bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison between Tadalafil and Tamsulosin in Reliving Stent Related Symptoms: A Randomised Study
Authors: Abdallah Hany Mostafa , Mohamed Mohamed Hassan , Riad Mina Murad
Published: August 2023

Background

Ureteroscopy had been recognized as a major method for treating ureteric calculi. Although invasive, the development of smaller and more flexible ureteroscopes, and a new generation of various intracorporial lithotripters, has made this procedure safer and more effective. Placing a ureteric stent after ureteroscopy with stone extraction is done by some urologists routinely to prevent possible stenosis or to decrease secondary pain caused by mucosal oedema.

Objective

To evaluate and compare the efficacy and safety of Tadalafil and Tamsulosin in reliving Double-J stent-related symptoms following uncomplicated ureteroscopic lithotripsy (URSL) and percutaneous nephrolithotomy (PCNL).

Patients and Methods

The present study was a prospective randomized comparative study conducted on 80 patients (56 men and 24 women) with double-J stent inserted following uncomplicated ureteroscopic lithotripsy (URSL) and unilateral percutaneous nephrolithotomy (PCNL) in Ain Shams University Hospital and Sohag Educational hospital over a period of 1 year.

Results

The study shows that Tadalafil is safe and effective in relieving DJ related symptoms. Tadalafil 5 mg once / day is as effective as Tamsulosin 0.4 mg once / day in relieving urinary symptom and body pain but more effective in relieving sexual symptoms and general health.

Conclusion

The study shows that Tadalafil is safe and effective in relieving DJ related symptoms. Tadalafil 5 mg once / day is as effective as Tamsulosin 0.4 mg once / day in relieving urinary symptom and body pain but more effective in relieving sexual symptoms and general health. Therefore Tadalafil 5 mg once / day could be recommended as preferred drug in sexually active patients undergoing DJ stenting.
Efficacy and Safety of Different Modalities for Treatment of Erectile Dysfunction in Chronic Renal Failure Patients
Authors: Zakher Mina Nageh , El Fattah Agour Abd , Hassan Ahmed Tawfick
Published: August 2023

Background

Erectile dysfunction has been found to be significantly more common in men with chronic kidney disease (CKD) than in the general population.

Objective of the Study

Detection of the safest and most effective medical treatment of erectile dysfunction(ED) in chronic renal failure patients.

Patients and Methods

. This study was conducted at Ain Shams University Hospitals with a sample size of 60 patients: 15 patients per group. We assessed the improvement in the erectile function through assessment of IIEF (International Index of Erectile Function) score and EHS (Erection Hardness Scale) score pre- and post-administration of the drugs used in the study (oral sildenafil, oral vardenafil, oral tadalafil and intracavernosal injection of alprostadil).

Results

There is a statistically significant increase in IIEF score post-administration of the drugs used in this study with p value of < 0.001 and a mean difference of 6.92. The mean score of IIEF pre-administration of the drugs used was 8.13 and post-administration was 15.05. There is also a statistically significant difference in EHS score with p value of < 0.001 and mean difference of 1.4. The mean score of EHS pre-administration of the drugs was 1.22 and post-administration was 2.62. From the four drugs used in this study, Alprostadil showed the highest improvement in IIEF and EHS scores. The study also showed a negative correlation between age, duration of haemodialysis and serum creatinine with erectile function. In addition, there was a statistically significant decrease in pre- and- post-treatment IIEF and EHS scores in diabetic cases than in the non-diabetic cases.

Conclusion

There is high incidence of ED in CKD patients. The drugs used in the study showed improvement in the erectile function with mild side effects. Alprostadil had the best IIEF and EHS scores amongst the four drugs.
Uretroscopy with Laser vs ESWL in Management of Upper Ureteric Stones
Authors: Maged Wael Ali , Ahmed Mahmoud Mahmoud , Ismail Mohamed Gamal Mohamed
Published: August 2023

Background

Although SWL and Laser remain the most common modalities for the treatment of proximal ureteral stones, there is still an ongoing debate among the academicians and medical practitioners regarding the best treatment modality.

Objective

To compare the efficacy of ureteroscopy using holmium: YAG laser lithotripsy versus shock wave lithotripsy in management of proximal ureteric stones (≤10 mm) regarding surgical efficacy, safety and cost effectiveness.

Patients and Methods

This study was performed to compare ureteroscopy using holmium: YAG laser lithotripsy versus shock wave lithotripsy in management of proximal ureteric stones (≤10 mm) regarding surgical efficacy, safety and cost effectiveness. It included 52 patients with proximal ureteral stones and it was done in the period starting from September 2021 to February 2022.

Results

There was a statistically significant difference between the both modalities in favor of SWL as regarding the anesthesia, the overall procedural time and overall cost as SWL group were treated as an outpatient cases. There was a significant difference in used anesthesia (sedation for SWL and general anesthesia for Laser). Regarding Overall procedural time (hours), it was 4.55 ± 1.94 and was 36.88 ± 5.38 for SWL and Laser groups respectively. Overall cost; even if patients underwent three sessions of SWL, the cost between the two options was still significantly different. The overall cost of Laser was 15000 EP, with an efficiency of 80 %, while overall cost of SWL was (2500 EP), with an efficiency of 49.9 %.

Conclusion

Laser is more effective, has the advantage of the higher SFR from the first session without need of multiple hospital visits and prolonged radiation exposure time. SWL has lower treatment costs, while complications were comparable in both groups, so treatment decision depends on not only stone characteristics but also cost-effectiveness ratio and this should be considered when counseling the patient with proximal ureteric stone. Larger sample size is required for more convenience data.
The Role of Renal Parenchyma to Hydronephrosis Area Ratio (PHAR) in Evaluation of Ureteropelvic Junction Obstruction in Children
Authors: Kotb Youssef Mahmoud , El Naga Mohamed Abdelmoneim Abu , El Hamid Waleed Mohamed Abd
Published: August 2023

Background

The cortex/ pelvis ratio or parenchymal to pelvicalyceal area ratio can help initial evaluation and follow up of the children with uretropelvic junction obstruction as simple modality using the cut off which is 1.6 (pelvis/ cortex) ratio. There are many studies evaluating the various preoperative parameters which influence the post-operative outcomes after pyeloplasty. Practically there are many ultrasound parameters in the post-operative period which indicate the change in renal function. So, our rationale in this study is to evaluate the role of the parenchyma hydronephrosis area ratio (PHAR) in initial evaluation and follow up of UPJO patients in correlation to renal isotope studies.

Objective

To evaluate sonographic assessment of Renal Parenchyma to Hydronephrosis Area Ratio (PHAR) in the initial management and follow up of UPJO patients in correlation with the renal scan.

Patients and Methods

Site of the study: All patients were selected from the children who attended our outpatient department and have proven UPJO and meeting the criteria for the need of surgical intervention at Faculty of Medicine, Ain Shams University. Sample Size: 36 patients. Using PASS II Program for sample size calculation and according to (Rickard et al,2016), the expected AUC for PHAR prediction of future surgical intervention = 0.18, 30% rate of surgical intervention, setting power at 8% and error at 0.05, sample size of 36 patients will be needed.

Results

We enrolled 36 cases of children ≤ 16 years old (7.93 ± 0.83) with unilateral UPJO. Preoperative ultrasound parameters of the hydronephrotic kidneys [including degree of hydronephrosis, parenchymal thickness and PHAR] and renal isotope are measured & compared with the same parameters after surgical repair of the UPJO (Anderson Hynes pyeloplasty) at 3rd months. After operation, 31 cases (86.1%) improved & 5 cases not improved (13.9%). We find a significant change in all parameters at 3 months postoperatively (p < 0.01) as T ½ (25.22 ± 2.49 & 17.57 ± 3.84) significantly decrease & parenchymal thickness (9.42 ± 4.92 & 15.12 ± 4.86), GFR of the affected kidney (34.31 ± 3.31 & 48.32 ± 6.99) split renal function (37.30 ± 3.80 & 44.03 ±4.11) and PHAR (0.86 ± 0.30 & 2.45 ± 0.93) significantly increase post operatively. PHAR post operatively shows positive correlation with parenchymal thickness & renal isotope while negative correlation with T ½.

Conclusion

PHAR is a promising parameter that can be estimated on presentation US to help predict the future need for surgery and follow up in children with ureteropelvic junction obstruction. Early identification of children who may require surgical intervention allows for closer surveillance of those patients as well as the opportunity for more selective ordering of invasive testing.
Is Inframallolar Angioplasty Effective for Wound Healing in Patients with Critical Lower Limb Ischemia and Tibial Only Disease?
Authors: Fathy Abdelghaffar Mohamed , Salem Abdelrahman Mohamed , Abdelsattar El dieb Khaled , Mohamed Moataz Ashraf Saleh
Published: August 2023

Background

Prevalence of PAD is approximately 3–10% in the population as a whole, with this increasing to between 15 and 20% when focusing on older patients (> 70 years of age). Critical limb ischemia is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration.

Aim of the Work

The aim of the study is to assess the outcome of inframallelar angioplasty in patients with multiple tibial and pedal arch disease by the impact of technical success in the form of Angiogrophically improvement of pedal arch classification and clinical success by wound healing.

Patient and Methods

In this observational prospective study; 40 patients were selected from the Ain Shams University Hospitals either at OPC or ER. Patients were subjected to Duplex study and Computerized tomography (CT) angiography for investigation. Patients were treated by balloon angioplasty. Post-intervention medical treatment included: Anti-platelet, Acetylecysitene & fluids.

Results

Incomparison between the Complete Pedal Arch(CPA), Icomplete Pedal Arch(IPA), Absent Pedal Arch (APA) show no significant change demography and different comorbidities as regard age, gender, smoking, and other co-morbitidies as diabetes, hypertention, renal insufficiency, and obesity. Comparison between 3 groups in terms of wound healing show significant differnerence between CPA(91.7%), IPA (88.9%) and APA (50%) while non significant difference between CPA and IPA. In terms of healing duration it shows non significant difference between CPA and IPA, significant difference between IPA and APA and high significance diference between CPA and APA.

Conclusion

This is a prospective observational cohort study to asses the outcome of inframallelar angioplasty in patients with multiple tibial and pedal arch disease by the impact of technical success in the form of Angiogrophically improvement of pedal arch classification and clinical success by wound healing. Our study proved that inframalleolar angioplasty play effective role in improving the foot wound healing, shortening its duration in the chronic threatening limb ischemia patients, improving limb salvage and quality of life.
Outcomes of Tibial Balloon Angioplasty in Patients with Single Tibial Runoff on Wound Healing
Authors: El Ganzoury Mahmoud Zakarya , Dosoky Atef Abdelhamid , Abdelsattar El dieb Khaled , Ramadan Ammar Mohamed
Published: August 2023

Background

The lower extremity peripheral artery disease (PAD) is between 3 and 12 percent, and If PAD left untreated, can lead to loss of the limb and in severe cases, death. Each year, there are 500 to 1000 new cases of chronic limb-threatening ischemia (CLTI) per million population with an estimated annual cost to the UK National Health Service (NHS) of more than GBP 200 million.

Aim of the Work

The aim of this study is to assess the outcome of tibial balloon angioplasty in patients with single tibial runoff by the impact of technical success in the form of single patent tibial vessel continuous with pedal arch and clinical success by wound healing.

Patients and Methods

This a prospective observational cohort study which was done to is to assess the outcome of tibial balloon angioplasty in patients with single tibial runoff by the impact of technical success in the form of single patent tibial vessel continuous with pedal arch and clinical success by wound healing in 40 patients with CLTI due to infrapopliteal disease. Our study included forty patients who visit out patient clinic or emergency room and scheduled for angioplasty. Then their wound healing rate was followed up for 6 months after the procedure.

Results

The mean of age was 62.55 ± 7.31 years. 17 patients (42.5%) were male while 23 patients (57.5%) were female. Regarding the past medical history; current Smoking was found in 30 patients (75%). Diabetes mellitus was found in 28 patients (70.0%). hypertension was found in 32 patients (80.0%). Cardiac diseases were found in 24 patients (60%).

Conclusion

This is a prospective observational cohort study to assess the outcome of tibial balloon angioplasty in patients with single tibial runoff by the impact of technical success in the form of single patent tibial vessel continuous with pedal arch and clinical success by wound healing. Our study proved that single tibial angioplasty has effective role in improving the foot wound healing, shortening its duration in the chronic threatening limb ischemia patients, improving limb salvage and quality of life.
English translation of the first study reporting cyclical periods of increased respiration and eye and body motility during sleep in infants in 1926, with commentary
Authors: Denisova Kristina
Published: August 2023

This is the first English translation of the work Periodic phenomena in the sleep in children, published in 1926 in the Journal Novoe v refleksologii i fiziologii nervnoi sistemy (Vol. 2, pp. 338–345) by Maria Denisova and Nicholai Figurin; it is the first study to report data on what is currently termed rapid eye movement (REM) sleep. The authors acquired continuous quantitative respiration data, as well as, eye and body movements during sleep in children for up to 6 hours, and discovered several novel features of sleep cycles in healthy infants from birth to about 1 year of age. First, the study reports cyclical periods of increased respiration and eye and body movements, with rapid ocular movements visible under relaxed eyelids (separation: 0.5–1 mm). These observations suggest atonia of REM sleep. Second, the length of the complete cycle (alternating active and quiet sleep phases or states) is about 50 minutes, an estimate that is consistent with later work. Third, the study identifies infant-specific ordering of sleep states, with the active phase beginning after sleep onset, followed by the quiescence phase. Importantly, these published data on sleep cycles precede all published studies related to the state now termed REM sleep by about 30 years (i.e. publishing in Science and in the Journal of Applied Physiology in the 1950s by Eugene Aserinski and Nathaniel Kleitman). In the historical commentary accompanying this translation, the findings of those later works are carefully compared to the original data on respiration and ocular and body motility cycles during sleep in infants, first reported and published by Denisova and Figurin (1926).
Mid-term outcomes of temporary medial distal femoral hemiepiphysiodesis with and without medial patellofemoral ligament repair for recurrent patellar instability in skeletally immature patients with genu valgum
Authors: Tomasevich Kelly M. , Kantor Adam H. , Metz Allan K. , Hanson Indiana T. , Froerer Devin L. , Rosenthal Reece M. , Aoki Stephen K.
Published: August 2023

Genu valgum contributes to patellar instability, though outcomes following temporary hemiepiphysiodesis via eight plating are less understood. The purpose of this study was to evaluate the outcomes and need for additional procedures following temporary hemiepiphysiodesis for the treatment of pediatric genu valgum and patellar instability, as well as evaluating the utility of a concurrent medial patellofemoral ligament (MPFL) repair. Patients who underwent medial distal femoral epiphysiodesis for the treatment of genu valgum and recurrent patellar instability were identified. Inclusion criteria were minimum 1-year follow-up and lack of concurrent ligamentous reconstruction. Patients were contacted to complete a questionnaire which included the International Knee Documentation Committee (IKDC) form and questions pertaining to knee function and patient satisfaction. Thirty-one patients aged 12.0 ± 1.9 years underwent 47 guided growth procedures and were included in final analysis. Seventeen knees (36%) required subsequent surgery for patellar instability. All patients requiring subsequent surgery were female, compared with 70% of patients not requiring subsequent surgery (P = 0.017). The MPFL repair group underwent fewer subsequent procedures to address instability, though this difference was NS (17 vs. 46%, P = 0.318). Mean IKDC score at 5.3 years follow-up among 18 survey respondents was 78.6. Medial distal femoral hemiepiphysiodesis may partially address recurrent patellar instability in skeletally immature patients with genu valgum. Concurrent MPFL repair may minimize the need for subsequent procedures to address recurrent instability. While correcting alignment may be helpful, patients should be aware of the potential need for further patellar instability surgery. Level of evidence: IV, case series.
Epiphyseal-entry cannulated screws for temporary guided growth of the knees: a retrospective review of 89 cases
Authors: Neal Kevin M. , Kiebzak Gary M.
Published: August 2023

Guided growth affects the physis in children to produce a desired effect. Several devices achieve alteration of growth, including staples, plates, and screws. Complications can include device failures, failure to modulate growth as expected, and unintended physeal arrest. We present the results of a unique technique designed to minimize these complications. This was a retrospective review of guided growth at the knee at a single institution utilizing cannulated screws with epiphyseal-entry points. Each case was reviewed to determine the presence of complications related to guided growth, including implant breakage, implant pull-out or pull-through, iatrogenic physeal arrest, failure to modulate growth, and the incidence of revision surgeries. There were 89 patients who had 146 epiphyseal-entry guided growth procedures with a total of 221 4.5 mm cannulated screws. There were no iatrogenic physeal arrests. Five (2.26%) screws in 4 (4.49%) patients had either a broken screw or screw pull-out/pull-through requiring revision procedures. Three patients had osteotomies after skeletal maturity. Four had revision-guided growth for other reasons: 2 due to a lack of timely follow-up, 1 for iatrogenic genu varum without implant failure, and 1 due to recurrent deformity after implant removal. Revision procedures were unanticipated in 6 (6.74%) patients. This study describes a technique for placing cannulated screws at the knee with epiphyseal starting points. Our rate of complications and number of revision surgeries compare favorably with those noted for other techniques. Guided growth using epiphyseal-entry cannulated screws is a safe, effective option for most patients.
Two Cases of Periodic Paralysis Associated With MCM3AP Variants
Authors: Oishi Tatsuya , Pagano Jennifer , Sellers Cody , Jerath Nivedita U.
Published: August 2023

Objectives:

Periodic paralysis is a rare genetic condition characterized by episodes of neuromuscular weakness, often provoked by electrolyte abnormalities, physiologic stress, physical exertion, and diet. In addition to mutations in genes coding for skeletal muscle ion channels, in 2019, Gustavasson et al discovered that the MCM3AP gene could be responsible for periodic paralysis. In this study, we present 2 individuals with clinical episodes of periodic paralysis who have variants in the MCM3AP gene.

Methods:

Two unrelated probands were independently evaluated with clinical, genetic, and electrodiagnostic testing.

Results:

Proband 1 is a 46-year-old man who presented with decades of ongoing episodic weakness and fatigue, clinically diagnosed with periodic paralysis and supported by electrodiagnostic studies. Proband 2 is a 34-year-old woman with a history of episodic paralysis since childhood. Genetic testing in both individuals revealed potentially pathogenic variants in the MCM3AP gene.

Conclusions:

Periodic paralysis is a condition that significantly affects the lives of those diagnosed. The results illustrate that MCM3AP gene variants can been associated with a clinical and electrodiagnostic presentation of periodic paralysis. Additional future research should focus on clarifying any relationship between these genetic variants and the disease, as well as other possible genetic causes.
The hidden diagnosis: hypogonadotropic hypogonadism unveiled in a rare Fanconi syndrome case—a case report and literature review
Authors: Zaidi Syeda Mahrukh Fatima , Siddiq Mohammad Arham , Qamar Safia , Hasan Syed Mohammad , Dua e Zehra Zaidi Syeda , Kashif Syed Muhammad , Alam Muhammad Tanveer
Published: August 2023

Introduction and importance:

Fanconi syndrome affects kidney function, whereas hypogonadotropic hypogonadism (HH) is gonadal failure due to deficient hormones. Diagnosis involves assays and imaging, whereas treatment targets cause and fluid balance. Here, there is a reported co-occurrence in Pakistan.

Case presentation:

A 14-year-old girl presented with joint pain and developmental delay. Physical examination revealed wrist widening, genu-varum, and underdeveloped secondary sexual characteristics. Laboratory findings confirmed Fanconi syndrome and coincidental ultrasound findings revealed HH. The patient received treatment in the form of oral medications and supplements to manage the condition.

Clinical discussion:

Fanconi syndrome is a complex disorder affecting the proximal tubule of the kidneys, leading to impaired reabsorption of various substances. In this case, potential genetic and acquired causes were ruled out, including inborn errors of metabolism and heavy metal intoxication. Prolonged valproic acid use was also considered but not confirmed as the cause. The patient also presented with HH, which is unrelated but coexisting. Treatment for Fanconi syndrome focuses on correcting electrolyte imbalances, whereas hormone replacement therapy is considered for HH. The patient’s progress and response to treatment are under careful monitoring.

Conclusion:

This case highlights the need for further research and comprehensive diagnostic evaluation to better understand the association between Fanconi syndrome and HH, emphasizing the importance of early diagnosis and management to prevent long-term complications.
In Vitro 3D Spheroid Culture System Displays Sustained T Cell-dependent CLL Proliferation and Survival
Authors: Haselager Marco V. , van Driel Bianca F. , Perelaer Eduard , de Rooij Dennis , Lashgari Danial , Loos Remco , Kater Arnon P. , Moerland Perry D. , Eldering Eric
Published: August 2023

Chronic lymphocytic leukemia (CLL) cells are highly dependent on microenvironmental cells and signals. The lymph node (LN) is the critical site of in vivo CLL proliferation and development of resistance to both chemotherapy and targeted agents. We present a new model that incorporates key aspects of the CLL LN, which enables investigation of CLL cells in the context of a protective niche. We describe a three-dimensional (3D) in vitro culture system using ultra-low attachment plates to create spheroids of CLL cells derived from peripheral blood. Starting from CLL:T cell ratios as observed in LN samples, CLL activation was induced by either direct stimulation and/or indirectly via T cells. Compared with two-dimensional cultures, 3D cultures promoted CLL proliferation in a T cell-dependent manner, and enabled expansion for up to 7 weeks, including the formation of follicle-like structures after several weeks of culture. This model enables high-throughput drug screening, of which we describe response to Btk inhibition, venetoclax resistance, and T cell-mediated cytotoxicity as examples. In summary, we present the first LN-mimicking in vitro 3D culture for primary CLL, which enables readouts such as real-time drug screens, kinetic growth assays, and spatial localization. This is the first in vitro CLL system that allows testing of response and resistance to venetoclax and Bruton's tyrosine kinase inhibitors in the context of the tumor microenvironment, thereby opening up new possibilities for clinically useful applications.
Health inequities in the modulator era
Authors: Palla John B. , Laguna Theresa A.
Published: August 2023

Purpose of review

To discuss the existing health inequities in people with cystic fibrosis (CF) and how the recent development of cystic fibrosis transmembrane regulator (CFTR) modulators may impact these inequities.

Recent findings

People with CF (pwCF) from low socioeconomic status (SES) have more pulmonary exacerbations, worse nutritional status, lower pulmonary function, and an increased mortality rate with less access to lung transplantation. pwCF who identify as racial and ethnic minorities have earlier mortality, lower lung function, are less likely to be detected on newborn screening resulting in a delayed diagnosis, are underrepresented in clinic trials, and less likely to be eligible for a CFTR modulator. Female sex is associated with more pulmonary exacerbations and earlier mortality. Sexual gender minorities are a vulnerable population with worse health outcomes, and more research is needed in CF. CFTR modulators are inaccessible to low to middle-income countries due to significant cost burden.

People with CF from low SES, racial and ethnic minorities, female sex, and sexual gender minorities face health inequities. CFTR modulator use will further widen existing health inequities given the unequal access to modulators based on nonqualifying genetics and exorbitant cost restricting use both on an individual and global level.
Urinary outcomes of new ultra-minimally invasive treatments for prostate cancers
Authors: De Cillis Sabrina , Osman Nadir , Guillot-Tantay Cyrille , Hervé Francois , Przydacz Mikolaj , Tutolo Manuela , Culha Gokhan , Geretto Paolo , Cancrini Fabiana , Checcucci Enrico , Phé Veronique
Published: August 2023

Purpose of review

The aim of this narrative review is to evaluate the current available literature on urinary outcomes following cryotherapy and high-intensity focused ultrasound (HIFU) for localized prostate cancer (PCa).

Recent findings

The available literature is heterogeneous in terms of intervention modalities and assessment of urinary outcome measures. Nevertheless, ultra-minimally invasive treatments seem to provide good urinary outcomes. Technological advancement and the adoption of more conservative ablation templates allow for a further reduction of toxicity and better preservation of urinary function. Urinary incontinence occurs in 0-10% of the patients and, is mostly transient. Voiding and storage lower urinary tract symptoms (LUTS) mostly occur in the early postoperative period and rarely require surgical treatment. Focal therapies performed with a salvage intent after external beam radiotherapy have a significantly higher impact on patient's urinary function.

Ultra-minimally invasive treatment for PCa show a good safety profile concerning urinary function, but consensus on when and how best to assess this is still lacking. Efforts should be made to standardize the report of preoperative and postoperative urinary function to provide higher level of evidence.
Focal Cerebral Vasculitis due to SARS-CoV-2 Infection With a Robust Response to Intravenous Steroids
Authors: Reyes Cleo Zarina , Villar Manny , Cheponis Kathryn , Yacoub Hussam A.
Published: August 2023

Introduction:

Severe and less common neurological manifestations of SARS-CoV-2 infection include acute ischemic stroke, intracerebral hemorrhage, central venous sinus thrombosis, and vasculitis. In this report, we present a case of a 42-year-old man with acute ischemic stroke due to SARS-CoV-2 infection-associated central nervous system vasculitis that improved with steroid therapy.

Case Report:

A 42-year-old man with SARS-CoV-2 infection presented with non-fluent aphasia and right-sided hemiparesis. Computed tomography angiography revealed an occlusion of the proximal left middle cerebral artery (MCA), with acute infarcts in the left posterior parietal, lentiform nucleus, and cortical frontal cortex on magnetic resonance imaging (MRI). Patient developed pulmonary emboli and was discharged on apixaban and atorvastatin. Four weeks later, the patient presented with recurring symptoms and was found to have worsening left MCA stenosis. MRI and MR angiography revealed a penumbra within the left MCA territory and pruning of the distal branches with severe stenosis. Laboratory workup for autoimmune causes of vasculitis was unrevealing. High-dose intravenous steroid treatment was initiated. Subsequent MRI and MR angiography revealed improved flow in the left cerebral vasculature and no novel ischemic infarcts.

Conclusion:

Central nervous system vasculitis is a rare manifestation of SARS-CoV-2 infection. This case suggests that high-dose intravenous steroids may have a therapeutic role in this patient population. Steroid use, in combination with vasopressor support to augment cerebral blood flow, may prevent further stroke burden.
Efficient assessment of real-world dynamics of circadian rhythms in heart rate and body temperature from wearable data
Authors: Kim Dae Wook , Mayer Caleb , Lee Minki P. , Choi Sung Won , Tewari Muneesh , Forger Daniel B.
Published: August 2023

Laboratory studies have made unprecedented progress in understanding circadian physiology. Quantifying circadian rhythms outside of laboratory settings is necessary to translate these findings into real-world clinical practice. Wearables have been considered promising way to measure these rhythms. However, their limited validation remains an open problem. One major barrier to implementing large-scale validation studies is the lack of reliable and efficient methods for circadian assessment from wearable data. Here, we propose an approximation-based least-squares method to extract underlying circadian rhythms from wearable measurements. Its computational cost is ∼ 300-fold lower than that of previous work, enabling its implementation in smartphones with low computing power. We test it on two large-scale real-world wearable datasets:

∼
600
 

days

of body temperature data from cancer patients and ∼ 184 000 days of heart rate and activity data collected from the ‘Social Rhythms’ mobile application. This shows successful extraction of real-world dynamics of circadian rhythms. We also identify a reasonable harmonic model to analyse wearable data. Lastly, we show our method has broad applicability in circadian studies by embedding it into a Kalman filter that infers the state space of the molecular clocks in tissues. Our approach facilitates the translation of scientific advances in circadian fields into actual improvements in health.
The non-deterministic genotype–phenotype map of RNA secondary structure
Authors: García-Galindo Paula , Ahnert Sebastian E. , Martin Nora S.
Published: August 2023

Selection and variation are both key aspects in the evolutionary process. Previous research on the mapping between molecular sequence (genotype) and molecular fold (phenotype) has shown the presence of several structural properties in different biological contexts, implying that these might be universal in evolutionary spaces. The deterministic genotype–phenotype (GP) map that links short RNA sequences to minimum free energy secondary structures has been studied extensively because of its computational tractability and biologically realistic nature. However, this mapping ignores the phenotypic plasticity of RNA. We define a GP map that incorporates non-deterministic (ND) phenotypes, and take RNA as a case study; we use the Boltzmann probability distribution of folded structures and examine the structural properties of ND GP maps for RNA sequences of length 12 and coarse-grained RNA structures of length 30 (RNAshapes30). A framework is presented to study robustness, evolvability and neutral spaces in the ND map. This framework is validated by demonstrating close correspondence between the ND quantities and sample averages of their deterministic counterparts. When using the ND framework we observe the same structural properties as in the deterministic GP map, such as bias, negative correlation between genotypic robustness and evolvability, and positive correlation between phenotypic robustness and evolvability.
Early urinary candidate biomarkers and clinical outcomes of intervention in a rat model of experimental autoimmune encephalomyelitis
Authors: Zhao Mindi , Zhang Yameng , Wu Jianqiang , Li Xundou , Gao Youhe
Published: August 2023

Multiple sclerosis is a chronic autoimmune demyelinating disease of the central nervous system and is difficult to diagnose in early stages. Without homeostatic control, urine was reported to have the ability to accumulate early changes in the body. We expect that urinary proteome can reflect early changes in the nervous system. The early urinary proteome changes in a most employed multiple sclerosis rat model (experimental autoimmune encephalomyelitis) were analysed to explore early urinary candidate biomarkers, and early treatment of methylprednisolone was used to evaluate the therapeutic effect. Twenty-five urinary proteins were altered at day 7 when there were no clinical symptoms and obvious histological changes. Fourteen were reported to be differently expressed in the serum/cerebrospinal fluid/brain tissues of multiple sclerosis patients or animals such as angiotensinogen and matrix metallopeptidase 8. Functional analysis showed that the dysregulated proteins were associated with asparagine degradation, neuroinflammation and lipid metabolism. After the early treatment of methylprednisolone, the incidence of encephalomyelitis in the intervention group was only 1/13. This study demonstrates that urine may be a good source of biomarkers for the early detection of multiple sclerosis. These findings may provide important information for early diagnosis and intervention of multiple sclerosis in the future.
Genome-wide association study of aphid abundance highlights a locus affecting plant growth and flowering inArabidopsis thaliana
Authors: Xu Chongmeng , Sato Yasuhiro , Yamazaki Misako , Brasser Marcel , Barbour Matthew A. , Bascompte Jordi , Shimizu Kentaro K.
Published: August 2023

Plant life-history traits, such as size and flowering, contribute to shaping variation in herbivore abundance. Although plant genes involved in physical and chemical traits have been well studied, less is known about the loci linking plant life-history traits and herbivore abundance. Here, we conducted a genome-wide association study (GWAS) of aphid abundance in a field population ofArabidopsis thaliana. This GWAS of aphid abundance detected a relatively rare but significant variant on the third chromosome ofA. thaliana, which was also suggestively but non-significantly associated with the presence or absence of inflorescence. Out of candidate genes near this significant variant, a mutant of a ribosomal gene (AT3G13882) exhibited slower growth and later flowering than a wild type under laboratory conditions. A no-choice assay with the turnip aphid,Lipaphis erysimi, found that aphids were unable to successfully establish on the mutant. Our GWAS of aphid abundance unexpectedly found a locus affecting plant growth and flowering.
Morphological and molecular study of Syllinae (Annelida, Syllidae) from Bermuda, with the description of five new species
Authors: Moreno-Martín Paula , Mourín Mar , Verdes Aida , Álvarez-Campos Patricia
Published: August 2023

Although polychaetes from the Bermuda Archipelago have been studied since the beginning of the twentieth century, syllids have been particularly neglected in this area, which is surprising considering this family is usually a dominant group in marine benthic ecosystems. To fill this knowledge gap, we have carried out an extensive analysis of Bermudan Syllidae, combining morphological and molecular data including four nuclear and mitochondrial markers (
cytochrome c oxidase subunit I
,
18S rRNA
,
16S rRNA
and
28S rRNA
). We have identified and established the phylogenetic position of five new species,
Haplosyllis anitae
n. sp.,
Haplosyllis guillei
n. sp.,
Haplosyllis larsi
n. sp.,
Haplosyllis vassiae
n. sp. and
Syllis laiae
n. sp., together with
Haplosyllis
cf.
cephalata
. Overall, our results extend the knowledge on the diversity of Syllidae in Bermuda, increasing the number of species present in the area to 25. Our results also recover
Opisthosyllis
and
Syllis
as non-monophyletic genera, for which traditional diagnostic morphological features do not accurately reflect their evolutionary histories, and thus we propose that these groups should be reorganized based on molecular characters.
Why and how to embrace AI such as ChatGPT in your academic life
Authors: Lin Zhicheng
Published: August 2023

Generative artificial intelligence (AI), including large language models (LLMs), is poised to transform scientific research, enabling researchers to elevate their research productivity. This article presents a how-to guide for employing LLMs in academic settings, focusing on their unique strengths, constraints and implications through the lens of philosophy of science and epistemology. Using ChatGPT as a case study, I identify and elaborate on three attributes contributing to its effectiveness—intelligence, versatility and collaboration—accompanied by tips on crafting effective prompts, practical use cases and a living resource online (https://osf.io/8vpwu/). Next, I evaluate the limitations of generative AI and its implications for ethical use, equality and education. Regarding ethical and responsible use, I argue from technical and epistemic standpoints that there is no need to restrict the scope or nature of AI assistance, provided that its use is transparently disclosed. A pressing challenge, however, lies in detecting fake research, which can be mitigated by embracing open science practices, such as transparent peer review and sharing data, code and materials. Addressing equality, I contend that while generative AI may promote equality for some, it may simultaneously exacerbate disparities for others—an issue with potentially significant yet unclear ramifications as it unfolds. Lastly, I consider the implications for education, advocating for active engagement with LLMs and cultivating students' critical thinking and analytical skills. The how-to guide seeks to empower researchers with the knowledge and resources necessary to effectively harness generative AI while navigating the complex ethical dilemmas intrinsic to its application.
Concurrent loss of ciliary genes
WDR93
and
CFAP46
in phylogenetically distant birds
Authors: Salve Buddhabhushan Girish , Kurian Amia Miriam , Vijay Nagarjun
Published: August 2023

The respiratory system is the primary route of infection for many contagious pathogens. Mucociliary clearance of inhaled pathogens is an important innate defence mechanism sustained by the rhythmic movement of epithelial cilia. To counter host defences, viral pathogens target epithelial cells and cilia. For instance, the avian influenza virus that targets ciliated cells modulates the expression of
WDR93
, a central ciliary apparatus C1d projection component. Lineage-specific prevalence of such host defence genes results in differential susceptibility. In this study, the comparative analysis of approximately 500 vertebrate genomes from seven taxonomic classes spanning 73 orders confirms the widespread conservation of
WDR93
across these different vertebrate groups. However, we established loss of the
WDR93
in landfowl, geese and other phylogenetically independent bird species due to gene-disrupting changes. The lack of
WDR93
transcripts in species with gene loss in contrast to its expression in species with an intact gene confirms gene loss. Notably, species with
WDR93
loss have concurrently lost another C1d component,
CFAP46
, through large segmental deletions. Understanding the consequences of such gene loss may provide insight into their role in host–pathogen interactions and benefit global pathogen surveillance efforts by prioritizing species missing host defence genes and identifying putative zoonotic reservoirs.
takeout
gene expression is associated with temporal kin recognition
Authors: Potticary Ahva L. , McKinney Elizabeth C. , Moore Patricia J. , Moore Allen J.
Published: August 2023

A key component of parental care is avoiding killing and eating one's own offspring. Many organisms commit infanticide but switch to parental care when their own offspring are expected, known as temporal kin recognition. It is unclear why such types of indirect kin recognition are so common across taxa. One possibility is that temporal kin recognition may evolve through alteration of simple mechanisms, such as co-opting mechanisms that influence the regulation of timing and feeding in other contexts. Here, we determine whether
takeout
, a gene implicated in coordinating feeding, influences temporal kin recognition in
Nicrophorus orbicollis
. We found that
takeout
expression was not associated with non-parental feeding changes resulting from hunger, or a general transition to the full parental care repertoire. However, beetles that accepted and provided care to their offspring had a higher
takeout
expression than beetles that committed infanticide. Together, these data support the idea that the evolution of temporal kin recognition may be enabled by co-option of mechanisms that integrate feeding behaviour in other contexts.
The influence of a soil amendment upon the abundance and interaction of arbuscular mycorrhizal fungi with arable soils and host winter wheat
Authors: Wilkes Thomas I
Published: August 2023

Arbuscular mycorrhizal (AM) fungi form close symbiotic relationships with an estimated 70% of terrestrial plant species and aid in the acquisition of soil nutrients. Due to their symbiotic relationship, AM fungi are able to provide a host with acquired soil bound nutrients in exchange for host produced photosynthetic carbohydrates. AM fungal-host relationships are affected by land and soil management practices employed in arable farming. Tillage, for example, can be one of the most detrimental physical disturbances to AM fungal populations. The present study aims to utilise compost and a commercially available AM fungal inoculant to amend arable soils supporting Zulu winter wheat, under controlled conditions, to determine changes in the degree of AM fungal-host symbiosis, crop growth and development, as well as comment on the potential integration of these soil amendments into arable soil management practices. Soils were sampled from 3 field from each of the 3 participating farms practicing either conventional, reduced, or zero tillage. Soil textures were assessed for each sampled soil. Via the employment of AM fungal symbiosis quantification methods, and proxy parameters for fungal biomass, AM fungi were able to be compared between soil amendments and their effects on crop growth and development. The current study was able to show soils amended with multipurpose compost produced a greater degree of AM fungal-host associations for all soil types across all tillage practices. Compost amended soils were also able to show increases in crop tiller numbers and their respective crop height. Reduced wheat root length was also seen from compost amended soils, however, this was correlated to an increase in AM fungal root arbuscules. Commercial AM fungal inocula, on the other hand, was seen to reduce AM fungal associations with their host as well as have little to no influence on crop root length and crop height. Number of tillers per plant were, however, seen to marginally increase with the addition of a commercial AM fungal inocula. From results presented in the current study, conclusions can be drawn towards the advantageous addition of multipurpose compost to arable soils for the tillage and soil types studied. Furthermore, the addition of compost is a more cost effective change to soil management.
Erosive balanitis caused by Staphylococcus haemolyticus in a healthy, circumcised adult male.
Authors: Mazuecos-Blanca José , Mazuecos-Gutiérrez José Rafael , Jiménez-Gil Ana
Published: August 2023

Introduction. Balanitis is an inflammation of the glans penis and balanoposthitis involves both the glans penis and prepuce. After candida infections, aerobic bacteria are the second etiological cause of infectious balanoposthitis, mainly streptococci, groups B and D, and staphylococci, usually S. aureus.
Coagulase-negative staphylococci (CoNS) are commensal skin bacteria, but are also recognized pathogens of the genitourinary system, mainly related to urinary tract infections. Staphylococcus haemolyticus is one of the main species of CoNS that also causes other infections of the male urogenital tract, such as chronic prostatitis and epididymo-orchitis, but it has not been associated with balanitis.
Case presentation. A 45-year-old man reports having suffered several episodes of balanoposthitis in the last 3 years, which were treated with topical antifungal treatments alone or associated with corticosteroids. For this reason, he underwent a postectomy by his urologist 8 months ago to avoid further recurrences.
The patient consulted for an episode of painful, erosive, and exudative lesions on the glans penis lasting 5 days. He had no urinary discomfort or inguinal lymphadenopathy. A complete blood count, biochemical analysis, and urinalysis were normal. Abundant growth of Staphylococcus haemolyticus was obtained in the culture in standard bacterial media of the sample taken from the genital lesion. The fungal culture was negative. Based on the antimicrobial susceptibility study, treatment with oral ciprofloxacin and topical mupirocin was started, and the genital infection was completely cured.
Conclusion. We present a healthy, non-diabetic, circumcised male patient with severe, erosive, and painful balanitis probably due to S. haemolyticus.