bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Physical Activity One Year After Moderate to Severe Traumatic Brain Injury
Authors: Pradhan Sujata , Esterov Dmitry , Driver Simon , Whyte John , Bell Kathleen R. , Barber Jason , Temkin Nancy , Bombardier Charles H.
Published: June 2024

Objectives:

To identify predictors of moderate to vigorous physical activity (MVPA) at 12-months post–moderate-severe traumatic brain injury (TBI).

Setting:

Four inpatient rehabilitation centers.

Participants:

Individuals enrolled in the TBI Model Systems with moderate to severe TBI, admitted to inpatient rehabilitation, and able to ambulate without physical assistance from another person.

Design:

Prospective longitudinal cohort study. MVPA was measured by having participants wear an ActiGraph GT3X on their wrist for 7 consecutive days.

Main Analyses:

We used multivariate regression to predict minutes per week of MVPA at 12 months after TBI. Three classes of predictors were entered hierarchically—demographic and clinical variables (age, sex, body mass index, education, TBI severity, neighborhood walkability score, and self-reported preinjury physical activity [PA] level), baseline TBI-related comorbid conditions (eg, measures of sleep, pain, mood, fatigue, and cognition), and intention to exercise and exercise self-efficacy assessed approximately 1 week after discharge from inpatient rehabilitation.

Results:

180 participants (ages 17.7–90.3 years) were enrolled, and 102 provided at least 5 days of valid accelerometer data at 12 months. At 12 months, participants recorded an average of 703 (587) minutes per week of MVPA. In univariate and multivariate analyses, age was the only significant predictor of 12-month MVPA (r = −0.52). A sharp decline in MVPA was observed in the tertile of participants who were over the age of 61.

Conclusions:

Older adults with TBI are at elevated risk of being physically inactive. Assuming PA may enhance health after TBI, older adults are a logical target for prevention or early intervention studies. Studies with longer outcomes are needed to understand the trajectory of PA levels after TBI.
Descemet Membrane Endothelial Keratoplasty for Endothelial Failure in Primary Angle Closure Suspects
Authors: Roy-Chowdhury Eva , Angerer Maximilian P. M. , Schlötzer-Schrehardt Ursula , Tourtas Theofilos , Kruse Friedrich E. , Weller Julia M.
Published: June 2024

Purpose:

To analyze the feasibility and outcome of Descemet membrane endothelial keratoplasty (DMEK) for treatment of endothelial failure in primary angle closure suspect (PACS) eyes.

Methods:

Retrospective, single-center case series of eyes treated by DMEK for endothelial failure caused by PACS. Main study parameters were success rate of DMEK, best-corrected visual acuity, anterior chamber depth, central corneal thickness, and endothelial cell density. Mean follow-up time was 16 ± 13 months.

Results:

Ten eyes of 9 patients receiving DMEK for the treatment of corneal endothelial failure because of PACS were included. Except for 2 eyes that had undergone cataract surgery, none of the eyes had previous ocular surgery. DMEK combined with cataract surgery was performed in 5 eyes, DMEK alone with second-step cataract surgery in 2 eyes. The eyes with corneal edema after cataract surgery received DMEK only. DMEK surgery was successful in nine out of 10 eyes, 1 patient required repeat DMEK because of primary graft failure. In the group of phakic eyes, mean preoperative internal anterior chamber depth was 1.74 ± 0.18 mm. In eyes with corneal edema, central corneal thickness was 849 ± 205 μm before DMEK surgery, and 517 ± 24 μm at the final postoperative visit (P = 0.002).

Conclusions:

DMEK is a feasible option in eyes with endothelial failure because of primary angle closure. In case of advanced corneal edema, a second-step procedure (first DMEK, second cataract surgery) is a possible approach if visibility of the lens is too poor for simultaneous cataract surgery.
Enterobacter Cloacae Cardiac Implantable Electronic Device Infection
Authors: Fanucci Victoria , Chauhan Dhaval , Mascio Christopher E. , Arora Sandeep , Gupta Shipra , Weisse Martin E. , Kohli Utkarsh
Published: June 2024

Enterobacter cloacae cardiac implantable electronic device infections are rare but can be associated with significant morbidity and mortality. We report an 11-year-old female with Enterobacter cloacae infection of a dual-chamber transvenous pacemaker pocket. The report is supplemented by a comprehensive review of the literature on Enterobacter cloacae cardiac implantable electronic device infections.
Comparison of Hepatitis B Surface Antibody Levels After Vaccination With Combined One Dose of Hexavalent Vaccine and Two Doses of Pentavalent Vaccine Versus Three Doses of Pentavalent Vaccine
Authors: Soonthornarrak Kantron , Limrungsikul Anchalee , Apiwattanakul Nopporn
Published: June 2024

Background:

Vaccination can effectively prevent hepatitis B virus (HBV) infection. Vaccination with 3 doses of hexavalent HBV-containing vaccines led to a higher Hepatitis B surface antibody (anti-HBs) antibody level than vaccination with 3 doses of pentavalent HBV-containing vaccines. Whether the substitution of one dose of hexavalent HBV-containing vaccine in the pentavalent regimen could lead to a higher anti-HBs antibody level remains unknown.

Methods:

A randomized, open-label controlled trial was conducted. Infants 30–120 days of age were randomly assigned to either a combined hexavalent/pentavalent regimen (hexavalent HBV-containing vaccine at 2 months of age and pentavalent HBV-containing vaccine at 4 and 6 months of age) or a 3-dose pentavalent regimen (pentavalent HBV-containing vaccine at 2, 4, and 6 months of age). Anti-HBs antibody levels were measured 3–6 months after the last vaccination.

Results:

Seventy-six infants were enrolled, 38 in each group. The geometric mean of anti-HBs antibody levels in the combined hexavalent/pentavalent group was significantly higher than that of the 3-dose pentavalent group [316.2 mIU/mL (95% CI: 173.8–575.4 mIU/mL) versus 81.3 mIU/mL (95% CI: 38.9–169.8 mIU/mL), P = 0.006]. By multivariate analysis, the combined hexavalent/pentavalent regimen (coefficient 0.57; P = 0.003) was associated with higher anti-HBs antibody levels, while body weight <10th percentile (coefficient −0.85; P = 0.006) and receiving concomitant pneumococcal conjugated vaccines (coefficient −0.65; P = 0.001) were associated with lower anti-HBs antibody levels.

Conclusion:

Substituting the first dose with a hexavalent HBV-containing vaccine in the pentavalent regimen for HBV vaccination led to higher anti-HBs antibody levels in infants. Concomitant pneumococcal conjugated vaccine administration may have an adverse impact on anti-HBs antibody level.
Treatment Outcomes and Associated Factors of Intravenous Colistin for Nosocomial Infections in Pediatric Patients: A Retrospective Study in a University Hospital in Thailand
Authors: Khamlek Sunisa , Lucksiri Aroonrut , Sunkonkit Kanokkarn , Oberdorfer Peninnah , Sukwuttichai Pattarapan
Published: June 2024

Background:

This study aimed to investigate the efficacy and safety of intravenous colistin in pediatric patients with nosocomial Gram-negative bacteria infections and to determine factors associated with treatment outcomes.

Methods:

This retrospective study recruited patients <18 years of age receiving intravenous colistin between January 2014 and December 2018. Clinical data and treatment outcomes were reviewed, and factors associated with treatment outcomes were assessed.

Results:

This study included 178 patients with a median age of 3.4 years (range, 0.1–17.8). The mean ± SD dose of colistin prescribed to patients without renal impairment was 5.1 ± 0.6 mg/kg/day. The clinical response rate was 70.8% in patients receiving colistin for specific treatment. Infection-related mortality and crude mortality were 17.5% and 19.7%, respectively. The nephrotoxicity rate was 29.8%; approximately 70% of the episodes occurred between the 3rd and 7th day of treatment. The presence of at least 2 organ dysfunctions [adjusted hazard ratio (aHR): 7.17; 95% CI: 1.64–31.40], septic shock (aHR: 2.69; 95% CI: 1.36–5.32) and receiving chemotherapy/immunosuppressants (aHR: 2.68; 95% CI: 1.36–5.25) were observed to be associated with clinical failure. The factors observed to be associated with nephrotoxicity included hypoalbuminemia (aHR: 2.93; 95% CI: 1.26–6.78), receiving amphotericin B (aHR: 2.29; 95% CI: 1.16–4.52), vancomycin (aHR: 3.36; 95% CI: 1.50–7.56) and vasopressors (aHR: 2.57; 95% CI: 1.27–5.21).

Conclusion:

Colistin is generally effective in the treatment of nosocomial Gram-negative bacteria infections in pediatric patients. Close monitoring of renal function should be considered, especially in high-risk patients. Optimal dosage regimens for pediatric populations to promote more favorable clinical outcomes and minimize nephrotoxicity require further investigation.
Cost-effectiveness of low-astigmatism correction with toric or spherical intraocular lenses combined with corneal incisions: an economic evaluation
Authors: Ginel José , Rodríguez-Vallejo Manuel , Piñero David , Sáez-Martín Alejandro , Haro De Rosario Arturo , Fernández Joaquín
Published: June 2024

Purpose:

To assess the cost-effectiveness of the treatment of low corneal astigmatism (≤1.5 diopters) at the moment of cataract surgery.

Setting:

Qvision, Ophthalmology Department, VITHAS Almería Hospital, Spain.

Design:

Economic evaluation.

Methods:

A decision tree was used to assess the cost-effectiveness of implanting spherical vs toric intraocular lenses (IOLs) or spherical lens combined with the following corneal incisions: limbal-relaxing incisions conducted manually (M-LRI) or assisted by femtosecond laser (F-LRI), arcuate keratotomies conducted manually (M-AK) or assisted by femtosecond laser (F-AK), and intrastromal arcuate keratotomies (F-iAK). Outcomes of cost were selected from a patient perspective considering the gross cost of each one of the surgeries at European centers, and the effectiveness variable was the probability of achieving a visual acuity of 20/20 postoperatively. A sensitivity analysis was conducted to assess the uncertainty considering the evidence retrieved from the transition probabilities of the model, effectiveness, and cost.

Results:

F-AK or toric IOLs were the most effective treatments, increasing an 16% or 9%, respectively, in the percentage of eyes attaining 20/20 vision. The M-LRI, F-iAK, and F-LRI procedures were strongly dominated while the M-AK and toric IOL were weakly dominated by the F-AK. A patient with low corneal astigmatism would need to be willing to pay 360€ (95% CI, 231-1224) with F-AK and 472€ (95% CI, 149-4490) with toric IOLs for a 10% increase in the probability of achieving 20/20 vision.

Conclusions:

From patient perspective, F-AK was generally the most cost-effective treatment, although toric IOLs can dominate in some countries.
Temporal trends and projections in the global burden of neck pain: findings from the Global Burden of Disease Study 2019
Authors: Cheng Siqing , Cao Jin , Hou Leying , Li Shuting , Sun Weidi , Shan Shiyi , Zhao Jianhui , Yao Lingzi , Li Xue , He Bin , Song Peige
Published: June 2024

Data were obtained from the Global Burden of Disease study 2019. Joinpoint regression model was used to analyze the temporal trends from 1990 to 2019 of neck pain burden, focusing on age-standardized incidence rates, age-standardized prevalence rates, and age-standardized years lived with disability (YLDs) rates at the global, regional, and national levels. The age–period–cohort analysis was used to estimate the effects of age (5-99 years), period (1990-2019), and cohort (1893-2012) at the global, regional, and national levels. Future projections for the global burden of neck pain from 2020 to 2044 were estimated using the nordpred age–period–cohort model. From 1990 to 2019, the global incidence, prevalence cases, and YLDs counts of neck pain have increased by 71.89%, 98.21%, and 78.17%, respectively. The joinpoint analysis indicated significant shifts in the global trends of age-standardized neck pain burden, which varied across regions and nations. The age–period–cohort model indicated that the neck pain burden was predominantly concentrated in middle-aged and older age, with period and cohort effects showing minimal variation from 1990 to 2019. Compared with 2019, the incident cases, prevalent cases, and YLDs counts of neck pain were projected to increase by 134%, 142%, and 140% by 2044. The global burden of neck pain has persisted at a relatively elevated level from 1990 to 2019, with projections indicating a continuing upward trend. Future research is urgently needed to better understand the predictors and clinical course of neck pain and to enhance prevention and management strategies.
Frequent Error Augmentation Training in Physical Therapy Post Stroke
Authors: Farrelly Sinead , Boan Andrea D. , Hartnett John , Monsch Emily , Hartis Audrey , Bowden Mark , Kautz Steve , Holmstedt Christine
Published: June 2024

Background:

The purpose of this pilot trial was to evaluate the impact of increased frequency of physical therapy sessions with error augmentation on functional mobility and disability outcomes in patients with acute stroke. We hypothesized that participants receiving frequent error augmentation physical therapy interventions (F-EA-PT) would demonstrate a higher degree of improvement on functional mobility and disability measures from admission to two post-intervention time points (treatment day 3, discharge, or 90-day follow-up).

Methods:

We allocated 100 individuals to receive either F-EA-PT or standard-of-care physical therapy (SOC-PT). The F-EA-PT group received physical therapy with error augmentation twice daily for 3 out of the first 5 days of hospitalization, and daily treatment sessions thereafter. Error augmentation training emphasizes impairments throughout mobility to challenge the individual, rather than facilitating normal movement patterns. The SOC-PT group received treatment once daily for 3 to 5 days per week. Assessments included National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Activity Measure for Post-Acute Care (AM-PAC), and Postural Assessment Scale for Stroke (PASS). A repeated measures mixed model approach compared treatment groups for all outcomes.

Results:

The F-EA-PT group demonstrated larger magnitudes of reduction of − 1.34 on NIHSS (P = .0426) and − 0.81 on mRS (P = .0037) from admission to 90-day follow-up compared to the SOC-PT group. The F-EA-PT group demonstrated larger magnitudes of change in AM-PAC of 2.12 at treatment day 3 (P = .0009) and 2.75 at discharge (P < .0001) compared to SOC-PT. F-EA-PT group experienced greater improvement in PASS over the SOC-PT group with a difference in change of 4.08 at treatment day 3 (P = .0019) and 4.45 at discharge (P = .001).

Conclusions:

Intervening with a regimen focused on increased frequency and error augmentation from a physical therapy standpoint was safe with only one adverse event and demonstrated significant improvements in functional outcomes post stroke above those seen with the standard-of-care regimen, as evidenced by PASS and AM-PAC scores.
Occurrence of Dysrhythmias During Ventilatory Weaning and Its Association With Length of Mechanical Ventilation and In-hospital Complications
Authors: Hammash Muna H. , Moser Debra K.
Published: June 2024

Background

The occurrence of cardiac dysrhythmias during ventilatory weaning and its impact on the length of ventilation and occurrence of complications have not been systematically investigated.

Objectives

The aim of this study was to evaluate the association between cardiac dysrhythmias during weaning and the duration of ventilation and complications during ventilator weaning.

Method

Data on the length of ventilation and complications were collected from the medical records of 30 mechanically ventilated patients. Continuous electrocardiographic recordings were collected at baseline and during the initial weaning trial. Multiple regression analysis was used to evaluate the association between dysrhythmias and length of ventilation. The relationship between prolonged ventilation and complications was assessed using the χ2 analysis.

Results

Supraventricular ectopic beats during weaning positively predicted the length of ventilation (P < .01). Prolonged ventilation (>7 days) is associated with the occurrence of renal insufficiency and septicemia.

Conclusion

The association between the occurrence of supraventricular ectopic beats during ventilator weaning and the length of ventilation requires further evaluation and tailored management to improve patient outcomes.
Diving Into Sports Specialization: The Association of Early Specialization on Injury Rates in Youth to Young Adult Divers
Authors: Lenz Annika , Provance Aaron , Johnson Luke August , Teramoto Masaru
Published: June 2024

Objectives:

This study explored the link between early sports specialization and injury rates in youth divers, a relationship that remains largely unexplored within diving.

Design:

Cross-sectional survey.

Setting:

Members of the USA Diving Organization and collegiate male and female divers participated in an online survey, reporting their sports involvement and injury history.

Participants:

One hundred eighty-two male and female divers aged 8 to 25 years were recruited through USA Diving or US collegiate team databases.

Independent Variables:

Early/late specialization (based on age <12 or 12 years or older), gender (M/F), springboard and/or platform divers, experience (junior/senior, regional/zone/national/international), hours of dryland/water training, and prior sport exposure.

Main Outcome Measures:

Injury history obtained on questionnaire.

Results:

One hundred eighty-two divers were surveyed; 70% female. Age to start diving and age to concentrate solely on diving were significantly associated with certain injuries (P < 0.05). Beginning diving before age 13 years of age was significantly associated with lower odds of injuries in the shoulder and wrist (P = 0.013 and 0.018, respectively), after adjusting for select covariates. Age of specialization was not significantly associated with injuries in any body part (P > 0.05), after adjusting for covariates. Greater years of diving experience was significantly associated with diving injuries in all 11 body parts (P < 0.05).

Conclusions:

This study indicates that early sports specialization is associated with decreased injury rates in elite youth divers who specialized before age 13 years, particularly for head/neck, shoulder, and wrist injuries. Moreover, we observed a positive correlation between experience and injury rate. Further investigation should focus on distinguishing between acute and overuse injuries.
Heterotopic ossification Post-Guillain–Barre syndrome in Saudi Arabia: a case report
Authors: Aldhilan Mansour M. , Alshahrani Abdullah H.
Published: June 2024

Background:

Heterotopic ossification (HO) is the formation of bone within the soft tissues. It can be a complication of Guillain–Barre syndrome (GBS). There are many risk factors for HO, including male sex, mechanical ventilation, and neurogenic trauma. Myelin and axons are the main targets and areas of injury in GBS, an autoimmune-inflammatory neuropathy. Literature shows that this may possibly be associated with the initial administration of the COVID-19 vaccine and GBS.

Presentation of the case:

A 27-year-old male was diagnosed with bile reflux gastritis. Days later, he presented to the emergency room (ER) with progressive weakness and a critical condition that required ICU. The patient undergoes intubation and remains in the ICU for 4 months. The patient, after extensive rehabilitation, started to complain of left hip pain and limitations of motion. Radiographs confirmed the HO diagnosis. Past drug history showed patients received a single dose of the COVID-19 vaccine 15 days before presentation to the ER.

Discussion:

There is no clear association between the COVID-19 vaccination and GBS. HO is the formation of abnormal bone within soft tissue. HO post-GBS usually affects large joints like the hips, knees, and shoulders. Researchers poorly understand the pathogenesis of GBS.

Conclusion:

Despite the absence of a definitive correlation between GSB and the COVID-19 vaccine. Physicians should maintain a state of suspicion while treating patients with a progressive weakness. Additional research is required.
Hoffa’s fat pad ganglion cyst of the knee: a case report of a rare cause of knee pain and swelling
Authors: Khadka Sabir K. , Banmala Sabin , Pandey Ashmita , Pandey Rakshya , Khadka Sushant K.
Published: June 2024

Introduction and importance:

Hoffa’s fat pad (HFP), also known as infrapatellar fat pad, is one of the three fat pads in the knee. Ganglion cyst (GC) rarely arises from HFP which presents knee pain and swelling.

Case presentation:

A 43-year-old female presented with left knee pain for 1 year and swelling in her left knee for 6 months. Clinical examination revealed a palpable swelling of size around 3 cm×2 cm over the anteromedial aspect of the left knee. The size of the swelling increased on extension and decreased on flexion of the knee. A musculoskeletal ultrasound of the left knee revealed a lobulated anechoic lesion of size ∼2.3 cm×2 cm in HFP. Open excision of cystic mass through medial parapatellar approach was done, and histopathological examination showed findings consistent with GC. At 6 months follow-up, there was no residual swelling and no recurrence. She was symptom-free on her recent evaluation after 1 year of operation.

Clinical discussion:

GCs arising from HFP are much rarer among the cysts around the knee. Diagnosis is primarily done by magnetic resonance imaging. However, the use of ultrasonography has grown in the diagnosis of the GC. Among different modalities of treatment, open excision is the most recommended to prevent recurrence and incomplete resection.

Conclusions:

This case illustrates the importance of ultrasonography in the early diagnosis of HFP GC and reserving more costly and time-consuming imaging modality magnetic resonance imaging for localizing the extent of the cyst. We recommend an open resection to avoid recurrence and incomplete resection of the cyst.
Lessons Learned From Data Falsification During an Academic Course Using A Root-Cause Analysis
Authors: Silvern Racheli , Shvartsur Rachel , Kagan Ilya , Savitsky Bella
Published: June 2024

Background:

Fabricating data or creating fictitious datasets undermines research credibility with severe consequences.

Purpose:

To describe a data falsification incident that occurred during an undergraduate nursing research seminar and share the subsequent corrective measures employed at individual and class levels.

Methods:

The students involved in the falsification were asked to identify the incident’s factors using an Ishikawa diagram and the 5M-Model approach, presenting their findings to the class.

Results:

In guided meetings, students offered diverse perspectives on the incident’s causes, thoroughly examining the decision-making process behind data falsification, considering motives and emotions. Despite initial tension, the atmosphere improved as students displayed openness and honesty.

Conclusions:

The current case study uniquely combines educational concepts with an approach to establishing a constructive organizational culture, incorporating tools from risk management and treatment safety. Academia should study adverse events, engage students in learning, and emphasize the integration of ethical codes in academia and nursing.
Comparative Whole-Genome Sequencing Analysis of In-situ and Invasive Acral Lentiginous Melanoma
Authors: Park Hyung Keon , Choi Yoo Duk , Shim Hyun Jeong , Choi Yoonjoo , Chung Ik Joo , Yun Sook Jung
Published: June 2024

Acral lentiginous melanoma (ALM) is the most common subtype of acral melanoma. Even though recent genetic studies are reported in acral melanomas, the genetic differences between in-situ and invasive ALM remain unclear. We aimed to analyze specific genetic changes in ALM and compare genetic differences between in-situ and invasive lesions to identify genetic changes associated with the pathogenesis and progression of ALM. We performed whole genome sequencing of 71 tissue samples from 29 patients with ALM. Comparative analyses were performed, pairing in-situ ALMs with normal tissues and, furthermore, invasive ALMs with normal and in-situ tissues. Among 21 patients with in-situ ALMs, 3 patients (14.3%) had SMIM14, SLC9B1, FRG1, FAM205A, ESRRA, and ESPN mutations, and copy number (CN) gains were identified in only 2 patients (9.5%). Comparing 13 invasive ALMs with in-situ tissues, CN gains were identified in GAB2 in 8 patients (61.5%), PAK1 in 6 patients (46.2%), and UCP2 and CCND1 in 5 patients (38.5%). Structural variants were frequent in in-situ and invasive ALM lesions. Both in-situ and invasive ALMs had very low frequencies of common driver mutations. Structural variants were common in both in-situ and invasive ALMs. Invasive ALMs had markedly increased CN gains, such as GAB2, PAK1, UCP2, and CCND1, compared with in-situ lesions. These results suggest that they are associated with melanoma invasion.
The Hope and Reality of Pain Relief Using Psychological Manipulations
Authors: Derbyshire Stuart W.G.
Published: June 2024

Many patients suffer from chronic pain despite the absence of injury or sufficient biomedical disease to explain their pain. These pains are highly resistant to treatment. Psychological therapies designed to help patients undermine the negative thought and behavioral patterns that maintain pain provide only modest pain relief, leading to suspicion that such pain might be maintained by unconscious processes. An article in this issue of Psychosomatic Medicine provides the first experimental evidence that unconscious negative memories can increase pain unpleasantness. These findings are exciting, but the effect sizes are small, which is consistent with the small effects of psychological therapy. It seems that pain stubbornly resists psychological manipulation, but this work provides some hope that psychological therapy for pain can be improved to provide more effective pain relief.
Evolution of Pancreas Transplantation At A Single Institution—50+ Years and 2500 Transplants
Authors: Finger Erik B. , Matar Abraham J. , Dunn Ty B. , Humar Abhinav , Gruessner Angelika C. , Gruessner Rainer W.G. , Ramanathan Karthik , Humphreville Vanessa , Matas Arthur J. , Sutherland David E.R. , Kandaswamy Raja
Published: June 2024

Objective:

To describe the evolution of pancreas transplantation, including improved outcomes and factors associated with improved outcomes over the past 5 decades.

Background:

The world’s first successful pancreas transplant was performed in December 1966 at the University of Minnesota. As new modalities for diabetes treatment mature, we must carefully assess the current state of pancreas transplantation to determine its ongoing role in patient care.

Methods:

A single-center retrospective review of 2500 pancreas transplants was performed over >50 years in bivariate and multivariable models. Transplants were divided into 6 eras; outcomes are presented for the entire cohort and by era.

Results:

All measures of patient and graft survival improved progressively through the 6 transplant eras. The overall death-censored pancreas graft half-lives were >35 years for simultaneous pancreas and kidney (SPK), 7.1 years for pancreas after kidney (PAK), and 3.3 years for pancreas transplants alone (PTA). The 10-year death-censored pancreas graft survival rate in the most recent era was 86.9% for SPK recipients, 58.2% for PAK recipients, and 47.6% for PTA. Overall, graft loss was most influenced by patient survival in SPK transplants, whereas graft loss in PAK and PTA recipients was more often due to graft failures. Predictors of improved pancreas graft survival were primary transplants, bladder drainage of exocrine secretions, younger donor age, and shorter preservation time.

Conclusions:

Pancreas outcomes have significantly improved over time through sequential, but overlapping, advances in surgical technique, immunosuppressive protocols, reduced preservation time, and the more recent reduction of immune-mediated graft loss.
Characterizing Seizure-Onset Patterns With the Responsive Neurostimulation System
Authors: Haneef Zulfi , Vallera Alexandra Celine , Vedantam Sameera , Feygin Maximillian S. , Cleboski Stephen , Gavvala Jay R.
Published: June 2024

Purpose:

The responsive neurostimulation system (RNS) aims to improve seizures by delivering electrical stimulation in response to epileptiform patterns detected by electrocorticograms. Seizure-onset patterns (SOPs) correspond to outcomes in intracranial EEG (IC-EEG), although whether this is true for RNS is unknown. This study characterizes common RNS SOPs and correlates them with seizure outcomes.

Methods:

Among 40 patients with RNS implants, long-episode electrocorticogram characteristics of each patient's seizures were classified by visual analysis as one of the eight patterns previously described in IC-EEG. Correlation between each type of SOP and eventual seizure outcome was analyzed, with ≥50% improvement in a number of patient-reported seizure counts defined as a favorable outcome.

Results:

Across 263 LEs analyzed, the most common SOP observed was low-voltage fast activity. There was no difference between the distribution of RNS SOPs and that of IC-EEG SOPs described in the literature (Kolmogorov–Smirnov test, P = 0.98). Additionally, there was no correlation between any particular SOP and favorable outcomes (Fisher's omnibus test, P = 0.997).

Conclusion:

This initial description of RNS SOPs finds them to be similar to previously described IC-EEG SOPs, which suggests similar prognostic/therapeutic potential. However, we found that RNS efficacy is independent of patient SOP, suggesting that RNS is likely an equally effective treatment for all SOPs. Future research on stimulation parameters for particular RNS SOPs and correlation with IC-EEG SOPs in the same patients would be instrumental in guiding personalized neurostimulation.
Mycotic Aneurysms: Uncommon Pathogens and Treatment Conundrums
Authors: Ravindra Akshatha , Naguthevar Santhanam , Kumar Deepak , Rajagopal Rengarajan , Khera Pushpinder Singh , Tak Vibhor , Ramankutty Neetha Thayil , Meena Durga Shankar , Midha Naresh , Bohra Gopal Krishana , Garg Mahendra Kumar
Published: June 2024

Introduction

Mycotic aneurysms, characterized by vessel wall dilation resulting from infections including bacteria, fungi, and viruses, are a rare yet severe consequence of systemic infections.These aneurysms, accounting for 0.6% of Western countries' aneurysms, carry a higher risk of rupture compared to uninfected conditions. While the femoral artery, aorta, and intracranial visceral arteries are commonly affected, pathogens causing mycotic aneurysms vary across regions. Diagnostic challenges arise from nonspecific symptoms such as fever, pulsatile mass, local discomfort, and arterial inflammation.

 

Materials & Methods:
The case series involves three patients diagnosed with mycotic aneurysms due to unusual pathogens. We describe each patient's clinical presentation, medical history, physical examination findings, laboratory results, imaging studies, and the diagnostic process leading to the identification of the causative pathogens.

Results

The first case depicts a 70-year-old male with a ruptured infra-renal abdominal aortic pseudoaneurysm caused by Salmonella Paratyphi A. The second case involves a 66-year-old male with a Streptococcus pneumoniae-associated descending thoracic aortic pseudoaneurysm. The third case pertains to a 70-year-old male with a ruptured descending thoracic aortic aneurysm into the esophagus due to Pseudomonas aeruginosa infection. Each case highlights unique clinical features, laboratory findings, imaging results, and the management approaches undertaken.

Conclusion

Mycotic aneurysms, stemming from infections involving diverse pathogens, pose diagnostic challenges due to their nonspecific symptoms. Early identification and intervention are essential to mitigate the severe complications associated with these aneurysms. The presented cases underscore the need for a comprehensive approach to diagnosis and management, ensuring optimal outcomes for patients affected by mycotic aneurysms.
Evaluation of welfare indicators for companion parrots: a Delphi consultation survey
Authors: Piseddu Andrea , van Zeeland Yvonne R. A. , Rault Jean-Loup
Published: June 2024

Parrots can experience several welfare challenges when kept as companions. Despite their popularity no science-based guidelines are available to assess parrot welfare. The aim of this Delphi study was to evaluate welfare indicators that owners could use to monitor parrot welfare. One hundred and twenty-two potential welfare indicators (behaviours, body measurements, husbandry and management conditions) were sourced from a systematic literature review and by consulting an avian medicine specialist. They were presented to participants with expertise on parrots in two rounds of online survey. We identified 73 welfare indicators that could be used by owners to monitor the welfare of all/most parrot species. Abnormal behaviours and management conditions that allow parrots to express their natural behaviours were ranked among the most important indicators. Participants concurred with scientific evidence about the impact of diet, species susceptibility to develop behavioural problems, early life, and pre-acquirement experiences on parrot welfare. When inquired about the suitability of species as companions, participants indicated seven small-sized species as most suitable to keep as a companion parrot, while cockatoos, critically endangered, and highly trafficked species were evaluated as those that should not be kept as companions. These findings could be useful to monitor and improve parrot welfare.
Simplest Model of Nervous System. III. Partial Optimization
Authors: Sinitskiy Anton V.
Published: June 2024

This paper extends our previous work on the simplest model of a nervous system by providing an asymptotic analysis of the evolutionarily optimal solution in this model. Building on the formalism and principles established earlier, we derive an asymptotic solution to the Fokker-Planck-Kolmogorov equation for a given dynamical equation for the state of the neuron. This solution provides the stationary probability distribution for the position of an organism in its environment and the state of its nervous system. Next, exact and asymptotic solutions for the optimal motor and sensory responses to the approach of a predator are derived. These results align with biological expectations and provide a robust mathematical framework for predicting the behavior of simple nervous systems.
LooMS: a novel peptide identification tools for data independent acquisition
Authors: Zhong Jiancheng , Wu Jia Rong , Zeng Xiangyuan , Moran Michael , Ma Bin
Published: June 2024

Advancements in mass spectrometry (MS)-based proteomics have produced large-scale datasets, necessitating the development of effective tools for peptide identification. Here, we present LooMS, a novel tool specifically designed for identifying peptides in data-independent acquisition (DIA) datasets. LooMS employs an innovative approach, using an unbiased generation strategy for positive and negative samples, which reduces the risk of overfitting in peptide identification with deep learning models. Additionally, LooMS addresses various critical aspects of DIA mass spectra data analysis, constructing a comprehensive set of 43 features for training deep learning models, which cover different stages of DIA data analysis. Notably, we propose a false discovery rate (FDR) control strategy that integrates results from both LooMS and DiaNN, another leading peptide identification tool. Our results demonstrate significant improvements in peptide identification performance, with enhancements of 40.61% and 26.60% at the unique peptide level for human and mouse datasets, respectively.

Highlights

LooMS is a novel tool for identifying peptides in DIA datasets that adopts an innovative unbiased positive and negative sample generation strategy, which aim to avoid the overfilling in peptide identification with deep learning model.

LooMS comprehensively considers various aspects of data analysis for DIA mass spectra and builds 43 useful features for training deep learning models, which involve different stages of DIA data analysis.

A FDR control strategy for integration of results from both LooMS and DiaNN is proposed, which can significantly improve the identification of peptides due to the differences in the features involved in peptide detection during their respective design.
The chemical chaperone 4-phenylbutyric acid rescues molecular cell defects ofCOL3A1mutations that cause vascular Ehlers Danlos Syndrome
Authors: Omar Ramla , Lee Michelle , Gonzalez-Trueba Laura , Lianos Spyridonas , Hazarika Snoopy , Ammar Malak A , Cassels Jennifer , Michie Alison M. , Bulleid Neil J , Malfait Fransiska , Agtmael Tom Van
Published: June 2024

Purpose

Vascular Ehlers Danlos Syndrome (vEDS) is a connective tissue disorder caused byCOL3A1mutations for which there are no treatments due to a limited understanding of underlying mechanisms. We aimed to address this critical knowledge gap, focusing on collagen folding, to establish if targeting protein folding represents a potential therapeutic approach.

Methods

We performed a mechanistic analysis of two novelCOL3A1glycine mutations, G189S and G906R, using primary patient fibroblast cultures, and performed pre-clinical proof-of-concept treatments using FDA-approved chemical chaperones targeting protein folding and/or degradation.

Results

COL3A1mutations caused secretion of misfolded collagen III and intracellular collagen retention, leading to matrix defects and endoplasmic reticulum (ER) stress, with increased severity for the more C-terminal mutation. Promoting ER protein folding capacity through the chemical chaperone 4-phenylbutyric acid rescued the ER stress, thermostability of secreted collagen, matrix defects and apoptosis. Optimising treatment duration and dosage helped overcome allele-dependent treatment efficacy. In contrast, protein degradation alone or combined with targeting protein folding did not increase efficacy.

Conclusion

ER stress is a molecular mechanism in vEDS that can be influenced by the position ofCOL3A1mutation, and promoting protein folding is a putative mechanism-based therapeutic approach that can rescue intra- and extracellular defects.
A roadmap for fair reuse of public microbiome data
Authors: Hug Laura A , Hatzenpichler Roland , Moraru Cristina , Soares Andre , Meyer Folker , Heyder Anke , Probst Alexander J
Published: June 2024

Science benefits from rapid, open data sharing but samples for sequencing data are expensive for data creators to acquire and process. Current guidelines for data reuse were established two decades ago, when databases were several million times smaller, necessitating an update. This article presents a roadmap to establish best practices for sequence data reuse, developed in consultation with a data consortium of 167 microbiome scientists. It introduces a Data Reuse Information tag (DRI) for public sequencing data, which will be associated with at least one Open Researcher and Contributor ID (ORCID) account. The machine-readable DRI tag indicates that the data creators prefer to be contacted prior to data reuse, and simultaneously provides data consumers with a mechanism to get in touch with the data creators. Ideally, the DRI will facilitate and foster collaborations, and serve as a guideline that can be expanded to other data types.
Keetia magassoubiana sp.nov. (Rubiaceae - Vanguerieae) a threatened evergreen forest climber of West Africa
Authors: Cheek Martin , Bowden-Pickstock Joel
Published: June 2024

Keetia magassoubianaCheek, an evergreen rainforest climber, is described and illustrated from the Republic of Guinea, Sierra Leone, Liberia and Ivory Coast. Previously indicated as being close to but different fromKeetia tenuiflora(Hiern) Bridson, it differs in the glossy black, glabrous, epidermis of the distal stem internodes, the first internode rarely with very sparse red adpressed hairs (vs epidermis pale white-brown, dense pale yellow spreading hairs) and abaxial leaf surface with domed domatia with a central aperture (vs domatia absent or obscure), the secondary stem leaf bases acute (vs obtuse to truncate), the bracts forming a laciniate sheath on the distal peduncle (vs two opposite triangular bracts), the pyrene surface honeycombed with pits (vs entire). The species was earlier included withinCanthium multiflorum(Schum. & Thonn.) Hiern (nowK. multiflora(Schum. & Thonn.) Bridson) in the Flora of West Tropical Africa second edition. An updated key is presented to the 16 species of the genus from West Africa.

Keetia magassoubianais provisionally assessed using the IUCN standard as Endangered EN B1ab(iii) due to only five of the recorded 14 locations having extant forest habitat, and because of ongoing threats of habitat clearance mainly for agriculture, but also mining.
Identifying conservation priorities of a pantropical plant lineage: a case study in Scleria (Cyperaceae)
Authors: Díaz Javier Galán , Bachman Steven P. , Forest Félix , Escudero Marcial , Rotton Hannah , Larridon Isabel
Published: June 2024

Scleriais a pantropical genus of annual and perennial herbs and the sixth largest genus in the Cyperaceae family with around 261 species. In this study, we produced preliminary extinction risk assessments for the ∼30% ofScleriaspecies that do not yet have a global Red List assessment and followed the Evolutionarily Distinct and Globally Endangered (EDGE2) and Ecologically Distinct and Globally Endangered (EoDGE) protocols to identify evolutionary and ecologically uniqueScleriaspecies at greatest risk of extinction and hotspots of rare and endangered species. Our results indicate that 38 of the 78Scleriaspecies not yet included in the Red List, and 26% of species in the genus, are potentially threatened with extinction. The risk of extinction is not equally distributed across the phylogeny, and the Afrotropics and the Neotropics accumulate most threatened species. Eleven ecoregions mostly from four African (Madagascar, D.R. Congo, Zambia and Tanzania) and two South American (Brazil, Venezuela) countries accumulate almost half ofScleriaspecies and stand out in terms of their sum of EDGE2 scores. Phylogenetic and functional distinctiveness metrics were largely uncorrelated, and the EcoDGE metric mostly points towards South American countries as reservoirs of ecologically distinctive and endangered species: Brazil, Venezuela, Bolivia, Peru, Colombia, Guyana and Dominican Republic. Recent methodological advances in the identification of species at-risk of extinction and the novel EDGE2 framework emerge as powerful tools to identify conservation priorities.
Digital Immunoassay for Rapid Detection of SARS-CoV-2 Infection in a Broad Spectrum of Animals
Authors: Li Siyan , Wang Weijing , Liu Weinan , Chen Chi , Shephard Skye , Yuan Fangfeng , Reinhart Jennifer M. , Diel Diego , Cunningham Brian T. , Fang Ying
Published: June 2024

The ability of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) to infect a wide-range of species raises significant concerns regarding both human-to-animal and animal-to-human transmission. There is an increasing demand for highly sensitive, rapid, and simple diagnostic assays that can detect viral infection across various species. In this study, we developed a biosensor assay that adapted a monoclonal-antibody (mAb)-based blocking ELISA format into an Activate Capture + Digital Counting (AC + DC)-based immunoassay. The assay employs a photonic crystal (PC) biosensor, gold-nanoparticle (AuNP) tags, SARS-CoV-2 nucleocapsid (N) protein, and specific anti-N mAb to detect antibody responses in animals exposed with SARS-CoV-2. We demonstrated a simple 2-step 15-min test that was capable of detecting as low as 12.5 ng of antibody in controlled standard serum samples. Based on an evaluation of 176 cat serum samples with known antibody status, an optimal percentage of inhibition (PI) cut-off value of 0.588 resulted in a diagnostic sensitivity of 98.3% and a diagnostic specificity of 96.5%. The test is highly repeatable with low variation coefficients of 2.04%, 2.73%, and 4.87% across different runs, within a single run, and on a single chip, respectively. The test was further employed to detect antibody responses in multiple animal species as well as investigate dynamics of antibody response in experimentally infected cats. This test platform provides an important tool for rapid field surveillance of SARS-CoV-2 infection across multiple species.
Stable platelet production via the bypass pathway explains the long-term reconstitution capacity of hematopoietic stem cells
Authors: Iwanami Shoya , Sato Toshiko , Haeno Hiroshi , Xu Longchen , Imamura Keimyo , Ooehara Jun , Lan Xun , Nakauchi Hiromitsu , Iwami Shingo , Yamamoto Ryo
Published: June 2024

Precise understanding how hematopoietic stem cells (HSCs) differentiate in vivo is difficult because we can not trace the in vivo differentiation of HSCs. The single-cell transplantation assay and our own paired daughter cell assay of phenotypic HSCs has revealed the presence of HSCs with reconstitution capacity whose differentiation potential is restricted to the myeloid lineage (MySCs) and the presence of novel direct differentiation pathway form HSCs to MySCs (named myeloid bypass pathway). However, how HSCs differentiate in vivo during hematopoiesis has remained unclear since the paired daughter cell assay was performed partially ex vivo. Aiming to characterize HSCs, including the myeloid bypass pathway, we examined the kinetics of HSC differentiation using a mathematical model. We analyzed data from single-cell transplantation assays in which five blood cell lineages were followed successively after transplantation. An age-related skewing to the myeloid lineage was quantitatively indicated as the production of B cells reduced with age. Dependence on platelet bypass increased with aging and consistently high dependence was associated with long-term reconstitution capacity of the HSCs. Focusing on the ratio of chimerism among cell lineages, the characteristics of dependence on platelet bypass can be accurately determined by the ratio of erythrocyte to platelet chimerism at 8 weeks after transplantation. This new identification criterion is an indicator of long-term reconstitution of HSCs that does not rely on observation of long-term transplantation experiments. These findings reveal the novel characteristics of HSCs related to aging and stemness and highlight the importance of the bypass pathway in HSC differentiation.

Significance statement

In vivo differentiation of hematopoietic stem cells (HSCs) is important for understanding blood cell production. Here we investigated the differentiation kinetics of HSCs in single-cell transplantation assays by using a mathematical model. Our findings demonstrate the importance of the bypass pathway in platelet production for the long-term reconstitution capacity of HSCs. These results also suggest the utility of studying time changes in HSC differentiation. The new HSC characteristics and its detection criteria identified in this study are expected to be useful in understanding HSC diversity and aging.