bluuebunny/crossref_metadata_2025 huggingface dataset:
Dopamine signalling in pancreatic islet cells and role in adaptations to metabolic stress
Authors: Sridhar Ananyaa , Flatt Peter R , Draper Matthew , Tarasov Andrei I , Moffett R Charlotte , Irwin Nigel , Khan Dawood
Published: April 2024

Objectives

Dopamine and related receptors are evidenced in pancreatic endocrine tissue, but the impact on islet β-cell stimulus-secretion as well as (patho)physiological role are unclear.

Methods

The present study has evaluated islet cell signalling pathways and biological effects of dopamine, as well as alterations of islet dopamine in rodent models of diabetes of different aetiology.

Key findings

The dopamine precursor l-DOPA partially impaired glucose tolerance in mice and attenuated glucose-, exendin-4, and alanine-induced insulin secretion. The latter effect was echoed by the attenuation of glucose-induced [Ca2+]i dynamics and elevation of ATP levels in individual mouse islet cells. l-DOPA significantly decreased β-cell proliferation rates, acting predominantly via the D2 receptor, which was most abundant at the mRNA level. The administration of streptozotocin (STZ) or high-fat diet (HFD) in mice significantly elevated numbers of dopamine-positive islet cells, with HFD also increasing colocalization of dopamine with insulin. At the same time, colocalization of dopamine with glucagon was increased in STZ-treated and pregnant mice, but unaffected by HFD.

Conclusion

These findings highlight a role for dopamine receptor signalling in islet cell biology adaptations to various forms of metabolic stress.
Sexy ways: approaches to studying plant sex chromosomes
Authors: Hobza Roman , Bačovský Václav , Čegan Radim , Horáková Lucie , Hubinský Marcel , Janíček Tomáš , Janoušek Bohuslav , Jedlička Pavel , Kružlicová Jana , Kubát Zdeněk , Rodríguez Lorenzo José Luis , Novotná Pavla , Hudzieczek Vojtěch
Published: April 2024

Sex chromosomes have evolved in many plant species with separate sexes. Current plant research is shifting from examining the structure of sex chromosomes to exploring their functional aspects. New studies are progressively unveiling the specific genetic and epigenetic mechanisms responsible for shaping distinct sexes in plants. While the fundamental methods of molecular biology and genomics are generally employed for the analysis of sex chromosomes, it is often necessary to modify classical procedures not only to simplify and expedite analyses but sometimes to make them possible at all. In this review, we demonstrate how, at the level of structural and functional genetics, cytogenetics, and bioinformatics, it is essential to adapt established procedures for sex chromosome analysis.
Constraining the global composition of D/H and 18O/16O in Martian water using SOFIA/EXES
Authors: Alday J , Aoki S , DeWitt C , Montmessin F , Holmes J A , Patel M R , Mason J P , Encrenaz T , Richter M J , Irwin P G J , Daerden F , Terada N , Nakagawa H
Published: April 2024

Isotopic ratios in water vapour carry important information about the water reservoir on Mars. Localized variations in these ratios can inform us about the water cycle and surface–atmosphere exchanges. On the other hand, the global isotopic composition of the atmosphere carries the imprints of the long-term fractionation, providing crucial information about the early water reservoir and its evolution throughout history. Here, we report the analysis of measurements of the D/H and 18O/16O isotopic ratios in water vapour in different seasons (LS = 15○, 127○, 272○, and 305○) made with the Echelon-Cross-Echelle Spectrograph (EXES) aboard the Stratospheric Observatory for Infrared Astronomy (SOFIA). These measurements, free of telluric absorption, provide a unique tool for constraining the global isotopic composition of Martian water vapour. We find the maximum planetary D/H ratio in our observations during the northern summer (D/H = 5.2 ± 0.2 with respect to the Vienna Standard Mean Ocean Water, VSMOW) and to exhibit relatively small variations throughout the year (D/H = 5.0 ± 0.2 and 4.3 ± 0.4 VSMOW during the northern winter and spring, respectively), which are to first order consistent though noticeably larger than the expectations from condensation-induced fractionation. Our measurements reveal the annually averaged isotopic composition of water vapour to be consistent with D/H = 5.0 ± 0.2 and 18O/16O = 1.09 ± 0.08 VSMOW. In addition, based on a comparison between the SOFIA/EXES measurements and the predictions from a Global Climate Model, we estimate the D/H in the northern polar ice cap to be $\sim\!{5}~{{\ \rm per\ cent}}$ larger than that in the atmospheric reservoir (D/Hice = 5.3 ± 0.3 VSMOW).
The impact of cosmic rays on the interstellar medium and galactic outflows of Milky Way analogues
Authors: Rodríguez Montero Francisco , Martin-Alvarez Sergio , Slyz Adrianne , Devriendt Julien , Dubois Yohan , Sijacki Debora
Published: April 2024

During the last decade, cosmological simulations have managed to reproduce realistic and morphologically diverse galaxies, spanning the Hubble sequence. Central to this success was a phenomenological calibration of the few included feedback processes, while glossing over higher complexity baryonic physics. This approach diminishes the predictive power of such simulations, preventing to further our understanding of galaxy formation. To tackle this fundamental issue, we investigate the impact of cosmic rays (CRs) and magnetic fields on the interstellar medium and the launching of outflows in a cosmological zoom-in simulation of a Milky Way-like galaxy. We find that including CRs decreases the stellar mass of the galaxy by a factor of 10 at high redshift and ∼4 at cosmic noon, leading to a stellar mass to halo mass ratio in good agreement with abundance matching models. Such decrease is caused by two effects: (i) a reduction of cold, high-density, star-forming gas, and (ii) a larger fraction of supernova (SN) events exploding at lower densities, where they have a higher impact. SN-injected CRs produce enhanced, multiphase galactic outflows, which are accelerated by CR pressure gradients in the circumgalactic medium of the galaxy. While the mass budget of these outflows is dominated by the warm ionized gas, warm neutral and cold gas phases contribute significantly at high redshifts. Importantly, our work shows that future JWST observations of galaxies and their multiphase outflows across cosmic time have the ability to constrain the role of CRs in regulating star formation.
Iterative removal of sources to model the turbulent electromotive force
Authors: Bendre Abhijit B , Schober Jennifer , Dhang Prasun , Subramanian Kandaswamy
Published: April 2024

We describe a novel method to compute the components of dynamo tensors from direct magnetohydrodynamic (MHD) simulations. Our method relies upon an extension and generalization of the standard Högbom CLEAN algorithm widely used in radio astronomy to systematically remove the impact of the strongest beams on to the corresponding image. This generalization, called the Iterative Removal of Sources (IROS) method, has been adopted here to model the turbulent electromotive force (EMF) in terms of the mean magnetic fields and currents. Analogous to the CLEAN algorithm, IROS treats the time series of the mean magnetic field and current as beams that convolve with the dynamo coefficients which are treated as (clean) images to produce the EMF time series (the dirty image). We apply this method to MHD simulations of galactic dynamos, to which we have previously employed other methods of computing dynamo coefficients such as the test-field method, the regression method, as well as local and non-local versions of the singular value decomposition (SVD) method. We show that our new method reliably recovers the dynamo coefficients from the MHD simulations. It also allows priors on the dynamo coefficients to be incorporated easily during the inversion, unlike in earlier methods. Moreover, using synthetic data, we demonstrate that it may serve as a viable post-processing tool in determining the dynamo coefficients, even when the power of additive noise to the EMF is twice as much the actual EMF.
Mass reconstruction and noise reduction with cosmic-web environments
Authors: Fang Feng , Cai Yan-Chuan , Li Zhuoyang , Yue Shiyu , Zhu Weishan , Feng Longlong
Published: April 2024

The clustering of galaxies and their connections to their initial conditions is a major means by which we learn about cosmology. However, the stochasticity between galaxies and their underlying matter field is a major limitation for precise measurements of galaxy clustering. Efforts have been made with an optimal weighting scheme to reduce this stochasticity using the mass-dependent clustering of dark matter haloes. Here, we show that this is not optimal. We demonstrate that the cosmic-web environments (voids, sheets, filaments, and knots) of haloes, when combined linearly with the linear bias, provide extra information for reducing stochasticity in terms of two-point statistics. Using the environmental information alone can increase the signal-to-noise of clustering by a factor of 3 better than the white-noise level at the scales of the baryon acoustic oscillations. The information about the environment and halo mass are complementary. Their combination increases the signal-to-noise by another factor of 2-3. The information about the cosmic web correlates with other properties of haloes, including halo concentrations and tidal forces – all are related to the assembly bias of haloes.
Doppler tomography as a tool for characterizing exoplanet atmospheres – II. An analysis of HD 179949 b
Authors: Matthews S M , Watson C A , de Mooij E J W , Marsh T R , Brogi M , Merritt S R , Smith K W , Steeghs D
Published: April 2024

High-resolution Doppler spectroscopy provides an avenue to study the atmosphere of both transiting and non-transiting planets. This powerful method has also yielded some of the most robust atmospheric detections to date. Currently, high-resolution Doppler spectroscopy detects atmospheric signals by cross-correlating observed data with a model atmospheric spectrum. This technique has been successful in detecting various molecules such as H2O, CO, HCN, and TiO, as well as several atomic species. Here, we present an alternative method of performing high-resolution Doppler spectroscopy, using a technique known as Doppler tomography. We present an analysis of HD 179949 b using Doppler tomography and provide Doppler tomograms confirming previous detections of CO at 2.3 μm and H2O at both 2.3 and 3.5 μm within the atmosphere of HD 179949 b, showing significantly lower background noise levels when compared to cross-correlation methods applied to the same data. We also present a novel detection of H2O at 2.1 μm as well as a tentative detection of CO on the night side of the planet at 2.3 μm. This represents the first observational evidence for molecular absorption in the night-side emission spectrum of an exoplanet using Doppler spectroscopy.
Carfilzomib-associated thrombotic microangiopathy: clinical features and outcomes
Authors: Joseph Adrien , Harel Stéphanie , Mesnard Laurent , Rafat Cédric , Knapp Silène , Rumpler Anne , Philipponnet Carole , Barba Christophe , Rebibou Jean-Michel , Buob David , Hertig Alexandre , Vargaftig Jacques , Halimi Jean-Michel , Arnulf Bertrand , Bretaud Anne-Sophie , Joly Bérangère , Grangé Steven , Coppo Paul
Published: April 2024

Background

Carfilzomib, a new proteasome inhibitor indicated for patients with relapsed/refractory myeloma, has been associated with cases of thrombotic microangiopathy (CFZ-TMA). The role of variants in the complement alternative pathway and therapeutic potential of complement blockade with eculizumab remain to be determined.

Methods

We report 37 cases of CFZ-TMA recorded in the French reference center for TMA with their clinical characteristics, genetic analysis and outcome according to treatments.

Results

A trigger was identified in more than half of cases, including eight influenza and five severe acute respiratory syndrome coronavirus-2 cases. All patients presented with acute kidney injury (AKI) [KDIGO stage 3 in 31 (84%) patients] while neurological (n = 13, 36%) and cardiac (n = 7, 19%) damage were less frequent. ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type I repeats-13) and complement activity were normal (n = 28 and 18 patients tested) and no pathogenic variant in the alternative complement pathway was found in 7 patients tested. TMA resolved in most (n = 34, 94%) patients but 12 (44%) still displayed stage 3 AKI at discharge. Nineteen (51%) patients were treated with therapeutic plasma exchange, 14 (38%) patients received corticosteroids and 18 (50%) were treated with eculizumab. However, none of these treatments demonstrated a significant impact on outcomes.

Conclusion

This study is the largest case series of CFZ-TMA since its approval in 2012. Patients present with severe AKI and experience frequent sequelae. Complement variants and blockade therapy do not seem to play a role in the pathophysiology and prognosis of the disease.
Phase I trial of dose escalation for preoperative stereotactic radiosurgery for patients with large brain metastases
Authors: Murphy Erin S , Yang Kailin , Suh John H , Yu Jennifer S , Stevens Glen , Angelov Lilyana , Vogelbaum Michael A , Barnett Gene H , Ahluwalia Manmeet S , Neyman Gennady , Mohammadi Alireza M , Chao Samuel T
Published: April 2024

Background

Single-session stereotactic radiosurgery (SRS) or surgical resection alone for brain metastases larger than 2 cm results in unsatisfactory local control. We conducted a phase I trial for brain metastases(>2 cm) to determine the safety of preoperative SRS at escalating doses.

Methods

Radiosurgery dose was escalated at 3 Gy increments for 3 cohorts based on maximum tumor dimension starting at: 18 Gy for >2–3 cm, 15 Gy for >3–4 cm, and 12 Gy for >4–6 cm. Dose-limiting toxicity was defined as grade III or greater acute toxicity.

Results

A total of 35 patients/36 lesions were enrolled. For tumor size >2–3 cm, patients were enrolled up to the second dose level (21 Gy); for >3–4 cm and >4–6 cm cohorts the third dose level (21 and 18 Gy, respectively) was reached. There were 2 DLTs in the >3–4 cm arm at 21 Gy. The maximum tolerated dose of SRS for >2–3 cm was not reached; and was 18 Gy for both >3–4 cm arm and >4–6 cm arm. With a median follow-up of 64.0 months, the 6- and 12-month local control rates were 85.9% and 76.6%, respectively. One patient developed grade 3 radiation necrosis at 5 months. The 2-year rate of leptomeningeal disease (LMD) was 0%.

Conclusions

Preoperative SRS with dose escalation followed by surgical resection for brain metastases greater than 2 cm in size demonstrates acceptable acute toxicity. The phase II portion of the trial will be conducted at the maximum tolerated SRS doses.
Do presenting symptoms predict treatment decisions and survival in glioblastoma? Real-world data from 1458 patients in the Swedish brain tumor registry
Authors: Bruhn Helena , Tavelin Björn , Rosenlund Lena , Henriksson Roger
Published: April 2024

Background

Glioblastoma is the most common malignant brain tumor in adults. Non-invasive clinical parameters could play a crucial role in treatment planning and serve as predictors of patient survival. Our register-based real-life study aimed to investigate the prognostic value of presenting symptoms.

Methods

Data on presenting symptoms and survival, as well as known prognostic factors, were retrieved for all glioblastoma patients in Sweden registered in the Swedish Brain Tumor Registry between 2018 and 2021. The prognostic impact of different presenting symptoms was calculated using the Cox proportional hazard model.

Results

Data from 1458 adults with pathologically verified IDH wild-type glioblastoma were analyzed. Median survival time was 345 days. The 2-year survival rate was 21.5%. Registered presenting symptoms were focal neurological deficits, cognitive dysfunction, headache, epilepsy, signs of raised intracranial pressure, and cranial nerve symptoms, with some patients having multiple symptoms. Patients with initial cognitive dysfunction had significantly shorter survival than patients without; 265 days (245–285) vs. 409 days (365–453; P < .001). The reduced survival remained after Cox regression adjusting for known prognostic factors. Patients presenting with seizures and patients with headaches had significantly longer overall survival compared to patients without these symptoms, but the difference was not retained in multivariate analysis. Patients with cognitive deficits were less likely to have radical surgery and to receive extensive anti-neoplastic nonsurgical treatment.

Conclusions

This extensive real-life study reveals that initial cognitive impairment acts as an independent negative predictive factor for treatment decisions and adversely affects survival outcomes in glioblastoma patients.
Developing an Ethical Evaluation Framework for Coercive Antimicrobial Stewardship Policies
Authors: Johnson Tess
Published: April 2024

Antimicrobial resistance (AMR) has been declared one of the top ten global public health threats facing humanity. To address AMR, coercive antimicrobial stewardship policies are being enacted in some settings. These policies, like all in public health, require ethical justification. Here, I introduce a framework for ethically evaluating coercive antimicrobial stewardship policies on the basis of ethical justifications (and their limitations). I consider arguments from effectiveness; duty of easy rescue; tragedy of the commons; responsibility-tracking; the harm principle; paternalism; justice and development; a precautionary approach; and professional duties. I consider how these justifications might form the basis for developing a comprehensive ethical framework, and the need for this to be context-specific and aligned with the priorities, evidence and needs of the particular jurisdictions in which a policy is to be enacted. I demonstrate how the ethical justifications might be used by reference to an example policy of the EU ban on the use of certain human-critical antibiotics for livestock, before concluding with challenges for further development of the framework.
Protein degradation in auxin response
Authors: de Roij Martijn , Borst Jan Willem , Weijers Dolf
Published: April 2024

The signaling molecule auxin sits at the nexus of plant biology where it coordinates essentially all growth and developmental processes. Auxin molecules are transported throughout plant tissues and are capable of evoking highly specific physiological responses by inducing various molecular pathways. In many of these pathways, proteolysis plays a crucial role for correct physiological responses. This review provides a chronology of the discovery and characterization of the auxin receptor, which is a fascinating example of separate research trajectories ultimately converging on the discovery of a core auxin signaling hub that relies on degradation of a family of transcriptional inhibitor proteins—the Aux/IAAs. Beyond describing the “classical” proteolysis-driven auxin response system, we explore more recent examples of the interconnection of proteolytic systems, which target a range of other auxin signaling proteins, and auxin response. By highlighting these emerging concepts, we provide potential future directions to further investigate the role of protein degradation within the framework of auxin response.
A group of L-type lectin receptor kinases function redundantly in mediating extracellular NAD(P) signaling in Arabidopsis
Authors: Li Qi , Zhou Mingxi , Harris Fiona , Mou Zhonglin
Published: April 2024

An Arabidopsis mutant lacking several L-type lectin receptor kinases shows severely reduced NAD(P)-induced local and systemic immunity and biological induction of systemic acquired resistance.
Brain compensatory mechanisms in depression and memory complaints in fibromyalgia: the role of theta oscillatory activity
Authors: Pacheco-Barrios Kevin , Teixeira Paulo E P , Martinez-Magallanes Daniela , Neto Moacir Silva , Pichardo Elly Angelica , Camargo Lucas , Lima Daniel , Cardenas-Rojas Alejandra , Fregni Felipe
Published: April 2024

Background

The different clinical presentations of fibromyalgia syndrome (FMS) might play independent roles in the unclear etiology of cognitive impairments and depressive symptoms seen in patients with FMS. Understanding how these clinical presentations are associated with the clinical and neurophysiological aspects of FMS is important for the development of effective treatments.

Aim

To explore the relationship of memory complaints and depressive symptoms with the different clinical and neurophysiological characteristics of FMS.

Methods

Cross-sectional data analysis from a randomized clinical trial. Baseline demographics and data on physical fitness, sleep, anxiety, depression, cortical excitability, and pain (clinical and mechanistic) from 63 subjects with FMS were used. Multiple linear and logistic association models were constructed.

Results

Final regression models including different sets of predictions were statistically significant (P < .001), explaining approximately 50% of the variability in cognitive complaints and depression status. Older subjects had higher levels of anxiety, poorer sleep quality, lower motor threshold, and higher relative theta power in the central area and were more likely to have clinical depression. Higher anxiety, pain, and theta power were associated with a higher likelihood of memory complaints.

Conclusion

Depression symptoms seem to be associated with transcranial magnetic stimulation–indexed motor threshold and psychosocial variables, whereas memory complaints are associated with pain intensity and higher theta oscillations. These mechanisms might be catalyzed or triggered by some behavioral and clinical features, such as older age, sleep disruption, and anxiety. The correlation with clinical variables suggests that the increasing of theta oscillations is a compensatory response in patients with FMS, which can be explored in future studies to improve the treatment of FMS.

Trial registration

ClinicalTrials.gov ID NCT03371225.
Key technology and development of industry–academia collaboration patents derived from the government subsidy program
Authors: Chang Shu-Hao
Published: April 2024

This study discusses the technology development direction of industry–academia collaboration patents derived from government-subsidized programs and uses technology network analysis to pinpoint the key technologies developed in government-subsidized programs that align with market needs. The main technologies that play a key role in the government-subsidized industry–academia collaboration technology network for recent years are revealed to be measurement and chemistry technologies. The technologies that bridge the gap between multiple fields within the field of medicine are found to be diagnosis, surgery, and identification technologies; these technologies require further attention and resources from the government and academia. Additionally, semiconductor technology is revealed to play an increasingly crucial role in the government-subsidized industry–academia collaboration network. The findings can serve as a reference for the government to allocate research resources and for enterprises to promote emerging technologies.
Prevalence, characterization, and implications of methicillin-resistant Staphylococcus aureus (MRSA) in ready-to-eat foods from Delta, Nigeria: a concern for consumer safety
Authors: Beshiru Abeni , Isichei-Ukah Brenda O , Uwhuba Kate E , Igere Bright E , Igbinosa Etinosa O
Published: April 2024

Ready-to-eat (RTE) foods are susceptible to contamination with methicillin-resistant Staphylococcus aureus (MRSA), presenting significant health risks to consumers. This study aimed to isolate, identify, and characterize MRSA from RTE foods in Delta, Nigeria, and assess their implications for consumer safety. Four hundred RTE food samples were collected from food outlets, and MRSA presence was determined using oxacillin resistance screening agar supplemented with polymyxin B and oxacillin. Polymerase chain reaction confirmed and characterized MRSA isolates for virulence potentials and antimicrobial resistance genes. Out of the 400 samples, 57(14.25%) tested positive for MRSA. The prevalence of virulence genes varied, with Panton-Valentine Leukocidin (pvl) detected in 40.51% of isolates, along with the detection of several staphylococcal enterotoxin genes. Antimicrobial resistance genes, including tetracycline (tetM, 43.04%), erythromycin (ermC, 32.91%), and methicillin (mecA, 100%; mecC, 29.11%) were detected. Staphylococcal cassette chromosome mec (SCCmec) typing revealed diverse profiles, with type V being predominant (32.9%). MRSA isolates exhibited resistance to multiple antibiotics, with 83.54% of them classified as multidrug-resistant. Extracellular virulence factors were common, with strong biofilm producers observed in 69.62% of isolates. These findings underscore the complexity of MRSA contamination in RTE foods, highlighting the need for enhanced surveillance and control measures to safeguard public health.
Nurse informaticists' role in promoting health equity
Authors: Johnson Charla B.
Published: April 2024

Nurse informaticists (NIs) play a pivotal role in addressing health-related social needs through integrating technology into electronic health records. NIs navigate regulatory landscapes, emphasizing screening for social determinants of health during hospital encounters. This article underscores NIs' strategic contributions to optimizing data collection, supporting health equity, and utilizing innovative technologies to bridge gaps in healthcare outcomes.
Enhanced Recovery After Surgery for Craniotomies: A Systematic Review and Meta-analysis
Authors: Kim Seung Hyun , Choi Seung Ho , Moon Jisu , Kim Hae Dong , Choi Yong Seon
Published: April 2024

The efficacy of the enhanced recovery after surgery (ERAS) protocols in neurosurgery has not yet been established. We performed a systematic review and meta-analysis of randomized controlled trials to compare the effects of ERAS protocols and conventional perioperative care on postoperative outcomes in patients undergoing craniotomy. The primary outcome was postoperative length of hospital stay. Secondary outcomes included postoperative pain visual analog pain scores, incidence of postoperative nausea and vomiting (PONV), postoperative complications, all-cause reoperation, readmission after discharge, and mortality. A literature search up to August 10, 2023, was conducted using PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases. Five studies, including 871 patients, were identified for inclusion in this review. Compared with conventional perioperative care, ERAS protocols reduced the length of postoperative hospital stay (difference of medians, −1.52 days; 95% CI: −2.55 to −0.49); there was high heterogeneity across studies (I
2, 74%). ERAS protocols were also associated with a lower risk of PONV (relative risk, 0.79; 95% CI: 0.69-0.90; I
2, 99%) and postoperative pain with a visual analog scale score ≥4 at postoperative day 1 (relative risk, 0.37; 95% CI: 0.28-0.49; I
2, 14%). Other outcomes, including postoperative complications, did not differ between ERAS and conventional care groups. ERAS protocols may be superior to conventional perioperative care in craniotomy patients in terms of lower length of hospital stay, lower incidence of PONV, and improved postoperative pain scores. Further randomized trials are required to identify the impact of ERAS protocols on the quality of recovery after craniotomy.
Transfer of Motor Fascicle From the Ulnar Nerve to the Axillary Nerve by Posterior Access. New Approach
Authors: Diaz Luis Carlos , Vergara-Amador Enrique
Published: April 2024

We describe a new technique of transferring the motor branch ulnar nerve (UN) to the axillary nerve (AN) by posterior approach. Three patients with C5, C6, and C7 brachial plexus injury were operated. By supraclavicular approach, the spinal accessory was transferred to the suprascapular nerve. By posterior approach in the arm, the AN was identified within the quadrilateral space, and the UN was identified medially with intrafascicular dissection of a motor fascicle, which is lifted to 4 cm in length and transferred to AN. By medial approach, a motor branch from the median nerve is transferred to the biceps nerve. At a follow-up minimum of 10 months, the maximum abduction was 160 and the minimum 90 degrees. This technique, neurotization of the AN with fascicles of the UN, spinal accessory to suprascapular nerve, and median nerve branch to biceps nerve are indicated in C5-C7 avulsion when there is no radial nerve available.

Level of Evidence:

Level IV.
Congenital Unilateral Zygomaticomaxillomandibular Fusion in a 4-year-old Girl
Authors: De Moor Alexander , Dormaar Jakob Titiaan , Willaert Robin
Published: April 2024

Congenital zygomaticomaxillomandibular (ZMM) fusion is an extremely rare and debilitating condition. Fusion of the jaws results in a severe limitation of the mouth opening accompanied by breathing and feeding difficulties. Mandibular fusions to the maxilla, palate, zygoma, and temporal bone are described in literature. We present the case of 4-year-old girl diagnosed with congenital unilateral ZMM fusion. She was treated surgically at 1 year and at 4 and a half years to release the fusion and to improve mouth opening. Second surgery was indicated due to recurrence. Management of young patients with congenital maxillomandibular fusion is challenging. The scarcity of cases makes formulating practice guidelines very difficult. If surgery is performed, the importance of postoperative physical therapy cannot be overstated. The goal of this article is to emphasize the risk of recurrence in ZMM fusion after surgical treatment and importance of regular follow-up.
Isolated Fibrous Dysplasia of the Bilateral Nasal Bones: Complex Management of the Bony Vault
Authors: Fisher Sean M. , Borab Zachary , Fearon Jeffrey A. , Rohrich Rod J.
Published: April 2024

Fibrous dysplasia is a benign fibro-osseous process affecting the skeletal system, with resulting cystic and fibrous tissue expansion. Craniofacial fibrous dysplasia represents a small subset of monostotic disease, accounting for approximately 10%–25% of all such cases. Involvement of the frontal, temporal, and sphenoid bones has most commonly been described, with a limited number of reported cases citing disease isolated to the nasal bones. The case reported here is differentiated by the degree of expansion of the bilateral nasal bones and the required clinical management of the bony vault in the setting of gross nasal asymmetry.
Alcohol-associated liver disease—Global epidemiology
Authors: Åberg Fredrik , Jiang Z. Gordon , Cortez-Pinto Helena , Männistö Ville
Published: April 2024

Alcohol-associated liver disease (ALD), as highlighted in this narrative review, is a major public health concern, increasingly impacting global disease burden and premature mortality. In 2019, ALD accounted for the loss of 11 million life-years worldwide. The rising number of deaths and disability-adjusted life-years attributed to ALD, particularly pronounced in the United States, are alarming. Projections suggest that the economic impact of ALD, as seen in the United States, could potentially double by 2040. ALD is increasingly prevalent among younger adults (20-45 y) and has become the leading cause of liver transplantation in both United States and Europe. During the COVID-19 pandemic, the existing trend was further amplified as high-risk drinking patterns coincided with a rise in hospital admissions for alcohol-associated hepatitis and increased ALD-related mortality. The prevalence of ALD is estimated at 3.5% in the general population, 26.0% among hazardous drinkers, and 55.1% among those with alcohol use disorders. Alarmingly, 5-year mortality rates for patients with ALD exceed 50%, with even higher rates in more advanced disease stages. Methodological challenges, such as underreporting, diagnostic difficulties, and variability in registry data quality, complicate the accurate assessment of the impact of ALD. Additionally, the contribution of alcohol to the progression of other liver diseases is often under acknowledged in health care registries, leading to a significant underestimation of its broader implications for liver health. Addressing the growing ALD concern requires robust public health initiatives, heightened awareness, refined diagnostic techniques, and comprehensive epidemiological studies. These measures are vital to tackle the increasing prevalence of ALD and mitigate its extensive impact on individuals and health care systems.
CLINICALLY RELEVANT POSTERIOR VITREOUS DETACHMENT STAGING USING CIRCUMPAPILLARY AND MACULAR VOLUME OPTICAL COHERENCE TOMOGRAPHY
Authors: Brown David M. , Laswell Stephen M. , Rahman Effie Z. , Fan Kenneth C. , Shah Ankoor , Patel Sagar B. , Wykoff Charles C.
Published: April 2024

Purpose:

This study was designed to investigate retinal nerve fiber layer circumpapillary optical coherence tomography to determine posterior vitreous detachment (PVD) status and to develop a clinically relevant PVD grading scale based on retinal nerve fiber layer circumpapillary optical coherence tomography to determine the incidence of PVD by age and association with vitreomacular traction disorders.

Methods:

Ophthalmic images and medical records of patients with retinal diseases were retrospectively analyzed by three masked graders using retinal nerve fiber layer circumpapillary optical coherence tomography and macular optical coherence tomography. Based on PVD status, eyes were categorized into five newly defined PVD stages.

Results:

Among 2002 eyes, PVD stages were as follows: A) 25 (1.25%); B) 725 (36.21%); C−) 248 (12.39%); C+) 151 (7.54%); D) 851 (42.51%); X) 2 (0.1%). Posterior vitreous detachment was correlated with advanced age (P < 0.0001). Limited separation or partial separation between lamella within the posterior vitreous cortex (Stage B) was noted early (68% of eyes <18 years). Overall, 34% of eyes >70 years did not exhibit complete PVD. Of 75 eyes with tractional vitreoretinal disorders, 64 (85.3%) were Stage C−/C+, identifying Stage C as the high-risk “complication” stage.

Conclusion:

Imaging analyses using retinal nerve fiber layer circumpapillary optical coherence tomography and macular optical coherence tomography scans in conjunction allow rapid assessment of the PVD stage. These techniques can assist clinicians and surgeons in counseling patients and planning surgical approaches. Observations confirmed the progression of PVD through predictable stages and the progression of PVD with age.
Identifying Malaria Hotspots Regions in Ghana Using Bayesian Spatial and Spatiotemporal Models
Authors: Iddrisu Abdul-Karim , Otoo Dominic , Hinneh Gordon , Kanyiri Yakubu Dekongmene , Samuel Kanimam Yaaba , Kubio Cecilia , Veriegh Francis Balungnaa Dhari
Published: April 2024

Background

Malaria remains a significant public health concern in Ghana, with varying risk levels across different geographical areas. Malaria affects millions of people each year and imposes a substantial burden on the health care system and population. Accurate risk estimation and mapping are crucial for effectively allocating resources and implementing targeted interventions to identify regions with disease hotspots. This study aimed to identify regions exhibiting elevated malaria risk so that public health interventions can be implemented, and to identify malaria risk predictors that can be controlled as part of public health interventions for malaria control.

Methods

The data on laboratory-confirmed malaria cases from 2015 to 2021 were obtained from the Ghana Health Service and Ghana Statistical Service. We studied the spatial and spatiotemporal patterns of the relative risk of malaria using Bayesian spatial and spatiotemporal models. The malaria risk for each region was mapped to visually identify regions with malaria hotspots. Clustering and heterogeneity of disease risks were established using correlated and uncorrelated structures via the conditional autoregressive and Gaussian models, respectively. Parameter estimates from the marginal posterior distribution were estimated within the Integrated Nested Laplace Approximation using the R software.

Results

The spatial model indicated an increased risk of malaria in the North East, Bono East, Ahafo, Central, Upper West, Brong Ahafo, Ashanti, and Eastern regions. The spatiotemporal model results highlighted an elevated malaria risk in the North East, Upper West, Upper East, Savannah, Bono East, Central, Bono, and Ahafo regions. Both spatial and spatiotemporal models identified the North East, Upper West, Bono East, Central, and Ahafo Regions as hotspots for malaria risk. Substantial variations in risk were evident across regions (H= 104.9,P< 0.001). Although climatic and economic factors influenced malaria infection, statistical significance was not established.

Conclusions

Malaria risk was clustered and varied among regions in Ghana. There are many regions in Ghana that are hotspots for malaria risk, and climate and economic factors have no significant influence on malaria risk. This study could provide information on malaria transmission patterns in Ghana, and contribute to enhance the effectiveness of malaria control strategies.
Association of Serum Bicarbonate Level with Mortality in Patients with Acute Kidney Injury: A Retrospective Cohort Study
Authors: Ling Xiaojing , Liu Linchang , Gao Zhuo , Yu Ying , Gu Junhui , Shan Jing , Qiu Dejun , Cui Yu , Lu Xiaomeng , Liu Dong
Published: April 2024

Background:

Metabolic acidosis due to a decreased level of serum bicarbonate in patients with chronic kidney disease is associated with increased mortality, but the association of serum bicarbonate with outcomes in patients with acute kidney injury (AKI) is uncertain. We investigated the association of serum bicarbonate level with mortality in patients with AKI.

Methods:

The study cohort consisted of 4800 patients diagnosed with AKI at multiple hospitals between September 17, 2013, and April 14, 2014. Smooth curve fitting, threshold effect analysis, and multiple regression analysis were used to assess the relationship between serum bicarbonate and 14-day mortality (primary outcome) and with intensive care unit (ICU) admission, length of hospitalization, and total hospital costs (secondary outcomes).

Results:

Multiple regression analysis, adjusting for confounding factors, demonstrated a U-shaped association between serum bicarbonate levels and AKI mortality. The lowest mortality rate was observed in patients with a bicarbonate level of 26.9 mmol/L, while greater rates were observed in those with lower and higher levels. Additionally, patients with AKI exhibiting high serum bicarbonate levels (> 26.9 mmol/L) had a significantly lower rate of ICU admission and a shorter hospital stay compared to those with low serum bicarbonate levels (< 26.9 mmol/L).

Conclusion:

A serum bicarbonate level of 26–29 mmol/L in patients with AKI is associated with a lower 14-day mortality rate, with the lowest rate observed at a serum bicarbonate level of 26.9 mmol/L. Prospective clinical studies are needed to determine whether optimizing the serum bicarbonate level can decrease mortality in this population.
Human olfactory neurosphere-derived cells: a unified tool for neurological disease modelling and neurotherapeutic applications
Authors: Irfan Saad , Etekochay Maudlyn O. , Atanasov Atanas G. , Prasad Vishnu P. , Kandimalla Ramesh , Mofatteh Mohammad , V Priyanka , Emran Talha B.
Published: April 2024

As one of the leading causes of global mortality and morbidity, various neurological diseases cause social and economic burdens. Despite significant advances in the treatment of neurological diseases, establishing a proper disease model, especially for degenerative and infectious diseases, remains a major challenging issue. For long, mice were the model of choice but suffered from serious drawbacks of differences in anatomical and functional aspects of the nervous system. Furthermore, the collection of postmortem brain tissues limits their usage in cultured cell lines. Overcoming such limitations has prompted the usage of stem cells derived from the peripheral nervous system, such as the cells of the olfactory mucosa as a preferred choice. These cells can be easily cultured in vitro and retain the receptors of neuronal cells life-long. Such cells have various advantages over embryonic or induced stem cells, including homology, and ease of culture and can be conveniently obtained from diseased individuals through either biopsies or exfoliation. They have continuously helped in understanding the genetic and developmental mechanisms of degenerative diseases like Alzheimer’s and Parkinson’s disease. Moreover, the mode of infection of various viruses that can lead to postviral olfactory dysfunction, such as the Zika virus can be monitored through these cells in vitro and their therapeutic development can be fastened.
Development and validation of models for predicting mortality in intertrochanteric fracture surgery patients with perioperative blood transfusion: a prospective multicenter cohort study
Authors: Guo Junfei , Geng Qian , Xu Ke , Jing Wensen , Li Zheng , He Jinwen , Pan Ying , Li Yanan , Wang Tao , Long Yubin , Hou Zhiyong , Xu Xin , Xu Peng
Published: April 2024

Background:

The association between allogenic blood transfusions and all-cause mortality in surgically treated hip fracture patients with perioperative transfusion (STHFPT) remained unknown. The authors aim to introduce transfusion-related factors, new variables to develop, and validate models to predict mortality in these patients.

Methods:

A prospective multicenter cohort study was conducted with STHFPT hospitalized during January 2018 and June 2021. The database was divided into training cohort and validation cohort in a ratio of 70–30% using the randomization method. All participants received a minimum of 2-year follow-up and all participants’ overall and eight time-specific survival status were recorded. Prediction models were developed using multivariate logistic regression and Cox regression for variable selection. Model performance was measured by determining discrimination, calibration, overall model performance or precision, and utility. Sensitivity analyses were performed to test robustness of the results.

Results:

A total of 7074 consecutive patients were prospectively screened and assessed for eligibility to participate. Finally, 2490 patients met our inclusion and exclusion criteria and 1743 (70%) patients were randomized to the training cohort and 747 (30%) to the validation cohort. The median duration of follow-up was 38.4 months (IQR 28.0–62.0). Our novel models highlight that preoperative transfusion is of significance for short-term mortality while mid-term outcomes are predominantly determined by severe complications, pulmonary complications, and advanced age. Our models showed high discriminative power, good calibration, and precision for mortality prediction in both training and validation cohorts, especially in short-term mortality prediction.

Conclusions:

The authors introduce transfusion-related factors, new variables to develop, and validate models to predict mortality with STHFPT. The models can be further tested and updated with the ultimate goal of assisting in optimizing individual transfusion strategy.
Endoscopic Submucosal Dissection Criteria for Differentiated-type Early Gastric Cancer Are Applicable to Mixed-type Differentiated Predominant
Authors: Yang Zhen , Yan Jin , Qian Hai-Sheng , Zhong Zi-Hang , Yang Ruo-Yun , Li Ke-Dong , Chen Han , Zhao Yu-Han , Gao Xin , Kong Zi-Hao , Zhang Guo-Xin , Wang Yun
Published: April 2024

Background:

There is a lack of sufficient evidence on whether mixed-type differentiated predominant early gastric cancer (MD-EGC) can be treated endoscopically by referring to the criteria for differentiated-type early gastric cancer (EGC). This study aims to evaluate the efficacy of endoscopic submucosal dissection (ESD) in MD-EGC.

Methods:

Patients with differentiated-type EGC treated with ESD first from January 2015 to June 2021 were reviewed, including MD-EGC and pure differentiated-type EGC (PD-EGC). Clinical data, including the clinicopathological characteristics, resection outcomes of ESD, and recurrence and survival time, were collected, and the difference between MD-EGC and PD-EGC was tested.

Results:

A total of 48 patients (48 lesions) with MD-EGC and 850 patients (890 lesions) with PD-EGC were included. Compared with PD-EGC, MD-EGC had a higher submucosal invasion rate (37.5% vs. 13.7%, P<0.001) and lymphatic invasion rate (10.4% vs. 0.4%, P<0.001). The rates of complete resection (70.8% vs. 92.5%, P<0.001) and curative resection (54.2% vs. 87.4%, P<0.001) in MD-EGC were lower than those of PD-EGC. Multivariate analysis revealed that MD-EGC (OR 4.26, 95% CI, 2.22-8.17, P<0.001) was an independent risk factor for noncurative resection. However, when curative resection was achieved, there was no significant difference in the rates of recurrence (P=0.424) between the 2 groups, whether local or metachronous recurrence. Similarly, the rates of survival(P=0.168) were no significant difference.

Conclusions:

Despite the greater malignancy and lower endoscopic curative resection rate of MD-EGC, patients who met curative resection had a favorable long-term prognosis.
Clinical characteristics and changes in serum CXCL10 and CXCL16 levels in patients with severe mycoplasma pneumonia
Authors: Zhang Yan , Ke Junlan , Wang Xiaojuan , Xia Shuozhi
Published: April 2024

To explore the clinical characteristics and changes in serum CXCL10 and CXCL16 in patients with severe mycoplasma pneumonia, and to analyze the risk factors of severe mycoplasma pneumonia. About 258 children with acute mycoplasma pneumoniae pneumonia (MPP) admitted to the respiratory department of a certain hospital from January 2020 to December 2022 were selected as the study subjects. According to the severity of MPP, patients are divided into 2 groups, namely the mild illness group (Q group) and the severe illness group (Z group). The number of cases in these 2 groups of children is 167 and 91, respectively. The serum CXCL10, CXCL16, and other indicators of 2 groups are tested. Compared to group Q, patients in group Z have a higher proportion of extrapulmonary complications, longer cough time, longer shortness of breath, and longer wheezing time (P < .05). The serum CXCL16 is higher and the proportion of pleural effusion is higher (P < .01). There are more cases of fever, longer fever duration, longer hospital stay, higher serum CXCL10, and higher D-dimer levels (P < .001). The area under the curve of the probability curve for predicting severe mycoplasma pneumonia is 0.975 (P < .05). Children with severe mycoplasma pneumonia have significantly longer fever duration and hospital stay than those with mild symptoms. The serum levels of CXCL10 and CXCL16 are significantly elevated.