bluuebunny/crossref_metadata_2025 huggingface dataset:
Updating cardiovascular disease risk prediction equations to account for lipid lowering treatment drop-in during follow up: a national data-linkage cohort
Authors: Liang J , Jackson R , Pylypchuk R , Poppe K
Published: November 2023

Background and Purpose

No commonly recommended cardiovascular disease (CVD) risk prediction equations account for the effect of medications initiated during follow-up (treatment drop-in) in the cohort studies used to derive equations. We have previously demonstrated that treatment drop-in is common. In this study we aim to compare equations before and after accounting for lipid-lowering medication drop-in during follow-up.

Methods

De-identified individual-level linkage of multiple administrative health datasets in Aotearoa New Zealand was undertaken to establish a cohort of almost all New Zealanders without CVD or heart failure, alive and aged 30-74 years on December 31, 2006, with follow-up linkage to hospitalisations and mortality until 31 December 2018. We derived age- and sex-specific Cox regression models to predict 5-year CVD risk, using pre-defined routinely available CVD risk predictors, both with and without a time-dependent lipid-lowering medication drop-in variable. The drop-in effect was set at a 20% CVD risk reduction, based on randomised controlled trial evidence. We compared the observed and predicted risks of the two equations using calibration plots.

Results

During 19,728,300 person-years of follow-up (mean: 11.3 years), 1,746,695 people had 155,943 first CVD events. Kaplan-Meier adjusted 5-year CVD risk was 2.36% (95% CI: 2.33%, 2.39%) in women and 4.36% (95% CI: 4.31%, 4.40%) in men. 1,586,421 individuals were not taking lipid-lowering medications at baseline, among whom 371,415 initiated lipid-lowering medications during follow-up. Median predicted five-year CVD risk was slightly higher when using equations that accounted for lipid-lowering medication drop-in and identified significantly more individuals as ≥15% 5-year CVD risk than equations that did not (15,355 vs 9,680 in women and 46,603 vs 36,460 in men). As expected, the increased predicted risk in equations accounting for medication drop-in was most marked in the high-risk groups.

Conclusions

CVD risk prediction equations that do not adjust for treatment drop-in will underestimate risk and lead to undertreatment, particularly among the highest risk patients. Traditional methods to evaluate model performance are unable to identify the impact of treatment drop-in. We demonstrate that incorporating a time-dependent lipid-lowering medication effect from trials is likely to be an effective approach for addressing treatment drop-in in CVD risk prediction equations. Future studies will also need to address the impact of other common drop-in treatments, particularly blood pressure-lowering medications.
L-shaped association of lipoprotein(a) on long-term bleeding risk in patients with coronary heart disease: insight from a multicenter cohort in Asia
Authors: Wang P , Yuan J
Published: November 2023

Background

Lipoprotein(a), or Lp(a), has been recognized as a strong risk factor for atherosclerotic cardiovascular disease. However, the relationship between Lp(a) and bleeding remains indistinct, especially in the secondary prevention population of coronary artery disease (CAD). This investigation aimed to evaluate the association of Lp(a) with long-term bleeding among patients with CAD.

Methods

Based on a prospective multicenter cohort of patients with CAD consecutively enrolled from January 2015 to May 2019 in China, the current analysis included 16,150 participants. Thus, according to Lp(a) quintiles, all subjects were divided into five groups. The primary endpoint was bleeding at 2-year follow-up, and the secondary endpoint was major bleeding at 2-year follow-up.

Results

A total of 2,747 (17.0%) bleeding and 525 (3.3%) major bleeding were recorded during a median follow-up of 2.0 years. Kaplan-Meier survival analysis showed the highest bleeding incidence in Lp(a) quintile 1, compared with patients in Lp(a) quintiles 2-5 (p < 0.001), while the incidence of major bleeding seemed similar between two groups. Moreover, restricted cubic spline analysis suggested that there was a L-shaped association between Lp(a) and 2-year bleeding after adjustment for potential confounding factors, whereas there was no significant association between Lp(a) and 2-year major bleeding.

Conclusion

There was the inverse and L-shaped association of Lp(a) with bleeding at 2-year follow-up in patients with CAD. More attention and effort should be made to increase the clinician awareness of Lp(a)’s role, as a novel marker for bleeding risk in order to better guide shared-decision making in clinical practice.Figure 1
The Novavax Heterologous Coronavirus Disease 2019 Booster Demonstrates Lower Reactogenicity Than Messenger RNA: A Targeted Review
Authors: Marchese Anthony M , Rousculp Matthew , Macbeth John , Beyhaghi Hadi , Seet Bruce T , Toback Seth
Published: November 2023

Coronavirus disease 2019 (COVID-19) continues to be a global health concern, and booster doses are necessary for maintaining vaccine-mediated protection, limiting the spread of severe acute respiratory syndrome coronavirus 2. Despite multiple COVID-19 vaccine options, global booster uptake remains low. Reactogenicity, the occurrence of adverse local/systemic side effects, plays a crucial role in vaccine uptake and acceptance, particularly for booster doses. We conducted a targeted review of the reactogenicity of authorized/approved messenger RNA (mRNA) and protein-based vaccines demonstrated by clinical trials and real-world evidence. It was found that mRNA-based boosters show a higher incidence and an increased severity of reactogenicity compared with the Novavax protein-based COVID-19 vaccine (NVX-CoV2373). In a recent study from the National Institute of Allergy and Infectious Diseases, the incidence of pain/tenderness, swelling, erythema, fatigue/malaise, headache, muscle pain, or fever was higher in individuals boosted with BNT162b2 (0.4% to 41.6% absolute increase) or mRNA-1273 (5.5% to 55.0% absolute increase) compared with NVX-CoV2373. Evidence suggests that NVX-CoV2373, when utilized as a heterologous booster, demonstrates less reactogenicity compared with mRNA vaccines, which, if communicated to hesitant individuals, may strengthen booster uptake rates worldwide.

Clinical Trials Registration NCT04889209.
Global International Relations and Worlding Beyond the West: A Pedagogical Critique
Authors: Ettinger Aaron
Published: November 2023

This paper addresses the pedagogical implications of the “Global International Relations (GIR)” and “Worlding Beyond the West” agendas. These two programs have criticized IR’s Western-centrism and offered systematic ways to expand beyond IR’s Euro-Atlantic roots. Their development coincides with other high-profile theoretical and historiographic developments, not to mention societal imperatives, to expand the substantive remit of the discipline. However, the diversification agenda has been mostly concerned with the research output of IR and has treated the pedagogical side of IR’s intellectual life as a secondary consideration. Proponents of the GIR and Worlding agendas have yet to convert these programs into a classroom pedagogy. This paper fills that gap. It critiques the practical and intellectual limits of GIR and Worlding pedagogies. More importantly, it provides theoretically informed ways to transpose their diversification projects into the undergraduate classroom. In doing so, this paper bridges disciplinary analysis, IR theory, and IR pedagogy in an integrated analysis of IR’s much-needed attempts at diversification.
Family Rules and Routines During the Early Phases of Pediatric Cancer Treatment: Associations With Child Emotional and Behavioral Health
Authors: Bates Carolyn R , Staggs Vincent S , Dean Kelsey M , August Keith J , Befort Christie A , Covitz Lynne M , Dreyer Gillette Meredith L
Published: November 2023

Objective

Consistent family rules and routines promote positive adaptation to stress and may be protective to child emotional and behavioral functioning. Few studies have quantified family engagement in these behaviors during pediatric cancer treatment or examined associations with child emotional and behavioral health.

Methods

In this cross-sectional observational study, 86 primary caregivers of youth ages 2–14 years (M = 7.9) with an initial diagnosis of cancer within 16 weeks reported on their frequency of engagement in family rules and routines (e.g., sleep, schoolwork, and meal routines) before their child’s cancer diagnosis and their current frequency of engagement in the same routines. Caregivers also reported demographics, psychosocial distress, and child emotional and behavioral health outcomes. Analyses examined demographic and psychosocial factors associated with engagement in rules and routines during cancer treatment, and associations with child emotional and behavioral health.

Results

Families reported a lower frequency of engagement in rules and routines during cancer treatment, compared to before treatment (mean difference 0.8 SDs [95% confidence interval 0.7–1.1 SDs]). Caregiver factors associated with lower engagement in rules and routines during treatment included being married, having lower educational attainment, and higher levels of psychosocial distress. Families who engaged in higher levels of rules and routines during treatment reported fewer child externalizing and behavioral challenges. There was limited evidence of association between family rules and routines and child internalizing outcomes.

Conclusions

Results found that engaging in family rules and routines during cancer treatment was associated with fewer child behavioral challenges during treatment. Future directions include longitudinal examinations of family rules, routines, and child emotional/behavioral outcomes to examine directional impact over time.
Alternative paths of professionalism at the margins of the healthcare system: The case of spiritual caregivers in Israel
Authors: Keshet Yael , Popper-Giveon Ariela , Avnoon Netta
Published: November 2023

Much of the research on professions in the field of healthcare focuses on standard bodies of knowledge, jurisdictional claims, state regulations, and professional closure, which are characteristics of professions like medicine. However, new notions such as client-based professionalization, professional fluidity, and connective professionalism have recently emerged in the sociology of professions literature. This article suggests a new perspective on alternative paths of professionalism at the margins of the healthcare system, drawing on the case of spiritual caregivers. Semi-structured in-depth interviews were conducted with 15 Israeli spiritual caregivers. The interviewees presented themselves as professionals by describing characteristics resembling the new notions of professionalism: the centrality of the patient, the fluid nature of the practice of spiritual care, and their connectivity with other healthcare practitioners. New notions in the sociological study of professions can help us understand alternative paths of professionalism at the margins of the healthcare system and to characterize the practitioners in these margins. This could contribute to a better understanding of the new sources of gaining legitimacy in the healthcare system to the benefit of patients, medical practitioners, other staff members, and medical institutions at large.
Incorporating short data into large mixed-frequency vector autoregressions for regional nowcasting
Authors: Koop Gary , McIntyre Stuart , Mitchell James , Poon Aubrey , Wu Ping
Published: November 2023

Interest in regional economic issues coupled with advances in administrative data is driving the creation of new regional economic data. Many of these data series could be useful for nowcasting regional economic activity, but they suffer from a short (albeit constantly expanding) time series which makes incorporating them into nowcasting models problematic. Regional nowcasting is already challenging because the release delay on regional data tends to be greater than that at the national level, and ‘short’ data imply a ‘ragged edge’ at both the beginning and the end of regional data sets, which adds a further complication. In this paper, via an application to the UK, we investigate various ways of including a wide range of short data into a regional mixed-frequency vector autoregression (MF-VAR) model. These short data include hitherto unexploited regional value-added tax turnover data. We address the problem of the two ragged edges by estimating regional factors using different missing data algorithms that we then incorporate into our MF-VAR model. We find that nowcasts of regional output growth are generally improved when we condition them on the factors, but only when the regional nowcasts are produced before the national (UK-wide) output growth data are published.
Cystic lymphangioma causing intussusception of the right colon: a case report and review of current literature
Authors: Park Jae Hyun , Park Jesung , Ku Ga Yoon , Moon Do Kyoon , Ahn Jong Sung , Kim Hyo Jun , Kim Min Jung , Park Ji Won , Ryoo Seung-Bum , Jeong Seung-Yong , Park Kyu Joo
Published: November 2023

Among intraabdominal lymphangiomas, colonic lymphangiomas are rare. These cystic tumors are generally asymptomatic and incidentally found but may present with bleeding or obstructive symptoms. Intussusception by such tumors is scarcely reported, with only nine previously reported cases listed in Pubmed. We report a case of a 41-year-old female Asian patient who presented with acute abdomen and was diagnosed with colonic intussusception caused by lymphangioma. She received emergent right hemicolectomy, recovered well without complications, and was discharged on the 5th postoperative day.
Recent progress in understanding the cellular and genetic basis of plant responses to low oxygen holds promise for developing flood-resilient crops
Authors: Fagerstedt Kurt V , Pucciariello Chiara , Pedersen Ole , Perata Pierdomenico
Published: November 2023

With recent progress in active research on flooding and hypoxia/anoxia tolerance in native and agricultural crop plants, vast knowledge has been gained on both individual tolerance mechanisms and the general mechanisms of flooding tolerance in plants. Research on carbohydrate consumption, ethanolic and lactic acid fermentation, and their regulation under stress conditions has been accompanied by investigations on aerenchyma development and the emergence of the radial oxygen loss barrier in some plant species under flooded conditions. The discovery of the oxygen-sensing mechanism in plants and unravelling the intricacies of this mechanism have boosted this very international research effort. Recent studies have highlighted the importance of oxygen availability as a signalling component during plant development. The latest developments in determining actual oxygen concentrations using minute probes and molecular sensors in tissues and even within cells have provided new insights into the intracellular effects of flooding. The information amassed during recent years has been used in the breeding of new flood-tolerant crop cultivars. With the wealth of metabolic, anatomical, and genetic information, novel holistic approaches can be used to enhance crop species and their productivity under increasing stress conditions due to climate change and the subsequent changes in the environment.
Unveiling Cellular Diversity in the Buffalo Corneal Stroma: Insights into Telocytes and Keratocytes Using Light Microscope, Transmission Electron Microscope, and Immunofluorescence Analysis
Authors: Rashwan Ahmed M , Alsafy Mohamed A M , El-Gendy Samir A A , El-Mansi Ahmed A , Ez Elarab Samar M
Published: November 2023

Telocytes and keratocytes are important cells that maintain the structure and function of the cornea. The buffalo cornea, known for its resilience in harsh conditions, has not been extensively studied regarding the presence and role of telocytes and keratocytes. We used light microscopy, transmission electron microscopy (TEM), and immunofluorescence assays with platelet-derived growth factor receptor alpha (PDGFRα), CD34, and Vimentin markers to investigate their expression and localization in the cornea. TEM analysis confirmed the presence of spindle-shaped keratocytes with intercellular connections, while telocytes exhibited small spindle-shaped bodies with long, thin branches connecting to corneal keratocytes. Immunofluorescence findings showed that CD34 was more abundant near the endothelium, Vimentin was prominently expressed near the epithelium, and PDGFRα was uniformly distributed throughout the corneal stroma. Co-expression of CD34 and Vimentin, PDGFRα and Vimentin, as well as CD34 and PDGFRα, was observed in keratocytes and telocytes within the stroma, indicating the potential presence of mesenchymal cells. These results suggest the involvement of telocytes and keratocytes in corneal wound healing, transparency maintenance, and homeostasis. The co-expression of these markers highlights the critical role of telocytes and keratocytes in regulating corneal physiological functions, further enhancing our understanding of corneal biology in the buffalo model.
Convergence of halo statistics: code comparison between rockstar and compaso using scale-free simulations
Authors: Maleubre Sara , Eisenstein Daniel J , Garrison Lehman H , Joyce Michael
Published: November 2023

In this study, we perform a halo-finder code comparison between rockstar and compaso. Based on our previous analysis aiming at quantifying resolution of N-body simulations by exploiting large (up to N = 40963) simulations of scale-free cosmologies run using abacus, we focus on convergence of the halo mass function, two-point correlation function, and mean radial pairwise velocities of halo centres selected with the aforementioned two algorithms. We establish convergence, for both rockstar and compaso, of mass functions at the 1 per cent precision level and of the mean pairwise velocities (and also two-point correlation function) at the 2 per cent level. At small scales and masses, we find that rockstar exhibits greater self-similarity. We also highlight the role played by the merger-tree post-processing of compaso haloes on their convergence. Finally, we give resolution limits expressed as a minimum particle number per halo in a form that can be directly extrapolated to Lambda cold dark matter.
DegronMD: Leveraging Evolutionary and Structural Features for Deciphering Protein-Targeted Degradation, Mutations, and Drug Response to Degrons
Authors: Xu Haodong , Hu Ruifeng , Zhao Zhongming
Published: November 2023

Protein-targeted degradation is an emerging and promising therapeutic approach. The specificity of degradation and the maintenance of cellular homeostasis are determined by the interactions between E3 ubiquitin ligase and degradation signals, known as degrons. The human genome encodes over 600 E3 ligases; however, only a small number of targeted degron instances have been identified so far. In this study, we introduced DegronMD, an open knowledgebase designed for the investigation of degrons, their associated dysfunctional events, and drug responses. We revealed that degrons are evolutionarily conserved and tend to occur near the sites of protein translational modifications, particularly in the regions of disordered structure and higher solvent accessibility. Through pattern recognition and machine learning techniques, we constructed the degrome landscape across the human proteome, yielding over 18,000 new degrons for targeted protein degradation. Furthermore, dysfunction of degrons disrupts the degradation process and leads to the abnormal accumulation of proteins; this process is associated with various types of human cancers. Based on the estimated phenotypic changes induced by somatic mutations, we systematically quantified and assessed the impact of mutations on degron function in pan-cancers; these results helped to build a global mutational map on human degrome, including 89,318 actionable mutations that may induce the dysfunction of degrons and disrupt protein degradation pathways. Multiomics integrative analysis unveiled over 400 drug resistance events associated with the mutations in functional degrons. DegronMD, accessible at https://bioinfo.uth.edu/degronmd, is a useful resource to explore the biological mechanisms, infer protein degradation, and assist with drug discovery and design on degrons.
Bilevel optimization for automated machine learning: a new perspective on framework and algorithm
Authors: Liu Risheng , Lin Zhouchen
Published: November 2023

Formulating the methodology of machine learning by bilevel optimization techniques provides a new perspective to understand and solve automated machine learning problems.
Aspartate Aminotransferase/Platelet Ratio Index Upon Admission Predicts 24-Week Mortality in Patients With HIV-Associated Talaromyces marneffei
Authors: Wang Qi , Zhao Handan , Tong Yong , Qin Jiaying , Zhou Minghan , Xu Lijun
Published: November 2023

Background

A high aspartate aminotransferase/platelet ratio index (APRI) predicts mortality in patients with severe infection. This study aims to assess the potential of APRI as a predictor for mortality in patients with HIV-associated Talaromyces marneffei (HTM).

Methods

Associations between APRI and CD4 count, white blood cell count, C-reactive protein (CRP) level, procalcitonin (PCT) level, and cytokines were assessed in 119 patients. Univariate and multivariate Cox regression models were used to predict APRI on 24-week mortality.

Results

APRI was positively associated with CRP (r = 0.190, P = .039), PCT (r = 0.220, P = .018), interleukin 6 (r = 0.723, P < .001), interleukin 10 (r = 0.416, P = .006), and tumor necrosis factor α (r = 0.575, P < .001) and negatively associated with CD4 count (r = −0.234, P = .011). In total, 20.2% (24/119) of patients died within the 24-week follow-up. The 24-week survival rate was 88.0% for patients with APRI <5.6% and 61.1% for those with APRI ≥5.6 (log-rank P < .001). After adjustment for sex, age, body mass index, and CD4 count, as well as serum levels of hemoglobin, APRI ≥5.6 (adjusted hazard ratio [95% CI]; 3.0 [1.2–7.1], P = .015), PCT ≥1.7 ng/mL (3.7 [1.5–9.6], P = .006), and non–amphotericin B deoxycholate treatment (2.8 [1.2–6.6], P = .018) were independent risk factors for 24-week mortality.

Conclusions

For patients with HTM, APRI is associated with severity and is an independent risk factor for 24-week mortality.
How will climate change affect ambient air pollution and what can policy-makers do now? Lessons from India
Authors: Ebenstein Avraham , Bansal Sangeeta , Dey Sagnik , Gupta Tanya , Abhay Kakade Kshitij , Simhon Avi
Published: November 2023

Air pollution is a growing concern in India, and its adverse health effects are well documented. Climate change is likely to exacerbate this problem by altering weather patterns and increasing the frequency and severity of extreme events. This paper examines the potential impact of climate change on ambient air pollution in India and its implications for policy design. Our analysis reveals that pollution in India is highly sensitive to variation in weather, particularly in the densely populated Indus-Gangetic Plain. Using our estimated relationship between weather and pollution, we predict that changing weather patterns will increase average PM2.5 concentrations by 3.1 µg/m3, leading to a loss of 364 million years of life expectancy. To address this challenge, we propose an emissions fee calibrated to be highest in regions most vulnerable to persistently high levels of pollution and most sensitive to future deterioration in air quality due to climate change.
How may solar geoengineering impact global prospects for climate change mitigation?
Authors: Ricke Katharine , Harding Anthony
Published: November 2023

As disruptions from climate change increase, so will the urgency to find shorter-term approaches to ameliorating its harms. This may include calls to implement solar geoengineering, an approach to cooling the planet by reflecting incoming sunlight back to space. While the exact effects of solar geoengineering are still highly uncertain, physical science to date suggests that it may be effective at reducing many aspects of climate change in the short term. One of the biggest concerns about solar geoengineering is the extent to which it may interfere with crucial emissions reductions policies, i.e. mitigation. There are multiple channels by which geoengineering could alter mitigation pathways, both financial and behavioural. Here we define three such linkages and present the evidence available to constrain their potential magnitudes. Because solar geoengineering is not a substitute for mitigation, policies to develop or implement technologies that could be used to carry it out should be designed to accentuate its complementary nature to mitigation and deter the possibility it is used to delay decarbonizing the economy.
Transcription factor PpNAC1 and DNA demethylase PpDML1 synergistically regulate peach fruit ripening
Authors: Cao Xiangmei , Li Xinzhao , Su Yike , Zhang Chi , Wei Chunyan , Chen Kunsong , Grierson Donald , Zhang Bo
Published: November 2023

Fruit ripening is accompanied by dramatic changes in color, texture, and flavor and is regulated by transcription factors (TFs) and epigenetic factors. However, the detailed regulatory mechanism remains unclear. Gene expression patterns suggest that PpNAC1 (NAM/ATAF1/2/CUC) TF plays a major role in peach (Prunus persica) fruit ripening. DNA affinity purification (DAP)-seq combined with transactivation tests demonstrated that PpNAC1 can directly activate the expression of multiple ripening-related genes, including ACC synthase1 (PpACS1) and ACC oxidase1 (PpACO1) involved in ethylene biosynthesis, pectinesterase1 (PpPME1), pectate lyase1 (PpPL1), and polygalacturonase1 (PpPG1) related to cell wall modification, and lipase1 (PpLIP1), fatty acid desaturase (PpFAD3-1), and alcohol acyltransferase1 (PpAAT1) involved in volatiles synthesis. Overexpression of PpNAC1 in the tomato (Solanum lycopersicum) nor (nonripening) mutant restored fruit ripening, and its transient overexpression in peach fruit induced target gene expression, supporting a positive role of PpNAC1 in fruit ripening. The enhanced transcript levels of PpNAC1 and its target genes were associated with decreases in their promoter mCG methylation during ripening. Declining DNA methylation was negatively associated with increased transcripts of DNA demethylase1 (PpDML1), whose promoter is recognized and activated by PpNAC1. We propose that decreased methylation of the promoter region of PpNAC1 leads to a subsequent decrease in DNA methylation levels and enhanced transcription of ripening-related genes. These results indicate that positive feedback between PpNAC1 and PpDML1 plays an important role in directly regulating expression of multiple genes required for peach ripening and quality formation.
Optimizing ancestral trait reconstruction of large HIV Subtype C datasets through multiple-trait subsampling
Authors: Li Xingguang , Trovão Nídia S , Wertheim Joel O , Baele Guy , de Bernardi Schneider Adriano
Published: November 2023

Large datasets along with sampling bias represent a challenge for phylodynamic reconstructions, particularly when the study data are obtained from various heterogeneous sources and/or through convenience sampling. In this study, we evaluate the presence of unbalanced sampled distribution by collection date, location, and risk group of human immunodeficiency virus Type 1 Subtype C using a comprehensive subsampling strategy and assess their impact on the reconstruction of the viral spatial and risk group dynamics using phylogenetic comparative methods. Our study shows that a most suitable dataset for ancestral trait reconstruction can be obtained through subsampling by all available traits, particularly using multigene datasets. We also demonstrate that sampling bias is inflated when considerable information for a given trait is unavailable or of poor quality, as we observed for the trait risk group. In conclusion, we suggest that, even if traits are not well recorded, including them deliberately optimizes the representativeness of the original dataset rather than completely excluding them. Therefore, we advise the inclusion of as many traits as possible with the aid of subsampling approaches in order to optimize the dataset for phylodynamic analysis while reducing the computational burden. This will benefit research communities investigating the evolutionary and spatio-temporal patterns of infectious diseases.
A revision of the higher latitude periwinkle species Laevilitorina caliginosa sensu lato
Authors: Rosenfeld Sebastián , Segovia Nicolás I , Maturana Claudia S , Aldea Cristián , Saucède Thomas , Brickle Paul , Spencer Hamish G , Poulin Elie , González-Wevar Claudio A
Published: November 2023

The marine gastropod genus Laevilitorina is exclusive to the Southern Hemisphere, with 21 species from southern South America, Antarctica, Australia, New Zealand, and sub-Antarctic Islands. We present a comprehensive revision of Laevilitorina, using molecular and morphological analyses, to address formally the interspecific divergences within the nominal taxon Laevilitorina caliginosa s.l. We confirm the validity of L. caliginosa and Laevilitorina venusta, and we demonstrate that specimens from the Strait of Magellan and Hornos Island constitute four new species here described: Laevilitorina magellanica sp. nov., Laevilitorina pepita sp. nov., Laevilitorina fueguina sp. nov., and Laevilitorina hicana sp. nov. All six species are clearly distinguishable genetically, morphologically, and through radular tooth shape and configurations. Laevilitorina venusta is broadly distributed across the Antarctic Peninsula, South Georgia, and sub-Antarctic Islands (Marion, Crozet, Kerguelen, and Macquarie), whereas L. caliginosa s.s. appears geographically restricted to Cape Horn, the Falkland/Malvinas Islands, and South Georgia. The identification of populations from Macquarie Island as L. caliginosa is dubious; we suggest that these records are likely to pertain to L. venusta. This detailed revision of Laevilitorina, whereby hidden diversity was detected, significantly enriches our knowledge of the evolutionary history of this group.
Placenta Accreta Spectrum on MRI
Authors: Patterson Kellie , Byun Sarah , Hines John
Published: November 2023

Placenta accreta spectrum (PAS) refers to a range of abnormally adhesive and penetrative placental tissues in the myometrium. It is critical to diagnose PAS before delivery, as maternal morbidity/mortality can occur due to life-threatening hemorrhage. Ultrasound has traditionally been the first-line imaging modality for the diagnosis of PAS; however MRI is a useful supplemental modality in the workup and is a valuable tool in cases where ultrasound is limited or equivocal. It is also indicated in further assessment of PAS in cases with a positive ultrasound diagnosis. There are three main categories of MRI findings of PAS, all of which involve disruption of the normal anatomic appearance of the placenta/myometrium and include gross morphologic signs (placental bulge, bladder wall interruption, exophytic mass, rolled-up placental edge, and placental protrusion into the cervix), interface signs (myometrial thinning, loss of T2 hypointense interface, abnormal vascularization of the placental bed, and placental infarction), and architecture signs (T2 dark bands, abnormal intraplacental vascularity, and placental heterogeneity). It is important for radiologists to be aware of these signs, and potential MRI imaging pitfalls to avoid false diagnosis. Numerous studies are currently being conducted to improve the diagnosis of PAS on imaging, including investigations looking at dynamic contrast gadolinium enhancement and machine learning.
Using Principles of Agile Leadership in a Frontier Hospital Electronic Health Record System Implementation
Authors: Stansbury Kevin M.
Published: November 2023

The challenge of implementing a new electronic health record system in any hospital can be daunting. Doing so in a small frontier hospital with limited resources can be monumental. By incorporating fundamental leadership principles, including Agile leadership principles and committing to a set of values, Lincoln Health in Hugo, Colorado, achieved a successful implementation on an accelerated schedule.
Health-Related Quality of Life in Patients With Ventricular Assist Device
Authors: Spielmann Hannah , Tigges-Limmer Katharina , Albert Wolfgang , Spitz-Köberich Christine , Semmig-Könze Sandra , Staus Paulina ,   on behalf of the Selma Study Group, Herrmann-Lingen Christoph , Sandau Kristin E. , Okeson Brynn , Geyer Siegfried , Kugler Christiane
Published: November 2023

Background

Ventricular assist device (VAD) implantation has become an alternative treatment for patients with end-stage heart failure. In Germany, valid and reliable instruments to assess health-related quality of life in patients with VAD are lacking.

Objective

The aim of this study was to present the psychometric validation of the German version of the Quality of Life with a Ventricular Assist Device questionnaire.

Methods

In a multicenter, cross-sectional study, 393 participants (mean age, 58.3 years; 85.8% male, 60.3% bridge to transplant, and 72.8% living with VAD for ≤2 years) completed the German Quality of Life with a Ventricular Assist Device questionnaire of physical, emotional, social, cognitive, and meaning/spiritual domains. Item and confirmatory factor analyses were conducted to test item difficulty and discrimination and the underlying structure, respectively. To examine internal consistency, Cronbach α was assessed. Convergent construct validity was tested using the Kansas City Cardiomyopathy Questionnaire and the Patient Health Questionnaire-9. Readability was examined using Flesch Reading Ease index and Vienna Factual Text Formula.

Results

The Quality of Life with a Ventricular Assist Device showed reasonable item difficulty (P
total = .67) and mostly moderate to high discriminatory power (r
it > 0.30). In confirmatory factor analysis, root-mean-square error of approximation (0.07) was acceptable for model fit, but no other indices. Acceptable internal consistency was found (α ≥ 0.79), with the exception of the cognitive domain (α = 0.58). The overall questionnaire and single domains demonstrated convergent validity (r ≥ 0.45, P < .001). The questionnaire showed adequate readability (Flesch Reading Ease, 64.11; Vienna Factual Text Formula, 6.91).

Conclusion

Findings indicate a promising standardized clinical instrument to assess health-related quality of life in patients with VAD.
Effects of cardiac rehabilitation on inflammatory biomarkers in unstable ischemic heart disease patients following percutaneous coronary intervention: a randomized controlled study
Authors: Awada Mohamad , Sanaei Shahin , Jameie Mana , Rahnamoun Zahra
Published: November 2023

Introduction

Several blood inflammatory markers, such as high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), are linked to increased risk for cardiovascular diseases. This study aimed to evaluate these inflammatory markers after cardiac rehabilitation (CR) in patients with unstable ischemic heart disease (UIHD) who underwent successful percutaneous coronary intervention (PCI).

Methods

A cohort of 115 patients with successful PCI due to UIHD enrolled in the study from January 2018 to March 2021. We used a permuted block stratified randomization technique (2 : 1 ratio). Seventy-seven patients were randomized to the CR group and 38 patients to the control group. The CR group underwent a 12-week pre-specified CR regimen. Blood samples were taken at baseline and follow-up at 12 weeks for both groups.

Result

Among the 115 patients, 33 patients were female. The mean age was (53 ± 5.55 years) in the control and (53 ± 6.09 years) in the CR group. The two groups were comparable regarding their baseline characteristics and the values of the inflammatory markers. By contrast, at 12 weeks, the inflammatory marker values were significantly lower in the CR group compared to the control group; hs-CRP: 0.11 [0.08–0.14] vs. 0.21 [0.19–0.21], P-value <0.001; NLR: 2.17 [1.42–2.43] vs. 2.26 [2.07–2.6], P-value: 0.016; PLR: 91.2821 [63.3333–103.2000] vs. 92.600 [84.6154–110.0000], P-value: 0.027.

Conclusion

CR after PCI in UIHD patients may attenuate some inflammatory markers, which might benefit cardiovascular health. Further studies are required to evaluate these findings with longer follow-up and the powered to measure major cardiovascular event rates.
Impact of Deceased-donor Acute Kidney Injury on Kidney Transplantation
Authors: Yaffe Hillary C. , von Ahrens Dagny , Urioste Alejandra , Mas Valeria R. , Akalin Enver
Published: November 2023

Even as record numbers of deceased donors are undergoing organ recovery, the global transplant community continues to struggle with a shortage of donor organs and a high organ discard rate. Acute kidney injury (AKI) occurs in many hospitalized patients, including up to 25% of patients in critical condition. Registry studies have shown a significant increase in nonrecovery or organ discard rates in AKI donors, despite most studies reporting similar clinical outcomes compared with non-AKI donors. This review aims to capture the salient information learned from these studies and to summarize the efforts that have been made to gain a more granular understanding of how kidneys from donors with AKI behave posttransplant. In particular, we reviewed the studies that analyzed the clinical outcomes in different stages of AKI and AKI in marginal donors, such as kidney donor profile index of >85%, older donors, and donation after circulatory death donors. We summarized studies investigating molecular biomarkers, transcriptomics, and possible future therapeutic targets for postdonation AKI.
Paternal environment effects are driven by female reproductive fluid but not sperm age in an external fertilizer
Authors: Hadlow Jessica H. , Lymbery Rowan A. , Evans Jonathan P.
Published: November 2023

Sperm ageing after ejaculation can generate paternal environment effects that impact offspring fitness. In many species, female reproductive fluids (FRFs), i.e. ancillary fluids released by eggs or within the female reproductive tract, may protect sperm from ageing and can additionally interact with sperm to influence offspring viability. This raises the intriguing prospect that FRFs may alleviate paternal effects associated with sperm ageing. Here, we test this novel hypothesis using the broadcast spawning mussel,
Mytilus galloprovincialis
. We show that incubating sperm in FRF prior to fertilization increases offspring viability, and that these effects occur independently of sperm age. Our results provide novel evidence that FRFs allow females to selectively bias fertilization toward higher quality sperm within an ejaculate, which in turn yields more viable offspring. We consider this FRF-mediated paternal effect in the context of female physiological control over fertilization and the transgenerational effects of female-regulated haploid selection.
Honeybee cluster—not insulation but stressful heat sink
Authors: Mitchell Derek
Published: November 2023

Since the early twentieth century, the outer layer (mantle) of honeybees (
Apis mellifera
) in the winter cluster has been said to insulate the cluster core. This has encouraged enforced clustering, by the beekeepers' dominant use of inadequately insulated hives and, in North America, refrigeration. This is often seen as a benign or even a necessary process, with beekeeping and academic research considering these conditions of extreme heat loss, compared with the honeybee's natural habitat, as natural and normal. By using porous material correlations, analysis of previous findings and a model of a cluster within a hive in a landscape that implements convection, conduction and radiation, we show that a honeybee colony increases in thermal conductivity, on transition from pre-cluster to dense mantle, by a factor of approximately 2, and insulation
R
-value can decrease by more than 11. These results show that the mantle does not act like insulation and that clustering is not benign, but instead is an evolutionary behavioural reaction to an existential threat that results in increased cold and exertion stress. Thus the attitude to forced clustering, i.e. deliberately provoking a stressful survival behaviour, needs revision as avoidable forced stress upon animals may be regarded as cruel.
Beyond kindness: a proposal for the flourishing of science and scientists alike
Authors: Schumann Frank , Smolka Mareike , Dienes Zoltan , Lübbert Annika , Lukas Wolfgang , Rees Mary Gehring , Fucci Enrico , van Vugt Marieke
Published: November 2023

We argue that many of the crises currently afflicting science can be associated with a present failure of science to sufficiently embody its own values. Here, we propose a response beyond mere crisis resolution based on the observation that an ethical framework of flourishing derived from the Buddhist tradition aligns surprisingly well with the values of science itself. This alignment, we argue, suggests a recasting of science from a competitively managed activity of knowledge production to a collaboratively organized moral practice that puts kindness and sharing at its core. We end by examining how Flourishing Science could be embodied in academic practice, from individual to organizational levels, and how that could help to arrive at a flourishing of scientists and science alike.
The name of the game: palaeoproteomics and radiocarbon dates further refine the presence and dispersal of caprines in eastern and southern Africa
Authors: Le Meillour Louise , Zazzo Antoine , Zirah Séverine , Tombret Olivier , Barriel Véronique , Arthur Kathryn W. , Arthur John W. , Cauliez Jessie , Chaix Louis , Curtis Matthew C. , Gifford-Gonzalez Diane , Gunn Imogen , Gutherz Xavier , Hildebrand Elisabeth , Khalidi Lamya , Millet Marie , Mitchell Peter , Studer Jacqueline , Vila Emmanuelle , Welker Frido , Pleurdeau David , Lesur Joséphine
Published: November 2023

We report the first large-scale palaeoproteomics research on eastern and southern African zooarchaeological samples, thereby refining our understanding of early caprine (sheep and goat) pastoralism in Africa. Assessing caprine introductions is a complicated task because of their skeletal similarity to endemic wild bovid species and the sparse and fragmentary state of relevant archaeological remains. Palaeoproteomics has previously proved effective in clarifying species attributions in African zooarchaeological materials, but few comparative protein sequences of wild bovid species have been available. Using newly generated type I collagen sequences for wild species, as well as previously published sequences, we assess species attributions for elements originally identified as caprine or ‘unidentifiable bovid’ from 17 eastern and southern African sites that span seven millennia. We identified over 70% of the archaeological remains and the direct radiocarbon dating of domesticate specimens allows refinement of the chronology of caprine presence in both African regions. These results thus confirm earlier occurrences in eastern Africa and the systematic association of domesticated caprines with wild bovids at all archaeological sites. The combined biomolecular approach highlights repeatability and accuracy of the methods for conclusive contribution in species attribution of archaeological remains in dry African environments.
Conserved grasslands support similar pollinator diversity as pollinator-specific practice regardless of proximal cropland and pesticide exposure
Authors: Kraus Johanna M. , Smalling Kelly L. , Vandever Mark W. , Givens Carrie E. , Smith Cassandra D. , Kolpin Dana W. , Hladik Michelle L.
Published: November 2023

Pollinator diversity and abundance are declining globally. Cropland agriculture and the corresponding use of agricultural pesticides may contribute to these declines, while increased pollinator habitat (flowering plants) can help mitigate them. Here we tested whether the relative effect of wildflower plantings on pollinator diversity and counts were modified by proportion of nearby agricultural land cover and pesticide exposure in 24 conserved grasslands in Iowa, USA. Compared with general grassland conservation practices, wildflower plantings led to only a 5% increase in pollinator diversity and no change in counts regardless of the proportion of cropland agriculture within a 1 km radius. Pollinator diversity increased earlier in the growing season and with per cent flower cover. Unexpectedly, neither insecticide nor total pesticide concentrations on above-ground passive samplers were related to pollinator diversity. However, pollinator community composition was most strongly related to date of sampling, total pesticide concentration, and forb or flower cover. Our results indicate very little difference in pollinator diversity between grassland conservation practices with and without wildflower plantings. Given the relatively high economic costs of wildflower plantings, our research provides initial evidence that investment in general grassland conservation may efficiently conserve pollinator diversity in temperate regions of intensive cropland agriculture.
Primary Subacute Talus Osteomyelitis Caused by Pasteurella Canis: Literature Review and Case Report
Authors: Shah Sohaib , Donnachie Douglas , Niazi Noman , Conyers Russell , Dartnell Jo , Katchburian Marcos , Ayodele Oluwarantimi
Published: November 2023

Case

We would like to demonstrate the case of a 6-year-old girl who presented with progressive ankle pain and eventual inability to weight bear. She was shown to have primary acute osteomyelitis of the talus caused by Pasteurella canis, a commensal organism usually found in the oropharynx of dogs, despite the absence of any history of a dog bite or other zoonotic risk factors.
We characterise the symptoms, signs, radiographic appearances and result of both the medical and surgical management, including a review of the literature. This review aims to increase awareness of this rare pathology and help guide other clinicians in accurately diagnosing and managing the condition.
Danielozyma pruni sp. nov., an asexual yeast species isolated from insect frass
Authors: Liu Shan , Guo Qi-Chao , An Ze-Ren , Hui Feng-Li
Published: November 2023

Two strains (NYNU 218101 and NYNU 218104) of an asexual yeast species were isolated from insect frass collected in insect tunnels of red leaf plum trees in the Henan Province, central China. Molecular phylogenetic analysis of the D1/D2 domain of the large subunit rRNA gene and the internal transcribed spacer (ITS) region showed that these two strains belonged to the genus Danielozyma, with Danielozyma litseae as the closest known species. They differed from the type strain of D. litseae by 0.6 % substitutions (three substitutions and one gap) in the D1/D2 domain and by 5.1 % substitutions (19 substitutions and six gaps) in the ITS region, respectively. When compared with the partial ACT1, TEF1 and RPB1 gene sequences, they differed by 3 % (26 substitutions), 2.7 % (25 substitutions) and 9 %(54 substitutions) from D. litseae NRRL YB-3246T in these regions. Physiologically, they also differed from its closest known species D. litseae based on the ability to assimilate inulin and galactitol, as well as to grow in 0.1 % cycloheximide and its inability to ferment maltose and raffinose. In order to classify the two new isolates based on morphological and molecular evidence, we proposed the description of a novel species Danielozyma pruni sp. nov. with strain JCM 35735T as holotype (Mycobank MB 849101).