bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of National Institute for Health and Care Excellence head injury guidelines among patients with delayed presentation after head trauma can lead to missed traumatic brain injury: a 5-year institutional review
Authors: Khan Muhammad Salman , Alam Muhammad Sami , Ismail Sameeha , Ghafoor Bushra , Sajjad Nida , Khan Noman , Memon Wasim Ahmed , Ameen Abdullah Muhammad , Khan Faheemullah , Mumtaz Hassan , Iqbal Javed , Ashraf Ahmer
Published: September 2023

Introduction:

In 2014, traumatic brain injury (TBI) caused 3 million ER visits, hospitalizations, and deaths in the US. The National Institute for Health and Care Excellence (NICE) guidelines, initially generated using data from patients presenting within 24 h of head trauma, are used to determine the need for head computed tomography (CT) scan in patients after 24 h. The authors wanted to determine the proportion of CT scans for head trauma performed at our center in late presenters (>24 h after head trauma), the incidence of intracranial pathology in early (24 h) versus late (>24 h) presenters, and the sensitivity of the NICE guidelines for TBI in these two subpopulations.

Methods:

A retrospective chart review was conducted at a tertiary care center in Karachi. All people (>16) who had a head CT for head trauma from 2010 to 2015 were included. Age, sex, primary diagnosis, comorbid disorders, mechanism-of-injury, duration (in hours) from head trauma to presentation, site, and extent of injury (injury severity scale), hospital stay, number and details of surgical procedures, CT scan findings, other injuries, and mortality were recorded. Means were compared using the Independent Sample t-test, while categorical variables were compared using χ
2. Multivariate logistic regression analyses were used to identify TBI predictors.

Results:

The authors found 2009 eligible patients; seven were excluded due to incomplete medical records. The final statistical analysis comprised 2002 head trauma patients. Overall, 52% of early and late presenters had severe injuries, and 2.3% died. 32.2% of patients with head trauma had CT after 24 h. Early presenters were 46.7% traumatized, while late presenters were 63%. The NICE guidelines were 93% sensitive for early presenters and 83% for late presenters with traumatic intracranial injury.

Conclusion:

Patients coming to the emergency department after 24 h of head trauma are a large proportion of the overall head trauma population. The NICE guidelines for late-presenting head injuries are less sensitive and may overlook intracranial injuries if imaging is not performed.
Successful removal of an aspirated broken metal tracheostomy tube from the right main bronchus: a case report
Authors: Vakili Ojarood Mohammad , Samady Khanghah Ali
Published: September 2023

Introduction and importance:

Tracheostomy has been done since ancient Greece, but in today’s modern format, it has been accepted for over one and a half centuries. Improvements in medical care and treatments have survived disabled patients who died in the past decades. Among these, tracheostomy tube (TT) segment aspiration was as rare as less than 100 cases have already been documented. We reported a case of aspirated metal TT to the right main bronchus from a 12-year-old teenage girl and then reviewed the available literature.

Case presentation:

The patient suffered from subglottic stenosis affected after adenotonsillectomy remained for 6 years. She was referred to the emergency department for acute respiratory distress and cyanosis. Immediately underwent rigid bronchoscopy, and on the way to the operating room, she was oxygenated from the tracheal orifice. The detached part was successfully removed.

Clinical discussion:

The common tracheostomy indications in children involve congenital or acquired airway stenosis, some conditions needing long-term ventilation, bilateral vocal fold insufficiency, and infectious compromise of the upper airway. Metal TTs for long-lasting are preferred to synthetic ones. Nevertheless, it has some potential complications.

Conclusion:

Careful inspecting, especially metallic TTs, after every disinfection and regular follow-up by the surgeon, is highly recommended to prevent potential casualties.
Immune-enhancing activity of Astragalus maximus extract for inhibiting the Toxoplasma gondii infection: experimental research
Authors: Behnam Salar , Kharazmkia Ali , Khalaf Amal Khudair , Adineh Ahmad , Ghasemian Yadegari Javad , Mahmoudvand Hossein
Published: September 2023

Background:

This study aimed to evaluate the in-vitro anti-Toxoplasma effects and cytotoxicity effects of Astragalus maximus chloroformic extract (AMCE) on the T. gondii Rh strain.

Methods:

In-vitro effects of AMCE (2–64 µg/ml) on tachyzoites were measured by MTT assay for 48 h. The effects of AMCE on infectivity rate and intracellular parasites into macrophage cells (J774-A1) were evaluated. The Griess reaction assay and quantitative real-time PCR were used to determine the nitric oxide (NO) and the mRNA expression levels of IFN-γ and iNOS in infected J774-A1 macrophage cells.

Results:

The mortality rate of the parasites significantly (P<0.001) increased in a dose-dependent manner with an IC50 value of 9.85 μg/ml. The rate of infection and the mean number of intracellular tachyzoites in macrophage cells were significantly reduced (P<0.001) after exposure of the macrophage cells to AMCE. The mRNA expression levels of IFN-γ, iNOS, and NO production in macrophage cells after treatment with the AMCE were increased, especially at the concentration of ½ IC50 and IC50 (P<0.001).

Conclusion:

The findings of the current in vitro investigation revealed favorable anti-Toxoplasma effects of AMCE against tachyzoites and intracellular forms of T. gondii. Despite the fact that the accurate anti-Toxoplasma mechanisms of AMCE are not clear, our results showed that triggering NO production and cellular immunity can be considered as the main mechanisms of action of AMCE for controlling and eliminating T. gondii. However, further surveys are mandatory to assess the efficacy and safety of AMCE in an animal model and its accurate mechanisms of action.
What makes women receptive to breast self-examination, animation, or simulation? – a comparative study
Authors: Idrees Sarrah , Mayilvaganan Sabaretnam , Mishra Shagun , Chand Gyan , Mishra Anjali , Agarwal Gaurav
Published: September 2023

Background:

Breast self-examination (BSE) plays an important role in the early diagnosis of breast cancer in India owing to the stigma attached to cancer. The authors compared the efficacies of animation video versus simulation techniques in BSE.

Methods:

Women with no previous history of conditions affecting the breasts were included in this prospective observational study and divided into an animation or simulation arm. The latter was further divided into three subgroups as per the simulation models used : the German (Delta Healthcare), British (Health Edco), and Indian (low-cost, validated) models used for teaching BSE. The hybrid animation video had a 9 min runtime with a lecture on BSE and a virtual character performing BSE. In both the arms, participants filled in a validated modified patient satisfaction questionnaire.

Results:

A total of 500 women participated. The mean age of the participants in the animation video arm was 20.21±3.88 years and 19.34±2.27, 22.94±9.6, and 18.97±1.31(20.41±5.99) years in the Indian, German, and British simulation models arm, respectively. The age difference between the two arms was statistically significant (P<0.05). Both animation video and simulation models were found to be useful by the participants. The participants’ response to animation video being a better organized tool for learning BSE was statistically significant (90.48±7.98 vs. 84.02±15.09 P≤0.001) when compared to simulation models. The younger women (≤20 years) found these tools significantly more useful than those aged >20 years.

Conclusions:

All models had good efficiency and utility as learning tools for BSE. However, large studies in BSE set up with combination models are needed.
Erythema nodosum after golimumab treatment in ankylosing spondylitis patients: a case report and literature review
Authors: Kudsi Maysoun , Asaad Wisam , Khalayli Naram , Soud Alkousa Hamzeh , Haidar Ghina
Published: September 2023

Introduction:

Erythema nodosum (EN) is a self-limited septal panniculitis that presents with fever, arthralgia, and arthritis. Tumor necrosis factor alpha (TNF-α) inhibitor such as golimumab has been found to treat EN in inflammatory bowel diseases (IBD). We herein report the paradoxical occurrence of EN following golimumab for ankylosing spondylitis.

Case presentation:

A 34-year-old female presented in June 2022 with a complaint of ‘sores’ on her feet that intermittently presented for approximately 5 months but that had worsened dramatically in the last 24 h. The patient had an 8-year history of ankylosing spondylitis for 7 years. Subcutaneous golimumab was administered every 4 weeks as she had not responded to other treatments. Twenty-four hours after the fifth subcutaneous injection, painful, erythematous nodules appeared, histologically compatible with EN. Despite this side effect, we continue therapy due to the good response and efficacy.

Discussion:

Skin reactions were associated with the treatment with golimumab, including warm tender skin around the injection site, eruptions, itchiness, and sometimes a full-body rash. Golimumab was successfully used in treating EN in Crohn’s disease. Because our patient continued on golimumab, the temporal association of EN flares with therapeutic injection and the lack of any etiology support a direct causal relationship between EN and golimumab treatment.

Conclusion:

TNF-α inhibitors are useful in treating Crohn’s disease patients with EN, although it may present as an adverse effect of this treatment. Further work is needed.
The comparative study of skin staples and polypropylene sutures for securing the mesh in Lichtenstein’s tension-free inguinal hernia repair in HIV and hepatitis (B and C)-positive patients: a randomized controlled trial
Authors: Pragya  , Kumar Anil , Manish  , Ranjan Rahul , Jha Nawal Kishore
Published: September 2023

Introduction:

The mesh fixation in the Lichtenstein’s hernioplasty was traditionally performed with polypropylene sutures. A modification of this technique uses skin staples for securing the mesh. Using polypropylene sutures may increase the needle prick injuries (NPIs) in HIV and hepatitis-positive patients. This is the first study in India to compare the efficacy of anchoring the mesh with skin staplers and polypropylene sutures in hepatitis and HIV-positive patients.

Methods:

Fifty-two seropositive patients undergoing sixty repairs were randomized into two groups. In the control group polypropylene mesh was secured with polypropylene sutures and the skin was closed with ethilon. In the study group polypropylene mesh was secured with skin staples and the skin was closed with staples from the same stapler. Duration of surgery, postoperative complications, NPIs, recurrences and costs were compared.

Results:

The operation was significantly shorter when staples were used (median 46 vs. 57 min, P<0.00001). There was no significant difference in the incidence of postoperative complications. The NPIs was statistically significant in the suture group as compared to the stapler group (P<0.05).

Conclusion:

Using skin staples to secure the mesh in Lichtenstein inguinal hernioplasty significantly reduced the duration of surgery. It was as effective as conventional mesh fixation with polypropylene with added advantages to reduce the operating time, duration of exposure to infected blood, and the NPIs significantly in HIV, hepatitis B virus and hepatitis C virus-positive patients.
Esophageal variceal bleeding: portal hypertension and portal vein thrombosis secondary to protein S deficiency – a case report
Authors: Sapkota Prakash , Mainali Sumina , Khadayat Paras , K.C. Narendra , Joshi Arun , Koirala Prashant
Published: September 2023

Introduction:

Proteins C and S play a key role in the inhibition of the coagulation cascade. Deficiencies of proteins C and S deficiency are rare conditions that lead to abnormal activation of the coagulation cascade, resulting in a prothrombotic state and an increased risk of venous thromboembolism. These deficiencies also pose a risk factor for the development of portal vein thrombosis (PVT). PVT secondary to these deficiencies in the acute phase is usually asymptomatic, but the disease in chronic cases may present with features suggestive of portal hypertension, usually hepatosplenomegaly, variceal bleeding. However, cavernous transformation of the portal vein due to proteins C and S is usually rare.

Introduction and Importance:

Proteins C and S are rare thrombophilic disorders that may present even with PVT, resulting in esophageal bleeding as an uncommon presentation. Hence, protein S and protein C deficiency should also be considered a cause of noncirrhotic portal hypertension with esophageal bleeding.

Case Presentation:

The authors hereby present you with the case of a 22-year-old female who presented with complaints of abdominal pain and black-colored stool in the emergency department.

Clinical Discussion:

Relevant investigations were sent, and she was treated in line with esophageal variceal bleeding with the cavernous transformation of a thrombosed portal vein secondary to noncirrhotic portal hypertension due to protein C and S deficiency. Esophageal varices were managed with rubber band ligation. An oral anticoagulant was started for the thrombophilic disorder. The patient was also advised for splenectomy for splenomegaly and ongoing anemia and thrombocytopenia.

Conclusion:

The main aim of the article is to highlight a rare case of protein S deficiency that has led to upper GI bleeding due to esophageal varices secondary to portal hypertension secondary to PVT. Esophageal variceal bleeding secondary to PVT is an uncommon presentation of protein S deficiency. PVT without liver cirrhosis is also uncommon. Protein S and C deficiency is a rare clotting disorder that may cause clots in vessels and ultimately dislodgement of clots that can result in life-threatening complications. Hence, timely diagnosis, treatment, and prophylaxis can prevent life-threatening complications.
Dying and Death in a Pediatric Cardiac ICU: Mixed Methods Evaluation of Multidisciplinary Staff Responses
Authors: Broden Elizabeth G. , Bailey Valerie K. , Beke Dorothy M. , Snaman Jennifer M. , Moynihan Katie M.
Published: September 2023

OBJECTIVES:

Understanding factors influencing quality of pediatric end-of-life (EOL) care is necessary to identify interventions to improve family and staff experiences. We characterized pediatric cardiac ICU (PCICU) staff free-text survey responses to contextualize patterns in quality of dying and death (QODD) scoring.

DESIGN:

This mixed methods study reports on a cross-sectional survey of PCICU staff involved in patient deaths.

SETTING:

Single, quaternary PCICU from 2019-2021.

PARTICIPANTS:

Multidisciplinary staff (bedside nurses, allied health professionals, and medical practitioners) rated QODD and voluntarily added free-text responses. We derived descriptive categories of free-text responses using content analysis. Response sentiment was classified as positive, negative or both positive and negative. We compared category and sentiment frequency by discipline, EOL medical intensity, years of experience and QODD score quartiles.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Of 60 deaths and 713 completed staff surveys, 269 (38%) contained free-text responses, including 103 of 269 (38%) from nurses. Of six qualitative categories (i.e., relational dynamics, clinical circumstances, family experiences, emotional expressions, temporal conditions, and structural/situational factors), relational dynamics was most frequent (173 responses). When compared by discipline, family experiences were more common in nursing responses than medical practitioners or allied health. High intensity was associated with infrequent discussion of family experience and greater focus on temporal conditions and clinical circumstances. Emotional expressions and temporal conditions were more common in lowest QODD quartile surveys. Although 45% staff responses contained both sentiments, relational dynamics and family experiences were more likely positive. Negative sentiments were more common in the lowest QODD quartile surveys and responses containing temporal conditions or structural/situational factors.

CONCLUSIONS:

Synergistic relationships between the multidisciplinary team and family shaped clinician’s positive responses. Attention to team dynamics may be a crucial ingredient in interventions to improve EOL care. Our data support that team-based education initiatives should consider differential foci between disciplines and EOL characteristics.
Test Characteristics of Cardiac Point-of-Care Ultrasound in Children With Preexisting Cardiac Conditions
Authors: Hoffmann Robert M. , Neal Jeffrey T. , Arichai Piyawat , Gravel Cynthia A. , Neuman Mark I. , Monuteaux Michael C. , Levy Jason A. , Miller Andrew F.
Published: September 2023

Objective

The aim of the study is to assess diagnostic performance of cardiac point-of-care ultrasound (POCUS) performed by pediatric emergency medicine (PEM) physicians in children with preexisting cardiac disease.

Methods

We evaluated the use of cardiac POCUS performed by PEM physicians among a convenience sample of children with preexisting cardiac disease presenting to a tertiary care pediatric ED. We assessed patient characteristics and the indication for POCUS. The test characteristics of the sonologist interpretation for the assessment of both pericardial effusion as well as left ventricular systolic dysfunction were compared with expert POCUS review by PEM physicians with POCUS fellowship training.

Results

A total of 104 children with preexisting cardiac disease underwent cardiac POCUS examinations between July 2015 and December 2017. Among children with preexisting cardiac disease, structural defects were present in 72%, acquired conditions in 22%, and arrhythmias in 13% of patients. Cardiac POCUS was most frequently obtained because of chest pain (55%), dyspnea (18%), tachycardia (17%), and syncope (10%). Cardiac POCUS interpretation compared with expert review had a sensitivity of 100% (95% confidence interval [CI], 85.7–100) for pericardial effusion and 100% (95% CI, 71.5–100) for left ventricular systolic dysfunction; specificity was 97.5% (95% CI, 91.3.1–99.7) for pericardial effusion and 98.9% (95% CI, 93.8–99.8) for left ventricular systolic dysfunction.

Conclusions

Cardiac POCUS demonstrates good sensitivity and specificity in diagnosing pericardial effusion and left ventricular systolic dysfunction in children with preexisting cardiac conditions when technically adequate studies are obtained. These findings support future studies of cardiac POCUS in children with preexisting cardiac conditions presenting to the ED.
Prescribing Practices for Agitation Medication in Obese Patients Admitted to the Emergency Department
Authors: Kang Connie , Williams Andrew , Butala Niyati
Published: September 2023

Introduction:

Weight is a factor that influences the dosages of many medications, although no clinical studies have evaluated this factor in the use of agitation medications in the obese population. The objectives of this study were to assess the need for weight considerations in dosing antipsychotics and benzodiazepines for patients with agitation and to assess prescribing patterns in agitated patients.

Methods:

This retrospective cohort study compared outcomes between obese and nonobese adult patients who received at least one parenteral administration of an antipsychotic or benzodiazepine for agitation in the emergency department. The primary outcomes were total antipsychotic and benzodiazepine doses within 24 hours (in chlorpromazine equivalents and lorazepam equivalents, respectively). Key secondary outcomes included antipsychotic and benzodiazepine doses used for first administration, incidence of repeat emergency medication administration within 24 hours, time to next administration, and number of repeat administrations within 24 hours.

Results:

The study examined 115 patient encounters in each cohort of patients in the study. The baseline characteristics of the 2 study cohorts were similar. Both groups had similar mean 24-hour antipsychotic usage [272.7 chlorpromazine equivalents (nonobese cohort), 313.5 chlorpromazine equivalents (obese cohort); P=0.157] and mean 24-hour benzodiazepine usage [0.9 lorazepam equivalents (both cohorts); P=0.750]. Differences between the study cohorts on all of the secondary outcomes were also not statistically significant (P>0.05).

Discussion:

This study did not find the use of higher dosages of agitation medication in the obese compared with the nonobese population. Future prospective trials, with possible emphasis on individual medications, specific etiologies of agitation, or morbid obesity, are required to confirm this finding or to elucidate potential differences in optimal medication dosages for the obese population.
Acute respiratory distress syndrome, acute kidney injury, and mortality after trauma are associated with increased circulation of syndecan-1, soluble thrombomodulin, and receptor for advanced glycation end products
Authors: Dixon Alexandra , Kenny James E. , Buzzard Lydia , Holcomb John , Bulger Eileen , Wade Charles , Fabian Timothy , Schreiber Martin ,   the PROPPR Study Group
Published: September 2023

Background

Disruption of the vascular endothelium and endothelial glycocalyx (EG) has been described after severe trauma. Plasma has been suggested to restore microvascular integrity by preservation and repair of the EG. We sought to evaluate whether plasma administered in a 1:1:1 ratio was associated with less endothelial marker circulation than a 1:1:2 ratio.

Methods

This is a secondary analysis of the PROPPR trial which investigated post-traumatic resuscitation with platelets, plasma, and red blood cells in a 1:1:1 ratio compared with a 1:1:2 ratio. Syndecan-1, soluble thrombomodulin (sTM), and receptor for advanced glycation end products (RAGE) were quantified for each treatment group on admission and at 2, 4, 6, 12, 24, 48, and 72 hours. Patients were excluded if they did not survive longer than 3 hours or had data from fewer than two time points.

Results

308 patients in the 1:1:1 group and 291 in the 1:1:2 group were analyzed. There were no statistically significant differences in syndecan-1, sTM, or RAGE between treatment groups at any time point (p > 0.05). Patients who developed acute respiratory distress syndrome, acute kidney injury, and death had significantly elevated biomarker expression at most time points when compared to patients who did not develop these sequelae (p < 0.05).

Conclusions

Administration of FFP in a 1:1:1 ratio does not consistently affect circulation of endothelial biomarkers following significant trauma when compared to a 1:1:2 ratio. The development of post-traumatic ARDS, AKI, and death was associated with increased endothelial biomarker circulation.

Level of Evidence

Secondary analysis of Level I evidence
Balanced resuscitation with whole blood versus component therapy in critically injured preadolescent children: Getting there faster with fewer exposures
Authors: McLoughlin Robert J. , Josephson Cassandra D. , Neff Lucas P. , Chandler Nicole M. , Gonzalez Raquel , Russell Robert T. , Snyder Christopher W.
Published: September 2023

PURPOSE

Balanced blood product resuscitation with red blood cells, plasma, and platelets can be achieved using whole blood (WB) or component therapy (CT). However, balanced resuscitation of younger children with severe traumatic hemorrhage may be complicated by delays in delivering all blood components and concerns regarding multiple product exposures. We hypothesized that WB achieves balanced resuscitation faster than CT, with fewer product exposures and improved clinical outcomes.

METHODS

Children younger than 12 years receiving balanced resuscitation within 4 hours of arrival were identified from the 2017 to 2019 Trauma Quality Improvement Program database. Time to balanced resuscitation was defined as the time of initiation of WB or all three components. Patient characteristics, resuscitation details, and outcomes were compared between WB and CT groups. Time to balanced resuscitation was compared using Kaplan-Meier analysis and Cox regression modeling to adjust for covariates. Additional multivariable regression models compared number of transfusion exposures, intensive care unit (ICU) length of stay, and mortality.

RESULTS

There were 390 patients (109 WB, 281 CT) with median age 7 years, 12% penetrating mechanism, 42% severe traumatic brain injury, and 49% in-hospital mortality. Time to balanced resuscitation was shorter for WB versus CT (median, 28 vs. 87 minutes; hazard ratio [HR], 2.93; 95% confidence interval [CI], 2.31–3.72; p < 0.0001). Whole blood patients received fewer transfusion exposures (mean, 3.2 vs. 3.9; adjusted incidence rate ratio, 0.82; 95% CI, 0.72–0.92; p = 0.001) and lower total product volumes (50 vs. 85 mL/kg; p = 0.01). Intensive care unit stays trended shorter for WB versus CT (median, 10 vs. 12 days; adjusted HR, 1.32; 95% CI, 0.93–1.86), while in-hospital mortality was similar (50% vs. 45%; adjusted odds ratio, 1.11; 95% CI, 0.65–1.88).

CONCLUSION

In critically injured preadolescent children receiving emergent transfusion, WB was associated with faster time to balanced resuscitation, fewer transfusion exposures, lower blood product volumes, and a trend toward shorter ICU stays than CT.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.
Emergency general surgery verification: Quality improvement and the case for optimal resources and process standards
Authors: Coleman Jamie J. , Davis Kimberly A. , Savage Stephanie A. , Staudenmayer Kristin , Coimbra Raul
Published: September 2023

Patients with emergency general surgery (EGS) diagnoses comprise over 10% of all hospital admissions, resulting in a projected number of 4.2 million admissions for 2023. Approximately 25% will require emergency surgical intervention, half will sustain a postoperative complication, and 15% will have a readmission within the first 30 days of surgery. In the face of this growing public health burden and to better meet the needs of these acutely ill patients, it was recognized that a formal quality improvement program, including standardization of data collection and the development of systems of care specifically for EGS have been lacking. Establishing standardized processes for quality improvement, including a national databank, and maintaining adherence to these processes as ensured by a robust verification process has improved outcomes research and patient care in the field of trauma, another time-sensitive specialty. In response to this perceived deficit, the “Optimal Resources for Emergency General Surgery” was developed. An extension of the current National Surgical Quality Improvement Program platform, specifically for operative and non-operative EGS cases, was developed and implemented. A robust set of standards were outlined to verify EGS programs/services. Defining the elements of an effective EGS program and developing hospital and practice standards consolidated EGS as an integral component of Acute Care Surgery. The verification program addresses a societal need and allows hospitals to better organize EGS care delivery and benchmark their results nationally.
Handedness and individual roll-angle specialism when plunge diving in the northern gannet
Authors: Bennison Ashley , Clark Bethany L. , Votier Stephen C. , Quinn John L. , Darby Jamie , Jessopp Mark
Published: September 2023

Many vertebrates show lateralized behaviour, or handedness, where an individual preferentially uses one side of the body more than the other. This is generally thought to be caused by brain lateralization and allows functional specializations such as sight, locomotion, and decision-making among other things. We deployed accelerometers on 51 northern gannets,
Morus bassanus
, to test for behavioural lateralization during plunge dives. When plunge diving, gannets ‘roll’ to one side, and standard indices indicated that 51% of individuals were left-sided, 43% right-sided, and 6% ‘non-lateralized’. Lateralization indices provide no measure of error and do not account for environmental covariance, so we conducted two repeatability analyses on individuals' dive roll direction and angle. Dive side lateralization was highly repeatable among individuals over time at the population level (
R
= 0.878,
p
< 0.001). Furthermore, roll angle was also highly repeatable in individuals (
R
= 0.751,
p
< 0.001) even after controlling for lateralized state. Gannets show individual specializations in two different parts of the plunge diving process when attempting to catch prey. This is the first demonstration of lateralization during prey capture in a foraging seabird. It is also one of the few demonstrations of behavioural lateralization in a mixed model approach, providing a structure for further exploring behavioural lateralization.
Evolution of conditional cooperation in collective-risk social dilemma with repeated group interactions
Authors: Hua Shijia , Hui Zitong , Liu Linjie
Published: September 2023

The evolution and long-term sustenance of cooperation has consistently piqued scholarly interest across the disciplines of evolutionary biology and social sciences. Previous theoretical and experimental studies on collective risk social dilemma games have revealed that the risk of collective failure will affect the evolution of cooperation. In the real world, individuals usually adjust their decisions based on environmental factors such as risk intensity and cooperation level. However, it is still not well understood how such conditional behaviours affect the evolution of cooperation in repeated group interactions scenario from a theoretical perspective. Here, we construct an evolutionary game model with repeated interactions, in which defectors decide whether to cooperate in subsequent rounds of the game based on whether the risk exceeds their tolerance threshold and whether the number of cooperators exceeds the collective goal in the early rounds of the game. We find that the introduction of conditional cooperation strategy can effectively promote the emergence of cooperation, especially when the risk is low. In addition, the risk threshold significantly affects the evolutionary outcomes, with a high risk promoting the emergence of cooperation. Importantly, when the risk of failure to reach collective goals exceeds a certain threshold, the timely transition from a defective strategy to a cooperative strategy by conditional cooperators is beneficial for maintaining high-level cooperation.
Simultaneous warming and acidification limit population fitness and reveal phenotype costs for a marine copepod
Authors: deMayo James A. , Brennan Reid S. , Pespeni Melissa H. , Finiguerra Michael , Norton Lydia , Park Gihong , Baumann Hannes , Dam Hans G.
Published: September 2023

Phenotypic plasticity and evolutionary adaptation allow populations to cope with global change, but limits and costs to adaptation under multiple stressors are insufficiently understood. We reared a foundational copepod species,
Acartia hudsonica
, under ambient (AM), ocean warming (OW), ocean acidification (OA), and combined ocean warming and acidification (OWA) conditions for 11 generations (approx. 1 year) and measured population fitness (net reproductive rate) derived from six life-history traits (egg production, hatching success, survival, development time, body size and sex ratio). Copepods under OW and OWA exhibited an initial approximately 40% fitness decline relative to AM, but fully recovered within four generations, consistent with an adaptive response and demonstrating synergy between stressors. At generation 11, however, fitness was approximately 24% lower for OWA compared with the AM lineage, consistent with the cost of producing OWA-adapted phenotypes. Fitness of the OWA lineage was not affected by reversal to AM or low food environments, indicating sustained phenotypic plasticity. These results mimic those of a congener,
Acartia tonsa
, while additionally suggesting that synergistic effects of simultaneous stressors exert costs that limit fitness recovery but can sustain plasticity. Thus, even when closely related species experience similar stressors, species-specific costs shape their unique adaptive responses.
Assessing variation inCitrus limon‘Assam lemon’: morphological, seed availability pattern, and biochemical diversity across different districts of Assam
Authors: Akhtar Suraiya , Ahmed Raja , Begum Khaleda , Das Ankur , Saikia Sarat , Banu Sofia
Published: September 2023

The Assam lemon is a highly valuedCitruscultivar known for its unique aroma, flavor, and seedless fruit characteristic. This study aimed to investigate for the first time the morphological, seeding pattern, and biochemical, variations within 133 populations of Assam lemon cultivar growing across 22 districts of Assam, India, and including control population, with the objective to offer comprehensive understanding that could facilitate the improvement of breeding programs and further improvement of this important cultivar. Using the dendrogram-based UPGMA algorithm, morphological and seeding pattern data were analyzed at both district and population levels. The resulting dendrograms revealed two major clusters, where all the populations of Upper Assam districts were in the same cluster with the original stock (control population). However, populations from Tinsukia and Dhemaji districts displayed more close similarities with the control population in comparison to other populations of Upper Assam districts. Another interesting observation was regarding flowering patterns, while some populations displayed both bisexual and unisexual flowers with less concentration of unisexual flowers, others had bisexual and unisexual flowers of almost equal concentration. Unisexual flowers contained only the male reproductive organs with 40 anthers, while bisexual flowers had 36 anthers. Seeding patterns were examined across the districts, and it was found that populations from Tinsukia, Dhemaji, Lakhimpur, Dibrugarh, Jorhat, and the control population exhibited seedless characteristic while populations from other selected districts displayed a combination of seedless and seeded traits. Interestingly, Golaghat district appears as the linking district and showed availability of both seeded and seedless Assam lemon fruit, connecting the regions of Upper, Central, Lower and North Assam and Barak valley. Biochemical analysis showed significant variations across districts, however, the populations from Dhemaji, Tinsukia, Lakhimpur, Dibrugarh, and Jorhat districts displayed similarity with the control population. The study also investigated variability in soil nutrient content revealing substantial variation among the populations studied, potentially influencing observed morphological variations. This comprehensive investigation provides valuable insights into the morphological, seeding pattern, and biochemical diversity within the Assam lemon cultivar. These findings can be instrumental in breeding programs to enhance thisCitruscultivar, particularly in producing high-quality seedless fruits to meet consumer demands.
G-PLIP: Knowledge graph neural network for structure-free protein-ligand bioactivity prediction
Authors: Crouzet Simon J. , Lieberherr Anja Maria , Atz Kenneth , Nilsson Tobias , Sach-Peltason Lisa , Müller Alex T. , Dal Peraro Matteo , Zhang Jitao David
Published: September 2023

Protein-ligand interaction (PLI) shapes efficacy and safety profiles of small molecule drugs. Existing methods rely on either structural information or resource-intensive computation to predict PLI, making us wonder whether it is possible to perform structure-free PLI prediction with low computational cost. Here we show that a light-weight graph neural network (GNN), trained with quantitative PLIs of a small number of proteins and ligands, is able to predict the strength of unseen PLIs. The model has no direct access to structural information of protein-ligand complexes. Instead, the predictive power is provided by encoding the entire chemical and proteomic space in a single heterogeneous graph, encapsulating primary protein sequence, gene expression, protein-protein interaction network, and structural similarities between ligands. The novel model performs competitively with or better than structure-aware models. Our observations suggest that existing PLI-prediction methods may be further improved by using representation learning techniques that embed biological and chemical knowledge.
Diet-induced plasticity of life-history traits and gene expression in outbredDrosophila melanogasterpopulation
Authors: Mudunuri Akhila , Chandrakanth M , Khan Soumen , Sura Chand , Kumar Nishant , Tung Sudipta
Published: September 2023

Food is fundamental for the survival of organisms, governing growth, maintenance, and reproduction through the provision of essential macronutrients. However, access to food with optimum macronutrient composition, which will maximize the evolutionary fitness of an organism, is not always guaranteed. This leads to dietary mismatches with potential impacts on organismal performance. To understand the consequences of such dietary mismatches, we examined the effects of isocaloric diets varying in macronutrient composition on eight key organismal traits spanning across the lifespan of a large outbredDrosophila melanogasterpopulation (n ∼ 2500). Our findings reveal that carbohydrate-reduced isocaloric diets correlates to accelerated pre-adult development and boosts reproductive output without impacting pre-adult viability and body size. Conversely, an elevated dietary carbohydrate content correlated to reduced lifespan in flies, evidenced by accelerated functional senescence including compromised locomotor activity and deteriorating gut integrity. Furthermore, transcriptomic analysis indicated a substantial difference in gene regulatory landscapes between flies subject to high carbohydrate vs high protein diet, with elevated protein levels indicating transcriptomes primed for reduced synthesis of fatty acids. Taken together, our study helps advance our understanding of the effect of macronutrient composition on life history traits and their interrelations, offering critical insights into potential adaptive strategies that organisms might adopt against the continual dietary imbalances prevalent in the rapidly evolving environment.
Scalable bio-platform to recover critical metals from complex waste sources
Authors: Good Nathan M. , Kang-Yun Christina S. , Su Morgan Z. , Zytnick Alexa M. , Vu Huong N. , Grace Joseph M. , Nguyen Hoang H. , Park Dan M. , Skovran Elizabeth , Fan Maohong , Martinez-Gomez N. Cecilia
Published: September 2023

Chemical methods for extraction and refinement of technologically critical rare earth elements (REEs) are energy intensive, hazardous, and environmentally destructive. Current bio-based extraction systems rely on extremophilic organisms and generate many of the same detrimental effects as chemical methodologies. The mesophilic methylotrophic bacteriumMethylobacterium extorquensAM1 was previously shown to grow using electronic waste by naturally acquiring REEs to power methanol metabolism. Here we show that growth using electronic waste as a sole REE source is scalable up to 10 L with consistent metal yields, without the use of harsh acids or high temperatures. Addition of organic acids increases REE leaching in a nonspecific manner. REE-specific bioleaching can be engineered through the overproduction of REE-binding ligands (called lanthanophores) and pyrroloquinoline quinone. REE bioaccumulation increases with leachate concentration and is highly specific. REEs are stored intracellularly in polyphosphate granules, and genetic engineering to eliminate exopolyphosphatase activity increases metal accumulation, confirming the link between phosphate metabolism and biological REE use. Finally, we report the innate ability ofM. extorquensto grow using other complex REE sources including pulverized smart phones, demonstrating the flexibility and potential for use as a recovery platform for these critical metals.
Membrane Lipid Nanodomains Modulate HCN Pacemaker Channels in Nociceptor DRG Neurons
Authors: Handlin Lucas J. , Macchi Natalie L. , Dumaire Nicolas L.A. , Salih Lyuba , Lessie Erin N. , McCommis Kyle S. , Moutal Aubin , Dai Gucan
Published: September 2023

Cell membranes consist of heterogeneous lipid nanodomains that influence key cellular processes. Using FRET-based fluorescent assays and fluorescence lifetime imaging microscopy (FLIM), we found that the dimension of cholesterol-enriched ordered membrane domains (OMD) varies considerably, depending on specific cell types. Particularly, nociceptor dorsal root ganglion (DRG) neurons exhibit large OMDs. Disruption of OMDs potentiated action potential firing in nociceptor DRG neurons and facilitated the opening of native hyperpolarization-activated cyclic nucleotide-gated (HCN) pacemaker channels. This increased neuronal firing is partially due to an increased open probability and altered gating kinetics of HCN channels. The gating effect on HCN channels was likely due to a direct modulation of their voltage sensors by OMDs. In animal models of neuropathic pain, we observed reduced OMD size and a loss of HCN channel localization within OMDs. Additionally, cholesterol supplementation inhibited HCN channels and reduced neuronal hyperexcitability in pain models. These findings suggest that disturbances in lipid nanodomains play a critical role in regulating HCN channels within nociceptor DRG neurons, influencing pain modulation.
Inflammation and autoimmunity are interrelated in patients with sickle cell disease at a steady-state condition: implications for vaso-occlusive crisis, pain, and sensory sensitivity
Authors: Li Wei , Pucka Andrew Q , Debats Candice , Reyes Brandon , Syed Fahim , O’Brien Andrew R , Mehta Rakesh , Manchanda Naveen , Jacob Seethal A , Hardesty Brandon M , Greist Anne , Harte Steven E , Harris Richard E , Yu Qigui , Wang Ying
Published: September 2023

This study aimed to comprehensively analyze inflammatory and autoimmune characteristics of patients with sickle cell disease (SCD) at a steady-state condition (StSt) compared to healthy controls (HCs) to explore the pathogenesis of StSt and its impact on patients’ well-being. The study cohort consisted of 40 StSt participants and 23 HCs enrolled between July 2021 and April 2023. StSt participants showed elevated white blood cell (WBC) counts and altered hematological measurements when compared to HCs. A multiplex immunoassay was used to profile 80 inflammatory cytokines/chemokines/growth factors in plasma samples from these SCD participants and HCs. Significantly higher plasma levels of 37 analytes were observed in SCD participants, with HGF, IL-18, IP-10, and MCP-2 being among the most significantly affected analytes. Additionally, autoantibody profiles were also altered, with elevated levels of anti-SSA/Ro60, anti-Ribosomal P, anti-Myeloperoxidase (MPO), and anti-PM/Scl-100 observed in SCD participants. Flow cytometric analysis revealed higher rates of red blood cell (RBC)/reticulocyte-leukocyte aggregation in SCD participants, predominantly involving monocytes. Notably, correlation analysis identified associations between inflammatory mediator levels, autoantibodies, RBC/reticulocyte-leukocyte aggregation, clinical lab test results, and pain crisis/sensitivity, shedding light on the intricate interactions between these factors. The findings underscore the potential significance of specific biomarkers and therapeutic targets that may hold promise for future investigations and clinical interventions tailored to the unique challenges posed by SCD. In addition, the correlations between vaso-occlusive crisis (VOC)/pain/sensory sensitivity and inflammation/immune dysregulation offer valuable insights into the pathogenesis of SCD and may lead to more targeted and effective therapeutic strategies.
The selective D3-Receptor antagonist VK4-116 effectively treats behavioral inflexibility in rats caused by self-administration and withdrawal from cocaine
Authors: Panayi Marios C. , Shetty Shohan , Porod Micaela , Bahena Lisette , Xi Zheng-Xiong , Newman Amy Hauck , Schoenbaum Geoffrey
Published: September 2023

Chronic psychostimulant use can cause long lasting changes to neural and cognitive function that persist even after long periods of abstinence. As cocaine users transition from drug use to abstinence, a parallel transition from hyperactivity to hypoactivity has been found in orbitofrontal-striatal glucose metabolism, and striatal D2/D3 receptor activity. Targeting these changes pharmacologically, using highly selective dopamine D3 receptor (D3R) antagonists and partial agonists, has shown significant promise in reducing drug-taking, and attenuating relapse in animal models of cocaine and opioid use disorder. However, much less attention has been focused on treating inflexible and potentially maladaptive non-drug behaviors following chronic psychostimulant use. Here we tested the selective D3R antagonist VK4-116 as a treatment for the long-term behavioral inflexibility in abstinent male and female rats with a prior history of chronic cocaine use. Rats were first trained to self-administer cocaine (0.75 mg/kg/reinforcer) or a sucrose liquid (10%, .04 mL/reinforcer) for 2 weeks (FR1 schedule, max 60 reinforcers in 3 hrs/ day), followed by 4 weeks of abstinence. Cognitive and behavioral flexibilities were then assessed using a sensory preconditioning (SPC) learning paradigm. Rats were given an VK4-116 (15 mg/kg, i.p.) or vehicle 30 mins prior to each SPC training session, thus creating four drug-treatment groups: sucrose-vehicle, sucrose-VK4-116, cocaine-vehicle, cocaine-VK4-116. The control groups (sucrose-vehicle, sucrose-VK4-116) demonstrated significant evidence of flexible SPC behavior, whereas cocaine use (cocaine-vehicle) disrupted SPC behavior. Remarkably, the D3R antagonist VK4-116 mitigated this cocaine deficit in the cocaine-VK4-116 group, demonstrating flexible SPC to levels comparable to the control groups. These preclinical findings demonstrate that highly selective dopamine D3R antagonists, particularly VK4-116, show significant promise as a pharmacological treatment for the long-term negative behavioral consequences of cocaine use disorder.