bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast Cancer and Physiologic Avidity From Breast Feeding on FDG PET/CT
Authors: Ulaner Gary A.
Published: February 2023

A 35-year-old woman presented with breast cancer diagnosed during pregnancy. Eleven days after delivery, the patient underwent FDG PET/CT for systemic staging. Avidity was seen diffusely in both breasts, with a more avid focus at the site of a biopsy clip in the right breast. There were no lymph nodes or distant metastases. The patient was actively breast feeding, explaining the diffuse breast avidity. This case demonstrates both malignant and benign FDG avidity in the breasts at the same time, with a focal FDG-avid right breast malignancy identified among bilateral breast parenchyma with elevated physiologic FDG-avid secondary to breast feeding.
Increased 18F-Fluoroestradiol Uptake of Radiation Pneumonitis in a Patient With Metastatic Breast Cancer
Authors: Pan Bo , Hao Zhixin , Zhou Yidong , Sun Qiang , Huo Li
Published: February 2023

A 42-year-old woman diagnosed with de-novo stage IV breast cancer underwent 18F-fluoroestradiol (FES) PET/CT to evaluate the estrogen receptor status of metastatic lesions. The largest pulmonary nodule showed obvious FES uptake, consistent with pulmonary metastases from breast cancer. Interestingly, the images revealed a striking accumulation of FES in ground-glass attenuation in the left lobe of lung, suggestive of radiation pneumonitis.
COVID Vaccination Status and Operative Outcomes after Kidney Transplantation
Authors: Kushner Bradley S , Doyle Maria B , Khan Adeel S , Lin Yiing , Alhamad Tarek , Yu Jennifer , Chapman William C , Wellen Jason R
Published: February 2023

Introduction:

Kidney transplantation remains the best available treatment for end-stage renal disease. However, promoting graft longevity and preventing allosensitization requires strict adherence with a stringent immunosuppression regimen. The COVID-pandemic has offered new challenges for kidney transplant patients and many transplant centers are denying transplantation to unvaccinated patients. The aim of this study was to evaluate whether unvaccinated patients had inferior adherence following kidney transplantation along with a reduction in graft survival.

Methods:

Patients undergoing a deceased donor kidney transplant at a single academic medical center from February 2021-May 2022 were retrospectively reviewed. February 2021 was chosen as a start date for record review as this was 3 months after the first COVID vaccination was authorized for Emergency Use. Patients were considered “vaccinated” if they received one dose or more of any mRNA vaccine by their transplant date.

Results:

There were 301 patients who met study criteria (234 vaccinated; 67 unvaccinated. Cohorts stratified by vaccination status were well-matched. However, younger age was an independent risk factor for non-vaccination. Interestingly, unvaccinated patients had worse postoperative adherence with an increased average number of postoperative clinic visits missed (p=0.03) and a strong trend towards missing .3 postoperative clinic visits (p=0.07). Lastly, unvaccinated patients had statistically more subtherapeutic tacrolimus troughs (p=0.01).

Conclusions:

COVID-unvaccinated patients had higher rates of postoperative nonadherence in key areas of immunosuppression monitoring and clinic visit attendance. Providers should be cognizant that vaccination status may pose as a harbinger for poor adherence and stricter strategies for patient outreach are critical to ensure graft success in this vulnerable patient population.
Suicidal Ideation and Electroconvulsive Therapy
Authors: Cai Haipeng , Du Ruonan , Song Jiaqi , Wang Zhiren , Wang Xin , Yu Yongjun , Wang Yanan , Shang Lan , Zhang Jianxin , Yang Kebing , Li Wei
Published: February 2023

Objective

Few studies on electroconvulsive therapy (ECT) investigate efficacy and safety on depressive adolescents with strong suicidal ideation. Our study examined adolescents (aged 13–18 years) with major depressive disorder to explore ECT effectiveness in improving suicidal ideation and depressive symptoms, as well as its impact on cognitive function.

Methods

This nonrandomized controlled trial enrolled 183 adolescent patients suffering from major depressive disorder. The ECT group (n = 81) was treated with antidepressants and 8 rounds of ECT for 2 weeks. The control group comprised 79 patients treated with antidepressants only. Depressive symptoms, suicidal ideation, and cognitive functions were assessed at baseline (pre-ECT) and at 2 and 6 weeks post-ECT.

Results

The ECT group showed significant improvements over control in suicidal ideation from the end of treatment to 6 weeks after (P < 0.001). Depressive symptoms also improved (P < 0.001). Patients treated with ECT demonstrated poorer performance in delayed memory, attention, and language, but these impairments were transient. Thus, ECT was generally safe in adolescent patients with major depressive disorder.

Conclusions

Our findings verified ECT as effective and safe for improving suicidal ideation and depressive symptoms of adolescent patients with major depressive disorder. In addition, partially impaired cognitive function recovered gradually after ECT.
An Unusual Presentation of Pseudomonas citronellolis Bacteremia and Campylobacter Gastroenteritis Infection in a Human – A Case Report and Literature Review
Authors: Hwang Catherine S. , Rahmati Elham , Gerbino Anthony J. , Rose Tracie M , Verma Punam , Schwartz Margot
Published: February 2023

Introduction: Pseudomonas citronellolis is an unusual pathogen in humans and has not been extensively described in the scientific literature. Herein, we present a case of bacteremia and septic shock due to Pseudomonas citronellolis following Campylobacter species gastroenteritis in a patient with immunosuppression.
Case Presentation: An 80-year-old man with myeloproliferative disorder on ruxolitinib presented with several days of worsening abdominal pain, which rapidly developed into septic shock with multi-organ failure and explosive diarrhea. Gram-negative bacilli observed in Gram staining of his blood culture broth were later identified as Pseudomonas citronellolis and Bacteroides thetaiotaomicron. Repeated abdominal imaging revealed no evidence of intestinal perforation or megacolon. In addition, stool polymerase chain reaction was positive for Campylobacter species. His clinical course improved after a total of 14 days of meropenem with complete resolution of his symptoms and organ failure.
Conclusion: Pseudomonas citronellolis is a rare infection in humans. We postulate that Janus Associated Kinase (JAK) inhibition in myeloproliferative disorders heightened this patient’s risk of bacterial translocation and severe illness in the setting of Campylobacter gastroenteritis. Pseudomonas citronellolis may be identified more frequently as a pathogen in humans as more advanced diagnostic technologies become increasingly available in clinical microbiology.
Eye-brain connections revealed by multimodal retinal and brain imaging genetics in the UK Biobank
Authors: Zhao Bingxin , Li Yujue , Fan Zirui , Wu Zhenyi , Shu Juan , Yang Xiaochen , Yang Yilin , Wang Xifeng , Li Bingxuan , Wang Xiyao , Copana Carlos , Yang Yue , Lin Jinjie , Li Yun , Stein Jason L. , O’Brien Joan M. , Li Tengfei , Zhu Hongtu
Published: February 2023

As an anatomical extension of the brain, the retina of the eye is synaptically connected to the visual cortex, establishing physiological connections between the eye and the brain. Despite the unique opportunity retinal structures offer for assessing brain disorders, less is known about their relationship to brain structure and function. Here we present a systematic cross-organ genetic architecture analysis of eye-brain connections using retina and brain imaging endophenotypes. Novel phenotypic and genetic links were identified between retinal imaging biomarkers and brain structure and function measures derived from multimodal magnetic resonance imaging (MRI), many of which were involved in the visual pathways, including the primary visual cortex. In 65 genomic regions, retinal imaging biomarkers shared genetic influences with brain diseases and complex traits, 18 showing more genetic overlaps with brain MRI traits. Mendelian randomization suggests that retinal structures have bidirectional genetic causal links with neurological and neuropsychiatric disorders, such as Alzheimer’s disease. Overall, cross-organ imaging genetics reveals a genetic basis for eye-brain connections, suggesting that the retinal images can elucidate genetic risk factors for brain disorders and disease-related changes in intracranial structure and function.
Semantic Retrieval of Similar Radiological Images using Vision Transformers
Authors: Thakrar Anjali , Jayasuriya Michael , Serapio Adrian , Wu Xiao , Davis Eric , Schroeder Jamie , Vella Maya , Sohn Jae Ho
Published: February 2023

Background

Identifying visually and semantically similar radiological images in a database can facilitate the creation of decision support tools, teaching files, and research cohorts. Existing content-based image retrieval tools are often limited to searching by pixel-wise difference or vector distance of model predictions. Vision transformers (ViT) use attention to simultaneously take into account radiological diagnosis and visual appearance.

Purpose

We aim to develop a ViT-based image retrieval framework and evaluate the algorithm on NIH Chest Radiographs (CXR) and NLST Chest CTs.

Materials and Methods

The model was trained on 112,120 CXR and 111,955 CT images. For CXR, a ViT binary classifier was trained on 4 ground truth labels (Cardiomegaly, Opacity, Emphysema, No Finding) and ensembled to produce multilabel classifications for each CXR. For CT, a regression model was trained to minimize L1 loss on the continuous ground truth labels of patient weight. The ViT image embedding layer was treated as a global image descriptor, using the L2 distance between descriptors as a similarity measure. To qualitatively evaluate the model, five radiologists performed a reader performance study with random query images (25 CT, 25 CXR). For each image, they chose the 5 most similar images from a set of 10 images (the 5 closest and 5 furthest images from the query in model space). Inter-radiologist and radiologist-model agreement statistics were calculated.

Results

The CXR model achieved nDCG@5 of 0.73 (p<0.001) and Cardiomegaly mAP@5 of 0.76 (p<0.001) among other results. The CT model achieved nDCG of 16.85 (p<0.001). The model prediction agreed with radiologist consensus on 86% of CXR samples and 79.2% of CT samples. Inter-radiologist Fleiss Kappa of 0.51 and radiologist-consensus-to-model Cohen’s Kappa of 0.65 were observed. A t-SNE of the CT model latent space was generated to validate similar image clustering.

Conclusion

Our ViT architecture retrieved visually and semantically similar radiological images.

Summary Statement

This study evaluates the efficacy of using ViT based image embeddings for CBIR tasks for CXR and CT images, finding that it performs well on visual and semantic recognition tasks.

Key Results

The CXR model achieved nDCG@5 of 0.73 (p<0.001) and Cardiomegaly mAP@5 of 0.76 (p<0.001) among other results for CXR.

The CT model achieved nDCG of 16.85 (p<0.001). The model prediction agreed with radiologist consensus on 86% of CXR samples and 79.2% of CT samples.

Inter-radiologist Fleiss Kappa of 0.51 and radiologist consensus to model Cohen’s Kappa of 0.65 were observed.
Dancing the Nanopore limbo – Nanopore metagenomics from small DNA quantities for bacterial genome reconstruction
Authors: Simon Sophie A. , Schmidt Katharina , Griesdorn Lea , Soares André R. , Bornemann Till L. V. , Probst Alexander J.
Published: February 2023

Background

While genome-resolved metagenomics has revolutionized our understanding of microbial and genetic diversity in environmental samples, assemblies of short-reads often result in incomplete and/or highly fragmented metagenome-assembled genomes (MAGs), hampering in-depth genomics. Although Nanopore sequencing has increasingly been used in microbial metagenomics as long reads greatly improve the assembly quality of MAGs, the recommended DNA quantity usually exceeds the recoverable amount of DNA of environmental samples. Here, we evaluated lower-than-recommended DNA quantities for Nanopore library preparation by determining sequencing quality, community composition, assembly quality and recovery of MAGs.

Results

We generated 27 Nanopore metagenomes using the commercially available ZYMO mock community and varied the amount of input DNA from 1000 ng (the recommended minimum) down to 1 ng in eight steps. The quality of the generated reads remained stable across all input levels. The read mapping accuracy, which reflects how well the reads match a known reference genome, was consistently high across all libraries. The relative abundance of the species in the metagenomes was stable down to input levels of 50 ng. High-quality MAGs (> 95% completeness, ≤ 5% contamination) could be recovered from metagenomes down to 35 ng of input material. When combined with publicly available Illumina reads for the mock community, Nanopore reads from input quantities as low as 1 ng improved the quality of hybrid assemblies.

Conclusion

Our results show that the recommended DNA amount for Nanopore library preparation can be substantially reduced without any adverse effects to genome recovery and still bolster hybrid assemblies when combined with short-read data. We posit that the results presented herein will enable studies to improve genome recovery from low-biomass environments, enhancing microbiome understanding.
Alteration of functional connectivity in the cortex and major brain networks of non-human primates following focused ultrasound exposure
Authors: Liu D , Munoz F , Sanatkhani S , Pouliopoulos A N , Konofagou E , Grinband J , Ferrera VP
Published: February 2023

Focused ultrasound (FUS) is a non-invasive neuromodulation technology that is being investigated for potential treatment of neurological and psychiatric disorders. Focused ultrasound combined with microbubbles can temporarily open the intact blood-brain barrier (BBB) of animals and humans, and facilitate drug delivery. FUS exposure, either with or without microbubbles, has been demonstrated to alter the behavior of non-human primates, and previous work has demonstrated transient and long-term effects of FUS neuromodulation on functional connectivity using resting state functional MRI. However, it is unknown whether opening the BBB affects functional connectivity differently than FUS alone. Thus we applied FUS alone (neuromodulation) and FUS with microbubbles (BBB opening) in the dorsal striatum of lightly anesthetized non-human primates, and compared changes in functional connectivity in major brain networks. We found different alteration patterns between FUS neuromodulation and FUS-mediated BBB opening in several cortical areas, and we also found that applying FUS to a deep brain structure can alter functional connectivity in the default mode network and frontotemporal network.
Exploring the onset and progression of prostate cancer through a multicellular agent-based model
Authors: Passier Margot , van Genderen Maisa , Zaalberg Anniek , Kneppers Jeroen , Bekers Elise , Bergman Andries M , Zwart Wilbert , Eduati Federica
Published: February 2023

Over ten percent of men will be diagnosed with prostate cancer (PCa) during their lifetime. Arising from luminal cells of the prostatic acinus, PCa is influenced by multiple cells in its microenvironment. To expand our knowledge and explore means to prevent and treat the disease, it is important to understand what drives the onset and early stages of PCa. In this study, we developed an agent-based model of a prostatic acinus including its microenvironment, to allow forin silicostudying of PCa development.

The model was based on prior reports and in-house data of tumor cells co-cultured with Cancer Associated Fibroblasts (CAFs) and pro-tumor and/or anti-tumor macrophages. Growth patterns depicted by the model were pathologically validated on H&E slide images of human PCa specimens. We identified that stochasticity of interactions between macrophages and tumor cells at early stages strongly affect tumor development. Additionally, we discovered that more systematic deviations in tumor development result from a combinatorial effect of the probability of acquiring mutations and the tumor-promoting abilities of CAFs and macrophages.In silicomodeled tumors were then compared with 494 cancer patients with matching characteristics, showing strong association between predicted tumor load and patients’ clinical outcome. Our findings suggest that the likelihood of tumor formation depends on a combination of stochastic events and systematic characteristics. While stochasticity cannot be controlled, information on systematic effects may aid the development of prevention strategies tailored to the molecular characteristics of an individual patient.
DeXtrusion: Automatic recognition of epithelial cell extrusion through machine learningin vivo
Authors: Villars Alexis , Letort Gaëlle , Valon Léo , Levayer Romain
Published: February 2023

Epithelial cell death is highly prevalent during development and in adult tissues. It plays an essential role in the regulation of tissue size, shape, and turnover. Cell elimination relies on the concerted remodelling of cell junctions, so-called cell extrusion, which allows the seamless expulsion of dying cells. The dissection of the regulatory mechanism giving rise to a certain number and pattern of cell death was so far limited by our capacity to generate high-throughput quantitative data on cell death/extrusion number and distribution in various perturbed backgrounds. Indeed, quantitative studies of cell death rely so far on manual detection of cell extrusion events or through tedious systematic error-free segmentation and cell tracking. Recently, deep learning was used to automatically detect cell death and cell division in cell culture mostly using transmission light microscopy. However, so far, no method was developed for fluorescent images and confocal microscopy, which constitute most datasets in embryonic epithelia. Here, we devised DeXtrusion, a pipeline for automatic detection of cell extrusion/cell death events in larges movies of epithelia marked with cell contour and based on recurrent neural networks. The pipeline, initially trained on large movies of theDrosophilapupal notum marked with fluorescent E-cadherin, is easily trainable, provides fast and accurate extrusion/cell death predictions in a large range of imaging conditions, and can also detect other cellular events such as cell division or cell differentiation. It also performs well on other epithelial tissues with markers of cell junctions with reasonable retraining.
Mechanism of germination inhibition ofClostridioides difficilespores by an aniline substituted cholate derivative (CaPA)
Authors: Yip Christopher , Abel-Santos Ernesto
Published: February 2023

Clostridioides difficileinfection (CDI) is the major identifiable cause of antibiotic-associated diarrhea and has been declared an urgent threat by the CDC.C. difficileforms dormant and resistant spores that serve as infectious vehicles for CDI. To cause disease,C. difficilespores recognize taurocholate and glycine to trigger the germination process. In contrast to other sporulating bacteria,C. difficilespores are postulated to use a protease complex, CspABC, to recognize its germinants. Since spore germination is required for infection, we have developed anti-germination approaches for CDI prophylaxis. Previously, the bile salt analog CaPA (an aniline-substituted cholic acid) was shown to block spore germination and protect rodents from CDI caused by multipleC. difficilestrains.

In this study, we found that CaPA is an alternative substrate inhibitor ofC. difficilespore germination. By competing with taurocholate for binding, CaPA delaysC. difficilespore germination and reduces spore viability, thus diminishing the number of outgrowing vegetative bacteria. We hypothesize that the reduction of toxin-producing bacterial burden explains CaPA’s protective activity against murine CDI. Previous data combined with our results suggests that CaPA binds tightly toC. difficilespores in a CspC-dependent manner and irreversibly trap spores in an alternative, time-delayed, and low yield germination pathway. Our results are also consistent with kinetic data suggesting the existence of at least two distinct bile salt binding sites inC. difficilespores.
A simple goniometer-compatible flow cell for serial synchrotron X-ray crystallography
Authors: Ghosh Swagatha , Zorić Doris , Dahl Peter , Bjelčić Monika , Johannesson Jonatan , Sandelin Emil , Borjesson Per , Björling Alexander , Banacore Analia , Edlund Petra , Aurelius Oskar , Milas Mirko , Nan Jie , Shilova Anastasya , Gonzalez Ana , Mueller Uwe , Brändén Gisela , Neutze Richard
Published: February 2023

Serial femtosecond crystallography was initially developed for room-temperature X-ray diffraction studies of macromolecules at X-ray free electron lasers. When combined with tools that initiate biological reactions within microcrystals, time-resolved serial crystallography allows the study of structural changes that occur during an enzyme catalytic reaction. Serial synchrotron X-ray crystallography (SSX), which extends serial crystallography methods to synchrotron radiation sources, is expanding the scientific community using serial diffraction methods. This report presents a simple flow cell that can be used to deliver microcrystals across an X-ray beam during SSX studies. This device consists of an X-ray transparent glass capillary mounted on a goniometer-compatible 3D-printed support and is connected to a syringe pump via lightweight tubing. This flow cell is easily mounted and aligned, and it is disposable so can be rapidly replaced when blocked. This system was demonstrated by collecting SSX data at MAX IV Laboratory from microcrystals of the integral membrane protein cytochrome c oxidase from Thermus thermophilus, from which an X-ray structure was determined to 2.12 Å resolution. This simple SSX platform may help to lower entry barriers for non-expert users of SSX.
High-efficiency focusing and imaging by dielectric kinoform zone plate lenses with soft X-rays
Authors: Tong Xujie , Chen Yifang , Xu Zijian , Li Yijie , Xing Zhenjiang , Mu Chengyang , Zhao Jun , Zhen Xiangjun , Mao Chengwen , Tai Renzhong
Published: February 2023

With fast advances in enhancing the focusing/imaging resolution of Fresnel zone plate lenses toward sub-10 nm, low diffraction efficiency in connection with their rectangular zone shape still remains a big issue in both soft and hard X-ray microscopy. In hard X-ray optics, encouraging progress has recently been reported in our earlier attempts of high focusing efficiency by 3D kinoform shaped metallic zone plates, formed by greyscale electron beam lithography. This paper addresses our efforts towards high focusing/imaging efficiency by developing a novel dielectric kinoform zone plate lens for soft X-rays. The effects of the zone materials and zone shapes on the focusing/imaging quality were first theoretically investigated by a modified thin-grating-approximation method, revealing superior efficiencies of dielectric kinoform zone plates over rectangular ones in metals. Optical characterizations of replicated dielectric kinoform zone plates by greyscale electron beam lithography demonstrate a focusing efficiency of 15.5% with a resolution of 110 nm in the water window of X-rays. Apart from high efficiency, the novel kinoform zone plate lenses developed in this work exhibit significant advantages over conventional zone plates, i.e. simplified process, low cost and no need for a beamstop.
Bis[1,2-bis(4-tert-butylphenyl)ethylene-1,2-dithiolato(1−)]nickel(II) pentane 0.25-solvate
Authors: Das Gupta Titir , Applebaum Jack , Broussard William , Mack Carson , Wu Che , Mague Joel T. , Donahue James P.
Published: February 2023

The title compound, [Ni(C22H26S2)2], 1, is a square-planar D
2h
-symmetric compound that occurs on a general position in non-centrosymmetric tetragonal P41212 (No. 92) with ¼ eq of n-pentane (C5H12) as co-crystallite. Intraligand bond lengths show the dithiolene ligands to be in their half-oxidized radical monoanionic form. Intermolecular
t
Bu-C—H...arenecentroid and
t
Bu-C—H...NiS2C2 centroid close contacts guide the packing arrangement for 1.
Smart orchard design improves crop pollination
Authors: Anders Mina , Grass Ingo , Linden Valerie M. G. , Taylor Peter J. , Westphal Catrin
Published: February 2023

More sustainable and environmentally friendly agricultural practices, including ecological intensification, are needed to reduce biodiversity loss and environmental degradation.

We evaluated the potential of ecological intensification through the enhancement of pollination services in an intensively managed and insect‐pollinated crop, Macadamia integrifolia. We compared the effects and importance of agronomic practices that include agronomic input (i.e. irrigation and managed honeybees), orchard design requiring no external inputs (i.e. spatial orchard structure) and landscape factors in 10 South African macadamia orchards.

In comparison to experimental pollinator exclusion, insect pollination increased the initial and final nut set by 304% and 23%, respectively. However, nut set was pollination limited as hand pollination further improved nut set.

Flower visitation rates increased with the cover of semi‐natural habitats in the surrounding landscape (1 km radius). This effect was outperforming the effect of the number of managed honeybee colonies, as agronomic practice.

Initial nut set increased with orchard design and flower visitation rates. Perpendicular orientation of the planted macadamia rows towards the semi‐natural habitats increased initial nut set more than threefold compared to parallel row orientation. The initial nut set was 80% higher at the edge to semi‐natural habitats than in the orchard centre. In contrast, agronomic practices, such as irrigation, did not increase initial nut set. Final nut set depended on the preconditions of the initial nut set, additionally, high altitudes and the position in the centre of the orchard had positive effects.

Synthesis and applications: Pollination services were prerequisites for high yields in macadamia and could be improved without further agronomic input. Especially, the orchard design, that is, spatial arrangement of tree rows and semi‐natural habitats at local and landscape scales, was more important to boost insect pollination and the initial development of macadamia nuts than agronomic practices, such as high levels of irrigation. Considering the urgency to reduce the environmental impacts of agricultural production, we highlight the high potential of ecological intensification by a smart orchard design and the restoration and conservation of semi‐natural habitats in the orchards and their surrounding landscape.
Anthropology of mutualism
Authors: Fijn Natasha , Gressier Catie , Kavesh Muhammad A.
Published: February 2023

What might anthropology offer to our understanding of mutualistic relations? In making sense of these interspecies interactions, which, despite some costs, are ultimately beneficial to each partner species, zoological approaches operate at the level of populations on an adaptive scale. Anthropologists bring focus on individual actors and their subjective experiences within far more condensed temporospatial ethnographic timescales. This guest editorial brings a multispecies anthropological approach into dialogue with zoological understandings of mutualism. It examines the practical and theoretical potential of mutuality to make sense of relations of domestication. Materialistic profit and market‐oriented forms of engagement in the domestic sphere are often detrimental to more‐than‐human communities. The persistence of different kinds of mutual co‐existences, as shown in different forms of care of orphaned animals in Mongolia, Pakistan and Australia, offers an alternative and perhaps more hopeful model of more‐than‐human engagement in the Anthropocene.
Thinking about social mutualism in transhumant farming in Croatia
Authors: Czerny Sarah
Published: February 2023

A close focus on the observed interaction type is essential to academic biological writing on mutualism and other symbiotic interactions. Through their observations, scholars note slight shifts in the forms these interactions take, meaning that they are not fixed but can shift according to changes – e.g. in the ecological context. When thinking about human/animal dairy interactions, it is tempting to think about them as purely parasitic. Humans take milk from animals for their own needs and harm the animals. However, borrowing biological approaches that closely focus on the interactions between actors, this article suggests that it is possible to see mutualistic interactions at specific points within dairy relations. In transhumant farming relations in Croatia, we need to account for evidence of mutualism.
A mutual ecological approach to health in Mongolia
Authors: Fijn Natasha
Published: February 2023

Herders spend much time and energy seeking pasture and nurturing their herd animals in Mongolia. In turn, herd animals are the primary food source for herders in the form of meat and dairy products, feeding and nurturing the herding family. The overall herding principle strives towards a mutual balance across different scales within the body and the ecological food chain, resulting in reciprocal health and well‐being. The powerful medicinal qualities of the blue and yellow pasque flower (yargui, Pulsatillaspp.) are valued in Mongolia, sought out in early spring by multiple species, including herders, goats and wild deer. Herding knowledge of goats and deer seeking out the pasque flower for medicinal purposes to expel gut parasites is an excellent example of Mongolian herding families’ awareness of their interdependent interconnections with other species as part of a larger surrounding ecology. However, this level of integration may not last, as herding families increasingly rely on introduced medicines, such as anthelmintics, bought from local pharmacies and wholesalers within rural townships.
Forced into exile: The untold journeys of Myanmar's CDM teachers
Authors: Jirattikorn Amporn
Published: February 2023

This article delves into the experiences of Myanmar schoolteachers who have fled to Mae Sot, Thailand, as refugees after participating in the civil disobedience movement (CDM) against the military junta's February 2021 coup. The CDM is unique for its large scale and prolonged duration, as well as for its leadership by civil servants, with teachers and educators from the Ministry of Education constituting the majority of protesters. The study analyses the impact of the challenges faced by these teachers, including job loss and legal repercussions, on their understanding of civil disobedience and their commitment to resistance. Through in‐depth interviews with 10 CDM schoolteacher refugees in March 2022, the author provides a firsthand account of the experiences and motivations of these individuals.
Managing the energy trilemma of reliability, affordability and renewables: Assessing consumer demands with discrete choice experiments
Authors: Tocock Mark , Tinch Dugald , Hatton MacDonald Darla , Rose John M.
Published: February 2023

In response to the looming climate crisis, many countries are adopting technologies to reduce the accumulation of greenhouse gases. However, national energy policies are often multiobjective and resolution deeply divisive. The result is a policy trilemma between the energy mix and the trade‐offs with other policy objectives, including cost and reliability. Utilising a discrete choice experiment (DCE), the objective of this study is to explore Australian household preferences for alternative electricity contracts containing features reflecting changes in future energy policy. The first set of features include investments in renewable generation and community‐based energy storage. The second set of features reflect demand‐side management policies, including installing smart meters and consumption limits being imposed on households during peak demand. Two versions of the DCE were developed to obtain both willingness to pay and willingness to accept estimates for the same features. In line with the literature, differences in the two sets of estimates were observed, with the willingness to accept estimates being statistically larger for some features. These dollar value measures can be used to support public policy decision‐making – the choice of which depending on the context of the policy problem being considered.
Australian Seventh‐day Adventism and World War One: A Different Path
Authors: Reynaud Daniel
Published: February 2023

The Seventh‐day Adventist (SDA) church in Australia differed from most Christian churches in its response to World War One, openly condemning the war as an evil to be avoided while attempting to remain focused on its evangelistic mission. This article explores the philosophy of the SDAs that allowed them to stand apart from the bulk of the churches, and the evolving nuanced path forward negotiated between the ideals of the church and the needs of the government. The success of the SDA church in maintaining its spiritual focus broadens our understanding of the relationship between churches and state in Australia in World War One, and adds a level of subtlety in understanding the government's response to a church that had an ambivalent response to the state's war goals.
Search, learning, and tracking
Authors: Preuss Marcel
Published: February 2023

In many search markets, some consumers search to learn both the price and their willingness‐to‐pay whereas others search only to learn prices. When a seller can track indicators of the likelihood that consumers already know their willingness‐to‐pay, I show that price discrimination reduces profits and welfare relative to uniform pricing if search costs are small, but may increase both if search costs are large. The analysis also applies to sequential search if learning causes the likelihood that consumers know their willingness‐to‐pay to depend on the search history.
Delivery system emergency department capacity and its effect on nonsystem service utilization
Authors: Tenso Kertu , Pizer Steven , Palani Sivagaminathan
Published: February 2023

Background

Emergency department (ED) use is often seen as a source of excess health care spending, prompting managers to limit ED capacity in their health systems. However, if limited ED capacity in a delivery system leads patients to seek emergency care elsewhere, then health care quality and efficient management may be compromised within the system.

Objective

The objective of this study was to explore the effect of the Veterans Health Administration (VHA) in‐house ED clinician capacity on VHA community care (CC) ED claims.

Methods

We used administrative data from the VHA to identify CC ED claims and Department of Veterans Affairs emergency physician (EP) capacity for 2014–2019. We used quasi‐experimental instrumental variables approach with two different instruments: percent weekday federal holidays and VHA EP full‐time equivalents (FTEs). We controlled for VHA ED variables such as ED wait times (door to triage, door to doctor, and door to admission) and demand variables such as alternative insurance coverage, driving time to VHA care, and demographic variables (employment, age, household income, race, gender, and VHA priority status).

Results

After instrumenting for capacity with percent weekday federal holidays, we found that one clinic‐day capacity (one 8‐h ED shift) per 10,000 enrollees increase at the VHA ED will result in a reduction of 61 CC ED claims per 10,000 enrollees. After instrumenting for capacity with EP FTE, we found that one clinic‐day capacity (one 8‐h ED shift) per 10,000 enrollees increase at the VHA ED will result in a reduction of 48 CC ED claims per 10,000 enrollees. Both of these results are statistically significant at p < 0.001.

Conclusions

Our findings imply that offering more in‐house ED care, in the form of clinician capacity, can substantially reduce out‐of‐system ED use. The results may be of interest to integrated health care system managers who prefer their patients to stay within network.
Chronic ethanol exposure induces mitochondrial dysfunction and alters gene expression and metabolism in human cardiac spheroids
Authors: Hwang Hyun , Liu Rui , Eldridge Ronald , Hu Xin , Forghani Parvin , Jones Dean P. , Xu Chunhui
Published: February 2023

Background

Chronic alcohol consumption in adults can induce various cardiac toxicities such as arrhythmias, cardiomyopathy, and heart failure. Prenatal alcohol exposure can increase the risk of developing congenital heart defects among offspring. Understanding the molecular mechanisms underlying long‐term alcohol exposure‐induced cardiotoxicity can help guide the development of therapeutic strategies.

Methods

Cardiomyocytes derived from human‐induced pluripotent stem cells (hiPSC‐CMs) were engineered into cardiac spheroids and treated with clinically relevant concentrations of ethanol (17 and 50 mM) for 5 weeks. The cells were then analyzed for changes in mitochondrial features, transcriptomic and metabolomic profiles, and integrated omics outcomes.

Results

Following chronic ethanol treatment of hiPSC‐CMs, a decrease in mitochondrial membrane potential and respiration and changes in expression of mitochondrial function‐related genes were observed. RNA‐sequencing analysis revealed changes in various metabolic processes, heart development, response to hypoxia, and extracellular matrix‐related activities. Metabolomic analysis revealed dysregulation of energy metabolism and increased metabolites associated with the upregulation of inflammation. Integrated omics analysis further identified functional subclusters and revealed potentially affected pathways associated with cardiac toxicities.

Conclusion

Chronic ethanol treatment of hiPSC‐CMs resulted in overall decreased mitochondrial function, increased glycolysis, disrupted fatty acid oxidation, and impaired cardiac structural development.
Mid‐term outcomes of laparoscopic vs open colectomy for pathological T4 and/or N2 colon cancer patients: Multicenter study using propensity score matched analysis
Authors: Hashimoto Shintaro , Tominaga Tetsuro , Nonaka Takashi , Shiraishi Toshio , To Kazuo , Takeshita Hiroaki , Fukuoka Hidetoshi , Araki Masato , Tanaka Kenji , Sawai Terumitsu , Nagayasu Takeshi
Published: February 2023

Objectives

We aimed to assess mid‐term outcomes after laparoscopic surgery (LAP) vs open surgery (OP) for pathological T4 (pT4) and/or N2 (pN2) colon cancer.

Methods

We retrospectively reviewed 255 primary tumor resections for pT4 and/or pN2 colon cancer performed from 2015 to 2020 at six hospitals, divided into LAP (n = 204) and OP groups (n = 51). After propensity score matching to minimize selection bias, 47 matched patients per group were assessed.

Results

Before matching, the rate of males (53.9% vs. 37.3%, P = .042), left sided colon cancer (53.9% vs 37.3%, P = .042), D3 lymph node dissection (90.7% vs 68.6%, P < .001) and body mass index (kg/m2) (22.3 vs 21.8, P = .039) were significantly greater in the LAP group. The rate of pT4b (7.8% vs 40.4%, P < .001) was lower and pN2 was higher (57.4% vs 37.3%, P = .012) in the LAP group. After matching, preoperative characteristics and pathologic status were equivalent between the groups. The LAP and OP groups showed comparable overall survival (OS) (2‐year OS, 84.5% vs 76.8%, P = .055) and recurrence‐free survival (RFS) (2‐year RFS, 73.9% vs 52.8%, P = .359). In the patients with pT4, OS (2‐year OS, 79.4% vs 75.7%, P = .359) and RFS (2‐year RFS, 71.3% vs 58.7%) were comparable. In the patients with pN2, OS (2‐year OS, 83.4% vs 76.3%) and RFS (2‐year RFS, 69.6% vs 36.2%) were also comparable.

Conclusions

LAP for pT4 and/or pN2 colon cancer showed comparable mid‐term outcomes compared with OP. LAP was an acceptable surgical approach in this cohort.
Urine supernatant reveals a signature that predicts survival in clear‐cell renal cell carcinoma
Authors: Daza Jorge , Salomé Bérengère , Okhawere Kennedy , Bane Octavia , Meilika Kirolos N. , Korn Talia G. , Qi Jingjing , Xe Hui , Patel Manishkumar , Brody Rachel , Kim‐Schulze Seunghee , Sfakianos John P. , Lewis Sara , Rich Jordan M. , Zuluaga Laura , Badani Ketan K. , Horowitz Amir
Published: February 2023

Objective

To profile the cell‐free urine supernatant and plasma of a small cohort of clear‐cell renal cell carcinoma (ccRCC) patients by measuring the relative concentrations of 92 proteins related to inflammation. Using The Cancer Genome Atlas (TCGA), we then performed a targeted mRNA analysis of genes encoding the above proteins and defined their effects on overall survival (OS).

Subjects/patients and Methods

Samples were collected prospectively from ccRCC patients. A multiplex proximity extension assay was used to measure the concentrations of 92 inflammation‐related proteins in cell‐free urine supernatants and plasma. Transcriptomic and clinical information from ccRCC patients was obtained from TCGA. Unsupervised clustering and differential protein expression analyses were performed on protein concentration data. Targeted mRNA analysis on genes encoding significant differentially expressed proteins was performed using TCGA. Backward stepwise regression analyses were used to build a nomogram. The performance of the nomogram and clinical benefit was assessed by discrimination and calibration, and a decision curve analysis, respectively.

Results

Unsupervised clustering analysis revealed inflammatory signatures in the cell‐free urine supernatant of ccRCC patients. Backward stepwise regressions using TCGA data identified transcriptomic risk factors and risk groups associated with OS. A nomogram to predict 2‐year and 5‐year OS was developed using these risk factors. The decision curve analysis showed that our model was associated with a net benefit improvement compared to the treat‐all/none strategies.

Conclusion

We defined four novel biomarkers using proteomic and transcriptomic data that distinguish severity of prognosis in ccRCC. We showed that these biomarkers can be used in a model to predict 2‐year and 5‐year OS in ccRCC across different tumour stages. This type of analysis, if validated in the future, provides non‐invasive prognostic information that could inform either management or surveillance strategies for patients.
Oral contraceptives (OCs) in combination with metformin versus OCs alone on metabolism in nonobese polycystic ovary syndrome: A meta‐analysis and systematic review of randomized controlled trials
Authors: Wu Limei , Liu Ye , Huang Xi , Lin Kaiping , Liu Yang , Li Zhizun , Wei Tianqin , Song Ling , Hua Yuanyuan , Wang Xiaoli
Published: February 2023

Background

To compare OCs(oral contraceptives) + metformin and OCs alone for metabolic effects in nonobese polycystic ovary syndrome (PCOS) patients.

Methods

The search was performed in PubMed, EMBASE, the Cochrane Library and clinicaltrials.gov for all published studies up to 30 April 2022 and was limited to English‐language articles. All randomized controlled trials (RCTs) comparing OCs + metformin and OCs alone for reproductive‐age women with PCOS were included. Data were processed using Revman 5.3 software.

Results

Of 396 studies identified, 14 RCTs were included for analysis comprising 707 women. OCs+metformin significantly modified fasting glucose (MD = −0.21 [95% confidence interval (CI) = −0.31, −0.12], p < .00001) and fasting insulin (MD = −2.54 [95%CI = −4.04, −1.04], p = .0009) at study completion compared with OCs alone in nonobese PCOS subjects. There was no statistic difference in the homoeostasis model assessment of insulin resistance (HOMA‐IR), high‐density lipoprotein (HDL), low‐density lipoprotein (LDL), total cholesterol or triglycerides at study end between the two groups.

Conclusions

Metformin, via its positive effects on insulin clearance, in combination with OCs, improved glucose metabolism and offered a good treatment alternative in nonobese women with PCOS.
Media reporting on alcohol and other drugs in Australia and the Mindframe guidelines: Baseline data
Authors: Sunderland Matthew , Kershaw Stephanie , Ward Caitlin , Bryant Zachary , Teesson Lily , Whittle Rebecca , Paton Elizabeth , Charnley Janine L. , Skehan Jaelea
Published: February 2023

Introduction

The aim of this study was to generate a baseline database of print media reporting on alcohol and other drug (AOD) issues prior to the release of the Mindframe guidelines in March 2019. Specifically, to: (i) describe the content associated with media entries that focus on AOD use in Australian news media; (ii) determine how the media entries compare to several domains associated with recently developed Mindframe guidelines for publicly reporting on AOD; and (iii) identify content factors associated with different scores.

Methods

Media entries between July 2016 and June 2017 were searched for key AOD‐related terms using the Australian and New Zealand Newsstream database. Two coding schemes were developed to rate a stratified sample of 50% of the media entries against the Mindframe guidelines. Associations between content and total comparison scores were determined using linear regression models.

Results

Detailed coding of the 2007 articles identified as relevant for the current study indicated that a majority (67%) were focused on one of three substances: alcohol, cannabis or methamphetamine. Most of the entries were either law enforcement (22%) or criminal justice related (19%). Entries that focused on methamphetamine scored significantly lower than entries on alcohol when compared to the Mindframe guidelines, similarly entries focused on crime/justice‐related topics scored significantly lower than entries focused on positive outcomes.

Discussion and Conclusions

A disproportionate number of print media entries, particularly those related methamphetamine use, focused on crime or justice‐related topics, potentially further contributing to stigma, and emphasising the legal consequences of AOD use.
Consensus on level descriptors for a functional children's eating and drinking activity scale
Authors: Hanks Emily , Stewart Alexandra , Au‐Yeung Claudia Kate , Johnson Emily , Smith Christina H.
Published: February 2023

Aim

To agree wording of level descriptors for a measure of functional outcome of children's eating and drinking.

Method

An online, modified Delphi method was used to gather feedback on current level descriptor wording and generate rewording suggestions. Thirty speech and language therapists, working in a variety of settings and geographical locations, were invited to be part of the Delphi expert panel. Content analysis was used to evaluate participants' comments and develop consensus level descriptors. Consensus for acceptable wording was set at 80% agreement. Face validity was assessed using 5‐point Likert scales.

Results

Nineteen expert speech and language therapists (median experience 18 years) completed round one; 15 out of 19 completed round two. Level descriptor rating reached 80% agreement in two rounds. Additionally, 93% of participants agreed the scale would accurately capture change in their setting, with 87% likely to use the scale in practice.

Interpretation

This study has produced agreed wording for a functional measure of eating and drinking activity suitable for use with paediatrics feeding disorders, regardless of disease aetiology, presentation, age, or setting. Potential for widespread use is supported. Further evaluation of the tool's reliability and validity is required.