bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of an Enhanced Recovery After Surgery (ERAS) Program in Colorectal Surgery: The Benefits of Late Adoption
Authors: Süsstrunk J , Mijnssen R , Müller-Stich B , Wilhelm A , Steinemann D
Published: June 2023

Background

Enhanced recovery after surgery (ERAS) protocols have shown beneficial outcomes in various surgical fields in the last 20 years. Nevertheless, some benefits such as lower complication rates, shorter length of stay and cost reduction might be related to other, simultaneously implemented technical improvements such as a minimally-invasive access or modified anesthesiology care.

Aims

To analyze the effects after the implementation of an ERAS protocol in 2021 in a high-volume colorectal center.

Methods

This is a propensity score matched single-center study comparing the short-term outcomes and cost analysis of patients undergoing elective colorectal surgery in an ERAS program from 2021 to August 2022 compared to regular perioperative care from 2019 to 2020.

Results

A total of 738 patients underwent elective colorectal surgery between 2019 and August 2022. 456 patients were included in the propensity score matched analysis with 228 patients per group (ERAS vs. non-ERAS). The predominant access in both groups was minimally-invasive with 78%; 17% were rectal procedures. There was no significant difference in age, sex, insurance status, body mass index, Charlson's Comorbidity Index, tumor entity and type of surgery between groups. Major complications (grade 3a or higher according to Clavien-Dindo) occurred in 6.6% vs. 7% (p=0.85) and anastomotic leakage demanding operative revision in 2.2% vs. 2.6% (p=0.68) in the ERAS and non-ERAS group, respectively. Mean length of stay (LOS) and mean costs per case were significantly lower in the ERAS group compared to the non-ERAS group (LOS 9.2 days vs. 12.7 days, p=0.001; costs 30’114 francs vs. 35’991 francs, p=0.004). At 30-day telephone follow-up, 97% of patients in the ERAS group were in a good general state and mean overall satisfaction level was at 9.2/10.

Conclusions

Late adoption to an ERAS protocol leads to a significant reduction of LOS and costs without increasing perioperative morbidity.
Breaking The Silence: A Content Analysis of Medical Students’ Perceptions of Failure in Medicine
Authors: Germann N , Lutz S , Beck J , Fourie L , Klasen J M
Published: June 2023

Background

Failure in medicine may cause severe harm to patients, especially in surgery where failure has immediate consequences. Despite often being an emotionally stressful experience for surgical residents, failure is a powerful teacher as well. Before entering residency where failure is inevitable, medical students should ideally learn how to talk about and cope with failure.

Aims

Educational interventions to support learners to regulate failure and its consequences are rare. Therefore, a four-day workshop entitled “How Physicians deal with Failure in Medicine” was offered to medical students at an academic institution to open the conversation about failure in medicine.

Methods

The curriculum provided insights into the ubiquity of failure in surgery and beyond. 30 participants wrote reflective essays as a pre- and post-intervention task. Tutors, namely two surgeons and a life coach, facilitated presentations, group discussions, and journal clubs about failure, and discussed potential coping strategies.

Results

The content analysis of 60 reflective essays revealed various self-experienced and observed failures in the clinical context. Experiencing and witnessing failure was emotionally draining and often in conflict with expectations of being a physician. Fear of failure was omnipresent, while students realized that failure in medicine is human and inevitable. Perceived clinical supervision often protected medical students from failure and its potential consequences. However, open communication about failure rarely occurred. Overall, medical students emphasized the importance of open conversations about failure to learn from it.

Conclusions

Medical students wish to discuss failure before entering residency. Without open discourse about failure, medical students, and later residents feel left alone with their experiences, triggering fear. Clinical supervisors should support learners entering clinical training by being more transparent about their own failures and sharing their coping strategies which will ultimately help them to make sense about failure experiences in order to learn from and cope with it.
Embosafe – A Novel Percutaneous Technique for Aorto-Iliac Thrombectomy without the Risk of Embolization
Authors: Mujagic E , D'amico R , Wolff T , Gürke L
Published: June 2023

Background

Aortoiliac thrombectomies have become more common during the Covid-19 pandemic. Classic surgical thrombectomy of the aorta and iliac arteries through an incision in the groin vessels harbours the risk of embolization to the viscero-renal as well as hypogastric arteries while percutaneous endovascular thrombectomy techniques can lead to peripheral embolization to the lower limb.

Aims

To describe a novel, percutaneous technique that tackles the above issues and to present our initial experience using it.

Methods

The principle of the technique is to percutaneously place large bore sheaths in the iliac arteries that deliberately occlude the latter to protect the lower limbs from embolization. Through one of these sheats, over the wire Fogarty® catheters can be placed and inflated in the ostia of the coeliac trunk, superior mesenteric artery, renal arteries and hypogastric arteries as needed. A large thrombectomy balloon catheter is then used to bring any aorto-iliac thrombus into the sheaths whereafter thrombus is removed from the sheaths by simply deflating their valves. Additional endovascular procedures of the aorto-iliac branches can be performed as needed.

Results

We report eight EmboSafe procedures in 7 patients (3 male, 4 female) with a median age of 61 (53-60). Sheaths were sized between 18F and 24F. Additional endovascular procedures had to be performed in 5 (62.5%) procedures, including relining of a renal briding stentgraft, thrombectomy of the coeliac trunk, kissing stentgrafts in the aortic bifurcation, thrombectomy of a hypogastric artery, one CERAB and stenting of a renal artery. All procedures were technically successful and all patients had palpable foot pulses on completion of the procedures. No patient had clinical signs of peripheral embolization.

Conclusions

EmboSafe is a very valid addition to the vascular surgeon's armamentarium when treating aorto-iliac thrombotic events because it is minimally invasive while still protecting against embolization and while offering the flexibility to perform additional endovascular procedures.
Multistage neurosurgical mapping of low-grade glioma relapses reveals cortical remodelling
Authors: Viganò Luca , Bello Lorenzo
Published: June 2023

This scientific commentary refers to ‘Intraoperative functional remapping unveils evolving patterns of cortical plasticity’ by Ng et al. (https://doi.org/10.1093/brain/awad116).
CD48 suppresses proliferation and migration as an immune-related prognostic signature in the cervical cancer immune microenvironment
Authors: Ma Yue , Yang Zhuo , Liu Jing , Wang Danbo
Published: June 2023

Cervical cancer (CC) is one of the most common malignant tumors in gynecology. Immunotherapy and targeted therapy are two particularly effective treatments. In this study, weighted gene co-expression network analysis and CIBERSORT algorithm that quantifies the composition of immune cells were used to analyze CC expression data based on the GEO database and identify modules related to T cells. Five candidate hub genes were identified by tumor-infiltrating immune cells estimation and Kaplan–Meier survival analysis according to CC data from The Cancer Genome Atlas (TCGA). Chemotherapeutic response, methylation, and gene mutation analyses were implemented so that the five candidate hub genes identified may be the potential biomarkers and therapeutic targets which were related to T cell infiltration. Moreover, the results of RT-qPCR revealed that CD48 was a tumor suppressor gene, which was negatively correlated with CC stages, lymph node metastasis, and differentiation. Furthermore, the functional study verified that the interference of CD48 was able to boost the proliferation and migration ability in vitro and the growth of transplanted tumors in vivo. Overall, we identified molecular targets related to immune infiltration and prognosis, regarded CD48 as a key molecule involved in the progression of CC, thus providing new insights into the development of molecular therapy and immunotherapeutics against CC.
Developmental differences in functional organization of multispectral networks
Authors: Petro Nathan M , Picci Giorgia , Embury Christine M , Ott Lauren R , Penhale Samantha H , Rempe Maggie P , Johnson Hallie J , Willett Madelyn P , Wang Yu-Ping , Stephen Julia M , Calhoun Vince D , Doucet Gaelle E , Wilson Tony W
Published: June 2023

Assessing brain connectivity during rest has become a widely used approach to identify changes in functional brain organization during development. Generally, previous works have demonstrated that brain activity shifts from more local to more distributed processing from childhood into adolescence. However, the majority of those works have been based on functional magnetic resonance imaging measures, whereas multispectral functional connectivity, as measured using magnetoencephalography (MEG), has been far less characterized. In our study, we examined spontaneous cortical activity during eyes-closed rest using MEG in 101 typically developing youth (9–15 years old; 51 females, 50 males). Multispectral MEG images were computed, and connectivity was estimated in the canonical delta, theta, alpha, beta, and gamma bands using the imaginary part of the phase coherence, which was computed between 200 brain regions defined by the Schaefer cortical atlas. Delta and alpha connectivity matrices formed more communities as a function of increasing age. Connectivity weights predominantly decreased with age in both frequency bands; delta-band differences largely implicated limbic cortical regions and alpha band differences in attention and cognitive networks. These results are consistent with previous work, indicating the functional organization of the brain becomes more segregated across development, and highlight spectral specificity across different canonical networks.
Platforming populism: the services transition, precarious urbanization, and digital platforms in the rise of illiberal populism in the Philippines
Authors: Cruz Jerik , de la Cruz Emille
Published: June 2023

Existing research on the adverse impact of digital platforms on democratic politics has generally focussed on supply side factors underlying illiberal populism. Yet by reinforcing a services-led growth model of capitalism in the developing world, the platform economy has also been implicated on the demand-side of the global populist upsurge by fostering new insecure classes as well as precarious urbanisation patterns. Through a case study of the rise of Rodrigo Duterte in the Philippines’ 2016 elections, we show how our theoretical argument has unfolded in one of the most well-known cases of illiberal populism within the Global South. Even while waging unprecedented disinformation campaigns on social media, the political opportunity structure underlying Duterte’s electoral victory in 2016 was fostered by the growth of ‘rising yet insecure’ classes linked to the Philippines’ services and platform economy, as well as the socio-spatial legacies of the country’s experience of premature deindustrialisation.
Fatigue in Patients with Newly Diagnosed Inflammatory Bowel Disease: Results from a Prospective Inception Cohort, the IBSEN III Study
Authors: Holten Kristina I Aass , Bernklev Tomm , Opheim Randi , Johansen Ingunn , Olsen Bjørn C , Lund Charlotte , Strande Vibeke , Medhus Asle W , Perminow Gøri , Bengtson May-Bente , Cetinkaya Raziye Boyar , Vatn Simen , Frigstad Svein Oskar , Aabrekk Tone B , Detlie Trond Espen , Hovde Øistein , Kristensen Vendel A , Småstuen Milada Cvancarova , Henriksen Magne , Huppertz-Hauss Gert , Høivik Marte Lie , Jelsness-Jørgensen Lars-Petter
Published: June 2023

Background and Aims

Although fatigue is common in inflammatory bowel disease [IBD], its pathogenesis remains unclear. This study aimed to determine the prevalence of fatigue and its associated factors in a cohort of patients newly diagnosed with IBD.

Methods

Patients ≥18 years old were recruited from the Inflammatory Bowel Disease South-Eastern Norway [IBSEN III] study, a population-based, observational inception cohort. Fatigue was assessed using the Fatigue Questionnaire and compared with data from a Norwegian general population. Univariate and multivariate linear and logistic regression analyses were performed to evaluate the associations of total fatigue [TF; continuous score] and substantial fatigue [SF; dichotomized score ≥4] with sociodemographic, clinical, endoscopic, laboratory, and other relevant patient data.

Results

In total, 983/1509 [65.1%] patients with complete fatigue data were included (ulcerative colitis [UC], 68.2%; Crohn’s disease [CD], 31.8%). The prevalence of SF was higher in CD [69.6%] compared with UC [60.2%] [p < 0.01], and in both diagnoses when compared to the general population [p < 0.001]. In multivariate analyses, depressive symptoms, pain intensity, and sleep disturbances were associated with increased TF for both diagnoses. In addition, increased clinical disease activity and Mayo endoscopic score were significantly associated with TF in UC, whereas all disease-related variables were insignificant in CD. Similar findings were observed for SF, except regarding the Mayo endoscopic score.

Conclusions

SF affects approximately two-thirds of patients newly diagnosed with IBD. Fatigue was associated with depressive symptoms, sleep disturbances, and increased pain intensity in both diagnoses, while clinical and endoscopic activity were associated factors only in UC.
Transgenerational sperm DMRs escape DNA methylation erasure during embryonic development and epigenetic inheritance
Authors: Ben Maamar Millissia , Wang Yue , Nilsson Eric E , Beck Daniel , Yan Wei , Skinner Michael K
Published: June 2023

Germline transmission of epigenetic information is a critical component of epigenetic inheritance. Previous studies have suggested that an erasure of DNA methylation is required to develop stem cells in the morula embryo. An exception involves imprinted genes that escape this DNA methylation erasure. Transgenerational differential DNA methylation regions (DMRs) have been speculated to be imprinted-like and escape this erasure. The current study was designed to assess if morula embryos escape the erasure of dichlorodiphenyltrichloroethane–induced transgenerational sperm DMR methylation. Observations demonstrate that the majority (98%) of transgenerational sperm DMR sites retain DNA methylation and are not erased, so appearing similar to imprinted-like sites. Interestingly, observations also demonstrate that the majority of low-density CpG genomic sites had a significant increase in DNA methylation in the morula embryo compared to sperm. This is in contrast to the previously observed DNA methylation erasure of higher-density CpG sites. The general erasure of DNA methylation during embryogenesis appears applicable to high-density DNA methylation sites (e.g. CpG islands) but neither to transgenerational DMR methylation sites nor to low-density CpG deserts, which constitute the vast majority of the genome’s DNA methylation sites. The role of epigenetics during embryogenesis appears more dynamic than the simple erasure of DNA methylation.
Statin therapy reduces dementia risk in atrial fibrillation patients receiving oral anticoagulants
Authors: Kim Moo Hyun , Yuan Song Lin , Lee Kwang Min , Jin Xuan , Song Zhao Yan , Park Jong-Sung , Cho Young-Rak , Lim Kyunghee , Yun Sung-Cheol , Lee Michael S , Choi Sun Young
Published: June 2023

Aims

Atrial fibrillation (AF) is linked to an increased risk of dementia, even in stroke-free patients. The impact of statin therapy on dementia risk is unclear in AF patients receiving oral anticoagulant (OAC) (vitamin K antagonist and direct-acting OAC). We sought to investigate the impact of statin therapy on dementia risk in AF patients receiving OAC.

Methods and results

Using the Korean National Health Insurance Service database, 91 018 non-valvular AF (NVAF) patients from January 2013 to December 2017 were included in the analysis. Of the total, 17 700 patients (19.4%) were in the statin therapy group, and 73 318 patients (80.6%) were in the non-statin therapy group. The primary endpoint was the occurrence of dementia. The median duration of follow-up was 2.1 years. Statin therapy was associated with a significantly lower dementia risk than non-statin therapy for CHA2DS2-VASc scores ≥2 (hazard ratio = 0.77, 95% confidence interval 0.64–0.90, P = 0.026) in NVAF patients receiving OAC. The statin therapy group had a significantly lower dementia risk in a dose-dependent relationship compared with the non-statin therapy group (P for trend <0.001).

Conclusion

In NVAF patients who received OAC, statin therapy lowered the dementia risk compared with no statin therapy. Furthermore, statin therapy is associated with a dose-dependent reduction in dementia risk.
Cardiovascular disease burden due to productivity losses in European Society of Cardiology countries
Authors: Luengo-Fernandez Ramon , Little Matthew , Gray Alastair , Torbica Aleksandra , Maggioni Aldo P , Huculeci Radu , Timmis Adam D , Vardas Panos , Leal Jose
Published: June 2023

Objective

Cardiovascular disease (CVD) is the leading cause of death across Europe. We estimated lost earnings (productivity losses) associated with premature mortality due to CVD, and separately for its main sub-categories of coronary heart disease and cerebrovascular disease, across 54 country members of the European Society of Cardiology (ESC).

Methods and results

We used a standardized approach to estimate working years and earnings lost due to premature death resulting from CVD across the 54 ESC member countries in 2018. Our population-based approach was based on national data on the number of deaths, employment rates, and earnings by age group and sex. We discounted future working years and earnings lost to present values using a 3.5% annual rate. In 2018, there were 4.4 million deaths due to CVD across the 54 countries, with 7.1 million working years lost. This represented productivity losses due to premature death of €62 billion in 2018. Deaths due to coronary heart disease accounted for 47% (€29 billion) of all CVD costs, and cerebrovascular disease accounted for 18% (€11 billion). Approximately 60% (€37 billion) of all productivity losses occurred in the 28 European Union member states, despite accounting for only 42% (1.8 million) of deaths and 21% (1.5 million) of working years lost across the 54 countries.

Conclusion

Our study provides a snapshot of the economic consequences posed by premature mortality due to CVD across 54 countries in 2018. The considerable variation across countries highlights the potential gains from policies targeting prevention and care of cardiovascular diseases.
Plasma Level of ATPase Inhibitory Factor 1 and Intrinsic Capacity in Community-Dwelling Older Adults: Prospective Data From the MAPT Study
Authors: da Silva Jaqueline Aragoni , Martinez Laurent O , Rolland Yves , Najib Souad , Croyal Mikaël , Perret Bertrand , Jabrane-Ferrat Nabila , El Costa Hicham , Guyonnet Sophie , Vellas Bruno , de Souto Barreto Philipe ,   for the MAPT/DSA group
Published: June 2023

Background

Intrinsic capacity (IC) is a concept related to functionality that reflects healthy aging. ATPase inhibitory factor 1 (IF1) is a multifaceted protein that regulates mitochondrial oxidative phosphorylation (OXPHOS), and may be involved in IC. The objective of this study is to investigate the association between plasma levels of IF1 and IC changes in community-dwelling older adults.

Methods

Community-dwelling older adults from the Multidomain Alzheimer Preventive Trial (MAPT Study) were enrolled in this study. A composite IC score was calculated based on 4 IC domains: locomotion, psychological dimension, cognition, and vitality (with data available annually over 4 years of follow-up). Secondary analyses were conducted on the sensory domain (with data available only for 1 year of follow-up). Mixed-model linear regression adjusted for confounders was conducted.

Results

A total of 1 090 participants with usable IF1 values were included in the study (75.3 ± 4.4 years; 64% females). Compared to the lowest quartile, both the low– and high–intermediate IF1 quartiles were found to be cross-sectionally associated with greater composite IC scores across 4 domains (βlow–intermediate, 1.33; 95% confidence interval [CI] 0.06–2.60 and βhigh–intermediate, 1.78; 95% CI 0.49–3.06). In the secondary analyses, the highest quartile was found to be associated with a slower decline in composite IC scores across 5 domains over 1 year (βhigh 1.60; 95% CI 0.06–3.15). The low– and high–intermediate IF1 quartiles were also found to be cross-sectionally associated with greater locomotion (βlow–intermediate, 2.72; 95% CI 0.36–5.08) and vitality scores (βhigh–intermediate, 1.59; 95% CI 0.06–3.12), respectively.

Conclusions

This study is the first to demonstrate that levels of circulating IF1, a mitochondrial-related biomarker, are associated with IC composite scores in both cross-sectional and prospective analyses among community-dwelling older adults. However, further research is needed to confirm these findings and elucidate the potential underlying mechanisms that may explain these associations.
Examining the Association of Pain and Pain Frequency With Self-Reported Difficulty in Activities of Daily Living and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults: Findings From the Longitudinal Aging Study in India
Authors: Muhammad Thalil , Rashid Muhammed , Zanwar Preeti Pushpalata
Published: June 2023

Objectives

We examined the prevalence and associations of self-reported difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) with pain among community-dwelling older adults in India. We also explored the interaction effects of age and sex in these associations.

Methods

We used the Longitudinal Ageing Study in India (LASI) Wave 1 data (2017–2018). Our unweighted sample included 31,464 older adults aged 60 years and above. Outcome measures were having difficulty in at least 1 ADL/IADL. We conducted multivariable logistic regression analyses to examine the association of pain with functional difficulties controlling for selected variables.

Results

A total of 23.8% of older adults reported ADL and 48.4% reported IADL difficulty. Among older adults who reported pain, 33.1% reported difficulty in ADL and 57.1% reported difficulty in IADL. The adjusted odds ratio (aOR) for ADL was 1.83 (confidence interval [CI]: 1.70–1.96) and for IADL was 1.43 (CI: 1.35–1.51) when respondents reported pain compared with those without pain. Older adults who reported frequent pain had 2.28 and 1.67 times higher odds of ADL (aOR: 2.28; CI: 2.07–2.50) and IADL difficulty (aOR: 1.67; CI: 1.53–1.82) compared with those with no pain. Additionally, age and sex of the respondents significantly moderated the associations of pain and difficulty in ADL and IADL.

Discussion

Given the higher prevalence and likelihood of functional difficulties among older Indian adults who experienced frequent pain, interventions to mitigate pain in this vulnerable population are needed to ensure active and healthy aging.
Critique and Postcritique: Analyzing Age Stereotypes in Literary Studies and Health Care
Authors: Wohlmann Anita
Published: June 2023

Background and Objectives

Gerontological research shows that stereotypes about older people negatively impact the quality of health care they receive. Therefore, knowledge of ageism is particularly relevant for medical students. Narrative Medicine draws on theory and methods from literary studies to interlace the humanities and medical studies.

Research Design and Methods

This paper first describes a Narrative Medicine intervention at the University of Southern Denmark where medical students learn about ageism and stereotypes through a presentation of gerontological research results. In addition, literary texts and methods of close reading and reflective writing are employed to help students identify problematic stereotypes. The results of a survey conducted during the intervention suggest that students’ awareness about ageism increased. Yet, rather than exploring the results of the survey, this paper’s second part uses the intervention as a springboard to self-critically ask what type of humanities approaches, methods and theories are best suited to convey knowledge about ageist stereotypes. The paper sketches 2 approaches within literary studies—critique and postcritique—and applies them to a poem about an older man.

Results

The paper discusses the gains and limitations of each approach and makes suggestions for how they can be joined with research about age stereotypes.

Discussion and Implications

To create productive pathways between the humanities and gerontology, the heterogeneity of the humanities—with literary studies as the example—need to be acknowledged. That is, clarity about the differences in humanities-based methods is crucial to establish a firmer ground for their usability in interdisciplinary contexts.
Molecular and genetic regulations of fleshy fruit shape and lessons fromArabidopsisand rice
Authors: Li Qiang , Luo Shuangxia , Zhang Liying , Feng Qian , Song Lijun , Sapkota Manoj , Xuan Shuxin , Wang Yanhua , Zhao Jianjun , van der Knaap Esther , Chen Xueping , Shen Shuxing
Published: June 2023

Fleshy fruit shape is an important external quality trait influencing the usage of fruits and consumer preference. Thus, modification of fruit shape has become one of the major objectives for crop improvement. However, the underlying mechanisms of fruit shape regulation are poorly understood. In this review we summarize recent progress in the genetic basis of fleshy fruit shape regulation using tomato, cucumber, and peach as examples. Comparative analyses suggest that the OFP-TRM (OVATE Family Protein - TONNEAU1 Recruiting Motif) and IQD (IQ67 domain) pathways are probably conserved in regulating fruit shape by primarily modulating cell division patterns across fleshy fruit species. Interestingly, cucumber homologs of FRUITFULL (FUL1), CRABS CLAW (CRC) and 1-aminocyclopropane-1-carboxylate synthase 2 (ACS2) were found to regulate fruit elongation. We also outline the recent progress in fruit shape regulation mediated by OFP-TRM and IQD pathways in Arabidopsis and rice, and propose that the OFP-TRM pathway and IQD pathway coordinate regulate fruit shape through integration of phytohormones, including brassinosteroids, gibberellic acids, and auxin, and microtubule organization. In addition, functional redundancy and divergence of the members of each of the OFP, TRM, and IQD families are also shown. This review provides a general overview of current knowledge in fruit shape regulation and discusses the possible mechanisms that need to be addressed in future studies.
Heterothermic Migration Strategies in Flying Vertebrates
Authors: McGuire Liam P , Leys Ryan , Webber Quinn M R , Clerc Jeff
Published: June 2023

Synopsis

Migration is a widespread and highly variable trait among animals. Population-level patterns arise from individual-level decisions, including physiological and energetic constraints. Many aspects of migration are influenced by behaviors and strategies employed during periods of stopover, where migrants may encounter variable or unpredictable conditions. Thermoregulation can be a major cost for homeotherms which largely encounter ambient temperatures below the lower critical temperature during migration, especially during the rest phase of the daily cycle. In this review we describe the empirical evidence, theoretical models, and potential implications of bats and birds that use heterothermy to reduce thermoregulatory costs during migration. Torpor-assisted migration is a strategy described for migrating temperate insectivorous bats, whereby torpor can be used during periods of inactivity to drastically reduce thermoregulatory costs and increase net refueling rate, leading to shorter stopover duration, reduced fuel load requirement, and potential consequences for broad-scale movement patterns and survival. Hummingbirds can adopt a similar strategy, but most birds are not capable of torpor. However, there is an increasing recognition of the use of more shallow heterothermic strategies by diverse bird species during migration, with similarly important implications for migration energetics. A growing body of published literature and preliminary data from ongoing research indicate that heterothermic migration strategies in birds may be more common than traditionally appreciated. We further take a broad evolutionary perspective to consider heterothermy as an alternative to migration in some species, or as a conceptual link to consider alternatives to seasonal resource limitations. There is a growing body of evidence related to heterothermic migration strategies in bats and birds, but many important questions related to the broader implications of this strategy remain.
Natural Animal Populations as Model Systems for Understanding Early Life Adversity Effects on Aging
Authors: Patterson Sam K , Petersen Rachel M , Brent Lauren J N , Snyder-Mackler Noah , Lea Amanda J , Higham James P
Published: June 2023

Synopsis

Adverse experiences in early life are associated with aging-related disease risk and mortality across many species. In humans, confounding factors, as well as the difficulty of directly measuring experiences and outcomes from birth till death, make it challenging to identify how early life adversity impacts aging and health. These challenges can be mitigated, in part, through the study of non-human animals, which are exposed to parallel forms of adversity and can age similarly to humans. Furthermore, studying the links between early life adversity and aging in natural populations of non-human animals provides an excellent opportunity to better understand the social and ecological pressures that shaped the evolution of early life sensitivities. Here, we highlight ongoing and future research directions that we believe will most effectively contribute to our understanding of the evolution of early life sensitivities and their repercussions.
Searching for Principles of Microbial Ecology Across Levels of Biological Organization
Authors: Gralka Matti
Published: June 2023

Synopsis

Microbial communities play pivotal roles in ecosystems across different scales, from global elemental cycles to household food fermentations. These complex assemblies comprise hundreds or thousands of microbial species whose abundances vary over time and space. Unraveling the principles that guide their dynamics at different levels of biological organization, from individual species, their interactions, to complex microbial communities, is a major challenge. To what extent are these different levels of organization governed by separate principles, and how can we connect these levels to develop predictive models for the dynamics and function of microbial communities? Here, we will discuss recent advances that point towards principles of microbial communities, rooted in various disciplines from physics, biochemistry, and dynamical systems. By considering the marine carbon cycle as a concrete example, we demonstrate how the integration of levels of biological organization can offer deeper insights into the impact of increasing temperatures, such as those associated with climate change, on ecosystem-scale processes. We argue that by focusing on principles that transcend specific microbiomes, we can pave the way for a comprehensive understanding of microbial community dynamics and the development of predictive models for diverse ecosystems.
Bivalent Coronavirus Disease 2019 Vaccine Antibody Responses to Omicron Variants Suggest That Responses to Divergent Variants Would Be Improved With Matched Vaccine Antigens
Authors: Wang Wei , Goguet Emilie , Paz Stephanie , Vassell Russell , Pollett Simon , Mitre Edward , Weiss Carol D
Published: June 2023

We compared neutralizing antibody responses to BA.4/5, BQ.1.1, XBB, and XBB.1.5 Omicron severe acute respiratory syndrome coronavirus 2 variants after a bivalent or ancestral coronavirus disease 2019 (COVID-19) messenger RNA booster vaccine or postvaccination infection. We found that the bivalent booster elicited moderately high antibody titers against BA.4/5 that were approximately 2-fold higher against all Omicron variants than titers elicited by the monovalent booster. The bivalent booster elicited low but similar titers against both XBB and XBB.1.5 variants. These findings inform risk assessments for future COVID-19 vaccine recommendations and suggest that updated COVID-19 vaccines containing matched vaccine antigens to circulating divergent variants may be needed.
Te heahea me ngā toi, te hikohiko: Productive Idiocy, mātauranga Māori and Art-activism Strategies in Aotearoa/New Zealand
Authors: Harvey Mark
Published: June 2023

This article explores what it can mean to navigate notions of productive idiocy with aspects of mātauranga Māori (Māori knowledge), through some recent art-as-activism practices of the author, Aotearoa/New Zealand artist Mark Harvey. The works explicated include Waitākere Drag and Auau in the Te Wao Nui ā Tiriwa forest ranges and Productive Promises, which was part of TEZA (Trans Economic Zone of Aotearoa) in Ōtautahi/Christchurch. Avital Ronell’s Nietzschean-influenced perspectives on idiocy are drawn from in relation to Western and Māori perspectives, along with Roger Sansi’s work on idiocy as dissent. From this aggregation of epistemologies, it is proposed that idiocy can be productive through art as activism and that this can align with Indigenous Māori perspectives on playing the fool as a form of resistance and refusal. Examples of Māori concepts engaged with here include perspectives on relationship building, human relationships with forests and the environment, and sovereignty under Te Tiriti o Waitangi (The Treaty of Waitangi). These art-activism projects promised micro-attempts at making positive changes for the communities in which they were situated through performatively generated actions from a Māori perspective within the shroud of ongoing colonization and capitalism.
Increased prevalence and stable clustering rate of HIV-1 transmitted drug resistance strains after ‘treat-all’ in a megacity of China
Authors: Zhang Dong , Han Jingwan , Li Hanping , Zheng Chenli , Liu Zhi , Sun Zixuan , Li Hao , Li Tianyi , Wang Xiaolin , Chen Lin , Yang Zhengrong , Lan Chunlin , Li Siqi , Jia Lei , Gan Yongxia , Zhong Yifan , Li Jingyun , Li Lin , Zhao Jin
Published: June 2023

Objectives

The ‘treat-all’ strategy was implemented in Shenzhen, China in 2016. The effect of this extensive treatment on transmitted drug resistance (TDR) of HIV is unclear.

Methods

TDR analysis was performed, based on the partial HIV-1 pol gene obtained from the newly reported HIV-1 positive cases from 2011 to 2019 in Shenzhen, China. The HIV-1 molecular transmission networks were inferred to analyse the spread of TDR. Logistic regression was used to identify the potential risk factors with TDR mutations (TDRMs) to cluster.

Results

A total of 12 320 partial pol sequences were included in this study. The prevalence of TDR was 2.95% (363/12 320), which increased from 2.57% to 3.52% after ‘treat-all’. The TDR prevalence was increased in populations with the characteristics of CRF07_BC, being single, educated to junior college level and above, MSM and male. The sensitivities of viruses to six antiretroviral drugs were decreased. The clustering rate of TDRMs remained stable, and the sequences in the three drug resistance transmission clusters (DRTCs) were mainly found during 2011–16. CRF07_BC and CRF55_01B were the factors associated with TDRMs clustering in the networks.

Conclusions

The ‘treat-all’ strategy might have contributed to a small increase in TDR, while most of the TDRMs were distributed sporadically, which implies that the ‘treat-all’ strategy is helpful for the control of TDR in high-risk populations.
A lipid scramblase TMEM41B is involved in the processing and transport of GPI-anchored proteins
Authors: Cao Shu-Ya , Liu Yi-Shi , Gao Xiao-Dong , Kinoshita Taroh , Fujita Morihisa
Published: June 2023

Protein modification by glycosylphosphatidylinositol (GPI) takes place in the endoplasmic reticulum (ER). GPI-anchored proteins (GPI-APs) formed in the ER are transported to the cell surface through the Golgi apparatus. During transport, the GPI-anchor structure is processed. In most cells, an acyl chain modified to the inositol of GPI is removed by a GPI-inositol deacylase, PGAP1, in the ER. Inositol-deacylated GPI-APs become sensitive to bacterial phosphatidylinositol-specific phospholipase C (PI-PLC). We previously reported that GPI-APs are partially resistant to PI-PLC when PGAP1 activity is weakened by the deletion of selenoprotein T (SELT) or cleft lip and palate transmembrane protein 1 (CLPTM1). In this study, we found that the loss of TMEM41B, an ER-localized lipid scramblase, restored PI-PLC sensitivity of GPI-APs in SELT-knockout (KO) and CLPTM1-KO cells. In TMEM41B-KO cells, the transport of GPI-APs as well as transmembrane proteins from the ER to the Golgi was delayed. Furthermore, the turnover of PGAP1, which is mediated by ER-associated degradation, was slowed in TMEM41B-KO cells. Taken together, these findings indicate that inhibition of TMEM41B-dependent lipid scrambling promotes GPI-AP processing in the ER through PGAP1 stabilization and slowed protein trafficking.
LUBAC-mediated linear ubiquitination in tissue homeostasis and disease
Authors: Sasaki Katsuhiro , Iwai Kazuhiro
Published: June 2023

In addition to its role in the ubiquitin–proteasome system of protein degradation, polyubiquitination is involved in the regulation of intracellular events. Depending on the type of ubiquitin–ubiquitin linkage used, polyubiquitin can assume several types of structures. The spatiotemporal dynamics of polyubiquitin involve multiple adaptor proteins and induce different downstream outputs. Linear ubiquitination, in which the N-terminal methionine on the acceptor ubiquitin serves as the site for ubiquitin–ubiquitin conjugation, is a rare and atypical type of polyubiquitin modification. The production of linear ubiquitin chains is dependent on various external inflammatory stimuli and leads to the transient activation of the downstream NF-κB signalling pathway. This in turn suppresses extrinsic programmed cell death signals and protects cells from activation-induced cell death under inflammatory conditions. Recent evidence has revealed the role of linear ubiquitination in various biological processes under both physiological and pathological conditions. This led us to propose that linear ubiquitination may be pivotal in the ‘inflammatory adaptation’ of cells, and consequently in tissue homeostasis and inflammatory disease. In this review, we focused on the physiological and pathophysiological roles of linear ubiquitination in vivo in response to a changing inflammatory microenvironment.
Inhalation Injury Severity Score on Admission Predicts Overall Survival in Burn Patients
Authors: Flinn Ashley N , Kemp Bohan Phillip M , Rauschendorfer Catherine , Le Tuan D , Rizzo Julie A
Published: June 2023

Inhalation injury is diagnosed in up to one-third of burn patients and is associated with increased morbidity and mortality. There are multiple scoring systems to grade inhalation injury, but no study has evaluated the ability of these scoring systems to predict outcomes of interest such as overall survival. We conducted a prospective, observational study of 99 intubated burn patients who underwent fiberoptic bronchoscopy within 24 hr of admission and graded inhalation injury using three scoring systems: abbreviated injury score (AIS), inhalation injury severity score (I-ISS), and mucosal score (MS). Agreement between scoring systems was assessed with Krippendorff’s alpha (KA). Multivariable analyses were conducted to determine if variables were associated with overall survival. At admission, median AIS, I-ISS, and MS scores were 2 for all scoring systems. Patients who died had higher overall injury burden than those who survived and had similar median admission AIS and MS scores, but higher I-ISS scores. There was strong correlation between the inhalation injury grade at admission using the three scoring systems (KA = 0.85). On regression analysis, the only scoring system independently associated with overall survival was I-ISS (score 3 compared to scores 1–2: OR 13.16, 95% CI 1.65–105.07; P = .02). Progression of injury after initial assessment may contribute to the poor correlation between admission score and overall survival for injuries graded with AIS and MS. Repeated assessment may more accurately identify patients at increased risk for mortality.
An Observational Study of Knowledge of First Aid for Burns among Parents in Indonesia
Authors: Wahyuningtyas Eka Sakti , Handayani Estrin , Wijayatri Ratna , Wardani Septi
Published: June 2023

Burns represent a large portion of injuries attending emergency departments each year, with children accounting for the biggest proportion. Appropriate first aid has been shown to help improve the outcome of burns and decrease the need for surgical intervention. Several studies outside of Indonesia demonstrate inadequate parental knowledge of burns first aid, but few evaluated interventions to improve knowledge. A period of data gathering from June to September 2022 was included the parents who have offspring aged between 18 and 12. This questionnaire was developed to achieve the objectives of this study and was based on others of a similar nature. A total of 102 participants were included in this study. In total, 102 parents (79.4% female [n = 81], 20.6% male [n = 21]) were questioned. Baseline knowledge was found to be poor overall; it was found that nearly 91% of parents did not know the first-aid procedures for treating pediatric burns. However, educational initiatives were effective in advancing this knowledge. When a child got burned, nearly 68% of parents knew to use cold running water, and about 70% knew to get help from a doctor. Cold running water being applied is an extremely positive sign, which can have the most beneficial effect on the healing of the injury. No other variables analyzed were shown to be statistically significant predictors of pre- or post-test scores (all P > 0.05). This study concluded that educational knowledge was effective to improve the parents’ ability in performing first aid for burn care.
Successful open surgery repair of isolated right diaphragmatic rupture in 1-year-old patient at Muhimbili National Hospital: a case report and literature review
Authors: Brighton Meshack Mushobozi , Kyaruzi Victor Meza , Nhungo Charles , Mwakimako Hassan , Salim Mohamed , Khamisi Ramadhani , Mwanga Ally
Published: June 2023

Diaphragmatic ruptures rarely occur in isolation, a pathology in paediatric that is difficult to diagnose and can lead to serious complications if left untreated. We present a rare case of isolated right diaphragmatic rupture with liver herniation that was successfully repaired, along with a literature review. A 1-year-old female child was admitted at Emergency Department after being involved in a motor traffic crash as a passenger. Based on clinical presentation and radiological findings, we diagnosed a diaphragmatic rapture, laparotomy was performed in which we found a right isolated diaphragmatic rupture, which was repaired primarily. After re-evaluations, the patient was discharged day 16 postoperative. It is essentially important to evaluate the level of organ damage thoroughly for making a timely informed decision in management paediatric chest trauma.
Air pollution crisis in Southeast Asia and its impact on international travellers
Authors: Kitro Amornphat , Panumasvivat Jinjuta , Pisutsan Phimphan , Matsee Wasin
Published: June 2023

Air pollution levels in Southeast Asia have increased, affecting the health of tourists. While short-term effects are reversible, prolonged exposure poses significant risks, particularly for those with pre-existing conditions. Effective communication and awareness are crucial to minimize harm, and urgent action is needed for traveller well-being and global health.
Increased antimicrobial resistance among non-typhoidal Salmonella infections in international travellers returning to the Netherlands
Authors: Chanamé-Pinedo Linda , Franz Eelco , van den Beld Maaike , Veldman Kees , Pijnacker Roan , Mughini-Gras Lapo
Published: June 2023

Highlights Increased fluoroquinolone resistance in the two most common non-typhoidal Salmonella (NTS) serotypes among travellers returning to the Netherlands.Resistant Salmonella Enteritidis infections are most likely to be acquired abroad, specifically outside Europe.This study highlights the importance of travel history when patients with NTS infections require empiric antimicrobial treatment.
Phenomic data-driven biological prediction of maize through field-based high-throughput phenotyping integration with genomic data
Authors: Adak Alper , Kang Myeongjong , Anderson Steven L , Murray Seth C , Jarquin Diego , Wong Raymond K W , Katzfuß Matthias
Published: June 2023

High-throughput phenotyping (HTP) has expanded the dimensionality of data in plant research; however, HTP has resulted in few novel biological discoveries to date. Field-based HTP (FHTP), using small unoccupied aerial vehicles (UAVs) equipped with imaging sensors, can be deployed routinely to monitor segregating plant population interactions with the environment under biologically meaningful conditions. Here, flowering dates and plant height, important phenological fitness traits, were collected on 520 segregating maize recombinant inbred lines (RILs) in both irrigated and drought stress trials in 2018. Using UAV phenomic, single nucleotide polymorphism (SNP) genomic, as well as combined data, flowering times were predicted using several scenarios. Untested genotypes were predicted with 0.58, 0.59, and 0.41 prediction ability for anthesis, silking, and terminal plant height, respectively, using genomic data, but prediction ability increased to 0.77, 0.76, and 0.58 when phenomic and genomic data were used together. Using the phenomic data in a genome-wide association study, a heat-related candidate gene (GRMZM2G083810; hsp18f) was discovered using temporal reflectance phenotypes belonging to flowering times (both irrigated and drought) trials where heat stress also peaked. Thus, a relationship between plants and abiotic stresses belonging to a specific time of growth was revealed only through use of temporal phenomic data. Overall, this study showed that (i) it is possible to predict complex traits using high dimensional phenomic data between different environments, and (ii) temporal phenomic data can reveal a time-dependent association between genotypes and abiotic stresses, which can help understand mechanisms to develop resilient plants.