bluuebunny/crossref_metadata_2025 huggingface dataset:
Mediastinal teratoma with double malignant transformation
Authors: Martín Serradilla Jose-Ignacio , Borrego Pintado María-Henar , Loucel Bellino Mauricio-Alfredo , De Sande Nacarino Eva-Leonor , Arranz Arija Fernando , Pérez Arnillas Quionia
Published: November 2023

We report a case of a 65-year-old woman with retrosternal discomfort, dyspnea, and weight loss in whom the computed tomography showed a multicystic mass with fat content and calcified wall in the anterior mediastinum. After surgical resection, pathological examination revealed synchronous primary colorectal adenocarcinoma and primary carcinoid tumor arising in a mediastinal mature cystic teratoma. Treatment with oxaliplatin and capecitabine was instituted, and subsequent checkups showed no evidence of recurrence. Malignant transformation of mature cystic teratoma is a rare complication that occurs in 1–3% of these tumors and consists of a nongerm cell malignant tumor arising from a preexisting mature teratoma. Any of the constituent tissues of a teratoma has the potential to undergo malignant transformation. In case of limited disease, treatment should be surgical. There is no consensus regarding adjuvant treatment, and the existence of a double neoplastic lineage may complicate the choice of chemotherapy treatment.
COMPLETE RESOLUTION OF SUBRETINAL FLUID OF THE FELLOW EYE AFTER AFLIBERCEPT INJECTION IN WET AGE-RELATED MACULAR DEGENERATION
Authors: Rouvas Alexandros , Theodossiadis Panagiotis , Georgalas Ilias , Gouliopoulos Nikolaos
Published: November 2023

Purpose:

To present a case of a patient with bilateral wet age-related macular degeneration who was unilaterally treated with intravitreal aflibercept injections (IAIs) and the disease status in the fellow eye ameliorated after an IAI.

Methods:

Retrospective case report.

Results:

A 72-year-old woman was diagnosed with wet and dry age-related macular degeneration in her right eye and left eye, respectively. In the right eye, treatment strategy comprised three monthly IAIs, followed by reinjections according to need, whereas optical coherence tomography scans were performed before IAIs. One month after the second IAI, subretinal fluid developed in the left eye. One week later, an IAI was applied in the right eye; 2 days later, the disease status in the left eye was assessed by fluorescein angiography and optical coherence tomography. Surprisingly, in the left eye, subretinal fluid completely resolved and fluorescein angiography did not detect leakage, highlighting the absence of an active choroidal neovascularization. The short interval between IAI and the resolution of exudative phenomena in the other eye is suggestive of a beneficial effect in the contralateral eye.

Conclusion:

In this article, we showed that an IAI had an effect to the fellow untreated eye. Our observation is consistent with active aflibercept in the systemic circulation. To the best of our knowledge, no other report in the literature has demonstrated this effect of aflibercept in wet age-related macular degeneration.
Ability to Process Multisensory Information Is Impaired in Open Angle Glaucoma
Authors: Loskutova Ekaterina , Butler John S. , Setti Annalisa , O’Brien Colm , Loughman James
Published: November 2023

Précis:

Patients with glaucoma demonstrated deficiencies in their ability to process multisensory information when compared with controls, with those deficiencies being related to glaucoma severity. Impaired multisensory integration (MSI) may affect the quality of life in individuals with glaucoma and may contribute to the increased prevalence of falls and driving safety concerns. Therapeutic possibilities to influence cognition in glaucoma should be explored.

Purpose:

Glaucoma is a neurodegenerative disease of the optic nerve that has also been linked to cognitive health decline. This study explored MSI as a function of glaucoma status and severity.

Methods:

MSI was assessed in 37 participants with open angle glaucoma relative to 18 age-matched healthy controls. The sound-induced flash illusion was used to assess MSI efficiency. Participants were presented with various combinations of simultaneous visual and/or auditory stimuli and were required to indicate the number of visual stimuli observed for each of the 96 total presentations. Central retinal sensitivity was assessed as an indicator of glaucoma severity (MAIA; CenterVue).

Results:

Participants with glaucoma performed with equivalent capacity to healthy controls on unisensory trials (F1,53=2.222,P=0.142). Both groups performed equivalently on congruent multisensory trials involving equal numbers of auditory and visual stimuliF1,53=1.032,P=0.314). For incongruent presentations, that is, 2 beeps and 1 flash stimulus, individuals with glaucoma demonstrated a greater influence of the incongruent beeps when judging the number of flashes, indicating less efficient MSI relative to age-matched controls (F1,53=11.45,P<0.002). In addition, MSI performance was positively correlated with retinal sensitivity (F3,49=4.042,P<0.025), adjustedR²=0.15).

Conclusions:

Individuals with open angle glaucoma exhibited MSI deficiencies that relate to disease severity. The type of deficiencies observed were similar to those observed among older individuals with cognitive impairment and balance issues. Impaired MSI may, therefore, be relevant to the increased prevalence of falls observed among individuals with glaucoma, a concept that merits further investigation.
Comparison between washed microbiota transplantation and infliximab: Medical cost during long-term management in patients with inflammatory bowel disease
Authors: Zhang Sheng , Huang Yihao , Lu Gaochen , Zhang Zulun , Wang Yun , Liu Yujie , Wang Weihong , Li Qianqian , Li Pan , Wen Quan , Cui Bota , Zhang Faming
Published: November 2023

Background:

Both infliximab (IFX) and fecal microbiota transplantation (FMT) have shown the efficacy for inflammatory bowel disease (IBD). However, there has no head-to-head study on the cost-value of the such treatments on IBD. This study aimed to compare the medical costs using IFX and the new method of FMT (washed microbiota transplantation [WMT]) in the long-term management for IBD under the current health economic condition in China.

Methods:

Patients with IBD who underwent initial WMT via upper gastrointestinal endoscopy, mid-gut tube, or colonic transendoscopic enteral tubing at a university hospital between April 2013 and August 2021 and achieved the long-term sustainment with WMT or WMT combined with mesalazine until August 2022 were recruited in the real-world. The costs and hospitalizations were analyzed among two therapies mentioned above and IFX standard therapy. The charge of WMT was stable in the long term at our center, and the charge of IFX came from virtual statistics publicized by China Healthcare Security.

Results:

Sixty eligible patients with IBD were included in the study. The long-term costs of patients using WMT monotherapy annually or per hospitalization were lower than those on WMT combined with mesalazine, respectively (p < 0.001, respectively). The cumulative costs of IFX at the time of 0.52 and 0.85 years exceeded that of the above WMT, respectively (p < 0.001, respectively). Besides, patients on WMT monotherapy paid 51.1 k CNY annually in the nonsustain phase but cut down the costs by 7.2 k CNY and duration of hospitalization by 5.1 days per hospitalization when reaching the goal of sustainment.

Conclusion:

This study demonstrated that WMT could dramatically reduce the cost and duration of hospitalizations in the long-term sustainment in the current Chinese IBD cohort. Compared with IFX, WMT could be a good way for the patients with IBD achieving long-term sustainment and saving medical costs.
Improving Quality Care and Patient Safety With Implementation of an Oversew Stitch in Lumbar Drains
Authors: Brown Erik C. , Fay Samantha , Raslan Ahmed M. , Sayama Christina M.
Published: November 2023

The lumbar drain exit site purse string oversew stitch is a well-described bedside intervention to stop or prevent cerebrospinal fluid (CSF) leak. It is not routinely placed at the time of lumbar drain placement. Via four plan-do-study-act (PDSA) cycles, we test the effect of prophylactic utilization of the lumbar drain exit site oversew stitch on house officers' paging burden, need to redress the drain, need to oversew the drain to stop a CSF leak, and need to replace the drain. We found that the simple act of placing an oversew stitch at the time of lumbar drain placement significantly reduced paging burden and reduced the frequency at which an oversew stitch was required to stop a CSF leak. Subjectively, during PDSA cycles during which overstitches were placed prophylactically, in-house residents perceived that there were less lumbar drains on service, although objectively, the overall number was unchanged. We conclude that prophylactic lumbar drain exit site stitch placement reduces risk and bedside interventions for patients and also reduces overall call burden on house officers. This simple intervention may therefore provide a more widespread improvement in care quality beyond lumbar drain care because house officers experience less burnout during their call shifts.
Current status of indocyanine green fluorescent angiography in assessing perfusion of gastric conduit and esophago-gastric anastomosis
Authors: Nusrath Syed , Kalluru Prasanthi , Shukla Srijan , Dharanikota Anvesh , Basude Madhunarayana , Jonnada Pawan , Abualjadayel Muayyad , Alabbad Saleh , Mir Tanveer Ahmad , Broering Dieter C. , Raju KVVN , Rao Thammineedi Subramanyeshwar , Vashist Yogesh Kumar
Published: November 2023

Anastomotic leak (AL) remains a significant complication after esophagectomy. Indocyanine green fluorescent angiography (ICG-FA) is a promising and safe technique for assessing gastric conduit (GC) perfusion intraoperatively. It provides detailed visualization of tissue perfusion and has demonstrated usefulness in esophageal surgery. GC perfusion analysis by ICG-FA is crucial in constructing the conduit and selecting the anastomotic site and enables surgeons to make necessary adjustments during surgery to potentially reduce ALs. However, anastomotic integrity involves multiple factors, and ICG-FA must be combined with optimization of patient and procedural factors to decrease AL rates. This review summarizes ICG-FA’s current applications in assessing esophago-gastric anastomosis perfusion, including qualitative and quantitative analysis and different imaging systems. It also explores how fluorescent imaging could decrease ALs and aid clinicians in utilizing ICG-FA to improve esophagectomy outcomes.
Clinical status and future prospects of single-incision robotic assisted surgery (SIRAS): A review
Authors: Cheng Xi , Huang Chenhao , Jia Wenqing , Guo Zichao , Shi Yiqing , Song Zijia , Feng Haoran , Huang Haiyan , Xu Shuiyu , Li Haosheng , Wang Shaodong , Zhang Yaqi , Zhang Tao , Liu Kun , Ji Xiaopin , Zhao Ren
Published: November 2023

Since the advent of conventional multiport laparoscopic surgery, the prosperity of minimally invasive surgery (MIS) has been thriving on the advancement of endoscopic techniques. Cosmetic superiority, recovery benefits and non-inferior surgical outcomes weigh single-incision laparoscopic surgery (SILS) as a promising modality. Although there are surgical challenges posed by steep learning curve and technological difficulties, such as instruments collision, triangulation loss and limited retraction, the establishment of robotic surgical platform as a solution to all is inspiring. Furthermore, with enhanced instrument maneuverability and stability, robotic ergonomic innovations adopt the advantages of SILS and surmount its recognized barriers by introducing a novel combination, single-incision robotic assisted surgery (SIRAS). As was gradually diffused in general surgery and other specialties, SIRAS manifests privileges in non-inferior clinical outcomes an satisfactory cosmetic effect among strictly-selected patients, and has the potential of a preferable surgical option for MIS.
Rotator Cuff Repair in Pediatric and Adolescent Athletes: Indications and Outcomes
Authors: Caldaria Antonio , Giovannetti de Sanctis Edoardo , Palumbo Alessio , Franceschi Francesco , Maffulli Nicola
Published: November 2023

Rotator cuff (RC) tears in pediatric and adolescent athletes are rare events. In these patients, RC tears are more likely to be traumatic or related to overuse among overhead. Repeated movements of abduction and external rotation are frequent mechanisms of injury. The supraspinatus is the most commonly involved tendon and the articular-sided tears are more common than the bursal side. Magnetic resonance imaging is considered the gold standard for diagnosing RC tears. Conservative treatment, arthroscopic, and open repair are all effective treatment methods depending on the type of injury. The risk of growth plate injury in these patients should be always considered when planning surgical interventions. Return to sport for competitive-level throwing athletes represents the greatest challenge in the treatment of these injuries.
Eryptosis: a driver of anemia in chronic kidney disease
Authors: Bissinger Rosi , Qadri Syed M. , Artunc Ferruh
Published: November 2023

Purpose of review

Anemia, characterized by a reduction in red blood cell (RBC) count or hemoglobin concentration, commonly accompanies chronic kidney disease (CKD), significantly impacting patients’ quality of life. This review delves into the multifaceted nature of anemia in CKD, with a focus on novel mechanisms, particularly the dysregulation of eryptosis or programmed cell death of RBCs, leading to shortened RBC lifespan.

Recent findings

Recent studies in CKD patients and mouse models revealed that eryptosis, driven by factors such as uremic toxins, inflammation, and imbalances in calcium homeostasis, plays a pivotal role in the development of renal anemia. Dysregulated eryptosis results in premature RBC destruction, exacerbating the hypoproliferative character of anemia in CKD.

Recognizing the intricate relationship between eryptosis and anemia in CKD opens promising prospects for improving patient outcomes and enhancing our understanding of this complex condition. Future research and therapeutic development in this area hold the potential to improve anemia treatment of CKD patients.
Dermoscopic findings in Tinea Capitis among under 18 children in dermatology polyclinic patients: a hospital-based cross-sectional study
Authors: Ali Ahmed Isse , Aden Abdisalam Ibrahim , Mohamud Abdirahman Khalif
Published: November 2023

Background:

Tinea capitis is a fungal infection that affects the scalp. It is caused by a group of fungi known as dermatophytes, which thrive in warm and moist environments. In Somalia, there is a data shortage regarding dermatological conditions, especially in Mogadishu, the most populous city in the country. Tinea capitis has gone unreported despite its high prevalence in Somali dermatology clinics and the Somali diaspora in Western countries. The absence of up-to-date information hampers the capability to diagnose, treat, and prevent Tinea capitis. Therefore, the study aims to evaluate dermoscopic signs about isolated organisms and potassium hydroxide (KOH) examination.

Method:

A hospital-based cross-sectional study was implemented between January and April 2023 in Mogadishu, Somalia. All eligible Tinea capitis-infected children were included in the study. Microscopically, analysis was conducted by adding 10% of KOH in fungal elements. Data were analyzed using descriptive statistics and the χ2test atPvalue less than 0.05.

Results:

A total of 76 tinea capitis-infected children participated in the study; 56% were age group between 5-9 years old, 68.4% were male, and 92.1% showed KOH positivity.Trichophyton violaceum(65.8%) andTrichophyton sudanense(14.5%) were the most common fungal organisms detected in the culture. comma hairs (93.10%), scales (40.80%), and corkscrews (32.90%) were the most common dermoscopic signs of tinea capitis. The demographical characteristics and dermoscopic signs of tinea capitis significantly associated with the positivity of KOH examination were age, sex, comma hairs, corkscrew hairs, broken hair, Scales, and Zigzag hair.

Conclusion:

Children in Mogadishu, Somalia, bear a significant burden of Tinea Capitis infections.Trichophyton violaceumandTrichophyton sudanensewere the predominant causative agents identified in the cultures. The most common dermoscopic signs of tinea capitis observed in this study were comma hairs, scales, and corkscrew patterns. Hence, early diagnosis of Tinea Capitis infections and timely, effective treatments with contact tracing are highly needed.
Subspecialty Clinic Scheduling for Emergency Room Follow-ups
Authors: Eldridge Leigha , Kujath Amber S.
Published: November 2023

Inaccurate patient scheduling disrupts the continuity of care between patient and provider, diminishing satisfaction. One clinic had 19% of patients scheduled incorrectly after follow-up from emergency room visits. The purpose of this project was to reduce the number of incorrectly scheduled patients following up from emergency room visits that required orthopaedic consultations from advanced practice providers (APPs) and monitor the impact the change process had on APP job satisfaction. The design was nonexperimental, did not have a control group for comparison, and used standardized electronic health record documentation. A pretest and posttest design was used for the job satisfaction survey. Postimplementation data showed patients were correctly scheduled 97% of the time. Provider satisfaction improved from 2.375 to 3.125 on a 0- to 5-point scale as it pertains to clinic scheduling. Organizations can benefit from the use of standardized communication documentation to ensure proper follow-up for patients, improve continuity of care, and positively impact provider satisfaction.
Near-Optimal Recovery Within 3 Months
Authors: Strijbos Daniël O. , Boymans Tim A. E. J. , Bimmel Richard
Published: November 2023

Single-stage bilateral hip replacement (SSBHR) is a safe and successful orthopaedic intervention for patients suffering from bilateral osteoarthritis of the hip. Data on short- and mid-term recovery outcome studies are, unfortunately, scarce. The purpose of this study was to investigate the change in the functional measures and quality of life after SSBHR and to determine the patient's willingness to undergo the same procedure again. Data were prospectively collected and analyzed from patients with bilateral symptomatic hip osteoarthritis who underwent SSBHR from January 2019 until December 2020. Patients were excluded only if they failed to sign an informed consent or were unable to fill out questionnaires due to language or cognitive problems. Preoperatively and 3 and 12 months after surgery, health-related quality of life (HRQOL) and physical functioning were measured. Twelve months after surgery, patient satisfaction (willingness to undergo the same procedure again) was obtained. Complications, blood loss, and length of stay (LOS) were abstracted from the clinical notes and the electronic patient files. Patients improved significantly on all domains of HRQOL (16.0%–59.7%) and physical functioning (14.7%–15.8%) 3 months after surgery in comparison with preoperatively. No improvement was reported on HRQOL and physical functioning, except the Timed Up and Go score (14.1%), at 12 months after surgery in comparison with 3 months. No major or minor complications were found, and LOS was 2.9 days on average. One year after the surgery, all patients expressed satisfaction as suggested by their willingness to undergo the same surgical procedure again. Our study demonstrates that SSBHR offers a rapid recovery time and significant improvements in both functional status and HRQOL within 3 months after surgery. These findings can inform healthcare professionals and patients, suggesting that SSBHR is a viable treatment option for patients with bilateral hip osteoarthritis. Further research, including multicenter randomized controlled trials, is recommended to compare the recovery outcomes of SSBHR with two-stage bilateral hip replacement and confirm our findings.
Primary Extranodal Nasal-Type Natural Killer/T-Cell Lymphoma of Lower Limb Muscles on 18F-FDG PET/CT
Authors: Li Chuan , Hu Xianwen
Published: November 2023

Extranodal nasal-type natural killer/T-cell lymphoma may arise anywhere outside the lymph nodes, predominantly including the nasal cavity, nasopharynx, oropharynx, upper respiratory tract, gastrointestinal tract, skin, testes, and salivary glands, whereas primary tumor arising in muscle is rarely documented. We report FDG PET/CT findings of primary extranodal nasal-type natural killer/T-cell lymphoma in the muscles of the right lower limb in an 82-year-old man.
FDG PET/CT in a Case of Primary Lymphoma of the Ureter
Authors: Ran Pengcheng , Zhou Wenyang , Zhang Xiaoyao , Lv Jieqin , Dong Aisheng
Published: November 2023

Primary lymphoma of the ureter is extremely rare. We describe the contrast-enhanced CT and FDG PET/CT findings in a case of diffuse large B-cell lymphoma transformed from mucosa-associated lymphoid tissue lymphoma limited to the left ureter. Contrast-enhanced CT showed 2 short-segment circumferential thickening and enhancement of the left pelvic and intramural ureteral wall. The thickened ureteral wall showed significantly increased FDG uptake mimicking urothelial carcinoma.
Evaluation of Helmeting Therapy Duration After Endoscopic Strip Craniectomy for Metopic and Sagittal Craniosynostosis
Authors: Nguyen Huan T. , Washington George N. , Cepeda Alfredo , Littlefield Tim , Teichgraeber John F. , Greives Matthew R. , Nguyen Phuong D.
Published: November 2023

Introduction:

Endoscopic strip craniectomy (ESC) is a minimally invasive option for early surgical treatment of metopic (MC) and sagittal craniosynostosis (SC). For ESC, however, the postoperative duration and compliance of helmet therapy are crucial to correct MC and SC asymmetry. The purpose of this study is to assess the period of postoperative band therapy and determine differences, if any, between MC and SC.

Methods:

A single-institution retrospective review was performed for patients with MC and SC who underwent ESC from November 2015 to 2019. Patients received preoperative, postoperative, and post-band 3-dimensional imaging. Factors recorded included patient sex, insurance type, number of helmets needed, age at surgery, time of first helmet, and at time of completion of helmet therapy, cephalic index, interfrontal angle, and cranial vault asymmetry index.

Results:

Patients with SC and MC had ESC surgery at 3.3 and 3.4 months of age, respectively.

Patients with SC were found to have completed banding therapy at a younger age (7.88 versus 10.0 mo), with shorter duration (4.17 versus 6.00 mo), and less number of bands (1.54 versus 2.21) than patients with MC. After regression analysis, suture type was found to be a significant predictor of total time in band therapy (P=0.039) with MC requiring a longer duration of banding therapy when compared with SC.

Conclusions:

Suture type directly correlates with duration of helmeting therapy for patients, with patients with MC requiring longer periods of postop helmeting and increased number of bands as compared with SC.
Haplotype-aware sequence alignment to pangenome graphs
Authors: Chandra Ghanshyam , Gibney Daniel , Jain Chirag
Published: November 2023

Modern pangenome graphs are built using haplotype-resolved genome assemblies. During read mapping to a pangenome graph, prioritizing alignments that are consistent with the known haplotypes has been shown to improve genotyping accuracy. However, the existing rigorous formulations for sequence-to-graph co-linear chaining and alignment problems do not consider the haplotype paths in a pangenome graph. This often leads to spurious read alignments to those paths that are unlikely recombinations of the known haplotypes. In this paper, we develop novel formulations and algorithms for haplotype-aware sequence alignment to an acyclic pangenome graph. We consider both sequence-to-graph chaining and sequence-to-graph alignment problems. Drawing inspiration from the commonly used models for genotype imputation, we assume that a query sequence is an imperfect mosaic of the reference haplotypes. Accordingly, we extend previous chaining and alignment formulations by introducing a recombination penalty for a haplotype switch. First, we solve haplotype-aware sequence-to-graph alignment in O(|Q||E||H|) time, where Q is the query sequence, E is the set of edges, and H is the set of haplotypes represented in the graph. To complement our solution, we prove that an algorithm significantly faster than O(|Q||E||H|) is impossible under the Strong Exponential Time Hypothesis (SETH). Second, we propose a haplotype-aware chaining algorithm that runs in O(|H|N log |H|N) time after graph preprocessing, where N is the count of input anchors. We then establish that a chaining algorithm significantly faster than O(|H|N) is impossible under SETH. As a proof-of-concept of our algorithmic solutions, we implemented the chaining algorithm in the Minichain aligner (https://github.com/at-cg/minichain). We demonstrate the advantage of the algorithm by aligning sequences sampled from human major histocompatibility complex (MHC) to a pangenome graph of 60 MHC haplotypes. The proposed algorithm offers better consistency with ground-truth recombinations when compared to a haplotype-agnostic algorithm.
Cellular and Transcriptional Signature of the Nasal Mucosa is Associated with Susceptibility to Pneumococcal Carriage in Older Adults
Authors: Urban Britta C. , Gonçalves André N. A. , Loukov Dessi , Passos Fernando M. , Reiné Jesús , Gonzalez-Dias Patrícia , Solórzano-Gonzalez Carla , Mitsi Elena , Nikolaou Elissavet , O’Connor Daniel , Collins Andrea M. , Adler Hugh , Rylance Jamie , Gordon Stephen B. , Jochems Simon P. , Nakaya Helder I. , Ferreira Daniela M.
Published: November 2023

Streptococcus pneumoniaecolonization in the upper respiratory tract is linked to pneumococcal disease development, predominantly affecting the very young and older adults. As the global population ages and comorbidities increase, there is a heightened concern about this infection. We investigated the immunological responses of older adults to pneumococcal controlled human infection by analysing the cellular composition and gene expression in the nasal mucosa. Our comparative analysis with younger adults revealed distinct gene expression patterns in older individuals susceptible to colonization, highlighted by neutrophil activation and elevated levels of CXCL9 and CXCL10. Unlike younger adults challenged with pneumococcus, older adults did not show recruitment of monocytes into the nasal mucosa following nasal colonization. These findings suggest age-associated cellular changes, in particular enhanced mucosal inflammation, that may predispose older adults to pneumococcal colonization. If similar changes are observed in the lung of susceptible older adults, these may explain the increased risk of pneumococcal disease in vulnerable populations.
Longitudinal changes in DNA methylation associated with clozapine use in treatment-resistant schizophrenia from two international cohorts
Authors: Gillespie Amy L. , Walker Emma M. , Hannon Eilis , McQueen Grant , Sendt Kyra-Verena , Avila Alessia , Lally John , Okhuijsen-Pfeifer Cynthia , van der Horst Marte , Hasan Alkomiet , Dempster Emma L. , Burrage Joe , Bogers Jan , Cohen Dan , Boks Marco P. , Egerton Alice , Luykx Jurjen J. , Mill Jonathan , MacCabe James H.
Published: November 2023

The second-generation antipsychotic clozapine is used as a medication for treatment-resistant schizophrenia. It has previously been associated with epigenetic changes in pre-clinical rodent models and cross-sectional studies of treatment-resistant schizophrenia. Cross-sectional studies are susceptible to confounding, however, and cannot disentangle the effects of diagnosis and medication. We therefore profiled DNA methylation in sequential blood samples (n=126) from two independent cohorts of patients (n=38) with treatment-resistant schizophrenia spectrum disorders who commenced clozapine after study enrolment and were followed up for up to six months. We identified significant non-linear changes in cell-type proportion estimates derived from DNA methylation data - specifically B-cells - associated with time on clozapine. Mixed effects regression models were used to identify changes in DNA methylation at specific sites associated with time on clozapine, identifying 37 differentially methylated positions (DMPs) (p < 5×10−5) in a linear model and 90 DMPs in a non-linear quadratic model. We compared these results to data from our previous epigenome-wide association study (EWAS) meta-analysis of psychosis, finding evidence that many previously identified DMPs associated with schizophrenia and treatment-resistant schizophrenia might reflect exposure to clozapine. In conclusion, our results indicate that clozapine exposure is associated with changes in DNA methylation and cellular composition. Our study shows that medication effects might confound many case-control studies of neuropsychiatric disorders performed in blood.
A transgenerational mutational signature from ionizing radiation exposure
Authors: Brand Fabian , Klinkhammer Hannah , Knaus Alexej , Holtgrewe Manuel , Weinhold Leonie , Beule Dieter , Ludwig Kerstin , Kothiyal Prachi , Maxwell George , Noethen Markus , Schmid Matthias , Sperling Karl , Krawitz Peter
Published: November 2023

The existence of transgenerational effects of accidental radiation exposure on the human germline remains controversial. Evidence for transgenerational biomarkers are of particular interest for populations, who have been exposed to higher than average levels of ionizing radiation (IR). This study investigated signatures of parental exposure to IR in offspring of former German radar operators and Chernobyl cleanup workers, focusing on clustered de novo mutations (cDNMs), defined as multiple de novo mutations (DNMs) within 20 bp. We recruited 110 offspring of former German radar operators, who were likely to have been exposed to IR (Radar cohort, exposure = 0-353 mGy), and reanalyzed sequencing data of 130 offspring of Chernobyl cleanup workers (CRU, exposure = 0-4,080 mGy) from Yeager, et al. In addition, we analyzed whole genome trio data of 1,275 offspring from unexposed families (Inova cohort). We observed on average 2.65 cDNMs (0.61 adjusted for the positive predictive value (PPV)) per offspring in the CRU cohort, 1.48 (0.34 PPV) in the Radar cohort and 0.88 (0.20 PPV) in the Inova cohort. This represented a significant increase (p< 0.005) of cDNMs counts, that scaled with paternal exposure to IR (p< 0.001). Our findings corroborate that cDNMs represent a transgenerational biomarker of paternal IR exposure.
Is Catheter Ablation Associated with Preservation of Cognitive Function? An Analysis From the SAGE-AF Observational Cohort Study
Authors: Srichawla Bahadar S. , Hamel Alexander P. , Cook Philip , Aleyadeh Rozaleen , Lessard Darleen , Otabil Edith M. , Mehawej Jordy , Saczynski Jane S. , McManus David D. , Moonis Majaz
Published: November 2023

Objectives

To examine the associations between catheter ablation treatment (CA) versus medical management and cognitive impairment among older adults with atrial fibrillation (AF).

Methods

Ambulatory patients who had AF, were ≥ 65-years-old, and were eligible to receive oral anticoagulation could be enrolled into the SAGE (Systematic Assessment of Geriatric Elements)-AF study from internal medicine and cardiology clinics in Massachusetts and Georgia between 2016 and 2018. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) tool at baseline, one-, and two years. Cognitive impairment was defined as a MoCA score ≤ 23. Multivariate-adjusted logistic regression of longitudinal repeated measures was used to examine associations between treatment with CA vs. medical management and cognitive impairment.

Results

887 participants were included in this analysis. On average, participants were 75.2 ± 6.7 years old, 48.6% women, and 87.4% white non-Hispanic. 193 (21.8%) participants received a CA before enrollment. Participants who had previously undergone CA were significantly less likely to be cognitively impaired during the two-year study period (aOR 0.70, 95% CI 0.50-0.97) than those medically managed (i.e., rate and/or rhythm control), even after adjusting with propensity score for CA. At the two-year follow-up a significantly greater number of individuals in the non-CA group were cognitively impaired (MoCA ≤ 23) compared to the CA-group (311 [44.8%] vs. 58 [30.1%],p=0.0002).

Conclusions

In this two-year longitudinal prospective cohort study participants who underwent CA for AF before enrollment were less likely to have cognitive impairment than those who had not undergone CA.
Disentangling abiotic and biotic effects of treated wastewater on stream biofilm resistomes enables the discovery of a new planctomycete beta-lactamase
Authors: Attrah Mustafa , Schärer Milo R. , Esposito Mauro , Gionchetta Giulia , Bürgmann Helmut , Lens Piet N.L. , Fenner Kathrin , van de Vossenberg Jack , Robinson Serina L.
Published: November 2023

Background

Antibiotic resistance, which is mediated by environmental reservoirs, poses a threat to human and animal health. Aquatic biofilms impacted by treated wastewater (WW) are known environmental reservoirs for antibiotic resistance, however the specific influence of biotic factors and abiotic factors from WW on the abundance of antibiotic resistance genes (ARGs) within aquatic biofilms remains unclear. Additionally, experimental evidence is limited as to whether genes with low sequence similarity to reference ARGs actually encode for functional ARGs, particularly within complex aquatic microbial communities.

Results

To disentangle the effects of abiotic and biotic factors on ARG abundances, natural biofilms were previously grown in flume systems with different proportions of stream water and either ultrafiltered or nonultrafiltered WW. In this study, we conducted deep shotgun metagenomic sequencing of 75 biofilm, stream, and WW samples from these flume systems and compared the taxonomic and functional microbiome and resistome composition. Statistical analysis revealed an alignment of the resistome and microbiome composition and a significant association with experimental treatment. Several ARG classes exhibited an increase in metagenomic abundances in biofilms grown with increasing percentages of nonultrafiltered WW. In contrast, sulfonamide and BEL family beta-lactamase ARGs showed greater abundances in biofilms grown in ultrafiltered WW compared to nonultrafiltered WW. Overall, our results pointed toward the dominance of biotic factors over abiotic factors in determining ARG abundances in WW-impacted stream biofilms and suggested gene family-specific mechanisms for ARGs which exhibited divergent abundance patterns. To investigate one of these specific ARG families experimentally, we biochemically characterized a new beta-lactamase from thePlanctomycetota(Phycisphaeraceae). This beta-lactamase displayed activity in the cleavage of cephalosporin analog despite sharing low sequence identity with known ARGs.

Conclusions

This discovery of a functional planctomycete beta-lactamase ARG is noteworthy, not only because it was the first beta-lactamase to be biochemically characterized from this phylum, but also because it was not detected by standard homology-based ARG tools. In summary, this study conducted metagenomic analysis on the relative importance of biotic and abiotic factors in the context of WW discharge and their impact on both known and new ARGs in aquatic biofilms.
Animal septins contain functional transmembrane domains
Authors: Perry Jenna A. , Werner Michael E. , Omi Shizue , Heck Bryan W. , Maddox Paul S. , Mavrakis Manos , Maddox Amy S.
Published: November 2023

Septins, a conserved family of filament-forming proteins, contribute to eukaryotic cell division, polarity, and membrane trafficking. Septins scaffold other proteins to cellular membranes, but it is not fully understood how septins associate with membranes. We identified and characterized an isoform ofCaenorhabditis elegansseptin UNC-61 that was predicted to contain a transmembrane domain (TMD). The TMD isoform is expressed in a subset of tissues where the known septins were known to act, and TMD function was required for tissue integrity of the egg-laying apparatus. We found predicted TMD-containing septins across much of opisthokont phylogeny and demonstrated that the TMD-containing sequence of a primate TMD-septin is sufficient for localization to cellular membranes. Together, our findings reveal a novel mechanism of septin-membrane association with profound implications for septin dynamics and regulation.
Examining the structural relationships between perceived value, satisfaction and loyalty among disabled tourists in two world heritage sites
Authors: Moreno-Manzo Jessenia , Coromina Lluís , Gassiot-Melian Ariadna
Published: November 2023

Purpose

This study aims to explore the dimensions of perceived value of tourists with disabilities at heritage sites. Second, it examines the differences in the precedents of satisfaction and loyalty among tourists with disabilities in two different World Heritage Sites (WHS).

Design/methodology/approach

The sample consists of 150 and 184 questionnaires given to tourists with disabilities in Ecuador’s WHS of Quito and Cuenca, respectively. To test the hypotheses, data were analysed using confirmatory factor analyses and structural equation modelling.

Findings

This study suggests a five-dimensional structure for perceived value of tourists with disabilities in WHS. However, differences in the behaviour of people with disabilities are found depending on the specific WHS. While the perceived value factors that determine satisfaction are different according to the WHS, the loyalty precedents remain the same.

Practical implications

This study contributes to the formulation of actions and strategies towards a more sustainable and inclusive future, where all tourism stakeholders in WHS have role. By understanding the behaviour of tourists with disabilities, these stakeholders will be more informed about the destinations’ elements that need to be improved and enhanced to satisfy this loyal market segment.

Originality/value

Although the importance of accessible tourism is widely recognised, there is a dearth of literature investigating the behaviour of tourists with disabilities in heritage destinations. This study proposes a model to understand the role of perceived value in cultural heritage destinations.
Libraries in an era of constant flux: establishing smart libraries in South Africa
Authors: Modiba Thomas Mashilo , Chisita Collence Takaingenhamo
Published: November 2023

Purpose

The study aims to draw lessons from other countries and propose a framework for developing smart libraries in transformation in South Africa. The framework will be useful to policymakers and scholars in library and information science.

Design/methodology/approach

This study used a qualitative approach based on a systematic literature review and the researchers’ experience concerning the transformation of smart libraries in South Africa. The researchers selected databases to access full-text, abstract or full-text linking facilities. The researchers generated the study’s literature review using keywords derived from themes. The keywords used include “smart libraries,” “functions of smart libraries” and “smart library infrastructure,” based on the objectives of the study.

Findings

The findings reveal that developing smart libraries in South Africa is feasible, but all stakeholders must cooperate and collaborate to create smart libraries. The findings of this study show that South Africa can draw lessons from other countries on the way forward in developing smart libraries. The results indicate that lack of funding, digital infrastructure and technical skills are among the factors inhibiting the development of smart libraries.

Originality/value

The issue of smart libraries has become a key on the agenda on a global scale, and South Africa is no exception to such developments. This study proposes a framework for developing smart libraries based on lessons learned within and outside South Africa.
Magneto-convective hybrid nanofluid slip flow over a moving inclined thin needle in a Darcy-Forchheimer porous medium with viscous dissipation
Authors: Hakeem A.K. Abdul , S. Priya , Bhose Ganga , Sivanandam Sivasankaran
Published: November 2023

Purpose

The purpose of this study is to provide that porous media and viscous dissipation are crucial considerations when working with hybrid nanofluids in various applications.Recent years have witnessed significant progress in optimizing these fluids for enhanced heat transfer within porous (Darcy–Forchheimer) structures, offering promising solutions for various industries seeking improved thermalmanagement and energy efficiency.

Design/methodology/approach

The first step is to transform the original partial differential equations into a system of first-order ordinary differential equations (ODEs). The fourth-order Runge–Kutta method is chosen for its accuracy in solving ODEs. The present study investigates the free convective boundary layer flow of hybrid nanofluids over a moving thin inclined needle with the slip flow brought about by inclined Lorentz force and Darcy–Forchheimer porous matrix, viscous dissipation.

Findings

It is found that slip conditions (velocity and Thermal) exist for a range of the natural convection boundary layer flow. In the hybrid nanofluid flow, which consists of Al2O3 and Fe3O4 are nanoparticles, H2O − C2H6O2 (50:50) are considered as the base fluid. The consequence of the governing parameter on the momentum and temperature profile distribution is graphically depicted. The range of the variables is 1 ≤ M ≤ 4, 1 ≤ d ≤ 2.5, 1 ≤ δ ≤ 4, 1 ≤ Fr ≤ 7, 1 ≤ Kr ≤ 7 and 0.5≤λ ≤ 3.5. The Nusselt number and skin friction factors are used to calculate the numerical values of various parameters, which are displayed in Table 4. These analyses elucidate that upsurges in the value of the Fr noticeably diminish the momentum and temperature. It is investigated to see if the contemporary results are in outstanding promise with the outcomes reported in earlier works.

Practical implications

The results can be very helpful to improve the energy efficiency of thermal systems.

Social implications

The hybrid nanofluids in heat transfer have the potential to improve the energy efficiency and performance of a wide range of systems.

Originality/value

This study proposes that in the combined effects of hybrid nanofluid properties, the inclined Lorentz force, the Darcy–Forchheimer model for porous media and viscous dissipation on the boundary layer flow of a conducting fluid over a moving thin inclined needle. Assessing the potential practical applications of the hybrid nanofluids in inclined needles, this could involve areas such as biomedical engineering, drug delivery systems or microfluidic devices. In future should explore the benefits and limitations of using hybrid nanofluids in these applications.
Tribological responses of steels to different surface films generated in oil lubricants
Authors: Cao Shoufan , Xu Zhang , Liang Yi , Mischler Stefano
Published: November 2023

Purpose

The aim of this study is to experimentally analyze the friction and wear responses of different steels to different surface films generated in oil-lubricated tribological contacts.

Design/methodology/approach

Tribological experiments were conducted using a 100Cr6 bearing ball sliding against a V155 carbon steel disk and 316L stainless steel disk, respectively. Lubricants with additives known to form zinc dialkyl-dithiophosphate (ZDDP) or Ca tribofilms were used.

Findings

Both of the ZDDP and Ca tribofilms helped stabilize the friction coefficient of the carbon steel and stainless steel. The ZDDP tribofilm could effectively protect the carbon steel from wear, in contrast to the stainless steel, whereas the wear of both carbon steel and stainless steel could be significantly reduced by the Ca tribofilm. In the case of neither ZDDP nor Ca tribofilms formation, the 100Cr6 ball was worn by the V155 disk and generated a special surface topography. A polishing wear mechanism was proposed to explain the wear of the 100Cr6 ball.

Originality/value

This study clearly shows the different friction and wear responses of steels to the different surface films and the response is dependent on the tested steel.
Revisiting long-run dynamics between financial inclusion and economic growth in developing nations: evidence from CS-ARDL approach
Authors: Mir Tariq Ahmad , Gopinathan R. , Joshi D.P. Priyadarshi
Published: November 2023

Purpose

This study aims to analyze the long-run dynamic relationship between financial inclusion and economic growth for developing nations.

Design/methodology/approach

This study develops a comprehensive financial inclusion index based on the UNDP methodology for 53 developing nations. The authors use second-generation unit root tests, cointegration techniques and an advanced dynamic common correlated effects estimator model called cross-sectional augmented autoregressive distributed lags (CS-ARDL) to examine long-run dynamics among variables.

Findings

The tests confirm the presence of slope-heterogeneity and cross-sectional dependency. The second-generation panel unit root tests show the chosen variables are stationary at first difference. The bootstrap Westerlund cointegration result shows the variables are cointegrated in the long run. The CS-ARDL estimates conclude that financial inclusion positively enhances gross domestic product per capita in selected developing countries. The robustness check through augmented mean group estimation validates the findings.

Originality/value

The study makes three important contributions: first, it constructs a comprehensive financial inclusion index using 10 variables for a panel of 53 developing nations; second, the potential cross-section dependence and slope heterogeneity of panel data have been accounted for by applying the second-generation unit root tests; third, the study uses the dynamic common correlated effects estimator model (CS-ARDL) to examine long-run dynamics among variables.