bluuebunny/crossref_metadata_2025 huggingface dataset:
Sudden diffuse spasm of multiple coronary arteries: A case report
Authors: Cai Hui , Chen Shuxia , Wang Dongxiao
Published: January 2024

Rationale:

Diffuse multivessel coronary artery spasm (DMV-CAS) was defined as a severe and reversible diffuse spasm occurring in more than 2 major coronary arteries, which is rare in clinical practice. Due to a wide lesion scope, DMV-CAS often occurs in the form of complications. It is not easy to be clinically diagnosed because it is too brief to be caught. Here, we report a rare case of spontaneous subtotal occlusion of 3 major coronary arteries induced by Vasalva action, which was confirmed in real-time by CAG.

Patient concerns:

A 68-year-old man had sudden chest pain after forced defecation during hospitalization. The electrocardiogram showed transient ST segment elevation of the inferior wall lead, inversion of the anterior wall, and lateral wall leads T waves. Emergency CAG revealed elongated vessel beds in 3 coronary arteries and multiple diffuse stenosis, but none of the coronary arteries were completely occlusive.

Diagnoses:

Diagnoses of DMV-CAS were made based on CAG findings and postmedication response.

Interventions:

Nitroglycerin was administered in the coronary arteries. The anti-vasospasm, antiplatelet aggregation and lipid-regulating drugs were administered orally.

Outcomes:

The patient was discharged on the 7th day with complete resolution of symptoms and normalization of the electrocardiography findings. No ischemic events occurred during a follow-up for 5 months.

Lessons:

This case highlights the identification of multivessel diffuse coronary spasm and acute myocardial infarction, and the prevention of CAS triggers, which requires the attention of clinicians.
Relieving urinary tract obstructions may increase the risk of gouty arthritis in patients with hyperuricemia and postrenal obstructions
Authors: Li Dapeng , Yue Xiaoyan , Wang An , Wang Jun , Zhang Wei , Wu Mingming , Wei Yangguang
Published: January 2024

To evaluate the effect of relieving urinary tract obstructions (RUO) on the risk of gouty arthritis in patients with postrenal obstructions and hyperuricemia. We retrospectively analyzed the clinical data of 130 patients with urinary tract obstructions at Rongcheng People’s Hospital from 2018 to 2021. Patients were divided into groups A (n = 62) and B (n = 68) according to the treatment method. Patients in group A underwent conservative treatments, such as drugs, extracorporeal shock wave lithotripsy (ESWL), and hemodialysis. Patients in Group B underwent catheterization, cystostomy, nephrostomy, or double J ureteral catheterization for rapid RUO. The ages of groups A and B were 58.40 ± 17.69 and 59.63 ± 16.12 years, respectively (P = .42). Before treatment, the serum uric acid values were 572.05 ± 106.93 and 567.79 ± 97.21 µmol/L, respectively (P = .94); serum creatinine values were 226.66 ± 269.67 and 280.15 ± 200.75 µmol/L, respectively (P = .88); and urine volumes were 913.23 ± 481.92 and 886.18 ± 552.72 mL/24 h, respectively (P = .08). No significant differences in the general data were identified between the two groups (P > .05). The effects of the two treatments on the incidence of gout in patients with hyperuricemia complicated by postrenal obstruction were compared based on changes in uric acid level, creatinine level, and urine volume within 1 week after treatment. Multivariate logistic regression analysis was used to analyze clinical factors that increased the incidence of gout after RUO. The gout incidence rates in group A before and after treatment were 8.1% (5/62) and 6.5% (4/62), respectively (P > .99). The gout incidence rates in group B before and after treatment were 4.4% (3/68) and 19.1% (10/68), respectively (P = .01). Group B had a statistically significant increase in the gout incidence rate after RUO (P < .05). Multivariate logistic regression analysis showed that having an age > 60 years, urine volume ≤400 mL/24 h, and creatinine level > 186 µmol/L before treatment were risk factors for gout in patients with hyperuricemia after RUO. Relieving urinary tract obstruction increases the risk of gouty arthritis in patients with hyperuricemia and acute postrenal obstruction. Age, urine volume, and creatinine levels before treatment are risk factors for gout in patients with hyperuricemia after RUO.
Clinical recurrence and antiplatelet drug resistance among patients with lower limb ischemia
Authors: Alrabadi Nasr , Aljarrah Qusai , Alzoubi Osama , Al-Jarrah Hussam , Elayyan Yasmin , Alnabulsi Zaid , Husein Anas , Alzoubi Karem H. , Bakkar Sohail , Aljanabi Mukhallad , Zihlif Malik , Haddad Razan
Published: January 2024

There is a high prevalence rate of peripheral artery disease worldwide, with estimated cases exceeding 200 million. Most patients are under-diagnosed and under-treated, and there is a lack of knowledge regarding the best therapeutic regimen and therapy duration, which leads to many cases of recurrence, complications, and amputations. This study aims to explore clinical recurrence, which was defined as the worsening of chronic peripheral artery disease requiring hospital admission, and its relationship with antiplatelet drug resistance among patients with lower limb ischemia. This cohort study includes both retrospective and prospective recruitment of patients with chronic lower limb ischemia. Platelet aggregation tests were offered to the patients. Between February 2018 and November 2020, 147 patients were recruited from King Abdullah University Hospital and followed up for at least 1 year. Platelet aggregation tests were done for 93 patients who agreed to participate in this part of the study. The prevalence of chronic lower limb ischemia was higher in young male patients who are current smokers with co-morbid diseases such as hypertension, diabetes mellitus, and/or dyslipidemia. There was a significant association only of clinical recurrence with younger age (P = .011) and with low platelets count in severe stages of the disease (P = .047). No significant association was found in terms of laboratory resistance. The clinical recurrence rates of chronic lower limb ischemia were higher in younger patients and among those with low platelet counts in the severe stages of the disease. Despite the laboratory responsiveness to anti-platelet therapy, we observed significant clinical resistance and increased recurrence rates.
Case report: A case of high virulence and multidrug resistant Klebsiella pneumoniae liver abscess in Ningxia, China
Authors: Wang Liangfang , Li Gang , Hou Xiaohui , Feng Lijun , Shi Zhiyun
Published: January 2024

Rationale:

Highly virulent multidrug-resistant Klebsiella pneumoniae (KP) is becoming more and more common in clinical practice, especially the rise of carbapenem-resistant KP in clinical practice, resulting in the emergence of KP liver abscess in Ningxia, China. For the prognosis of liver abscess patients, it is particularly important to identify the types of pathogens and identify antibiotics that are sensitive to the pathogens.

Patient concerns:

A 73-year-old man from China presents to our hospital with abdominal pain, jaundice and fever. Patients have no obvious cause of abdominal pain, abdominal distension, and abdominal pain is persistent. Abdominal examination showed hepatomegaly, no tenderness 2 cm from the right costal margin, abdominal distension and other general examinations did not have obvious abnormalities. He had no history of hypertension and diabetes, ERCP was performed for cholangiocarcinoma 1 year before the current visit, and no significant complications occurred.

Diagnoses:

His initial diagnosis was obstructive cholangitis, and computed tomographic images and liver drainage fluid bacterial culture and genetic polymerase chain reaction tests later determined that the patient had KP liver abscess.

Interventions:

Drainage by liver catheter and antibiotic treatment for 7 weeks.

Outcomes:

The patient liver abscess is basically gone.

Lession:

It is particularly important to optimize the diagnosis of liver abscess pathogens for timely and effective treatment of patients.
A bibliometric review and visual analysis of orthotic treatment in adolescent idiopathic scoliosis from the Web of Science database and CiteSpace software
Authors: Luo Changliang , Wu Huidong , Liu Wei , Wong Mansang
Published: January 2024

Orthotic treatment has been the primary nonoperative treatment for patients with adolescent idiopathic scoliosis (AIS), however, no bibliometric study has been conducted in this field to date. Therefore, this study aims to analyze potential trends and new advances in the field of orthotic treatment of AIS through a bibliometric analysis and visualization study. Relevant literature included in the Web of Science database from the start of the database to the 1st month of 2023 was retrieved and analyzed using CiteSpace software (version 6.1.R6). Data on the nations, institutions, authors, journals, keywords, and cited references were collected for each publication. A total of 1005 records were included. The most productive countries and institutions were the USA and Hong Kong Polytechnic University, respectively. Spine was the most influential journal, with the highest number of citations. Hubert Labelle had the most publications, whereas Weinstein was the most cited author. The efficacy of orthotic treatment has always been at the frontier of research. Notably, changes in the quality of life after orthotic treatment, success rate or curve progression, new classification systems, and exercises have been the focus of research in recent years. This study enriches the understanding of research landscapes and key contributors in orthotic treatment for AIS.
Case report: Blood pressure variation during cardiopulmonary bypass in a patient with multiple sclerosis
Authors: Helms Florian , Rümke Stefan , Schill Bettina , Kühn Christian
Published: January 2024

Introduction and importance:

Multiple sclerosis is known to be associated with both sympathetic and parasympathetic cardiovascular autonomic dysregulation. Thus, patients with multiple sclerosis comorbidity represent a potentially challenging patient population in cardiac surgery, especially in on-pump operations. Despite this, very little is known about the hemodynamics during cardiopulmonary bypass and the optimal perfusion strategy for patients with multiple sclerosis undergoing cardiac operations.

Case presentation:

In this report, the authors describe a patient with relapsing-remitting multiple sclerosis, who underwent successful triple valve operation for aortic and mitral stenosis and tricuspid valve insufficiency. Distinct blood pressure variations in form of temporary pressure dips were noted during total cardiopulmonary bypass time as well as during the reperfusion period.

Clinical discussion:

Pressure variations were not attributable to surgical, pharmacological or perfusion-related manoeuvres. Thus, they most likely represent symptoms of cardiovascular autonomic dysregulation manifesting during cardiopulmonary bypass. In this patient, blood pressure variations terminated spontaneously and remained within an acceptable range without external correction.

Conclusions:

When treating patients with multiple sclerosis comorbidity, the potential pressure variability due to cardiovascular autonomic dysregulation should be taken into consideration to avoid increased blood pressure volatility due to overcorrection or undercorrection during cardiopulmonary bypass.
Three-dimensional imaging evaluation of facial swelling after orthognathic surgery with compression and Kinesio taping therapy: a randomized clinical trial
Authors: Nakao Hiroaki , Hasegawa Shogo , Tomimatsu Mai , Sasaki Jun , Yamamoto Satoshi , Watanabe Satoshi , Miyabe Satoru , Terasawa Fumitaka , Miyachi Hitoshi , Goto Mitsuo
Published: January 2024

Background

Postoperative swelling is a common complication of orthognathic surgery. The authors used three-dimensional (3D) image analysis and body surface temperature to determine the effects of compression taping (CT) and Kinesio taping (KT) by the epidermis, dermis, and fascia method (EDF-KT) on postoperative swelling.

Materials and methods:

The authors conducted a prospective, parallel-group, randomized controlled trial. Among the 162 patients diagnosed with jaw deformity and who underwent orthognathic surgery from August 2020 to October 2022, 105 patients (men: 36, women: 69, mean age: 28.27±8.92) underwent Le Fort type I + sagittal split ramus osteotomy (SSRO) or SSRO and were included in this study. Patients were randomly divided into three groups: EDF-KT group (n=31), CT group (n=41), and no tape group (control group, n=30). All taping was performed immediately postoperatively and removed on postoperative day (POD) 5. Three-dimensional images of the participants’ faces were obtained preoperatively and at PODs 3, 7, 30, and 90 using a hand-held 3D imaging system and infrared thermography.

Results:

No significant difference was observed in postoperative swelling and postoperative body surface temperature between the groups at each time point. The CT group showed a trend towards reduced swelling on PODs 3 and 7 and a trend toward residual swelling on POD 90. The EDF-KT group showed a trend towards an increase in postoperative body surface temperature.

Conclusion:

CT taping may not be appropriate for postoperative swelling control, suggesting that EDF-KT may affect body surface temperature. Further validation of the efficacy of KT for jaw deformities is needed.
Current use of intraoperative ultrasound in modern liver surgery
Authors: Chu Kai-Jian , Kawaguchi Yoshikuni , Hasegawa Kiyoshi
Published: January 2024

Ultrasound plays an important role not only in preoperative diagnosis but also in intraoperative guidance for liver surgery. Intraoperative ultrasound (IOUS) has become an indispensable tool for modern liver surgeons, especially for minimally invasive surgeries, partially substituting for the surgeon's hands. In fundamental mode, Doppler mode, contrast enhancement, elastography, and real-time virtual sonography, IOUS can provide additional real-time information regarding the intrahepatic anatomy, tumor site and characteristics, macrovascular invasion, resection margin, transection plane, perfusion and outflow of the remnant liver, and local ablation efficacy for both open and minimally invasive liver resections. Identification and localization of intrahepatic lesions and surrounding structures are crucial for performing liver resection, preserving the adjacent vital vascular and bile ducts, and sparing the functional liver parenchyma. Intraoperative ultrasound can provide critical information for intraoperative decision-making and navigation. Therefore, all liver surgeons must master IOUS techniques, and IOUS should be included in the training of modern liver surgeons. Further investigation of the potential benefits and advances in these techniques will increase the use of IOUS in modern liver surgeries worldwide. This study comprehensively reviews the current use of IOUS in modern liver surgeries.
The health equity implications of the Health Resources and Services Administration's Ryan White HIV/AIDS Program
Authors: Goyal Ravi , Hotchkiss John , Gilman Boyd , Klein Pamela W. , Mills Robert J. , Starling Jennifer , Martin Natasha K. , Patton Thomas , Cohen Stacy M. , Cheever Laura
Published: January 2024

Objective:

Investigate the role of the Ryan White HIV/AIDS Program (RWHAP) – which funds services for vulnerable and historically disadvantaged populations with HIV – in reducing health inequities among people with HIV over a 10-year horizon.

Design:

We use an agent-based microsimulation model to incorporate the complexity of the program and long-time horizon.

Methods:

We use a composite measure (the Theil index) to evaluate the health equity implications of the RWHAP for each of four subgroups (based on race and ethnicity, age, gender, and HIV transmission category) and two outcomes (probability of being in care and treatment and probability of being virally suppressed). We compare results with the RWHAP fully funded versus a counterfactual scenario, in which the medical and support services funded by the RWHAP are not available.

Results:

The model indicates the RWHAP will improve health equity across all demographic subgroups and outcomes over a 10-year horizon. In Year 10, the Theil index for race and ethnicity is 99% lower for both outcomes under the RWHAP compared to the non-RWHAP scenario; 71–93% lower across HIV transmission categories; 31–44% lower for age; and 73–75% lower for gender.

Conclusion:

Given the large number of people served by the RWHAP and our findings on its impact on equity, the RWHAP represents an important vehicle for achieving the health equity goals of the National HIV/AIDS Strategy (2022–2025) and the Ending the HIV Epidemic Initiative goal of reducing new infections by 90% by 2030.
Prospective Sensory Outcomes for Targeted Nipple Areola Complex Reinnervation (TNR) in Gender-Affirming Double Incision Mastectomy with Free Nipple Grafting
Authors: Remy Katya , Packowski Kathryn , Alston Chase , Kozanno Liana N. , Carruthers Katherine H. , Tomczyk Eleanor G. , Winograd Jonathan M. , Austen William G. , Valerio Ian L. , Gfrerer Lisa
Published: January 2024

Objective:

This study analyses the anatomy and sensory outcomes of targeted nipple areola complex reinnervation (TNR) in gender-affirming double incision mastectomy with free nipple grafting (FNG).

Background:

TNR is a novel technique to preserve and reconstruct intercostal nerves (ICN) to improve postoperative sensation. There is little evidence on relevant anatomy and outcomes.

Methods:

25 patients were prospectively enrolled. Data included demographics, surgical technique, and axon/fascicle counts. Quantitative sensory evaluation using monofilaments and qualitative patient reported questionnaires were completed preoperatively, and at one, three, six, nine and twelve months postoperatively.

Results:

50 mastectomies were performed. Per mastectomy, the median number of ICN found and used was 2 (1-5). Axon and fascicle counts were not significantly different between ICN branches (P>0.05). BMI ≥30 kg/m2 and mastectomy weight ≥800 g were associated with significantly worse preoperative sensation (P<0.05). Compared to preoperative values, NAC sensation was worse at 1 month (P<0.01), comparable at 3 months (P>0.05), and significantly better at 12 months (P<0.05) postoperatively. Chest sensation was comparable to the preoperative measurements at 1 and 3 months (P>0.05), and significantly better at 12 months (P<0.05) postoperatively. NAC sensation was significantly better when direct coaptation was performed compared to use of allograft only (P<0.05), and with direct coaptation of ≥2 branches compared to direct coaptation of a single branch (P<0.05). All patients reported return of nipple and chest sensation at one year postoperatively and 88% reported return of some degree of erogenous sensation.

Conclusion:

TNR allows for restoration of NAC and chest sensation within 3 months postoperatively. Use of multiple ICN branches and direct coaptation led to the best sensory outcomes.
Artificial Intelligence to Predict Quality-of-Life Outcomes for Vascular Intervention of the Leg
Authors: Brothers Thomas E , Baliga Prabhakar
Published: January 2024

BACKGROUND:

Artificial intelligence (AI) tools created to enhance decision-making may have a significant impact on treatment algorithms for peripheral arterial disease (PAD). A Markov-based AI model was developed to predict optimal therapy based on maximization of calculated quality of life (cQoL), a patient-centered system of assessment designed to report outcomes directly linked to health-related quality of life.

STUDY DESIGN:

The AI model was prospectively interrogated immediately after individual interventions for PAD over a 12-year period to test predictive performance. Patient cQoL was determined at each patient follow-up visit.

RESULTS:

A total of 1,143 consecutive patients were evaluated, with a median follow-up of 18 months. Observed mean annualized cQoL was higher than predicted by the model (0.85 ± 0.38 vs 0.79 ± 0.18, p < 0.0001). Of 5 potential clinical outcomes, the AI model correctly predicted final status in 71.3% of patients, with insignificant model performance deterioration over time (−0.15% per month, r = −0.49, p = 0.063). The chance of having the condition predicted by the model was 0.57 ± 0.32, compared with a theoretical maximum of 0.70 ± 0.19 (p < 0.0001, mean ratio 0.79). The AI model performed better in patients with claudication than limb-threatening ischemia (75.5% vs 63.6%, p = 0.014) but equally well for open or endovascular intervention (69.8% vs 70.5%, p = 0.70). Graft or artery patency and amputation-free survival were better for patients with claudication and those treated with endovascular techniques.

CONCLUSIONS:

AI can successfully predict treatment for PAD that maximizes patient quality of life in most cases. Future application of AI incorporating better estimates of patient anatomic and physiological risk factors and refinement of model structure should further enhance performance.
Surrogate Perception of Disability after Hospitalization for Traumatic Brain Injury
Authors: Maiga Amelia W , Cook Madison , Nordness Mina F , Gao Yue , Rakhit Shayan , Rivera Erika L , Harrell Frank E , Sharp Kenneth W , Patel Mayur B
Published: January 2024

BACKGROUND:

The Glasgow Outcome Scale Extended (GOSE) is a measure of recovery after traumatic brain injury (TBI). Public surveys rate some GOSE states as worse than death. Direct family experience caring for patients with TBI may impact views of post-TBI disability.

STUDY DESIGN:

We conducted a national cross-sectional computer-adaptive survey of surrogates of TBI dependents incurring injury more than 1 year earlier. Using a standard gamble approach in randomized order, surrogates evaluated preferences for post-TBI GOSE states from GOSE 2 (bedridden, unaware) to GOSE 8 (good recovery). We calculated median (interquartile range [IQR]) health utilities for each post-TBI state, ranging from −1 to 1, with 0 as reference (death = GOSE 1), and assessed sociodemographic associations using proportional odds logistic regression modeling.

RESULTS:

Of 515 eligible surrogates, 298 (58%) completed scenarios. Surrogates were median aged 46 (IQR 35 to 60), 54% married, with Santa Clara strength of faith 14 (10 to 18). TBI dependents had a median GOSE5 (3 to 7). Median (IQR) health utility ratings for GOSE 2, GOSE 3, and GOSE 4 were −0.06 (−0.50 to −0.01), −0.01 (−0.30 to 0.45), and 0.30 (−0.01 to 0.80), rated worse than death by 91%, 65%, and 40%, respectively. Surrogates rated GOSE 4 (daily partial help) worse than the general population. Married surrogates rated GOSE 4 higher (p < 0.01). Higher strength of faith was associated with higher utility scores across GOSE states (p = 0.034).

CONCLUSIONS:

In this index study of surrogate perceptions about disability after TBI, poor neurologic outcomes—vegetative, needing all-day or partial daily assistance—were perceived as worse than death by at least 1 in 3 surrogates. Surrogate perceptions differed from the unexposed public. Long-term perceptions about post-TBI disability may inform earlier, tailored shared decision-making after neurotrauma.
Gating of Memory to Behavior by the Locus Coeruleus
Authors: Wang Tianyu , Zhang Xinyang , Duan Haoyu , Xia Dan , Li Tianxiang , Yan Rongzhen , Zhan Yang , Li Yulong , Gao Wen-Jun , Zhou Qiang
Published: January 2024

An essential function of memory is to guide behavior for survival and adaptation. While considerable knowledge has been accumulated on memory formation, much less is understood about how retrieved memories direct behavior/action. In the auditory Pavolovian threat conditioning paradigm, retrieval of conditioned threat memory activates dorsomedial prefrontal (dmPFC) neurons exhibiting transient responses (T-neurons), which activate both dmPFC neurons exhibiting sustained responses (S-neurons) and locus coeruleus (LC) neurons. Auditory inputs to S-neurons enable the conversion from transient to sustained responses so that the freezing durations match those of the auditory cues. Activation of LC neurons is required for the conversion by enhancing S-neuron responses, which, interestingly, opens a short time window during which non-conditioned cues also lead to freezing. The transition from memory to behavior thus hinges on the integration of retrieved memory, sensory inputs, and emotional/body state cues to generate a selective, adequate, and finely tuned behavior.

Significance statement

This study provides new insights into the neural circuitry and mechanisms of how retrieved memories direct the execution of behavior in response to conditioned threatening stimuli. It reveals how different neuron types in the dmPFC interact with LC neurons to determine and modulate the duration and intensity of defensive responses. It also shows that activation of LC neurons can induce the generalization of freezing to non-threatening cues, which may have implications for understanding anxiety disorders. This study contributes to the field of neuroscience by advancing the understanding of memory-behavior conversion and role of the dmPFC and LC in conditioned threat/fear behavior.
Reduced Oxygen Extraction Fraction in Deep Cerebral Veins Associated with Cognitive Impairment in Multiple Sclerosis
Authors: Sawan Hasan , Li Chenyang , Buch Sagar , Bernitsas Evanthia , Haacke E. Mark , Ge Yulin , Chen Yongsheng
Published: January 2024

Studying the relationship between cerebral oxygen utilization and cognitive impairment is essential to understanding neuronal functional changes in the disease progression of multiple sclerosis (MS). This study explores the potential of using venous susceptibility in internal cerebral veins (ICVs) as an imaging biomarker for cognitive impairment in relapsing-remitting MS (RRMS) patients. Quantitative susceptibility mapping derived from fully flow-compensated MRI phase data was employed to directly measure venous blood oxygen saturation levels (SvO2) in the ICVs. Results revealed a significant reduction in the susceptibility of ICVs (212.4 ± 30.8 ppb vs 239.4 ± 25.9 ppb) and a significant increase of SvO2(74.5 ± 1.89 % vs 72.4 ± 2.23 %) in patients with RRMS compared with age- and sex-matched healthy controls. Both the susceptibility of ICVs (r= 0.646,p= 0.004) and the SvO2(r= −0.603,p= 0.008) exhibited a strong correlation with cognitive decline in these patients assessed by the Paced Auditory Serial Addition Test, while no significant correlation was observed with clinical disability measured by the Expanded Disability Status Scale. The findings suggest that venous susceptibility in ICVs has the potential to serve as a specific indicator of oxygen metabolism and cognitive function in RRMS.
Associations between Sympathetic Nerve Activity and Ischemia in Takotsubo Syndrome and Stable Ischemic Heart Disease
Authors: Borle Sanjana , Liu Xiao , Kote Anxhela , Rosenberg Carine , Reaso Jewel , Chen Peng-Sheng , Bairey Merz C. Noel , Wei Janet
Published: January 2024

Background

Patients with stable ischemic heart disease (IHD) frequently experience ambulatory myocardial ischemia. Takotsubo Syndrome (TTS) often mimics IHD and is associated with heightened sympathetic activity. We hypothesized that skin sympathetic nerve activity (SKNA) differs between participants with prior TTS, stable IHD, and reference controls and that SKNA increases relative to electrocardiographic (ECG) evidence of ischemia.

Methods

Simultaneous recordings of SKNA and ECG (neuECG) measured ST height and average SKNA (aSKNA) in ambulatory participants with a history of TTS (n=6), stable IHD (n=7), and reference controls (n=19). Ambulatory ischemia was defined as ischemic ST segment depression ≥0.5 mm. SKNA burst frequency, duration, amplitude, and total area above the threshold were calculated during ischemic and non-ischemic episodes.

Results

Baseline aSKNA was similar between TTS, IHD, and reference controls (0.980± 0.061 µV vs 0.916±0.050 µV vs 1.098±0.291 µV respectively, p=0.06). Ischemic episodes (n=15) were identified in 2 TTS and 4 IHD participants, while reference controls had none. Among the TTS and IHD groups, ischemic ST depression was associated with increased heart rate and elevated aSKNA from baseline. An analysis of SKNA burst patterns at similar heart rates revealed that SKNA total burst area was significantly higher during ischemic episodes than non-ischemic episodes (0.301±0.380 µV.s and 0.165±0.205 µV.s, p=0.023) in both the TTS and IHD participants.

Conclusions

Compared with heart rate-matched non-ischemic episodes, ischemic episodes were associated with larger SKNA burst areas in the TTS and IHD groups. The neuECG may be a useful tool in studying the pathophysiology of sympathetic nervous system-related ischemia.

Clinical Perspective

Ambulatory monitoring with neuECG can assess sympathetic skin nerve activity (SKNA) and electrocardiography simultaneously.

We found that ischemic episodes are present not only in patients with stable ischemic heart disease (SIHD) but also those with a history of Takotsubo Syndrome.

SKNA burst activity was greater during ischemic episodes than nonischemic episodes in patients with SIHD and history of Takotsubo Syndrome.

NeuECG may be a noninvasive tool in studying mechanisms of sympathetic nervous system-related ischemia.
NGN3 oscillatory expression controls the timing of human pancreatic endocrine differentiation
Authors: Miller Anzy , Biga Veronica , Rowntree Andrew , Chhatriwala Mariya , Woods Florence , Marinopoulou Elli , Kamath Anoushka , Vallier Ludovic , Papalopulu Nancy
Published: January 2024

Understanding protein expression dynamics is crucial for the mechanistic understanding of cell differentiation. We investigate the dynamics of NGN3, a transcription factor critical for pancreatic endocrine development, including their function and decoding mechanisms. A knock-in endogenous reporter shows that the expression of NGN3 protein oscillates with a 13-hour periodicity in human iPS-derived endocrine progenitors and is switched off as cells differentiate to β-like and α-like cells. Increasing the stability of NGN3 protein results in one broad peak of expression instead of oscillations, with a larger peak to trough fold-change. This leads to precocious endocrine differentiation to both β-like and α-like cells and precocious expression of key NGN3 target genes. Single-cell analysis of dynamics, mathematical modelling and bioinformatics suggest that decoding of NGN3 oscillations occurs by fold-change detection via an incoherent feedforward motif that explains both normal and precocious differentiation. Our findings suggest that oscillatory NGN3 dynamics control the timing of differentiation, but not fate specification.
CD14 Blockade Does Not Improve Outcomes of Deep Vein Thrombosis Following Inferior Vena Cava Stenosis in Mice
Authors: Pandey Nilesh , Kaur Harpreet , Chandaluri Lakshmi , Anand Sumit Kumar , Chokhawala Himanshu , Magdy Tarek , Stokes Karen Y , Orr A Wayne , Rom Oren , Dhanesha Nirav
Published: January 2024

Background

Neutrophil-mediated persistent inflammation and neutrophil extracellular trap formation (NETosis) promote deep vein thrombosis (DVT). CD14, a co-receptor for toll-like receptor 4 (TLR4), is actively synthesized by neutrophils, and the CD14/TLR4 signaling pathway has been implicated in proinflammatory cytokine overproduction and several aspects of thromboinflammation. The role of CD14 in the pathogenesis of DVT remains unclear.

Objective

To determine whether CD14 blockade improves DVT outcomes.

Methods

Bulk RNA sequencing and proteomic analyses were performed using isolated neutrophils following inferior vena cava (IVC) stenosis in mice. DVT outcomes (IVC thrombus weight and length, thrombosis incidence, neutrophil recruitment, and NETosis) were evaluated following IVC stenosis in mice treated with a specific anti-CD14 antibody, 4C1, or control antibody.

Results

Mice with IVC stenosis exhibited increased plasma levels of granulocyte colony-stimulating factor (G-CSF) along with a higher neutrophil-to-lymphocyte ratio and increased plasma levels of cell-free DNA, elastase, and myeloperoxidase. Quantitative measurement of total neutrophil mRNA and protein expression revealed distinct profiles in mice with IVC stenosis compared to mice with sham surgery. Neutrophils of mice with IVC stenosis exhibited increased inflammatory transcriptional and proteomic responses, along with increased expression of CD14. Treatment with a specific anti-CD14 antibody, 4C1, did not result in any significant changes in the IVC thrombus weight, thrombosis incidence, or neutrophil recruitment to the thrombus.

Conclusion

The results of the current study are important for understanding the role of CD14 in the regulation of DVT and suggest that CD14 lacks an essential role in the pathogenesis of DVT following IVC stenosis.
Increased chromatin accessibility mediated by nuclear factor I drives transition to androgen receptor splice variant dependence in castration-resistant prostate cancer
Authors: Poluben Larysa , Nouri Mannan , Liang Jiaqian , Varkaris Andreas , Ersoy-Fazlioglu Betul , Voznesensky Olga , Lee Irene I. , Qiu Xintao , Cato Laura , Seo Ji-Heui , Freedman Matthew L. , Sowalsky Adam G. , Lack Nathan A. , Corey Eva , Nelson Peter S. , Brown Myles , Long Henry W. , Russo Joshua W. , Balk Steven P.
Published: January 2024

Androgen receptor (AR) splice variants, of which ARv7 is the most common, are increased in prostate cancer (PC) that develops resistance to androgen signaling inhibitor drugs, but the extent to which these variants drive AR activity, and whether they have novel functions or dependencies, remain to be determined. We generated a subline of VCaP PC cells (VCaP16) that is resistant to the AR inhibitor enzalutamide (ENZ) and found that AR activity was independent of the full-length AR (ARfl), despite its continued high-level expression, and was instead driven by ARv7. The ARv7 cistrome and transcriptome in VCaP16 cells mirrored that of the ARfl in VCaP cells, although ARv7 chromatin binding was weaker, and strong ARv7 binding sites correlated with higher affinity ARfl binding sites across multiple models and clinical samples. Notably, although ARv7 expression in VCaP cells increased rapidly in response to ENZ, there was a long lag before it gained chromatin binding and transcriptional activity. This lag was associated with an increase in chromatin accessibility, with the AR and nuclear factor I (NFI) motifs being most enriched at these more accessible sites. Moreover, the transcriptional effects of combined NFIB and NFIX knockdown versus ARv7 knockdown were highly correlated. These findings indicate that ARv7 can drive the AR program, but that its activity is dependent on adaptations that increase chromatin accessibility to enhance its intrinsically weak chromatin binding.
Generative artificial intelligence performs rudimentary structural biology modeling
Authors: Ille Alexander M. , Markosian Christopher , Burley Stephen K. , Mathews Michael B. , Pasqualini Renata , Arap Wadih
Published: January 2024

Natural language-based generative artificial intelligence (AI) has become increasingly prevalent in scientific research. Intriguingly, capabilities of generative pre-trained transformer (GPT) language models beyond the scope of natural language tasks have recently been identified. Here we explored how GPT-4 might be able to perform rudimentary structural biology modeling. We prompted GPT-4 to model 3D structures for the 20 standard amino acids and an α-helical polypeptide chain, with the latter incorporating Wolfram mathematical computation. We also used GPT-4 to perform structural interaction analysis between nirmatrelvir and its target, the SARS-CoV-2 main protease. Geometric parameters of the generated structures typically approximated close to experimental references. However, modeling was sporadically error-prone and molecular complexity was not well tolerated. Interaction analysis further revealed the ability of GPT-4 to identify specific amino acid residues involved in ligand binding along with corresponding bond distances. Despite current limitations, we show the capacity of natural language generative AI to perform basic structural biology modeling and interaction analysis with atomic-scale accuracy.
Genomic surveillance of SARS-CoV-2 and emergence of XBB.1.16 variant in Rajasthan
Authors: Sharma Pratibha , Gautam Swati , Sharma Abhaya , Parsoya Dinesh , Deeba Farah , Pal Nita , Singh Ruchi , Sharma Himanshu , Bhomia Neha , Sharma Ravi P. , Potdar Varsha , Malhotra Bharti
Published: January 2024

Background & objectives

Genomic surveillance of positive SARS-CoV-2 samples is important to monitor the genetic changes occurring in virus, this was enhanced after the WHO designation of XBB.1.16 as a variant under monitoring in March 2023. From 5thFebruary till 6thMay 2023 all positive SARS-CoV-2 samples were monitored for genetic changes.

Methods

A total of 1757 samples having Ct value <25 (for E and ORF gene) from different districts of Rajasthan were processed for Next Generation sequencing (NGS). The FASTA files obtained on sequencing were used for lineage determination using Nextclade and phylogenetic tree construction.

Results and discussion

Sequencing and lineage identification was done in 1624 samples. XBB.1.16 was the predominant lineage in 1413(87.0%) cases while rest was other XBB (207, 12.74%) and other lineages (4, 0.2%). Of the 1413 XBB.1.16 cases, 57.47% were males and 42.53% were females. Majority (66.53%) belonged to 19-59 year age. 84.15% of XBB.1.16 cases were infected for the first time. Hospitalization was required in only 2.2% cases and death was reported in 5 (0.35%) patients. Most of the cases were symptomatic and the commonest symptoms were fever, cough and rhinorrhoea. Co-morbidities were present in 414 (29.3%) cases. Enhanced genomic surveillance helped to rapidly identify the spread of XBB variant in Rajasthan. This in turn helped to take control measures to prevent spread of virus and estimate public health risks of the new variant relative to the previously circulating lineages. XBB variant was found to spread rapidly but produced milder disease.
A Multilevel Intervention to Reduce Chronic Disease Risk in Socioeconomically Disadvantaged Unemployed Populations: TheNorth Carolina Works 4 Health (NCW4H)Clinical Trial Protocol
Authors: Kneipp Shawn M.
Published: January 2024

Background

The overall goal of the North Carolina Works for Health (NCW4H) study is to adapt and test the effectiveness of a multilevel intervention to reduce chronic disease risk in socioeconomically disadvantaged, unemployed (SEDU) populations who rely on publicly-funded job placement programs to secure employment. Studies have shown an unemployment episode increases in psychological distress, health-compromising coping behavior, blood pressure, and weight gain – all of which increase chronic disease risk.

Methods

A randomized, 2 x 2 factorial design will test an individual level (IL) and employer level (EL) intervention, and their joint effects, in SEDU adults receiving job placement services through publicly-funded programs. Interventions consist of a chronic disease prevention program adapted from the Diabetes Prevention Program at the IL, and an implicit bias-based supervisor support program for newly-hired SEDU adults at the EL. We will enroll 600 SEDU adults 18 to 64 years of age who have either received public assistance benefits in the prior two yearsorhave <4-year college degree, used publicly-funded job placement services during the most recent unemployment episode, and are not receiving disability income, not pregnant, and fluent in English; and 80-200 supervisors of our SEDU enrolled participants when hired by an employer. Primary outcomes include psychological distress, blood pressure, and weight gain, and will be collected at baseline and 3, 6, and 12 months post-enrollment. Secondary outcomes related to coping, health behavior, workplace support, and employment will also be collected. Main effects of the IL and EL interventions, and IL x EL interactions, will be analyzed using generalized multivariate models accounting for clustering effects.

Discussion

This multilevel intervention is novel in that it is designed to mitigate chronic disease risk during an unemployment episode, and includes an intervention at a level at the employer level, where social determinants of health operate. Despite the design challenges that multilevel intervention trials such as the NCW4H study present, they are needed to meaningfully address health inequities in the U.S. Findings from this study are expected to inform how approaches that incorporate public health and employment sectors could reduce chronic disease among socioeconomically disadvantaged populations.

Ethics and dissemination

The trial is ongoing and has been approved by the University of North Carolina at Chapel Hill Institutional Review Board. Trial results will be published in a scientific journal and presented at scientific conferences.

Trial registration number

NCT04815278, ClinicalTrials.gov
Binding domain mutations provide insight into CTCF’s relationship with chromatin and its contribution to gene regulation
Authors: Do Catherine , Jiang Guimei , Cova Giulia , Katsifis Christos C. , Narducci Domenic N. , Sakellaropoulos Theodore , Vidal Raphael , Lhoumaud Priscillia , Tsirigos Aristotelis , Regis Faye Fara D. , Kakabadze Nata , Nora Elphege P , Noyes Marcus , Hansen Anders S. , Skok Jane A
Published: January 2024

Here we used a series of CTCF mutations to explore CTCF’s relationship with chromatin and its contribution to gene regulation. CTCF’s impact depends on the genomic context of bound sites and the unique binding properties of WT and mutant CTCF proteins. Specifically, CTCF’s signal strength is linked to changes in accessibility, and the ability to block cohesin is linked to its binding stability. Multivariate modelling reveals that both CTCF and accessibility contribute independently to cohesin binding and insulation, however CTCF signal strength has a stronger effect. CTCF and chromatin have a bidirectional relationship such that at CTCF sites, accessibility is reduced in a cohesin-dependent, mutant specific fashion. In addition, each mutant alters TF binding and accessibility in an indirect manner, changes which impart the most influence on rewiring transcriptional networks and the cell’s ability to differentiate. Collectively, the mutant perturbations provide a rich resource for determining CTCF’s site-specific effects.
Forced and natural dynamics of a clamped flexible fiber in wall turbulence
Authors: Foggi Rota Giulio , Koseki Morie , Agrawal Riya , Olivieri Stefano , Rosti Marco Edoardo
Published: January 2024

We characterize the dynamical behavior of a clamped flexible fiber immersed in wall turbulence over a wide range of natural frequencies (fnat) by means of direct numerical simulations. Only two flapping states are possible: one where the fiber oscillates at the characteristic frequency of the largest turbulent eddies (fturb) and another where the natural structural response dominates. The former is obtained in the more flexible cases (fnatfturb). We observe that in the turbulence-dominated regime, the fiber always sways at a frequency proportional to the largest scale of the flow, regardless of its structural parameters. The hindrance of the clamp to the wall prevents the synchronization of the fiber with turbulent eddies of comparable size.

Published by the American Physical Society
2024
A bibliometric analysis of trends in the relationship between innovation and food
Authors: Dzhunushalieva Gulnara Dzhenishevna , Teuber Ramona
Published: January 2024

Purpose

Food-related innovations might contribute to a qualitative leap in the transition to sustainable food systems. In this article, the authors map the existing literature on food and innovation in order to identify and systematise major research streams and relate them to current discussions on sustainability. The authors rely on a broad definition of innovation covering specific technological innovations as well as social, environmental and system innovations.

Design/methodology/approach

The authors analysed the relationship between innovation and food through bibliometric and content analysis, augmented with visualisation based on data (N = 7,987) extracted from the Web of Science. The published volume, research areas and influential journals were investigated using descriptive analyses.

Findings

This review categorises the literature on innovation and food into six main clusters, showing that most of the studies are carried out at the macro-level related to the global sustainable food systems. Network visualisation allowed them to distribute recent keywords associated with innovation across the agri-food value chain. Moreover, the authors identified environmental, social and economic pillars of innovation, which not only relate to sustainability but also are associated with open innovation as well as social innovation and eco-innovation.

Originality/value

This bibliometric analysis is amongst the first to examine the holistic knowledge structure surrounding a triple concept of innovation, food and sustainability. In addition, the study identifies research gaps and indicates new research directions, which add further value.
Ethical labels and conspicuous consumption: impact on civic virtue and cynicism in luxury foodservice
Authors: Jin Dan , Qi Rui
Published: January 2024

Purpose

The primary objective of this study is to explore the nuanced interplay of conspicuous consumption, ethical label purchasing and the ensuing dynamics of civic virtue and cynicism within the luxury foodservice context.

Design/methodology/approach

Grounded in a theoretical understanding of solidarity within the context of product consumption, this research employs a two-pronged approach involving secondary data analysis and scenario-based experimental studies. The initial phase involves analyzing firm-level data from the Euromonitor database in 2019 and 2021. The main study employs a between-subjects experimental design with a cohort of 316 participants sourced from an online panel.

Findings

The results reveal a consistent pattern in the consumption of luxury foodservice and underscore a distinct upward trajectory in consumer demand for ethically labeled food. Notably, these findings underscore the moderating role of ethical label purchasing in the relationship between conspicuous consumption and consumers civic virtue. Additionally, ethical label purchasing moderates the impact of conspicuous consumption on consumer cynicism, both directly and indirectly through emotional solidarity related to both communal and equitable principles.

Originality/value

This study holds significance for both luxury food service researchers and market design practitioners. It provides valuable insights into how ethical labeling interacts with consumers conspicuous consumption, all facilitated by emotional solidarity.
The effects of neurodiversity on cognitive attributes of entrepreneurs
Authors: Lanivich Stephen E. , Moore Curt , McIntyre Nancy
Published: January 2024

Purpose

This study investigates how attention deficit/hyperactivity disorder (ADHD) in entrepreneurs functions through coping schema to affect entrepreneurship-related cognitions. It is proposed that the resource-induced coping heuristic (RICH) bridges the conceptual gap between pathological cognitive executive control/reward attributes and cognitive resources, specifically entrepreneurial alertness, cognitive adaptability and entrepreneurial intent.

Design/methodology/approach

With data from 581 entrepreneurs, this study utilizes partial least squares structural equation modeling for analysis. Additionally, a two-stage hierarchical component modeling approach was used to estimate latent variable scores for higher-order constructs.

Findings

Findings indicate the RICH mediates the relationships ADHD has with alertness, cognitive adaptability and entrepreneurial intent.

Originality/value

The RICH is introduced as a mechanism to explain how ADHD indirectly influences entrepreneurial alertness, cognitive adaptability and entrepreneurial intent.