bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastrointestinal cancer and occupational diesel exhaust exposure: a meta-analysis of cohort studies
Authors: Collatuzzo G , Teglia F , Boffetta P
Published: June 2024

Background

Diesel exhaust exposure and cancer other than the lungs have been limitedly investigated.

Aims

To conduct a systematic review and meta-analysis on the association between occupational exposure to diesel exhaust and gastrointestinal cancers.

Methods

Two researchers performed a systematic literature review to identify all cohort studies on occupational exposure to diesel exhaust and risk of cancers other than lung. Of the 30 retained studies, 10 reported risk estimates for oesophageal, 18 on gastric, 15 on colon and 14 on rectal cancer. We performed random-effects meta-analyses to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for ever-exposure to diesel exhaust.

Results

We calculated summary RR = 1.08 (95% CI 0.97–1.21, P heterogeneity = 0.06) for oesophageal, 1.06 (95% CI 0.99–1.14, P < 0.001) for gastric, 0.98 (95% CI 0.96–1.00, P = 0.453) for colon, and RR = 1.04 (95% CI 0.97–1.11, P = 0.013) for rectal cancer. Drivers showed an association with oesophageal (RR = 1.26, 95% CI 0.99–1.62), gastric (RR = 1.20, 95% CI 0.91–1.59) and rectal cancer (RR = 1.41, 95% CI 1.13–1.75); machine operators with oesophageal (RR = 1.09, 95% CI 1.00–1.20) and gastric (RR = 1.15, 95% CI 1.10–1.20) and handlers with oesophageal cancer (RR = 1.95, 95% CI 1.23–3.09). Studies from Europe revealed an association with gastric cancer while those from North America did not (P < 0.05). No difference was found by quality score except for gastric cancer, where high-quality studies but not low-quality ones showed increased risk (P heterogeneity = 0.04). There was no evidence of publication bias.

Conclusions

An increased but insignificant risk of oesophageal, gastric and rectal, but not colon cancer, was suggested in workers exposed to diesel exhaust. Residual confounding cannot be excluded.
Exploring the effects of digital technologies in health financing for universal health coverage: a synthesis of country experiences and lessons
Authors: Oranje Maarten , Mathauer Inke
Published: June 2024

The use of digital technologies (DTs) for health financing receives increased attention in policy, practice and research. However, not much robust evidence exists on their effects on the intermediate and final universal health coverage objectives. This paper seeks to contribute to evidence gathering, by synthesizing the findings from nine country case studies which covered diverse applications of DTs and identified their effects on health financing and universal health coverage objectives. This paper also draws on review papers on the use of DTs for health financing. Our synthesis reveals that DTs can support and simplify health financing tasks and thus contribute to enhanced efficiency and transparency and more equitable resource distribution. If well designed, DTs can help overcome challenges inherent in paper-based data systems and enable otherwise hardly implementable policy options, especially options that rely on near real-time exchange of data. Yet, the studies also point to various risks. Caution is for instance required when the use of DTs enhances inequities between population groups due to various digital divides. The findings point to a number of policy orientations. There is need to include the application of DTs for health financing in national digital health strategies and to develop health financing specific guidance and regulation. This is for instance necessary to avoid that DTs negatively affect financial protection. Clear stipulations related to equity will serve to ensure that positive effects accrue to vulnerable population groups. The future research agenda calls for more and methodologically robust evidence generation with a clear universal health coverage orientation.
A Broken Record? A Feminist Exploration of Mary Magdalene in Music
Authors: Jolley Siobhán
Published: June 2024

Mary Magdalene has long since been associated with music and musicality for as long as her story has been performed. This chapter explores how she became a byword for female sexuality in reception, focusing specifically on music for a general audience. It takes four case studies—Wagner’s Parsifal, Adamo’s The Gospel of Mary Magdalene, Jesus Christ Superstar and FKA twigs’ MAGDALENE—to analyze how the presence of patriarchal myth regarding the Magdalene became so pervasive. It makes the case that such musical reception for a modern and nonreligious audience need not be in itself a corrective in order to make a constructive contribution to cultural discourse. By offering a new stimulus for revisiting old assumptions, the presence of Mary Magdalene in music can keep critical questions alive beyond the domain of the feminist biblical scholar.
Population-level exploration of alternative splicing and its unique role in controlling agronomic traits of rice
Authors: Zhang Hong , Chen Wu , Zhu De , Zhang Bintao , Xu Qiang , Shi Chuanlin , He Huiying , Dai Xiaofan , Li Yilin , He Wenchuang , Lv Yang , Yang Longbo , Cao Xinglan , Cui Yan , Leng Yue , Wei Hua , Liu Xiangpei , Zhang Bin , Wang Xianmeng , Guo Mingliang , Zhang Zhipeng , Li Xiaoxia , Liu Congcong , Yuan Qiaoling , Wang Tianyi , Yu Xiaoman , Qian Hongge , Zhang Qianqian , Chen Dandan , Hu Guanjing , Qian Qian , Shang Lianguang
Published: June 2024

Alternative splicing (AS) plays crucial roles in regulating various biological processes in plants. However, the genetic mechanisms underlying AS and its role in controlling important agronomic traits in rice (Oryza sativa) remain poorly understood. In this study, we explored AS in rice leaves and panicles using the rice minicore collection. Our analysis revealed a high level of transcript isoform diversity, with approximately one-fifth of the potential isoforms acting as major transcripts in both tissues. Regarding the genetic mechanism of AS, we found that the splicing of 833 genes in the leaf and 1,230 genes in the panicle was affected by cis-genetic variation. Twenty-one percent of these AS events could only be explained by large structural variations. Approximately 77.5% of genes with significant splicing quantitative trait loci (sGenes) exhibited tissue-specific regulation, and AS can cause 26.9% (leaf) and 23.6% (panicle) of sGenes to have altered, lost, or gained functional domains. Additionally, through splicing-phenotype association analysis, we identified phosphate–starvation-induced RING-type E3 ligase (OsPIE1; LOC_Os01g72480), whose splicing ratio was significantly associated with plant height. In summary, this study provides an understanding of AS in rice and its contribution to the regulation of important agronomic traits.
NIN-LIKE PROTEIN3.2 inhibits repressor Aux/IAA14 expression and enhances root biomass in maize seedlings under low nitrogen
Authors: Wang Ruifeng , Zhong Yanting , Han Jienan , Huang Liangliang , Wang Yongqi , Shi Xionggao , Li Mengfei , Zhuang Yao , Ren Wei , Liu Xiaoting , Cao Huairong , Xin Beibei , Lai Jinsheng , Chen Limei , Chen Fanjun , Yuan Lixing , Wang Yi , Li Xuexian
Published: June 2024

Plants generally enhance their root growth in the form of greater biomass and/or root length to boost nutrient uptake in response to short-term low nitrogen (LN). However, the underlying mechanisms of short-term LN-mediated root growth remain largely elusive. Our genome-wide association study, haplotype analysis, and phenotyping of transgenic plants showed that the crucial nitrate signaling component NIN-LIKE PROTEIN3.2 (ZmNLP3.2), a positive regulator of root biomass, is associated with natural variations in root biomass of maize (Zea mays L.) seedlings under LN. The monocot-specific gene AUXIN/INDOLE-3-ACETIC ACID14 (ZmAux/IAA14) exhibited opposite expression patterns to ZmNLP3.2 in ZmNLP3.2 knockout and overexpression lines, suggesting that ZmNLP3.2 hampers ZmAux/IAA14 transcription. Importantly, ZmAux/IAA14 knockout seedlings showed a greater root dry weight (RDW), whereas ZmAux/IAA14 overexpression reduced RDW under LN compared with wild-type plants, indicating that ZmAux/IAA14 negatively regulates the RDW of LN-grown seedlings. Moreover, in vitro and vivo assays indicated that AUXIN RESPONSE FACTOR19 (ZmARF19) binds to and transcriptionally activates ZmAux/IAA14, which was weakened by the ZmNLP3.2–ZmARF19 interaction. The zmnlp3.2 ZmAux/IAA14-OE seedlings exhibited further reduced RDW compared with ZmAux/IAA14 overexpression lines when subjected to LN treatment, corroborating the ZmNLP3.2–ZmAux/IAA14 interaction. Thus, our study reveals a ZmNLP3.2–ZmARF19–ZmAux/IAA14 module regulating root biomass in response to nitrogen limitation in maize.
Pistil-derived lipids influence pollen tube growth and male fertility in Arabidopsis thaliana
Authors: Song Jingpu , Mavraganis Ioannis , Shen Wenyun , Yang Hui , Patterson Nii , Wang Liping , Xiang Daoquan , Cui Yuhai , Zou Jitao
Published: June 2024

Pollen germination and pollen tube elongation require rapid phospholipid production and remodeling in membrane systems that involve both de novo synthesis and turnover. Phosphatidic acid phosphohydrolase (PAH) and lysophosphatidylcholine acyltransferase (LPCAT) are 2 key enzymes in membrane lipid maintenance. PAH generates diacylglycerol (DAG), a necessary precursor for the de novo synthesis of phosphatidylcholine (PC), while LPCAT reacylates lysophosphatidylcholine to PC and plays an essential role in the remodeling of membrane lipids. In this study, we investigated the synthetic defects of pah and lpcat mutations in sexual reproduction of Arabidopsis (Arabidopsis thaliana) and explored the prospect of pistil lipid provision to pollen tube growth. The combined deficiencies of lpcat and pah led to decreased pollen tube growth in the pistil and reduced male transmission. Interestingly, pistils of the lipid mutant dgat1 ameliorated the male transmission deficiencies of pah lpcat pollen. In contrast, pollination with a nonspecific phospholipase C (NPC) mutant exacerbated the fertilization impairment of the pah lpcat pollen. Given the importance of DAG in lipid metabolism and its contrasting changes in the dgat1 and npc mutants, we further investigated whether DAG supplement in synthetic media could influence pollen performance. DAG was incorporated into phospholipids of germinating pollen and stimulated pollen tube growth. Our study provides evidence that pistil-derived lipids contribute to membrane lipid synthesis in pollen tube growth, a hitherto unknown role in synergistic pollen–pistil interactions.
A potyvirus provides an efficient viral vector for gene expression and functional studies in Asteraceae plants
Authors: Yang Yi-Zhou , Xie Liang , Gao Qiang , Nie Zhang-Yao , Zhang Ding-Liang , Wang Xian-Bing , Han Cheng-Gui , Wang Ying
Published: June 2024

Plant virus-derived vectors are rapid and cost-effective for protein expression and gene functional studies in plants, particularly for species that are difficult to genetically transform. However, few efficient viral vectors are available for functional studies in Asteraceae plants. Here, we identified a potyvirus named zinnia mild mottle virus (ZiMMV) from common zinnia (Zinnia elegans Jacq.) through next-generation sequencing. Using a yeast homologous recombination strategy, we established a full-length infectious cDNA clone of ZiMMV under the control of the cauliflower mosaic virus 35S promoter. Furthermore, we developed an efficient expression vector based on ZiMMV for the persistent and abundant expression of foreign proteins in the leaf, stem, root, and flower tissues with mild symptoms during viral infection in common zinnia. We showed that the ZiMMV-based vector can express ZeMYB9, which encodes a transcript factor inducing dark red speckles in leaves and flowers. Additionally, the expression of a gibberellic acid (GA) biosynthesis gene from the ZiMMV vector substantially accelerated plant height growth, offering a rapid and cost-effective method. In summary, our work provides a powerful tool for gene expression, functional studies, and genetic improvement of horticultural traits in Asteraceae plant hosts.
Association of TyG index with aortic valve calcification in valvular heart disease patients
Authors: Wang Peiyu , Zeng Yiyao , Wang Li , Jiang Yufeng , Shen Jinsheng , Jin Fulu , Zhou Yafeng , Zhao Liangping
Published: June 2024

Background

In recent years, triglyceride glucose (TyG) index, as a popular metabolic index, has been proposed as an alternative index of insulin resistance, and it has been proved to be associated with many cardiovascular diseases, but the relationship between it and aortic valve calcification is still unknown.

Methods

A total of 450 aortic valve disease patients were enrolled in this study, including 361 patients with aortic valve calcification (AVC) (calcification group) and 89 patients without (control group). According to the severity of AVC, patients with AVC included severe calcification, moderate calcification and low calcification. The TyG index was calculated based on fasting triglyceride and fasting blood glucose levels.

Results

The TyG index in the calcification group was significantly higher than that in the control group (P < .05), and with the increase of the degree of calcification, the TyG index showed an increasing trend. The univariate and multivariate logistic regression analysis showed TyG index has a high predictive value for the presence of AVC (OR (95% CI): 1.743 (1.036–2.933)) and severe AVC (OR (95% CI): 1.608 (1.143–2.262)). In assessing the predictive value of the TyG index distribution width for AVC, with the first quartile as a reference, the last quartile of the TyG index had significant predictive value for the presence of AVC and severe AVC.

Conclusions

TyG index was significantly associated with the presence and severity of AVC, suggesting that TyG index may be a valid predictor of AVC.
Lentivirus-modified hematopoietic stem cell gene therapy for advanced symptomatic juvenile metachromatic leukodystrophy: a long-term follow-up pilot study
Authors: Zhang Zhao , Jiang Hua , Huang Li , Liu Sixi , Zhou Xiaoya , Cai Yun , Li Ming , Gao Fei , Liang Xiaoting , Tsang Kam-Sze , Chen Guangfu , Ma Chui-Yan , Chai Yuet-Hung , Liu Hongsheng , Yang Chen , Yang Mo , Zhang Xiaoling , Han Shuo , Du Xin , Chen Ling , Hwu Wuh-Liang , Zhuo Jiacai , Lian Qizhou
Published: June 2024

Metachromatic leukodystrophy (MLD) is an inherited disease caused by a deficiency of the enzyme arylsulfatase A (ARSA). Lentivirus-modified autologous hematopoietic stem cell gene therapy (HSCGT) has recently been approved for clinical use in pre and early symptomatic children with MLD to increase ARSA activity. Unfortunately, this advanced therapy is not available for most patients with MLD who have progressed to more advanced symptomatic stages at diagnosis. Patients with late-onset juvenile MLD typically present with a slower neurological progression of symptoms and represent a significant burden to the economy and healthcare system, whereas those with early onset infantile MLD die within a few years of symptom onset. We conducted a pilot study to determine the safety and benefit of HSCGT in patients with postsymptomatic juvenile MLD and report preliminary results. The safety profile of HSCGT was favorable in this long-term follow-up over 9 years. The most common adverse events (AEs) within 2 months of HSCGT were related to busulfan conditioning, and all AEs resolved. No HSCGT-related AEs and no evidence of distorted hematopoietic differentiation during long-term follow-up for up to 9.6 years. Importantly, to date, patients have maintained remarkably improved ARSA activity with a stable disease state, including increased Functional Independence Measure (FIM) score and decreased magnetic resonance imaging (MRI) lesion score. This long-term follow-up pilot study suggests that HSCGT is safe and provides clinical benefit to patients with postsymptomatic juvenile MLD.
Schwinger–Dyson Equation on the Complex Plane: A Four-Fermion Interaction Model at Finite Temperature
Authors: Tanaka Hidekazu , Sasagawa Shuji
Published: June 2024

We extend the Schwinger–Dyson equation (SDE) on the complex plane, which was treated in our previous research, to finite temperature. As a simple example, we solve the SDE for a model with four-fermion interactions in (1+1) space-time dimensions in the strong coupling region. We investigate the properties of the effective mass and energy for the fermions, especially near the phase transition temperature.
Stock Market Participation, Inequality, and Monetary Policy
Authors: Melcangi Davide , Sterk Vincent
Published: June 2024

Recent literature has shown that the fraction of liquidity-constrained households in the population critically determines the mix of transmission channels of monetary policy. In this article, we bring a different but important dimension of heterogeneity to the forefront: stock market participation. We show that the stock market participation rate not only shapes the mix of policy channels but also heavily affects the aggregate responses. This happens as direct rebalancing effects and indirect equilibrium effects into investment are both increasing in the number of stock market participants, reinforcing each other. We show this in a quantitative New Keynesian model designed to account for the population share of stock market participants, their position in the income and wealth distribution, and their saving rates. The model implies that, as stock market participation has increased since the 1980s, the power of monetary policy on the real economy has strengthened considerably.
Normativity vs. uniqueness: effects of social relationship strength on neural representations of others
Authors: Guthrie Taylor D , Chavez Robert S
Published: June 2024

Understanding others involves inferring traits and intentions, a process complicated by our reliance on stereotypes and generalized information when we lack personal information. Yet, as relationships are formed, we shift toward nuanced and individualized perceptions of others. This study addresses how relationship strength influences the creation of unique or normative representations of others in key regions known to be involved in social cognition. Employing a round-robin interpersonal perception paradigm (N = 111, 20 groups of five to six people), we used functional magnetic resonance imaging to examine whether the strength of social relationships modulated the degree to which multivoxel patterns of activity that represented a specific other were similar to a normative average of all others in the study. Behaviorally, stronger social relationships were associated with more normative trait endorsements. Neural findings reveal that closer relationships lead to more unique representations in the medial prefrontal cortex and anterior insula, areas associated with mentalizing and person perception. Conversely, more generalized representations emerge in posterior regions like the posterior cingulate cortex, indicating a complex interplay between individuated and generalized processing of social information in the brain. These findings suggest that cortical regions typically associated with social cognition may compute different kinds of information when representing the distinctiveness of others.
Executive dysfunction and cortical variations among intimate partner violence perpetrators and the association with sexism
Authors: Romero-Martínez Ángel , Beser-Robles María , Cerdá-Alberich Leonor , Aparici Fernando , Martí-Bonmatí Luis , Sarrate-Costa Carolina , Lila Marisol , Moya-Albiol Luis
Published: June 2024

Malfunctioning in executive functioning has been proposed as a risk factor for intimate partner violence (IPV). This is not only due to its effects on behavioral regulation but also because of its association with other variables such as sexism. Executive dysfunctions have been associated with frontal and prefrontal cortical thickness. Therefore, our first aim was to assess differences in cortical thickness in frontal and prefrontal regions, as well as levels of sexism, between two groups of IPV perpetrators (with and without executive dysfunctions) and a control group of non-violent men. Second, we analyzed whether the cortical thickness in the frontal and prefrontal regions would explain sexism scores. Our results indicate that IPV perpetrators classified as dysexecutive exhibited a lower cortical thickness in the right rostral anterior cingulate superior frontal bilaterally, caudal middle frontal bilaterally, right medial orbitofrontal, right paracentral, and precentral bilaterally when compared with controls. Furthermore, they exhibited higher levels of sexism than the rest of the groups. Most importantly, in the brain structures that distinguished between groups, lower thickness was associated with higher sexism scores. This research emphasizes the need to incorporate neuroimaging techniques to develop accurate IPV profiles or subtypes based on neuropsychological functioning.
The interplay between insomnia symptoms and Alzheimer’s disease across three main brain networks
Authors: Elberse Jorik D , Saberi Amin , Ahmadi Reihaneh , Changizi Monir , Bi Hanwen , Hoffstaedter Felix , Mander Bryce A , Eickhoff Simon B , Tahmasian Masoud , Alzheimer’s Disease Neuroimaging Initiative
Published: June 2024

Study Objectives

Insomnia symptoms are prevalent along the trajectory of Alzheimer’s disease (AD), but the neurobiological underpinning of their interaction is poorly understood. Here, we assessed structural and functional brain measures within and between the default mode network (DMN), salience network, and central executive network (CEN).

Methods

We selected 320 participants from the ADNI database and divided them by their diagnosis: cognitively normal (CN), Mild Cognitive Impairment (MCI), and AD, with and without self-reported insomnia symptoms. We measured the gray matter volume (GMV), structural covariance (SC), degrees centrality (DC), and functional connectivity (FC), testing the effect and interaction of insomnia symptoms and diagnosis on each index. Subsequently, we performed a within-group linear regression across each network and ROI. Finally, we correlated observed abnormalities with changes in cognitive and affective scores.

Results

Insomnia symptoms were associated with FC alterations across all groups. The AD group also demonstrated an interaction between insomnia and diagnosis. Within-group analyses revealed that in CN and MCI, insomnia symptoms were characterized by within-network hyperconnectivity, while in AD, within- and between-network hypoconnectivity was ubiquitous. SC and GMV alterations were nonsignificant in the presence of insomnia symptoms, and DC indices only showed network-level alterations in the CEN of AD individuals. Abnormal FC within and between DMN and CEN hubs was additionally associated with reduced cognitive function across all groups, and increased depressive symptoms in AD.

Conclusions

We conclude that patients with clinical AD present with a unique pattern of insomnia-related functional alterations, highlighting the profound interaction between both conditions.
Improving tobacco cessation interventions in hospitals: Pre–post evaluation of an innovative health systems intervention in Catalonia (Spain)
Authors: Martínez Cristina , Feliu Ariadna , Enriquez Marta , Antón Laura , Castellano Yolanda , Company Assumpta , Romero Olga , Ripoll Ruth , Ruz Angels , Papadakis Sophia , Fernández Esteve
Published: June 2024

This study measured changes in healthcare professionals’ (HCPs) performance in tobacco cessation intervention before and 6 months after a health system intervention. The intervention involved exposure to online training for staff and the implementation of a structured organizational change-level practice model that included some strategies, comprising establishing tobacco cessation steering groups with champions in each hospital, developing tailored protocols and guidelines within each organization, conducting on-site workshops for clinicians, and creating posters and pocket materials summarizing the intervention. Pre–post evaluation in four hospitals in Barcelona province (Catalonia, Spain). We assessed the knowledge, attitudes, behaviors, and organizational factors (KABO) and the performance of each of the components of the 5As Model for Treating Tobacco Use according to a scale from 0 (“Never”) to 10 (“Always”) among HCPs. We performed Wilcoxon signed-rank tests for paired samples and assessed changes in performance by performing linear regression. A total of 255 HCPs completed the pre–post evaluation. All components of the 5As Model increased, with “Assist” and “Arrange a follow-up” showing the greatest improvement. Several KABO dimensions significantly increased, including individual skills (mean score: 3.3–5.7, P < .001), attitudes and beliefs (4.8–5.4, P < .001), individual commitment (5.9–6.6, P < .001), and perception of having positive organizational support (4.3–4.7, P < .001). An increase in each point in individual skills and support of the organization was associated with increased rates of 5As delivery, with the greatest associations found for “Assist” (0.60 and 0.17, respectively) and “Arrange a follow-up” (0.71 and 0.18, respectively). The intervention was successful in increasing HCPs individual skills, attitudes and beliefs, individual commitment, and perception of having positive organizational support and the performance of all components of the 5As. Future research should focus on strategies that promote organizational support, a dimension that is essential to increasing Assist and Arrange, which were less implemented at baseline.
Xanthomonas sontii, and Not X. sacchari, Is the Predominant Vertically Transmitted Core Rice Seed Endophyte
Authors: Rana Rekha , Patil Prabhu B.
Published: June 2024

Seed endophytes, particularly the abundant, core, and vertically transmitted species, are major areas of focus in host microbiome studies. Apart from being the first members to colonize, they accompany the plant throughout its development stages and to the next generation. Recently published studies have reported the keystone species to be Xanthomonas sacchari, a core endophyte that is vertically transmitted in rice with probiotic properties. Furthermore, the Xanthomonas species was reported to be involved in the assembly of beneficial bacteria after early inoculation in rice seeds. However, the strains discussed in these studies were misclassified as X. sacchari, a well-known pathogen of sugarcane. By including nonpathogenic Xanthomonas species with plant-protective functions reported from rice seeds, we have correctly established the phylogenetic and taxonomic identity of the keystone species as X. sontii. This will enable researchers to use the correct reference or lab strain of X. sontii for further systematic and in-depth studies as a model endophyte in plant–microbe interactions apart from its exploitation in seed health.
A Novel Bis-Trifluoromethylated Compound Demonstrates High Efficacy as a Nematicide Against Root-Knot Nematodes on Pistachio, Supported by Docking Studies
Authors: Khatamidoost Zeynab , Darehkordi Ali , Saremi Hossein , Heydari Ramin
Published: June 2024

Three novel trifluoromethylated compounds were designed and synthesized by reacting trifluoroacetimidoyl chloride derivatives with acetamidine hydrochloride or thiourea in the presence of potassium carbonate or sodium hydrogen carbonate as a base. In vitro and in vivo assays demonstrated the efficacy of the tested compounds in controlling root-knot nematode disease on pistachio rootstocks caused by Meloidogyne incognita. Bis-trifluoromethylated derivatives, namely N, N′′-thiocarbonylbis( N′-(3,4-dimethylphenyl)-2,2,2-trifluoroacetimidamide) (compound A1), showed high efficacy as novel and promising nematicides, achieving up to 78.28% control at a concentration of 0.042 mg/liter. This effect is attributed to four methyl and two trifluoromethyl groups. In the pre-inoculation application of compound A1, all three concentrations (0.033, 0.037, and 0.042 mg/liter, and Velum) exhibited a higher level of control, with 83.79, 87.46, and 80.73% control, respectively. In the microplot trials, compound A1 effectively reduced population levels of M. incognita and enhanced plant growth at a concentration of 0.037 mg/liter. This suggests that compound A1 has the potential to inhibit hedgehog protein and could be utilized to prevent the progression of root-knot disease. Furthermore, the molecular docking results revealed that compounds A1 and A3 interact with specific amino acid residues (Gln60, Asp530, Glu70, Arg520, and Thr510) located in the active site of hedgehog protein. Based on the experimental findings of this study, compound A1 shows promise as a lead compound for future investigations.
Ovarian cancer
Authors: Thull Tessa , Kempton Danielle
Published: June 2024

Ovarian cancer is the second most common gynecologic cancer in the United States and the deadliest gynecologic cancer worldwide, with a 5-year survival rate of less than 50%. Because of its vague symptoms, more than half of patients present with advanced disease and metastasis. This article reviews the epidemiology, pathogenesis, risk factors, screening, presentation, and diagnosis of ovarian cancer, in addition to providing an overview of the standard approach to treatment and novel targeted biologic therapies.
Comparing Relative Value Units for Intramedullary Limb Lengthening Procedures to Common Pediatric Orthopaedic Surgeries to Determine Adequate Compensation
Authors: Flanagan Jill C. , Gilani Sonia , Bafor Anirejuoritse , Iobst Christopher A.
Published: June 2024

Objective:

Reimbursement for surgical procedures is determined by a computation of the relative value unit (RVU) associated with CPT codes. It is based on the amount of work required to provide a service, resources available, and level of expertise involved. Given the evolution of changes in the limb lengthening field, we wanted to evaluate whether the RVU values were comparable across different orthopaedic subspecialties. Consequently, this study compares the work relative value unit (wRVU) totals of 3 common pediatric orthopaedic surgeries—arthroscopic ACL reconstruction, spinal fusion for adolescent idiopathic scoliosis, and antegrade femoral intramedullary limb lengthening.

Methods:

This was an IRB-approved, multicenter, retrospective chart review. Charts of subjects who had ACL reconstructions, including meniscal repairs; spinal fusion surgeries for adolescent idiopathic scoliosis (7 to 12 levels), including Ponte osteotomies, and femoral antegrade internal limb lengthening procedures, each completed by fellowship-trained orthopaedic surgeons were reviewed. Comparisons were carried out between several parameters, including mean duration per procedure, number of CPT codes billed per procedure, number of postoperative visits in the 90-day global period, and the wRVU for each procedure.

Results:

Fifty charts (25 per center) per procedure were reviewed. The wRVU per hour was lowest in the antegrade femur lengthening group (P < 0.0001). The number of postoperative visits in the 90-day global postsurgery period was significantly higher in the antegrade femur lengthening group (P < 0.0001). Intramedullary limb lengthening also had the least number of CPT codes billed.

Conclusions:

RVUs per time are statistically lowest in the limb lengthening group and highest in the scoliosis group. The limb lengthening patient also requires significantly more visits and time in the postoperative period compared with the other groups. These extra visits during the global period do not add any RVU value to the lengthening surgeon and occupy clinic spots that could be filled with new patients. Based on these data, a review of the RVU values assigned to the limb lengthening codes may be necessary.

Level of Evidence:

Level III—retrospective comparison study.
Quantitative Comparison of Ventilation Parameters of Different Approaches to Ventilator Splitting and Multiplexing
Authors: Kim Doowon , Roy Steven , McBeth Paul , Lee Jihyun
Published: June 2024

CONTEXT:

Amid the COVID-19 pandemic, this study delves into ventilator shortages, exploring simple split ventilation (SSV), simple differential ventilation (SDV), and differential multiventilation (DMV). The knowledge gap centers on understanding their performance and safety implications.

HYPOTHESIS:

Our hypothesis posits that SSV, SDV, and DMV offer solutions to the ventilator crisis. Rigorous testing was anticipated to unveil advantages and limitations, aiding the development of effective ventilation approaches.

METHODS AND MODELS:

Using a specialized test bed, SSV, SDV, and DMV were compared. Simulated lungs in a controlled setting facilitated measurements with sensors. Statistical analysis honed in on parameters like peak inspiratory pressure (PIP) and positive end-expiratory pressure.

RESULTS:

Setting target PIP at 15 cm H2O for lung 1 and 12.5 cm H2O for lung 2, SSV revealed a PIP of 15.67 ± 0.2 cm H2O for both lungs, with tidal volume (Vt) at 152.9 ± 9 mL. In SDV, lung 1 had a PIP of 25.69 ± 0.2 cm H2O, lung 2 at 24.73 ± 0.2 cm H2O, and Vts of 464.3 ± 0.9 mL and 453.1 ± 10 mL, respectively. DMV trials showed lung 1’s PIP at 13.97 ± 0.06 cm H2O, lung 2 at 12.30 ± 0.04 cm H2O, with Vts of 125.8 ± 0.004 mL and 104.4 ± 0.003 mL, respectively.

INTERPRETATION AND CONCLUSIONS:

This study enriches understanding of ventilator sharing strategy, emphasizing the need for careful selection. DMV, offering individualization while maintaining circuit continuity, stands out. Findings lay the foundation for robust multiplexing strategies, enhancing ventilator management in crises.
Deep Learning Versus Corneal Tomography Features to Detect Subclinical Corneal Edema in Fuchs Endothelial Corneal Dystrophy
Authors: Fitoussi Léa , Zéboulon Pierre , Rizk Maria , Ghazal Wassim , Rouger Hélène , Saad Alain , Elahi Sina , Gatinel Damien
Published: June 2024

Purpose:

To compare a deep learning model with corneal tomography features for detecting subclinical corneal edema in patients with Fuchs endothelial corneal dystrophy (FECD).

Methods:

We trained a deep learning model to detect corneal edema on 379 optical coherence tomography B-scans of normal and edematous corneas. 51 eyes of 32 patients with FECD were analyzed and compared with 100 eyes of 50 normal patients. For each eye, the cornea was scanned on the same day using 2 modalities of the same swept-source optical coherence tomography device (Anterion): corneal tomography maps and 6 high-resolution radial B-scans. The 6 radial B-scans were analyzed using our model from which an en face map of edema was reconstructed. The location exhibiting the highest probability of edema was derived from that map. Two corneal surgeons assessed the tomography maps and labeled the location of the supposed highest edema. This location was compared with our model's en face map.

Results:

According to tomography features, 64.7% of eyes presented subclinical edema. Our model and tomography features agreed in 80% of cases for the presence or absence of subclinical edema. The average distance between the location of maximal edema determined by human experts on tomography maps and that derived from our model's en face map was 1.91 ± 1.15 mm. Our model detected superior peripheral edema in a majority of eyes.

Conclusions:

Despite being based on different approaches, both methods agreed in the detection of subclinical edema in most cases. The location of detected edema was very similar in both methods. In cases where both methods disagree, our approach provides new objective results that might help the surgeon in making a decision in difficult cases.
Multiple Follicular Hybrid Tumors Presenting in Association With Myotonic Dystrophy Type 1
Authors: Wang Robin H. , Krouse Adam , Eilers David B. , Dahiya Madhu
Published: June 2024

Follicular hybrid cysts are uncommon entities derived from 2 or more components of the folliculo–sebaceous–apocrine unit. The pathogenesis of follicular hybrid cysts is uncertain; however, they are proposed to derive from the multipotent nature of follicular stem cells. Myotonic dystrophy type 1 is an inherited muscular dystrophy caused by an unstable trinucleotide repeat expansion in the myotonic dystrophy protein kinase gene, notably associated with multiple pilomatricomas. We report a novel case of multiple follicular hybrid tumors presenting in association with myotonic dystrophy type 1. We suspect that multipotent follicular stem cells, under the influence of the hypermutability phenotype present in myotonic dystrophy type 1, contributed to the pathogenesis of multiple follicular hybrid tumors in our patient.
Successful Treatment of Disseminated Fusariosis in a 15-Month-old Boy With Refractory Acute Lymphoblastic Leukemia Using High-dose Voriconazole
Authors: Petrikkos Loizos , Kourti Maria , Stathi Angeliki , Antoniadi Kondilia , Ampatzidou Mirella , Stefanaki Kalliopi , Zachariadou Levantia , Iosifidis Elias , Roilides Emmanuel , Polychronopoulou Sophia
Published: June 2024

Background:

Infections due to rare molds, such as Fusarium spp., cause severe and difficult-to-control diseases with increasing frequency. Data on fusariosis in children and on the use of voriconazole (VCZ), considered a drug of choice, are scarce in infants and children <2 years of age.

Case Presentation:

We present the first, to our knowledge, pediatric case of disseminated mycosis due to Fusarium musae in a 15-month-old boy with relapsed/refractory acute lymphoblastic leukemia, diagnostics and outcome. Herein, at this severely immunocompromised patient, after prompt diagnosis, disseminated fusariosis was successfully treated with high-dose VCZ at a final dose of 15 mg/kg of body weight twice a day. This occurred by achieving adequate drug exposures as determined by drug susceptibility testing and followed by therapeutic drug monitoring without observed toxicity.

Conclusions:

Appropriate diagnostic approach and timely administration of optimal antifungal therapy with VCZ were important for the successful treatment of disseminated fusariosis. Therapeutic drug monitoring, especially in <2-year-old children, is necessary to achieve sufficient drug exposure for optimal therapeutic response without toxicity.
Reusing surgical materials for cataract surgery: an assessment of potential contamination
Authors: Shukla Aakriti Garg , Chang David F. , Dhanaseelan Thamizhselvi , Vivekanandan Vellam Ramakrishnan , Gubert Joseph , Robin Alan L. , Venkatesh Rengaraj
Published: June 2024

Purpose:

To evaluate microbiological cultures of cataract surgical devices and products that were reused for multiple cases.

Setting:

Aravind Eye Hospital, Pondicherry, Tamil Nadu, India.

Design:

Prospective cohort study.

Methods:

Samples from multiple surgical instruments and products that were reused for consecutive cataract surgeries underwent bacterial and fungal cultures and were monitored alongside positive controls for 7 days. This included instruments that were processed using immediate use steam sterilization (IUSS) between cases (eg, surgical cannulas, syringes, phacoemulsification and coaxial/bimanual irrigation/aspiration [I/A] tips, phacoemulsification and I/A sleeves) (Group 1), instruments that were used without sterilization between cases (eg, phacoemulsification tubing/handpieces, coaxial I/A handpieces) (Group 2), and the residual (unused) fluid from balanced salt solution bags after being used for multiple patients (Group 3).

Results:

3333 discrete samples were collected from all 3 product groups that were reused across multiple patients. In all collected samples, no bacterial or fungal growth was observed. Of the 3241 cataract surgeries that used reused and IUSS-sterilized instruments alongside instrument sets cultured on the same day and balanced salt solution bags shared across multiple patients, no eyes developed endophthalmitis over a 6-week follow-up period.

Conclusions:

Bacterial or fungal growth was not found in extensive microbiological cultures of IUSS-sterilized ophthalmic surgical instruments and cataract surgical products that were reused in multiple patients. This microbiological data complements clinical endophthalmitis data from 2 million consecutive cases at the Aravind Eye Hospital, suggesting that their instrument and surgical supply processing practices may allow for safe and sustainable ophthalmic care.
Consistency of Physical Therapist Discharge Recommendations in Acute Care
Authors: Widenhoefer Tricia , Dickman Kendall , Meara Grace , Liter Donovan , Schoonveld Sarah , Almonroeder Sarah , Almonroeder Thomas Gus
Published: June 2024

Introduction:

Physical therapists assist with discharge planning for hospitalized patients by making recommendations regarding a patient’s optimal discharge location and ongoing rehabilitation needs. The purpose of this study was to examine the consistency of discharge recommendations made by physical therapists with experience working in an acute care setting, when provided with a set of clinical vignettes describing hospitalized patients.

Review of Literature:

Considering the complex/multifactorial nature of making discharge recommendations, one would expect there to be inconsistencies among physical therapists. However, we are not aware of a previous study examining the level of consistency for discharge recommendations made by physical therapists, when reviewing a set of clinical vignettes.

Subjects:

Nineteen physical therapists working in an acute care setting.

Methods:

The physical therapists were provided with 10 clinical vignettes describing hospitalized patients via an electronic survey distributed across three rehabilitation departments. Each vignette described the patient’s medical condition, past medical history, prior level of function, living situation, key examination findings, and other general characteristics. After independently reviewing each case, the physical therapists selected a discharge recommendation from a list of standard options. Fleiss’ kappa was examined to assess the level of agreement among the physical therapists.

Results:

Overall, Fleiss’ kappa was 0.28, which reflects fair agreement among the physical therapists.

Discussion and Conclusion:

The 19 physical therapists who participated in this study only exhibited fair agreement with respect to their discharge recommendations. This relatively low level of agreement suggests that efforts to improve the consistency of discharge recommendations should be explored.
The Healthcare Improvement and Innovation in Quality (THINQ) Collaborative: A Novel Quality Improvement Training Program for Undergraduate and Postgraduate Students
Authors: Krishnan Dhwani , Kareddy Abhinav , Chen Caitlin , Kerbel Russel , Dowling Erin , Simon Wendy , Dermenchyan Anna
Published: June 2024

The Healthcare Improvement and Innovation in Quality (THINQ) Collaborative is a uniquely designed program that engages undergraduate and postgraduate students to participate in improving health care and addressing important clinical problems. In 9 years, over 120 THINQ Fellows have been trained in quality improvement (QI) frameworks and methodologies focusing on research skills, social justice, leadership development, and problem-solving. Program evaluation has included surveying current and former THINQ Fellows about their experiences with the program and its subsequent impact on their careers. THINQ’s research and outreach initiatives have contributed to improvements in workflows and clinical care on topics such as interdisciplinary team communication, discharge and care transition, sepsis management, and physician burnout. The THINQ Program has equipped future health care leaders to engage with and address QI issues in clinical practice. The structures, processes, and outcomes discussed here can guide other institutions in creating similar QI programs.
Development and validation of a nomogram for nonalcoholic fatty liver disease in Western Xinjiang, China
Authors: Zheng Shuaiyin , Li Di , Shi Zhuoyue , Yang Ying , Li Lidan , Chen Peidi , A bulimiti Xieerwaniguli , Li Fuye
Published: June 2024

Objective

The aim of this study was to establish a simple, nonalcoholic fatty liver disease (NAFLD) screening model using readily available variables to identify high-risk individuals in Western Xinjiang, China.

Methods

A total of 40 033 patients from the National Health Examination were divided into a training group (70%) and a validation group (30%). Univariate regression and least absolute shrinkage and selection operator models optimized feature selection, while a multivariate logistic regression analysis constructed the prediction model. The model’s performance was evaluated using the area under the receiver operating characteristic curve, and its clinical utility was assessed through decision curve analysis.

Results

The nomogram assessed NAFLD risk based on factors such as sex, age, diastolic blood pressure, waist circumference, BMI, fasting plasma glucose, alanine aminotransferase, platelet count, total cholesterol, triglycerides, low-density lipoprotein–cholesterol, and high-density lipoprotein–cholesterol. The area under the receiver operating characteristic curves were 0.829 for men and 0.859 for women in the development group, and 0.817 for men and 0.865 for women in the validation group. The decision curve analysis confirmed the nomogram’s clinical usefulness, with consistent findings in the validation set.

Conclusion

A user-friendly nomogram prediction model for NAFLD risk was successfully developed and validated for Western Xinjiang, China.
Evolution of Pediatric Critical Care Medicine Physicians Clinical and Academic Profile by Gender*
Authors: Wai Kitman , Pollack Murray M. , Basu Sonali
Published: June 2024

OBJECTIVES:

To examine career trajectory and academic profile of Pediatric Critical Care Medicine (PCCM) physicians, with special focus on gender differences.

DESIGN:

Observational cross-sectional study of PCCM fellowship graduates using publicly available data.

SETTING:

Publicly available databases including National Provider Identifier registry, American Board of Pediatrics, Doximity, official hospital websites, and Scopus.

SUBJECTS:

Two thousand one hundred twenty-nine PCCM fellowship graduates employed in clinical positions in U.S. practice locations.

INTERVENTION:

None.

MEASUREMENTS AND MAIN RESULTS:

Physician demographic characteristics included gender and time since fellowship completion. Current career and academic characteristics included employment data, publication productivity (h-index), and academic rank. Data from 2129 career PCCM physicians was included, with recent graduates showing a notable increase in female representation. Workplace characteristics revealed that most PCCM physicians worked in university-affiliated hospitals, with higher percentages of female physicians working in university-affiliated hospitals compared with male physicians. The study also highlighted significant gender disparities in academic metrics, with male physicians having higher h-indices (3 vs. 2; p < 0.001) and more publications (6 vs. 4; p < 0.001) than their female counterparts across various career phases. Additionally, the analysis showed gender differences in academic rank, with a higher proportion of female faculty holding assistant and associate professor ranks (58.2% vs. 47.5%; p < 0.001), while a greater percentage of male faculty held the rank of professor (20.2% vs. 11.1%; p < 0.001). Multiple variable regression analysis identified both male gender and time since fellowship graduation as independently associated with a physician’s h-index, while only time since fellowship graduation was linked to current academic rank.

CONCLUSIONS:

This is the first analysis of career and academic characteristics of practicing PCCM physicians, additionally studying the association of gender and career trajectory. Gender discrepancy was seen in employment hospital characteristics, h-indices, and academic rank. Additional studies are required to further explore the impact of gender on career trajectory.