bluuebunny/crossref_metadata_2025 huggingface dataset:
Turismos de interior y pandemia en España: del colapso a la resiliencia asimétrica. Un análisis de la ocupación hotelera
Authors: Monteserín Abella Obdulia , Méndez Gutiérrez del Valle Ricardo
Published: December 2023

Las restricciones de movilidad y la percepción de inseguridad por la COVID-19 generaron un colapso sin precedentes de la actividad turística. Tanto la vulnerabilidad como la capacidad de recuperación de los destinos españoles resultó muy desigual, lo que ha reactivado el debate sobre la sostenibilidad económica, social y ambiental de los diferentes modelos turísticos. El objetivo general del artículo es analizar el desigual impacto de la pandemia en la demanda turística entre enero de 2019 y diciembre de 2021 a diferentes escalas territoriales, aunque la escasez de datos a escala local redujo las posibilidades del análisis. Tras una reflexión teórica sobre las claves del desigual comportamiento de los destinos y el valor estratégico de los turismos de interior, el análisis sobre la evolución de la oferta y la demanda registrada en los alojamientos turísticos en 2020 y 2021 permite elaborar una tipología de destinos, que diferencia entre los vulnerables, resistentes, reactivos y resilientes. Aporta así un resultado original respecto a la bibliografía publicada y contribuye al debate postpandemia sobre los riesgos del simple regreso a la situación anterior.
Reinterpretando la moratoria turística de Canarias desde la perspectiva del decrecimiento
Authors: Simancas Cruz Moisés
Published: December 2023

Las moratorias constituyen estrategias e instrumentos utilizados por las políticas públicas para plantear el control y limitación, cuantitativa, cualitativa y temporal, del crecimiento de la oferta de alojamiento turístico. Habitualmente se justifican por la necesidad de corregir los fallos de mercado e incorporar criterios de racionalidad al desarrollo territorial del turismo desde planteamientos vinculados con la sostenibilidad. Así, contemplan algunas medidas dirigidas al establecimiento de límites y ritmos de contención turística, que, en algunos casos, se dirigen al decrecimiento. Sin embargo, en ocasiones, estas medidas resultan de procesos de captura del regulador. El objetivo principal de este trabajo es analizar las medidas de contención y limitación del crecimiento de la oferta de alojamiento turístico de las moratorias turísticas, con el fin de determinar si algunas de ellas se aproximaron al paradigma del postcrecimiento turístico, así como detectar algunos efectos no deseados de las mismas. Con el fin de aportar un contenido empírico —no especulativo—, así como dotar de una dimensión aplicada los enunciados generales, nos basamos en la evidencia paradigmática de la moratoria al alojamiento turístico implementada en Canarias (España).
Reprogramming Short-Chain Fatty Acid Metabolism Mitigates Tissue Damage for Streptococcus pyogenes Necrotizing Skin Infection
Authors: Caparon Michael , Xu Wei , Bradstreet Tara , Zou Zongsen , Hickerson Suzanne , Zhou Yuan , He Hongwu , Edelson Brian
Published: December 2023

Disease Tolerance (DT) is a host response to infection that limits collateral damage to host tissues while having a neutral effect on pathogen fitness. Previously, we found that the pathogenic lactic acid bacterium Streptococcus pyogenes manipulates DT using its aerobic mixed-acid fermentation (ARMAF) pathway via the enzyme pyruvate dehydrogenase (PDH) to alter expression of the immunosuppressive cytokine IL-10. However, the microbe-derived molecules that mediate communication with the host’s DT pathways remain elusive. Here, we show that ARMAF inhibits accumulation of IL-10-producing inflammatory cells including neutrophils and macrophages, leading to delayed bacterial clearance and wound healing. Expression of IL-10 is inhibited through streptococcal production of the short chain fermentation end-products acetate and formate, via manipulation of host acetyl-CoA metabolism, altering non-histone regulatory lysine acetylation. A bacterial-specific PDH inhibitor reduced tissue damage during murine infection, suggesting that reprogramming carbon flow provides a novel therapeutic strategy to mitigate tissue damage during infection.
Fibroblast Growth Factor (FGF) 23 and FGF Receptor 4 promote cardiac metabolic remodeling in chronic kidney disease
Authors: Grabner Alexander , Fuchs Michaela , Burke Emily , Latic Nejla , Murray Susan , Li Hanjun , Sparks Matthew , Abraham Dennis , Zhang Hengtao , Rosenberg Paul , Hänzelmann Sonja , Hausmann Fabian , Huber Tobias , Erben Reinhold , Fisher-Wellman Kelsey , Bursac Nenad , Wolf Myles
Published: December 2023

Chronic kidney disease (CKD) is a global health epidemic that significantly increases mortality due to cardiovascular disease. Left ventricular hypertrophy (LVH) is an important mechanism of cardiac injury in CKD. High serum levels of fibroblast growth factor (FGF) 23 in patients with CKD may contribute mechanistically to the pathogenesis of LVH by activating FGF receptor (FGFR) 4 signaling in cardiac myocytes. Mitochondrial dysfunction and cardiac metabolic remodeling are early features of cardiac injury that predate development of hypertrophy, but these mechanisms of disease have been insufficiently studied in models of CKD. Wild-type mice with CKD induced by adenine diet developed LVH that was preceded by morphological changes in mitochondrial structure and evidence of cardiac mitochondrial and metabolic dysfunction. In bioengineered cardio-bundles and neonatal rat ventricular myocytes grown in vitro, FGF23-mediated activation of FGFR4 caused mitochondrial dysfunction, characterized by increased mitochondrial respiration and increased glycolysis, that preceded the development of cellular hypertrophy. The cardiac metabolic changes and associated mitochondrial dysfunction in mice with CKD were prevented by global or cardiac-specific deletion of FGFR4. These findings indicate that metabolic remodeling and mitochondrial dysfunction are early cardiac complications of CKD that precede structural remodeling of the heart. Mechanistically, FGF23-mediated activation of FGFR4 causes mitochondrial dysfunction, suggesting that early pharmacologic inhibition of FGFR4 might serve as novel therapeutic intervention to prevent development of LVH and heart failure in patients with CKD.
miR-9-5p is downregulated in serum extracellular vesicles of patients treated with biperiden after traumatic brain injury
Authors: Villena-Rueda Beatriz Enguidanos , Kajitani Gustavo , Ota Vanessa Kiyomi , Honorato-Mauer Jessica , Santoro Marcos Leite , Bugiga Amanda Victória Gomes , Rosa Joice Santos , Asprino Paula Fontes , Torrecilhas Ana Claudia Trocoli , Intasqui Paula , Bertolla Ricardo Pimenta , Foresti Maira Lucia , Naffah-Mazzacoratti Maria Graça , Mello Luiz Eugênio Araújo Moraes , Belangero Sintia Iole
Published: December 2023

Traumatic brain injury (TBI) is a prevalent and debilitating condition, which often leads to the development of post-traumatic epilepsy (PTE), a condition that yet lacks preventive strategies. Biperiden, an anticholinergic drug, is a promising candidate that has shown efficacy in murine models of PTE. MicroRNAs (miRNAs), small regulatory RNAs, can help in understanding the biological basis of PTE, and act as TBI- and PTE-relevant biomarkers that can be detected peripherally, as they are present in extracellular vesicles (EVs) that cross the blood brain barrier. This study aimed to investigate miRNAs in serum EVs from patients with TBI, and their association with biperiden treatment and PTE. Blood samples of 37 TBI patients were collected 10 days after trauma and treatment initiation in a double-blind clinical trial. A total of 18 patients received biperiden, with 3 subjects developing PTE, and 19 received placebo, with 2 developing PTE. Serum EVs were characterized by size distribution and protein profiling, followed by high-throughput sequencing of the EV miRNome. Differential expression analysis revealed no significant differences in miRNA expression between TBI patients with and without PTE. Interestingly, miR-9-5p displayed decreased expression in biperiden-treated patients compared to the placebo group. This miRNA regulates genes enriched in stress response pathways, including axonogenesis and neuronal death, relevant to both PTE and TBI. These findings suggest serum miR-9-5p as a possible marker for biperiden treatment, which may play a role in TBI resolution.
Matrix stiffening promotes chondrocyte senescence and the osteoarthritis development through downregulating HDAC3
Authors: Huang Wenhua , Fu Bowen , Liu Huan , Shen Jianlin , Zeng Canjun , Zou Xuenong , Sun Nian
Published: December 2023

Cartilage aging is a quintessential feature of knee osteoarthritis, and extracellular matrix (ECM) stiffening is a typical feature of cartilage aging. However, the mechanism of ECM stiffening to influence chondrocytes and downstream molecules is still poorly understood. Here, we mimicked the physiological and pathological stiffness of human cartilage by using polydimethylsiloxane-based substrates. We show that the epigenetic regulation of Parkin by histone deacetylase 3 (HDAC3) represents a new mechanosensitive mechanism by which the stiff matrix affects the physiology of chondrocytes. We found that ECM stiffening could accelerate the senescence of cultured chondrocytes in vitro, and also found that stiff ECM downregulated HDAC3, drove Parkin acetylation to activate excessive mitophagy, and accelerated chondrocyte senescence and osteoarthritis in mice. In contrast, intra-articular injection of adeno-associated virus expressing HDAC3 restored the young phenotype of aged chondrocytes stimulated by ECM stiffening and alleviated osteoarthritis in mice. Our findings indicate that changes in the mechanical properties of ECM initiate pathogenic mechanotransduction signals, promote the acetylation of Parkin and hyperactivate mitophagy, and damage the health of chondrocytes. These findings may provide new insights into how the mechanical properties of ECM regulate chondrocytes.
Prolonged critical avalanche burial for nearly 23 hours with severe hypothermia and severe frostbite with good recovery: A case report
Authors: Gruber Elisabeth , Oberhammer Rosmarie , Brugger Hermann , Bresadola Elisa , Avogadri Matteo , Kompatscher Julia , Kaufmann Marc
Published: December 2023

Background
Accidental hypothermia with severe frostbite is a rare combination of injuries with a high risk for long-term sequelae. There are widely accepted recommendations for the management of avalanche victims and for frostbite treatment, but no recommendation exists for the treatment of frostbite in severe hypothermic patients, specifically for the management of hypothermic avalanche victims presenting with frostbite.
Case Presentation
We present a case of a previously healthy, 53-year-old male skier who was critically buried by an avalanche at 2300 m of altitude at an ambient temperature of -8°C for nearly 23 hours. The victim was found with the right hand out of the snow and an air connection to outside. He was spontaneously breathing, somnolent with Glasgow Coma Scale 11 (Eye 4, Verbal 2, Motor 5), in a severely hypothermic state with an initial core temperature of 23.1°C and signs of cold injuries in all four extremities. After rescue and active external forced air rewarming in the intensive care unit, the clinical signs of first-degree frostbite on both feet and the left hand vanished, while third- to fourth-degree frostbite injuries became apparent on all fingers of the right hand. After reaching a core body temperature of approximately 36°C, aggressive frostbite treatment was started with peripheral arterial catheter-directed thrombolysis with alteplase, intravenous iloprost, ibuprofen, dexamethasone and regional sympathicolysis with a right-sided continuous axillary block. After ten months, the patient had no tissue loss but needed neuropathic pain treatment with pregabalin.
Conclusion
The combination of severe accidental hypothermia and severe frostbite is rare and challenging, as drug metabolism is unpredictable in a hypothermic patient and no recommendations for combined treatment exist. There is general agreement to give hypothermia treatment the priority and to begin frostbite treatment after full rewarming of the patient. This strategy is not based on evidence and may be questioned. More evidence is needed to identify the optimal dosage and time point to initiate treatment of frostbite in severely hypothermic patients.
Adverse maternal outcomes and associated factors among mothers of advanced age delivering at a tertiary hospital, southwestern Uganda: a cross-sectional study
Authors: MASEMBE SEZALIO , MIGISHA RICHARD , TURYASINGURA GODWIN , HILLARY AHEISIBWE , NZABANDORA EMMANUEL , LULE PROFESSOR JOHN C
Published: December 2023

Background: Mothers of advanced age, defined as pregnant women aged ≥35years at the time of giving birth, are traditionally known to be associated with increased risks of adverse maternal outcomes. We determined the prevalence of adverse maternal outcomes and associated factors among mothers of advanced age who delivered at Kabale Regional Referral Hospital (KRRH), in Southwestern, Uganda.
Methods: We conducted a cross-sectional study at the Maternity Ward of KRRH from April to September 2023. We consecutively enrolled pregnant women aged ≥35years during their immediate post-delivery period and before discharge. We obtained data on their socio-demographic, obstetric, medical characteristics and their maternal outcomes using interviewer-administered structured questionnaires. We defined adverse maternal outcome as any complication sustained by the mother that was related to pregnancy, delivery and immediate post-partum events (obstructed labour, antepartum haemorrhage, mode of delivery [cesarean or vacuum extraction], postpartum haemorrhage, hypertensive disorders of pregnancy, preterm or postdate pregnancy, anemia, premature rupture of membranes, multiple pregnancy, and maternal death). We identified factors associated with adverse outcomes using modified Poisson regression.
Results: Out of 427 participants, most were aged 35-37 years (n=206; 49.4%), and multiparous (n=157; 65.5%). The prevalence of adverse maternal outcomes was 37.6% (n=157, 95%CI: 33.1-42.4%). Common adverse maternal outcomes included caesarian delivery (23%), and obstructed labour (14.4%). Other complications included anemia in pregnancy (4.5%), chorioamnionitis (4.1%), preterm prelabour rupture of membranes (3.9%), and chronic hypertension and preeclampsia (both 2.4%). Factors associated with adverse maternal outcomes were precipitate labour (adjusted prevalence ratio [aPR] =1.95, 95%CI: 1.44-2.65), prolonged labour, lasting >12 hours (aPR=2.86, 95%CI: 1.48-3.16), and chronic hypertension (aPR=2.01, 95%CI: 1.34-3.9).
Conclusion: The rate of adverse maternal outcomes was high, with approximately one-third of the advanced-aged mothers surveyed affected. Mothers with prolonged labour, precipitate labour and chronic hypertension were more likely to experience adverse outcomes compared to their counterparts. We recommend implementation of targeted interventions, emphasizing proper management of labor, close monitoring of hypertensive mothers, and a deliberate effort to avoid both prolonged and precipitate labor, to mitigate risks of adverse outcomes within this study population.
Statistical assessment of reliability of anthropometric measurements in the multi-site South African National Dietary Intake Survey 2022
Authors: Nel Sanja , De man Jeroen , Berg Louise Van den , Wenhold Friedeburg
Published: December 2023

Background
Anthropometric data quality in large multicentre nutrition surveys is seldom adequately assessed. In preparation for the South African National Dietary Intake Survey (NDIS-2022), this study assessed site leads and fieldworkers' intra- and inter-rater reliability for measuring weight, length/height, mid-upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC).
Methods
Standardised training materials and measurement protocols were developed, and new anthropometric equipment was procured. Following two training rounds (12 site lead teams, 46 fieldworker teams), measurement reliability was assessed for both groups, using repeated measurements of volunteers similar to the survey target population. Reliability was statistically assessed using the technical error of measurement (TEM), relative TEM (%TEM), intra-class correlation coefficient (ICC) and coefficient of reliability (R). Agreement was visualised with Bland-Altman analysis.
Results
By %TEM, the best reliability was achieved for weight (%TEM = 0.260–0.923) and length/height (%TEM = 0.434–0.855), and the poorest for MUAC by fieldworkers (%TEM = 2.592–3.199) and WC (%TEM = 2.353–2.945). Whole-sample ICC and R were excellent (> 0.90) for all parameters except site leads' CC inter-rater reliability (ICC = 0.896, R = 0.889) and fieldworkers' inter-rater reliability for MUAC in children under two (ICC = 0.851, R = 0.881). Bland-Altman analysis revealed no significant bias except in fieldworkers' intra-rater reliability of length/height measurement in adolescents/adults (+ 0.220 (0.042, 0.400) cm). Reliability was higher for site leads vs. fieldworkers, for intra-rater vs. inter-rater assessment, and for weight and length/height vs. circumference measurements.
Conclusion
NDIS-2022 site leads and fieldworkers displayed acceptable reliability in performing anthropometric measurements, highlighting the importance of intensive training and standardised measurement protocols. Ongoing reliability assessment during data collection is recommended.
Tackling Gender Disparities in Energy Research: A Diagnostic Tool for Equality in Research Centres
Authors: Sánchez-López Sara , Poveda-Bautista Rocío , Corona-Sobrino Carmen , Otero-Hermida Paula , Garcia-Melon Mónica
Published: December 2023

Background
The unequal proportion of men and women in research organizations in the energy field is severe, and so are the dynamics long established that might determine differences in access to leadership positions and inequalities between men and women in research careers. The gender gap in historically masculinized fields such as energy engineering transcends beyond the number of men and women.
This study aims to explore the gender gap in Energy Research Centres and to identify barriers that potentially hinder the research careers of women. We propose the development of a diagnostic tool based on indicators to monitor and evaluate gender roles and inequalities in the activity of research centres to identify and address the dynamics and obstacles that hinder women progress in the energy sector and their potential contribution to the field. This DEMATEL-ANP based tool prioritizes these indicators by their influence and importance in the context of energy research and is applied to the monitoring of a specific Spanish Energy Research Centre.
Results
The analysis of the main indicators shows that the insufficient representation of women within the organization remains a prominent issue. There is a prevailing belief within the research centre that only meritocracy drives success, dismissing other factors—especially gender—as irrelevant. Furthermore, there are a number of dynamics and conditions inherent to the Spanish Research and Innovation context that contribute to the drop out of women working in energy research. The lack of women in organisational leadership positions is pronounced in the case of the study and other particular dynamics are detected such as head positions being occupied only by men, or men not using work-life balance measures. However, the results suggest that, no gender gap is recognized by part of the staff and thus, no measures are being taken to improve the situation.
Conclusions
Comprehensive data and contextualized monitoring are necessary to effectively study and enhance the presence and participation of women in the energy science field. Our methodology, combining quantitative and qualitative techniques, is suitable for any research centre that would like to monitor its gender gap, identify potential sources of inequity and thus, address them. This methodology serves a dual purpose: it's both a diagnostic tool and a conversation starter driven by data that can be used to demonstrate the persistent existence of the gender gap that demands attention and resolution.
Caregiver-Reported Barriers to Care for Children and Adults with Williams Syndrome
Authors: Barnhardt Elizabeth W. , Martens Marilee , Walton Jennifer
Published: December 2023

Individuals with Williams syndrome (WS) may experience a variety of medical, behavioral, and educational concerns. The primary objective of this study was to assess barriers to health care for patients with WS, primarily using the Barriers to Care Questionnaire (BCQ), and to assess whether various demographic factors are correlated with these barriers. A REDCap survey was distributed using the Williams Syndrome Association Research Registry. 319 caregivers of individuals with WS in the United States completed the BCQ. On the BCQ, lower scores indicate more barriers to care. Younger age was associated with both the pragmatics and the skills subscales while lower income levels and increased distances to providers knowledgeable about WS were consistently associated with lower total BCQ scores.
Unveiling the Mediating Role of Psychological Well-being on the Relationship Between Social Connections and Cognition: A Study of Indian Old-Age Homes
Authors: Mishra Bijeta , Pradhan Jalandhar , Dhaka Suman
Published: December 2023

Background
Research evidences suggest that factors like social isolation and loneliness fasten the process of inevitable cognitive decline among the older adults. This study examines the association of loneliness and social isolation with cognitive abilities of elderly individuals. It investigates how psychological well-being affects the relationship between loneliness, social isolation, and cognition in older persons.
Method
Data was collected from various old-age homes of Odisha, India. The study employed purposive sampling for selecting study participants, resulting in inclusion of 320 older persons (aged 60 years and above). Data collection involved use of standardised tests such as the Lubben Social Network Scale-6 (LSNS-6), Revised UCLA Loneliness Scale, Mini-Mental State Examination (MMSE), and Ryff’s Psychological Well-Being Scale. Data was analysed using descriptive statistics, intercorrelation, regression, and mediation analysis.
Results
The prevalence of social isolation and loneliness is high among older adults with 78 percent being lonely and socially isolated. A significant regression equation was obtained (F = 19.28, p < .01), indicating that loneliness had a substantial effect on the cognitive performance of older persons, as seen by an R2 value of 0.154. Furthermore, significant indirect impact on cognitive performance of individuals due to both social isolation (z= -4.71**) and loneliness (z = 4.03**), mediated by psychological well-being was observed.
Conclusion
The study indicates that social isolation, loneliness, and psychological well-being are pivotal factors that influence cognition. The findings can be utilised to develop strategies for addressing loneliness and social isolation, prevent faster cognitive decline, and enhance psychological well-being of older adults; thereby ensuring a fulfilling senescence for the older adults.
Takotsubo syndrome induced by pheochromocytoma activation after resection of medullary thyroid carcinoma: a case report
Authors: Fang Fuquan , Kang Xianhui , Zhu Shengmei
Published: December 2023

Background
Medullary thyroid carcinoma (MTC) and pheochromocytoma are rare neuroendocrine tumors, which are diagnosed simultaneously in approximately 35% of patients. Heart failure and Takotsubo Syndrome (TTS) are rare and life-threatening cardiovascular complications of pheochromocytoma.
Case presentation:
A 42-year-old woman was admitted to the hospital for surgery because of a thyroid nodule detected on physical examination. After surgery, she presented with acute heart failure in the general ward. The clinical manifestations combined with electrocardiogram, echocardiography, coronary angiography, and myocardial enzyme examination were consistent with the diagnosis of TTS. Postoperative abdominal enhanced CT and catecholamine levels at the time of heart failure supported that acute heart failure and TTS are due to enhanced adrenal pheochromocytoma activity.
Conclusions
MTC may be complicated with pheochromocytoma. Preoperative examination should be completed. It is recommended to perform pheochromocytoma surgery before MTC resection. In addition, acute heart failure and TTS are rare and serious complications of pheochromocytoma. Further studies are needed on the treatment and pathogenesis of TTS.
Oral microbial signatures associated with age and frailty in Canadian adults
Authors: DeClercq Vanessa , Wright Robyn J. , Nearing Jacob T , Langille Morgan GI
Published: December 2023

This study aimed to assess the association between the oral microbiome, age, and frailty. Data and saliva samples were obtained from male and female participants aged 35-70 years (n=1,357). Saliva samples were analysed by 16S rRNA gene sequencing and differences in microbial diversity and community compositions were examined in relation to chronological age and the frailty index (FI).  Most alpha diversity measures (Richness, Shannon Diversity, Faith’s Phylogenetic Diversity) showed an inverse association with frailty, whereas a positive association was observed with age and Shannon Diversity and Evenness. A further sex-stratified analysis revealed differences in measures of microbial diversity and composition. Multiple genera were detected as significantly differentially abundant with increasing frailty and age by at least two methods. With age, the relative abundance of Veillonella was reduced in both males and females, whereas increases in Corynebacterium appeared specific to males and Aggregatibacter, Fusobacterium, Neisseria, Stomatobaculum, and Porphyromonas specific to females. Beta diversity was significantly associated with multiple mental health components of the FI. This study shows age and frailty are differentially associated with measures of microbial diversity and composition, suggesting the oral microbiome may be a useful indicator of increased risk of frailty or a potential target for improving health in ageing adults.
Foliar fungal endophyte communities remain unaltered under urban air-pollution but differentially express stress-related genes
Authors: Flores-Almaraz Valeria Stephany , Truong Camille , Hernández-Oaxaca Diana , Reyes-Galindo Verónica , Mastretta-Yanes Alicia , Jaramillo-Correa Juan Pablo , Salas-Lizana Rodolfo
Published: December 2023

Air pollution caused by tropospheric ozone contributes to the decline of forest ecosystems; for instance, coniferous forests dominated by sacred fir, Abies religiosa (Kunth) Schltdl. & Cham., in the peri-urban forests of Mexico City. Individual trees within these forests exhibit variation in their response to ozone exposure, such as the presence or absence of visible symptoms in needles. Using RNA-Seq metatranscriptomic data and ITS2 metabarcoding, we investigated whether such symptom variation correlates with the taxonomic and functional composition of fungal endophytes from needles collected in a highly polluted area in the surroundings of Mexico City. Our findings indicate that ozone-related symptoms do not significantly correlate with changes in the taxonomic composition of fungal endophytes. However, 21 putative proteins were differentially expressed in fungal endophytes from asymptomatic needles, including eight genes previously associated with resistance to oxidative stress. These results suggest that fungal endophyte communities likely play a role in mitigating the oxidative burst caused by tropospheric ozone to sacred fir. Our study illustrates the feasibility of using RNA-Seq data, accessible from global sequence repositories of plants, for the characterization of fungal endophyte communities and gene expression.
Comparing the Efficacy of Endovascular Simulation Training in different Training Formats: a randomized controlled trial
Authors: Wippel David , Westreicher Werner , Gummerer Maria , Kluckner Michaela , Ouaret Miar , Lamprecht Fabian , Grams Astrid , Gratl Alexandra , Wipper Sabine
Published: December 2023

Background
High-fidelity endovascular simulators have demonstrated significant potential in enhancing interventionalists’ performance metrics, including procedure time, fluoroscopy time, and contrast volume usage. However, it is less clear whether trainee performance, when assessed using both multidimensional global and procedure-specific rating scales, improves in a manner consistent with these metric parameters. This study aimed to determine whether the structure of the training – conducted in block sessions or weekly intervals – impacts the effectiveness of the training.
Methods
20 students were enrolled in this prospective, randomized, controlled, single-center trial. They were randomly divided into block and weekly training groups, each undergoing 6 hours of supervised endovascular training on a Mentice simulator over a span of 3 weeks. At the outset and conclusion of their training, students performed a predefined peripheral endovascular intervention, which was assessed by an experienced interventionalist. Furthermore, participants were prompted to complete a survey at both the beginning and the end of the study.
Results
Both groups exhibited significant improvements in procedure time, fluoroscopy time, contrast volume usage, global rating scale scores, and performance-specific rating scale scores. However, no significant difference was observed between the two groups. The simulator training notably boosted the trainee’s self-confidence.
Conclusion
Simulator training not only enhances metric performance parameters, but also improves performance as assessed by both global rating scale and procedure-specific rating scale. Whether the training is conducted in block sessions or weekly intervals did not affect its efficacy. As such, the training format can be tailored to best fit the specific circumstances and setting.
Circumtropical distribution and cryptic species of the meiofaunal enteropneust Meioglossus (Harrimaniidae, Hemichordata).
Authors: Defourneaux Éloïse , Herranz Maria , Armenteros Maickel , Sørensen Martin V , Norenburg Jon , Park Taeseo , Worsaae Katrine
Published: December 2023

Hemichordata has always played a central role in evolutionary studies of Chordata due to their close phylogenetic affinity and shared morphological characteristics. Neither chordates nor hemichordates had meiofaunal representatives until the surprising discovery of a microscopic, paedomorphic enteropneust Meioglossus psammophilus (Harrimaniidae, Hemichordata) from the Caribbean in 2012. No additional species have been described since, questioning the broader distribution and significance of this genus. However, being less than a mm long and superficially resembling an early juvenile acorn worm, Meioglossusmay easily be overlooked in both macrofauna and meiofauna surveys.
We here present the discovery of 11 additional populations of Meioglossus from shallow subtropical and tropical coralline sands of the Caribbean Sea, Red Sea, Indian Ocean, and South China Sea. The geographically widely separated populations show identical morphology but differ genetically. Our phylogenetic reconstructions include four gene markers and support the monophyly of Meioglossus. Species delineation analyses revealed eight new cryptic species, which we herein describe using DNA-taxonomy. This study reveals a broad circumtropical distribution, supporting the validity and ecological importance of this enigmatic meiobenthic genus. The high cryptic diversity and apparent morphological stasis of Meioglossus may exemplify a potentially common evolutionary ‘dead-end’ scenario, of groups with highly miniaturized and simplified body plan losing their ability to diversify morphologically.
A comprehensive in silico analysis of the functional and structural consequences of the deleterious missense nonsynonymous SNPs in human GABRA6 gene
Authors: Mohammadpour Tahere , Mohammadzadeh Reza
Published: December 2023

Epilepsy, a prevalent neurological disorder, affects more than 50 million individuals worldwide and is characterized by recurring seizures. Nonsynonymous single nucleotide polymorphisms (nsSNPs) found within coding regions of epilepsy-related genes are believed to have significant impacts on protein function. This is due to their tendency to cause mutations in the encoded amino acids, which can subsequently lead to pathogenic alterations in protein structure and function. Consequently, nsSNPs have the potential to serve as diagnostic markers for epilepsy and other neuropsychiatric conditions. The primary objective of this study is to evaluate the deleterious effects of missense nsSNP mutations on the GABRA6 gene. The GABRA6 gene encodes the alpha-6 subunit of the \({\text{G}\text{A}\text{B}\text{A}}_{\text{A}}\) receptor and is associated with genes implicated in epilepsy. To achieve this, we employed various computational tools, including SIFT, PolyPhen-2, PROVEAN, Condel, SNPs&GO, PMut, SNAP2, MutPred2, and SNPeffect4.0, for predicting missense nsSNPs. Additionally, we used I-Mutant3.0 and MUpro to analyze protein stability, ConSurf to assess evolutionary conservation, FTSite and COACH to predict ligand binding sites, SOPMA and PSIPRED to analyze protein secondary structures, project HOPE to predict structural changes, and I-TASSER to model the 3D structure. Furthermore, structural validation was conducted using the PROCHECK and ERRAT servers, while molecular dynamics simulations were performed using GROMACS to gain a better understanding of the effects of mutations on protein structure. Among the 451 missense nsSNPs identified within the GABRA6 gene, three were found to have pathogenic effects on the structure and function of the protein, potentially contributing to the development of epilepsy or other neuropsychiatric disorders. Notably, two of these nsSNPs (W87S and W112R) were located within the ligand-binding domain, while the third (C310R) was situated in the transmembrane domain. These identified missense nsSNPs hold promise as potential diagnostic markers and drug targets.
Comparative analysis of the adsorption properties of a carbon sorbent modified with sulfosalicylic acid from individual solutions and upon addition of amino acid
Authors: Sedanova A. V. , Delyagina M. S. , P'yanova L. G. , Kornienko N. V. , Vasilevich A. V. , Lavrenov A. V.
Published: December 2023

The adsorption properties of a carbon sorbent with respect to sulfosalicylic acid from individual solutions and upon addition of amino acid (arginine, phenylalanine) were studied. The addition of amino acids to an aqueous solution of sulfosalicylic acid was shown to increase the amount of adsorbed sulfosalicylic acid on the carbon sorbent. Carbon sorbents before and after the adsorption/desorption of biologically active substances were studied using various physicochemical methods (low-temperature nitrogen adsorption, spectrophotometric method, thermal analysis, et al); adsorption properties of the tested samples toward the substances modeling toxic compounds (methylene blue, metanil yellow) were estimated. The modified samples in the presence of amino acids showed high adsorption capacity toward methylene blue dye. The produced materials are recommended as enterosorbents for treatment of gastrointestinal disturbances.
Association between Pediatric Postoperative Delirium and Regional Cerebral Oxygen Saturation: A Prospective Observational Study
Authors: Liu Kexian , Lin Nan , Xiang Yujun , Li Jiahuan , Jin Jingyi , Lai Dengming , Xu Hongzhen
Published: December 2023

Background
Postoperative delirium (POD) represents a prevalent and noteworthy complication in the context of pediatric surgical interventions. In recent times, a hypothesis has emerged positing that cerebral ischemia and regional cerebral oxygen desaturation might serve as potential catalysts in the pathogenesis of POD. The primary aim of this study was to methodically examine the potential relationship between POD and regional cerebral oxygen saturation (rSO2) and to assess the predictive and evaluative utility of rSO2 in the context of POD.
Methods
This prospective observational study was conducted at the Children's Hospital, Zhejiang University School of Medicine, Zhejiang, China, spanning the period from November 2020 to March 2021. The research cohort comprised children undergoing surgical procedures within this clinical setting. To measure rSO2 dynamics, cerebral near-infrared spectroscopy (NIRS) was used to monitor rSO2 levels both before and after surgery. In addition, POD was assessed in the paediatric patients according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. The analysis of the association between the rSO2 index and the incidence of POD was carried out through the application of either the independent samples t-test or the nonparametric rank-sum test. To ascertain the threshold value of the adjusted rSO2 index for predictive and evaluative purposes regarding POD in the pediatric population, the Receiver Operating Characteristics (ROC) curve was employed.
Results
A total of 211 cases were included in this study, of which 61 (28.9%) developed POD. Participants suffering delirium had lower preoperative rSO2mean, lower preoperative rSO2min, and lower postoperative rSO2min, higher ∆rSO2mean, higher amount of ∆rSO2mean, lower ∆rSO2min (P < 0.05). Preoperative rSO2mean (AUC = 0.716, 95%CI 0.642–0.790), ∆rSO2mean (AUC = 0.694, 95%CI 0.614–0.774), amount of ∆rSO2mean (AUC = 0.649, 95%CI 0.564–0.734), preoperative rSO2min (AUC = 0.702, 96%CI 0.628–0.777), postoperative rSO2min (AUC = 0.717, 95%CI 0.647–0.787), and ∆rSO2min (AUC = 0.714, 95%CI 0.638–0.790) performed well in sensitivity and specificity, and the best threshold were 62.05%, 1.27%, 2.41%, 55.68%, 57.36%, 1.29%.
Conclusions
There is a close relationship between pediatric POD and rSO2. rSO2 could be used as an effective predictor of pediatric POD. It might be helpful to measure rSO2 with NIRS for early recognizing POD and making it possible for early intervention.
Incidence of posterolateral tibia plateau fractures and concomitant injuries in Chinese patients who underwent an anterior cruciate ligament reconstruction
Authors: Jiang Shijie , Zhu Ruixia , Jia Xiaojun , Zheng Dong , Wang Yuji , Xu Wei , Cheng Rongshan , Dimitriou Dimitris , Ren Weizhi
Published: December 2023

Objective
The purpose of the present study was to report the incidence and classify the morphological subtypes of posterolateral tibial plateau fractures accompanying anterior cruciate ligament (ACL) tears in an East China population, as well as to evaluate the implications of such injuries on the functional recovery following ACL reconstruction.
Methods
488 cases of patients treated for ACL rupture between January 2016 and June 2020 were retrospectively reviewed, and their posterolateral tibial plateau fractures were classified based on MRI assessment. Functional outcomes were evaluated at a two-year postoperative follow-up using a range of validated scoring systems.
Results
The study identified a high incidence of posterolateral tibial plateau fractures (41.6%) among ACL injury cases, with type ⅢA and ⅢB fractures occurring more frequently. Patients with high-grade fractures experienced significantly lower functional recovery than those with low-grade injuries. Major findings included noncontact mechanism predominance in ACL injuries, a higher occurrence rate of type ⅢA and ⅢB fractures among older females, and a substantial association with meniscal and medial collateral ligament tears.
Conclusions
The incidence and distinct morphological classification of posterolateral tibial plateau fractures are clinically significant in ACL injury cases. The higher grade posterotibial plateau fractures are associated with worse functional outcomes in patients undergoing an ACLR.
Feasibility, perceived aesthetic outcomes and patients’ interest in transoral endoscopic thyroidectomy (TOETVA) in a cohort of patients in the Thames Valley United Kingdom
Authors: Puttergill Brooke , Asher Cyra , Yarwood William , Down Billy , Everson James , Mihai Radu
Published: December 2023

Introduction: Thyroid surgery techniques without visible scar have grown internationally with little traction in the UK. The aim was to assess the perception of neck scar after thyroid surgery, estimate the feasibility for transoral endoscopic thyroidectomy (TOETVA) and define the public demand for scarless thyroidectomy.
Methods: A mixed cohort study approved by national ethics committee assessed retrospectively the feasibility of TOETVA based on current guidelines. A standardised questionnaire used Manchester Scar Scale (MSS) and explored patient-centred outcomes and views.
Results: Out of 265 patients (75% women, median age 56 years) who underwent thyroid lobectomy for indeterminate nodules (n=160) or proven low-risk thyroid cancer (n=105), 64% would have been suitable for TOETVA, including 49% of cancers.
Of 92 respondents, MSS was excellent (25%), good (56%; MSS<7) or poor (15%; MSS > 10). Negative scar perception preoperatively resulted in poor MSS scores post operatively (p<0.0001). Poor MSS impacted all individuals regardless of preoperative neck scar concerns (p<0.001). Worse MSS scores were significant in patients with complications or cancer recurrence concerns (p<0.002) independent of age (p=0.065) and gender (p=0.7118). Need for thyroid hormone replacement in 34% of patients didn’t correlate with to MSS.
Patients’ interest in scarless technique didn’t correlate with MSS and appeared to be attributable to personal values, geographic accessibility, and intensity of aversion to complication (p<0.05). Overall, 29% of patients would consider a scarless technique and 31% opposed the idea.
Conclusion: This study population showed comparable interest and feasibility for scarless thyroid surgery as international populations. How to respond to this need will become apparent in the coming years.
Examining Physiological Features Underlying Team Coordination Breakdowns
Authors: Eijndhoven Kyana H. J. van , Wiltshire Travis J. , Hałgas Elwira A. , Gevers Josette M. P. , Louwerse Max
Published: December 2023

Team coordination breakdowns (TCBs) generally reflect episodes of ineffective team functioning, resulting in suboptimal team performance. Computational identification of TCBs enables us to examine the underlying characteristics of suboptimal performance, and to potentially deliver real-time feedback to teams. Especially in time-critical crisis situations, such feedback can be invaluable. Previous studies found difficulties in distinguishing between coordination patterns that indicate TCBs, and patterns that might indicate other aspects of teamwork. Subsequently, we examined features capturing underlying characteristics of team coordination, based on multiple physiological signals and coordination measures, to identify TCBs. Our multi-methodological approach allowed us to identify features that are important for TCB identification. We also observed that distributions of feature data related and unrelated to TCBs were significantly different, indicating that the features captured underlying patterns in team coordination data. In addition, our results indicated that team performance, measured as goal achievement duration, is more severely compromised when TCBs last longer. By showing a relationship between TCBs and goal achievement duration, as well as understanding the key features of these TCBs, our study contributes to deepening our understanding of TCBs, and supporting effective team functioning and performance.
The Ability to Predict the Progression of the Change in Oct Angiography Values in the Visional Field and Retina Nerve Layer Tomography in Patients With Glaucoma Progress
Authors: Demir Süleyman , KÖYLÜ MEHMET TALAY
Published: December 2023

INTRODUCTION: To examine the ability of changes in optical coherence tomography angiography (OCTA) values to predict progression in the visual field (GA) and retinal nerve fiber layer (RNFL) in patients with glaucoma progression. METHODS: All patients in the glaucoma outpatient clinic of SBU Gülhane Medical Faculty between 2021–2023 underwent RNFL, 24:2 GA and simultaneous peripapillary OCT-A. 130 eyes that progressed were included in the study. Thinning of more than 5 µ in any quadrant in the RNFL or a decrease of more than 1 dB in the MD value in the visual field within 6 months was accepted as a progression criterion. The ability of changes in OCTA-RNFL and OCTA radial peripapillary capillary plexus (RPCP) analysis to predict progression in RNFL and GA was prospectively investigated. RESULTS: The mean age of the patients was 66.9 ± 11.8 years. There was progression in GA in 70 eyes and RNFL in 89 eyes between baseline and 6-month controls. The ability to predict the progression of the change in OCTA-RNFL in the superior, inferior, nasal, temporal and total quadrants was not sufficient (p = 0.55, 0.40, 0.84, 0.91, 0.39, respectively). Changes in OCTA-RNFL values failed to predict GA MD progression in the superior, inferior, nasal, temporal, and total quadrants (p = 0.40,0.11,0.24,0.44, and 0.10, respectively). The ability of the change in OCT-A Radial Peripapillary Capillary Plexus (RPCP) values to predict progression in the RNFL failed to show superiority in the superior, inferior, nasal, temporal and total quadrants (respectively p = 0,21,0,53,0,39,0,39, 0.29). The ability of the change in OCT-A RPCP values to predict progression in GA failed to show superiority in the superior, inferior, nasal, temporal, and total quadrants (p = 0.96,0.29,0,77,0.42, 0.21, respectively). DISCUSSION AND CONCLUSION: Although OCT-A is a non-invasive imaging test whose use and popularity have been increasing in recent years; In our study could not show superiority compared to RNFL and GA tests in demonstrating glaucoma progression.