bluuebunny/crossref_metadata_2025 huggingface dataset:
Circulatory Support for Repair of Cerebral Aneurysms Using Heparin-Bonded Bypass Circuits and Low-Dose Heparin
Authors: DeFoe Gordon R. , Harbaugh Robert E. , Shumaker Grant H. , DioDato Christian P. , Dame Norman A. , Farrell Mark S. , Marrin Charles A.S. , Dacey Lawrence J. , Sanders John H. , Nugent William C.
Published: August 2023

Modern advances in neurosurgical technique and improvements in cardiopulmonary bypass technology have facilitated a renewed interest in the ligation of giant cerebral aneurysms utilizing deep hypothermia and low-flow conditions. The widespread introduction of biocompatible heparin-bonded bypass circuits presents perfusionists with the opportunity to curtail sharply the need for heparin and protamine in these patients. We briefly discuss the merits of this procedure and describe our clinical experience.
The Effect of Temperature Management During Cardiopulmonary Bypass on Clinical Outcome in Pediatric Patients Undergoing Correction of Ventricular Septal Defect
Authors: Golab H.D. , Wijers M.J. , Witsenburg M. , Bol-Raap G. , Cruz E. , Bogers A.J.J.C.
Published: August 2023

Moderate hypothermia of 28°C is widely accepted in cardiac surgery with cardiopulmonary bypass (CPB). Recently, however, several studies suggested that normothermic or “tepid” bypass techniques may improve the clinical outcome for patients undergoing cardiac operations.

To assess the effect of bypass temperature management strategy in pediatric patients undergoing correction of ventricular septal defect, 26 patients with body weight under 10 kg were randomly assigned to two treatment groups: Group 1, mild hypothermia, patients cooled to nasopharyngeal temperature of 32°C during the bypass; or Group 2, moderate hypothermia of 28°C. Clinical parameters were recorded, and blood samples were obtained just before, during, and 24 hours after operation.

All the population characteristics and intraoperative variables were similar in the two groups. Hematologic data after CPB and protamine administration revealed a significantly (p < .05) longer activated partial thromboplastin time in the 32°C group; however, the difference in blood loss did not reach significance. Our study shows that both perfusion temperatures equally well facilitated CPB for this type of intracardiac surgery.
Impact of Hollow-Fiber Membrane Surface Area on Oxygenator Performance: Dideco D903 Avant Versus a Prototype with Larger Surface Area
Authors: Mueller Xavier M. , Tevaearai Hendrick T. , Jegger David , Boone Yves , Augstburger Monique , von Segesser Ludwig K.
Published: August 2023

This study compares the gas transfer capacity, the blood trauma, and the blood path resistance of the hollow-fiber membrane oxygenator Dideco D 903 with a surface area of 1.7 m2 (oxygenator 1.7) versus a prototype built on the same principles but with a surface area of 2 m2 (oxygenator 2).

Six calves (mean body weight: 68.2 ± 3.2 kg) were connected to cardiopulmonary bypass (CPB) by jugular venous and carotid arterial cannulation, with a mean flow rate of 4l/min for 6 h. They were randomly assigned to oxygenator 1.7 (N = 3) or 2 (N = 3). After 7 days, the animals were sacrificed. A standard battery of blood samples was taken before the bypass, throughout the bypass, and 24 h, 48 h, and 7 days after the bypass.

The oxygenator 2 group showed significantly better total oxygen and carbon dioxide transfer values throughout the perfusion (p < .001 for both comparison). Hemolytic parameters (lactate dehydrogenase and free plasma hemoglobin) exhibited a slight but significant increase after 5 h of bypass in the oxygenator 1.7 group. The pressure drop through the oxygenator was low in both groups (range, 43–74 mmHg).

With this type of hollow-fiber membrane oxygenator, an increased surface of gas exchange from 1.7m2 to 2 m2 improves gas transfer, with a limited impact on blood trauma and no increase of blood path resistance.
Perfusion Technique for Perfusion-Assisted Direct Coronary Artery Bypass (PADCAB)
Authors: Steele Mark , Palmer-Steele Candace
Published: August 2023

The role for the perfusionist has changed at many institutions that perform Off-Pump Coronary Artery Bypass (OPCAB). Surgeons at our hospitals have adapted a technique called Perfusion-Assisted Direct Coronary Bypass (PADCAB) (1). A simple circuit and pump have been devised for the perfusionist to deliver arterial blood to the myocardium immediately after the completion of the distal coronary anastomosis. Flow is controlled by a pressure-sensing servomechanism, and grafts are perfused at systemic or suprasystemic pressure. The pump is capable of delivering optional agents for myocardial vasodilatation, myocardial resuscitation, and for increasing myocardial performance.
HeartSaver VAD: A Totally Implantable Ventricular Assist Device. Results of In Vivo Studies
Authors: Mussivand Tofy , Henry Paul J. , Masters Roy G. , Keon Wilbert J.
Published: August 2023

Currently, the most widely utilized ventricular assist devices (VADs) require percutaneous connections and are located either externally (e.g., Thoratec, Abiomed) or intra-abdominally (e.g., Novacor, TCI). These attributes have been implicated in a variety of complications (infection, thromboembolic, gastrointestinal, etc.). To address these concerns, a totally implantable VAD that requires no percutaneous connections and can be implanted in the left hemi-thorax has been developed.

The developed device has undergone in vivo evaluation as part of the design and development process. A total of 43 implants in the bovine model, with 5 device versions, have been conducted between July 1992 and February 2000. These studies successfully have demonstrated several important aspects of the developed device, including 1) feasibility of a totally implantable system; 2) capability of the device to support a dysfunctional heart; and 3) ability of the device to provide flows up to 10 L/min in a physiological setting.

The studies to date have played a vital role in the design and development process as well as demonstrating the feasibility of a totally implantable intrathoracic VAD. Based on these studies, design optimization was conducted, resulting in the development of the pre-clinical version of the device in preparation for clinical trials.
An Experimental Evaluation of Continuous Cardiotomy Reservoir Ultrafiltration
Authors: Niimi Kevin S. , Stammers Alfred H. , Tremain Kimberly D. , Glogowski Kimberly R. , Trowbridge Cody C. , Muhle Michelle L. , Yang Tianyu , Jiang Jun
Published: August 2023

Ultrafiltration has been suggested as a means to reduce the morbidity associated with blood activation. However, the application of ultrafiltration to the highly activated blood of the cardiotomy suction subcircuit has not been investigated. The purpose of this study was to determine whether cardiotomy reservoir ultrafiltration (CRUF) would be effective in altering cytokine levels. Six swine, undergoing 90 min of cardiopulmonary bypass (CPB), were divided into two groups; one group was assigned to receive CRUF (N = 3), the other was to serve as controls and did not receive ultrafiltration (N = 3). Blood samples were analyzed for hematocrit, plasma-free hemoglobin, total protein, interleukin-8 (IL-8), and tumor necrosis factor alpha (TNF-α). Samples were taken pre-bypass, post-heparinization, every 30 min during CPB, post-CPB and post-protamine. All data were analyzed using a one-way analysis of variance (ANOVA), with significance accepted at p < .05. There were no significant differences found between treatment and control groups for plasma-free hemoglobin levels (22.4 ± 22.2 vs. 14.6 ± 14.4; 40.1 ± 26.1 vs. 40.0 ± 19.3). After 90 min of ultrafiltration, there was a significant decrease in TNF-α (261.6 ± 119.6 vs. 71.8 ± 11.4; p 4 .02). Although IL-8 levels decreased from throughout the experiment, concentrations did not reach statistical significance. In conclusion, CRUF can be used without increasing cellular destruction, and can decrease certain cytokine levels. Our results suggest that further clinical studies should be undertaken utilizing this technique with a larger sample size.
Evidence of Increased Matrix Metalloproteinase-9 Concentration in Patients Following Cardiopulmonary Bypass
Authors: Steinberg J , Fink G , Picone A , Searles Bruce , Schiller H , Lee Hsi-Ming , Nieman G
Published: August 2023

Cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response, which can result in acute lung injury known as “postperfusion syndrome.” Neutrophil activation with concomitant serine protease release has been implicated in the pathogenesis of “postperfusion syndrome.” Increased plasma levels of neutrophil elastase (NE) have been demonstrated in patients undergoing CPB, and it is well documented that both NE and matrix metalloproteinase-9 (MMP-9) have a synergistic role in pulmonary injury. We, therefore, hypothesized that plasma levels of MMP-9 would be elevated in patients after CPB. Human plasma was obtained after informed consent from eight patients undergoing CPB. Plasma was collected at the start of CPB, 5 minutes after the initiation of CPB, and at the termination of CPB (156 ± 17 min). All samples were analyzed by both standard enzyme-linked immunosorbent assay (ELISA) and gelatin zymography for MMP-9 (free and total enzyme) concentration. Data were expressed as means ±SE and assessed by analysis of variance (ANOVA). Plasma MMP-9 concentration was significantly increased at the end of CPB (191±30.4 ng/mL; p <.05) as compared to both the start of CPB (28.3±13.2 ng/mL) and 5 minutes after the initiation of CPB (44.3±15.4 ng/mL). Patients undergoing CPB show an increase in serum MMP-9 levels. Prior studies utilizing an animal model of “postperfusion syndrome” have shown that inhibition of MMP-9 and NE prevented pulmonary injury following CPB. The results of the current study suggest that such an approach may also have merit in the clinical setting of cardiopulmonary bypass.
Anticoagulation Management in a Patient with an Acquired Antithrombin III Deficiency
Authors: Heller Eileen L. , Paul Leena
Published: August 2023

We report a case of heparin resistance and its management during cardiopulmonary bypass (CPB). A 63-yearold, 96 Kg female with a posterior myocardial infarction (MI) with previous deep venous thrombosis was treated with intravenous (IV) heparin infusion for 7 days before myocardial revascularization surgery. The patient required 1200 IU/Kg of beef lung heparin to extend the activated clotting time (ACT) in order to initiate CPB. A total of 1562 IU/Kg of heparin was administered throughout the procedure. This acquired heparin resistance was attributed to an antithrombin (AT III) deficiency, and was treated with fresh frozen plasma (FFP) to restore adequate anticoagulation. The patient’s heparinized ACTs ranged between 368 seconds and 387 seconds before FFP administration as opposed to 626 seconds to 1329 seconds after treatment with FFP and additional heparin once on CBP. The patient experienced an uneventful postoperative course. Future treatment with AT III concentrate rather than FFP may reduce heparin requirements that will, in turn, reduce protamine reversal dose, postoperative bleeding attributable to heparin rebound, and its associated complications.
Einsatz von spezifischen Antidots bei DOAK-assoziierter schwerer gastrointestinaler Blutung – ein Expertenkonsensus
Authors: Fuhrmann Valentin , Koscielny Jürgen , Vasilakis Thomas , Andus Tilo , Herber Adam , Fusco Stefano , Roeb Elke , Schiefke Ingolf , Rosendahl Jonas , Dollinger Matthias , Caca Karel , Tacke Frank
Published: August 2023

Gastrointestinale (GI) Blutungen gehören zu den häufigsten Komplikationen beim Einsatz direkt wirkender oraler Antikoagulanzien (DOAK). Für die Maßnahmen bei (vermuteter) GI-Blutung existieren klare (Notfall-)Algorithmen, bei denen im präendoskopischen Management die anamnestische Erfragung einer medikamentösen Antikoagulation und einfache Gerinnungstests erfolgen sollen. Zur Gerinnungsoptimierung werden beispielsweise Thrombozyten-Konzentrate, Frischplasma (FFP) oder Prothrombinkomplex-Präparate (PPSB) eingesetzt. Für schwere Blutungen unter dem Thrombin-Inhibitor Dabigatran steht Idarucizumab, für Blutungen unter den Faktor Xa-Inhibitoren Rivaroxaban oder Apixaban steht Andexanet alfa als spezifisches Antidot zur DOAK-Antagonisierung zur Verfügung. Diese Antidote stellen Notfallpräparate dar, die typischerweise erst nach Durchführung leitlinienkonformer multimodaler Maßnahmen einschließlich Notfallendoskopie eingesetzt werden. Eine Antagonisierung oraler Antikoagulanzien sollte bei schwerer gastrointestinaler Blutung in folgenden Situationen erfolgen: (1) refraktärer hämorrhagischer Schock, (2) endoskopisch unstillbare Blutungen, oder (3) nicht vermeidbare Verzögerungen bis zur Notfallendoskopie bei lebensbedrohlicher Blutung. Nach erfolgreicher (endoskopischer) Blutstillung sollte die Antikoagulation (z.B. DOAK, Vitamin-K-Antagonist, Heparin) unter Berücksichtigung des individuellen Blutungsrisikos und des Thromboembolierisikos wieder zeitnah (d.h. in der Regel innerhalb einer Woche) fortgeführt werden.
Nanodiamond in the rough
Authors: Ikenson Ben
Published: August 2023

Emerging quantum metrology tech opens doors for cellular probing and imaging in living biological systems.
Resonance instability: the link between drag and electrostatic interactions in dusty plasmas
Authors: Lange Katherine De
Published: August 2023

Examining various forms of instabilities reveals a shared framework of resonance in dusty plasmas, both in laboratory and astrophysical contexts
Machine learning classification can significantly reduce the cost of calculating the Hamiltonian matrix in CI calculations
Authors: Qu Chen , Houston Paul L. , Yu Qi , Conte Riccardo , Pandey Priyanka , Nandi Apurba , Bowman Joel M.
Published: August 2023

Hamiltonian matrices in electronic and nuclear contexts are highly computation intensive to calculate, mainly due to the cost for the potential matrix. Typically, these matrices contain many off-diagonal elements that are orders of magnitude smaller than diagonal elements. We illustrate that here for vibrational H-matrices of H2O, C2H3 (vinyl), and C2H5NO2 (glycine) using full-dimensional ab initio-based potential surfaces. We then show that many of these small elements can be replaced by zero with small errors of the resulting full set of eigenvalues, depending on the threshold value for this replacement. As a result of this empirical evidence, we investigate three machine learning approaches to predict the zero elements. This is shown to be successful for these H-matrices after training on a small set of calculated elements. For H-matrices of vinyl and glycine, of order 15 552 and 8828, respectively, training on a percent or so of elements is sufficient to obtain all eigenvalues with a mean absolute error of roughly 2 cm−1.
Effect of initial generating eddy height on formation and flame geometry of fire whirl
Authors: Ji Congcong , Liu Naian , Lei Jiao , Zhang Linhe , Xie Xiaodong , Zhang Yang
Published: August 2023

Background Fire whirl is an extreme fire behaviour in wildland fires, and an essential factor for its formation is the surrounding generating eddy. No systematic experimental study has been conducted on natural fire whirls with varying heights of the initial generating eddy. Aims The aim of this research was to provide a comprehensive experimental study on the effect of initial generating eddy height on fire whirl formation and flame characteristics. Methods The experiments were conducted in a fixed-frame facility with varying channel wall height (representing the initial generating eddy height). A 20-cm-diameter propane burner (10.0–100.0 kW in heat release rate) was used. Key results The critical channel wall height for fire whirl formation decreases with the heat release rate. The mean flame height grows remarkably with initial generating eddy height for large heat release rates, but it varies only slightly at relatively small heat release rates. Conclusions The formation of fire whirl depends on the initial generating eddy height, rotational strength, and heat release rate. A flame height correlation of the fire whirl is obtained by considering the initial generating eddy height. Implications This work provides a basis for improving the prediction accuracy of natural fire whirls in wildland fires.
Inequities in Forensic Mental Health in South Africa and Recommendations for Service Development
Authors: Pillay Anthony L. , Kramers-Olen Anne L. , Gowensmith W. Neil
Published: August 2023

The roots of South Africa’s forensic mental health system are plagued by its colonial and apartheid legacy. Extensive forensic waitlists exist partly due to restrictive criminal justice legislation and an under-funded forensic mental health system, predicated largely on European norms and standards. There are several areas of concern in South Africa’s forensic mental health system, which may be viewed as inequitable to Black Africans and other marginalized groups. Black Africans are over-represented in the forensic mental health system, and many defendants are not fluent in English – the official language of the courts. The absence of competency restoration can result in extended detention in forensic hospitals. People with intellectual disabilities are disproportionately targeted for sexual assault, and face significant barriers in attempts to achieve justice. Further, the colonial legacy of the rebuttable presumption of doli incapax (children presumed incapable of forming criminal intent) can affect determinations of children’s criminal capacity. These issues warrant change, including introducing competency restoration, improving systems for testimony by sexual violence survivors with intellectual disabilities, reconsidering the rebuttable presumption in child justice matters, and using psychologists and outpatient evaluations to address the waitlists for forensic examinations. Comparisons are also made with US standards, challenges, and developments, especially in view of the authors’ knowledge of both systems and the common challenges facing them.
Existence of sign-changing radial solutions with prescribed numbers of zeros for elliptic equations with the critical exponential growth in ℝ²
Authors: Chen Lu , Xue Ying , Zhu Maochun
Published: August 2023

In this paper, we are concerned with the existence of sign-changing radial solutions with any prescribed numbers of zeros to the following Schrodinger equation with the critical exponential growth:
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="StartLayout Enlarged left-brace 1st Row minus normal upper Delta u plus u equals lamda u e Superscript u squared Baseline in double-struck upper R squared comma 2nd Row limit Underscript StartAbsoluteValue x EndAbsoluteValue right-arrow normal infinity Endscripts u left-parenthesis x right-parenthesis equals 0 comma EndLayout">

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\begin{equation*} \begin {cases} -\Delta u +u=\lambda ue^{u^2} \quad \quad \text {in } \quad \mathbb {R}^2,\\ \displaystyle \lim _{|x|\to \infty }u(x)=0, \end{cases} \end{equation*}

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. Our proof relies on the shooting method, the Sturm’s comparison theorem and a Liouville type theorem in exterior domain of

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. It seems to be the first existence result of sign-changing solution for Schrodinger equation with the critical exponential growth.
The Curious Case of Tommy (Woodrow) Wilson
Authors: Halliwell Martin
Published: August 2023

This essay review explores the representation of the twenty-eighth president of the United States, Woodrow Wilson, in a curious project involving Austrian psychoanalyst Sigmund Freud and US diplomat William C. Bullitt that began soon after Wilson’s death in 1924. The article focuses on political scientist Patrick Weil’s investigative account of this collaborative project in his 2023 book The Madman in the White House and interrogates the ways in which Freud and Bullitt’s psychoanalytic approach to Wilson unearths deep tensions between public and private lives. These tensions reveal themselves both in the subject of their psychobiography—Woodrow Wilson the statesman contrasts with the more neurotic private persona Tommy Wilson—and in the motivations and misgivings expressed by Bullitt and Freud in their unique yet controversial collaboration.Weil’s initial and closing focus is a collaborative account of Wilson drafted by Sigmund Freud and the US diplomat William C. Bullitt in the late 1920s and early 1930s during a phase when Bullitt was being analyzed by Freud in Paris
Integrative taxonomy supports the recognition of four taxa in the Notholaena trichomanoides complex (Pteridaceae) in Cuba
Authors: Regalado Ledis , Hernández Arturo , Serguera Maité , Gómez-Hechavarría José Luis , Beck Andreas
Published: August 2023

With nearly 40 species, the fern genus Notholaena has its evolutionary centre in the deserts of Mexico and the southwestern United States. Previous studies have focused on assessing the monophyly of the genus and the patterns of farina evolution, but little attention has been given to species complexes. Notholaena trichomanoides s.l. is endemic to the Greater Antilles, growing on all four islands. Although at least two varieties have been described, many authors have hesitated to recognize them and have treated this complex as only one taxon. A multivariate morphometric analysis including 80 representatives of N. trichomanoides from the Greater Antilles allowed us to recognize four morphological groups. Twenty individuals from seven populations representing all these morphological groups were sampled in Cuba. Differences among the four lineages were supported by molecular phylogenetics (including three plastid and two nuclear markers), molecular species delimitation, morphology and geological preferences. Ploidy levels inferred using spore sizes calibrated by chromosome counts revealed the existence of diploid and tetraploid lineages within the complex. Time-calibrated trees suggest that the divergence of the common ancestral populations of N. trichomanoides s.l. and those of its sister taxon N. ekmanii occurred between the Middle Miocene and the Miocene–Pliocene boundary followed by a recent diversification within the complex, ranging between the Middle Pliocene and the Middle Pleistocene.
Comparative floral anatomy in species of Cyperoideae (Poales: Cyperaceae) and insights into the evolution of floral traits
Authors: Silva Lucimara Reis de Oliveira , Trevisan Rafael , Oriani Aline
Published: August 2023

Species of Cyperoideae exhibit wide morphological variation in their flowers due to reduction processes. Their flowers can be bisexual or unisexual, achlamydeous or not, with tepals and stamens varying from one to six and a trimerous or dimerous gynoecium, the latter dorsiventrally or laterally flattened. We studied the floral anatomy and vasculature of Fuirena robusta, Cyperus sesquiflorus, Rhynchospora panicoides, and Schoenoplectus californicus to understand the reduction processes that resulted in different floral morphologies. The floral development of C. sesquiflorus was also analysed. All these species have spikelets with bisexual flowers, but they vary in relation to the perianth, androecium, and gynoecium. Our results show the loss of the outer abaxial tepal in R. panicoides, the total loss of the outer whorl of tepals in F. robusta, and the loss of abaxial tepals (outer and inner) in S. californicus. The tepals are vascularized in F. robusta and R. panicoides and non-vascularized in S. californicus. In C. sesquiflorus, the perianth is absent. Phenolic compounds present in the epidermal cells of the receptacle mark the boundaries between tepals and stamens, before the individualization of these parts. The three stamens present in F. robusta and R. panicoides correspond to the outer whorl. In S. californicus, there is a loss of the adaxial stamens (outer and inner), whereas in C. sesquiflorus the outer stamen whorl and the inner adaxial stamen are lost. The laterally flattened dimerous gynoecium in C. sesquiflorus may be the result of the pressure exerted by the distichously arranged glumes. The most distal flower of the spikelet in this species is staminate by abortion of the gynoecium. The morphological diversity observed in the flowers of Cyperoideae is the result of distinct reduction processes that probably occurred independently in the different clades of the subfamily during the evolution of Cyperaceae.
An effective patient-supporting intervention for topical treatment of psoriasis is also cost-effective
Authors: Svendsen Mathias Tiedemann , Andersen Klaus Ejner , Feldman Steven R , Mejldal Anna , Möller Sören , Kongstad Line Planck
Published: August 2023

Background

A randomized controlled trial (RCT) of topical treatment combined with regular patient support provided by dermatological nurses in structured consultations of 20-min duration every fourth week improved psoriasis severity, quality of life and treatment adherence compared with topical treatment combined with standard patient support, which is seeing a dermatologist every third month.

Objectives

To examine the economic impact of the patient support from a healthcare-sector perspective in the RCT.

Methods

Costs for primary care, secondary healthcare services and costs of prescription medication were compared for the intervention and nonintervention groups over 48 weeks. Health benefits were expressed in terms of quality-adjusted life-years (QALYs) measured by the EuroQoL five-dimension three-level questionnaire. Regression analyses were used to estimate incremental cost and QALYs.

Results

The incremental cost was estimated at £462, with an average increase of 0.08 QALYs per patients for participants receiving the intervention compared with those receiving standard care. The incremental cost-effectiveness ratio for patients was £5999/QALY. The intervention had an almost 100% probability of being cost-effective at a willingness-to-pay threshold of £30 000 per QALY.

Conclusions

Addressing adherence issues is critical to improving outcomes for patients with psoriasis who use topical treatment. The personal support intervention was effective with an acceptable increase in costs.
IAPs and RIPK1 mediate LPS-induced cytokine production in healthy subjects and Crohn’s disease
Authors: Seidelin Jakob Benedict , Jensen Simone , Hansen Morten , de Carvalho Bronze Mariana Rodrigues , Cuchet-Lourenҫo Delphine , Nejentsev Sergey , LaCasse Eric Charles , Nielsen Ole Haagen
Published: August 2023

Innate immune activity fuels intestinal inflammation in Crohn’s disease (CD), an inflammatory bowel disease. Identification and targeting of new molecular regulators of the innate activity are warranted to control the disease. Inhibitor of apoptosis proteins (IAPs) regulate both cell survival and inflammatory signaling. We investigated the effects of IAP inhibition by second mitochondria-derived activator of caspases (SMAC) mimetics (SMs) on innate responses and cell death to pathogen-associated molecular patterns in peripheral blood mononuclear cells (PBMCs) and monocytes. IAPs inhibited lipopolysaccharide (LPS)-induced expression of proinflammatory interleukin (IL)-1β, IL-6. Likewise, LPS (but not muramyl dipeptide or Escherichia coli) induced TNF-α was inhibited in CD and control PBMCs. The SM effect was partially reversed by inhibition of receptor-interacting serine/threonine-protein kinase 1 (RIPK1). The effect was mainly cell death independent. Thus, IAP inhibition by SMs leads to reduced production of proinflammatory cytokines and may be considered in the efforts to develop new therapeutic strategies to control CD.
Rapid meropenem/vaborbactam NP test for detecting susceptibility/resistance in Enterobacterales
Authors: Nordmann Patrice , Kerbol Auriane , Bouvier Maxime , Sadek Mustafa , Poirel Laurent , Raro Otávio Hallal Ferreira
Published: August 2023

Background

The treatment options for infections caused by carbapenem-resistant Enterobacterales (CRE) are extremely scarce nowadays and the development of new antibiotics does not follow the exponential increase in the dissemination of carbapenem resistance determinants worldwide. Meropenem/vaborbactam was recently approved for clinical use and it has been indicated for treating several infections. Although relatively rare, meropenem/vaborbactam resistance has already been reported in Enterobacterales and its early detection could be a valuable tool for faster clinical decision-making.

Objectives

To develop a rapid test, namely the Rapid MEV NP, for the identification of meropenem/vaborbactam resistance in Enterobacterales.

Methods

The Rapid MEV NP test is based on detection of glucose metabolization occurring upon bacterial growth in the presence of meropenem/vaborbactam at a concentration of 16/8 mg/L. Bacterial growth is detectable by a colour change of phenol red (from red to yellow) subsequent of the acidification of the medium upon bacterial growth. A total of 75 Enterobacterales isolates were randomly selected for evaluating the performance of the Rapid MEV NP test.

Results

The test showed 97.2% sensitivity and 93.8% specificity when compared with the reference method. The results are obtained after 3 h of incubation at 35°C ± 2°C, which is a gain of time of at least 15 h (one day in practice) compared with currently used antimicrobial susceptibility testing including broth microdilution methods.

Conclusions

The Rapid MEV NP test, easy to perform and to interpret, showed remarkable performance while providing fast results, and is therefore suitable for implementation in routine clinical microbiology laboratories.
A novel radio imaging method for physical spectral index modelling
Authors: Ceccotti E , Offringa A R , Koopmans L V E , Timmerman R , Brackenhoff S A , Gehlot B K , Mertens F G , Munshi S , Pandey V N , van Weeren R J , Yatawatta S , Zaroubi S
Published: August 2023

We present a new method, called ‘forced-spectrum fitting’, for physically based spectral modelling of radio sources during deconvolution. This improves upon current common deconvolution fitting methods, which often produce inaccurate spectra. Our method uses any pre-existing spectral index map to assign spectral indices to each model component cleaned during the multifrequency deconvolution of wsclean, where the pre-determined spectrum is fitted. The component magnitude is evaluated by performing a modified weighted linear least-squares fit. We test this method on a simulated LOFAR high-band antenna (HBA) observation of the 3C 196 QSO and a real LOFAR HBA observation of the 4C+55.16 FRI galaxy. We compare the results from the forced-spectrum fitting with traditional joined-channel deconvolution using polynomial fitting. Because no prior spectral information was available for 4C+55.16, we demonstrate a method for extracting spectral indices in the observed frequency band using ‘clustering’. The models generated by the forced-spectrum fitting are used to improve the calibration of the data sets. The final residuals are comparable to existing multifrequency deconvolution methods, but the output model agrees with the provided spectral index map, embedding correct spectral information. While forced-spectrum fitting does not solve the determination of the spectral information itself, it enables the construction of accurate multifrequency models that can be used for wide-band calibration and subtraction.
A Gaia view of the optical and X-ray luminosities of compact binary millisecond pulsars
Authors: Koljonen Karri I I , Linares Manuel
Published: August 2023

In this paper, we study compact binary millisecond pulsars with low- and very low-mass companion stars (spiders) in the Galactic field, using data from the latest Gaia data release (DR3). We infer the parallax distances of the optical counterparts to spiders, which we use to estimate optical and X-ray luminosities. We compare the parallax distances to those derived from radio pulse dispersion measures and find that they have systematically larger values, by 40 per cent on average. We also test the correlation between X-ray and spin-down luminosities, finding that most redbacks have a spin-down to X-ray luminosity conversion efficiency of ∼0.1 per cent, indicating a contribution from the intrabinary shock. On the other hand, most black widows have an efficiency of ∼0.01 per cent, similar to the majority of the pulsar population. Finally, we find that the bolometric optical luminosity significantly correlates with the orbital period, with a large scatter due to different irradiated stellar temperatures and binary properties. We interpret this correlation as the effect of the increasing size of the Roche Lobe radius with the orbital period. With this newly found correlation, an estimate of the optical magnitude can be obtained from the orbital period and a distance estimate.
Magnesian Andesites from Kibblewhite Volcano in the Kermadec Arc, New Zealand
Authors: Hirai Yasuhiro , Tamura Yoshihiko , Sato Tomoki , Miyazaki Takashi , Chang Qing , Vaglarov Bogdan S , Kimura Jun-Ichi , Hoernle Kaj , Werner Reinhard , Hauff Folkmar , Timm Christian
Published: August 2023

Primary andesitic magmas could be an important component of arc magma genesis and might have played a key role in the advent of continents. Recent studies hypothesized that primary andesitic magmas occur in the oceanic arc, where the crust is thin. The Kermadec arc has the thinnest crust among all the studied oceanic arcs (<15 km in thickness); however, there are no studies that corroborate the formation of primary andesitic magmas in the arc. The aim of this study is to develop a better understanding of primary andesites in oceanic arcs through the petrology of the Kermadec arc. Here, we present the petrology of volcanic rocks dredged from the Kibblewhite Volcano in the Kermadec arc during the R/V SONNE SO-255 expedition in 2017. Magma types range from andesite to rhyolite at the Kibblewhite Volcano, but basalts dominate at the neighboring cones. This study focuses on magnesian andesites from the northeastern flank of this volcano. The magnesian andesites are nearly aphyric and plagioclase free but contain microphenocrysts of olivine (Fo84–86) and clinopyroxene (Mg# = 81–87). Using olivine addition models, the primary magmas were estimated to contain 55–56 wt % SiO2 and 10–12 wt % MgO, similar to the high-Mg andesites observed in other convergent plate margins, indicating the generation of primary andesitic magma beneath the Kibblewhite Volcano. The trace element and isotopic characteristics of the magnesian andesites are typical of volcanic rocks from the Kermadec arc. This indicates that the subduction of a young plate or melting of a pyroxenitic source is not necessary to produce magnesian andesites. Instead, we propose that the magnesian andesites were produced by the direct melting of the uppermost mantle of the Kermadec arc. The thin crust of the Kermadec arc should yield low-pressure conditions in the uppermost mantle, allowing the sub-arc mantle to generate primary andesitic melts. This study supports the hypothesis that primary andesitic magmas generate in the arc where the crust is thin and provides a new insight into the magma genesis of the Kermadec arc.
The Use of Multifilament Suture for SMAS Plication in Rhytidectomy
Authors: Wahdan Wessam , El Saloussy Yasmeen
Published: August 2023

Background:

In the public’s mind, rhytidectomy, better known as a facelift procedure, is the technique most closely associated with plastic surgery. When done correctly, it yields highly satisfactory results. The aim of our study was to retrospectively review results of our patients whose procedures were performed using the superficial musculoaponeurotic system (SMAS) plication technique. Plication was performed with multifilament braided sutures, which provided a sustainable lift and satisfactory results.

Methods:

This study involves a retrospective review of 137 patients who underwent primary or secondary facelift procedures over a period of 46 months. The average patient age was 59 years, with ages ranging from 30 to 77. Patients were reviewed at 6 and 12 months postoperatively. Subjective evaluation based on photographic analysis was performed pre- and postoperatively.

Results:

All cases included in this study indicated satisfaction with postoperative results on 1 year postoperative review for both the patients and performing surgeons. Four patients presented with a postoperative hematoma that required surgical intervention. One patient developed skin infection that was followed by skin necrosis. Another patient presented with wound infection that resulted in partial wound dehiscence. Both cases were managed conservatively.

Conclusions:

With the abundance of techniques directed toward the SMAS layer, it has become a pivot point for facelift procedures. This expansion in approaches places emphasis on the SMAS layer and its manipulations. The type of suture material utilized in SMAS plication is, therefore, undoubtedly essential. Our use of braided multifilament sutures for SMAS plication provided satisfactory results at 1-year postoperative review.
Surgical Delay of Thoracodorsal Artery Perforator Flaps for Bilateral Autologous Breast Reconstruction
Authors: Hoffman Ryan D. , Maier Mark A. , St. Hilaire Hugo , Allen Robert J.
Published: August 2023

Autologous reconstruction accounts for nearly one-quarter of all breast reconstruction cases in the United States, with the abdomen functioning as the most popular donor site. This case describes a 62-year-old woman who presented to our clinic with a remote history of estrogen receptor+/progesterone+ breast cancer and bilateral implant-based reconstruction. After grade IV capsular contracture of her left breast, she presented for autologous reconstruction. Due to her body habitus and prior belt lipectomy, deep inferior epigastric perforator flap reconstruction was contra-indicated. The thoracodorsal artery perforator (TDAP) flap is well described in the literature, and was chosen as an alternative salvage procedure to avoid latissimus harvest and the need for implants. The TDAP flap is often limited in volume and prone to distal tip necrosis, limiting its use in breast reconstruction. We have previously demonstrated the utility of the surgical delay phenomenon in improving the reliability of superficial inferior epigastric artery free flap breast reconstruction. In this case, we demonstrate the surgically delayed TDAP flap as a viable alternative to the latissimus flap with implants for bilateral total autologous breast reconstruction.
Avoiding Surgery: Endoscopic Treatment of Congenital Duodenal Stenosis
Authors: Baran Jessica V. , Brown Jerry M. , Rivera-Nieves Desiree , Karjoo Sara , Smithers C. Jason , Wilsey Michael J.
Published: August 2023

Duodenal stenosis is a rare congenital anomaly that is typically treated surgically, although endoscopic incisional therapy (EIT) and balloon dilation are minimally invasive alternatives. We present a case of a 15-month-old male with vomiting and difficulty tolerating solid food due to severe congenital duodenal stenosis. The patient underwent EIT and serial duodenal dilation to a diameter of 20 mm, which resulted in significant symptom improvement. Intralesional corticosteroid injection (ISI) was administered to help prevent the duodenal septum from restricturing. The combination of EIT, balloon dilation, and ISI was successful in treating the patient’s congenital duodenal stenosis and avoided the need for surgery. However, further studies are required to confirm the efficacy of this treatment approach in this patient population. This report highlights the potential of this minimally invasive approach as an alternative to surgical intervention in the management of congenital duodenal stenosis.
Helicobacter pylori Found Guilty of Obstructive Jaundice: A Pediatric Case Report
Authors: Giroux Parker , Palmer Andrew , Thomas Aby , Camacho-Gomez Sandra Mabel
Published: August 2023

Pediatric Helicobacter pylori infection represents a small proportion of disease that is otherwise decreasing in the developed world. Typical presentations have been well-described in the literature. We report a 15-year-old male who presented with jaundice, anemia, dark urine, and poorly characterized abdominal pain and was found to have obstructive jaundice secondary to a duodenal ulcer resulting from H. pylori infection. Obstructive jaundice is a seldom reported complication of duodenal ulcer, particularly in children. This report reviews H. pylori infection, outlines complications of peptic ulcer disease, and illustrates the rarity of obstructive jaundice as a presenting sign of duodenal ulcer in children.
Identification of secondary metabolites containing a diketopiperazine core in extracts from myxobacterial strains with growth inhibition activity against a range of prey species
Authors: Radford Emily Jade , Whitworth David , Allison Gordon
Published: August 2023

Myxobacteria produce a variety of bioactive secondary metabolites, and with a wealth of under-researched species they hold vast potential for undiscovered compounds. With the ever-increasing need for new antibiotics, the development of novel therapeutics is vitally important. Therefore, this study aimed to extract and elucidate antimicrobial metabolites from the following myxobacteria: Myxococcus xanthus CA010 and AB022; Corallococcus exiguus DSM14696T; Myxococcus stipitatus DSM14675T; Corallococcus aberystwythensis AB050AT. Metabolite mixtures were extracted in acetone from XAD-16 resin incubated in liquid cultures and analysed using GC-MS. Bioactivity was identified using a growth inhibition assay against a panel of clinically relevant prey species including Gram-positive and Gram-negative bacteria and a fungus. The growth of Klebsiella pneumoniae and Enterococcus faecalis was most affected by the metabolite mixtures and the mixtures from AB022 and AB050AT were effective against the most prey. GC-MS analysis revealed metabolites with roles in synthesis and degradation of amino acids and fatty acids, but also identified compounds A and B with a diketopiperazine (DKP) core. With previously confirmed bioactivity of compound A, it is suggested that these DKP compounds are contributing to the antimicrobial activity observed.  Furthermore, many compounds could not be identified and so these unknowns present further potential for novel bioactive compounds.
Antimicrobial resistance and molecular characteristics of N. gonorrhoea isolates in Ghana
Authors: Musah Haris Sualah , Addy Francis , Dufailu Osman Adamu
Published: August 2023

Gonorrhoea is a disease associated with humans and it is caused by N. gonorrhoea. N. gonorrhoea’s ability to evolve and evade various treatment regimens can lead to untreatable Gonorrhoea disease. In the absence of a viable vaccine, national database on antimicrobial resistance (AMR) and molecular characteristics of N. gonorrhoea, and the reliance on syndromic management regimes, continuous national antimicrobial resistance surveillance and molecular characterisation of N. gonorrhoea remain imperative. Only two gonococcal data describing its molecular characteristics links to AMR have been reported in Ghana.
Secondary N. gonorrhoea isolates (n=4) were collected from two metropolises in Ghana: Tamale in the northern sector (n=1), and Accra in the southern sector (n=3). The isolates were characterised using polymerase chain reaction (PCR) targeting the porB and tbpB genes, and the disk diffusion method was used to evaluate antimicrobial resistance (AMR). NG-MAST and porB gene sequence analysis was used to reveal molecular epidemiology and evolutionary trajectory, respectively.
All four isolates showed multidrug resistance to at least four antibiotics. One isolate showed resistance to all seven antibiotics including ciprofloxacin, ceftriaxone, and azithromycin.  NG-MAST typing revealed isolates S3 (MZ313864) as ST211 while the locus of S2 (MZ313863) (tbpB) was identified as tbpB1844 but not its porB locus. Isolate S3 (MZ313864) is globally known while S2 (MZ313863) is not previously known.
Multidrug-resistance and previously unknown gonococcal variant was recorded. Therefore, continuous AMR and molecular surveillance in Ghana is essential to compliment the syndromic management regime.
Hypoxia dampens innate immune signalling at early time points and increases Zika virus RNA levels in iPSC-derived macrophages
Authors: Schilling Mirjam , Vaughan-Jackson Alun , James William , McKeating Jane A.
Published: August 2023

Type I interferons (IFNs) are the major host defence against viral infection and are induced following activation of cell surface or intracellular pattern recognition receptors, including retinoic-acid-inducible gene I (RIG-I)-like receptors (RLRs). All cellular processes are shaped by the microenvironment and one important factor is the local oxygen tension. The majority of published studies on IFN signalling are conducted under laboratory conditions of 18% oxygen (O2), that do not reflect the oxygen levels in most organs (1–5 % O2). We studied the effect of low oxygen on IFN induction and signalling in induced Pluripotent Stem Cell (iPSC)-derived macrophages as a model for tissue-resident macrophages and assessed the consequence for Zika virus (ZIKV) infection. Hypoxic conditions dampened the expression of interferon-stimulated genes (ISGs) following RLR stimulation or IFN treatment at early time points. RNA-sequencing and bio-informatic analysis uncovered several pathways including changes in transcription factor availability, the presence of HIF binding sites in promoter regions, and CpG content that may contribute to the reduced ISG expression. Hypoxic conditions increased the abundance of ZIKV RNA highlighting the importance of understanding how low oxygen conditions in the local microenvironment affect pathogen sensing and host defences.
An Evolutionary Perspective on the Genetics of Anorexia Nervosa
Authors: Breton Édith , Kaufmann Tobias
Published: August 2023

Anorexia nervosa (AN) typically emerges around adolescence and predominantly affects females. Recent progress has been made in identifying biological correlates of AN, but more research is needed to pinpoint the specific mechanisms that lead to its development and maintenance. There is a known phenotypic link between AN, growth and sexual maturation, yet the genetic overlap between these phenotypes remains enigmatic. One may hypothesize that shared factors between AN, energy metabolism and reproductive functions may have been under recent evolutionary selection. Here, we characterize the genetic overlap between AN, BMI and age at menarche, and aimed to reveal recent evolutionary factors that may help explain the origin of AN. We obtained publicly available GWAS summary statistics of AN, BMI and age at menarche and studied the polygenic overlap between them. Next, we used Neandertal Selective Sweep scores to explore recent evolutionary selection. We found 22 loci overlapping between AN and BMI, and 9 loci between AN and age at menarche, with 7 of these not previously associated with AN. We found that loci associated with AN may have been under particular evolutionary dynamic. Chronobiology appeared relevant to the studied genetic overlaps and prone to recent evolutionary selection, offering a promising avenue for future research. Taken together, our findings contribute to the understanding of the genetic underpinning of AN. Ultimately, better knowledge of the biological origins of AN may help to target specific biological processes and facilitate early intervention in individuals who are most at risk.