bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and patient‐reported outcomes in patients with chronic hepatitis B and C and non‐alcoholic fatty liver disease from real‐world practices in Saudi Arabia, Turkey and Egypt
Authors: Alqahtani Saleh A. , Yilmaz Yusuf , El‐Kassas Mohamed , Alswat Khalid , Sanai Faisal , AlZahrani May , Abaalkhail Faisal , AlShaikh Manal , Al‐Hamoudi Waleed K. , Nader Fatema , Stepanova Maria , Younossi Zobair M. ,   the Global NASH Council
Published: April 2024

Patients with chronic liver disease (CLD) experience health‐related quality of life (HRQoL) and patient‐reported outcomes (PROs) impairments. We assessed and identified predictors of HRQoL and PROs in CLD patients from Saudi Arabia (SA), Turkey and Egypt. Patients enrolled in Global Liver Registry™ with chronic hepatitis B (CHB), chronic hepatitis C (CHC) and non‐alcoholic fatty liver disease (NAFLD) or non‐alcoholic steatohepatitis (NASH) were included. Clinical data and PRO questionnaires (FACIT‐F, CLDQ and WPAI) were compared across countries. Linear regression identified PRO predictors. Of the 4014 included patients, 26.9% had CHB, 26.9% CHC and 46.1% NAFLD/NASH; 19.2% advanced fibrosis. Compared across countries, CHB patients were younger in Egypt (mean age [years] 41.2 ± 11.4 vs. 45.0 ± 10.3 SA, 46.1 ± 12.0 Turkey), most often employed in SA (64.8% vs. 53.2% Turkey) and had the lowest prevalence of obesity in Turkey (26.7% vs. 37.8% SA, 38.5% Egypt). In SA, CHB patients had lowest prevalence of fibrosis and comorbidities (all p < .01). There was a higher frequency of males with NAFLD/NASH in SA (70.0% vs. 49.6% Turkey, and 35.5% Egypt). Among NAFLD/NASH patients, CLDQ‐NAFLD/NASH scores were highest in SA (mean total score: 5.3 ± 1.2 vs. 4.8 ± 1.2 Turkey, 4.1 ± 0.9 Egypt, p < .01). Independent predictors of worse PROs included younger age, female sex, advanced fibrosis, non‐hepatic comorbidities and lack of regular exercise (all p < .05). Clinical presentation and PRO scores of CLD patients vary across SA, Turkey and Egypt. Impairment of HRQoL is associated with demographic factors, lack of regular exercise, advanced fibrosis and non‐hepatic comorbidities.
Similar rates of denial in NICHD and control interviews with alleged child abuse victims in the Netherlands
Authors: Bücken Charlotte A. , Mangiulli Ivan , Erens Brenda , de Ruiter Corine , Otgaar Henry
Published: April 2024

Purpose

In the current study, we investigated whether denial and avoidance rates differed statistically significantly based on the interview protocol used.

Method

We examined 38 National Institute of Child Health and Human Development (NICHD) interview transcripts, and 30 control transcripts from interviews from an earlier study (Applied Cognitive Psychology, 2022, 36, 7) conducted with alleged child victims of abuse at Dutch child protection services.

Results

We detected 57 denial and 282 avoidance statements across the 68 interviews. No statistically significant differences emerged between (1) the proportion of denials using NICHD (42%, n = 16/38) and control interviews (30%, n = 9/30), and (2) the average number of denial statements between NICHD (M = 0.84) and control interviews (M = 0.83). Furthermore, denials (and avoidances) were not more or less likely to occur in response to certain types of questions, even though the majority of denials in our sample occurred in response to option‐posing questions (60%, n = 34/57). Denials did occur statistically significantly less often within the first half of the individual interviews in NICHD than in control interviews.

Conclusions

Our findings call attention to the difficulties child protection services face in investigative interviews with alleged child victims.
Importance of the ECM–receptor interaction for adaptive response to hypoxia based on integrated transcription and translation analysis
Authors: Huo Da , Liu Shilin , Zhang Libin , Yang Hongsheng , Sun Lina
Published: April 2024

Low dissolved oxygen (LO) conditions represent a major environmental challenge to marine life, especially benthic animals. For these organisms, drastic declines in oxygen availability (hypoxic events) can trigger mass mortality events and thus, act as agents of selection influencing the evolution of adaptations. In sea cucumbers, one of the most successful groups of benthic invertebrates, the exposure to hypoxic conditions triggers adaptive adjustments in metabolic rates and behaviour. It is unclear, however, how these adaptive responses are regulated and the genetic mechanisms underpinning them. Here, we addressed this knowledge gap by assessing the genetic regulation (transcription and translation) of hypoxia exposure in the sea cucumber Apostichopus japonicus. Transcriptional and translational gene expression profiles under short‐ and long‐term exposure to low oxygen conditions are tightly associated with extracellular matrix (ECM)–receptor interaction in which laminin and collagen likely have important functions. Finding revealed that genes with a high translational efficiency (TE) had a relatively short upstream open reading frame (uORF) and a high uORF normalized minimal free energy, suggesting that sea cucumbers may respond to hypoxic stress via altered TE. These results provide valuable insights into the regulatory mechanisms that confer adaptive capacity to holothurians to survive oxygen deficiency conditions and may also be used to inform the development of strategies for mitigating the harmful effects of hypoxia on other marine invertebrates facing similar challenges.
Toxic to the touch: The makings of lethal mantles in pitohui birds and poison dart frogs
Authors: Zaaijer Sophie , Groen Simon C.
Published: April 2024

How do chemically defended animals resist their own toxins? This intriguing question on the concept of autotoxicity is at the heart of how species interactions evolve. In this issue of Molecular Ecology (Molecular Ecology, 2024, 33), Bodawatta and colleagues report on how Papua New Guinean birds coopted deadly neurotoxins to create lethal mantles that protect against predators and parasites. Combining chemical screening of the plumage of a diverse collection of passerine birds with genome sequencing, the researchers unlocked a deeper understanding of how some birds sequester deadly batrachotoxin (BTX) from their food without poisoning themselves. They identified that birds impervious to BTX bear amino acid substitutions in the toxin‐binding site of the voltage‐gated sodium channel Nav1.4, whose function is essential for proper contraction and relaxation of vertebrate muscles. Comparative genetic and molecular docking analyses show that several of the substitutions associated with insensitivity to BTX may have become prevalent among toxic birds through positive selection. Intriguingly, poison dart frogs that also co‐opted BTX in their lethal mantles were found to harbour similar toxin insensitivity substitutions in their Nav1.4 channels. Taken together, this sets up a powerful model system for studying the mechanisms behind convergent molecular evolution and how it may drive biological diversity.
The ‘Candidatus phytoplasma ziziphi’ effectors SJP1 and SJP2 destabilise the bifunctional regulator ZjTCP7 to modulate floral transition and shoot branching
Authors: Ma Fuli , Huang Xiang , Zhou Junyong , Zhang Ning , Deng Mingsheng , Zheng Yunyan , Zhao Meiqi , Chen Wei , Zhou Wenmin , Zhai Liping , Zhong Lei , Pang Kaixue , Liu Xin , Zhong Xinyue , Ren Yifan , Liu Yu , Sun Qibao , Sun Jun
Published: April 2024

Phytoplasmic SAP11 effectors alter host plant architecture and flowering time. However, the exact mechanisms have yet to be elucidated. Two SAP11‐like effectors, SJP1 and SJP2, from ‘Candidatus Phytoplasma ziziphi’ induce shoot branching proliferation. Here, the transcription factor ZjTCP7 was identified as a central target of these two effectors to regulate floral transition and shoot branching. Ectopic expression of ZjTCP7 resulted in enhanced bolting and earlier flowering than did the control. Interaction and expression assays demonstrated that ZjTCP7 interacted with the ZjFT‐ZjFD module, thereby enhancing the ability of these genes to directly bind to the ZjAP1 promoter. The effectors SJP1 and SJP2 unravelled the florigen activation complex by specifically destabilising ZjTCP7 and ZjFD to delay floral initiation. Moreover, the shoot branching of the ZjTCP7‐SRDX transgenic Arabidopsis lines were comparable to those of the SJP1/2 lines, suggesting the involvement of ZjTCP7 in the regulation of shoot branching. ZjTCP7 interacted with the branching repressor ZjBRC1 to enhance suppression of the auxin efflux carrier ZjPIN3 expression. ZjTCP7 also directly bound to and upregulated the auxin biosynthesis gene ZjYUCCA2, thereby promoting auxin accumulation. Our findings confirm that ZjTCP7 serves as a bifunctional regulator destabilised by the effectors SJP1 and SJP2 to modulate plant development.
The pore‐rhizosheath shapes maize root architecture by enhancing root distribution in macropores
Authors: Liu Lingling , Qin Shijie , Richard Whalley W. , Zhou Hu , Ren Tusheng , Gao Weida
Published: April 2024

Pores and old root‐channels are preferentially used by roots to allow them to penetrate hard soils. However, there are few studies that have accounted for the effects of pore‐rhizosheath on root growth. In this study, we developed an approach by adding the synthetic root exudates using a porous stainless tube with 0.1‐mm micropores through a peristaltic pump to reproduce the rhizosheath around the artificial pore, and investigated the effects of pores with and without rhizosheaths on maize root growth in a dense soil. The results indicated that the artificial rhizosheath was about 2.69 mm wide in the region surrounding the pores. The rhizosheath had a higher content of organic carbon, total nitrogen, and abundance of Actinobacteria than that of the bulk soil. Compared with the artificial macropores, the artificial root‐pores with a rhizosheath increased the opportunities for root utilisation of the pores space, promoting steeper and deeper root growth. It is concluded that the pore‐rhizosheath has a significant impact on root architecture by enhancing root distribution in macropores.
Dermatologic needs of transgender and gender diverse youth: A retrospective cohort study
Authors: Butler William , Cai Casey R. , Carswell Jeremi M. , Huang Jennifer T.
Published: April 2024

Several dermatologic concerns are known to disproportionally affect transgender and gender‐diverse (TGD) adults, but little is known about dermatologic conditions in TGD youth. This study assesses the prevalence of acne, androgenic alopecia, scarring from gender‐affirming procedures, and eczema in pediatric TGD patients seen at Boston Children's Hospital between April 2021 and April 2022. The results demonstrate that, for TGD youth, the studied dermatologic concerns are common, referral rates to dermatology are low, and acne is significantly associated with testosterone use. Future studies should examine additional dermatologic concerns and barriers to accessing dermatologic care for this historically underserved population.
Alternaria brassicicola‐induced ROS accumulation during black spot disease differentially affects antioxidant efficiency, phenolic content and susceptibility of Brassica species
Authors: Macioszek Violetta Katarzyna , Piotrowska‐Niczyporuk Alicja , Kononowicz Andrzej Kiejstut
Published: April 2024

Early‐stage responses of Brassica juncea, B. napus and B. oleracea during black spot disease and the development of Alternaria brassicicola were evaluated. Infection of plant cells by the fungus occurred mainly through direct penetration or by appressoria and, rarely, stomata in B. juncea and B. oleracea; in B. napus, penetration was mostly direct. The process of conidial germination, germ tubes and appressoria formation on a leaf surface was correlated with the post‐inoculation time and host species (p < 0.05). Changes in the leaf surface were observed at successful infection sites as bright, wax‐deprived areas. Significant differences in progression of infection between Brassica species were observed, with B. oleracea being the most susceptible and B. napus the least. Accumulation of superoxide anion radicals and hydrogen peroxide was not only observed in plant cells, but also in A. brassicicola germ tubes and appressoria at 8 and 12 h post‐inoculation (hpi). Enhanced production of reactive oxygen species (ROS) and lipid peroxidation during infection triggered diverse patterns of enzymatic and non‐enzymatic antioxidant activities and phenolic compound contents in response to A. brassicicola. In each Brassica species, a different antioxidant was the most active. With their antioxidant properties, phenolic compounds also played an essential role in these interactions. This phenomenon could be related to the disparate levels of susceptibility of the Brassica species to A. brassicicola; for example, the most susceptible, B. oleracea, showed high ROS accumulation with decreasing tendency during disease progression, unchanged phenolics content, and the highest catalase activity, differentiating it from B. juncea and B. napus.
Abortion‐related crowdfunding post‐Dobbs
Authors: Snyder Jeremy , Grewal Ashmita
Published: April 2024

Previous research on abortion‐related crowdfunding campaigns found that they are impacted by stigma around abortion and rarely successful. This paper analyzes crowdfunding activity in the US following a leak of the Supreme Court decision in Dobbs. V. Jackson Women's Health Organization, a time period that saw increased financial support of abortion access funds. Crowdfunding campaigns that included “abort” or “abortion” and were created between May 2 and November 8, 2022 were recorded from the GoFundMe and GiveSendGo crowdfunding platforms. These campaigns were reviewed for whether they were US based and sought funding where abortion was used as a justification for support. Included campaigns were assigned a campaign recipient type: (1) Organizations providing abortion access; (2) Organizations seeking legal protection for abortion; (3) Individuals seeking abortion access; (4) Organizations seeking to reduce abortion access; and (5) Individuals with needs resulting from choosing not to access abortion. The authors also identified four types of rationale for supporting these campaigns. Following a leak of the Dobbs decision, 398 abortion‐related crowdfunding campaigns in the US raised over $3.8 million from over 50,000 donations. Campaigns supporting abortion access organizations raised higher median amounts than organizations seeking to reduce abortion access. Individuals seeking abortion access raised higher median amounts than individuals who chose not to terminate a pregnancy. In a reversal from pre‐Dobbs crowdfunding, abortion access campaigns tended to outperform other abortion‐related campaigns. It is not clear how long‐lived this change in support will be and campaigners remain vulnerable to changes in platforms' content moderation policies.
Mapping the well‐being of Norwegian mothers during the COVID‐19 pandemic
Authors: Kvalø Marie , Parks‐Stamm Elizabeth J. , Thorsteinsen Kjærsti , Olsen Marte , Martiny Sarah E.
Published: April 2024

The COVID‐19 pandemic had negative effects on many people's well‐being and quality of life. In the present work, we focused on Norwegian mothers with elementary school children, and investigated whether their well‐being, stress, and worries (and the relationships between them) changed across the early months of the pandemic. We collected data at two time points in 2020. In June 2020, 231 mothers (mean age = 40.09, SD = 6.22) responded to an online questionnaire in which they were asked to indicate their well‐being, stress, and worries before the pandemic, during the lockdown (i.e., March 2020), and currently (i.e., June 2020). Of these 231 mothers, 97 (mean age = 40.58, SD = 5.66) answered the same questionnaire again in November 2020. Mothers' well‐being was lower in November 2020 than before the pandemic (retrospectively reported). The age of the youngest child showed the strongest and most consistent relationship with mothers' well‐being across all time points. In addition, we found that the stress mothers felt during the national lockdown in March 2020 was strongly associated with their well‐being both during the lockdown and in June 2020. Finally, in November 2020, mothers' financial pandemic‐related worries were negatively related to their well‐being. Implications and suggestions for future research and for how societies can cope with future health‐related crises are discussed.
High‐resolution KIR and HLA genotyping in three Chinese ethnic minorities reveals distinct origins
Authors: Tao Sudan , Norman Paul J. , You Xuan , Kichula Katherine M. , Dong Lina , Chen Nanying , He Yizhen , Chen Chen , Zhang Wei , Zhu Faming
Published: April 2024

Polymorphism of killer‐cell immunoglobulin‐like receptors (KIRs) and their HLA class I ligands impacts the effector activity of cytotoxic NK cell and T cell subsets. Therefore, understanding the extent and implications of KIR and HLA class I genetic polymorphism across various populations is important for immunological and medical research. In this study, we conducted a high‐resolution investigation of KIR and HLA class I diversity in three distinct Chinese ethnic minority populations. We studied the She, Yugur, and Tajik, and compared them with the Zhejiang Han population (Zhe), which represents the majority Southern Han ethnicity. Our findings revealed that the Tajik population exhibited the most diverse KIR copy number, allele, and haplotype diversity among the four populations. This diversity aligns with their proposed ancestral origin, closely resembling that of Iranian populations, with a relatively higher presence of KIR‐B genes, alleles, and haplotypes compared with the other Chinese populations. The Yugur population displayed KIR distributions similar to those of the Tibetans and Southeast Asians, whereas the She population resembled the Zhe and other East Asians, as confirmed by genetic distance analysis of KIR. Additionally, we identified 12.9% of individuals across the three minority populations as having KIR haplotypes characterized by specific gene block insertions or deletions. Genetic analysis based on HLA alleles yielded consistent results, even though there were extensive variations in HLA alleles. The observed variations in KIR interactions, such as higher numbers of 2DL1‐C2 interactions in Tajik and Yugur populations and of 2DL3‐C1 interactions in the She population, are likely shaped by demographic and evolutionary mechanisms specific to their local environments. Overall, our findings offer valuable insights into the distribution of KIR and HLA diversity among three distinct Chinese ethnic minority populations, which can inform future clinical and population studies.
Living, Leading & Medicine: A two‐tiered leadership development programme for family medicine residents
Authors: Cook Jeffrey S. , Money Briana , Dyer Daniel , Whiteley Georgianna , Huntington Mark K.
Published: April 2024

Background

There is increasing awareness of the necessity and importance for physician leadership in health care. Despite this, formal leadership training is not widespread in medical education.

Approach

We describe the structure, curriculum and development of a robust two‐tiered leadership development programme within a community‐based family medicine residency programme. Living, Leading & Medicine (LLM, tier 1) consists of nine 2.5‐h discussion‐based training sessions occurring thrice annually. The Advanced Leadership Track (ALT, tier 2) includes mentoring, additional readings, personal evaluations and leadership projects.

Evaluation

We used post‐session surveys and exit surveys for LLM and ALT, respectively. We utilised the modified Kirkpatrick framework for programme evaluation to present outcomes from the first 3 years for each tier. Over three quarters (40 out of 53) of residents participated in LLM sessions. The post‐session survey response rate for LLM was 95% (124 out of 130 participants). Eighteen out of 33 residents (54.5%) completed the ALT. Of these, 72% (13 of 18) returned exit surveys. Residents found the programme valuable and relevant (Kirkpatrick level 1). Residents demonstrated improvements in leadership knowledge and skills (3.85 v. 3.11, p < 0.0001; Kirkpatrick level 2) compared with an internal, historic control group. We noted changes in resident behaviour and attitudes towards leadership (Kirkpatrick level 3). Finally, the completion of leadership projects demonstrates Kirkpatrick level 4 outcomes.

Implications

We have created a longitudinal, two‐tiered leadership development programme that has improved the leadership capabilities of our family medicine residents.
A case of Crimean‐Congo haemorrhagic fever complicated with portal vein thrombosis and hemophagocytosis
Authors: Çaydaşı Özge , Arslan Eyüp , Adıyeke Esra , Kuzan Taha Yusuf , Karadağ Fatma Yılmaz , Engin Derya Öztürk
Published: April 2024

Objectives

Crimean‐Congo haemorrhagic fever (CCHF) is a zoonotic viral infection which is an important public health problem in Turkey. CCHF causes fever and bleeding and can lead to severe health outcomes. The study aims to report a case of a male patient with severe CCHF, hemophagocytic lymphohistiocytosis (HLH) treated with steroids and portal vein thrombosis.

Case Report

A 37‐year‐old man was admitted to the emergency department with complaints of high fever, headache, myalgia and diarrhoea. The patient travelled to the endemic region of Turkey. In laboratory findings, thrombocytopenia, abnormal liver function tests and elevated coagulation parameters were observed. Real‐time polymerase chain reaction assay was used for diagnosis of CCHF. Hypofibrinogenemia, hypertriglyceridemia, elevated ferritin and d‐dimer levels were observed in the clinical follow‐up. Prednisolone treatment was performed due to considered the diagnosis of HLH. Portal vein thrombosis was detected on abdominal computed tomography scan. He was successfully treated with ribavirin, corticosteroids, anticoagulant and supportive therapy.

Conclusion

The clinical presentation of CCHF can range from self‐limiting flu‐like to severe symptoms possibly fatal. Acute portal vein embolism is a rare complication that has not been reported before to our knowledge. Corticosteroids may be a life‐saving treatment for CCHF patients presenting with HLH.
A FLOWERING LOCUS T ortholog is associated with photoperiod‐insensitive flowering in hemp (Cannabis sativa L.)
Authors: Dowling Caroline A. , Shi Jiaqi , Toth Jacob A. , Quade Michael A. , Smart Lawrence B. , McCabe Paul F. , Schilling Susanne , Melzer Rainer
Published: April 2024

Hemp (Cannabis sativa L.) is an extraordinarily versatile crop, with applications ranging from medicinal compounds to seed oil and fibre products. Cannabis sativa is a short‐day plant, and its flowering is highly controlled by photoperiod. However, substantial genetic variation exists for photoperiod sensitivity in C. sativa, and photoperiod‐insensitive (“autoflower”) cultivars are available. Using a bi‐parental mapping population and bulked segregant analysis, we identified Autoflower2, a 0.5 Mbp locus significantly associated with photoperiod‐insensitive flowering in hemp. Autoflower2 contains an ortholog of the central flowering time regulator FLOWERING LOCUS T (FT) from Arabidopsis thaliana which we termed CsFT1. We identified extensive sequence divergence between alleles of CsFT1 from photoperiod‐sensitive and insensitive cultivars of C. sativa, including a duplication of CsFT1 and sequence differences, especially in introns. Furthermore, we observed higher expression of one of the CsFT1 copies found in the photoperiod‐insensitive cultivar. Genotyping of several mapping populations and a diversity panel confirmed a correlation between CsFT1 alleles and photoperiod response, affirming that at least two independent loci involved in the photoperiodic control of flowering, Autoflower1 and Autoflower2, exist in the C. sativa gene pool. This study reveals the multiple independent origins of photoperiod insensitivity in C. sativa, supporting the likelihood of a complex domestication history in this species. By integrating the genetic relaxation of photoperiod sensitivity into novel C. sativa cultivars, expansion to higher latitudes will be permitted, thus allowing the full potential of this versatile crop to be reached.
PROTEIN L‐ISOASPARTYL METHYLTRANSFERASE protects enolase dysfunction by repairing isoaspartyl‐induced damage and is positively implicated in agronomically important seed traits
Authors: Kamble Nitin Uttam , Ghosh Shraboni , Petla Bhanu Prakash , Achary Rakesh Kumar , Gautam Shikha , Rao Venkateswara , Salvi Prafull , Hazra Abhijit , Varshney Vishal , Majee Manoj
Published: April 2024

The protein‐repairing enzyme (PRE) PROTEIN L‐ISOASPARTYL METHYLTRANSFERASE (PIMT) influences seed vigor by repairing isoaspartyl‐mediated protein damage in seeds. However, PIMTs function in other seed traits, and the mechanisms by which PIMT affects such seed traits are still poorly understood. Herein, through molecular, biochemical, and genetic studies using overexpression and RNAi lines in Oryza sativa and Arabidopsis thaliana, we demonstrate that PIMT not only affects seed vigor but also affects seed size and weight by modulating enolase (ENO) activity. We have identified ENO2, a glycolytic enzyme, as a PIMT interacting protein through Y2H cDNA library screening, and this interaction was further validated by BiFC and co‐immunoprecipitation assay. We show that mutation or suppression of ENO2 expression results in reduced seed vigor, seed size, and weight. We also proved that ENO2 undergoes isoAsp modification that affects its activity in both in vivo and in vitro conditions. Further, using MS/MS analyses, amino acid residues that undergo isoAsp modification in ENO2 were identified. We also demonstrate that PIMT repairs such isoAsp modification in ENO2 protein, protecting its vital cellular functions during seed maturation and storage, and plays a vital role in regulating seed size, weight, and seed vigor. Taken together, our study identified ENO2 as a novel substrate of PIMT, and both ENO2 and PIMT in turn implicate in agronomically important seed traits.
Characteristics of red blood cell transfusion among very preterm infants in China
Authors: Zheng Lu , Gu Xinyue , Zhao Pu , Yang Tongling , Zhang Qin , Jiang Siyuan , Cao Yun , Lee Shoo K. , Zhou Wenhao , Wang Jin
Published: April 2024

Background and Objectives

National‐level data on the incidence of red blood cell (RBC) transfusions and outcomes among very preterm infants (VPIs) are lacking in China. This study aims to describe the use and variation of RBC transfusion among VPIs in China.

Materials and Methods

This cohort study was conducted among 70 tertiary hospitals participating in the Chinese Neonatal Network (CHNN) from 2019 to 2020 across China. All VPIs admitted to the CHNN neonatal intensive care units (NICUs) were included.

Results

A total of 13,447 VPIs were enrolled, of whom 7026 (52.2%) received ≥1 RBC transfusions. The mean number of transfusions per infant was 2 (interquartile range [IQR] 1–4 times) and the median age at first transfusion was 15 days (IQR 3–27 days). The transfusion rate was higher in critically ill infants compared with non‐critically ill infants (70.5% vs. 39.3%). The transfusion rate varied widely (13.5%–95.0%) between different NICUs. The prevalence of death, severe intra‐ventricular haemorrhage, necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP), sepsis, bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (ROP) and cystic periventricular leukomalacia (cPVL) was significantly higher in the transfused group. Among non‐critically ill infants, RBC transfusion was independently associated with BPD, severe ROP and cPVL.

Conclusion

Our study, providing the first baseline data on RBC transfusions among VPIs in China, shows an alarmingly high RBC transfusion rate with significant site variations. There is an urgent need for national guidelines on RBC transfusions for VPIs in China.
Pulmonary interstitial emphysema and spontaneous pneumomediastinum are more prevalent in sighthounds than other dog breeds undergoing thoracic CT
Authors: Sánchez Jiménez César , Schofield Imogen , Plested Mark
Published: April 2024

Spontaneous pneumomediastinum is an uncommon condition described in veterinary medicine with concurrent respiratory disease. It can be caused by the Macklin effect, which is when gas leaks from the alveoli into the surrounding interstitial lung tissue. Pulmonary interstitial emphysema (PIE) is the presence of gas within the pulmonary vascular sheaths and indicates the presence of the Macklin effect. In the authors’ experience, spontaneous pneumomediastinum and PIE are more prevalent in sighthound dogs than in other breeds and are often considered incidental findings. This retrospective, observational, cross‐sectional study compared the prevalence of PIE and subsequent pneumomediastinum in sighthound with other purebred dogs. It characterized the appearance of PIE in CT and analyzed a possible association with concomitant pulmonary pathologies or with the use of general anesthesia. Medical records and thoracic CTs of sighthounds and nonsighthound dogs from two institutions were reviewed. A total of 256 dogs, comprising 127 sighthounds and 129 other purebred dogs, were included. The prevalence of PIE and pneumomediastinum was statistically higher in sighthound (14.2%) compared with other nonsighthound dogs (2.2%). There was no statistical association between the presence of PIE and pneumomediastinum with different age and weight groups or with sex. There was no statistical difference in the prevalence of PIE and pneumomediastinum between dogs with and without pulmonary pathology or in dogs undergoing CT with sedation or general anesthesia. Spontaneous pneumomediastinum in sighthounds is more prevalent than in other breeds, and its prevalence is not associated with the presence of pulmonary pathology or the use of general anesthesia.
Foundations of the wald space for phylogenetic trees
Authors: Lueg Jonas , Garba Maryam K. , Nye Tom M. W. , Huckemann Stephan F.
Published: April 2024

Evolutionary relationships between species are represented by phylogenetic trees, but these relationships are subject to uncertainty due to the random nature of evolution. A geometry for the space of phylogenetic trees is necessary in order to properly quantify this uncertainty during the statistical analysis of collections of possible evolutionary trees inferred from biological data. Recently, the wald space has been introduced: a length space for trees which is a certain subset of the manifold of symmetric positive definite matrices. In this work, the wald space is introduced formally and its topology and structure is studied in detail. In particular, we show that wald space has the topology of a disjoint union of open cubes, it is contractible, and by careful characterisation of cube boundaries, we demonstrate that wald space is a Whitney stratified space of type (A). Imposing the metric induced by the affine invariant metric on symmetric positive definite matrices, we prove that wald space is a geodesic Riemann stratified space. A new numerical method is proposed and investigated for construction of geodesics, computation of Fréchet means and calculation of curvature in wald space. This work is intended to serve as a mathematical foundation for further geometric and statistical research on this space.
Additive and geometric transversality of fractal sets in the integers
Authors: Glasscock Daniel , Moreira Joel , Richter Florian K.
Published: April 2024

By juxtaposing ideas from fractal geometry and dynamical systems, Furstenberg proposed a series of conjectures in the late 1960's that explore the relationship between digit expansions with respect to multiplicatively independent bases. In this work, we introduce and study — in the discrete context of the integers — analogs of some of the notions and results surrounding Furstenberg's work. In particular, we define a new class of fractal sets of integers that parallels the notion of ‐invariant sets on the 1‐torus and investigate the additive and geometric independence between two such fractal sets when they are structured with respect to multiplicatively independent bases. Our main results in this direction parallel the works of Furstenberg, Hochman–Shmerkin, Shmerkin, Wu, and Lindenstrauss–Meiri–Peres and include:

a classification of all subsets of the positive integers that are simultaneously ‐ and ‐invariant;

integer analogs of two of Furstenberg's transversality conjectures pertaining to the dimensions of the intersection and the sumset of ‐ and ‐invariant sets and when and are multiplicatively independent; and

a description of the dimension of iterated sumsets for any ‐invariant set .

We achieve these results by combining ideas from fractal geometry and ergodic theory to build a bridge between the continuous and discrete regimes. For the transversality results, we rely heavily on quantitative bounds on the ‐dimensions of projections of restricted digit Cantor measures obtained recently by Shmerkin. We end by outlining a number of open questions and directions regarding fractal subsets of the integers.
Peak Performance: Characteristics and Key Factors in the Development of the World Top-8 Swimmers Based on Longitudinal Data
Authors: Chen Yuming , Huang Chenbin , Chen Hui , Huang Ting , Su Christine , Chen Jiexing
Published: April 2024

Purpose: This study aimed to investigate the peak performance characteristics of the world top-8 swimmers and the key factors involved in the journey toward achieving better peak performance. Methods: The results of the world top-8 swimmers from 2001 to 2022 were collected from the World Aquatics performance database. Progression to peak performance was tracked with individual quadratic trajectories (1191 cases). Utilizing k-means clustering to group competitive feature variables, this study investigated key developmental factors through a binary logistic regression model, using the odds ratio (OR) to represent whether a factor was favorable (OR > 1) or unfavorable (OR < 1). Results: Significant differences (P < .001) in the peak age between men (23.54/3.80) and women (22.31/4.60) were noticed, while no significant differences (P > .05) in the peak-performance window for both sexes appeared. Peak performance occurred at later ages for the sprint for both sexes, and women had a longer duration in peak-performance window for sprint (P < .05). Peak-performance occurred at later ages for the breaststroke and butterfly for both sexes (P < .05). Binary logistic regression revealed that high first-participation performance (OR = 1.502), high major-competition performance (OR = 4.165), early first-major-competition age (OR = 1.441), participation frequency above 4 times/year in both phase 2 (4.3–8.0 times/y, OR = 3.940; 8.1–20.0 times/y, OR = 5.122) and phase 3 (4.1–7.5 times/y: OR = 5.548; 7.7–15.0 times/y: OR = 7.526), and a career length of 10 years or more (10–15 y, OR = 2.102; 16–31 y, OR = 3.480) were favorable factors for achieving better peak performance. Conclusions: Peak performance characteristics varied across sex, swimming stroke, and race distance in the world top-8 swimmers. Meanwhile, the research indicated that certain specific developmental factors were key conditions for the world top-8 swimmers to achieve better peak performance in the future.
The Role of Physical Literacy in the Association Between Weather and Physical Activity: A Longitudinal Multilevel Analysis With 951 Children
Authors: Carl Johannes , Melby Paulina S. , Kurtzhals Mette L. , Nielsen Glen , Bentsen Peter , Elsborg Peter
Published: April 2024

Background: Numerous studies showed an effect of weather on physical activity (PA) levels in children. However, no study has yet examined the relevance of personal factors in this relationship. Therefore, this study analyzes (1) whether there are systematic interindividual differences in the extent to which weather affects the PA behavior and (2) whether physical literacy (PL) moderates the weather–PA association in children. Methods: A total of 951 children in 12 Danish schools (age 9.76 [1.59] y; 54.3% girls) completed objective PA assessments via accelerometry (moderate to vigorous PA, light PA, and sedentary behavior). Local weather data (precipitation, wind speed, temperature, and sunshine duration) were provided by the Danish Meteorological Institute. Participants’ PL was measured employing the Danish version of the Canadian Assessment of Physical Literacy-2. The 4116 accelerometer days underwent longitudinal multilevel analyses while considering their nesting into pupils and school classes (n = 51). Results: Fluctuations in all PA indicators were significantly explained by variations in weather conditions, especially precipitation (P ≤ .035). Significant interindividual differences were found for 9 of 12 analytical dimensions, suggesting that weather changes influence PA behavior differently across individuals (especially moderate to vigorous PA, χ2[4] ≥ 11.5, P ≤ .021). However, PL moderated the relationship between weather and PA in only 2 of the 48 analytical constellations. Conclusions: Despite the varying impact of weather on PA across individuals, the present study favors a main effect model in which weather and PL exert independent effects on children’s PA. The insufficient support for PL as a moderating factor calls for future studies to test alternative mechanisms in the weather–PA association.
A devastating blow: personal reflections on Argentina’s scientific decline
Authors: Perez Daniel R.
Published: April 2024

As an Argentine scientist, the defunding of CONICET and INTA feels like a blow to progress and our future. Despite free education, these cuts force talented researchers to seek opportunities abroad. Argentina’s history of scientific achievement, from Nobel Prizes to COVID-19 vaccines, is at risk. Defunding science weakens our ability to solve problems and compete globally.
Complete genome sequence of hepatitis B virus identified from a patient suffering from chronic kidney disease in Bangladesh
Authors: Hossain Md. Golzar , Islam Mahfuz , Jeba Nurejunnati , Hasan S. M. Nazmul , Akter Marjana , Mou Moslema Jahan , Paul Shyamal Kumar , Akter Sharmin , Khan Mohammad Kamruzzaman , Saha Sukumar , Ahmed Muzahed Uddin , Debnath Chirojit , Sumon Md. Arif Uddin , Salauddin Md. , Debnath Chitta Ranjan
Published: April 2024

Hepatitis B virus (HBV) infection is reported as a risk factor for chronic kidney disease (CKD). In this study, we sequenced the complete genome of an HBV strain identified in a CKD patient in Bangladesh, followed by genomic characterization and mutational analyses.
Supplemental Material: Early Oligocene record of an “iceberg alley” in the Weddell Sea from quartz sand microtextural analysis at ODP Site 696
Authors: Hojnacki Victoria , Passchier Sandra
Published: April 2024

Includes mass accumulation rate methodology and heavy mineral analysis. 
3D printing: a useful tool for safe clinical practice in children with complex vasculature
Authors: Paessler Alicia , Forman Colin , Minhas Kishore , Patel Premal Amrishkumar , Carmichael James , Smith Luke , Jaradat Fayyad , Assia-Zamora Sergio , Arslan Zainab , Calder Francis , Ray Samiran , Kessaris Nicos , Stojanovic Jelena
Published: April 2024

Background

3D printing has been used in different medical contexts, although it is underutilised in paediatrics. We present the first use of 3D printing in the management of three paediatric patients with complex renovascular disease.

Methods

Patient-specific 3D models were produced from conventional 2D imaging and manufactured using 3D polyjet printing technology. All three patients had different underlying pathologies, but all underwent multiple endovascular interventions (renal artery balloon angioplasty) prior to 3D printing and subsequent vascular surgery. The models were verified by an expert radiologist and then presented to the multidisciplinary team to aid with surgical planning.

Results

Following evaluation of the 3D-printed models, all patients underwent successful uni/bilateral renal auto-transplants and aortic bypass surgery. The 3D models allowed more detailed preoperative discussions and more focused planning of surgical approach, therefore enhancing safer surgical planning. It influenced clinical decision-making and shortened general anaesthetic time. The families and the patients reported that they had a significantly improved understanding of the patient’s condition and had more confidence in understanding proposed surgical intervention, thereby contributing to obtaining good-quality informed consent.

Conclusion

3D printing has a great potential to improve both surgical safety and decision-making as well as patient understanding in the field of paediatrics and may be considered in wider surgical areas.
Haemophilus parainfluenzaeinfective endocarditis complicated by multiorgan septic emboli
Authors: Bowden Jarred , Hunt Molly , Harhay Jason , Patel Tejal , Thomas-Gosain Neena
Published: April 2024

Infective endocarditis (IE) caused byHaemophilus parainfluenzaeis a rare but serious condition if not diagnosed and treated promptly. In this article, we describe a patient withH. parainfluenzaeIE who initially presented with non-specific symptoms but subsequently developed multiple sequelae of IE. The diagnosis of IE was made based on clinical, echocardiographic, radiological and microbiological findings. He was treated successfully with a mitral valve replacement along with 4 weeks of intravenous antibiotic therapy. Our case highlights the importance of obtaining a thorough history and a complete physical examination to ensure an early diagnosis of IE.
Acute diverticulitis of the appendix
Authors: Abdelrahim Ahmed , Yusuf Yusuf , Ali Omer , Abudeeb Haytham
Published: April 2024

Acute diverticulitis of the appendix (ADA), though uncommon, often presents similarly to acute appendicitis but carries a higher risk of complications such as perforation and malignancy. We report the case of a male patient in his 50s with acute right iliac fossa abdominal pain, diagnosed via CT scan with ADA. Urgent laparoscopic appendicectomy was performed, and the patient was discharged without further issues. This case highlights the importance of promptly identifying and managing such conditions to minimise complications and improve outcomes. Despite the overlap in symptoms between appendiceal diverticulitis and acute appendicitis, accurate diagnosis is crucial for appropriate treatment. Healthcare providers should maintain a high index of suspicion, particularly in older patients presenting with an acute appendicitis, like clinical picture to ensure timely intervention and optimal patient care.
Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS): challenges in diagnosis and management
Authors: Murali Keerthika , Dhua Anjan Kumar
Published: April 2024

Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is a rare, congenital functional intestinal obstruction, characterised by megacystis (bladder distention in the absence of mechanical obstruction), microcolon and intestinal hypoperistalsis (dysmotility).

We are reporting a case of a female child with normal antenatal course who presented with recurrent episodes of abdominal distension since the second day of life and underwent negative exploratory laparotomy on multiple occasions. She also had urinary retention with a grossly distended bladder, requiring drainage by clean intermittent catheterisation. Surgical procedures for bowel decompression, including gastrostomy and ileostomy, were carried out without success. Genetic analysis revealed a mutation in the human smooth muscle (enteric) gamma-actin gene (ACTG2 gene), clinching the diagnosis of MMIHS. The patient was managed with parenteral nutrition and prokinetic medications and tolerated jejunostomy feeds for a brief period before she succumbed to the illness.

Female neonates or infants presenting with abdominal distension and dilated urinary tract should be investigated for MMIHS early on. A timely diagnosis will enable the early involvement of a multidisciplinary team to provide the best options available for management.
The precision by the Face Arm Speech Time (FAST) algorithm in stroke capture, sex and age differences: a stroke registry study
Authors: Hagberg Guri , Ihle-Hansen Haakon , Abzhandadze Tamar , Reinholdsson Malin , Viktorisson Adam , Ihle-Hansen Hege , Stibrant Sunnerhagen Katharina
Published: April 2024

Background

The shift towards milder strokes and studies suggesting that stroke symptoms vary by age and sex may challenge the Face-Arm-Speech Time (FAST) coverage. We aimed to study the proportion of stroke cases admitted with FAST symptoms, sex and age differences in FAST presentation and explore any additional advantage of including new item(s) from the National Institute of Health Stroke Scale (NIHSS) to the FAST algorithm.

Methods

This registry-based study included patients admitted with acute stroke to Sahlgrenska University Hospital (November 2014 to June 2019) with NIHSS items at admission. FAST symptoms were extracted from the NIHSS at admission, and sex and age differences were explored using descriptive statistics.

Results

Of 5022 patients, 46% were women. Median NIHSS at admission for women was (2 (8–0) and for men 2 (7–0)). In total, 2972 (59%) had at least one FAST symptom, with no sex difference (p=0.22). No sex or age differences were found in FAST coverage when stratifying for stroke severity. 52% suffered mild strokes, whereas 30% had FAST symptoms. The most frequent focal NIHSS items not included in FAST were sensory (29%) and visual field (25%) and adding these or both in modified FAST algorithms led to a slight increase in strokes captured by the algorithms (59%–67%), without providing enhanced prognostic information.

Conclusions

60% had at least one FAST symptom at admission, only 30% in mild strokes, with no sex or age difference. Adding new items from the NIHSS to the FAST algorithm led only to a slight increase in strokes captured.
Study protocol: improving response to malaria in the Amazon through identification of inter-community networks and human mobility in border regions of Ecuador, Peru and Brazil
Authors: Janko Mark M , Araujo Andrea L , Ascencio Edson J , Guedes Gilvan R , Vasco Luis E , Santos Reinaldo O , Damasceno Camila P , Medrano Perla G , Chacón-Uscamaita Pamela R , Gunderson Annika K , O’Malley Sara , Kansara Prakrut H , Narvaez Manuel B , Coombes Carolina , Pizzitutti Francesco , Salmon-Mulanovich Gabriela , Zaitchik Benjamin F , Mena Carlos F , Lescano Andres G , Barbieri Alisson F , Pan William K
Published: April 2024

Introduction

Understanding human mobility’s role in malaria transmission is critical to successful control and elimination. However, common approaches to measuring mobility are ill-equipped for remote regions such as the Amazon. This study develops a network survey to quantify the effect of community connectivity and mobility on malaria transmission.

Methods

We measure community connectivity across the study area using a respondent driven sampling design among key informants who are at least 18 years of age. 45 initial communities will be selected: 10 in Brazil, 10 in Ecuador and 25 in Peru. Participants will be recruited in each initial node and administered a survey to obtain data on each community’s mobility patterns. Survey responses will be ranked and the 2–3 most connected communities will then be selected and surveyed. This process will be repeated for a third round of data collection. Community network matrices will be linked with each country’s malaria surveillance system to test the effects of mobility on disease risk.

Ethics and dissemination

This study protocol has been approved by the institutional review boards of Duke University (USA), Universidad San Francisco de Quito (Ecuador), Universidad Peruana Cayetano Heredia (Peru) and Universidade Federal Minas Gerais (Brazil). Results will be disseminated in communities by the end of the study.