bluuebunny/crossref_metadata_2025 huggingface dataset:
Trichophyton indotineae extensive tinea: successful posaconazole treatment in four cases from Spain
Authors: Fernandez-Gonzalez Pablo , Garcia-Donoso Carmen , Garcia-Mouronte Emilio , Alejo Fernandez-Baillo Jose Luis , De Nicolas-Ruanes Belen , Berna-Rico Emilio , Perez-Ayala Ana , Gomez-Garcia de la Pedrosa Elia
Published: October 2024

Four patients with extensive tinea infections caused by Trichophyton indotineae, resistant to terbinafine and partially responsive to itraconazole, were successfully treated with posaconazole after molecular identification confirmed T. indotineae. Given the growing terbinafine resistance associated with this pathogen, particularly in travellers from endemic areas, antifungal susceptibility testing is critical. Posaconazole, although not typically indicated for dermatophytoses, demonstrated complete resolution in these cases, highlighting its potential as an alternative treatment for resistant tinea infections.
Three-year observational study on the ​long-term efficacy and safety of dupilumab in elderly patients with severe atopic dermatitis
Authors: Chiei-Gallo Alessandra , Barei Francesca , Calzari Paolo , Pisapia Armando , Marzano Angelo V , Ferrucci Silvia M
Published: October 2024

The safety of dupilumab in older adults is crucial due to comorbidities and polypharmacy, but this group is often underrepresented in clinical trials. We herein report a real-world experience with dupilumab in treating 138 atopic dermatitis in patients aged 60 years and older. Our study demonstrated that dupilumab has excellent safety outcomes and consistent improvements across all clinical scores.
Evidence of interleukin-17-secreting mast cells in scalp lesions of folliculitis decalvans points to new therapeutic targets in recalcitrant lesions
Authors: Franciozi Amithis B , Sotto Mirian N , Rivitti-Machado Maria C M , Pagliari Carla , Doche Isabella
Published: October 2024

Folliculitis decalvans (FD) is a chronic neutrophilic scarring alopecia, the exact pathogenesis of which remains unknown. A recent report on the successful use of a novel anti-interleukin (IL)-17 biologic agent to treat FD and the presence of IL-17-secreting mast cells in other types of scarring alopecias point to a distinct pathogenic mechanism in this disease. Our aim was to study and correlate the expression of IL-17 and mast cells in lesional and nonlesional scalp areas of patients with FD, using immunohistochemical techniques. There was significantly greater expression of IL-17 and mast cells in lesional compared with nonlesional scalp areas (P < 0.05). We also found a significantly positive correlation between IL-17 and tryptase-immunolabelled mast cells in nonlesional scalp (r = 0.64), highlighting the role of IL-17-secreting mast cells in ‘normal-appearing’ sites of FD. These findings suggest that novel treatments targeting both IL-17 and mast cells may be potentially beneficial in controlling the chronic inflammatory status of FD, especially for patients with recalcitrant FD.
Sudden pruritic eruption in a patient with vulvar cancer
Authors: Batut Laurine , Sauvain Elise , Canard Clothilde , Fontaine Marine , Vigneau Estelle , Viguier Manuelle
Published: October 2024

We report the case of a female patient who developed a widespread maculopapular rash with severe pruritus during radiotherapy treatment for a vulvar carcinoma. A complete blood count showed mild eosinophilia and skin biopsy displayed a perivascular lymphocytic and eosinophilic infiltrate. She was diagnosed with a rare syndrome and received topical corticosteroids, which resulted in a favourable outcome without relapse.
Refractory lichen planus: success with dupilumab
Authors: Read Madison H , Swain Elizabeth , Lovell Katie K , Feldman Steven R
Published: October 2024

Lichen planus (LP) is an autoimmune inflammatory disease typically treated with topical and systemic corticosteroids, but biologics such as dupilumab are emerging as a novel therapeutic treatment. The literature suggests that dupilumab can improve LP symptoms, but there are limited reports of its efficacy. This case presents a 55-year-old African American man with refractory LP who failed multiple treatments but experienced improvement with dupilumab.
Intrinsic functional networks for distinct sources of error in visual working memory
Authors: Li Xuqian , Oestreich Lena K L , Rangelov Dragan , Lévy-Bencheton Delphine , O’Sullivan Michael J
Published: October 2024

Visual working memory (VWM) is a core cognitive function wherein visual information is stored and manipulated over short periods. Response errors in VWM tasks arise from the imprecise memory of target items, swaps between targets and nontargets, and random guesses. However, it remains unclear whether these types of errors are underpinned by distinct neural networks. To answer this question, we recruited 80 healthy adults to perform delayed estimation tasks and acquired their resting-state functional magnetic resonance imaging scans. The tasks required participants to reproduce the memorized visual feature along continuous scales, which, combined with mixture distribution modeling, allowed us to estimate the measures of memory precision, swap errors, and random guesses. Intrinsic functional connectivity within and between different networks, identified using a hierarchical clustering approach, was estimated for each participant. Our analyses revealed that higher memory precision was associated with increased connectivity within a frontal-opercular network, as well as between the dorsal attention network and an angular-gyrus-cerebellar network. We also found that coupling between the frontoparietal control network and the cingulo-opercular network contributes to both memory precision and random guesses. Our findings demonstrate that distinct sources of variability in VWM performance are underpinned by different yet partially overlapping intrinsic functional networks.
Computing Capital Stocks in the German Social Security Records and Quantifying Their Role for Wage Inequality
Authors: Janser Markus , Lehmer Florian , Zierahn-Weilage Ulrich
Published: October 2024

We develop a method to impute capital stocks from investments for a sub-sample of firms in the German social security records and implement a machine-learning algorithm to predict capital stocks for the universe of firms. These capital stocks explain 40% of the variation in capital stocks of the Bureau van Dijk data. We make our data available for other researchers. We find that these capital stocks explain a sizeable fraction of wage inequality by extending the variance decomposition of Card et al. (2013), suggesting that rising firm heterogeneity in capital intensity may further amplify wage inequality. (JEL codes: C81, D24, and J31)
Sperm depletion and mate choice of the crab spider, Ebrechtella tricuspidata (Fahricius)
Authors: Guo Haobo , Wen Lelei , Yu Yue , Wang Chao , Wang Yancong , Li Changchun , Jiao Xiaoguo
Published: October 2024

Mounting evidence suggests that male sperm may be gradually depleted after consecutive matings, resulting in the decline of female reproductive output in insect species. It is predicted that females may employ adaptive strategies to avoid the sperm-depleted males, such as mating multiply with different males and/or discriminating against previously mated males (MMs). Similarly, males may exhibit adaptive behaviors toward females varying in mating status. However, in spiders with males lacking primary copulatory organs and their pedipalps modified to transfer sperm, there are few studies on male mating potential and previous mating experience on their subsequent mate choice. In this study, we used a polyandrous crab spider, Ebrechtella tricuspidata, a sit-and-wait predator with female-biased sex ratio as a model system to ascertain whether 1) male mating experiences influence female reproductive fitness; 2) females respond differently to males varying in mating status; and 3) males respond differently to females varying in mating status. Our results showed that female fecundity was independent of male mating experiences, but female fertility markedly declined with the increase of male previous mating experiences in the first eggsac. Counter to our predictions, females preferred to choose and mate with the larger males, regardless of their mating status. In contrast, male mating status influenced their mating preference toward females. Virgin males did not show any preference between virgin and mated females; however, MMs were more likely to prefer the virgin females over the mated ones. Overall, our results indicated that female choice depended primarily on male relative size rather than male mating status, whereas male choice depended on female mating status. Depending on the investigation of reproductive dynamics and mate choice in E. tricuspidata, the study will provide valuable insights into the adaptive behaviors of both males and females exhibiting toward mates varying in mating status.
Minimally invasive vs open vs hybrid esophagectomy for esophageal cancer: a systematic review and network meta-analysis
Authors: Patton Andrew , Davey Matthew G , Quinn Eogháin , Reinhardt Ciaran , Robb William B , Donlon Noel E
Published: October 2024

Robot-assisted minimally invasive esophagectomy (RAMIE) for esophageal carcinoma has emerged as the contemporary alternative to conventional laparoscopic minimally invasive (LMIE), hybrid (HE) and open (OE) surgical approaches. No single study has compared all four approaches with a view to postoperative outcomes. A systematic search of electronic databases was undertaken. A network meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-network meta-analysis guidelines. Statistical analysis was performed using R and Shiny. Seven randomised controlled trials (RCTs) with 1063 patients were included. Overall, 32.9% of patients underwent OE (350/1063), 11.0% underwent HE (117/1063), 34.0% of patients underwent LMIE (361/1063), and 22.1% of patients underwent RAMIE (235/1063). OE had the lowest anastomotic leak rate 7.7% (27/350), while LMIE had the lowest pulmonary 10.8% (39/361), cardiac 0.56% (1/177) complications, re-intervention rates 5.08% (12/236), 90-day mortality 1.05% (2/191), and shortest length of hospital stay (mean 11.25 days). RAMIE displayed the lowest 30-day mortality rate at 0.80% (2/250). There was a significant increase in pulmonary complications for those undergoing OE (OR 3.63 [95% confidence interval: 1.4–9.77]) when compared to RAMIE. LMIE is a safe and feasible option for esophagectomy when compared to OE and HE. The upcoming RCTs will provide further data to make a more robust interrogation of the surgical outcomes following RAMIE compared to conventional open surgery to determine equipoise or superiority of each approach as the era of minimally invasive esophagectomy continues to evolve (International Prospective Register of Systematic Reviews Registration: CRD42023438790).
Experimental study on radiational characteristics and nursing care of a novel radioisotope 188Re memory alloy esophageal stent
Authors: Chen Jing , Wang Zhiqiang , Huang Jianfeng , Zhang Yunxia , Zhang Xiaojun , Zhu Yan , Chu Jianjun
Published: October 2024

Radioactive esophageal stent, known for inhibiting tumor growth and delaying restenosis in malignant esophageal tumors, presents challenges due to potent radiation, leading to side effects. This study aims to support the clinical use of 188Re radioactive esophageal stent. The 188Re stent with 128 MBq initial activity was placed in a biomimetic esophageal membrane. Radiation absorption doses were measured by thermoluminescence and calculated using mathematical software. Under simulated positioning, the stent was implanted in the esophagus of an experimental pig, followed by the feeding of Kangfuxin solution and nursing care (KFX-RT). Non-implanted and implanted-only pigs served as normal (CR) and experimental (RT) controls. Blood samples collected on days 7 and 21 were analyzed for inflammatory factors (TGF-β1, TNF-α, IL-6) using enzyme-linked immunosorbent assay. Esophageal tissue cells were assessed for deoxyribonucleic acid index (DI) and subdiploid content through flow cytometry. Absorbed doses at 0.5 mm and 5 mm reference points were 223.91 cGy and 20.55 cGy, respectively, with 92.64% absorbed within a 1 mm thickness. Radiation dose significantly decreased at 6.5 mm, with only 4.72% absorbed at depths ≥6.5 mm. On days 7 and 21, levels of inflammatory factors, DI and subdiploid content were significantly increased in the KFX-RT and RT groups compared to the CR group, while all levels in the KFX-RT group were significantly lower than in the RT group. The 188Re esophageal stent exhibits high radiation absorption in superficial tissues and low absorption in deeper tissues. Kangfuxin solution combined with nursing care alleviates radiation-induced inflammatory damage.
The disease progression of end-stage atrial cardiomyopathy over three decades: a case report
Authors: Oka Takafumi , Sekihara Takayuki , Ozu Kentaro , Nakano Tomoaki , Sakata Yasushi
Published: October 2024

Background

Atrial cardiomyopathy (AtCM) has drawn attention as the pathophysiology related to cardiovascular events such as atrial tachyarrhythmia, congestive heart failure, and embolic stroke. As the concept of AtCM is relatively recent, the long-term clinical course of AtCM has not been reported.

Case summary

Here, we describe a 78-year-old patient diagnosed with end-stage AtCM. He had started to visit our hospital due to paroxysmal atrial fibrillation (AF) and hypertrophic cardiomyopathy over three decades since the age of 45. During follow-up, he experienced cardiogenic embolism and pacemaker implantation due to sick sinus syndrome. At this time, he complained of palpitation due to AF and underwent catheter ablation. Regardless of de novo ablation, left atrial voltage mapping showed ultimately extensive scar in left atrium and pulmonary vein, suggesting that conventional AF ablation strategy was ineffective. From this finding, he was diagnosed with end-stage AtCM. In the review of the previous 12-lead electrocardiogram, P-wave amplitude was decreased, and PR duration was prolonged gradually. We performed only cavotricuspid isthmus ablation and ended the ablation session. After six months, he complained of dyspnoea on effort due to pacing-induced cardiomyopathy. Furthermore, before the cardiac resynchronization therapy with a defibrillator (CRT-D) upgrade, left atrial appendage thrombus was detected even under the administration of apixaban. After thrombolysis with warfarin, CRT-D upgrade the left ventricular ejection fraction was improved.

Discussion

In this case, the patient slowly developed end-stage AtCM and experienced multiple cardiovascular events related to severe AtCM. We should care for the disease progression of AtCM with vigilance.
Great debate: pre-diabetes is not an evidence-based treatment target for cardiovascular risk reduction
Authors: Marx Nikolaus , Rydén Lars , Federici Massimo , Marx-Schütt Katharina , Verket Marlo , Müller-Wieland Dirk , Gerstein Hertzel C , Chan Juliana , Cosentino Francesco , Holman Rury R , Mellbin Linda , Ray Kausik K , Standl Eberhard , Verma Subodh , Wood David , Tuomilehto Jaakko , De Caterina Raffaele
Published: October 2024

With the increasing burden of diabetes as a cause of macro- and microvascular disease linked to the epidemics of obesity, attention is being paid to dysglycaemic states that predict and precede the development of type 2 diabetes. Such conditions, termed pre-diabetes, are characterized by fasting plasma glucose, or plasma glucose levels on an oral glucose tolerance test, or values of glycated haemoglobin intermediate between ‘normal’ values and those characterizing diabetes. These last are by definition associated, in epidemiological terms, with a higher incidence of microvascular disease—mostly retinopathy. Pre-diabetes overlaps with the components of the ‘metabolic syndrome’—among which are excess visceral adiposity; hypertension; hypertriglyceridaemia; high levels of small, dense low-density lipoproteins; and metabolic-associated fatty liver disease. There is little doubt that pre-diabetes has important prognostic implications, especially for the occurrence of myocardial infarction, ischaemic stroke, and peripheral arterial disease. It is disputed, however, whether pre-diabetes is itself an actionable disease entity, in addition to the risk factors characterizing it. Because of this uncertainty, the latest European Society of Cardiology guidelines chose not to include pre-diabetes as a treatment target for atherosclerotic cardiovascular disease, at variance from the three previous editions of such guidelines. This is spurring a debate, the Pro and Contra arguments featured in the present debate article.
Patient preferences for conservative treatment of shoulder pain: a discrete choice experiment
Authors: Versloot Annelotte H C , Veldwijk Jorien , Ottenheijm Ramon P G , de Graaf Marloes , van der Windt Daniëlle A , Koes Bart W , Runhaar Jos , Schiphof Dieuwke
Published: October 2024

Background

Shoulder pain is common amongst adults, but little is known about patients’ preferences.

Objective

The aim of this study was to determine patients’ preferences for treatment options offered for shoulder pain in primary care.

Methods

A discrete choice experiment was used to investigate these preferences. Adults with shoulder pain were asked to make 12 choices between two treatment options, or to opt-out. The attributes of the 12 treatment options were presented as varying in: treatment effectiveness (50%, 70%, or 90%), risk of relapse (10%, 20%, or 30%), time to pain reduction (2 or 6 weeks), prevention of relapse (yes/no), requiring injection (yes/no), and including physiotherapy (none, 6, or 12 sessions). A conditional logit model with latent class analysis was used for the analysis and a class assignment model.

Results

Three hundred and twelve participants completed the questionnaire with mean age of 52 ± 15.2 years. Latent class analysis revealed three groups. Group 1 preferred to opt-out, unless the attributes were highly favorable (90% effectiveness). Group 2 preferred treatment, but not an injection. Group 3 preferred to opt-out and did not opt for treatment. The likelihood of a participant belonging to one of these groups was 68.8%, 9.3%, and 21.9%, respectively. The class assignment was related to having previously received injection or physiotherapy, as they did not prefer that same treatment again.

Conclusion

This study showed that most patients with shoulder pain prefer to opt-out, unless treatment attributes are highly favorable. Characteristics of influence on this decision was whether the patient had received an injection or physiotherapy before.
Integrative multiomic analysis identifies genes associated with cuticular wax biogenesis in adult maize leaves
Authors: Lin Meng , Bacher Harel , Bourgault Richard , Qiao Pengfei , Matschi Susanne , Vasquez Miguel F , Mohammadi Marc , van Boerdonk Sarah , Scanlon Michael J , Smith Laurie G , Molina Isabel , Gore Michael A
Published: October 2024

Studying the genetic basis of leaf wax composition and its correlation with leaf cuticular conductance (gc) is crucial for improving crop productivity. The leaf cuticle, which comprises a cutin matrix and various waxes, functions as an extracellular hydrophobic layer, protecting against water loss upon stomatal closure. To address the limited understanding of genes associated with the natural variation of adult leaf cuticular waxes and their connection to gc, we conducted statistical genetic analyses using leaf transcriptomic, metabolomic, and physiological data sets collected from a maize (Zea mays L.) panel of ∼300 inbred lines. Through a random forest analysis with 60 cuticular wax traits, it was shown that high molecular weight wax esters play an important role in predicting gc. Integrating results from genome-wide and transcriptome-wide association studies via a Fisher's combined test revealed 231 candidate genes detected by all 3 association tests. Among these, 11 genes exhibit known or predicted roles in cuticle-related processes. Throughout the genome, multiple hotspots consisting of genome-wide association study signals for several traits from 1 or more wax classes were discovered, identifying 4 additional plausible candidate genes and providing insights into the genetic basis of correlated wax traits. Establishing a partially shared genetic architecture, we identified 35 genes for both gc and at least 1 wax trait, with 4 considered plausible candidates. Our study enhances the understanding of how adult leaf cuticle wax composition relates to gc and implicates both known and novel candidate genes as potential targets for optimizing productivity in maize.
Mucin-driven ecological interactions in an in vitro synthetic community of human gut microbes
Authors: Berkhout Maryse D , Ioannou Athanasia , de Ram Carol , Boeren Sjef , Plugge Caroline M , Belzer Clara
Published: October 2024

Specific human gut microbes inhabit the outer mucus layer of the gastrointestinal tract. Certain residents of this niche can degrade the large and complex mucin glycoproteins that constitute this layer and utilise the degradation products for their metabolism. In turn, this microbial mucin degradation drives specific microbiological ecological interactions in the human gut mucus layer. However, the exact nature of these interactions remains unknown. In this study, we designed and studied an in vitro mucin-degrading synthetic community that included mucin O-glycan degraders and cross-feeding microorganisms by monitoring community composition and dynamics through a combination of 16S rRNA gene amplicon sequencing and qPCR, mucin glycan degradation with PGC-LC–MS/MS, production of mucin-degrading enzymes and other proteins through metaproteomics, and metabolite production with HPLC. We demonstrated that specialist and generalist mucin O-glycan degraders stably co-exist and found evidence for cross-feeding relationships. Cross-feeding on the products of mucin degradation by other gut microbes resulted in butyrate production, hydrogenotrophic acetogenesis, sulfate reduction and methanogenesis. Metaproteomics analysis revealed that mucin glycan degraders Akkermansia muciniphila, Bacteroides spp. and Ruminococcus torques together contributed 92% of the total mucin O-glycan degrading enzyme pool of this community. Furthermore, comparative proteomics showed that in response to cultivation in a community compared to monoculture, mucin glycan degraders increased carbohydrate-active enzymes whereas we also found indications for niche differentiation. These results confirm the complexity of mucin-driven microbiological ecological interactions and the intricate role of carbohydrate-active enzymes in the human gut mucus layer.
Evidence to inform biopharmaceutical policy: call for research on the impact of public policies on investment in drug development
Authors: Barbosu Sandra , Axelsen Kirsten , Ezell Stephen
Published: October 2024

This paper highlights the pressing need for updated, robust evidence to inform biopharmaceutical policy, particularly in light of recent initiatives such as the Inflation Reduction Act. Current estimates that inform such policies, including those from the Congressional Budget Office, rely on outdated data and models that fail to fully capture the complexities of modern investment decisions or the broader impact of policies on drug development in areas like oncology, rare diseases, and vaccines. Understanding how expectations of financial returns influence investment in all stages of drug development is critical for evaluating these policies’ long-term effects on innovation. This piece reviews the current evidence on the relationship between financial returns and research and development investment and considers how this evidence is being used to shape biopharmaceutical policy. It also highlights gaps in data and methodology, emphasizing the need for better models that reflect real-world trade-offs, investment risks, and therapeutic area-specific impacts. Finally, this paper calls for improved access to federal and private data to better inform evidence-based policymaking and to study policy impact on investments in the next generation of medicines, particularly in emerging fields like gene and cell therapies, where the implications of policy decisions are not yet fully understood.
Adapting management of Pacific salmon to a warming and more crowded ocean
Authors: Connors Brendan , Ruggerone Gregory T , Irvine James R
Published: October 2024

The North Pacific Ocean is warming and overall Pacific salmon abundance is higher now than at any other time in the past century. This increase in abundance is in large part due to warming-related changes in marine ecosystems at northern latitudes that primarily benefit pink salmon, and industrial-scale hatchery production to support commercial fisheries. A large body of evidence indicates that increasing and more variable ocean temperatures, as well as competition among salmon at sea, are associated with shifts in salmon productivity, body size, and age at maturation. However, these relationships vary by species, location, and time, resulting in increased harvest opportunities in some regions and exacerbated conservation concerns in others. The weight-of-evidence suggests North Pacific salmon nations should, as a minimum, limit further increases in hatchery salmon production until there is a better scientific understanding of hatchery and wild salmon distribution at sea, how they interact, and how the consequences of these interactions are influenced by broader climate and ecosystem conditions. Coordinated research to overcome knowledge gaps and develop strategies to reduce unintended interactions between hatchery and wild salmon could be funded (in part) by a tax placed on industrial-scale hatchery salmon releases. A tax would formalize recognition that there are finite prey resources to support salmon in the ocean and that both prey and wild salmon represent a “common property” whose use should not be without cost to those that seek to benefit from them. We highlight additional approaches salmon nations can take to adapt to changing conditions and suggest that improved communication and collaboration among North Pacific salmon research and management agencies will be key to balancing the benefits and risks of a warming and more crowded ocean.
Left-handed cardiac surgery and training: a survey-based assessment
Authors: Vinck Eric E , Nia Peyman Sardari
Published: October 2024

OBJECTIVES

There is a lack of guidance and scant learning resources for left-handed (LH) cardiac surgery residents and surgeons. No objective data exists to evaluate the reality of the training experience of LH cardiac surgeons and residents.

METHODS

A 32-question survey was designed for LH cardiac surgeons and residents. The survey questions were aimed towards understanding the experiences of LH cardiac surgeons and residents in order to identify and determine where the challenges of LH in cardiac surgery lie. The survey was disseminated by the European Association for Cardio-thoracic Surgery (EACTS) through online platforms, social media and the EACTS website.

RESULTS

74 total responses were gathered from the survey; 73% were true LH operators. During residency, 78.1% of LH cardiac surgery residents had no access to LH faculty. Of those with LH mentors, only 53.3% were supportive and helped teach LH techniques. As trainees, 49.3% considered coronary artery bypass grafting anastomosis to be the most difficult portion of LH technique. Upon initiating independent practice, LH cardiac surgeons consider being LH an advantage in comparison to residency.

CONCLUSIONS

In LH cardiac surgery, there is a lack of tailored surgical exposure, training guidance, standardization, learning tools and teaching resources. Training resources for LH cardiac surgeons and residents should be developed.
Cumulative incidence of chronic health conditions recorded in hospital inpatient admissions from birth to age 16 in England
Authors: Jay Matthew A , Herlitz Lauren , Deighton Jessica , Gilbert Ruth , Blackburn Ruth
Published: October 2024

Background

Monitoring the incidence of chronic health conditions (CHCs) in childhood in England, using administrative data to derive numerators and denominators, is challenged by unmeasured migration. We used open and closed birth cohort designs to estimate the cumulative incidence of CHCs to age 16 years.

Methods

In closed cohorts, we identified all births in Hospital Episode Statistics (HES) from 2002/3 to 2011/12, followed to 2018/19 (maximum age 8 to 16 years), censoring on death, first non-England residence record or 16th birthday. Children must have linked to later HES records and/or the National Pupil Database, which provides information on all state school enrolments, to address unmeasured emigration. The cumulative incidence of CHCs was estimated to age 16 using diagnostic codes in HES inpatient records. We also explored temporal variation. Sensitivity analyses varied eligibility criteria. In open cohorts, we used HES data on all children from 2002/3 to 2018/19 and national statistics population denominators.

Results

In open and closed approaches, the cumulative incidence of ever having a CHC recorded before age 16 among children born in 2003/4 was 25% (21% to 32% in closed cohort sensitivity analyses). There was little temporal variation. At least 28% of children with any CHC had more than one body system affected by age 16. Multimorbidity rates rose with later cohorts.

Conclusions

Approximately one-quarter of children are affected by CHCs, but estimates vary depending on how the denominator is defined. More accurate estimation of the incidence of CHCs requires a dynamic population estimate.
Topological Edge Spectrum Along Curved Interfaces
Authors: Drouot Alexis , Zhu Xiaowen
Published: October 2024

We prove that if the boundary of a topological insulator divides the plane into two regions, each containing arbitrarily large balls, then it acts as a conductor. Conversely, we construct a counterexample to show that topological insulators that fit within strips do not need to admit conducting boundary modes. This constitutes a new setup where the bulk-edge correspondence is violated. Our proof relies on a seemingly paradoxical and underappreciated property of the bulk indices of topological insulators: they are global quantities that can be locally computed.
Imbalanced intracellular nutrient stoichiometries drive the regional structural variation of microeukaryotic communities in paddy fields
Authors: Sun Pengfei , Silvano Eleonora , Chen Yin , Wu Yonghong
Published: October 2024

Periphytons serve as critical microbial nutrient sinks at the soil–water interface, influencing biogeochemical cycles and nutrient migration in paddy fields. Despite their importance, the impact of accumulated intracellular nutrients on the spatial dynamics and community assembly of periphytons, particularly their microeukaryote communities, remains unclear. To address this gap, we examined the nutrient accumulation potential and its effects on microeukaryotes in periphytons from 220 paddy fields spanning up to 3469 km across three temperature zones. Our study reveals that the periphytons exhibit varying capacities to accumulate carbon, nitrogen, and phosphorus, leading to imbalanced intracellular nutrient stoichiometries (carbon-to-nitrogen ratio = 10.3 ± 2.1, carbon-to-phosphorus ratio = 30.9 ± 13.1, nitrogen-to-phosphorus ratio = 3.1 ± 1.3). This stoichiometric imbalance induces intracellular environmental heterogeneity, which partially influences the local species richness of microeukaryotic communities and their regional structural variations on a large scale. Contrary to the typical latitudinal diversity gradient theory, local microeukaryotic species richness follows a distance-decay model, with both deterministic and stochastic processes contributing to community assembly. These results underscore the complex interplay of environmental filtering, species interactions, and dispersal dynamics in shaping the structure and adaptability of microeukaryotic communities within periphytons. This study contributes to a broader understanding of the factors driving regional structural variations of microeukaryotes at the soil–water interface in agricultural landscapes.
Patella fractures are associated with bone fragility – a retrospective study
Authors: Rosillo Isabella , Germosen Carmen , Agarwal Sanchita , Rawal Ragyie , Colon Ivelisse , Bucovsky Mariana , Kil Nayoung , Shane Elizabeth , Walker Marcella
Published: October 2024

Patella fractures are not typically considered osteoporotic fractures. We compared bone mineral density (BMD) and microstructure in elderly women from a multiethnic population-based study in New York City with any history of a patella fracture (n = 27) to those without historical fracture (n = 384) and those with an adult fragility forearm fracture (n = 28) using dual energy x-ray absorptiometry (DXA) and high resolution peripheral quantitative computed tomography (HR-pQCT). Compared to those without fracture, women with patella fracture had 6.5% lower areal BMD (aBMD) by DXA only at the total hip (p=.007), while women with forearm fracture had lower aBMD at multiple sites and lower trabecular bone score (TBS), adjusted for age, body mass index, race and ethnicity (all p<.05). By HR-pQCT, adjusted radial total and trabecular (Tb) volumetric BMD (vBMD) and Tb number were 10%–24% lower while Tb spacing was 12-23% higher (all p<.05) in the fracture groups versus women without fracture. Women with a forearm, but not a patella, fracture also had lower adjusted radial cortical (Ct) area and vBMD and 21.8% (p<.0001) lower stiffness vs. women without fracture. At the tibia, the fracture groups had 9.3%–15.7% lower total and Tb vBMD (all p<.05) compared to the non-fracture group. Women with a forearm fracture also had 10.9, and 14.7% lower tibial Ct area and thickness versus those without fracture. Compared to women without fracture, tibial stiffness was 9.9% and 12% lower in the patella and forearm fracture groups, respectively (all p<.05). By HR-pQCT, the patella vs. forearm fracture group had 36% higher radial Tb heterogeneity (p<.05). In summary, women with patella fracture had Tb deterioration by HR-pQCT associated with lower tibial mechanical competence that was similar to those with fragility forearm fracture, a more universally accepted “osteoporotic” fracture. These data suggest patella fractures are associated with skeletal fragility and warrant skeletal evaluation.
In nondiabetic C57BL/6J mice, canagliflozin affects the skeleton in a sex- and age-dependent manner
Authors: Chlebek Carolyn , McAndrews Casey , Costa Samantha N , DeMambro Victoria E , Yakar Shoshana , Rosen Clifford J
Published: October 2024

Canagliflozin (CANA) is a sodium glucose cotransporter-2 inhibitor that reduces blood glucose levels. Sodium glucose cotransporter-2 is primarily expressed in the kidney, but not in any bone cells, therefore effects on the skeleton are likely to be non-cell autonomous. Originally developed to treat type II diabetes, CANA use has expanded to treat cardiovascular and renovascular disease. Clinical trials examining CANA in diabetic patients have produced contradictory reports on fracture risk, but there are limited data of CANA in nondiabetic conditions. In nondiabetic preclinical models, short-term treatment with CANA negatively affected trabecular bone whereas long-term treatment reduced cortical bone mineralization in male but not female mice. To investigate the skeletal effects of an intermediate period of CANA treatment, we treated male and female C57BL/6 J mice with CANA (180 ppm) for 6 months. Age at treatment initiation was also evaluated, with cohorts starting CANA prior to skeletal maturity (3-months-old) or in adulthood (6-months-old). Longitudinal assessments of bone mineral density revealed early benefits of CANA treatment in female mice. At euthanasia, both trabecular and cortical bone morphology were improved by CANA treatment in males and females. Bone formation was reduced at the endosteal surface. CANA decreased osteoblast number in male mice and bone marrow adiposity in females. Overall, more skeletal benefits were recorded in CANA-treated females than males. Urinary calcium output increased with CANA treatment, but parathyroid hormone was not changed. Despite reduced fasting blood glucose, body composition and whole-body metabolism were minimally changed by CANA treatment. For all outcome measures, limited differences were recorded based on age at treatment initiation. This study demonstrated that in nondiabetic C57BL/6 J mice, an intermediate period of CANA treatment improved bone morphology, but reduced osteoblast and bone marrow adipocyte number as well as serum procollagen type 1 N-terminal pro-peptide in a sex-specific manner.
Empirical evidence of resource dependent evolution of payoff matrices in Saccharomyces cerevisiae populations
Authors: Venkataraman Pavithra , Mahilkar Anjali , Raj Namratha , Saini Supreet
Published: October 2024

In evolutionary game theory, a relative comparison of the cost and benefit associated with obtaining a resource, called payoff, is used as an indicator of fitness of an organism. Payoffs of different strategies, quantitatively represented as payoff matrices, are used to understand complex inter-species and intra-species interactions like cooperation, mutualism, and altruism. Payoff matrices, however, are usually treated as invariant with time—largely due to the absence of any empirical data quantifying their evolution. In this paper, we present empirical evidence of three types of resource-dependent changes in the payoff matrices of evolving Saccharomyces cerevisiae populations. We show that depending on the carbon source and participating genotypes, N-player games could collapse, be born, or be maintained. Our results highlight the need to consider the dynamic nature of payoff matrices while making even short-term predictions about population interactions and dynamics.
Treatment of malignant primary cardiac tumors requires attention to cardiovascular complications: a single-center, retrospective study
Authors: Furukawa Kanami , Ohmura Hirofumi , Moriyama Shohei , Uehara Koki , Ito Mamoru , Tsuchihashi Kenji , Isobe Taichi , Ariyama Hiroshi , Fukata Mitsuhiro , Kusaba Hitoshi , Shiose Akira , Akashi Koichi , Baba Eishi
Published: October 2024

Background

Malignant primary cardiac tumors require multimodal approaches including surgery, chemotherapy and radiotherapy, but these treatments can be associated with cardiovascular complications. However, few reports have described the cardiovascular complications related to primary cardiac tumor treatment because of their rarity.

Methods

Clinical records of patients with primary cardiac tumors treated at Kyushu University Hospital from January 2010 to August 2021 were retrospectively examined.

Results

Of the 47 primary cardiac tumor patients, 13 (28%) were diagnosed with malignancy, including 5 angiosarcomas, 3 intimal sarcomas, 3 diffuse large B-cell lymphomas, 1 Ewing’s sarcoma and 1 fibrosarcoma. Cardiovascular events were observed in 10 patients (77%), including cardiac dysfunction in 6 patients, arrhythmias in 5 patients, right heart failure in 2 patients, and excessively prolonged prothrombin time due to the combination of warfarin and chemotherapy in 1 patient. Two patients who showed notable cardiac complications are described. Case A involved a 69-year-old woman who underwent surgery for a left atrial intimal sarcoma, followed by postoperative chemotherapy with doxorubicin plus ifosfamide and radiotherapy. After three cycles of chemotherapy and sequential radiotherapy, her left ventricular ejection fraction decreased to 34%, and ongoing heart failure therapy was required. Case B involved a 66-year-old man who received chemotherapy for primary cardiac lymphoma, resulting in tumor shrinkage. However, due to tumor involvement of the intraventricular septum, atrioventricular block developed, requiring cardiac pacemaker implantation.

Conclusion

High incidences of cardiac failure and arrhythmias were observed during multimodal treatments for malignant primary cardiac tumors. Proper management of complications may lead to a favorable prognosis in patients with malignant primary cardiac tumors.
Impact of trastuzumab emtansine (T-DM1) on spleen volume in patients with HER2-positive metastatic breast cancer
Authors: Akyildiz Arif , Ismayilov Rashad , Abdurrahimli Najmaddin , Ormanci Aylin , Guven Deniz Can , Tuncel Murat , Onur Mehmet Ruhi , Aksoy Sercan
Published: October 2024

Background

Trastuzumab emtansine (T-DM1) is a novel therapy for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer, combining the targeted action of trastuzumab with the cytotoxic effects of emtansine. Although T-DM1 has demonstrated greater efficacy and safety compared to traditional therapies, concerns about hepatotoxicity and spleen-related complications have arisen.

Methods

We conducted a retrospective study of 64 HER2-positive metastatic breast cancer patients treated with T-DM1 at our institution. Patients underwent computed tomography or magnetic resonance imaging at baseline and during treatment cycles. Spleen volume, portal vein diameter, and laboratory values were compared between baseline and 12 months after T-DM1 treatment.

Results

Median spleen volume significantly increased from 201 cm3 (IQR, 157–275) at baseline to 291 cm3 (IQR, 215–420) after 12 months of T-DM1 treatment (P < 0.001). Spleen enlargement was observed in 87.5% of patients, while no significant alteration was detected in portal vein diameter. The change in spleen volume was positively correlated with changes in serum globulin levels, liver enzymes, and bilirubin levels, but did not impact survival outcomes.

Conclusions

T-DM1 therapy in HER2-positive metastatic breast cancer leads to significant spleen enlargement and systemic biochemical changes. Future studies should focus on elucidating the long-term implications of these findings and optimizing monitoring strategies for spleen-related complications.
Gender differences in the health workforce in China: an analysis of national data
Authors: Yu Wenya , Liu Xiang , Chen Hong , Tian Jiahe , Li Meina , Mu Wei , Ge Yang
Published: October 2024

Gender differences in the health workforce matter for women's health and healthcare, and is also crucial for both health and economic development. Drawing on limited national gender data from China over the last 10 years, during which the country was undergoing a healthcare reform, this study dissects gender-related issues to identify existing problems, monitor progress, and develop strategies to promote change. Although women constituted the majority of health workers, they are predominantly engaged in service-oriented occupations. The gender distribution substantially differed between urban and rural primary health institutions. Moreover, significant differences in gender distribution among professional public health institutions were observed. The gender distribution of administrators varied in different types of health institutions. Women had lighter workloads because of the imbalanced distribution of specialties. Academicians comprised very few female scientists. To promote a more balanced gender distribution, policies should be developed to encourage a more reasonable division of family responsibilities. Further, equal higher education opportunities should be ensured for girls, especially in rural areas. Solutions to free more women from work–marriage–childcare conflicts and to decrease turnover rates deserve further discussion. Gender data should be highlighted and optimized to further advance gender differences among the health workforce and for women's health in China.
Importance of high suspicion of intestinal perforation in blunt abdominal injury in patients with inflammatory bowel disease
Authors: El-Diaz Nadia , Goutham Meera , Sheth Hemant
Published: October 2024

Estimated to affect 3 million individuals in Europe alone, Crohn’s disease is an inflammatory bowel disease causing transmural inflammation throughout the gastrointestinal tract. We describe the case of a patient with a known background of Crohn’s disease who presented with abdominal pain following blunt abdominal trauma after a hit and run where initial diagnosis of perforation was missed on pan-computed tomography, however, diagnosis was made early due to high clinical suspicion of perforation. This suggests that current diagnostic imaging can be inaccurate, leading to delays where urgent surgery is otherwise indicated which is a cause for concern. Herein, we emphasize the importance of a high index of suspicion for perforation in patients with blunt abdominal trauma, especially where there is underlying bowel disease.
Coherence via focusing for symmetric skew monoidal and symmetric skew closed categories
Authors: Veltri Niccolò
Published: October 2024

The symmetric skew monoidal categories of Bourke and Lack are a weakening of Mac Lane’s symmetric monoidal categories where (i) the three structural laws of left and right unitality and associativity are not required to be invertible, they are merely natural transformations with a specific orientation; (ii) the structural law of symmetry is a natural isomorphism involving three objects rather than two. In a similar fashion, symmetric skew closed categories are a weakening of de Schipper’s symmetric closed categories with non-invertible structural laws of left and right unitality. In this paper, we study the structural proof theory of symmetric skew monoidal and symmetric skew closed categories, progressing the project initiated by Uustalu et al. on deductive systems for categories with skew structure. We discuss three equivalent presentations of the free symmetric skew monoidal (resp. closed) category on a set of generating objects: a Hilbert-style categorical calculus; a cut-free sequent calculus; a focused subsystem of derivations, corresponding to a sound and complete goal-directed proof search strategy for the cut-free sequent calculus. Focusing defines an effective normalization procedure for maps in the free symmetric skew monoidal (resp. closed) category, as such solving the coherence problem for symmetric skew monoidal (resp. closed) categories.
Evolution of the dual AGN in Mrk 266: a young AGN and a rotation-dominated disc in the SW nucleus
Authors: Ruby Mason , Müller-Sánchez Francisco , Comerford Julia M , Stern Daniel , Cales Sabrina L , Harrison Fiona , Malkan Matthew A , Privon George C , Treister Ezequiel
Published: October 2024

Dual active galactic nuclei (AGNs) offer a unique opportunity to probe the relationship between supermassive black holes (SMBH) and their host galaxies as well as the role of major mergers in triggering AGN activity. The confirmed dual AGN Mrk 266 has been studied extensively with multiwavelength imaging. Now, high-spatial-resolution IFU spectroscopy of Mrk 266 provides an opportunity to probe the kinematics of both the merger event and AGN feedback. We present for the first time high-spatial-resolution kinematic maps for both nuclei of Mrk 266 obtained with the Keck OSIRIS IFU spectrograph, utilizing adaptive optics to achieve a resolution of $0.31$ and $0.20\,\mathrm{ arcsec}$ for the NE and SW nuclei, respectively. Using the $M_\text{BH} \!-\! \sigma _*$ relation for mergers, we infer an SMBH mass of approximately $7 \times 10^{7}\, \mathrm{M}_{\odot }$ for the south-western nucleus. Additionally, we report that the molecular gas kinematics of the south-western nucleus are dominated by rotation rather than large-scale chaotic motions. The south-west nucleus also contains both a circumnuclear ring of star formation from which an inflow of molecular gas is likely fuelling the AGN and a compact, AGN-dominated outflow of highly ionized gas with a time-scale of approximately 2 Myr, significantly shorter than the time-scale of the merger. The north-eastern nucleus, on the other hand, exhibits complex kinematics related to the merger, including molecular gas that appears to have decoupled from the rotation of the stars. Our results suggest that while the AGN activity in Mrk 266 was likely triggered during the merger, AGN feeding is currently the result of processes internal to each host galaxy, thus resulting in a strong asymmetry between the two nuclei.