the presence of conformers

Fluorinated phenyl alanine derived ligand interacts with TSPO

Fluor NMR enables characterization of TSPO ligand interactions

Fluor NMR facilitates exchange rate studies between free and bound ligand states

Graphical Abstract
Improving inference in wastewater-based epidemiology by modelling the statistical features of digital PCR
Authors: Lison Adrian , Julian Timothy R. , Stadler Tanja
Published: October 2024

The growing field of wastewater-based infectious disease surveillance relies on the quantification of pathogen concentrations in wastewater using polymerase chain reaction (PCR) techniques. However, existing models for monitoring pathogen spread using wastewater have often been adapted from methods for case count data and neglect the statistical features of PCR techniques. In this paper, we seek to overcome the widespread simplistic modelling of wastewater PCR measurements as normally or log-normally distributed by proposing an appropriate model for digital PCR (dPCR). Building on established statistical theory of dPCR, we derive approximations for the coefficient of variation of measurements and the probability of non-detection and propose a hurdle model-based likelihood for estimating concentrations from dPCR measurements. Using simulations and real-world data, we show that simple likelihoods based on normal or log-normal distributions are misspecified, affecting the estimation of pathogen concentrations and infection trends over time. In contrast, the proposed dPCR-specific likelihood accurately models the distribution of dPCR measurements, improving epidemiological estimates and forecasts even if details of the laboratory protocol are unknown. The method has been implemented in the open-source R package “EpiSewer” to improve wastewater-based monitoring of pathogens.
Assessing the Validity of Leucine Zipper Constructs Predicted in AlphaFold2
Authors: Mitic Isobel , Michie Katharine A. , Jacques David A.
Published: October 2024

AP-1 transcription factors are a network of cellular regulators, that combine in different dimer pairs to control a range of pathways involved in differentiation, growth, and cell death. They dimerise via leucine zipper coiled-coil domains, that are preceded by a basic DNA binding domain. Depending on which AP-1 transcription factors dimerise, different DNA sequences will be recognised resulting in differential gene expression. The affinity of AP-1 transcription factors for each other dictates which dimers form. The relative concentration of AP-1 transcription factors varies with tissue type and environment, adding another layer of control to this integral network of cellular regulation. The development of artificial intelligence (AI) protein structure prediction programs gives us a new technique to investigate or predict how dimerization effects combinatorial control. AlphaFold2 and AlphaFold-Multimer are AI programs that predict 3D structures of proteins using primary sequence as their only input, even if there is no homologous model available. To fully realise the potential of AI for structural biology, it is essential to understand its current capabilities and limitations. In this study we used the classical example of an AP-1 dimer: Fos and Jun, to interrogate how AlphaFold2 and AlphaFold-Multimer model leucine zipper domains, and if AlphaFold-Multimer can be used to differentiate between probable and improbable dimer interfaces. We found that AlphaFold-Multimer predicts highly confident leucine zipper dimers, even for dimer pairs, such as the FosB homodimer, for which electrostatics are known to prevent their formation in vivo. This is an important case study concerning high-confidence, but low-accuracy protein structure prediction.

statement

Artificial intelligence (AI) programs that predict protein structures, like AlphaFold, could transform structural biology by speeding up the experimental process. However, it is important to grasp the capabilities and limitations of these AI tools. This study examines how AlphaFold identifies structural features, specifically a leucine zipper, while not considering other factors like electrostatic interactions, using the well-studied transcription factors Fos and Jun as a case study.
Lower left ventricular ejection time inMYBPC3variant carriers with overt or subclinical hypertrophic cardiomyopathy
Authors: Yan Isabell , Möhring Zoe , Reichart Daniel , Münch Julia , Woitschach Rixa , Kirchhof Paulus , Carrier Lucie , Ho Carolyn Y. , Eschenhagen Thomas , Patten Monica
Published: October 2024

Aims

Hypertrophic cardiomyopathy (HCM) is an inherited cardiomyopathy mainly caused by pathogenic variants inMYBPC3andMYH7,encoding myosin binding protein C3 and myosin heavy chain 7, respectively. These variants can cause increased actin-myosin crossbridge cycling resulting in ventricular hypercontractility. Little is known about genotype-specific differences. Mice lackingMybpc3exhibited reduced left ventricular ejection time (LVET). In this study we tested whether LVET is specifically altered in patients carryingMYBPC3variants by retrospective echocardiographic analysis in two genotype-defined HCM cohorts.

Methods and results

LVET was measured by echocardiography and adjusted for heart rate (LVET index, LVETI) in 173 patients carryingMYBPC3orMYH7pathogenic variant. There was a discovery cohort (Hamburg; 46MYBPC3,31MYH7)and a validation cohort (“Valsartan in Attenuating Disease Evolution in Early Sarcomeric HCM”; 55MYBPC3, 41MYH7). Data were compared with 44 healthy controls from Hamburg. Variant carriers were stratified for overt (G+LVH+) or subclinical left ventricular hypertrophy (G+LVH-). LVETI was lower inMYBPC3and higher inMYH7G+LVH+ patients than in controls in the discovery, validation and pooled cohorts (pooled: 385 ± 23 msMYBPC3, 436 ± 38 msMYH7,411 ± 15 ms controls). Similar findings were seen in G+LVH-.

Conclusion

The data suggest that variants inMYBPC3andMYH7result in distinct biophysical consequences, which can be detected by measuring LVETI in patients. The findings may have implications for potential genotype-specific differences in response to therapies targeting sarcomere function.