bluuebunny/crossref_metadata_2025 huggingface dataset:
High pressure–combined calcium lactate treatment improves colour stability in yaks due to changes in myoglobin and muscle microstructure
Authors: Li Cai-Yun , Liu Shu-Hua , Zhang Yu-Bin
Published: February 2025

This study investigated the effect of high pressure (300 MPa; 15 min) combined with treatment with 0.06 g/ml calcium lactate (5% of meat samples) on the postmortem colour stability of the yak longissimus lumborum. The combined treatment increased the pH value, water holding capacity, a* (redness) and L* (lightness) values while decreasing the b* (yellowness) value and muscle fibre diameter of the longissimus lumborum as storage time progressed (p < 0.05). And the combined treatment decreased the α-helix content and increased the β-fold content and β-turn angle in the myoglobin structure (p < 0.05). Furthermore, the combined treatment induced increases in myoglobin reductase and lactate dehydrogenase reductase activities and NADH concentration (p < 0.05). Collectively, this study explored the important role of high pressure combined with calcium lactate on the microstructure of myoglobin and muscle in the stability of yak meat colour and broadens our knowledge on high pressure-mediated meat colour regulation.
Preservation of fresh chicken breast by sodium alginate edible coating containing cinnamon essential oil microcapsules
Authors: Hu Nan , Ji Dingdan , Liu Yufei , Li Jiawen , Zhang Huiting , Cui Baozhong , Fu Hongfei , Wang Yunyang , Chen Xiangwei
Published: February 2025

The sodium alginate based edible coating containing cinnamon essential oil microcapsules (CEOM) was produced to extend the shelf life of fresh chicken breast during refrigeration storage. Cinnamon essential oil (CEO) was successfully encapsulated by gum Arabic through a spray drying process. Additionally, an appropriate core/wall material for 1:4 was found to produce microcapsules with maximum encapsulation efficiency (72.21%). The particles of microcapsules were quite small (4.73 μm) with a uniform particle size distribution. The molecular interaction between CEO and gum Arabic was identified as the hydrogen bond. Additionally, the CEOM demonstrated good storage stability, and the encapsulation efficiency was maintained at 59.81% after 7 days at 4 °C. CEOM exhibited great antibacterial activities against E. coli and S. aureus, and the minimum inhibition concentration (MIC) was 10.000 and 5.000 mg/mL for two strains. Compared with control samples, incorporating CEOM into SA coatings could significantly retard the increase in weight loss, pH, total viable counts (TVC), and total volatile base nitrogen (TVB-N). The SA-CEOM-3.0 coating extended the shelf-life of chicken samples to 3 days, and the samples showed no unpleasant odour, a good texture, and high overall acceptability. In summary, SA-CEOM coatings could be developed as a promising antibacterial agent in meat preservation.
Predicting dry matter intake in cattle at scale using gradient boosting regression techniques and Gaussian process boosting regression with SHAP explainable AI, MLflow and its containerization
Authors: ArunKumar K E , Blake Nathan E , Walker Matthew , Yost Tylor J , Mata-Padrino Domingo , Holásková Ida , Yates Jarred W , Hatton Joseph , Wilson Matthew E
Published: February 2025

Dry matter intake (DMI) is a measure critical to managing and evaluating livestock. Methods exist for quantifying individual DMI in dry lot settings that employ expensive intake systems. No methods exist to accurately measure individual DMI of grazing cattle. Accurate prediction of DMI using machine learning (ML) promotes improved production and management efficiency. It also opens the door to empowering producers to validate and verify intakes in order to participate in incentive programs for delivering ecosystem service credits. We explored gradient boosting-based approaches to predict DMI in beef cattle using actual animal intake and climate dataset of 12,056 daily records from 178 cattle fed at West Virginia University from 2019 to 2020. The tested and developed methods include gradient boosting regression (GBR), Light boosting regression (LGB), extreme gradient boosting regression (XGB), and Gaussian process boosting (GPBoost) models and two baseline models: 1. Nutrient Requirements of Beef Cattle (NASEM 2016) Equation & 2. Mixed Linear Model Regression (MLM). The GPBoost models were developed considering the random effects associated with animal ID and date. Moreover, we developed an end-to-end MLoperations (MLOps) pipeline to streamline the ML steps using crucial components, such as MLflow and Dockerization. The best performing model was determined by comparing the common evaluation metrics such as root mean squared error (RMSE), mean squared error (MSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). The RMSE values on the test data of the optimized models ranged from 1.18 kg to 1.54 kg. The focus was developing a generalized algorithm that models covariates associated with animal ID and date that would generalize well on unseen data. The GPBoost models exhibited the best bias and variance compared to the other models (MLM, GBR, LGB, XGB). The R2 of the GPBoost on the training and test datasets were 0.58 and 0.55 respectively. The GPBoost model generalized well on the test dataset and train dataset with MAE values of 0.92 kg and 0.90 kg respectively We implemented an end-to-end MLOps pipeline with MLflow and Docker, enabling experiment tracking, model registry, reproducibility and scalability (to deploy on multiple computers) and seamless deployment. This approach offers a reliable and scalable solution for accurate DMI prediction, enhancing livestock management and facilitating participation in ecosystem service credits.
Validation of a Novel LC-MS-MS Method for the Separation and Differentiation of Δ8- and Δ9-Tetrahydrocannabinol Isomers and their Major Metabolites in Antemortem Whole Blood
Authors: Mikhaltsevich Petronela
Published: February 2025

The 2018 Farm Bill legalized hemp and defined it as cannabis plant material having not more than 0.3% ∆9-tetrahydrocannabinol (∆9-THC) by dry weight. This has opened the door for the sale of hemp-derived ∆8-tetrahydrocannabinol (∆8-THC), a psychoactive isomer of ∆9-THC. Hemp has minimal amounts of naturally occurring ∆8-THC; however, the cannabidiol (CBD) found in hemp can be chemically converted into ∆8-THC. Unfortunately, depending on the method of conversion, the amount of ∆8-THC, ∆9-THC and other by-products can vary widely. For many laboratories, the emergence of ∆8-THC products resulted in analytical challenges because of the structural similarity of the isomers resulting in coelution. In response, a novel liquid chromatography–tandem mass spectrometry method was developed to separate the two isomers, with improved limit of detection (LOD) and lower limit of quantification (LLOQ). With this method, clear separation was achieved between ∆9-THC and ∆8-THC, 11-nor-9-carboxy-∆9-tetrahydrocannabinol (∆9-THC-COOH) and 11-nor-9-carboxy-∆8-tetrahydrocannabinol (∆8-THC-COOH) and partial separation of 11-hydroxy-∆9-tetrahydrocannabinol (∆9-THC-OH) and 11-hydroxy-∆8-tetrahydrocannabinol (∆8-THC-OH). While ∆9-THC-OH and ∆8-THC-OH did not achieve baseline separation, sufficient separation was achieved to confidently identify and differentiate the two compounds. LOD and LLOQ were the same for quantitative compounds. Quantitative range of 0.5 ng/mL to 100 ng/mL was achieved for ∆9-THC, ∆8-THC and ∆9-THC-OH and 2.5 ng/mL to 250 ng/mL for ∆9-THC-COOH. Qualitative analysis with LOD of 0.5 ng/mL was achieved for ∆8-THC-OH and 2.5 ng/mL for ∆8-THC-COOH. To achieve the desired LODs and LLOQs, alternate multiple reaction monitoring (MRM) transitions were also explored in addition to those utilized in the laboratory’s prior method and other published methods. The method was validated following the American National Standards Institute/Academy Standards Board (ANSI/ASB) Standard 036, Standard Practices for Method Validation in Forensic Toxicology with minor exceptions, and was proven to be reliable and robust.
A243 CILIATED PANCREATIC FOREGUT CYST MIMICKING A MUCINOUS CYSTIC LESION: A CASE REPORT
Authors: Roda C , Telford J , Berg K , Sanders D
Published: February 2025

Background

Ciliated foregut cysts are rare congenital cysts that arise from the embryonic foregut and tracheobronchial tree, and are composed of an inner ciliated epithelium. While most commonly found in the mediastinum, they can also occur in the hepatopancreaticobiliary system. To our knowledge there has been less than 10 case reports describing ciliated pancreatic foregut cysts.

Aims

Report a case of a ciliated pancreatic foregut cyst and its associated imaging characteristics, cyst fluid analysis, and cytology.

Methods

A retrospective case report.

Results

A 66 year old female with invasive ductal adenocarcinoma of the right breast diagnosed in 2016 was found incidentally during staging work-up to have a 6.9 x 5.8 cm pancreatic tail cyst with peripheral calcifications on computed tomography scan of the abdomen. She had no history of pancreatitis or family history of pancreatic cancer, was a non-smoker, consumed minimal alcohol, and had normal liver enzymes.

An endoscopic ultrasound (EUS) with fine needle aspiration (FNA) was performed 02/2017 showing normal pancreatic parenchyma with a 7 cm anechoic simple pancreatic tail cyst without septations, mural nodularity or dilation of the pancreatic duct. Cyst fluid analysis showed an amylase of 9,174 U/L and carcinoembryonic antigen (CEA) of 1,731mg/L in keeping with a mucinous cystic lesion. The patient was subsequently followed by magnetic resonance imaging of the pancreas every 6 - 12 months for 5 years with ongoing cyst stability (5.2 x 4.9 x 5.7 cm on 06/2017 and 5.8 x 3.8 x 4.8 cm on 09/2021). Three subsequent EUS with FNA were performed between 02/2022 - 09/2023 showing constancy in cyst characteristics. Cyst fluid CEA remained >200 mg/L and cytologic evaluation on two occasions was non revealing (Table 1).

The working diagnosis was a side branch intraductal papillary mucinous neoplasm. Given concern for malignant potential, a laparoscopic distal pancreatectomy with splenectomy was performed 02/2024. Surgical pathology showed a unilocular cyst with serious fluid and an epithelial lining with a ciliated boarder positive for CK7 and negative for ER. Findings were diagnostic of a congenital ciliated foregut cyst.

Conclusions

Our case report is the first to show EUS FNA cyst fluid analysis overtime for a ciliated pancreatic foregut cyst. The cysts fluid mimics that of a mucinous cystic lesion. Obtaining adequate cytology is paramount for identifying ciliated epithelium in order to differentiate these benign congenital cysts from those with malignant potential.

Table 1. Endoscopic ultrasound fine needle aspiration cyst fluid analysis from a ciliated pancreatic foregut cyst

Funding Agencies

None
Earthworms and arbuscular mycorrhizal fungi improve salt tolerance in maize through symplastic pathways
Authors: Wang Binglei , Xiao Mingxuan , Cao Jia , Wang Chong
Published: February 2025

Symplastic pathways involving plasma membrane H+-ATPases and Na+/H+ antiporters maintain sodium (Na+) homeostasis in the symplastic pathways and protect plant functions under salt stress. In this study, we characterised the effects of earthworms and arbuscular mycorrhizal fungi (AMF) on Na+ absorption and transport in roots. Measurements of root Na+ content, plasma membrane H+-ATPase and Na+/H+ antiporter and antioxidant enzyme activities were performed together with transcriptome analysis. The addition of earthworms and AMF under saline conditions decreased the accumulation of Na+ in maize roots and significantly increased the root K:Na ratios, as well as increasing the levels of transcripts encoding plasma membrane H+-ATPases, Na+/H+ antiporters, antioxidant enzymes and proteins involved in nitrogen and phosphorus uptake under saline conditions. The transcript changes induced by earthworms and AMF indicate that abscisic acid mediates the effects on salt tolerance. Taken together, these findings suggest that earthworms and AMF improve the salt tolerance of maize seedlings through improved symplastic pathways.
A critical review on the relevance, essentiality, and analytical techniques of trace elements in human cancer
Authors: Liu Rui , Zhang Qian , Yan Xueting , Lv Yi
Published: February 2025

Trace elements (TEs) are indispensable nutritional elements, playing a pivotal role in maintaining human health and serving as essential cofactors for numerous enzymes that facilitate crucial biological processes. The dysregulation (excess or deficiency) of TEs can affect the proper functioning of various organs and lead to diseases like cancer. However, the current research findings remain contentious, and the association between TE variations and cancer remains elusive. This article reviews the recent advances in the quantitative detection of TEs in tumor research to fully understand the important role of TEs in disease diagnosis and prognosis. The changes in the levels of various elements (such as Cu, Zn, Fe, Se, Ca, etc.) are analyzed and summarized from five systems of the human body, including the digestive system, urinary system, reproductive system, endocrine system, and respiratory system. By analyzing the relevant findings in diverse biological samples, we systematically investigate the disruption of TEs homeostasis in cancer patients, thereby underscoring the potential of TEs as cancer biomarkers. We also present novel analytical techniques such as isotope ratio determination and bioimaging, along with advanced auxiliary tools like machine learning, for the detection of TEs in disease research. This review aims to provide a comprehensive overview of TEs variations in the main cancer types of different systems, which addresses the knowledge gap in TEs on human health, and provides proposals for future research.
Global ultrasound synovitis scores reflect symptom severity and patient outcomes in chronic chikungunya disease
Authors: Watson Hugh , del Valle-Mendoza Juana , Aguilar-Luis Miguel Angel , Aquino-Ortega Ronald , Silva-Caso Wilmer , Tarazona-Castro Yordi , Nizzardo Andrea , Calusi Giulia , Mandron Marie , Puentes Esteban , Luxemburger Christine , D’Agostino Maria Antonietta
Published: February 2025

Objectives

Acute chikungunya virus infection often leads to chronic post-infection arthritis, but investigation and evaluation of treatment is hampered by the subjectivity of symptoms. This study was designed to evaluate ultrasound scores and serum inflammatory markers as objective measures for the severity of chronic post-chikungunya arthritis.

Methods

Patients with acute chikungunya virus infection were enrolled in a prospective study and followed up at 3, 6 and 12 months. Assessments included both a physical exam and standardized ultrasound examination of 40 joints. Symptom severity and patient reported outcomes were recorded, and serum inflammatory markers were measured. Global ultrasound synovitis and tenosynovitis scores were calculated and correlation of ultrasound and serum markers with clinical symptoms and outcomes was analysed.

Results

Sixty patients (mean age 34 years, 67% female) were followed up. Widespread joint involvement was observed in the acute infection phase. This was followed by increasing involvement of small joints contributing to persistent symptoms in 57% of patients at 3 months and 30% at 12 months. Global ultrasound scores for synovitis at 3 months correlated with tender joint counts (r = 0.54, P < 0.0001), pain severity (r = 0.59, P < 0.0001), musculoskeletal stiffness (r = 0.42, P < 0.001) and RAPID3 scores (r = 0.59, P < 0.0001), confirmed at 6 and 12 months. Serum inflammatory markers were poorly associated with persistent symptoms during follow-up.

Conclusion

Global ultrasound scores for synovitis were found to be a relevant measure to support clinical observations in studies of chronic post-chikungunya joint disease.
Indications for Surgery and Surgical Options in Chiari Malformation
Authors: Visocchi Massimiliano , Signorelli Francesco , Alves Óscar L. , Goel Atul , Parthiban Jutty , Baeesa Saleh , Sharif Salman , Sampaio Francisco , Ben Ali Said , Lee June Ho , Oertel Joachim , Zileli Mehmet , Botelho Ricardo
Published: February 2025

Study Design.

A systematic literature review and consensus using Delphi method.

Objectives.

This review aims to create recommendations on the surgical indications and approaches to treat Chiari Malformation (CM) with or without syringomyelia.

Summary of Background Data.

Despite the growing body of knowledge on CM, there are diverse and sometimes contradicting perspective about surgical indications and procedures in both pediatric and adult populations.

Methods.

The authors reviewed the literature on CM published from 2011 to 2022. Two consensus conferences were organized by WFNS Spine Committee. The first one was held in Sao Paulo, Brazil on August 2022, and the second one was held in Porto, Portugal on December 2022. Using the Delphi method, a panel expert spine surgeons and members of the WFNS Spine Committee examined the strength of the literature, elaborated and voted statements about the surgical management of CM.

Results.

We present 11 consensus statements on the surgical management of CM. Surgery is recommended for patients who have symptoms or if MRI shows progression in asymptomatic patients. In pediatrics, osteoligamentous decompression only is indicated, whereas adults can have foramen magnum decompression with duroplasty, which is usually sufficient to control the associated syringomyelia. Syrinx drainage is the last option. Arachnoid opening can be performed in patients who have previously failed surgery or if arachnoid morphological anomalies are identified during the initial procedure. Tonsillar shrinkage provides somewhat better clinical efficacy than decompression alone, but at a larger risk of complications. Only patients with concurrent basilar invagination and atlanto-axial instability are advised to undergo atlanto-axial fixation alone.

Conclusions.

The consensus statements created by a collaborative work provide useful information for surgeons treating CM worldwide in order to achieve better surgical outcomes and avoid complications.
Type IV Hypersensitivity Reaction to Dermabond Prineo in Plastic Surgery Patients: A Report of 4 Cases
Authors: Ramirez-Folleco Alexander , Lancheros-Ramirez Paula , Guerrero-Calderón Daniel , Ramirez-Folleco Andres
Published: February 2025

Dermabond Prineo, a 2-octyl cyanoacrylate-based skin closure system, is widely used in surgical procedures, but reports of adverse effects remain limited. This study aimed to report and analyze 4 cases of type IV hypersensitivity reactions to Dermabond in plastic surgery patients. The study was conducted in a private hospital in Cali, Colombia, between 2022 and 2024. Four patients who underwent reconstructive surgery and presented type IV hypersensitivity reaction after the use of Dermabond were included. Variables such as time of onset of symptoms, number of Dermabond applications, and postoperative management were considered. A literature review was performed for the analysis. All patients developed type IV hypersensitivity reactions after Dermabond application. Symptoms included erythema, pruritus, and other localized signs. These reactions improved significantly after the withdrawal of Dermabond and treatment with topical corticosteroids. All patients had been previously exposed to Dermabond in previous procedures. Dermabond reexposure in sensitized patients may induce type IV allergic reactions. Early identification and treatment of these reactions is crucial.
Accuracy of the smartphone blood pressure measurement solution OptiBP to track blood pressure changes in pregnant women
Authors: Almeida Pedro , Cuénoud Alexia , Hoang Harry , Othenin-Girard Alexandra , Salhi Nadia , Köthe Andreas , Christen Urvan , Schoettker Patrick
Published: February 2025

Introduction:

Hypertensive disorders present significant morbidity and mortality during pregnancy. Although ambulatory blood pressure measurement remains the standard of care for normotensive women, self-monitoring at home is increasingly prevalent. The widespread use of smartphones worldwide has sparked interest in mobile applications that leverage the built-in hardware for blood pressure estimation, yet few trials have assessed their accuracy.

Methods:

This prospective, longitudinal and monocentric study evaluated the accuracy of the OptiBP algorithm against standard oscillometric blood pressure measurements in a sample of pregnant women. Patients scheduled for elective caesarean sections were enrolled during the preoperative anesthesia consultations. Paired blood pressure measurements using OptiBP and the reference method were obtained at multiple time-points in late pregnancy and the postpartum period. Agreement between methods was assessed using the AAMI/ESH/ISO 81060-2:2018 standard thresholds of 5 ± 8 mmHg for mean ± standard deviation of the error (criterion 1) and patient-specific standard deviation of the mean error (criterion 2) and represented graphically by Bland–Altman scatterplots.

Results:

Forty-eight women were enrolled of which 32 completed the protocol, yielding 338 total valid measurement pairs. Mean and standard deviation of the error were −1.78 ± 7.94 and 1.19 ± 7.59, and the patient-specific standard deviation of the mean error was 4.68 and 4.52, for SBP and DBP, respectively.

Conclusion:

Compared with blood pressure measurements taken with an oscillometric device, OptiBP's blood pressure estimates meet the AAMI/ESH/ISO 81060-2:2018 criteria.
Evaluation of Aktiia cuffless blood pressure monitor across 24-h, daytime, and night-time measurements versus ambulatory monitoring: a prospective, single-centre observational study
Authors: Almeida Tiago P. , Perruchoud David , Alexandre Jérémy , Vermare Pascale , Sola Josep , Shah Jay , Marques Luisa , Pellaton Cyril
Published: February 2025

Objectives:

Cuffless blood pressure (BP) monitors represent an innovative approach to BP assessment, overcoming the traditional episodic nature of readings obtained from cuff-based, oscillometric modalities. Nonetheless, the comparison of these cuffless devices against their cuff-based counterparts remain debated.

Methods:

This study evaluated BP readings from a cuffless, continual BP monitor (Aktiia monitor, Neuchâtel, Switzerland) and a standard 24-h ambulatory BP monitor (ABPM; Dyasis 3, Novacor, Paris, France) in 54 patients undergoing a 12-week cardiac rehabilitation program in Neuchâtel, Switzerland. Comparisons encompassed 24-h, daytime (9 a.m.–9 p.m.), and night-time (11 p.m.–7 a.m.) systolic and diastolic BP (SBP, DBP) using a 7-day average from Aktiia overlapping a 1-day average from ABPM. Nocturnal dip analysis was performed with 1-day average from Aktiia coinciding with ABPM measurements.

Results:

No significant differences emerged between the Aktiia and ABPM monitors for 24-h and daytime SBP (24-h:

2.6 ± 12.3 [-0.2, 5.4] mmHg, r = 0.57, P = 0.06; daytime: 1.2 ± 12.4 [−1.6, 4.0] mmHg, r = 0.60, P = 0.38). Night-time SBP showed more evident differences (12.5 ± 14.4 [9.3, 15.8] mmHg, r = 0.39, P < 0.001). DBP were within clinical range across 24-h and daytime (24-h: −2.9 ± 7.9 [−4.7, −1.1] mmHg, r = 0.63, P = 0.002; daytime: −3.1 ± 8.2 [−5.0, −1.3] mmHg, r = 0.64, P = 0.001), and showed significant differences for night-time (4.1 ± 8.5 [2.2, 6.0] mmHg, r = 0.57, P < 0.001). The concordance rate with ABPM's nocturnal dip was 79% for 1-day average from Aktiia.

Conclusions:

These results demonstrate that the Aktiia monitor yields BP measurements consistent with an ABPM monitor despite some systematic differences during night-time readings. The Aktiia monitor holds potential for future use in continual BP monitoring.

Clinical Trial Registration:

NCT04548986. URL: https://clinicaltrials.gov/study/NCT04548986?tab=results
Promising therapeutic targets for neuroprotection in retinal disease
Authors: Pan Warren W. , Wubben Thomas J. , Zacks David N.
Published: February 2025

Purpose of review

Neurodegeneration is a common endpoint of various blinding retinal diseases. Yet, despite exciting advances in disease treatment, there continues to exist a critical need for the development of neuroprotective strategies to prevent retinal cell death. Here, we summarize the recent advances in neuroprotective strategies.

Recent findings

From laboratory deciphering of the mechanisms involved in disease, many novel neuroprotective strategies have emerged and are currently under investigation for the treatment of various retinal and ocular diseases such as inherited retinal degeneration, retinal detachment, diabetic retinopathy, age-related macular degeneration, macular telangiectasia type 2, and glaucoma. These strategies include gene therapies, Fas inhibition, and targeting inflammatory, metabolic and reduction-oxidation abnormalities. Interestingly, investigation of several treatments across different diseases suggests shared neuroprotection mechanisms that can be targeted regardless of the particular disease.

Retinal neuroprotection can improve treatment of different retinal diseases. Fortunately, the current landscape, with a plethora of novel neuroprotective therapies, portends a better future for patients.
Protein phosphatases in systemic autoimmunity
Authors: Pan Wenliang , Tsokos Maria G. , Li Wei , Tsokos George C.
Published: February 2025

Protein phosphatases play a critical role in maintaining immune homeostasis by regulating various signaling pathways involved in immune cell activation, differentiation, and function. In the context of systemic autoimmune diseases, dysregulation of phosphatase activity contributes to aberrant immune responses, leading to chronic inflammation and tissue damage. This review explores the role of key phosphatases from the protein serine/threonine phosphatase and protein tyrosine phosphatase families that are implicated in systemic autoimmunity. We discuss their diverse roles in immune cell subsets, the mechanisms by which their dysregulation drives autoimmune pathogenesis, and the therapeutic potential of targeting these enzymes.
Lung-protective ventilation strategy to improve oxygenation function and respiratory mechanics in patients undergoing robotic bariatric surgery: A randomized double-blind trial (CONSORT)
Authors: Song Zichen , Sun Lin , Chen Peng , Yu Yonghao
Published: February 2025

Background:

The respiratory effects of lung-protective ventilation strategy (LPVS) on patients undergoing robotic abdominal surgery are still controversial, and prospective studies are needed to validate the lung-protective effects of LPVS, especially in robotic bariatric surgery.

Methods:

Forty-two patients undergoing robotic bariatric surgery were included in this study, of whom 20 received an LPVS and 22 received a standard ventilation strategy. Parameters were recorded at 5 intraoperative time points to assess respiratory mechanics, hemodynamics, and oxygenation. The incidence of intraoperative ventilation complications and postoperative pulmonary complications. Statistical analyses were performed using repeated measures analysis of variance and chi-square tests.

Results:

First, we demonstrated that the LPVS using a small tidal volume, positive end-expiratory pressure ventilation, and low inspired oxygen concentration could reduce peak and plateau airway pressures in patients undergoing robotic bariatric surgery (P < .05). Second, patients’ oxygenation index (P < .01) and partial pressure of oxygen (P < .05) increased considerably after lung-protective ventilation treatment, suggesting that this strategy facilitates oxygenation function in patients. Finally, we found that high inhaled oxygen concentration was an independent risk factor for postoperative pulmonary complications in robotic bariatric surgery patients (P < .05).

Conclusions:

This study confirms that LPVS can improve oxygenation function and respiratory mechanics in patients undergoing robotic bariatric surgery, which is of clinical significance.
An overview of persistent chylomicronemia: much more than meets the eye
Authors: Larouche Miriam , Watts Gerald F. , Ballantyne Christie , Gaudet Daniel
Published: February 2025

Purpose of review

The aim of this review is to provide an overview of severe hypertriglyceridemia presenting in the form of chylomicronemia that persists despite treatment of secondary causes and the use of conventional lipid-lowering treatment.

Recent findings

Persistent chylomicronemia is a rare syndromic disorder that affects carriers of bi-allelic combinations of pathogenic gene variants impairing lipoprotein lipase (LPL) activity, as well as a significant number of individuals who do not meet this genetic criterion. It is associated with a high risk of acute pancreatitis and other morbidities. Effective innovative treatments for severe hypertriglyceridemia are being developed and are becoming available. Patients with persistent chylomicronemia of any cause respond equally to next-generation therapies with LPL-independent mechanisms of action and do not generally respond to conventional LPL-dependent treatments.

Not all individuals with persistent chylomicronemia carry a proven pathogenic combination of gene variants that impair LPL activity. Documenting the clinical characteristics of people with persistent chylomicronemia and their response to emerging therapies is essential to correctly establish their risk trajectory and ensure equitable access to personalized treatment.
Internal astigmatism and risk factors in Tibetan schoolchildren: The Lhasa Childhood Eye Study
Authors: Meng Zhaojun , Yao Yao , Liu Jiawen , Li Lei , Chen Weiwei , Fu Jing
Published: February 2025

SIGNIFICANCE

The study first investigated the prevalence and internal relationship of astigmatism components under cycloplegia in Tibetan children on plateau areas of China. We found a higher prevalence of refractive (RA) and corneal astigmatism (CA) in Lhasa children and certified the compensation of internal astigmatism (IA), which might be associated with myopic progression.

PURPOSE

This study aimed to investigate the prevalence and related risk factors of RA, CA, and IA and evaluate compensation and associated influence factors of IA in Lhasa Tibetan children.

METHODS

This was a school-based cross-sectional study. Stratified random clustering was used to recruit 1751 Tibetan children with a mean age of 7.90 ± 0.48 years from schools in Lhasa, China. Cycloplegic autorefraction was conducted, and ocular biometrics were examined.

RESULTS

The prevalence rates of RA, CA, and IA were 18.73, 72.53, and 40.72%, respectively, with the diagnosis criteria ≥1.00 D. With-the-rule was the main type of RA (70.05%) and CA (91.93%), whereas the against-the-rule was predominant in IA (79.67%). Compared with the reference group (spherical equivalent range, 0.51 to 1.00 D), mean RA and CA increased with more hyperopic and myopic refractions, and mean IA was significantly lower only in myopia and emmetropia groups. Girls had a higher incidence of CA and IA than boys. Internal astigmatism was negatively correlated with CA in the vertical/horizontal vector (J
0) and oblique vector (J
45). The majority of IA compensated for RA in different degrees (95.25% in J
0 and 66.43% in J
45) and no compensation accounted for a higher proportion in myopic children (10.47% in J
0 and 5.76% in J
45).

CONCLUSIONS

The prevalence of RA and CA in Tibetan children from Lhasa was higher than reported in most previous studies. The compensation of IA in reducing CA was prominent, and the function could decrease with the myopic progression.
Predictors of Neurodevelopmental Impairment After Intestinal Resection for Necrotizing Enterocolitis
Authors: Patwardhan Utsav M , Gonzalez Alex , Campwala Insiyah , West Erin E , Goldfarb Madeline , Gehle Daniel B , Camp Lauren , Manohar Krishna , Allen Brooke E , Moya-Mendez Mary E , DeLaura Isabel , Maselli Kathryn , Gershner Grant , Golubkova Alena , Mladenov Georgi , Witte Amanda , Grisotti Gabriella , Markel Troy A , Brown Rebeccah L , Rice Henry E , Salazar Jose H , Hunter Catherine J , Jancelewicz Tim , Gadepalli Samir , Radulescu Andrei , Waltz Paul , Longshore Shannon , Gollin Gerald
Published: February 2025

Objective:

The aim of this study was to evaluate pre-resection risk factors for neurodevelopmental impairment (NDI) in infants with necrotizing enterocolitis (NEC) that might better inform the timing of intestinal resection.

Summary Background Data:

Surgical NEC is associated with a 57% risk for NDI.

Methods:

A retrospective study of patients with NEC who underwent intestinal resection within 10 days of diagnosis between 2010 and 2019 was conducted in 11 US children’s hospitals. The primary outcome was NDI at 16-26 months. Demographics, findings at NEC diagnosis, and the presence and trajectory of appearance of five established indicators of metabolic derangement were assessed as risk factors for NDI.

Results:

Of 365 total patients, 297 underwent resection for NEC within 10 days and 77 (26%) died. NDI was identified in 112 (55%) of patients who were assessed and was more likely in males; infants with lower birth weight, gestational age, or Apgar scores; or older age at diagnosis. Risk for NDI was associated with more indicators of metabolic derangement prior to resection (1.78 vs 1.15, P=0.002) and was progressively greater when more indicators were detected (44%-83% with 0-5 indicators, P=0.04). The median times to identification of one (15 min) to five (48 h) indicators increased progressively.

Conclusions:

Risk for NDI in surgical NEC was associated with the number and trajectory of identification of indicators of metabolic derangement prior to resection. As these indicators progressively appear over hours to days, their assessment might offer an objective means of defining failure of medical management and lead to improvement in neurodevelopmental outcomes in NEC.
Epilepsy in low- to middle-income countries
Authors: Sen Arjune , Newton Charles R. , Ngwende Gift
Published: February 2025

Purpose of review

Epilepsy disproportionately affects those in low- and middle-income countries (LMICs) where diagnostic and treatment gaps persist.

We highlight key recent developments and showcase practical opportunities to improve epilepsy care in resource limited settings.

Recent findings

In LMICs, cultural, socioeconomic and infrastructural factors drive the epilepsy treatment gap. Robust implementation of the WHO Intersectoral Global Action Plan (WHO IGAP) and Mental Health Gap Action Program (mhGAP), for example, will reduce the epilepsy education gap. Engaging traditional healers and other key community leaders should lessen stigma. The Epilepsy Diagnostic Companion, a culture specific tool that helps identify convulsive seizures, can expedite epilepsy diagnosis at primary care level. Novel, robust 3-D printable EEG headsets prototypes that can be deployed in remote rural communities have been piloted with encouraging results. Levetiracetam has been added to the WHO Essential Medicines List (EML), paving way to safer, less teratogenic antiseizure medications (ASMs). Epilepsy surgery programs in carefully selected patients potentially offer cheap, effective and potentially curative treatments, including in LMICs.

Apps, EEG prototypes, better access to ASMs and implementation of WHO iGAP offer current, tangible opportunities to improve epilepsy care in LMICs. Bidirectional learning must be facilitated to also help hard to reach communities in high-income settings.
Minisyncoccus archaeiphilus gen. nov., sp. nov., a mesophilic, obligate parasitic bacterium and proposal of Minisyncoccaceae fam. nov., Minisyncoccales ord. nov., Minisyncoccia class. nov. and Minisyncoccota phyl. nov. formerly referred to as Candidatus Patescibacteria or candidate phyla radiation
Authors: Nakajima Meri , Nakai Ryosuke , Hirakata Yuga , Kubota Kengo , Satoh Hisashi , Nobu Masaru K. , Narihiro Takashi , Kuroda Kyohei
Published: February 2025

In the domain Bacteria, one of the largest, most diverse and environmentally ubiquitous phylogenetic groups, Candidatus Patescibacteria (also known as candidate phyla radiation/CPR), remains poorly characterized, leaving a major knowledge gap in microbial ecology. We recently discovered a novel cross-domain symbiosis between Ca. Patescibacteria and Archaea in highly purified enrichment cultures and proposed Candidatus taxa for the characterized species, including Ca. Minisyncoccus archaeophilus and the corresponding family Ca. Minisyncoccaceae. In this study, we report the isolation of this bacterium, designated strain PMX.108T, in a two-strain co-culture with a host archaeon, Methanospirillum hungatei strain DSM 864T (JF-1T), and hereby describe it as the first representative species of Ca. Patescibacteria. Strain PMX.108T was isolated from mesophilic methanogenic sludge in an anaerobic laboratory-scale bioreactor treating synthetic purified terephthalate- and dimethyl terephthalate-manufacturing wastewater. The strain could not grow axenically and is obligately anaerobic and parasitic, strictly depending on M. hungatei as a host. The genome was comparatively large (1.54 Mbp) compared to other members of the clade, lacked some genes involved in the biosynthesis pathway and encoded type IV pili-related genes associated with the parasitic lifestyle of ultrasmall microbes. The G+C content of the genomic DNA was 36.6 mol%. Here, we report the phenotypic and genomic properties of strain PMX.108T; we propose Minisyncoccus archaeiphilus gen. nov., sp. nov. to accommodate this strain. The type strain of the species is PMX.108T (=JCM 39522T). We also propose the associated family, order, class and phylum as Minisyncoccaceae fam. nov. Minisyncoccales nov., Minisyncoccia class. nov. and Minisyncoccota phyl. nov. within the bacterial kingdom Bacillati.
The nisin O cluster: species dissemination, candidate leader peptide proteases and the role of regulatory systems
Authors: Scadden Jacob , Ansorge Rebecca , Romano Stefano , Telatin Andrea , Baker Dave J. , Evans Rhiannon , Gherghisan-Filip Cristina , Zhang Zhenrun J. , Mayer Melinda J. , Narbad Arjan
Published: February 2025

Nisin O is an antimicrobial peptide encoded by the human gut bacterium Blautia obeum A2-162 which has antimicrobial activity against clinically relevant organisms. The nisin O biosynthetic gene cluster (BGC) varies from other nisin BGCs as it lacks a leader-peptide cleaving protease and contains two bacterial two-component response regulator–histidine kinase (RK) systems. The dissemination of the nisin O cluster, the final proteolytic biosynthesis step and the regulation of nisin O are currently unknown and are the foci of this study. We identified six nisin O-like BGCs across Blautia, Dorea and Ruminococcus species using comparative genomics. These BGCs show evidence of genetic transfer between genera, with genes involved in transposition discovered up- and downstream of the BGCs. All nisin O-like BGCs contained two RK systems but no protease. Mining the B. obeum A2-162 genome identified candidate proteases that were cloned and used in pre-nisin O leader peptide cleavage assays. None of the candidate proteases removed the leader; however, cleavage was achieved using trypsin. To maximize the expression of the nsoA1-4 peptides, the interactions of the two RK systems with predicted promoters in the nisin O cluster were assessed using a PepI reporter assay. We observed that the PnsoR2K2 promoter was constitutively expressed, with NsoR1K1 increasing its activity, and that there was increased nsoA1-4 expression when the nisin A RK system and nisin A were present. Long-read cDNA sequencing confirmed nso gene transcription in the heterologous expression system and identified a novel, highly expressed gene. This study provides evidence that the nisin O BGC has been transferred between different gut-associated genera, with all clusters lacking a protease and containing two RK systems. We hypothesize that this BGC has lost its protease due to negative selection as a result of high trypsin concentrations in the gut. Further work is required to maximize nisin O expression for it to be used as a potential antimicrobial therapy.
Replication-Deficient Whole-Virus Vaccines Against Cytomegalovirus Induce Protective Immunity in a Guinea Pig Congenital Infection Model
Authors: Schleiss Mark R. , Fernández-Alarcón Claudia , Bierle Craig J. , Geballe Adam P. , Badillo-Guzman Alexey , Tanna Christine E. , Tsriwong Kanokpan , Blackstad Mark , Wang Jian Ben , McVoy Michael A.
Published: February 2025

Vaccines are needed to prevent congenital cytomegalovirus (CMV) infections. This study used the guinea pig cytomegalovirus (GPCMV) model to examine replication-deficient whole-virus vaccines against maternal viremia and congenital infection. Two recombinant GPCMVs, GP51-DD and GP52-DD, were engineered with destabilization domains fused to essential viral late proteins GP51 and GP52. These viruses, predicted to replicate in the presence of the synthetic ligand Shield-1 but not in its absence, were evaluated for Shield-1-dependencein vitroand for safety, immunogenicity, and efficacy in a pregnancy/challenge model. GP52-DD was profoundly Shield-1-dependent, producing no detectable infectious progeny in its absence. In contrast, the replication of GP51-DD was delayed in the absence of Shield-1, but the virus reached similar peak titers with or without the compound. GPCMV-seronegative guinea pigs received two subcutaneous injections of placebo (sham-immunized), GP51-DD, GP52-DD, or wild-type GPCMV (WT-GPCMV). DNAemia post-vaccination was detected in only one of 14 dams in each of the GP51-DD- and GP52-DD-immunized groups compared to 10/10 control animals immunized with WT-GPCMV, confirming the recombinant viruses were attenuated. GPCMV-specific antibody responses were similar in all three vaccinated groups. When immunized dams were bred and challenged with virulent GPCMV, DNAemia was detected in all sham-immunized controls and in 44% of GP52-DD-immunized dams (at significantly reduced levels) but was absent in dams immunized with GP51-DD or WT-GPCMV. Notably, immunization with GP52-DD, GP51-DD, or WT-GPCMV significantly reduced congenital GPCMV transmission (protective efficacies of 89%, 94%, and 100%, respectively). Thus, the replication-deficient GP52-DD vaccine was attenuated and protected against intrauterine GPCMV transmission.

Importance

Congenital cytomegalovirus (CMV) infections could be prevented by a vaccine, but most of the vaccine designs that have advanced to clinical trials have been subunit vaccines. These viral envelope glycoprotein-targeting designs have not yielded an effective vaccine that provides durable immunity. A vaccine that confers immune responses to a broader repertoire of viral immunogens, such as vaccines based on the whole virus, could enhance protection. However, there are concerns about the safety of live attenuated CMV vaccines. Using the guinea pig/guinea pig cytomegalovirus model of congenital infection, this study demonstrates that two replication-deficient whole virus vaccines are attenuated in animals while also being highly immunogenic, providing protective immunity against maternal viremia and fetal infection at levels similar to that conferred by a wild-type virus.
Medical and Endovascular Treatment for Acute Large Vessel Occlusion with Mild Stroke: A Real-World Nationwide Registry
Authors: Yi Tingyu , Gan Shujuan , Wu Meihua , Huang Weifeng , Sun Dalong , He Yuehong , Wu Yanmin , Lin Dinglai , Lin Xiaohui , Pan Zhinan , Yang Yining , Ye Jinhua , Li Caixia , Chen Zhiting , Huang Mingzhu , Zheng Xiufen , Li Xiaobin , Lang Fenglong , Tan Qian , Jin Xiaojun , Fu Jianqiu , Fan Fuqiang , Xu Na , Shao Ya , Sui Yi , Miao Zhongrong , Chen Wenhuo
Published: February 2025

Background and Purpose

EVT is a standard treatment for LVO in patients with an NIHSS score ≥6, but its role in mild stroke (NIHSS <6) remains uncertain. This study aims to explore the association between EVT and clinical outcomes in mild stroke.

Methods

This non-randomized cohort study prospectively enrolled consecutive mild stroke patients at 35 comprehensive stroke centers across 15 Chinese provinces from January 2020 to December 2023. Patients were categorized into pEVT or BMM groups, including those who received rEVT after deterioration. The primary outcome was an excellent outcome (mRS score of 0-1) at 90 days. Secondary outcomes included a good outcome (mRS score of 0-2) and mRS shift. Safety endpoints were mortality and sICH. Outcomes were compared between groups using multivariable logistic regression and IPTW.

Results

Finally, 307 patients were included. 110 received pEVT, and 190 received BMM. In the IPTW model, the pEVT group had higher rates of excellent (aOR=3.6, 95%CI=2.5-5.2) and good (aOR=4.0, 95%CI=2.5-5.6) outcomes, lower mortality (aOR=0.1, 95%CI=0.01-0.4), and a better 90-day mRS shift (aOR=0.2, 95%CI=0.1-0.3,), with similar sICH rates. Among the BMM group, 80 patients (42.1%) experienced early neurological deterioration (END), with 55 receiving rEVT. In the multivariable model, the pEVT group had higher rates of excellent (aOR=7.2, 95%CI=1.4-37.9) and good (aOR=4.1, 95%CI=1.2-14.8) outcomes and a better mRS shift (aOR=2.0, 95%CI=0.9-4.8).

Conclusions

Primary EVT significantly increases the likelihood of achieving an excellent outcome in mild stroke. Over 40% of mild stroke patients treated with BMM experienced END, and rEVT effectively improved the prognosis.

Key Points

Question

What is the optimal strategy for mild stroke with LVO?

Findings

This national prospective registry study demonstrated that pEVT significantly improved the prognosis of mild stroke patients with LVO compared to BMM. Approximately 40% of patients in the BMM group experienced END, and rEVT increased the likelihood of an excellent outcome in these patients.

Meaning

Primary EVT can significantly increase the probability of an excellent outcome in patients with mild stroke and LVO. Over 40% of patients with mild stroke treated with BMM experienced END, and rEVT effectively improved their prognosis.
Development of ferret immune repertoire reference resources and single-cell-based high-throughput profiling assays
Authors: Walsh Evan S. , Yang Kui , Tollison Tammy S. , Seenu Sujatha , Adams Nicole , Zeitoun Guilhem , Sideri Ifigeneia , Folch Geraldine , Brochu Hayden N. , Chou Hsuan , Kossida Sofia , York Ian A. , Peng Xinxia
Published: February 2025

Domestic ferrets (Mustela putorius furo) are important for modeling human respiratory diseases. However, ferret B and T cell receptors have not been completely identified or annotated, limiting immune repertoire studies. Here we performed long read transcriptome sequencing of ferret splenocyte and lymph node samples to obtain over 120,000 high-quality full-length immunoglobin (Ig) and T cell receptor (TCR) transcripts. We constructed a complete reference set of the constant regions of ferret Ig and TCR isotypes and chain types. We also systematically annotated germline Ig and TCR variable (V), diversity (D), joining (J), and constant (C) genes on a recent ferret reference genome assembly. We designed new ferret-specific immune repertoire profiling assays by targeting positions in constant regions without allelic diversity across 11 ferret genome assemblies, and experimentally validated them using a commercially compatible single-cell-based platform. These improved resources and assays will enable future studies to fully capture ferret immune repertoire diversity.