bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel resistance ICEs carrying the
bla
FIM-1
metallo-β-lactamase gene from an ST235
Pseudomonas aeruginosa
sublineage
Authors: Antonelli Alberto , Coppi Marco , Bonaiuto Chiara , Giovacchini Nicla , Vaggelli Guendalina , Farese Alberto , Pollini Simona , Rossolini Gian Maria
Published: January 2024

FIM-1 is an acquired metallo-β-lactamase identified in a multidrug-resistant
Pseudomonas aeruginosa
(index strain FI-14/157) of clinical origin isolated in 2007 in Florence, Italy. Here we report on a second case of infection by FIM-1-positive
P. aeruginosa
(FI-17645), which occurred in 2020 in the same hospital. Both FIM-1-positive strains exhibited resistance to all anti-
Pseudomonas
antibiotics except colistin and cefiderocol. Comparative genomic characterization revealed that the two FIM-positive strains were closely related [core genome difference, 16 single nucleotide polymorphisms (SNPs)], suggesting a local circulation of similar strains. In the FI-14/157 index strain, the
bla
FIM-1
gene was associated with an IS
CR19
-like element that likely contributed to its capture downstream an integron platform inserted aboard a Tn
21
-like transposon, named Tn
7703.1
, which was associated with a large integrative and conjugative element (ICE) named ICE
7705
.1, integrated into an
att
site located within the 3′-end of tRNA
Gly
CCC gene of the
P. aeruginosa
chromosome. In strain FI-17645,
bla
FIM-1
was associated with a closely related ICE, named ICE
7705
.
2
, integrated in the same chromosomal site. Similar ICE platforms, lacking the
bla
FIM-1
-containing region, were detected in other ST235
P. aeruginosa
strains from different geographic areas, suggesting a common ancestry and underscoring the role of these elements in the dissemination of resistance genes in
P. aeruginosa
. Sequence database mining revealed two draft
P. aeruginosa
genomes, one from Italy and one from the USA (both isolated in 2012), including a contig with
bla
FIM-1
, suggesting that this resistance gene could have a broader distribution than originally anticipated.
Outer membrane vesicles and the outer membrane protein OmpU govern
Vibrio cholerae
biofilm matrix assembly
Authors: Potapova Anna , Garvey William , Dahl Peter , Guo Shuaiqi , Chang Yunjie , Schwechheimer Carmen , Trebino Michael A. , Floyd Kyle A. , Phinney Brett S. , Liu Jun , Malvankar Nikhil S. , Yildiz Fitnat H.
Published: January 2024

Cholera remains a major public health concern.
Vibrio cholerae
, the causative agent of cholera, forms biofilms, which are critical for its transmission, infectivity, and environmental persistence. While we know that the
V. cholerae
biofilm matrix contains exopolysaccharide, matrix proteins, and extracellular DNA, we do not have a comprehensive understanding of the majority of biofilm matrix components. Here, we discover outer membrane vesicles (OMVs) within the biofilm matrix of
V. cholerae
. Proteomic analysis of the matrix and matrix-associated OMVs showed that OMVs carry key matrix proteins and
Vibrio
polysaccharide (VPS) to help build biofilms. We also characterize the role of the highly abundant outer membrane protein OmpU in biofilm formation and show that it impacts biofilm architecture in a VPS-dependent manner. Understanding
V. cholerae
biofilm formation is important for developing a better prevention and treatment strategy framework.
Colony phase variation switch modulates antimicrobial tolerance and biofilm formation in
Acinetobacter baumannii
Authors: Mushtaq Fizza , Nadeem Aftab , Yabrag Abdelbasset , Bala Anju , Karah Nabil , Zlatkov Nikola , Nyunt Wai Sun , Uhlin Bernt Eric , Ahmad Irfan
Published: January 2024

Carbapenem-resistant
Acinetobacter baumannii
causes one of the most difficult-to-treat nosocomial infections. Polycationic drugs like polymyxin B or colistin and tetracycline drugs such as doxycycline or minocycline are commonly used to treat infections caused by carbapenem-resistant
A. baumannii
. Here, we show that a subpopulation of cells associated with the opaque/translucent colony phase variation by
A. baumannii
AB5075 displays differential tolerance to subinhibitory concentrations of colistin and tetracycline. Using a variety of microscopic techniques, we demonstrate that extracellular polysaccharide moieties mediate colistin tolerance to opaque
A. baumannii
at single-cell level and that mushroom-shaped biofilm structures protect opaque bacteria at the community level. The colony switch phenotype is found to alter several traits of
A. baumannii
, including long-term survival under desiccation, tolerance to ethanol, competition with
Escherichia coli
, and intracellular survival in the environmental model host
Acanthamoeba castellanii
. Additionally, our findings suggest that extracellular DNA associated with membrane vesicles can promote colony switching in a DNA recombinase-dependent manner.

IMPORTANCE

As a WHO top-priority drug-resistant microbe,
Acinetobacter baumannii
significantly contributes to hospital-associated infections worldwide. One particularly intriguing aspect is its ability to reversibly switch its colony morphotype on agar plates, which has been remarkably underexplored. In this study, we employed various microscopic techniques and phenotypic assays to investigate the colony phase variation switch under different clinically and environmentally relevant conditions. Our findings reveal that the presence of a poly N-acetylglucosamine-positive extracellular matrix layer contributes to the protection of bacteria from the bactericidal effects of colistin. Furthermore, we provide intriguing insights into the multicellular lifestyle of
A. baumannii
, specifically in the context of colony switch variation within its predatory host,
Acanthamoeba castellanii
.
Upc2-mediated mechanisms of azole resistance in
Candida auris
Authors: Li Jizhou , Aubry Lola , Brandalise Danielle , Coste Alix T. , Sanglard Dominique , Lamoth Frederic
Published: January 2024

Candida auris
is an emerging yeast pathogen of major concern because of its ability to cause hospital outbreaks of invasive candidiasis and to develop resistance to antifungal drugs. A majority of
C. auris
isolates are resistant to fluconazole, an azole drug used for the treatment of invasive candidiasis. Mechanisms of azole resistance are multiple, including mutations in the target gene
ERG11
and activation of the transcription factors Tac1b and Mrr1, which control the drug transporters Cdr1 and Mdr1, respectively. We investigated the role of the transcription factor Upc2, which is known to regulate the ergosterol biosynthesis pathway and azole resistance in other
Candida
spp. Genetic deletion and hyperactivation of Upc2 by epitope tagging in
C. auris
resulted in drastic increases and decreases in susceptibility to azoles, respectively. This effect was conserved in strains with genetic hyperactivation of Tac1b or Mrr1. Reverse transcription PCR analyses showed that Upc2 regulates
ERG11
expression and also activates the Mrr1/Mdr1 pathway. We showed that upregulation of
MDR1
by Upc2 could occur independently from Mrr1. The impact of
UPC2
deletion on
MDR1
expression and azole susceptibility in a hyperactive Mrr1 background was stronger than that of
MRR1
deletion in a hyperactive Upc2 background. While Upc2 hyperactivation resulted in a significant increase in the expression of
TAC1b
,
CDR1
expression remained unchanged. Taken together, our results showed that Upc2 is crucial for azole resistance in
C. auris
, via regulation of the ergosterol biosynthesis pathway and activation of the Mrr1/Mdr1 pathway. Notably, Upc2 is a very potent and direct activator of Mdr1.

IMPORTANCE

Candida auris
is a yeast of major medical importance causing nosocomial outbreaks of invasive candidiasis. Its ability to develop resistance to antifungal drugs, in particular to azoles (e.g., fluconazole), is concerning. Understanding the mechanisms of azole resistance in
C. auris
is important and may help in identifying novel antifungal targets. This study shows the key role of the transcription factor Upc2 in azole resistance of
C. auris
and shows that this effect is mediated via different pathways, including the regulation of ergosterol biosynthesis and also the direct upregulation of the drug transporter Mdr1.
Moderate and high disease activity levels increase the risk of subclinical atherosclerosis progression in early rheumatoid arthritis: a 5-year prospective study
Authors: Meng Huan , Cheng Isaac T , Yan Bryan Ping Yen , Lee Alex P , So Ho , Tam Lai-Shan
Published: January 2024

Objectives

To elucidate the association between different disease activity levels over time on long-term vascular outcomes in patients with early rheumatoid arthritis (ERA).

Methods

This was a 5-year prospective study. Patients with consecutive ERA without overt cardiovascular disease (CVD) were recruited to receive 1 year of tight-control treatment followed by standard-of-care management. High-resolution carotid ultrasound was assessed at baseline and year 5. The primary outcome was subclinical atherosclerosis progression (AP+), defined as the occurrence of incident plaque, increased region harbouring plaques and/or maximum carotid intima-media thickness progression ≥0.9 mm at year 5. Inflammatory burden during the follow-up period was represented by the cumulative average Disease Activity Score 28-erythrocyte sedimentation rate (ca-DAS28-ESR). Persistent low disease activity (LDA) or remission state was defined as ca-DAS28-ESR≤3.2.

Results

One-hundred and four patients with ERA (age: 52±11 years, 81 (77.9%) female) were included in this analysis. Fifty-two (50%) patients achieved persistent LDA or remission and 42 patients (40.4%) had AP+. Patients in the AP+ group were older and had more traditional cardiovascular risk factors at baseline. Multivariate logistic regression analysis revealed that patients with persistent moderate or high disease activity (ca-DAS28-ESR>3.2) had a significantly increased risk of AP+ (OR 5.05, 95% CI 1.53, 16.64, p=0.008) compared with those who achieved persistent remission. The risk of AP+ was similar in patients who achieved persistent LDA and remission.

Conclusions

Achieving persistent LDA or remission may prevent progression of atherosclerosis in ERA. A treat-to-target approach aiming at sustained LDA or remission may reduce the risk of CVD by preventing AP+.
Prognostic factors for liver, blood and kidney adverse events from glucocorticoid sparing immune-suppressing drugs in immune-mediated inflammatory diseases: a prognostic systematic review
Authors: Leaviss Joanna , Carroll Christopher , Essat Munira , van der Windt Danielle , Grainge Matthew J , Card Tim , Riley Richard , Abhishek Abhishek
Published: January 2024

Background

Immune-suppressing drugs can cause liver, kidney or blood toxicity. Prognostic factors for these adverse-events are poorly understood.

Purpose

To ascertain prognostic factors associated with liver, blood or kidney adverse-events in people receiving immune-suppressing drugs.

Data sources

MEDLINE, Web of Science, EMBASE and the Cochrane library (01 January 1995 to 05 January 2023), and supplementary sources.

Data extraction and synthesis

Data were extracted by one reviewer using a modified CHARMS-PF checklist and validated by another. Two independent reviewers assessed risk of bias using Quality in Prognostic factor Studies tool and assessed the quality of evidence using a Grading of Recommendations Assessment, Development and Evaluation-informed framework.

Results

Fifty-six studies from 58 papers were included. High-quality evidence of the following associations was identified: elevated liver enzymes (6 studies) and folate non-supplementation (3 studies) are prognostic factors for hepatotoxicity in those treated with methotrexate; that mercaptopurine (vs azathioprine) (3 studies) was a prognostic factor for hepatotoxicity in those treated with thiopurines; that mercaptopurine (vs azathioprine) (3 studies) and poor-metaboliser status (4 studies) were prognostic factors for cytopenia in those treated with thiopurines; and that baseline elevated liver enzymes (3 studies) are a prognostic factor for hepatotoxicity in those treated with anti-tumour necrosis factors. Moderate and low quality evidence for several other demographic, lifestyle, comorbidities, baseline bloods/serologic or treatment-related prognostic factors were also identified.

Limitations

Studies published before 1995, those with less than 200 participants and not published in English were excluded. Heterogeneity between studies included different cut-offs for prognostic factors, use of different outcome definitions and different adjustment factors.

Conclusions

Prognostic factors for target-organ damage were identified which may be further investigated for their potential role in targeted (risk-stratified) monitoring.

PROSPERO registration number

CRD42020208049.
Multispherical shapes of vesicles with intramembrane domains
Authors: Lipowsky Reinhard
Published: January 2024

Phase separation of biomembranes into two fluid phases, a and b, leads to the formation of vesicles with intramembrane a- and b-domains. These vesicles can attain multispherical shapes consisting of several spheres connected by closed membrane necks. Here, we study the morphological complexity of these multispheres using the theory of curvature elasticity. Vesicles with two domains form two-sphere shapes, consisting of one a- and one b-sphere, connected by a closed ab-neck. The necks’ effective mean curvature is used to distinguish positive from negative necks. Two-sphere shapes of two-domain vesicles can attain four different morphologies that are governed by two different stability conditions. The closed ab-necks are compressed by constriction forces which induce neck fission and vesicle division for large line tensions and/or large spontaneous curvatures. Multispherical shapes with one ab-neck and additional aa- and bb-necks involve several stability conditions, which act to reduce the stability regimes of the multispheres. Furthermore, vesicles with more than two domains form multispheres with more than one ab-neck. The multispherical shapes described here represent generalized constant-mean-curvature surfaces with up to four constant mean curvatures. These shapes are accessible to experimental studies using available methods for giant vesicles prepared from ternary lipid mixtures.

Graphic abstract
PRODUCT MIX STRATEGY AT GOLDEN GRAINS
Authors: Chandrasekaran N , Venkatesh V. G. , Deakins Eric
Published: January 2024

Golden Grains was a Chennai-based industrial bakery producing large volumes of bread, cakes, and confectionary items for sale to contract manufacturers and retail outlets. An emphasis on being a localized city brand and contract manufacturer made its business model unique among the brand- and market-focused competition. A city-market bakery’s challenge was to ensure freshness, availability, and financial viability in a low-margin and operationally intensive industry. The operations management challenges included production planning, deciding the optimal product mix, and establishing an operational plan to ensure profitability and effective cost management of resources. Investor anxiety due to poor financial performance required top management to turn the business around, but identifying a product mix and implementation plan that satisfied operational needs while dramatically improving operating margins would not be easy.
Zebrafish as a model for podocyte research
Authors: Schindler Maximilian , Endlich Nicole
Published: January 2024

Podocytes, specialized postmitotic cells, are central players in various kidney-related diseases. Zebrafish have become a valuable model system for studying podocyte biology because they are genetically easy to manipulate, transparent, and their glomerular structure is similar to that of mammals. This review provides an overview of the knowledge of podocyte biology in zebrafish larvae, with particular focus on their essential contribution to understanding the mechanisms that underlie kidney diseases as well as supporting drug development. In addition, special attention is given to advances in live-imaging techniques allowing the observation of dynamic processes, including podocyte motility, podocyte process behavior, and glomerulus maturation. The review further addresses the functional aspects of podocytes in zebrafish larvae. This includes topics such as glomerular filtration, ultrastructural analyses, and evaluation of podocyte response to nephrotoxic insults. Studies presented in this context have provided important insights into the maintenance and resistance of the glomerular filtration barrier in zebrafish larvae and explored the potential transferability of these findings to mammals such as mice, rats, and most importantly, humans. The recent ability to identify potential therapeutic targets represents a promising new way to identify drugs that could effectively treat podocyte-associated glomerulopathies in humans. In summary, this review gives an overview about the importance of zebrafish as a model for podocyte-related disease and targeted drug development. It also highlights the key role of advanced imaging techniques in transparent zebrafish larvae, improving our understanding of glomerular diseases and the significant potential for translation of these findings to humans.
Performance and Physician Experience of INGEVITY+ Active Fixation Leads: Prospective INGEVITY+ Lead Clinical Study in Korea
Authors: Joung Boyoung , Bae Myung Hwan , Oh Il-Young , Park Hyung-Seob , Shim Jaemin , Cho Min Soo , Lee Jung Myung , Choi Eue-Keun , Lee Young Soo
Published: January 2024

Background. Boston Scientific INGEVITY+ pacing lead (Boston Scientific, Marlborough, MA, USA) has been upgraded to INGEVITY. The performance of the INGEVITY+ pacing lead has not yet been reported. This study aimed to evaluate the short- and long-term safety, effectiveness, and handling experience of INGEVITY+ leads. Methods. Consecutive patients were included from 9 institutions in Korea, where 400 leads (200 right ventricular active fixation leads and 200 right atrial active fixation leads) were implanted or attempted in 200 subjects. Results. During the implantation, only one patient required a lead change because of lead screw failure. The handling questionnaires of the lead received very positive feedback with 88% of operators agreeing that it is easy for leads to pass through small vessels or vessels with multiple leads. At the 3-month follow-up, 95.7% of RA leads and 99.5% of RV leads had pacing thresholds less than 1.5 V. A total of 92.4% of atrial leads had amplitudes greater than 1.5 mV, and 96.5% of ventricular leads had sensing amplitudes greater than 5 mV at 3 months. A total of 99.8% had impedances between 300 and 1,300 ohms. The lead-related complication-free rate for all leads during follow-up was 100%, and the overall rates of lead dislodgment, perforation, and pericardial effusion were all 0.0%. Conclusions. The INGEVITY+ pacing lead exhibited exceptional clinical performance, with a high complication-free rate throughout the 3-month follow-up period. In addition, the lead displayed excellent electrical characteristics, and the lead-handling experience was reported to be very good.
Association of Monocyte‐to‐HDL Cholesterol Ratio with Endothelial Dysfunction in Patients with Type 2 Diabetes
Authors: Zhang Huihui , Lu Jun , Gao Jie , Sha Wenjun , Cai Xinhua , Rouzi Mai Re Yan Mu , Xu Yuanying , Tang Wenjun , Lei Tao
Published: January 2024

Aims. To explore the relationship between monocyte‐to‐HDL cholesterol ratio (MHR) and endothelial function in patients with type 2 diabetes (T2DM). Methods. 243 patients diagnosed with T2DM were enrolled in this cross‐sectional study. Patients were divided into two groups by flow‐mediated dilation (FMD) quintile as nonendothelial dysfunction (FMD ≥ 6.4%) and endothelial dysfunction (FMD < 6.4%). The relationship between MHR and FMD was analyzed using Spearman’s correlation, partial correlation, and multiple logistic regression analysis. ROC curve was fitted to evaluate the ability of MHR to predict endothelial dysfunction. Results. Endothelial dysfunction was present in 193 (79%) patients. Patients with endothelial dysfunction had higher MHR (p < 0.05) than those without endothelial dysfunction. Furthermore, MHR had a significantly positive correlation with endothelial dysfunction (r = 0.17, p < 0.05), and the positive association persisted even after controlling for confounding factors (r = 0.14, p < 0.05). Logistic regression showed that MHR was an independent contributor for endothelial dysfunction (OR: 1.35 (1.08, 1.70), p < 0.05) and the risk of endothelial dysfunction increases by 61% with each standard deviation increase in MHR (OR: 1.61 (1.12, 2.30), p < 0.05) (model 1). After adjusting for sex, age, BMI, disease course, hypertension, smoking, and drinking (model 2) as well as HbA1c, HOMA‐IR, C‐reactive protein, and TG (model 3), similar results were obtained. In ROC analysis, the area of under the ROC curve (AUC) for MHR was 0.60 (95% CI 0.52‐0.69, p < 0.05). Conclusion. MHR was independently associated with endothelial dysfunction in T2DM patients. It could be a new biomarker for vascular endothelial function assessment.
Comparison of Outcomes between Open and Arthroscopic Rotator Cuff Repair
Authors: Menekse Serdar
Published: January 2024

Objective. The objective of this retrospective cohort study is to evaluate the long-term clinical and functional outcomes of two surgical techniques for rotator cuff repair, namely, open and arthroscopic methods. Methods. A total of 100 patients diagnosed with rotator cuff tears and treated at Seyhan State Hospital in the past five years were enrolled, considering the same inclusion criteria for both groups. The study groups consisted of 50 patients who underwent open rotator cuff repair and 50 patients who underwent arthroscopic rotator cuff repair. We used the SPSS programme to analyse the data, focusing on parameters such as postoperative recovery time, functional capacity scores, pain levels measured by the VAS scale, quality of life evaluated by the SF-36 scores, and complication rates. Results. Both methods resulted in similar recovery times and functional capacity scores, but patients treated with the open method reported slightly lower pain levels (average VAS score: 2.8) compared to those treated with the arthroscopic method (average VAS score: 3.1). The study also found slightly better quality of life scores in the arthroscopic group (average SF-36 score: 71.4) compared to the open surgery group (average SF-36 score: 68.7). The complications rates were lower in the arthroscopic group (2%) than in the open surgery group (4%), but these differences were not statistically significant. Conclusions. The study suggests that, while there are no significant differences in terms of clinical outcomes between the two surgical methods, short-term pain levels may be influenced by the more frequent application of acromioplasty in arthroscopic methods. Therefore, the choice of the surgical method should be made based on the unique characteristics, including the location and size, the patient’s overall health status, and the surgeon’s experience. These findings should be used as a guide and not as absolute results.
Quality Assurance in Extracorporeal Membrane Oxygenation Patients
Authors: Mrkonjic Ruzica
Published: January 2024

The selection of patients for extracorporeal membrane oxygenation (ECMO) support is a critical component of any perfusion program. Teams must evaluate when to start the support, how long to support the patient, and when is the ideal time to wean. The timing of ECMO support is debated. While some programs emphasize prompt timing, others suggest the conservative approach is better (>7 hours). Delaying ECMO support could increase complications; thus, more evidence has been attained for prompt support. Importantly, complications are common with ECMO support. Despite advances in ECMO support over the last ten years, bleeding remains a high risk. Current guidelines have evolved based on the findings. One of the newest technologies is Cytosorb (CytoSorbents Inc.); however, the optimization of its use and its true efficacy is unknown. Our institution has recently used the Seraph 1000 Microbind Affinity blood filter, which allows up to a 90% reduction of bloodstream pathogens during a single treatment, and we have found it to be a highly effective approach and a possible advancement in treating septic patients.
Thrompella: Acute Impella Thrombosis during Ecpella Support
Authors: Araj Faris , Hall Hurst , Hackman Amy
Published: January 2024

We present a case of acute Impella thrombosis during Ecpella support in a 48-year-old man listed for a heart transplant. After two weeks of Ecpella support, echocardiography revealed a 2.6 x 1.1 cm mobile thrombus attached to the Impella inlet (Video). The Impella and attached thrombus were pulled across the aortic valve into the descending aorta and removed without systemic thromboembolism. Due to the ongoing need for left ventricular venting, a new Impella CP was placed.
ANCA-associated vasculitis with active kidney involvement in the United States: 2016–2020
Authors: Tao Jianling , Liu Sai , Montez-Rath Maria , Charu Vivek , Chertow Glenn M.
Published: January 2024

Introduction. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and its subtypes, granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic GPA (EGPA), frequently present with acute kidney injury and can often lead to kidney failure, even with successful induction therapy. Few contemporary, nationally representative studies have described hospital complications of AAV.
Methods. Using data from the 2016–2020 National Inpatient Sample, a nationally representative database, we identified hospitalizations from adults with a new diagnosis of AAV (subtype or unspecified) and an inpatient kidney biopsy during the index hospitalization. We described baseline characteristics, associated inpatient procedures and complications, and compared lengths of stay and costs by geographic region, hospital characteristics, and AAV subtype.
Results. We identified an average of 1329 cases of hospitalized AAV with a concurrent kidney biopsy per year over the 5-year period. More than 50% were not designated as having a specific subtype, likely owing to delays in documentation of histopathology. Kidney involvement was severe as the majority of patients developed acute kidney injury and the proportion of patients who required inpatient dialysis was approximately 24%. Approximately 20% of patients developed hypoxia. Inpatient plasmapheresis was delivered to 20.4% and 20.6% of patients with GPA and MPA, respectively. There were no clinically meaningful or statistically significant differences in adjusted length of stay or inpatient costs among AAV subtypes. Admission in the Midwest region was associated with shorter hospital stays and lower costs than that in the Northeast, South, or West regions of the US (adjusted p=0.007 and <0.001, respectively).
Conclusion. AAV with acute kidney involvement remains a challenging, high-risk condition. Maintaining a high index of suspicion and a low threshold for kidney biopsy should help to ameliorate short- and longer-term complications (281 words)
Expanding Ventricular Diverticulum Overlying the Cerebral Hemisphere through an Open-Lip Schizencephalic Cleft: A Report of Two Pediatric Cases
Authors: Murakami Nobuya , Kurogi Ai , Shono Tadahisa , Torio Michiko , Shimogawa Takafumi , Mukae Nobutaka , Morioka Takato , Yoshimoto Koji
Published: January 2024

Introduction: Open-lip-type schizencephaly is characterized by trans-cerebral clefts filled with cerebrospinal fluid (CSF) between the subarachnoid space at the hemisphere surface and the lateral ventricles. Disorders related to CSF retention, including hydrocephalus and arachnoid cysts, have reportedly been associated with open-lip schizencephaly and have induced intracranial hypertension in some cases. However, detailed neuroimaging and surgical treatment findings have rarely been described. Case Presentation: We report 2 cases of open-lip schizencephaly with an expanding CSF-filled cavity overlying the ipsilateral cerebral hemisphere that manifested as signs of intracranial hypertension. Detailed three-dimensional heavily T2-weighted imaging revealed thin borders between the CSF-filled cavity and the subarachnoid space, but no separating structures between the cavity and the lateral ventricle, suggesting that the cavity was directly connected to the lateral ventricle through the schizencephalic cleft but not to the subarachnoid space. Neuroendoscopic observation in case 1 confirmed this finding. Endoscopic fenestration of the cavity to the prepontine cistern was ineffective in case 1. Shunting between the lateral ventricle (case 1) or CSF-filled cavity (case 2) and the peritoneal cavity slightly decreased the size of the CSF-filled cavity. Discussion: We speculate that the thin borders along the margin of the CSF-filled cavity are membranes that previously covered the schizencephalic cleft and are now pushed peripherally. In addition, we believe that the cavity is a ventricular diverticulum protruding through the cleft and that shunting operation is effective against such expanding cavity. Detailed magnetic resonance imaging can be useful for evaluating patients with schizencephaly associated with CSF retention disorders.
Consumption Pattern of Tea Is Associated with Serum Ferritin Levels of Women of Childbearing Age in Nandi County, Kenya: A Cross-Sectional Study
Authors: Nyakundi Patrick Nyamemba , Kiio Juliana , Munyaka Ann Wambui , Galgalo Dahabo Adi , Lohner Szimonetta
Published: January 2024

Introduction: Tea consumption with meals affects iron absorption, increasing the risk of iron deficiency. Our study investigated the association between tea consumption patterns and serum ferritin levels among women of childbearing age (WCA) in Nandi County, Kenya. Methods: We conducted a cross-sectional analytical study among 160 WCA selected using a systematic random sampling technique from Kapsabet Ward. Information on tea consumption practices was gathered using a researcher-administered questionnaire, and serum ferritin and C-reactive protein were measured. We assessed associations between tea consumption and iron status of respondents by multivariable regression analysis, adjusting for potential confounders, including parasitic infections and recent severe blood losses. Results: The prevalence of anaemia and iron deficiency among the study participants were 86.2% and 45%, respectively. Majority (90.6%) of the respondents consumed tea or coffee, with an infusion time of more than 5 min (60.0%) and a moderate tea strength (64.1%), within 1 h before or after meals. Iron deficiency was associated the number of teacups consumed (adjusted odds ratio = 7.282, 95% CI = 3.580–14.812). Conclusion: High tea consumption is positively associated with iron deficiency among WCA. Lower tea infusion strength, shorter tea infusion duration, and a lower number of teacups overall consumed, as well as consuming tea 1 h before or after meals instead of with meals, may be recommended for better outcomes in iron status among WCA.
A Novel Dry Simulator Model for Learning Comprehensive Endoscopic Retrograde Cholangiopancreatography/Endoscopic Sphincterotomy Procedures while Minimizing Adverse Bleeding Events (with Video)
Authors: Hatayama Yutaka , Kanno Takeshi , Takikawa Tetsuya , Matsumoto Ryotaro , Arata Yutaro , Suzuki Suguo , Ogata Yohei , Saito Masahiro , Jin Xiaoyi , Miura Shin , Hatta Waku , Hamada Shin , Uno Kaname , Kume Kiyoshi , Kikuta Kazuhiro , Asano Naoki , Imatani Akira , Koike Tomoyuki , Masamune Atsushi
Published: January 2024

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) are essential skills for performing endoscopic cholangiopancreatic procedures. However, these procedures have a high incidence of adverse events, and current training predominantly relies on patient-based approaches. Herein, we aimed to develop an ERCP/EST simulator model to address the need for safer training alternatives, especially for learners with limited ERCP experience. Methods: The model was designed to facilitate the use of actual endoscopic devices, supporting learning objectives that align with the components of the validated Bethesda ERCP Skill Assessment Tool (BESAT). BESAT focuses on skills, such as papillary alignment, maintenance of duodenoscope position, gentle and efficient cannulation, controlled sphincterotomy in the correct trajectory, and guidewire manipulation. Thirty gastroenterology trainees used the simulator between May 2022 and March 2023, and their satisfaction was assessed using a visual analog scale (VAS) and pre- and post-training questionnaires. Results: The novel simulator model comprised a disposable duodenal papillary section, suitable for incision with an electrosurgical knife, alongside washable upper gastrointestinal tract and bile duct sections for repeated use. The duodenal papillary section enabled reproduction of a realistic endoscope position and the adverse bleeding events due to improper incisions. The bile duct section allowed for the reproduction of fluoroscopic-like images, enabling learners to practice guidewire guidance and insertion of other devices. Following training, the median VAS score reflecting the expectation for model learning significantly increased from 69.5 (interquartile range [IQR]: 55.5–76.5) to 85.5 (IQR: 78.0–92.0) (p < 0.01). All participants expressed a desire for repeated simulator training sessions. Conclusions: This innovative simulator could serve as a practical educational tool, particularly beneficial for novices in ERCP. It could facilitate hands-on practice with actual devices, enhancing procedural fluency and understanding of precise incisions to minimize the risk of bleeding complications during EST.
Impact of Polycystic Ovary Syndrome on Periodontal Status of Women of Adolescent and Adult Age Groups: A Cross-Sectional Study
Authors: Jaglan Swati , Tewari Shikha , Singhal Savita Rani , Sharma Rajinder Kumar
Published: January 2024

Objective: Polycystic ovary syndrome (PCOS) is identified as the most common endocrine disorder in reproductive-aged women, and symptoms of PCOS appear during the early pubertal age. There is a gap in knowledge in recognizing the status of gingival inflammation/periodontal destruction and high-sensitivity C-reactive protein levels (hsCRP) in adolescents versus adults with PCOS. This study aimed to observe the impact of PCOS on periodontal status and systemic inflammation in adolescents and compared them with adults with PCOS. Methods: A total of 100 newly diagnosed female subjects with PCOS were enrolled into two groups: adolescents (11–19 years, n = 50) and adult females (20–40 years, n = 50). Periodontal parameters, anthropometric parameters, PCOS phenotype, hirsutism score, and serum hsCRP levels were recorded. Results: High levels of mean hsCRP, gingival index, and bleeding on probing % were observed in adolescent and adult PCOS groups, though nonsignificant between the groups (p > 0.05). Significantly more sites with probing pocket depth 3–4 mm, higher mean clinical attachment level (CAL) and sites with CAL 1–2 mm, and high frequency of patients (n = 11) with periodontitis (stage 1) were observed in adults with PCOS compared to adolescents (p ≤ 0.05). Similar and predominant prevalence of PCOS phenotype A (66%) and moderate hirsutism (46% adolescents vs. 58% adults) were observed in both groups. Conclusion: Similar levels of hsCRP and periodontal inflammation were found in adolescents and adults with PCOS. More periodontal tissue destruction was observed in adults with PCOS as compared to adolescents with PCOS.
Reviewers For Vol 14 No. 2
Authors: - Editor
Published: January 2024

Prof. Dr. Haryono Semangun, Faculty of Agriculture, Gadjah Mada University (UGM),Yogyakarta 55281, Indonesia Dr. N.C. Rachaputi, Farming Systems Institute Queensland, Department of Primary Industries and Fisheries, Kingaroy, QLD 4610, Australia Dr. Noviar Handayani, Postgraduate Program for Biology, University of Indonesia (UI), Depok, Jakarta, Indonesia Dr. (Eng.) Sukma Nuswantara, MPHIL. Sandia Biotech Diagnostic Centre, Santosa Bandung International Hospital, Jl. Kebonjati 38, Bandung, Indonesia Dr. Tresnawati Purwadaria, Indonesian Research Institute for Animal Production, P.O. Box 221, Bogor 16002, Indonesia Dr. Soetijoso Soemitro, Biochemistry Laboratory, Department of Chemistry, Faculty of Science and Mathematics (FMIPA), Padjadjaran University, Bandung 40133, Indonesia Dr. Tri Panji, Laboratory of Microbes and Bioprocess, Biotechnology Research Institute for Estate Crops, Bogor, Indonesia Dr. Puspita Lisdiyanti, R & D Center for Biotechnology, Indonesian Institute of Sciences (LIPI), Cibinong 16911, Jakarta, Indonesia Dr. Sigit A.P. Dwiono, Mataram Marine Bio Industry Tech. Implementation Unit, Research Center for Oceanography, Indonesian Institute of Sciences (LIPI), Teluk Kodek, Malaka, Pemenang, Lombok Barat 83352, Indonesia Dr. Estu Nugroho, Research Institute for Freshwater Aquaculture, Jl. Sempur, Bogor 16154, Indonesia Dr. Sudarto, Indonesian Research Institute for Aquaculture (RIFA), Depok, Jakarta, IndonesiaÂ Â Â Â Â Â Â Â
Jogar e viver: correlações. Uma interpretação kantiana
Authors: Barros Wagner Barbosa de
Published: January 2024

Para Kant, os jogos desempenham um papel extremamente importante na vida humana, já que são responsáveis por colocarem o espírito em atividade e, ao fazê-lo, avivá-lo na direção da sociabilidade, da moderação e do refinamento. De acordo com suas Lições de pedagogia e de antropologia, os jogos não são uma mera distração, eles são uma ótima ferramenta para se aprender a viver. O objetivo deste artigo é o de, em um primeiro momento, recuperar alguns dados biográficos de Kant para aclarar, à luz dos jogos, a dinamicidade subjacente à austeridade do cumprimento da famosa rotina do filósofo alemão e, em seguida, explorar conceitualmente o destaque que Kant dá aos jogos no processo de moralização da criança e do adulto.
Maquiavel: a vida civil e a vida militar, das tropas próprias ao uso público da guerra
Authors: Benevenuto Flávia
Published: January 2024

Trata-se de investigar os tipos de tropas, tal como apresentados por Maquiavel, procurando compreender as características que destacam as tropas próprias. Feito isso, assumiremos o debate entre o que é público e o que é particular, tal como posto na Arte da Guerra, relacionando-o ao tema da guerra. Tal objetivo diz respeito à investigação anunciada por Maquiavel e que relaciona a vida civil à vida militar. Procurar-se-á mostrar a perspectiva do autor sobre o uso público da guerra tanto quanto as consequências desastrosas de seu uso particular. Pretende-se, em tal percurso, evidenciar a guerra como ponto central do pensamento maquiaveliano, diretamente relacionada aos fundamentos da política, assim como o interesse de Maquiavel em pensar os problemas de seu tempo e abordá-los por uma perspectiva filosófica. A pesquisa se restringe a investigar o tema a partir do Príncipe, dos Discursos sobre a Primeira Década de Tito Lívio e da Arte da Guerra.
A aposta no transindividual: resenha do livro Intersoggettività o Transindividualità, de Vittorio Morfino
Authors: Santiago Homero
Published: January 2024

Resenha de: Vittorio Morfino, Intersoggettività o transindividualità. Materiali per un’alternativa, Castel di San Pietro Romano, Manifestolibri, 2022.
Questões sobre a liberdade, a necessidade e o acaso, de Thomas Hobbes: resenha da tradução de Celi Hirata
Authors: Nakayama Patricia
Published: January 2024

Trata-se de uma resenha da tradução de Celi Hirata das Questões sobre a Liberdade, a Necessidade e o Acaso de Thomas Hobbes.
Comparing callisthenic and motor control exercises for forward head posture on craniovertebral angle and postural stability: a randomised clinical trial
Authors: Phadke R. , Gurudut P. , Welling A. , Kage V.
Published: January 2024

Forward head posture (FHP) is a prevalent adaptive postural malalignment caused due to poor working and leisure habits. Prolonged FHP eventually leads to muscle imbalance, postural instability, and can advance the progression of cervical disorders. Early intervention through screening may help to prevent this posture from being symptomatic. Therefore, correction of FHP through exercise regimen is necessary. Callisthenic exercises (CE) and motor control exercises (MCE) are known to improve muscle imbalance. Hence, it was hypothesised that CE and MCE would have positive effects on craniovertebral angle (CVA) and postural stability in asymptomatic FHP. This randomised clinical trial recruited 30 individuals aged between 18 and 40 years with asymptomatic FHP. The CE group received callisthenic exercises whereas MCE group received motor control exercises, thrice weekly for 4 weeks. The outcome measures were CVA, postural stability [risk of fall (ROF), stability index (SI), and anterio-posterior sway (AP sway)] and craniocervical flexion endurance (CCFE), which were assessed using photographic method, TETRAX, and pressure biofeedback unit (PBU), respectively. Paired t-test for within group analysis showed statistically significant improvement in all the outcomes for both the groups (). Between group analysis by independent t-test revealed that both groups had similar improvement in CVA () and CCFE () but CE showed better improvement for postural stability () than MCE. CE and MCE are effective in improving CVA, postural stability, and CCFE in individuals with asymptomatic FHP. However, CE has a superior effect on postural stability over MCE.

Clinical Trials Registry – India: CTRI/2021/08/046535
Weaknesses of Community Law and Legalization of Norms in the Central American Integration System
Authors: Santana-Paisano Diana , Santos-Carrillo Francisco , Caldentey del Pozo Pedro
Published: January 2024

This paper examines Central American community law, legal production, and the levels of legalization in the Central American Integration System (sica) from an interdisciplinary perspective. While exemplifying regional integration through community law and common rule production, sica´s progress in modest after thirty years, raising doubt about achieving its objectives. Findings reveal the influential role of intergovernmental design and anomalies in the norms production, leading to medium-low levels of legalization that hinder quality and effectiveness. This scenario erodes Community Law, rendering sica ineffective in advancing its constitutive agreements goals. This paper underscores the value of interdisciplinary analysis in understanding the intricate link between legal and political factors in international organization. It advocates prioritizing complementarity between law and politics, emphasizing the need for institutions with legal and political capacity to produce derived norms. This conceptual shift could drive reforms, enhancing legalization levels, and fostering a more effective regional institutionality to prevent delegitimization.
تحوّلات الرواية العربيّة
Authors: الموسوي محسن جاسم
Published: January 2024

المستخلص

‫تومئ مقالة إدوار الخرّاط بعنوان ”الحساسيّة الجديدة“ ولعدّة أسباب إلى انتقالة بعيدة عن الملحمة البورجوازيّة التي أتقنها نجيب محفوظ بصفته ”مؤسّسة“ تتبنّاها شريحة واسعة جدًّا من القرّاء وتدعو إليها. إنّ التاريخ الطويل نسبيًّا للرواية العربيّة، منذ تكييفات منتصف القرن التاسع عشر لترجمات المسرحيّات والروايات من الفرنسيّة والإنكليزيّة، قد أفضى إلى رومانسيّة الشجون التي بقيت واضحة لمدّة ليست قصيرة في السرديّات القصيرة والطويلة، قبيل اللقاء بالرواية الروسيّة. ثمّ توالدت الرواية الواقعيّة الاجتماعيّة والواقعيّة النقديّة التي ميّزت جيلًا من الروائيّين في مصر وسوريا والعراق ولبنان. أمّا المواجهة مع القوى المستعمرة لا سيّما في الجزائر والمغرب فقد جاءت إلى مركز الاهتمام بالرواية السيريّة المعنيّة بنشأة الكاتب وكذلك بالسرديّات الفرانكوفونيّة. ثمّ ظهر جيل جديد من الروائيّين الذين خلطوا خطاب ما بعد الاستعمار بما بعد الحداثة. كان أفول البطل والبطولة محتّمًا في الرواية، وبدلًا من الاستمراريّة المنطقيّة وتسلسلها السرديّ حلّت أساليب مختلفة منها ما وراء الرواية (رواية النصّ)، وتيّار الوعي، والذاكرة المرتدّة، والثرثرة، والحواريّة، والسخرية الهازلة، والمفارقة. وكان أن قدم التصوّف إلى صدارة ما، ولم تعد المدينة مركز السرد. وحلّت نظرة فاحصة عميقة وانتباهة للطبيعة والبوادي، ونبّهت الروايات إلى جشع القوى المحلّيّة والأجنبيّة والهجمة على معطيات الحياة في الريف والبادية. وتحت وطأة الحروب المندلعة في المنطقة وتجربة السجن، تحوّلت الشخصيّات عند الروائيّين والروائيّات إلى صحفيّين ومراسلين وكتّاب غفل ومتدرّبين. وجرى استرجاع مفارق ساخر للسرد التتابعيّ مرقّعًا بتجريبيّة ما بعد حداثيّة ليختزل المسيرة الطويلة للرواية العربيّة.‬
ثيمة الزواج في التراث العذريّ
Authors: الحارثي جوخة
Published: January 2024

المستخلص

‫تهدف هذه الدراسة إلى سبر ثيمة الزواج في التراث العذريّ، على المستويين السرديّ والشعريّ، وذلك بتحليل نصوص المدوّنة العذريّة، متمثّلةً في أهمّ شعرائها: المجنون (ت ‫68‬/688) وجميل بثينة (ت ‫82‬/701) وقيس لبنى (ت ‫68‬/688) وعروة بن حزام (ت ‫30‬/650). تتنازع موضوعة الزواج تحوّلات كبرى في المدوّنة العذريّة تميّزها عمّا سبقها من مدوّنات غزليّة؛ إذ نلاحظ في قصص العذريّين مقاومةً لفكرة الزواج على المستوى السرديّ، واصطناعًا للعوائق ومنعًا لتحقيقه. هذا على الرغم من تعبير شعر العذريّين الصريح عن الرغبة وتمنّي جمع الشمل، وعلى الرغم من مشاهد ”السعي للتزويج“ في قصصهم، ولكن حتّى إذا ما تحقّق الزواج فلن تعدم الروايات بُنًى حَدَثيّة جديدة تُفْصَم بها عُرى العلاقة الزوجيّة بين الحبيبين. وتحلّل هذه الدراسة كيف تنبني هذه القصص على التوتّر المستمرّ بين العلاقتين الزوجيّة والغراميّة، وعلى تصوّر خاصّ لمنظومة الزواج. ومن ثمّ يقدّم الشعر العذريّ مُتعاضِدًا مع السرد المصاحب له صورةً للزوج غير مألوفة في التراث العربيّ، ممّا يدخل في باب التحوّلات التي مرّ بها التراث الأدبيّ في ذلك العصر. فهل لهذا كلّه علاقة بإعلاء الشعر وضمان تدفّقه؟ تخلص هذه الدراسة إلى أنّ التلقّي المـُعجَب للشعر يرفع مكانةَ الشاعر في قصّة عشقه، ويُذكي لعبةَ الوصل والهجر حتّى يتّقد الشعرُ وتستمرّ الحكاية. وهذا يفسّر لنا لم لا يتضمّن التراث العذريّ أيَّ أثر لإنجاب الأطفال؛ إذ الذرّيّة الممكنة الوحيدة للعاشق العذريّ هي الشعر. إنّه نتاجٌ لغويّ وليس بيولوجيًّا.‬
تحوّلات السرد العربيّ من الأندلس إلى إسبانيا المسيحيّة: إشكالات الترجمة والتلقّي (المقامة أنموذجًا)
Authors: بوكيل أمينة
Published: January 2024

المستخلص

‫اتّسعت الأندلس لتكون فضاءً ضمّ الثقافات المختلفة وعرف حركيّة ثقافيّة فتحت أبواب التأثّر والتأثير، وغدت بوّابةً انتقلت عن طريقها العديد من المعارف والعلوم. كما انطلقت منها أجناسٌ أدبيّة عربيّة وتحوّلت في آداب أخرى، منها الأدب العبريّ والأدب القشتاليّ (الإسبانيّ)، رغم تباين الأنساق الثقافيّة. وكان ذلك عن طريق الترجمة أو تحوُّل المؤثّرات الأدبيّة – سواءٌ كانت موضوعاتيّة أم شكليّة – واندماجها في النصّ الجديد مع عناصر أخرى محلّيّة. نسعى في هذا المقال إلى تتبُّع مسار السرد العربيّ باتّخاذ المقامة أنموذجًا، فننظر في انتقال السرد العربيّ إلى كلٍّ من الأدب العبريّ والأدب الإسبانيّ في إسبانيا المسيحيّة، ونتساءل عن كيفيّة تلقّي الآخر للسرد العربيّ لا سيّما في سياق تاريخيّ عرف صراعًا بين الأندلس وإسبانيا المسيحيّة. كما نعالج التحوّلات والتحويرات التي طرأت على النصّ الجديد، فنحلّل ترجمة المقامات إلى اللغة العبريّة عن طريق دراسة آليّات هذه الترجمة وكيفيّة تعامل المترجمين اليهود مع نصّ الآخر، ثمّ نقف عند تحوُّل موضوع الكدية من المقامة العربيّة إلى السرد الإسبانيّ الوسيط عن طريق تحليل هذا التحوّل في نصّ لاثاريو دي تورمس (Lazarillo de Tormes) ومقارنته بالمقامة.‬
‫”سندباد من؟“: التعريب وتحوّلات ألف ليلة وليلة ونشوء أدب اﻷطفال العربيّ الحديث (مشروع كامل كيلاني 1927–1959)‬
Authors: أبو هريرة خالد
Published: January 2024

المستخلص

‫في قصصه للأطفال التي استلهمت حكايات ألف ليلة وليلة، عمد الأديب المصريّ كامل كيلاني (1897–1959) – رائد أدب الأطفال العربيّ الحديث – إلى تعريب النسخ الأوروبّيّة للأطفال من ألف ليلة بدلًا من استخدام الأصول العربيّة المكتوبة بلغته الأمّ. يبحث هذا المقال في خطوة كيلاني بوصفها دليلًا على العلاقة المعقّدة التي جمعت الأدب العربيّ الحديث بنظيره قبل الحديث. وعن طريق دراسة السياق التاريخيّ لمشروع كيلاني، والذي شهد تحوّلات رئيسة في طرائق فهم اللغة والتراث والفنّ القصصيّ، يفسّر المقال عودته إلى النسخ الأوروبّيّة من ألف ليلة برغبة من جانبه في استنساخ الأغراض البيداغوجيّة والأخلاقيّة لهذه النسخ. وتتلخّص بنشر العقلانيّة والتفكير النقديّ والفضول المعرفيّ داخل محيط الطفل العربيّ لتأسيس ثقافة عقلانيّة عربيّة في مواجهة دعوات التغريب الشامل التي ذاعت في مصر والعالم العربيّ في النصف الأوّل من القرن العشرين. ويتّخذ المقال من حكاية ”السندباد البحريّ“ التي نشرها كيلاني للمرّة الأولى في العام 1928 نموذجًا تطبيقيًّا لمشروعه الذي يُعَدّ أوّل محاكاة عربيّة منظّمة لأدب الأطفال الغربيّ.‬