bluuebunny/crossref_metadata_2025 huggingface dataset:
Doctor Bryerly emerges
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

When Milly joined me at breakfast, her eyes were red and swollen. She was still sniffing with that little sobbing hiccough, which betrays, even were there no other signs, recent violent weeping. She sat down quite silent.

‘Is he worse, Milly?’ I inquired, anxiously.

‘No,...
A midnight departure
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

‘I’m going this minute — I — I want to know’ — another glance at the door — ‘are you really quite comfortable here?’

‘Quite,’ I answered promptly.

‘You have only your cousin’s company?’ he continued, glancing at the table, which was laid for two.

‘Yes; but Milly and I are very...
News at Bartram Gate
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

Milly and I, thanks to our early Bartram hours, were first down next morning; and so soon as Cousin Monica appeared we attacked her.

‘So Lady Mary is the fiancée of Mr. Carysbroke,’ said I, very cleverly; ‘and I think it was very...
A friend arises
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

At the top of the great staircase I was glad to see the friendly face of Mary Quince, who stood, candle in hand, greeting us with many little courtesies, and a very haggard and pallid smile.

‘Very welcome Miss, hoping you are very well.’

‘All...
The rivals
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

All the time that Dudley chose to persecute me with his odious society, I continued to walk at a brisk pace toward home, so that I had nearly reached the house when Milly met me, with a note which had arrived for me by...
An apparition
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

‘But, after all,’ he suddenly resumed, as if a new thought had struck him, ‘is it quite such folly, after all? It really strikes me, dear Maud, that the subject may be worth a second thought. No, no, you won’t refuse to hear...
Milly’s farewell
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

A few days’ time saw me much better. Doctor Jolks was so contemptuously sturdy and positive on the point that I began to have comfortable doubts about the reality of my ghost; and having still a horror indescribable of the illusion, if such...
Sarah Matilda comes to light
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

Some time after this interview, one day as I sat, sad enough, in my room, looking listlessly from the window, with good Mary Quince, whom, whether in the house or in my melancholy rambles, I always had by my side, I was startled by...
The picture of a wolf
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

I went down that evening to the sitting-room which had been assigned to Milly and me, in search of a book — my good Mary Quince always attending me. The door was a little open, and I was startled by the light of a candle...
In search of Mr. Charke’s skeleton
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

On the whole, however, I was unspeakably relieved. Dudley Ruthyn, Esq., and Mrs. D. Ruthyn, were now skimming the blue waves on the wings of the Seamew, and every morning widened the distance between us, which was to go on increasing until...
The journey
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

Waiting for the train, as we stood upon the platform, I looked back again toward the wooded uplands of Bartram; and far behind, the fine range of mountains, azure and soft in the distance, beyond which lay beloved old Knowl, and my lost father...
Spiced claret
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

I did not lie down; but I despaired. I walked round and round the room, wringing my hands in utter distraction. I threw myself at the bed-side on my knees. I could not pray. I could only shiver and moan, with hands clasped,...
In which I make another cousin’s acquaintance
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

My correspondence about this time was not very extensive. About once a fortnight a letter from honest Mrs. Rusk conveyed to me how the dogs and ponies were, in queer English, oddly spelt; some village gossip, a critique upon Doctor Clay’s or the Curate’s...
Involvement of Peptidoglycan Receptor Proteins in Mediating the Growth-Promoting Effects of Bacillus pumilus TUAT1 in Arabidopsis thaliana
Authors: Islam Md. Monirul , Agake Shin-ichiro , Ito Takehiro , Habibi Safiullah , Yasuda Michiko , Yamada Tetsuya , Stacey Gary , Ohkama-Ohtsu Naoko
Published: February 2024

Bacillus pumilus TUAT1 acts as plant growth–promoting rhizobacteria for various plants like rice and Arabidopsis. Under stress conditions, B. pumilus TUAT1 forms spores with a thick peptidoglycan (PGN) cell wall. Previous research showed that spores were significantly more effective than vegetative cells in enhancing plant growth. In Arabidopsis, lysin motif proteins, LYM1, LYM3 and CERK1, are required for recognizing bacterial PGNs to mediate immunity. Here, we examined the involvement of PGN receptor proteins in the plant growth promotion (PGP) effects of B. pumilus TUAT1 using Arabidopsis mutants defective in PGN receptors. Root growth of wild-type (WT), cerk1-1, lym1-1 and lym1-2 mutant plants was significantly increased by TUAT1 inoculation, but this was not the case for lym3-1 and lym3-2 mutant plants. RNA-seq analysis revealed that the expression of a number of defense-related genes was upregulated in lym3 mutant plants. These results suggested that B. pumilus TUAT1 may act to reduce the defense response, which is dependent on a functional LYM3. The expression of the defense-responsive gene, WRKY29, was significantly induced by the elicitor flg-22, in both WT and lym3 mutant plants, while this induction was significantly reduced by treatment with B. pumilus TUAT1 and PGNs in WT, but not in lym3 mutant plants. These findings suggest that the PGNs of B. pumilus TUAT1 may be recognized by the LYM3 receptor protein, suppressing the defense response, which results in plant growth promotion in a trade-off between defense and growth.
“You have to be grateful that they have eyes watching over us”: When Security Guards Protect and Serve People Experiencing Homelessness
Authors: Maier Katharina , Urbanik Marta-Marika , Greene Carolyn
Published: February 2024

Relationships between private security and People Experiencing Homelessness (PEH) are largely portrayed in negative, controlling, and punitive terms. Studies have shown that like police, security guards regularly engage in behaviors that impede PEH’s access to public spaces and produce harm. By contrast, drawing upon interviews with 50 PEH in a mid-sized Canadian city, our research examining PEH’s experiences with security suggests these relationships are much more variegated than previously documented. We find that, rather than treating PEH wholly punitively, security guards often take a benevolent approach to their work, making important contributions to PEH’s perceptions of safety in public space and taking a harm reduction role for PEH who use drugs. Our analysis contributes practical and theoretical knowledge about the work of private security and further illuminates the intersections of drugs, security, and public health.
Genetic insights of H9N2 avian influenza viruses circulating in Mali and phylogeographic patterns in Northern and Western Africa
Authors: Sanogo Idrissa Nonmon , Guinat Claire , Dellicour Simon , Diakité Mohamed Adama , Niang Mamadou , Koita Ousmane A , Camus Christelle , Ducatez Mariette
Published: February 2024

Avian influenza viruses (AIVs) of the H9N2 subtype have become widespread in Western Africa since their first detection in 2017 in Burkina Faso. However, the genetic characteristics and diffusion patterns of the H9N2 virus remain poorly understood in Western Africa, mainly due to limited surveillance activities. In addition, Mali, a country considered to play an important role in the epidemiology of AIVs in the region, lacks more comprehensive data on the genetic characteristics of these viruses, especially the H9N2 subtype. To better understand the genetic characteristics and spatio-temporal dynamics of H9N2 virus within this region, we carried out a comprehensive genetic characterization of H9N2 viruses collected through active surveillance in live bird markets in Mali between 2021 and 2022. We also performed a continuous phylogeographic analysis to unravel the dispersal history of H9N2 lineages between Northern and Western Africa. The identified Malian H9N2 virus belonged to the G1 lineage, similar to viruses circulating in both Western and Northern Africa, and possessed multiple molecular markers associated with an increased potential for zoonotic transmission and virulence. Notably, some Malian strains carried the R-S-N-R motif at their cleavage site, mainly observed in H9N2 strains in Asia. Our continuous phylogeographic analysis revealed a single and significant long-distance lineage dispersal event of the H9N2 virus to Western Africa, likely to have originated from Morocco in 2015, shaping the westward diffusion of the H9N2 virus. Our study highlights the need for long-term surveillance of H9N2 viruses in poultry populations in Western Africa, which is crucial for a better understanding of virus evolution and effective management against potential zoonotic AIV strain emergence.
Unravelling the obscure homology: postembryonic development of chaetotaxic traits in a basal hexapod taxon (Collembola: Tomoceridae)
Authors: Yu Daoyuan , Zhang Yating , Wang Ziqiang , Hu Feng , Liu Manqiang
Published: February 2024

Homology assessment is essential for systematic zoology, but for many taxa and traits, precise recognition of homology can be challenging with limited evidence. Tomoceridae is one of the earliest branches in the elongate-bodied springtails (Collembola: Entomobryomorpha), and is among the commonest and best-known families in the class. However, the homology of some important traits is still obscure in this group, including its characteristic chaetotaxic traits. In this study, we conducted the first rigorous homology assessment of chaetotaxy in Tomoceridae based on ontogenetic evidence. The postembryonic development of chaetotaxy was investigated in three species of Tomocerus. The primary chaetotaxy of first instar larvae show high similarity within Tomocerinae. The postembryonic development involves extensive transformations between chaetal types. The continuous dwarfism of primary chaetae during development leads to apparent oligochaetosis in adults. The thoracic bothriotricha are transformed from primary macrochaetae. The sensory chaetotaxy is stable during postembryonic development, and shows interspecific differences mainly on the mesothorax and the fourth abdominal segment. This study will promote the future use of chaetotaxic traits in the taxonomic and phylogenetic studies of Tomoceridae, and will potentially illuminate the early evolution of Entomobryomorpha.
Xanthomonas citri pv. citri Findings in Citrus Fruits Imported in the Netherlands
Authors: Volkers Rita J. M. , van Doorn Bo B. J. A. , Blom Nathalie I. , van de Bilt Jeroen L. J. , Gorkink-Smits Peggy M. A. , Landman Marco N. M. , Teunissen Manon , Pel Michiel J. C. , Raaymakers Tom M. , Bergsma-Vlami Maria
Published: February 2024

Xanthomonas citri pv. citri and pv. aurantifolii are responsible for citrus bacterial canker. The trade of citrus fruit is recognized as one of the seven X. citri pv. citri introduction pathways. Under the current European Union phytosanitary measures, the likelihood of these X. citri pathovars being introduced into the Mediterranean region via infected fruit is rated as unlikely. To closely monitor the commercial trade flow of citrus fruit, imported lots that contained fruits with citrus bacterial canker symptoms were quarantined, and a sample was sent for laboratory analysis. Survey results revealed the presence of viable and highly pathogenic X. citri pv. citri isolates in 97 infected lots between 2013 and 2022, whereas X. citri pv. aurantifolii was never found. These X. citri pv. citri-infected lots primarily concerned Citrus latifolia (64), C. hystrix (17), and C. grandis (11) fruits, mainly from South America but also from several Asian countries. Additionally, a genetic characterization of these X. citri pv. citri isolates demonstrated that, although they originated from different countries, years, and Citrus species, they were all highly related, with average nucleotide identity scores ranging from 99.98 to 100%. These intercepted lots containing symptomatic citrus fruits due to the presence of X. citri pv. citri underlines the importance of continued vigilance by both the exporting and importing countries. Import inspections of the citrus fruit trade flow for the presence of citrus bacterial canker symptoms and subsequent laboratory testing remain significant tools for assessing the long-distance dispersal of X. citri pv. citri.
Safety and Complications of Landmark-Based Paravertebral Blocks
Authors: Ardon Alberto E. , Curley Emma , Greengrass Roy
Published: February 2024

Objective:

This study aimed to determine the incidence of complications after landmark-based paravertebral blocks for breast surgery.

Methods:

The medical records of patients that received a paravertebral block for breast surgery between 2019 and 2022 were reviewed. Patient age, gender, type of procedure, number of injections, volume of injected anesthetic, and possible complications were noted. A record was identified as a possible serious block-related complication if there was concern or treatment for local anesthetic systemic toxicity (LAST), pneumothorax, altered mental status, or intrathecal/epidural spread. Other complications recorded were immediate post-block hypotension and nausea/vomiting requiring treatment and unanticipated post-surgical admission. Patients receiving ultrasound guided paravertebral blocks were excluded from this study.

Results:

Over a 3-year period, 979 patients received paravertebral blocks using the landmark technique for breast surgery, totaling 4983 injections. Overall, 6 patients required assessment for post-block issues (0.61%), including hypotension (2 patients), nausea (3 patients), and hypotension + altered mental status (1 patient). This latter patient was identified as having a serious complication related to the paravertebral block (0.1%). This patient had unintentional intrathecal spread and altered mental status that required mechanical ventilation. The incidence of block related hypotension and nausea requiring treatment was thus 0.31% and 0.31% respectively. Four patients required unanticipated admission, but none were for block-related reasons. No patients in this study were found to have LAST or pneumothorax.

Conclusion:

Our study suggests that landmark based paravertebral blocks for breast surgery result in a very low complication rate and are a safe technique for post-surgical analgesia.
Word Learning in Deaf Adults Who Use Cochlear Implants: The Role of Talker Variability and Attention to the Mouth
Authors: Hartman Jasenia , Saffran Jenny , Litovsky Ruth
Published: February 2024

Objectives:

Although cochlear implants (CIs) facilitate spoken language acquisition, many CI listeners experience difficulty learning new words. Studies have shown that highly variable stimulus input and audiovisual cues improve speech perception in CI listeners. However, less is known whether these two factors improve perception in a word learning context. Furthermore, few studies have examined how CI listeners direct their gaze to efficiently capture visual information available on a talker’s face. The purpose of this study was two-fold: (1) to examine whether talker variability could improve word learning in CI listeners and (2) to examine how CI listeners direct their gaze while viewing a talker speak.

Design:

Eighteen adults with CIs and 10 adults with normal hearing (NH) learned eight novel word-object pairs spoken by a single talker or six different talkers (multiple talkers). The word learning task comprised of nonsense words following the phonotactic rules of English. Learning was probed using a novel talker in a two-alternative forced-choice eye gaze task. Learners’ eye movements to the mouth and the target object (accuracy) were tracked over time.

Results:

Both groups performed near ceiling during the test phase, regardless of whether they learned from the same talker or different talkers. However, compared to listeners with NH, CI listeners directed their gaze significantly more to the talker’s mouth while learning the words.

Conclusions:

Unlike NH listeners who can successfully learn words without focusing on the talker’s mouth, CI listeners tended to direct their gaze to the talker’s mouth, which may facilitate learning. This finding is consistent with the hypothesis that CI listeners use a visual processing strategy that efficiently captures redundant audiovisual speech cues available at the mouth. Due to ceiling effects, however, it is unclear whether talker variability facilitated word learning for adult CI listeners, an issue that should be addressed in future work using more difficult listening conditions.
Preference Sensitive Care and Shared Decision-Making in Lumbar Spinal Stenosis
Authors: Asthana Shravan , Walker James , Staub Jacob , Bajaj Pranav , Reyes Samuel , Shlobin Nathan A. , Beestrum Molly , Hsu Wellington K. , Patel Alpesh A. , Divi Srikanth N.
Published: February 2024

Study Design.

Scoping review.

Objective.

The objective of this study was to conduct a scoping review exploring the extent to which preference sensitivity has been studied in treatment decisions for lumbar spinal stenosis (LSS), utilizing shared decision-making (SDM) as a proxy.

Background.

Preference-sensitive care involves situations where multiple treatment options exist with significant tradeoffs in cost, outcome, recovery time, and quality of life. LSS has gained research focus as a preference-sensitive care scenario.

Materials and Methods.

A scoping review protocol in accordance with “Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews” regulations was registered with the Open Science Framework (ID: 9ewup) and conducted across multiple databases from January 2000 to October 2022. Study selection and characterization were performed by 3 independent reviewers and an unbiased moderator.

Results.

The search resulted in the inclusion of 16 studies varying in design and sample size, with most published between 2016 and 2021. The studies examined variables related to SDM, patient preferences, surgeon preferences, and decision aids (DAs). The outcomes assessed included treatment choice, patient satisfaction, and patient understanding. Several studies reported that SDM influenced treatment choice and patient satisfaction, while the impact on patient understanding was less clear. DAs were used in some studies to facilitate SDM.

Conclusion.

The scoping review identified a gap in comprehensive studies analyzing the preference sensitivity of treatment for LSS and the role of DAs. Further research is needed to better understand the impact of patient preferences on treatment decisions and the effectiveness of DAs in LSS care. This review provides a foundation for future research in preference-sensitive care and SDM in the context of lumbar stenosis treatment.
The global gastric cancer consortium: an update from the Stomach cancer Pooling (StoP) project
Authors: Pelucchi Claudio , La Vecchia Carlo , Bonzi Rossella , Negri Eva , Corso Giovanni , Boccia Stefania , Boffetta Paolo , Camargo M. Constanza , Curado Maria Paula , Lunet Nuno , Vioque Jesus , Zhang Zuo-Feng ,   on behalf of the StoP Project Working Group
Published: February 2024

We updated to December 2023 the main findings of the stomach cancer pooling (StoP) project including about 13 000 cases and 31 000 controls from 29 case–control and 5 nested studies. The StoP project quantified more precisely than previously available the positive associations of tobacco smoking, high alcohol consumption, meat intake, selected occupations (e.g. agricultural and miners), gastric ulcer and family history with gastric cancer and the inverse associations with socioeconomic status and selected aspects of diet (fruits, including citrus fruits, vegetables, including allium and mushrooms, and polyphenols). No consistent associations were found with coffee, yoghurt and leisure-time physical activity, metformin or proton pump inhibitors use.
Profiles of Cultural Adaptation and Parenting Approach for Childhood Obesity in Lifestyle Interventions for Families With Young Children
Authors: Fukkink Ruben G. , Booij Yvonne S. , Leistra Loes H. M. , van Verseveld Marloes D. A.
Published: February 2024

Background and Objectives:

Various interventions aim to reduce obesity and promote healthy lifestyles among different cultural groups.

Methods:

We have conducted a systematic literature review, following PRISMA guidelines (registered at https://doi.org/10.17605/OSF.IO/HB9AX), to explore profiles of cultural adaptation and parenting approach of lifestyle interventions for families with young children (1-4 years).

Results:

Our search (in CINAHL, ERIC, PsycINFO, PubMed, Scopus, and SSCI) yielded 41 studies reporting 31 interventions. Drawing on Intervention Mapping, we applied a newly developed framework with various indicators of cultural adaptation and a parenting approach to analyze interventions. Our review shows clear differences in the level of cultural adaptation. A categorical principal component analysis revealed 6 different empirical profiles of cultural adaptation.

Conclusions:

Based on our profiles, we discuss how cultural adaptation can be strengthened in the design of future early interventions aimed at promoting a healthy lifestyle.
Dynamic Reconstruction Using Bilateral Lengthening Temporalis Myoplasty for Facial Palsies in Patients with Hereditary Skin Laxity
Authors: Hirata Akiko , Hayashi Akiteru , Yamazaki Shun , Hanada Hayato , Nakamura Syogo , Ogino Akihiro
Published: February 2024

Hereditary skin laxity is a rare condition, some cases of which are also referred to as cutis laxa, and those involving facial skin are considered a target for treatment by plastic surgery as patients present with an aged face, which can reduce their quality of life. In some of these patients, the facial nerve and muscles may be affected, and cause weakness of mimetic muscles. We performed one-stage bilateral lengthening temporalis myoplasty reanimation, followed by lower facial contouring with partial lower lip excision and hammock-shaped fascia grafting in two patients with hereditary facial skin laxity coexisting with facial palsy. The patient was a 63-year-old woman with hereditary gelsolin amyloidosis and a 64-year-old man who was diagnosed with oculopharyngeal muscular dystrophy. Postoperatively, a symmetrical facial contour was achieved in repose, and smiling with and without biting was possible. To our knowledge, there are no reports of dynamic smile reconstruction for facial weakness in patients with hereditary facial skin laxity. Although these patients may experience progressive loss of function of the trigeminal nerve and its innervating muscles, the static suspension effect of lengthening temporalis myoplasty can be expected to continue even if the temporal muscles lose their function in the future. We believe that, with careful patient selection, dynamic reconstruction is an option for progressive facial paralysis. In this article, we present the chronological history of two patients who underwent multiple plastic surgery procedures and discuss the importance of the role of plastic surgery in improving the quality of life under these conditions.
Stellate cell-specific adhesion molecule protocadherin 7 regulates sinusoidal contraction
Authors: Carter James K. , Tsai Ming-Chao , Venturini Nicholas , Hu Jiangting , Lemasters John J. , Torres Martin Miguel , Sia Daniela , Wang Shuang , Lee Youngmin A. , Friedman Scott L.
Published: February 2024

Background and Aims:

Sustained inflammation and hepatocyte injury in chronic liver disease activate HSCs to transdifferentiate into fibrogenic, contractile myofibroblasts. We investigated the role of protocadherin 7 (PCDH7), a cadherin family member not previously characterized in the liver, whose expression is restricted to HSCs.

Approach and Results:

We created a PCDH7fl/fl mouse line, which was crossed to lecithin retinol acyltransferase-Cre mice to generate HSC-specific PCDH7 knockout animals. HSC contraction in vivo was tested in response to the HSC-selective vasoconstrictor endothelin-1 using intravital multiphoton microscopy. To establish a PCDH7 null HSC line, cells were isolated from PCDH7fl/fl mice and infected with adenovirus-expressing Cre. Hepatic expression of PCDH7 was strictly restricted to HSCs. Knockout of PCDH7 in vivo abrogated HSC-mediated sinusoidal contraction in response to endothelin-1. In cultured HSCs, loss of PCDH7 markedly attenuated contractility within collagen gels and led to altered gene expression in pathways governing adhesion and vasoregulation. Loss of contractility in PCDH7 knockout cells was impaired Rho-GTPase signaling, as demonstrated by altered gene expression, reduced assembly of F-actin fibers, and loss of focal adhesions.

Conclusions:

The stellate cell-specific cadherin, PCDH7, is a novel regulator of HSC contractility whose loss leads to cytoskeletal remodeling and sinusoidal relaxation.
“Entonces, Como Promotores, Pues, No Somos Intérpretes”
Authors: Logan Ryan I. , Strater Richard L.
Published: February 2024

Community health workers (CHWs) and promotores de salud are frontline health workers who typically come from the communities they serve. Despite providing crucial services, they are not institutionalized (or integrated) within much of the U.S. health care system. Many work, either officially or unofficially, as medical interpreters–restricting their full impact as CHWs/promotores. In this paper, we detail the misemployment and its effects among a subsample of CHWs/promotores in two geographically distinct, exploratory projects. We encourage that collaborative research with CHWs/promotores continue and that fidelity to the CHW model be ensured to realize their true potential.
Ethical Expert Witness Testimony
Authors:   International Association of Forensic Nurses
Published: February 2024

Forensic nurses are routinely called upon to provide expert consultation and witness testimony. Nearly half of the enumerated standards in the Forensic Nursing Scope and Standards of Practice reference competencies directly related or complementary to ethical testimony. Requests from the field, coupled with the increasing opportunities for forensic nurses to serve as expert witnesses, necessitate the development of clear parameters for ethical expert witness testimony.
Right Ventricular Assist Device Placement During Left Ventricular Assist Device Implantation Is Associated With Improved Survival
Authors: Crespo-Diaz Ruben , Mudy Karol , Khan Nadeem , Samara Michael , Eckman Peter M. , Sun Benjamin , Hryniewicz Katarzyna
Published: February 2024

Right ventricular failure (RVF) is a significant cause of mortality in patients undergoing left ventricular assist device (LVAD) implantation. Although right ventricular assist devices (RVADs) can treat RVF in the perioperative LVAD period, liberal employment before RVF is not well established. We therefore compared the survival outcomes between proactive RVAD placement at the time of LVAD implantation with a bailout strategy in patients with RVF. Retrospectively, 75 adult patients who underwent durable LVAD implantation at our institution and had an RVAD placed proactively before LVAD implantation or as a bailout strategy postoperatively due to hemodynamically unstable RVF were evaluated. Patients treated with a proactive RVAD strategy had lower Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) and a higher proportion of these required temporary mechanical circulatory support (MCS) preoperatively. Preoperative hemodynamic profiling showed a low pulmonary artery pulsatility index (PAPi) score of 1.8 ± 1.4 and 1.6 ± 0.94 (p = 0.42) in the bailout RVAD and proactive RVAD groups, respectively. Survival at 3, 6, and 12 months post-LVAD implantation was statistically significantly higher in patients who received a proactive RVAD. Thus, proactive RVAD implantation is associated with short- and medium-term survival benefits compared to a bailout strategy in RVF patients undergoing LVAD placement.
Hemodynamic Optimization by Invasive Ramp Test in Patients Supported With HeartMate 3 Left Ventricular Assist Device
Authors: Rubinstein Gal , Moeller Cathrine M. , Lotan Dor , Slomovich Sharon , Fernandez-Valledor Andrea , Oren Daniel , Oh Kyung T. , Fried Justin A. , Clerkin Kevin J. , Raikhelkar Jayant K. , Topkara Veli K. , Kaku Yuji , Takeda Koji , Naka Yoshifumi , Burkhoff Daniel , Latif Farhana , Majure David , Colombo Paolo C. , Yuzefpolskaya Melana , Sayer Gabriel T. , Uriel Nir
Published: February 2024

In patients supported by the HeartMate 3 left ventricular assist device (HM3 LVAD), pump speed adjustments may improve hemodynamics. We investigated the hemodynamic implications of speed adjustments in HM3 recipients undergoing hemodynamic ramp tests. Clinically stable HM3 recipients who underwent routine invasive hemodynamic ramp tests between 2015 and 2022 at our center were included. Filling pressure optimization, defined as central venous pressure (CVP) <12 mm Hg and pulmonary capillary wedge pressure (PCWP) <18 mm Hg, was assessed at baseline and final pump speeds. Patients with optimized pressures were compared to nonoptimized patients. Overall 60 HM3 recipients with a median age of 62 years (56, 71) and time from LVAD implantation of 187 days (124, 476) were included. Optimized filling pressures were found in 35 patients (58%) at baseline speed. Speed was adjusted in 84% of the nonoptimized patients. Consequently, 39 patients (65%) had optimized pressures at final speed. There were no significant differences in hemodynamic findings between baseline and final speeds (p > 0.05 for all). Six and 12 month readmission-free rates were higher in optimized compared with nonoptimized patients (p = 0.03 for both), predominantly due to lower cardiac readmission-free rates (p = 0.052). In stable outpatients supported with HM3 who underwent routine ramp tests, optimized hemodynamics were achieved in only 2 of 3 of the patients. Patients with optimized pressures had lower all-cause readmission rates, primarily driven by fewer cardiac-related hospitalizations.
ANGPTL3 and ApoC-III inhibitors for treating hypertriglyceridemia in context: horses for courses?
Authors: Chan Dick C. , Watts Gerald F.
Published: February 2024

Purpose of review

Hypertriglyceridemia (HTG) is an independent and casual risk factor for atherosclerotic cardiovascular disease (ASCVD). There is an unmet need for more effective treatments for patients with HTG. Angiopoietin-like protein 3 (ANGPTL3) and apolipoprotein C-III (apoC-III) are key regulators of triglyceride-rich lipoprotein (TRL) metabolism. We review recent clinical trials targeting ANGPTL3 and apoC-III with monoclonal antibody and nucleic acid therapies, including antisense oligonucleotides and small interfering RNA.

Recent findings

ANGPTL3 and apoC-III inhibitors are effective in lowering plasma triglycerides and TRLs, with possibly greater efficacy with the inhibition of apoC-III. By contrast to ANGPTL3 inhibition that has the advantage of greater lowering of plasma low-density lipoprotein (LDL)-cholesterol and apoB levels, apoC-III inhibition only has a modest or no effect in lowering plasma LDL-cholesterol and apoB concentrations. Therapeutic inhibition of ANGPTL3 and apoC-III can correct HTG possibly by reducing production and increasing catabolism of TRL particles, but this remains to be formally investigated in patients with HTG.

Novel agents targeting ANGPTL3 and apoC-III can correct HTG and potentially lower risk of ASCVD in patients with HTG. The long-term safety and cost-effectiveness of these agents await confirmation in ongoing and future studies.
Case Report: congenital single kidney in tuberous sclerosis complex (bourneville disease)
Authors: Bzeih Wafaa , Kbar Mohammad , Rihan Oussama
Published: February 2024

Introduction:

Bournevile disease is a rare global condition that presents a diagnostic challenge due to its diverse multisystemic involvement.

Case Presentation:

This report presents the case of a 14-year-old male with a medical history of congenital single kidney, heart rate abnormalities, Bournevile disease with cognitive deficits, brain lesions, and dermatological features. The patient presented with sudden onset renal angiolipomatosis, and the diagnosis was based on specific CT findings. Despite having these complex medical conditions, the patient had never been admitted to the hospital since infancy, and treatment was limited to surveillance only.

Clinical Discussion:

Bourneville disease is a multisystemic disease that affects several organ systems within the human body and thus demands multidisciplinary approach in the treatment and followup options.

Conclusion:

This case report highlights Bournevile disease in a patient with a congenital single kidney, a rare finding that further complicates the disease. It emphasises the importance of recognizing and managing this condition to ensure appropriate care for affected individuals.
Evaluation of Automated Processing of Electronically Reported Serological Tests for Syphilis Using Current and Historical Syphilis Results Compared With Traditional Reactor Grid Processing in Florida
Authors: Matthias James , Khan Amir M. , Craze Kristin , Karki Saugat , Newman Daniel R.
Published: February 2024

Background

Syphilis in Florida increased 49% from 2016 to 2020. Moreover, many serological tests for syphilis (STS) do not indicate current infection. Traditionally, syphilis surveillance systems used reactor grids, a method for prioritizing STS for investigation based on age, nontreponemal titer, and/or sex. In 2022, Florida's sexually transmitted disease surveillance system implemented an automated method for processing electronically reported STS (eSTS), expanding upon the reactor grid, using an individual's current STS (treponemal and nontreponemal), treatment history, and historical STS results aiming for more efficiently processing eSTS. We compared the new method of processing eSTS results against the reactor grid and determined potential value in time/cost savings of this change.

Methods

All eSTSs (n = 4144) from January 2, 2023 to January 8, 2023, were compared by how the logic-based method processed test results versus how the reactor grid processed test results. Each method was compared using measurements of accuracy (e.g., sensitivity/specificity). Time and cost savings in eSTS processing were estimated.

Results

Using the surveillance case definition as reference, the accuracy of the logic-based method for processing eSTS was nearly double (82.3% vs. 43.6%), had greater specificity (79.0% vs. 33.0%), and increased positive predictive value (47.5% vs. 22.0%) when compared with the reactor grid method. Sensitivity (99.5% vs. 98.6%) and negative predictive value (99.9% vs. 99.2%) remained similar. The logic-based method is estimated to save 7783 hours annually (~$185,000).

Conclusions

Processing eSTS based on current and historical STS results is significantly more accurate than using a reactor grid. Moreover, these improvements save time and resources that can be better allocated to other program prevention activities.
Impact of Severe Obesity on Major Perioperative Complications for Prolapse Surgery
Authors: Kisby Cassandra K. , Vermunt Jane , Maciejko Laura A. , Abd El Aziz Mohamed A. , Perry William , Occhino John A.
Published: February 2024

Importance

Obesity adds complexity to the decision of surgical approach for pelvic organ prolapse; data regarding perioperative complications are needed.

Objective

The aim of the study was to evaluate associations of body mass index (BMI) and surgical approach (vaginal vs laparoscopic) on perioperative complications.

Study Design

Patients who underwent prolapse surgery were identified via the Current Procedural Terminology codes from the American College of Surgeons National Surgical Quality Improvement Program database 2007–2018. Thirty-day major complications were compared across BMI to identify an inflection point, to create a dichotomous BMI variable. Multivariable logistic regression was used to assess the association between BMI and complications. An interaction term was introduced to evaluate for effect modification by operative approach.

Results

A total of 26,940 patients were identified (25,933 BMI < 40, 1,007 BMI ≥ 40). The proportion of patients experiencing a major complication was higher in the BMI ≥ 40 group (2.0 vs 1.1%, P = 0.007). In multivariate analysis, the odds of a major complication was 1.8 times higher for women with a BMI ≥ 40 (95% confidence interval, 1.1–2.9, P = 0.04). There was a significant interaction between operative approach and BMI; therefore, further analyses were restricted to either vaginal or laparoscopic operative approaches. Among women who underwent vaginal prolapse repair, there was no difference in the odds of a major complication (adjusted odds ratio, 1.4; 0.8–2.4; P = 0.06). Among women who underwent laparoscopic repair, those with a BMI ≥ 40 were 6 times more likely to have a major complication (adjusted odds ratio, 6.0; 2.5–14.6; P < 0.001).

Conclusions

Body mass index ≥ 40 was associated with an increased odds of a 30-day major complication. This association was greatest in women who underwent a laparoscopic prolapse repair.
Extracorporeal Photopheresis Reduces Fibrotic and Inflammatory Transcriptomic Biological Marker of Chronic Antibody-mediated Kidney Rejection
Authors: Lionet Arnaud , Van Triempon Marine , Figeac Martin , Fages Victor , Gibier Jean-Baptiste , Provot François , Maanaoui Mehdi , Pottier Nicolas , Cauffiez Christelle , Glowacki François
Published: February 2024

Background.

The benefit of extracorporeal photopheresis on the course of kidney transplant rejection is unknown. The aim of our study was to investigate the variations in transcriptomics on graft biopsies when extracorporeal photopheresis was used to treat chronic humoral rejection after kidney transplantation.

Methods.

We retrospectively analyzed the mRNA expression of 770 genes of interest in graft biopsies performed before and after treatment. Eight patients received an average of 23 extracorporeal photopheresis sessions over 4 mo between the 2 biopsies.

Results.

Transcriptomic analysis of the graft biopsies identified a significant (adjusted P < 0.05) increase in CAV1 mRNA in all patients and a significant decrease in CD19, IL21, PAX5, and SFTPA2 mRNAs in 7 of 8 patients.

Conclusions.

In patients treated with extracorporeal photopheresis for chronic humoral rejection after renal transplantation, omic analysis of repeated biopsies shows a reduction in fibrotic and inflammatory transcriptomic biologicals markers.
Assessment of Reversibility of Transverse Venous Sinus Stenosis in Patients With Papilledema
Authors: Handzic Armin , Tao Brendan K. , O'Cearbhaill Roisin M. , Nicholson Patrick J. , Margolin Edward A. , Micieli Jonathan A.
Published: February 2024

Background:

Bilateral transverse venous sinus stenosis (TVSS) or stenosis of a dominant venous sinus has been found to be very sensitive radiological findings in patients with intracranial hypertension (IH), yet there is still an ongoing debate whether they constitute reversible or permanent phenomena. Thus, the purpose of this study was to investigate the reversibility of TVSS in patients with IH, including conservatively treated patients with signs of IH as defined by the presence of papilledema.

Methods:

This was a retrospective chart review of all patients diagnosed with IH between 2016 and 2022, assessed from 2 tertiary university-affiliated neuro-ophthalmology practices. Inclusion criteria were the presence of papilledema, as quantified by optical coherence tomography, and bilateral TVSS, which is considered typical of IH on neuroimaging. During follow-up, included patients must have had confirmation of papilledema resolution as well as subsequent neuroimaging after conservative treatment or cerebrospinal fluid flow diversion. Patients with dural sinus vein thrombosis or intrinsic stenosis from sinus trabeculations or significant arachnoid granulations were excluded from the study. Either CT venography or MRI/MR venography was reviewed by a fellowship-trained neuroradiologist, and the degree of stenosis was scored through the combined conduit score (CCS), as described by Farb et al. The primary outcome was to assess TVSS changes after resolution or improvement of papilledema.

Results:

From 435 patients, we identified a subset of 10 who satisfied all inclusion criteria. Our cohort comprised entirely women with a median age of 29.5 years and a median BMI of 32.5 kg/m2. Treatment consisted of acetazolamide in 7 patients, of which 1 had additional topiramate and 2 underwent cerebrospinal fluid flow diversion. Furthermore, 6 patients demonstrated significant weight loss during follow-up. For the primary outcome, 5 of 10 patients exhibited no appreciable TVSS change, and 5 patients demonstrated significant improvement in TVSS, of which 4 received conservative treatment only. Papilledema resolution or improvement was statistically significantly associated with increasing average CCS, TVSS diameter, and grade.

Conclusions:

We were able to demonstrate that TVSS can be both irreversible and reversible in patients with resolved papilledema. The finding of TVSS reversibility from conservative treatment alone is novel and has important implications to optimize patient care. Future studies should work to identify factors associated with irreversible TVSS for subsequent targeted intervention and prevention.
Refractory and Recurrent Idiopathic Granulomatous Mastitis Treatment: Adaptive, Randomized Clinical Trial
Authors: Shojaeian Fatemeh , Haghighat Shahpar , Abbasvandi Fereshteh , Houshdar Tehrani Alireza , Najar Najafi Niki , Zandi Ashkan , Olfatbakhsh Asiie , Sharifi Maryam , Hashemi Esmat , Nafissi Nahid , Najafi Safa
Published: February 2024

BACKGROUND:

Idiopathic granulomatous mastitis (IGM) is mostly described as an autoimmune disease with higher prevalence among Middle Eastern childbearing-age women. This study aimed to evaluate the best treatment of choice in patients with resistant or recurrent IGM.

STUDY DESIGN:

Patients with established recurrent or resistant IGM who were referred to the Breast Cancer Research Center from 2017 to 2020 were randomly assigned to either one of the following treatment groups: A (best supportive care), B (corticosteroids: prednisolone), and C (methotrexate and low-dose corticosteroids). This adaptive clinical trial evaluated radiological and clinical responses, as well as the potential side effects, on a regular basis in each group, with patients followed up for a minimum of 2 years.

RESULTS:

A total of 318 participants, with a mean age of 33.52 ± 6.77 years, were divided into groups A (10 patients), B (78 patients), and C (230 patients). In group A, no therapeutic response was observed; group B exhibited a mixed response, with 14.1% experiencing complete or partial responses, 7.7% maintaining stability, and 78.2% experiencing disease progression. Accordingly, groups A and B were terminated due to inadequate response. In group C, 94.3% achieved complete response, 3% showed partial remission, and 2.7% had no response to therapy. Among the entire patient cohort, 11.6% tested positive for antinuclear antibodies, 3.5% for angiotensin-converting enzyme, and 12.3% for erythema nodosum. Notably, hypothyroidism was a prevalent condition among the patients, affecting 7.2% of the cohort. The incidence of common side effects was consistent across all groups.

CONCLUSIONS:

The most effective treatment option for patients with recurrent or resistant IGM is a combination therapy involving steroids and disease-modifying antirheumatic drugs such as methotrexate.
Evaluating Outcomes of Nonaccidental Trauma in Military Children
Authors: Joskowitz Katie , Patwardhan Utsav M , Floan Gretchen M , Heflinger Megan , Cruz Sheena , David Maya , Jadhav Priyanka , Nienow Shalon , Thangarajah Hari , Ignacio Romeo C
Published: February 2024

BACKGROUND:

Nonaccidental trauma (NAT), or child abuse, is a leading cause of childhood injury and death in the US. Studies demonstrate that military-affiliated individuals are at greater risk of mental health complication and family violence, including child maltreatment. There is limited information about the outcomes of military children who experience NAT. This study compares the outcomes between military-dependent and civilian children diagnosed with NAT.

STUDY DESIGN:

A single-institution, retrospective review of children admitted with confirmed NAT at a Level I trauma center was performed. Data were collected from the institutional trauma registry and the Child Abuse Team’s database. Military affiliation was identified using insurance status and parental or caregiver self-reported active-duty status. Demographic and clinical data including hospital length of stay (LOS), morbidity, specialty consult, and mortality were compared.

RESULTS:

Among 535 patients, 11.8% (n = 63) were military-affiliated. The median age of military-associated patients, 3 months (interquartile range [IQR] 1 to 7), was significantly younger than civilian patients, 7 months (IQR 3 to 18, p < 0.001). Military-affilif:ated patients had a longer LOS of 4 days (IQR 2 to 11) vs 2 days (IQR 1 to 7, p = 0.041), increased morbidity or complication (3 vs 2 counts, p = 0.002), and a higher mortality rate (10% vs 4%, p = 0.048). No significant difference was observed in the number of consults or injuries, trauma activation, or need for surgery.

CONCLUSIONS:

Military-affiliated children diagnosed with NAT experience more adverse outcomes than civilian patients. Increased LOS, morbidity or complication, and mortality suggest military-affiliated patients experience more life-threatening NAT at a younger age. Larger studies are required to further examine this population and better support at-risk families.
Relationship between Blood Group (ABO) and Risk of COVID-19 Infection in a Patient Cohort in Tehran, Iran
Authors: Fathollahi Asal , bashizadeh fakhar haniyeh , Shaghaghi Babak
Published: February 2024

Background and purpose: Coronavirus (COVID-19) is a contagious disease causing severe acute respiratory syndrome which had a catastrophic effect on the world population and resulted in more than 2.9 million deaths worldwide. Epidemiological investigations have recently announced blood type has an association with the incidence of COVID-19 infection. Consequently, research in this regard can be effective in determining a person's susceptibility to a viral infection. Therefore, we investigated the relationship between blood types and the risk of COVID-19 in patients admitted to Khorshid laboratory, Tehran, Iran.
Materials and methods: From January to March 2020, 50 nasal and throat swap samples of patients’ secretions were obtained from patients who were admitted to Khorshid laboratory. They were confirmed to have COVID-19 virus RNA and real-time polymerase chain reaction (PCR)-ABI, and their blood type was determined simultaneously. After collecting data to determine the relationship between COVID-19 infection and blood type, a confidence interval of 90% was considered using SPSS 16.
Results: The mean age of the patients was measured at 38.4±6.3 years. According to PCR results, 100% of the subjects with COVID-19 showed blood type A. In addition, the ratio of blood type A to the percentage of reference type O was higher (P=0.009).
Conclusion: There was a significant relationship between ABO blood type and susceptibility to COVID-19. As the current study suggests, those with blood type A are at a higher COVID-19 infection risk than those with blood type O.