bluuebunny/crossref_metadata_2025 huggingface dataset:
Management and outcomes of spinal tuberculosis in Africa: a scoping review protocol
Authors: Enemuo Tochukwu N , Oladeji Emmanuel O , Anthony-Awi Temitayo A
Published: March 2023

Background

Spinal tuberculosis (TB) remains a major public health challenge in Africa, where 85% of the global deaths from TB is recorded. Patients with spinal TB have a high tendency to develop permanent disability, with significant financial costs. Most patients with spinal TB from Africa are unable to receive timely and effective intervention due to several socio-economic factors, deplorable healthcare infrastructure and inadequate specialized workforce. In addition, there is a lack of contextually appropriate evidence-based guidelines for management of this potentially debilitating but treatable condition. This scoping review protocol outlines how the authors aim to investigate the available evidence on the management and outcome of spinal TB in Africa.

Methods

AJOL, Embase, Pubmed/Medline, Google Scholar and Conchrane will be searched for articles published on the management and outcome of TB since the inception of the database. All patients from any of the 54 African countries will be included regardless of the socio-demographics.

Results

The primary outcomes will include the available treatment modalities and the clinical outcomes among patients managed for spinal TB in Africa. Secondary outcomes will include the epidemiology of spinal TB in Africa, information on the availability of diagnostic tools and the challenges faced in the management of spinal TB in Africa, including delays in treatment.

Discussion

Analysis of the outcomes and prognostic indicators will allow for a comparison of patient cohorts and the effectiveness of the different treatment modalities employed across Africa. This scoping review will be the first to address this research question.
The growing need to establish a global wastewater surveillance consortium for future pandemic preparedness
Authors: Murakami Michio , Kitajima Masaaki , Endo Noriko , Ahmed Warish , Gawlik Bernd Manfred
Published: March 2023

Recognizing the risk of pandemic and the importance of monitoring and data sharing, we highlight the importance of establishing a global wastewater surveillance consortium, particularly under the umbrella of an international organization such as WHO, to strengthen future pandemic preparedness.
Fluorescent visualization and evaluation of NPC1L1-mediated vesicular endocytosis during intestinal cholesterol absorption in mice
Authors: Wu Xiaojing , Ma Xian-Hua , Lin Jie , Yang Xiaohang , Shi Jian-Hui , Xie Zhifang , Chen Yu-Xia , Zhang Weiping J
Published: March 2023

Excessive cholesterol absorption from intestinal lumen contributes to the pathogenesis of hypercholesterolemia, which is an independent risk factor for atherosclerotic cardiovascular disease. Niemann-Pick C1-like 1 (NPC1L1) is a major membrane protein responsible for cholesterol absorption, in which the physiological role of vesicular endocytosis is still controversial, and it lacks a feasible tool to visualize and evaluate the endocytosis of NPC1L1 vesicles in vivo. Here, we genetically labeled endogenous NPC1L1 protein with EGFP in a knock-in mouse model, and demonstrated fluorescent visualization and evaluation of the endocytic vesicles of NPC1L1-cago during intestinal cholesterol absorption. The homozygous NPC1L1-EGFP mice have normal NPC1L1 expression pattern as well as cholesterol homeostasis on chow or high-cholesterol diets. The fluorescence of NPC1L1-EGFP fusion protein localizes at the brush border membrane of small intestine, and EGFP-positive vesicles is visualized beneath the membrane as early as 5 min post oral gavage of cholesterol. Of note, the vesicles colocalize with the early endosomal marker early endosome antigen 1 (EEA1) and the filipin-stained free cholesterol. Pretreatment with NPC1L1 inhibitor ezetimibe inhibits the formation of these cholesterol-induced endocytic vesicles. Our data support the notion that NPC1L1-mediated cholesterol absorption is a vesicular endocytic process. NPC1L1-EGFP mice are a useful model for visualizing cellular NPC1L1-cargo vesicle itineraries and for evaluating NPC1L1 activity in vivo in response to diverse pharmacological agents and nutrients.
Contrasting X-ray/UV time-lags in Seyfert 1 galaxies NGC 4593 and NGC 7469 usingAstroSatobservations
Authors: Kumari Kavita , Dewangan G C , Papadakis I E , Beard Max W J , McHardy I M , Singh K P , Bhattacharya D , Bhattacharyya S , Chandra S
Published: March 2023

We study accretion disc–corona connection in Seyfert 1 galaxies using simultaneous UV/X-ray observations of NGC 4593 (2016 July 14–18) and NGC 7469 (2017 October 15–19) performed with AstroSat. We use the X-ray (0.5–7.0 keV) data acquired with the Soft X-ray Telescope (SXT) and the UV (FUV: 130–180 nm, NUV: 200–300 nm) data obtained with the Ultra-Violet Imaging Telescope (UVIT). We also use the contemporaneous Swift observations of NGC 4593 and demonstrate AstroSat’s capability for X-ray/UV correlation studies. We performed UV/X-ray cross-correlation analysis using the interpolated and the discrete cross-correlation functions and found similar results. In the case of NGC 4593, we found that the variations in the X-rays lead to those in the FUV and NUV bands by ∼38 ks and ∼44 ks, respectively. These UV lags favour the disc-reprocessing model; they are consistent with the previous results within uncertainties. In contrast, we found an opposite trend in NGC 7469 where the soft X-ray variations lag those in the FUV and NUV bands by ∼41 ks and ∼49 ks, respectively. The hard lags in NGC 7469 favour the thermal Comptonization model. Our results may provide direct observational evidence for the variable intrinsic UV emission from the accretion disk, which acts as the seed for thermal Comptonization in a hot corona in a lamp-post-like geometry. The non-detection of disk reverberation photons in NGC 7469, using AstroSat data, is most likely due to a high accretion rate resulting in a hot accretion disc and large intrinsic emission.
A reconnection-driven magnetic flux cancellation and a quiet Sun Ellerman bomb
Authors: Kaithakkal Anjali J , Borrero J M , Yabar A Pastor , de la Cruz Rodríguez J
Published: March 2023

The focus of this investigation is to quantify the conversion of magnetic to thermal energy initiated by a quiet Sun cancellation event and to explore the resulting dynamics from the interaction of the opposite-polarity magnetic features. We used imaging spectroscopy in the Hα line, along with spectropolarimetry in the Fe i 6173 Å and Ca ii 8542 Å lines from the Swedish Solar Telescope (SST) to study a reconnection-related cancellation and the appearance of a quiet Sun Ellerman bomb (QSEB). We observed, for the first time, QSEB signature in both the wings and core of the Fe i 6173 Å line. We also found that, at times, the Fe i line-core intensity reaches higher values than the quiet Sun continuum intensity. From FIRTEZ-dz inversions of the Stokes profiles in Fe i and Ca ii lines, we found enhanced temperature, with respect to the quiet Sun values, at the photospheric (log τc  = −1.5; ∼1000 K) and lower chromospheric heights (log τc  = −4.5; ∼360 K). From the calculation of total magnetic energy and thermal energy within these two layers, it was confirmed that the magnetic energy released during the flux cancellation can support heating in the aforesaid height range. Further, the temperature stratification maps enabled us to identify cumulative effects of successive reconnection on temperature pattern, including recurring temperature enhancements. Similarly, Doppler velocity stratification maps revealed impacts on plasma flow pattern, such as a sudden change in the flow direction.
Cosmic void exclusion models and their impact on the distance scale measurements from large-scale structure
Authors: Variu Andrei , Zhao Cheng , Forero-Sánchez Daniel , Chuang Chia-Hsun , Kitaura Francisco-Shu , Tao Charling , Tamone Amélie , Kneib Jean-Paul
Published: March 2023

Baryonic Acoustic Oscillations (BAOs) studies based on the clustering of voids and matter tracers provide important constraints on cosmological parameters related to the expansion of the Universe. However, modelling the void exclusion effect is an important challenge for fully exploiting the potential of this kind of analyses. We thus develop two numerical methods to describe the clustering of cosmic voids. Neither model requires additional cosmological information beyond that assumed within the galaxy de-wiggled model. The models consist in power spectra whose performance we assess in comparison to a parabolic model on Patchy cubic and light-cone mocks. Moreover, we test their robustness against systematic effects and the reconstruction technique. The void model power spectra and the parabolic model with a fixed parameter provide strongly correlated values for the Alcock-Paczynski (α) parameter, for boxes and light-cones likewise. The resulting α values – for all three models – are unbiased and their uncertainties are correctly estimated. However, the numerical models show less variation with the fitting range compared to the parabolic one. The Bayesian evidence suggests that the numerical techniques are often favoured compared to the parabolic model. Moreover, the void model power spectra computed on boxes can describe the void clustering from light-cones as well as from boxes. The same void model power spectra can be used for the study of pre- and post-reconstructed data-sets. Lastly, the two numerical techniques are resilient against the studied systematic effects. Consequently, using either of the two new void models, one can more robustly measure cosmological parameters.
The importance of nuclear RAGE–Mcm2 axis in diabetes or cancer-associated replication stress
Authors: Han Zhe , Andrš Martin , Madhavan Bindhu K , Kaymak Serap , Sulaj Alba , Kender Zoltan , Kopf Stefan , Kihm Lars , Pepperkok Rainer , Janscak Pavel , Nawroth Peter , Kumar Varun
Published: March 2023

An elevated frequency of DNA replication defects is associated with diabetes and cancer. However, data linking these nuclear perturbations to the onset or progression of organ complications remained unexplored. Here, we report that RAGE (Receptor for Advanced Glycated Endproducts), previously believed to be an extracellular receptor, upon metabolic stress localizes to the damaged forks. There it interacts and stabilizes the minichromosome-maintenance (Mcm2–7) complex. Accordingly, RAGE deficiency leads to slowed fork progression, premature fork collapse, hypersensitivity to replication stress agents and reduction of viability, which was reversed by the reconstitution of RAGE. This was marked by the 53BP1/OPT-domain expression and the presence of micronuclei, premature loss-of-ciliated zones, increased incidences of tubular-karyomegaly, and finally, interstitial fibrosis. More importantly, the RAGE–Mcm2 axis was selectively compromised in cells expressing micronuclei in human biopsies and mouse models of diabetic nephropathy and cancer. Thus, the functional RAGE–Mcm2/7 axis is critical in handling replication stress in vitro and human disease.
Automated tumor segmentation and brain tissue extraction from multiparametric MRI of pediatric brain tumors: A multi-institutional study
Authors: Fathi Kazerooni Anahita , Arif Sherjeel , Madhogarhia Rachel , Khalili Nastaran , Haldar Debanjan , Bagheri Sina , Familiar Ariana M , Anderson Hannah , Haldar Shuvanjan , Tu Wenxin , Chul Kim Meen , Viswanathan Karthik , Muller Sabine , Prados Michael , Kline Cassie , Vidal Lorenna , Aboian Mariam , Storm Phillip B , Resnick Adam C , Ware Jeffrey B , Vossough Arastoo , Davatzikos Christos , Nabavizadeh Ali
Published: March 2023

Background

Brain tumors are the most common solid tumors and the leading cause of cancer-related death among all childhood cancers. Tumor segmentation is essential in surgical and treatment planning, and response assessment and monitoring. However, manual segmentation is time-consuming and has high interoperator variability. We present a multi-institutional deep learning-based method for automated brain extraction and segmentation of pediatric brain tumors based on multi-parametric MRI scans.

Methods

Multi-parametric scans (T1w, T1w-CE, T2, and T2-FLAIR) of 244 pediatric patients (n = 215 internal and n = 29 external cohorts) with de novo brain tumors, including a variety of tumor subtypes, were preprocessed and manually segmented to identify the brain tissue and tumor subregions into four tumor subregions, i.e., enhancing tumor (ET), non-enhancing tumor (NET), cystic components (CC), and peritumoral edema (ED). The internal cohort was split into training (n = 151), validation (n = 43), and withheld internal test (n = 21) subsets. DeepMedic, a three-dimensional convolutional neural network, was trained and the model parameters were tuned. Finally, the network was evaluated on the withheld internal and external test cohorts.

Results

Dice similarity score (median ± SD) was 0.91 ± 0.10/0.88 ± 0.16 for the whole tumor, 0.73 ± 0.27/0.84 ± 0.29 for ET, 0.79 ± 19/0.74 ± 0.27 for union of all non-enhancing components (i.e., NET, CC, ED), and 0.98 ± 0.02 for brain tissue in both internal/external test sets.

Conclusions

Our proposed automated brain extraction and tumor subregion segmentation models demonstrated accurate performance on segmentation of the brain tissue and whole tumor regions in pediatric brain tumors and can facilitate detection of abnormal regions for further clinical measurements.
With power comes responsibility: Mazzoleni v Summerhill
Authors: Rimmer John
Published: March 2023

The exercise of a power held in a fiduciary capacity can be open to challenge in court. In Mazzoleni v Summerhill Trust Company (Isle of Man) Limited (2021) 2DS 2021/3 the Isle of Man High Court tackled the decision by a conflicted trustee not to appoint a protector who might have overseen its decisions. Was a trustee bound to appoint a protector in any case? And could a trustee be compelled to exercise a power to appoint a protector—even if the terms of the power were not mandatory?
Stable isotopes in tree rings record physiological trends inLarix gmeliniiafter fires
Authors: Zhang Yujian , Qin Qianqian , Zhu Qiang , Sun Xingyue , Bai Yansong , Liu Yanhong
Published: March 2023

Fire is an important regulator of ecosystem dynamics in boreal forests, and in particular has a complicated association with growth and physiological processes of fire-tolerant tree species. Stable isotope ratios in tree rings are used extensively in eco-physiological studies for evaluating the impact of past environmental (e.g., drought and air pollution) factors on tree growth and physiological processes. Yet, such studies based on carbon (δ13C) and oxygen (δ18O) isotope ratios in tree rings are rarely conducted on fire effect, and are especially not well explored for fire-tolerant trees. In this study, we investigated variations in basal area increment and isotopes of Larix gmelinii (Rupr.) Rupr. before and after three moderate fires (different fire years) at three sites across the Great Xing’an Mountains, Northeastern China. We found that the radial growth of L. gmelinii trees has significantly declined after the fires across study sites. Following the fires, a simultaneous increase in δ13C and δ18O has strengthened the link between the two isotopes. Further, fires have significantly enhanced the 13C-derived intrinsic water-use efficiency (iWUE) and largely altered the relationships between δ13C, δ18O, iWUE and climate (temperature and precipitation). A dual-isotope conceptual model revealed that an initial co-increase in δ13C and δ18O in the fire year can be mainly attributed to a reduction in stomatal conductance with a constant photosynthetic rate. However, this physiological response would shift to different patterns over post-fire time between sites, which might be partly related to spring temperature. This study is beneficial to better understand, from a physiological perspective, how fire-tolerant tree species adapt to a fire-prone environment. It should also be remembered that the limitation of model assumptions and constraints may challenge model applicability and further inferred physiological response.
The Collateral Effect of Enhanced Recovery After Surgery Protocols on Spine Patients With Neuromuscular Scoliosis
Authors: Tøndevold Niklas , Bari Tanvir Johanning , Andersen Thomas Borbjerg , Gehrchen Martin
Published: March 2023

Introduction:

Enhanced recovery after surgery (ERAS) protocols are often specific to a specific type of surgery without assessing the overall effect on the ward. Previous studies have demonstrated reduced length of stay (LOS) with ERAS protocols in patients with adolescent idiopathic scoliosis (AIS), although the patients are often healthy and with few or no comorbidities. In 2018, we used ERAS principles for patients undergoing AIS surgery with a subsequent 40% reduced LOS. The current study aims to assess the potential collateral effect of LOS in patients surgically treated for neuromuscular scoliosis admitted to the same ward and treated by the same staff but without a standardized ERAS protocol.

Methods:

All patients undergoing neuromuscular surgery 2 years before and after ERAS introduction (AIS patients) with a gross motor function classification score of 4 to 5 were included. LOS, intensive care stay, and postoperative complications were recorded. After discharge, all complications leading to readmission and mortality were noted with a minimum of 2 years of follow-up using a nationwide registry.

Results:

Forty-six patients were included; 20 pre-ERAS and 26 post-ERAS. Cross groups, there were no differences in diagnosis, preoperative curve size, pulmonary or cardiac comorbidities, weight, sex, or age. Postoperative care in the intensive care unit was unchanged between the two groups (1.2 vs 1.1; P = 0.298). When comparing LOS, we found a 41% reduction in the post-ERAS group (11 vs 6.5; P < 0.001) whereas the 90-day readmission rates were without any significant difference (45% vs 34% P = 0.22) We found no difference in the 2-year mortality in either group.

Conclusion:

The employment of ERAS principles in a relatively uncomplicated patient group had a positive, collateral effect on more complex patients treated in the same ward. We believe that training involving the caregiving staff is equally important as pharmacological protocols.
A Novel Utility of Bilobed Flap for Amputation Stump Coverage
Authors: Hasan Meirizal , Aprilya Dina , Surya Arian
Published: March 2023

Preparing a good amputation stump with a well-padded, stable, sensate, and painless soft tissue coverage is of utmost importance to achieve early ambulation and return the patient to the daily activity level. When the primary closure is impossible or fails to achieve a good closure, secondary closure must be considered. To date, no literature reported the use of bilobed flaps for stump defect closure. We aimed to utilize this technically easy procedure for better management of defect closure on amputated limb stumps that often cause complex clinical problems. This is a retrospective observational study in limb amputation patients with various etiologies: crush injury, chronic limb necrosis, and amniotic band syndrome. All patients had stump defect closure with bilobed flap and were observed with a minimum of 6-months follow-up to evaluate the wound healing, the use of prosthesis, and the complications. A bilobed flap was performed in 11 amputation cases as the final closure (64% trans-femoral, 18% trans-tibial, 9% trans-humeral, and 9% trans-radial). The mean follow-up time was 8.5 ± 2.21 months. Most of the patients healed uneventfully with the optimal use of prosthesis in a mean healing time of 29.64 ± 7.49 days. The bilobed flap potentially provides a good amputation stump coverage that is ideal for prosthesis fitting. This simple procedure can be done without the necessity of special microsurgery settings. Thus, when the neighboring tissue is available and mobile enough to be transposed to the stump defect, a bilobed flap can be considered.
Noninvasive assessment of liver disease severity in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes
Authors: Pennisi Grazia , Enea Marco , Falco Vincenzo , Aithal Guruprasad P. , Palaniyappan Naaventhan , Yilmaz Yusuf , Boursier Jerome , Cassinotto Christophe , de Lédinghen Victor , Chan Wah Kheong , Mahadeva Sanjiv , Eddowes Peter , Newsome Philip , Karlas Thomas , Wiegand Johannes , Wong Vincent Wai-Sun , Schattenberg Jörn M. , Labenz Christian , Kim Won , Lee Myoung Seok , Lupsor-Platon Monica , Cobbold Jeremy F. L. , Fan Jian-Gao , Shen Feng , Staufer Katharina , Trauner Michael , Stauber Rudolf , Nakajima Atsushi , Yoneda Masato , Bugianesi Elisabetta , Younes Ramy , Gaia Silvia , Zheng Ming-Hua , Cammà Calogero , Anstee Quentin M. , Mózes Ferenc E. , Pavlides Michael , Petta Salvatore
Published: March 2023

Background and Aims:

We evaluated the diagnostic accuracy of simple, noninvasive tests (NITs) in NAFLD patients with type 2 diabetes (T2D).

Methods and Results:

This was an individual patient data meta-analysis of 1780 patients with biopsy-proven NAFLD and T2D. The index tests of interest were FIB-4, NAFLD Fibrosis Score (NFS), aspartate aminotransferase-to-platelet ratio index, liver stiffness measurement (LSM) by vibration-controlled transient elastography, and AGILE 3+. The target conditions were advanced fibrosis, NASH, and fibrotic NASH(NASH plus F2-F4 fibrosis). The diagnostic performance of noninvasive tests. individually or in sequential combination, was assessed by area under the receiver operating characteristic curve and by decision curve analysis. Comparison with 2278 NAFLD patients without T2D was also made. In NAFLD with T2D LSM and AGILE 3+ outperformed, both NFS and FIB-4 for advanced fibrosis (area under the receiver operating characteristic curve:LSM 0.82, AGILE 3+ 0.82, NFS 0.72, FIB-4 0.75, aspartate aminotransferase-to-platelet ratio index 0.68; p < 0.001 of LSM-based versus simple serum tests), with an uncertainty area of 12%–20%. The combination of serum-based with LSM-based tests for advanced fibrosis led to a reduction of 40%–60% in necessary LSM tests. Decision curve analysis showed that all scores had a modest net benefit for ruling out advanced fibrosis at the risk threshold of 5%–10% of missing advanced fibrosis. LSM and AGILE 3+ outperformed both NFS and FIB-4 for fibrotic NASH (area under the receiver operating characteristic curve:LSM 0.79, AGILE 3+ 0.77, NFS 0.71, FIB-4 0.71; p < 0.001 of LSM-based versus simple serum tests). All noninvasive scores were suboptimal for diagnosing NASH.

Conclusions:

LSM and AGILE 3+ individually or in low availability settings in sequential combination after FIB-4 or NFS have a similar good diagnostic accuracy for advanced fibrosis and an acceptable diagnostic accuracy for fibrotic NASH in NAFLD patients with T2D.
Plasma metabolomics study in screening and differential diagnosis of multiple primary lung cancer
Authors: Liu Zixu , Wang Ling , Gao Shugeng , Xue Qi , Tan Fengwei , Li Zhili , Gao Yushun
Published: March 2023

Background:

Multiple primary lung cancer (MPLC) is becoming increasingly common in clinical practice. Imaging examination is sometimes difficult to differentiate from intrapulmonary metastasis (IM) or single primary lung cancer (SPLC) before surgery. There is a lack of effective blood biomarkers as an auxiliary diagnostic method.

Participants and Methods

A total of 179 patients who were hospitalized and operated in our department from January to June 2019 were collected, and they were divided into SPLC with 136 patients, MPLC with 24 patients, and IM with 19 patients. In total, 96 healthy people without lung cancer were enrolled. Medical history, imaging, and pathology data were assembled from all participants. Plasma metabolomics analysis was performed by quadrupole time-of-flight tandem mass spectrometry, and data were analyzed using SPSS19.0/Simca 14.1/MetaboAnalyst5.0 software. Significant metabolites were selected by variable importance in projection, P value, and fold change. The area under the receiver operating characteristic curve was used to evaluate their diagnostic ability.

Results

There were significant differences in plasma metabolite profiles between IM and MPLC. Seven metabolites were screened out. Two metabolites had higher levels in IM, and five metabolites had higher levels in MPLC. All had favorable discriminating capacity. Phosphatidyl ethanolamine (38:5) showed the highest sensitivity (0.95) and specificity (0.92). It was followed by l-histidine with sensitivity 0.92 and specificity 0.84. l-tyrosine can be used to identify SPLC and MPLC. The panel composed of related metabolites exhibited higher diagnostic ability. Eight principal metabolites caused remarkable differences between healthy people and MPLC, and five of them had area under the curves greater than 0.85, showing good discriminating power.

Conclusion

Through the study of plasma metabolomics, it was found that there were obvious differences in the metabolite profiles of MPLC, IM, SPLC, and the healthy population. Some discovered metabolites possessed excellent diagnostic competence with high sensitivity and specificity. They had the potential to act as biomarkers for the screening and differential diagnosis of MPLCs.
Magnetic Resonance Imaging Findings in Idiopathic Intracranial Hypertension With and Without Pulsatile Tinnitus: An Age-Matched Cohort Study
Authors: Widmeyer Jonathan R. , Sismanis Aristides , Felton Warren , Haines Scott , Tang Yang , Gharavi Mohammed , Miller Nathaniel , Coelho Daniel H.
Published: March 2023

Objective

Many but not all patients with idiopathic intracranial hypertension (IIH) have pulsatile tinnitus (PT). However, little is known about why some patients with IIH develop PT and others do not. The purpose of this study was to determine if any of the classic magnetic resonance imaging (MRI)–detectable markers of IIH differ between patients with and without PT, thereby shedding light on potential pathophysiology.

Methods

A retrospective age-matched cohort study of patients with documented IIH (diagnosed by neuro-ophthalmologist) was performed. All patients had MRI performed around the time of diagnosis. MRIs were assessed for 16 variables known to be associated with IIH (e.g., pituitary displacement/empty sella, optic nerve tortuosity, transverse sinus stenosis, inferior cerebellar tonsils, arachnoid granulations, slit-like ventricles) by two blinded neuroradiologists. All binary variables were analyzed via χ
2 test with Yates correction, or Fisher exact when appropriate. Continuous variables were analyzed via Student t test. Inter-rater reliability for binary variables was assessed by Cohen κ. For continuous variables, intraclass correlation coefficient was calculated.

Results

Forty age-matched patients with IIH met the inclusion criteria (20 with PT, 20 without PT). For all known binary MRI findings associated with IIH, there were no statistically significant differences between groups. Likewise, there were no statistically significant differences for continuous variables.

Conclusions

The classic MRI findings associated with IIH do not differ between patients with and without PT, suggesting that systemic (rather than localized intrinsic or extrinsic) factors may play a critical role in the pathophysiology.
Management Challenges of Recurrent Foreign Body Ingestions in a Psychiatric Patient: A Case Report
Authors: Jaini Paresh A. , Haliburton James , Rush A. John
Published: March 2023

Intentional foreign body ingestions (FBIs) are commonly seen in adult patients with intellectual disabilities, substance use, severe psychiatric conditions, or external motivations, but these cases are rarely reported in the psychiatric literature. We present the case of a patient with an extensive history of FBIs and suicide attempts and a multitude of psychiatric diagnoses including borderline personality disorder, major depressive disorder, posttraumatic stress disorder from significant abuse in foster care, obsessive-compulsive disorder, and pica. During the single hospitalization described in this report, she had multiple incidents of self-harm, aggression, and 9 FBIs. A multidisciplinary team involving psychiatry, emergency medicine, gastroenterology, surgery, internal medicine, nursing, social work, behavioral health technicians, case management, chaplain, the legal department, police officers, and hospital maintenance was necessary for care coordination. Interventions included 8 endoscopies and an abdominal surgery to retrieve swallowed foreign bodies, pain management, psychopharmacological and psychotherapeutic interventions for agitation, and environmental precautions to minimize the risk of ingestion. Ultimately, to prevent further trauma and limit additional opportunities for FBI, a collaborative decision was made with the patient to discharge her to her home with outpatient psychologist and psychiatrist support. This case describes the complexities of hospital management of a patient with intentional recurrent FBI, highlighting the importance of a critical assessment of risk versus benefit for prolonging hospitalization. Development of practical management protocols and risk assessments for continued hospitalization is necessary for patients with recurrent intentional FBIs.
Point-of-care urine tenofovir testing to predict HIV drug resistance among individuals with virologic failure
Authors: McCluskey Suzanne M. , Govender Katya , Adamson John , Gandhi Monica , Spinelli Matthew A. , Moosa Mahomed-Yunus , Muyindike Winnie , Moodley Pravi , Pillay Melendhran , Masette Godfrey , Sunpath Henry , Pillay Selvan , Chen Geoffrey , Hedt-Gauthier Bethany , Marconi Vincent C. , Siedner Mark J.
Published: March 2023

Objective:

We sought to evaluate the utility of a point-of-care (POC) urine tenofovir (TFV) assay, developed to objectively assess adherence, to predict HIV drug resistance (HIVDR) in people failing first-line antiretroviral therapy (ART).

Design:

We retrospectively analyzed TFV levels as a biomarker of adherence in urine specimens collected during a clinical trial that enrolled adults with virologic failure on first-line ART in Uganda and South Africa.

Methods:

Urine specimens were analyzed from participants on TFV-containing regimens who had a viral load >1000 copies/ml and paired genotypic resistance test (GRT) results. We assessed recent ART TFV adherence with a qualitative POC lateral flow urine assay with a cut-off value of 1500 ng/ml. We then calculated performance characteristics of the POC urine TFV assay to predict HIVDR, defined as intermediate or high-level resistance to any component of the current ART regimen.

Results:

Urine specimens with paired plasma GRT results were available from 283 participants. The most common ART regimen during study conduct was emtricitabine, tenofovir disoproxil fumarate, and efavirenz. The overall prevalence of HIVDR was 86% (n = 243/283). Of those with TFV detected on the POC assay, 91% (n = 204/224) had HIVDR, vs. only 66% (n = 39/59) among those with no TFV detected (P-value < 0.001). Positive and negative predictive values of the assay to predict HIVDR were 91% and 34%, respectively.

Conclusions:

In populations with a high prevalence of HIVDR, the POC urine TFV assay can provide a low-cost, rapid method to guide requirements for confirmatory resistance testing and inform the need for regimen change.
Estimated cost-effectiveness of point-of-care testing in community pharmacies vs. self-testing and standard laboratory testing for HIV
Authors: Mital Shweta , Kelly Deborah , Hughes Christine , Nosyk Bohdan , Thavorn Kednapa , Nguyen Hai V.
Published: March 2023

Objective:

Point-of-care-testing (POCT) for HIV at community pharmacies can enhance care linkage compared with self-tests and increase testing uptake relative to standard lab testing. While the higher test uptake may increase testing costs, timely diagnosis and treatment can reduce downstream HIV treatment costs and improve health outcomes. This study provides the first evidence on the cost-effectiveness of pharmacist-led POCT vs. HIV self-testing and standard lab testing.

Design:

Dynamic transmission model

Methods:

We compared three HIV testing strategies: POCT at community pharmacies; self-testing using HIV self-test kits; and standard lab testing. Analyses were conducted from the Canadian health system perspective over a 30-year time horizon for all individuals aged 15–64 years in Canada. Costs were measured in 2021 Canadian dollars and effectiveness was captured using quality-adjusted life-years (QALYs).

Results:

Compared with standard lab testing, POCT at community pharmacies would save $885 million in testing costs over 30 years. Though antiretroviral treatment costs would increase by $190 million with POCT as more persons living with HIV are identified and treated, these additional costs would be partly offset by their lower downstream healthcare utilization (savings of $150 million). POCT at community pharmacies would also yield over 5000 additional QALYs. Compared with HIV self-testing, POCT at community pharmacies would generate both higher costs and higher QALYs and would be cost-effective with an incremental cost-effectiveness ratio of $47 475 per QALY gained.

Conclusions:

Offering POCT at community pharmacies can generate substantial cost savings and improve health outcomes compared with standard lab testing. It would also be cost-effective vs. HIV self-testing.
Preliteracy assessment in children living with HIV in Tanzania: comparison to results from children living without HIV in Tanzania and the United States
Authors: Bonacina Silvia , Niemczak Christopher , Lichtenstein Jonathan D. , Magohe Albert , Fellows Abigail , Nicol Trent , Massawe Enica , Buckey Jay C. , Kraus Nina
Published: March 2023

Objective:

Children with HIV (CWH) are at increased risk for cognitive and developmental delays. Whether HIV affects literacy development, however, remains unknown. Rapid automatized naming (RAN) tasks offer the simplest preliteracy assessment a child can perform that predicts future reading skills across languages.

Design and Methods:

RAN performance was analyzed cross-sectionally on 473 children (249 children without HIV and 217 CWH; ages 3–9) drawn from a longitudinal study in Tanzania. These data were compared to results from 341 normally developing children without HIV (ages 3–8) from the United States. Participants performed two RAN subtests: colors and objects.

Results:

RAN object completion was greater than for the RAN color in Tanzanian children. CWH were less likely to complete either subtest and performed worse on the object subtest compared to Tanzanian children without HIV. Compared to the US cohort, the Tanzanian cohort was less likely to complete both subtests - in particular the colors subtest - and showed more variability in responses at younger ages. After approximately age 6, however, the trajectory of improvement between the United States and Tanzania was similar.

Conclusions:

CWH performed worse on this per-literacy test, indicating literacy skill development in CWH needs further study. The differences between US and Tanzanian results likely reflect variability in when children learn to name colors and objects. The trajectory of improvement between countries became more similar as the children aged. This study motivates further longitudinal analyses aimed at assessing the developmental trajectory of the RAN, its predictive ability for reading skills, and its link with other preliteracy and cognitive skills.
Successful living donor liver transplantation from an HIV and HCV positive donor: report from the first case in the world
Authors: Di Sandro Stefano , Catellani Barbara , Guidetti Cristiano , Magistri Paolo , Ballarin Roberto , Pecchi Annarita , Caracciolo Daniela , Guaraldi Giovanni , Guerrini Gian Piero , Di Benedetto Fabrizio
Published: March 2023

HIV (human-immunodeficiency-virus) and HCV (hepatitis-C-virus) infections cause millions of deaths across the world every year. Since the introduction of effective therapies for HIV, in the middle of 1990s, and HCV, after 2013, those two untreatable infections became completely controlled.

Donor safety is the main goal in living donor liver transplantation (LDLT). An accurate predonation screening is mandatory for excluding risk factors related with any increase of donors’ short-term and long-term morbidity. We present the first LDLT from a donor with both HIV and HCV previous infections. Donor and recipient did not experience any complication. Individuals with well controlled HIV/HCV infections and without any risk factors may be suitable for donation of a part of their healthy liver.

Abstract video, http://links.lww.com/QAD/C833
Increased transmigration of intermediate monocytes associated with atherosclerotic burden in people with HIV on antiretroviral therapy
Authors: Chow Dominic C. , Saiki Katelyn M.W. , Siriwardhana Chathura , Lozano-Gerona Javier , Vanapruks Selena , Ogle Jenie , Premeaux Thomas A. , Ndhlovu Lishomwa C. , Boisvert William A.
Published: March 2023

This study evaluated the association between the transmigration of monocyte subpopulations that contributes to atherosclerosis development, along with surrogate biomarkers of inflammation and atherosclerosis, through carotid intima-media thickness (cIMT) measurements of 72 people with HIV (PWH) on suppressive antiretroviral therapy (ART). We found that the transmigration of intermediate monocytes was positively correlated with D-dimer and cIMT, suggesting that intermediate monocytes may have a greater propensity to promote cardiovascular disease (CVD) in PWH on ART.
Mechanisms of systemic low-grade inflammation in HIV patients on long-term suppressive antiretroviral therapy: the inflammasome hypothesis
Authors: Guerville Florent , Vialemaringe Marine , Cognet Celine , Duffau Pierre , Lazaro Estibaliz , Cazanave Charles , Bonnet Fabrice , Leleux Olivier , Rossignol Rodrigue , Pinson Benoît , Tumiotto Camille , Gabriel Frederic , Appay Victor , Déchanet-Merville Julie , Wittkop Linda , Faustin Benjamin , Pellegrin Isabelle
Published: March 2023

Objective:

We aimed to determine the contribution of inflammasome activation in chronic low-grade systemic inflammation observed in patients with HIV (PWH) on long-term suppressive antiretroviral therapy (ART) and to explore mechanisms of such activation.

Design:

Forty-two PWH on long-term suppressive ART (HIV-RNA < 40 copies/ml) were compared with 10 HIV-negative healthy controls (HC).

Methods:

Inflammasome activation was measured by dosing mature interleukin (IL)-1β and IL-18 cytokines in patient serum. We explored inflammasome pathways through ex vivo stimulation of PWH primary monocytes with inflammasome activators; expression of inflammasome components by transcriptomic analysis; and metabolomics analysis of patient sera.

Results:

Median (Q1; Q3) age, ART and viral suppression duration in PWH were 54 (48; 60), 15 (9; 20) and 7.5 (5; 12) years, respectively. Higher serum IL-18 was measured in PWH than in HC (61 (42; 77) vs. 36 (27–48 pg/ml), P = 0.009); IL-1β was detected in 10/42 PWH (0.5 (0.34; 0.80) pg/ml) but not in HC. Monocytes from PWH did not produce more inflammatory cytokines in vitro, but secretion of IL-1β in response to NOD like receptor family, pyrin domain containing 3 (NLRP3) inflammasome stimulation was higher than in HC. This was not explained at the transcriptional level. We found an oxidative stress molecular profile in PWH sera.

Conclusion:

HIV infection with long-term effective ART is associated with a serum inflammatory signature, including markers of inflammasome activation, and an increased activation of monocytes upon inflammasome stimulation. Other cells should be investigated as sources of inflammatory cytokines in PWH. Oxidative stress might contribute to this chronic low-grade inflammation.
FDG PET/CT Imaging of Severe Polymyalgia Rheumatica
Authors: Chen Jeffrey , Wong Veronica Chi Ken , Bui Chuong , Mansberg Robert
Published: March 2023

A 68-year-old woman was referred for an 18F-FDG PET/CT for evaluation of arthralgia and raised inflammatory markers, which demonstrated intense FDG activity (SUVmax, 25.5) at numerous periarticular and extra-articular sites including the cervical and lumbar interspinous bursae, lumbar facet joints, bilateral ischial tuberosities, and greater trochanters and the aorta consistent with active polymyalgia rheumatica.
A Single-Center Case Series of Successful Abdominal Organ Transplantation From SARS-CoV-2–infected Donors to Uninfected Recipients—Do We Need Rigorous Monitoring?
Authors: Singh Priyamvada , Von Stein Lauren , Doraiswamy Mohankumar , Samidurai Lakshmi , Singh Navdeep , Maxwell Molly , Pesavento Todd E
Published: March 2023

Background.

There is limited documentation of hematogenous transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in non–lung transplants from infected donors to uninfected recipients.

Methods.

We analyzed 16 recipients (7 liver, 9 kidney) transplanted from SARS-CoV-2 nucleic acid test+deceased donors from December 25, 2021, to February 28, 2022, who were followed-up for at least 90 d. Primary outcomes included coronavirus disease 2019–positivity, allograft loss, and all-cause mortality. Secondary outcomes included biopsy-proven rejection (BPAR), donor-specific antibodies, delayed graft function, and opportunistic infections. Unlike previous studies, we followed the recipients clinically with the intent to treat if they developed SARS-CoV-2 symptoms.

Results.

All donors were SARS-CoV-2 polymerase chain reaction–positive 72 h before donation. No recipients developed SARS-CoV-2 infection. The nadir serum creatinine and estimated glomerular filtration rate were 1.33 mg/dL and 64 mL/min/1.732 m2for kidney transplantation (KTx) respectively. The median alanine transaminase was 14.5 IU/L, aspartate aminotransferase 13 IU/L, and alkaline phosphatase 74 IU/L. Two KTx patients lost allograft, and 1 liver transplantation patient died with a failed allograft. However, this was unrelated to their SARS-CoV-2–positive donor status. One BPAR in the liver transplantation was treated with steroids. No donor-specific antibodies or BPAR were reported in the KTx. Six KTx patients experienced delayed graft function, and 4 are off dialysis. Two KTx patients developed cytomegalovirus infection because of an error in reporting the cytomegalovirus serostatus by the donor center. We did not do serial testing for SARS-CoV-2 by polymerase chain reaction, imaging, or cycle threshold score pre- or posttransplant for donor/recipient and had comparable outcomes with previous studies.

Conclusions.

Because of the low risk of transmission, serial testing might not be necessary and, thus, could be reciprocated at small-volume transplant centers.
Tamlana laminarinivorans sp. nov. and Tamlana sargassicola sp. nov., two novel species isolated from Sargassum, show genomic and physiological adaptations for a Sargassum-associated lifestyle
Authors: Li Jin , Liang Yumei , He Zhixiao , An Lu , Liu Yongjin , Zhong Mingqi , Hu Zhong
Published: March 2023

The genus

Tamlana

from the

Bacteroidota

currently includes six validated species. Two strains designated PT2-4T and 62-3T were isolated from Sargassum abundant at the Pingtan island coast in the Fujian Province of China. 16S rRNA gene sequence analysis showed that the closest described relative of strains PT2-4T and 62-3T is

Tamlana sedimentorum

JCM 19808T with 98.40 and 97.98% sequence similarity, respectively. The 16S rRNA gene sequence similarity between strain PT2-4T and strain 62-3T was 98.68 %. Furthermore, the highest average nucleotide identity values were 87.34 and 88.97 % for strains PT2-4T and 62-3T, respectively. The highest DNA–DNA hybridization (DDH) value of strain PT2-4T was 35.2 % with strain 62-3T, while the DDH value of strain 62-3T was 37.7 % with

T. sedimentorum

JCM 19808T. Growth of strains PT2-4T and 62-3T occurs at 15–40 °C (optimum, 30 °C) with 0–4 % (w/v) NaCl (optimum 0–1 %). Strains PT2-4T and 62-3T can grow from pH 5.0 to 10.0 (optimum, pH 7.0). The major fatty acids of strains PT2-4T and 62-3T are iso-C15 : 0 and iso G-C15 : 1. MK-6 is the sole respiratory quinone. Genomic and physiological analyses of strains PT2-4T and 62-3T showed corresponding adaptive features. Significant adaptation to the growth environment of macroalgae includes the degradation of brown algae-derived diverse polysaccharides (alginate, laminarin and fucoidan). Notably, strain PT2-4T can utilize laminarin, fucoidan and alginate via specific carbohydrate-active enzymes encoded in polysaccharide utilization loci, rarely described for the genus

Tamlana

to date. Based on their distinct physiological characteristics and the traits of utilizing polysaccharides from Sargassum, strains PT2-4T and 62-3T are suggested to be classified into two novel species, Tamlana laminarinivorans sp. nov. and Tamlana sargassicola sp. nov. (type strain PT2-4T=MCCC 1K04427T=KCTC 92183T and type strain 62-3T=MCCC 1K04421T=KCTC 92182T).
Spathaspora brunopereirae sp. nov. and Spathaspora domphillipsii sp. nov., two d-xylose-fermenting ascosporogenous yeasts from Amazonian Forest biomes
Authors: Santos Ana Raquel O. , Souza Gisele F. L. , Barros Katharina O. , Alvarenga Flávia B. M. , Lopes Mariana R. , Souza Láuren M. D. , Rosa Luiz H. , Góes-Neto Aristóteles , Morais Paula B. , Lachance Marc-André , Rosa Carlos A.
Published: March 2023

Four isolates of Spathaspora species were recovered from rotting wood collected in two Brazilian Amazonian biomes. The isolates produced unconjugated allantoid asci with a single elongated ascospore with curved ends. Sequence analysis of the ITS-5.8S region and the D1/D2 domains of the large subunit rRNA gene showed that the isolates represent two different novel Spathaspora species, phylogenetically related to Sp. boniae. Two isolates were obtained from rotting wood collected in two different sites of the Amazonian forest in the state of Pará. The name Spathaspora brunopereirae sp. nov. is proposed to accommodate these isolates. The holotype of Spathaspora brunopereirae sp. nov. is CBS 16119T (MycoBank MB846672). The other two isolates were obtained from a region of transition between the Amazonian forest and the Cerrado ecosystem in the state of Tocantins. The name Spathaspora domphillipsii sp. nov. is proposed for this novel species. The holotype of Spathaspora domphillipsii sp. nov. is CBS 14229T (MycoBank MB846697). Both species are able to convert d-xylose into ethanol and xylitol, a trait with biotechnological applications.
Guidelines for interpreting the International Code of Nomenclature of Prokaryotes and for preparing a Request for an Opinion
Authors: Arahal David R. , Bull Carolee T. , Busse Hans-Jürgen , Christensen Henrik , Chuvochina Maria , Dedysh Svetlana N. , Fournier Pierre-Edouard , Konstantinidis Konstantinos T. , Parker Charles T. , Rossello-Mora Ramon , Ventosa Antonio , Göker Markus
Published: March 2023

In this paper the Judicial Commission provides general guidance for interpreting the International Code of Nomenclature of Prokaryotes (ICNP) and specific assistance to authors, reviewers and editors of a Request for an Opinion, or of other suggestions related to the ICNP. The role of the Judicial Commission is recapitulated, particularly with respect to the processing of such Requests. Selected kinds of nomenclature-related proposals are discussed that are unsuitable as the basis for a Request. Particular emphasis is put on Requests for placing names or epithets on the list ofnomina rejicienda, and a dichotomous identification key is provided to guide potential authors of a Request that targets the name of a species or subspecies because of issues with its type strain. To this end, the criteria for the valid publication of such names under the ICNP are revisited. Aspects of other kinds of Requests are also addressed. The study is based on a comprehensive review of all Judicial Opinions issued since the publication of the Approved Lists in 1980. One goal of this paper is to assist potential authors in deciding whether their concern should be the subject of a Request, and if so, in composing it with the greatest chance of success. It is also clarified how to obtain additional help regarding nomenclature-related issues.