bluuebunny/crossref_metadata_2025 huggingface dataset:
Iodine dissolution mechanisms in high-pressure aluminoborosilicate glasses and their relationship to oxygen speciation
Authors: Morizet Yann , Soudani Sami , Hamon Jonathan , Paris Michael , La Carole , Gautron Eric
Published: September 2023

Incorporation of iodine into high-pressure vitrified glasses is a strong function of alkali content. The vitrification under high-pressure conditions could represent a potential solution for the immobilization of 129I radioisotopes.
Compositional engineering of ZnBr2-doped CsPbBr3 perovskite nanocrystals: insights into structure transformation, optical performance, and charge-carrier dynamics
Authors: Varnakavi Naresh , Gupta Kiran , Lee Kyunghoon , Yang Jiwoong , Cha Pil-Ryung , Lee Nohyun
Published: September 2023

ZnBr2 incorporated CsPbBr3 transformed into to Cs4PbBr6via the intermediate CsPbBr3/Cs4PbBr6 heterostructure, resulting in improved PL characteristics (near unity PLQY).
Surface chemical mechanisms of trimethyl aluminum in atomic layer deposition of AlN
Authors: Rönnby Karl , Pedersen Henrik , Ojamäe Lars
Published: September 2023

Two different pathways for decomposition of adsorbed trimethyl aluminum in the ALD of AlN have been investigated by computation chemistry. The two pathways give different saturation coverage and thus growth per cycle.
Achieving dynamic quintuple-mode luminescence in Ca3Ti2O7:Pr3+,Er3+ phosphor for anti-counterfeiting applications
Authors: Zhang Jian , You Xin , Wang Ting , Cai Yiyu , Wang Chao , Li Xin , Liu Zhichao , Dai Heng , Yakovlev Alexey Nikolaevich , Xu Xuhui , Yu Jie
Published: September 2023

In this work, we have synthesized Ca3Ti2O7:Pr3+, Er3+ phosphors with PL, LPL, PSL, UCL, and ML phenomena. Based on the skillful cooperation of PSL and UCL, dynamic anti-counterfeiting technology has been realized by modulating the 980 nm laser.
A constructive airborne‐ground matrix algorithm for modern telecommunication systems
Authors: Arun Raj A Samson , Xavier S Basil , Kathrine G Jaspher Wilisie , Silas Salaja , J Andrew
Published: September 2023

Conventional Mobile Communication Systems (MCS) reliably transfer critical messages from authorised remote information sources like military bases and ground control stations in the war field. As tactical advancement grows rapidly, the challenges of transmitting tactical messages via conventional satellite methods increase the processing overhead related to cost, Line of Sight (LOS) communication, packet loss, delay, and retransmission requests. Modern mobile communication systems use Airborne Node Networks (ANN) between satellites and Mobile Ground Nodes (MGNs) as they provide many advantages in mobile communication systems. Hence airborne network reduces the burden of satellites as they are only used as relay stations. The mobility problem caused by ANN and MGNs is solved by proposing a novel constructive airborne‐ground matrix algorithm known as the Who‐To‐Whom (WTW) matrix. With the help of this matrix acting as a reference index, it determines which nodes relate to whom at every time interval T in the tactical environment. This WTW matrix holds precise status/information about connectivity among all stakeholders in the operating environment by carefully and effectively accounting for frequent location changes. The methodology of the proposed matrix is that it contains the physical parameters of the nodes and their behaviour in the tactical environment. The WTW matrix construction algorithm discusses how the reference matrix is constructed in every aerial node to monitor the mobile ground nodes by leading them to safety and providing aerial guidance as they move along the tactical environment. The performance metrics are measured with other existing schemes, and the merits and demerits of the proposed WTW matrix are identified and discussed in detail.
Fortgeschrittenes Melanom: Langszeitoutcome nach BRAF-MEK-Erstlinientherapie
Authors: Kretzschmar Alexander
Published: September 2023

Beim fortgeschrittenen Melanom kann mit der zielgerichteten Hemmung des BRAF- und MEK-Proteins das mediane Gesamtüberleben (OS) signifikant verbessert werden. Eine niederländische Arbeitsgruppe untersuchte nun, ob das reale OS im Real-World-Setting dem OS der klinischen Phase-III-Studien entspricht. Der Vergleich ergab, dass nur 28 % der Real-World-Patient*innen ein medianes OS von mindestens 2 Jahren erreichten. Dabei schnitt die Gruppe, welche die Einschlusskriterien erfüllte (17,9 Monate), deutlich besser ab als die Gruppe mit Patient*innen, die die Kriterien nicht erfüllte (8,7 Monate).
Smartwatch und Telemedizin
Authors: Röhmig Conny
Published: September 2023

Sie kann Prozesse verändern, Diagnosen erleichtern, Medizin verbessern: Die Digitalisierung ist ein Game-Changer in der Gesundheitsversorgung. Doch neben ersten spannenden Ansätzen gibt es noch immer viele Hürden, wie eine Diskussionsrunde auf dem diesjährigen Kongress der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP) zeigte.
Metastasiertes Nierenzellkarzinom
Authors: Arnheim Katharina
Published: September 2023

Gemäß dem 4-Jahres-Update der Studie CLEAR profitieren Patienten mit fortgeschrittenem Nierenzellkarzinom (RCC) dauerhaft von der Kombinationstherapie mit Lenvatinib plus Pembrolizumab.
Erste Phase-III-Studie zur Checkpoint-Blockade nach Progress unter Immuntherapie
Authors: Arnheim Katharina
Published: September 2023

Immuntherapeutisch vorbehandelte Patienten mit metastasiertem Nierenzellkarzinom (RCC) profitieren nicht von einer Rechallenge mit einem Checkpoint-Inhibitor (CPI): In der Studie CONTACT-03 war Atezolizumab plus Cabozantinib nicht effektiver als Cabozantinib allein, verursachte aber mehr Nebenwirkungen.
Hepatozelluläres Karzinom
Authors: Arnheim Katharina
Published: September 2023

Patienten mit hepatozelluärem Karzinom (HCC) und hohem Rezidivrisko nach Resektion oder Ablation profitieren von der adjuvanten Therapie mit Atezolizumab plus Bevacizumab. Erreicht wird eine signifikante Reduktion des Rezidivrisikos ohne Einschränkung der Lebensqualität.
Operables Magenkarzinom
Authors: Arnheim Katharina
Published: September 2023

Die Phase-III-Studie ATTRACTION-5 beim operablen Magenkarzinom ging negativ aus: Bei Addition von Nivolumab zur adjuvanten Chemotherapie wurde keine Senkung des Rezidivrisikos erreicht.
Sporttherapie bei schizophrenen Psychosen: Von der Idee bis zur
Leitlinie
Authors: Falkai Peter , Schwaiger Rebecca , Schmitt Andrea , Röll Lukas , Maurus Isabel
Published: September 2023

Schizophrene Psychosen sind aufgrund der Einführung von Antipsychotika
vor ca. 70 Jahren in Verbindung mit der Implentierung spezifischer
Psychotherapien heute deutlich besser behandelbar. Im Bereich der
Negativsymptomatik und krankheitsassoziierten kognitiven Defiziten sind die
aktuellen Behandlungsmöglichkeiten jedoch weiter limitiert. In den
letzten 15 Jahren konnten randomisiert kontrollierte Studien (RCTs) zeigen, dass
körperliches Training und insbesondere Ausdauertraining einen
umfassenden ergänzenden Behandlungsansatz darstellen könnte und
zu einer signifikanten Verbesserung der Positiv-, aber insbesondere auch der
Negativsymptomatik und von kognitiven Defiziten zu führen vermag. In der
Folge hat Sporttherapie bei schizophrenen Psychosen Eingang in die nationale
Behandlungsleitlinie der Deutschen Gesellschaft für Psychiatrie,
Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), aber auch in
europäische Empfehlungen, wie der European Psychiatric Association (EPA)
Einzug gehalten. Im nächsten Schritt muss eine breite Implementierung in
die Versorgung erfolgen, was mit der Einführung des „Living
guideline“ Formats (hier erfolgt mindestens einmal jährlich eine
Aktualisierung) besser als bisher möglich sein wird. Die vorliegende
Arbeit bildet, basierend auf einem narrativen Review, den Prozess der
Implementierung von Sporttherapie bei schizophrenen Psychosen von ihren
Anfängen bis zur Verankerung in Leitlinien ab und kann analog
für andere Therapieformen gelten.
Physiological Responses Associated with Nordic-Walking and Walking in
Middle-age Women
Authors: Wiacek Magdalena , Natora Justyna , Zubrzycki Igor Z , Tomasiuk Ryszard
Published: September 2023

This study aimed to analyze the influence of supervised 12-week walking (W) and
Nordic-walking (NW) programs on changes in specific physiological parameters in
middle-aged women 55.40±7.87 and 52.58±6.91 years of age,
respectively. Body mass, fat tissue percentage, muscle tissue percentage,
systolic blood pressure, diastolic blood pressure, resting pulse, and maximum
oxygen uptake were measured at the beginning and end of the exercise program.
Intra- and intergroup differences in physiological parameters as a function of
the preparation period were analyzed using bootstrap analysis. Clinically
reliable changes for a specific subject in the W and NW programs were analyzed
using the Reliable Change Index (RCI). The results of this study indicate that
more distinct differences were observed in the NW group. However, both programs
improved the parameters studied. Nevertheless, an analysis of the RCI indicates
that the W provides results similar to, if not better than, NW for increasing
neuromuscular, cardiovascular, and cardiorespiratory fitness. This study leads
us to the conclusion that the W is not less efficient than the NW for
middle-aged women.
Point-of-Care Ultrasound for the Tip of the Endotracheal Tube: A Neonatologist Perspective
Authors: Sahin Ozlem , Tasar Sevinc , Colak Derya , Yavanoglu Atay Funda , Guran Omer , Mungan Akin Ilke
Published: September 2023

Objective Point-of-care ultrasound (POCUS) has been reported to reduce radiation exposure and has been shown to be a reliable bedside technique to confirm endotracheal tube (ETT) placement, but evidence in neonates is still limited. The aim of this study was to compare the effectiveness and reliability of POCUS performed by a neonatologist, as an alternative to chest radiography (CXR) for the optimal position of ETT.

Study Design Newborns who underwent intubation were included in this prospective observational study. The CXR was used to evaluate the position of the ETT tip and categorized into three groups: above the T1, between the T1 and T3, and below the T3 vertebra. An experienced neonatologist measured the distance between the ETT tip and the upper border of the aortic arch from the suprasternal notch with ultrasonography (US). A 5 to 10 mm measurement was considered as the optimal distance, and the position was classified into three categories: correct, high, and deep.

Results Among 91 measurements performed on 63 intubated patients with US, 73 (80%) were within the 5 to 10 mm range (correct position). Of these, 61 (92.4%) were determined to be between T1 and 3 vertebrae in CXR. There was no significant difference between the two methods, and the US had an excellent ability to distinguish the correct position of the ETT. The distance measured by the US for the ETT tip to be located between the T1 and T3 vertebrae on CXR should range between 6.17 and 9.0 mm.

Conclusion This study showed that the US by an experienced neonatologist is an easy and feasible alternative to determine the position of the ETT in the neonatal intensive care unit.

Key Points
Management of Gestational Gigantomastia with Goldilocks Procedure after Mastectomy: A Case Report and Review of Literature
Authors: Yoon Jeong Ho , Kang Taewoo , Park Heeseung , Eun Kim Kyoung , Bong Nam Su , Young Go Ju , Hwan Bae Seong
Published: September 2023

Gestational gigantomastia is characterized by the rapid growth of breasts during pregnancy. The treatment method of gestational gigantomastia is unclear; if the medical treatment is ineffective, surgery is considered. However, sufficient research on which method is best to perform breast reconstruction for the gestational gigantomastia patient has not yet been conducted. Our patient was young and had aesthetic needs; thus, we did not recommend modified radical mastectomy. However, it was difficult for the patient to consider active reconstruction using an implant or autologous tissue because of the expected complications and economic problems. The patient had a thin body shape and very large breasts compared with the trunk. Therefore, breast volume was not significantly required after reconstruction. Additionally, we expected that a considerable portion of skin would remain after mastectomy as a tubular-shaped breast. It was expected that the Goldilocks technique would be sufficient to meet the patient's volume needs. Therefore, we proceeded with total mastectomy and reconstruction using the Goldilocks procedure. No complications were recorded after the operation; most of the patient's discomfort was resolved, and the shape and size of the breasts were satisfactory.
Necrotizing Otitis Externa: A Proposal for Diagnostic and Therapeutic Approach
Authors: Costa Marília Batista , Onishi Ektor Tsuneo
Published: September 2023

Introduction Necrotizing otitis externa has a high impact on the quality of life of patients and has shown a significant increase in its incidence in recent years. There has been a change in the profile of affected patients and a lack of consensus on the management of these patients.

Objective To develop a practical and effective care protocol to standardize the diagnostic and therapeutic management of necrotizing otitis externa.

Methods A retrospective cohort study of necrotizing otitis externa patients between January 2015 and December 2020.

Results There were 34 patients with two bilateral cases, totaling 36 ears. The mean age was 68.5, with a higher prevalence of males (76%). Diabetes was present in 97% of the samples. The involvement of cranial pairs was identified in 35% of the sample. Pseudomonas aeruginosa was the most frequent pathogen isolated, found in 50% of the cases. Among the cultures with bacterial agents isolated, 35% showed resistance to ciprofloxacin. The most frequent exam was computed tomography (94%). Hospital admission was indicated for 31 patients (91%), and ceftazidime was the most prescribed drug (35.5%). There were 11 recurrences (32%), and 12 patients (35%) had complications during treatment. Among the unfavorable outcomes, 12% persisted with some degree of peripheral facial paralysis, 6% maintained dysphagia, and 9% died of the disease.

Conclusions The present study developed a diagnostic and therapeutic protocol for the effective management of necrotizing otitis externa. This protocol is a dynamic tool and should be revised and updated as new demands emerge during its implementation.
Angioleiomyoma of the Sinonasal Tract: A Systematic Review of an Uncommon Clinicopathological Entity
Authors: Velletrani Gianluca , Maurizi Riccardo , De Padova Alessandro , Di Girolamo Stefano
Published: September 2023

Introduction Angioleiomyoma is a rare neoplasm that represents ∼ 0.2 % of all head and neck benign tumors and ∼ 2% of total cases of tumors of the sinonasal tract. It was once considered a possible subtype of leiomyoma, but, in the 2020 World Health Organization (WHO) classification of soft tissue tumors, it is accepted as a singular entity.

Objective To systematically review the existing literature on angioleiomyoma in the light of the new classification of soft tissue tumors.

Data Synthesis The present study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search in the PubMed, Cochrane, Scopus, and Google Scholar databases was performed in January 2022. The search items included the following keywords: nasal angioleiomyoma OR sinonasal angioleiomyoma OR nasal vascular leiomyoma OR sinonasal vascular leiomyoma. A total of 87 patients were evaluated. He age of the patients in the studies ranged from 15 to 88 years (mean age at diagnosis: 55.6 years). The most common site of involvement was the nasal septum (28.4 %), followed by the inferior turbinate (22.5%). The most common symptom was nasal obstruction (66.7%), followed by epistaxis (47.1%). Surgical excision represented the main treatment, and there was recurrence of pathology in only 1 case (0.9%).

Conclusion To our knowledge, only 87 cases of sinonasal-tract angioleiomyoma have been previously described. The results of the present review seem to confirm the rarity and the benign nature of this neoplasm, and they seem to confirm the necessity to improve the available data about sinonasal-tract angioleiomyoma.
Endoscopic Study of Ethmoidal Canals in Cadavers, Including a Histological Analysis of Their Contents
Authors: Felippu Alexandre Wady Debes , Morsch Thiago Picolli , Felippu André Wady Debes , Cascio Filippo , Oliveira Claudia Regina Gomes Cardim Mendes de , Felippu Alexandre , Voegels Richard Louis
Published: September 2023

Introduction The advent of the endoscope has enabled the use of the endonasal approach for a variety of diseases. Studying the ethmoidal canals is important for surgeries of the paranasal sinuses and the anterior base of the skull.

Objective To investigate the ethmoidal canals and evaluate their structure, the presence of vessels and nerves, their location, and to perform an anatomopathological study of their contents.

Methods We evaluated 20 cadavers (20 left and 20 right nasal cavities) through endoscopic dissection of the anterior base of the skull and exposure of the medial periorbita and dura mater; then, the ethmoidal canals were located and measured in relation to the anterior wall of the sphenoid sinus and between the ethmoidal canals, followed by removal of their content for histological analysis.

Results Vessels were present in 75% of the left anterior ethmoidal canals, 70% of the left posterior ethmoidal canals, 75% of the left middle ethmoidal canals, 85% of the right anterior ethmoid canals, and 64.5% of the right posterior ethmoid canals; 50% of the right middle ethmoidal canals contained one vessel.

Conclusion The ethmoidal canal does not necessarily contain an ethmoidal artery. Studies with a larger sample should be performed to quantify the correct proportion of arteries and ethmoidal canals.
Disease-Based Prognostication: Neuro-Oncology
Authors: Waite Kristin A. , Cioffi Gino , Malkin Mark G. , Barnholtz-Sloan Jill S.
Published: September 2023

Primary malignant and non-malignant brain and other central nervous system (CNS) tumors, while relatively rare, are a disproportionate source of morbidity and mortality. Here we provide a brief overview of approaches to modeling important clinical outcomes, such as overall survival, that are critical for clinical care. Because there are a large number of histologically distinct types of primary malignant and non-malignant brain and other CNS tumors, this chapter will provide an overview of prognostication considerations on the most common primary non-malignant brain tumor, meningioma, and the most common primary malignant brain tumor, glioblastoma. In addition, information on nomograms and how they can be used as individualized prognostication tools by clinicians to counsel patients and their families regarding treatment, follow-up, and prognosis is described. The current state of nomograms for meningiomas and glioblastomas are also provided.
Plant species, nitrogen status and endophytes are drivers of soil microbial communities in grasslands
Authors: Rasmussen Susanne , Parsons Anthony J. , Russell Julia , Bastías Daniel A. , Liu Qianhe
Published: September 2023

Context There is concern that the introduction of ‘novel’ plant germplasm/traits could outpace our capacity to measure and so assess their impacts on soil microbial communities and function. Aim This study aimed to investigate the effects of plant species/functional traits, nitrogen (N) fertilisation and endophyte infection on grassland soil microbial communities within a short time span of 2 years. Methods Two field experiments with monoculture plots were conducted in a common soil. Experiment 1 compared grasses and legumes, using two cultivars of perennial ryegrass (Lolium perenne) that varied in fructan content, along with the legumes white clover (Trifolium repens) and bird’s-foot trefoil (Lotus pedunculatus) that varied in tannin content. Grass treatments received high and low N application levels. Experiment 2 compared the presence/absence of Epichloë strains in ryegrass, tall fescue (Schedonorus phoenix) and meadow fescue (Schedonorus pratensis). Soil microbial communities were analysed by using high-throughput sequencing of DNA isolated from bulk soil cores. Key results Higher abundance of ligninolytic fungi was found in grass soils and pectinolytic fungi in legume soils. Levels of N fertilisation and fructan in ryegrass had only minor effects on soil fungal communities. By contrast, N fertilisation or fixation had a strong effect on bacterial communities, with higher abundance of nitrifiers and denitrifiers in high-N grass soils and in legume soils than in low-N grass soils. Epichloë affected soil microbiota by reducing the abundance of certain fungal phytopathogens, increasing mycorrhizal fungi and reducing N-fixing bacteria. Conclusions Chemical composition of plant cell walls, which differs between grasses and legumes, and presence of Epichloë in grasses were the main drivers of shifts in soil microbial communities. Implications Impacts of farming practices such as mono- or poly-culture, N fertilisation and presence of Epichloë in grasses on soil microbial communities should be considered in pasture management.
Structure of the
bc
1
–
cbb
3
respiratory supercomplex from
Pseudomonas aeruginosa
Authors: Di Trani Justin M. , Gheorghita Andreea A. , Turner Madison , Brzezinski Peter , Ädelroth Pia , Vahidi Siavash , Howell P. Lynne , Rubinstein John L.
Published: September 2023

Energy conversion by electron transport chains occurs through the sequential transfer of electrons between protein complexes and intermediate electron carriers, creating the proton motive force that enables ATP synthesis and membrane transport. These protein complexes can also form higher order assemblies known as respiratory supercomplexes (SCs). The electron transport chain of the opportunistic pathogen
Pseudomonas aeruginosa
is closely linked with its ability to invade host tissue, tolerate harsh conditions, and resist antibiotics but is poorly characterized. Here, we determine the structure of a
P. aeruginosa
SC that forms between the quinol:cytochrome
c
oxidoreductase (cytochrome
bc
1
) and one of the organism’s terminal oxidases, cytochrome
cbb
3
, which is found only in some bacteria. Remarkably, the SC structure also includes two intermediate electron carriers: a diheme cytochrome
c
4
and a single heme cytochrome
c
5
. Together, these proteins allow electron transfer from ubiquinol in cytochrome
bc
1
to oxygen in cytochrome
cbb
3
. We also present evidence that different isoforms of cytochrome
cbb
3
can participate in formation of this SC without changing the overall SC architecture. Incorporating these different subunit isoforms into the SC would allow the bacterium to adapt to different environmental conditions. Bioinformatic analysis focusing on structural motifs in the SC suggests that cytochrome
bc
1
–
cbb
3
SCs also exist in other bacterial pathogens.
Discriminating between sick and healthy faces based on early sickness cues: an exploratory analysis of sex differences
Authors: Tognetti Arnaud , Thunell Evelina , Zakrzewska Marta , Olofsson Jonas , Lekander Mats , Axelsson John , Olsson Mats J
Published: September 2023

Background and objectives

It has been argued that sex and disease-related traits should influence how observers respond to sensory sickness cues. In fact, there is evidence that humans can detect sensory cues related to infection in others, but lack of power from earlier studies prevents any firm conclusion regarding whether perception of sickness cues is associated with sex and disease-related personality traits. Here, we tested whether women (relative to men), individuals with poorer self-reported health, and who are more sensitive to disgust, vulnerable to disease, and concerned about their health, overestimate the presence of, and/or are better at detecting sickness cues.

Methodology

In a large online study, 343 women and 340 men were instructed to identify the sick faces from a series of sick and healthy photographs of volunteers with an induced acute experimental inflammation. Participants also completed several disease-related questionnaires.

Results

While both men and women could discriminate between sick and healthy individuals above chance level, exploratory analyses revealed that women outperformed men in accuracy and speed of discrimination. Furthermore, we demonstrated that higher disgust sensitivity to body odors is associated with a more liberal decision criterion for categorizing faces as sick.

Conclusion

Our findings give strong support for the human ability to discriminate between sick and healthy individuals based on early facial cues of sickness and suggest that women are significantly, although only slightly, better at this task. If this finding is replicated, future studies should determine whether women’s better performance is related to increased avoidance of sick individuals.
26. Security and everyday life in uncertain times
Authors: Loader Ian , Sparks Richard , Bradford Ben , Casey Ryan , Girling Evi , Polanska Gosia
Published: September 2023

What crimes and security concerns trouble differently-situated groups of people today? What demands for action do these prompt from different authorities? To what extent are contemporary insecurities mediated through people’s sense of place and attendant feelings of belonging? The field of criminology used to be confident that it knew how to answer these questions and had a paradigm—‘fear of crime’—within which to investigate and theorize them. That paradigm was always unstable. But over recent decades it has been thoroughly dissolved by the sheer range and scale of technological, cultural, economic and political transformations —from the Great Crash and its aftermath, to the digital revolution, Brexit and the rise of nativist populism, #MeToo and #BlackLivesMatter, the gathering climate crisis, and the legacies of the COVID pandemic, to name only a fraction of the concerns that bear upon people’s everyday lives. We are currently investigating these questions of in/security in everyday life by revisiting an old research site, Macclesfield in Cheshire, and an old study, Girling et al., Crime and Social Change in Middle England (Routledge 2000). In this paper, we sketch the changing landscape that bears upon the question of how to theorize and investigate in/security in everyday social relations today, and consider the intellectual resources that we need to marshal if we are to understand the hopes, fears and fantasies that are in play when people think, deliberate and act in response to the question—What does it mean to be and feel secure in Britain today?
Quantification of Drospirenone- and Ethinyl Estradiol-Related Impurities in a Combined Pharmaceutical Dosage Form by a Chromatography Method With a QbD Robustness Study
Authors: Chinta Srinivasa Reddy , Chintala Vaishnavi , Nandimalla Vishnu , Ch Rajyalakshmi , Ediga Sasikiran Goud , Kowtharapu Leela Prasad , Katari Naresh Kumar
Published: September 2023

Background

The estimation of drugs containing drospirenone (DRSP) and ethinyl estradiol (EE), and their related impurities, in low-dose oral contraceptive drug products is an extremely challenging target. The proposed research sought to develop and validate a stability-indicating method for quantifying drug substances and their related impurities in tablet formulation.

Objective

To develop and validate a simple, specific, accurate, precise, and stability-indicating reverse-phase (RP)-HPLC method for quantification of DRSP, EE, and their impurities in accordance with International Conference on Harmonisation (ICH) guidelines.

Method

The separation was achieved using an Agilent Zorbax SB C18 column (4.6 mm × 250 mm, 5 µm) with a detection wavelength of 215 nm and mobile phases A (100% acetonitrile) and B (acetonitrile–water, 1 + 3, v/v) at a flow rate of 1.3 mL/min and a column temperature of 40°C.

Results

The recovery study of each impurity was conducted in the range of 24 to 72 µg/mL for DRSP-related impurities and 0.2 to 0.6 µg/mL for EE-related impurities with respect to the specification limit. A linearity study was conducted over a range of 1.5 to 90 µg/mL for DRSP and DRSP-related impurities, and 0.125 to 0.75 µg/mL for EE-related impurities. A Quality by Design (QbD) study demonstrated the method’s robustness.

Conclusions

As per current guidelines, a stability-indicating method has been developed for the determination of impurities in DRSP/EE film-coated tablets. A QbD-based robustness test was performed and the method was found to be robust.

Highlights

An accurate, precise, stability-indicating, gradient RP-HPLC method has been developed and validated to determine DRSP, EE, and nine related impurities in tablet formulation. A QbD technique was used to establish a robustness study.
Hypoglycemia
Authors: Beattie Sarah
Published: September 2023

Primary care NPs are central to the management of diabetes mellitus, which carries with it the risk of hypoglycemia. Fully understanding risk factors, prevention strategies, and treatment assist in reducing hypoglycemic events. This article details hypoglycemia, risk factors for hypoglycemia, prevention strategies, and appropriate treatment plans.
Diphtheria update
Authors: Schweon Steven J.
Published: September 2023

Travelers from parts of the world where diphtheria is endemic and vaccines are underutilized or unavailable may carry diphtheria, become ill, and spread the disease. This article provides an overview of diphtheria as well as management updates that are particularly critical amid new travel records and a climate of vaccine hesitancy.
Generating and measuring effective vaccine-elicited HIV-specific CD8+ T cell responses
Authors: Borgo Gina M. , Rutishauser Rachel L.
Published: September 2023

Purpose of review

There is growing consensus that eliciting CD8+ T cells in addition to antibodies may be required for an effective HIV vaccine for both prevention and cure. Here, we review key qualities of vaccine-elicited CD8+ T cells as well as major CD8+ T cell-based delivery platforms used in recent HIV vaccine clinical trials.

Recent findings

Much progress has been made in improving HIV immunogen design and delivery platforms to optimize CD8+ T cell responses. With regards to viral vectors, recent trials have tested newer chimp and human adenovirus vectors as well as a CMV vector. DNA vaccine immunogenicity has been increased by delivering the vaccines by electroporation and together with adjuvants as well as administering them as part of a heterologous regimen. In preclinical models, self-amplifying RNA vaccines can generate durable tissue-based CD8+ T cells. While it may be beneficial for HIV vaccines to recapitulate the functional and phenotypic features of HIV-specific CD8+ T cells isolated from elite controllers, most of these features are not routinely measured in HIV vaccine clinical trials.

Identifying a vaccine capable of generating durable T cell responses that target mutationally vulnerable epitopes and that can rapidly intercept infecting or rebounding virus remains a challenge for HIV. Comprehensive assessment of HIV vaccine-elicited CD8+ T cells, as well as comparisons between different vaccine platforms, will be critical to advance our understanding of how to design better CD8+ T cell-based vaccines for HIV.
Robot-assisted ileocystoplasty for the treatment of adult neurogenic bladder: A video demonstration and outcomes
Authors: Yeow Siying , Goolam Ahmed , Chung Amanda
Published: September 2023

Ileocystoplasty is one of the treatment options in the armamentarium for the management of adults with neurogenic bladder dysfunction, after failure of less invasive treatment alternatives, such as intravesical onabotulinum toxin A injection therapy and sacral neuromodulation. It has traditionally been performed as open surgery and can be associated with significant morbidity, especially in the early postoperative period.[1] Complications associated with open ileocystoplasty include prolonged postoperative ileus, wound infections, and pain. Performing robot-assisted ileocystoplasty can reduce the morbidity associated with open surgery[2] and has been shown to be safe and feasible in experienced hands,[3] although it may be associated with increased operative duration because of its learning curve. Our technique of robot-assisted ileocystoplasty and early postoperative outcomes is demonstrated in this video (Supplemental Digital Content, http://links.lww.com/CURRUROL/A47).

Robotic console time was 180 minutes, with minimal blood loss. Eight-hourly catheter aspiration and flushes were performed to manage the mucus in the urine. There were no metabolic acidosis or electrolyte derangements postoperatively. The patient was discharged on postoperative day 5. Postoperative cystogram at week 2 showed no leak and the patient is doing well at 1 year postoperatively. Robotic ileocystoplasty is safe and feasible and can reduce the morbidity associated with open surgery with good outcomes.
A review of transplant infectious diseases and pediatric transplant infectious diseases curriculum
Authors: Morales Megan K. , Danziger-Isakov Lara , Nematollahi Saman
Published: September 2023

Purpose of review

As the volume and complexity of solid organ and hematopoietic stem cell transplantation continue to see rapid growth, the training of a specialized transplant infectious diseases physician workforce is of increasing interest and importance. This review provides an overview of the evolution of transplant infectious diseases training programs, essential elements of training, as well as future needs.

Recent findings

Despite the first publication of a transplant infectious diseases curriculum in 2010, more recent surveys of infectious diseases trainees have identified gaps in didactic curriculum, donor and recipient assessment, and safe living practices.

This review of transplant infectious diseases training summarizes growth through the decades, the current landscape of recommend training elements, suggested areas for continued development and expansion in training as well as novel methodologies to reach a modern trainee audience.
Papillary Hemangioma Harbors Somatic GNA11 and GNAQ Mutations
Authors: Gestrich Catherine K. , Vivero Mathew P. , Konczyk Dennis J. , Goss Jeremy A. , Labow Brian I. , Pearson Gregory D. , Cottrell Catherine E. , Mathew Mariam T. , Prasad Vinay , Kozakewich Harry P. , Fletcher Christopher D.M. , Greene Arin K. , Al-Ibraheemi Alyaa
Published: September 2023

Papillary hemangioma (PH) is a small, primarily dermal lesion occurring predominantly in the head and neck in both children and adults. Its signature characteristics are dilated thin-walled channels containing papillary clusters of mainly capillary-sized vessels and endothelial cytoplasmic eosinophilic inclusions. Given certain histopathologic similarities to congenital hemangioma which harbor mutations in GNAQ and GNA11, we investigated whether similar mutations are present in PH. Seven PH specimens were studied. All presented in the first 4 years of life, with one being noted at birth. With the exception of one lesion, all were in the head and neck. Lesions were bluish and ranged in size from 0.5 to 2.8 cm. Four samples had GNA11 p.Q209L and 3 had GNAQ p.Q209L missense mutations. Mutations in GNA11 and GNAQ are associated with other types of somatic vascular lesions including capillary malformation, congenital hemangioma, anastomosing hemangioma, thrombotic anastomosing hemangioma, and hepatic small cell neoplasm. Shared mutations in GNA11 and GNAQ may account for some overlapping clinical and pathologic features in these entities, perhaps explicable by the timing of the mutation or influence of the germline phenotype.
Evaluating Potential Disparities in Geospatial Access to ACS/AAST Verified Emergency General Surgery Centers
Authors: Silver David S. , Beiringer Jamison , Lu Liling , Peitzman Andrew B. , Neal Matthew D. , Brown Joshua B.
Published: September 2023

Background

The American Association for the Surgery of Trauma and the American College of Surgeons have recently introduced emergency general surgery (EGS) center verification, which could enhance patient outcomes. Distance and resource availability may affect access to these centers, which has been linked to higher mortality. Although many patients can receive adequate care at community centers, those with critical conditions may require specialized treatment at EGS-verified centers. We aimed to evaluate geospatial access to potential EGS-verified centers and identify disparities across different scenarios of EGS verification program uptake in the US.

Methods

We utilized hospital capabilities and verified pilot centers to estimate potential patterns of which centers would become EGS verified under four scenarios (EGS centers; high volume EGS centers; high volume EGS + level 1 trauma centers; quaternary referral centers). We calculated the spatial accessibility index (SPAI) using an enhanced 2-step floating catchment technique to determine geospatial access for each scenario. We also evaluated social determinants of health across geospatial access using the Area Deprivation Index (ADI).

Results

1932 hospitals were categorized as EGS centers, 307 as high volume EGS centers, 401 as high volume EGS + level 1trauma centers; and 146 as quaternary centers. SPAI decreased as the stringency of EGS verification increased in each scenario (226.6 [111.7, 330.7]; 51.8 [0, 126.1]; 71.52 [3.34-164.56]; 6.2 [0, 62.2], p < 0.001). Within each scenario, SPAI also declined as the ADI quartile increased (p < 0.001). The high volume EGS + level 1trauma center scenario had the most significant disparity in access between the 1st and 4th ADI quartiles (-54.68).

Conclusions

Access to EGS-verified centers may vary considerably based on the program's implementation. Disadvantaged communities may be disproportionately affected by limited access. Further work to study regional needs can allow a strategic implementation of the EGS verification program to optimize outcomes while minimizing disparities.

Evidence Level

Level III, Epidemiological
Anesthesia and Critical Care for the Prediction and Prevention for Small-for-size Syndrome: Guidelines from the ILTS-iLDLT-LTSI Consensus Conference
Authors: Chadha Ryan , Sakai Tetsuro , Rajakumar Akila , Shingina Alexandra , Yoon Uzung , Patel Dhupal , Spiro Michael , Bhangui Pooja , Sun Li-Ying , Humar Abhinav , Bezinover Dmitri , Findlay James , Saigal Sanjiv , Singh Shweta , Yi Nam-Joon , Rodriguez-Davalos Manuel , Kumar Lakshmi , Kumaran Vinay , Agarwal Shaleen , Berlakovich Gabriela , Egawa Hiroto , Lerut Jan , Clemens Broering Dieter , Berenguer Marina , Cattral Mark , Clavien Pierre-Alain , Chen Chao-Long , Shah Samir , Zhu Zhi-Jun , Ascher Nancy , Bhangui Prashant , Rammohan Ashwin , Emond Jean , Rela Mohamed
Published: September 2023

Background.

During the perioperative period of living donor liver transplantation, anesthesiologists and intensivists may encounter patients in receipt of small grafts that puts them at risk of developing small for size syndrome (SFSS).

Methods.

A scientific committee (106 members from 21 countries) performed an extensive literature review on aspects of SFSS with proposed recommendations. Recommendations underwent a blinded review by an independent expert panel and discussion/voting on the recommendations occurred at a consensus conference organized by the International Liver Transplantation Society, International Living Donor Liver Transplantation Group, and Liver Transplantation Society of India.

Results.

It was determined that centers with experience in living donor liver transplantation should utilize potential small for size grafts. Higher risk recipients with sarcopenia, cardiopulmonary, and renal dysfunction should receive small for size grafts with caution. In the intraoperative phase, a restrictive fluid strategy should be considered along with routine use of cardiac output monitoring, as well as use of pharmacologic portal flow modulation when appropriate. Postoperatively, these patients can be considered for enhanced recovery and should receive proactive monitoring for SFSS, nutrition optimization, infection prevention, and consideration for early renal replacement therapy for avoidance of graft congestion.

Conclusions.

Our recommendations provide a framework for the optimal anesthetic and critical care management in the perioperative period for patients with grafts that put them at risk of developing SFSS. There is a significant limitation in the level of evidence for most recommendations. This statement aims to provide guidance for future research in the perioperative management of SFSS.
Rescue Liver Transplantation for Posthepatectomy Liver Failure: A Systematic Review and Survey of an International Experience
Authors: Azoulay Daniel , Desterke Christophe , Bhangui Prashant , Serrablo Alejandro , De Martin Eleonora , Cauchy François , Salloum Chady , Allard Marc Antoine , Golse Nicolas , Vibert Eric , Sa Cunha Antonio , Cherqui Daniel , Adam René , Saliba Faouzi , Ichai Philippe , Feray Cyrille , Scatton Olivier , Lim Chetana
Published: September 2023

Background.

Rescue liver transplantation (LT) is the only life-saving option for posthepatectomy liver failure (PHLF) whenever it is deemed as irreversible and likely to be fatal. The goals were to perform a qualitative systematic review of rescue LT for PHLF and a survey among various international LT experts.

Methods.

A literature search was performed from 2000 to 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Population, Intervention, Comparison, Outcome framework, and to this, the authors’ experience was added. The international online open survey included 6 cases of PHLF extracted from the literature and submitted to 976 LT experts. The primary outcome was whether experts would consider rescue LT for each case. Interrater agreement among experts was calculated using the free-marginal multirater kappa methodology.

Results.

The review included 40 patients. Post-LT mortality occurred in 8 (20%) cases (7/28 with proven cancer and 1/12 with benign disease). In the long term, 6 of 21 (28.6%) survivors with cancer died of recurrence (median = 38 mo) and 15 (71.4%) were alive with no recurrence (median = 111 mo). All 11 survivors with benign disease were alive and well (median = 39 mo). In the international survey among experts in LT, the percentage agreement to consider rescue LT was 28%–98%, higher for benign than for malignant disease (P = 0.011). Interrater agreement for the primary endpoint was low, expected 5-y survival >50% being the strongest independent predictor to consider LT.

Conclusions.

Rescue LT for PHLF may achieve good results in selected patients. Considerable inconsistencies of decision-making exist among LT experts when considering LT for PHLF.
The signalling lipid PI3,5P
2
is essential for timely mitotic exit
Authors: Huda Mariam , Bektas Seyma Nur , Bekdas Baris , Caydasi Ayse Koca
Published: September 2023

Coordination of mitotic exit with chromosome segregation is key for successful mitosis. Mitotic exit in budding yeast is executed by the mitotic exit network (MEN), which is negatively regulated by the spindle position checkpoint (SPOC). SPOC kinase Kin4 is crucial for SPOC activation in response to spindle positioning defects. Here, we report that the lysosomal signalling lipid phosphatidylinositol-3,5-bisphosphate (PI3,5P
2
) has an unanticipated role in the timely execution of mitotic exit. We show that the lack of PI3,5P
2
causes a delay in mitotic exit, whereas elevated levels of PI3,5P
2
accelerates mitotic exit in mitotic exit defective cells. Our data indicate that PI3,5P
2
promotes mitotic exit in part through impairment of Kin4. This process is largely dependent on the known PI3,5P
2
effector protein Atg18. Our work thus uncovers a novel link between PI3,5P
2
and mitotic exit.
Draft genome sequences of corn pathogenic and no pathogenic Pantoea ananatis strains
Authors: Moura Duin Izabela , Yumi Baba Viviane , Neves Paduan Fernanda , Sugahara Rodrigues Vanessa , Huguet-Tapia Jose , Jones Jeffrey , Giovanetti Canteri Marcelo , Pereira Leite Júnior Rui , Balbi-Peña Maria Isabel
Published: September 2023

We performed genome sequencing and comparative studies of Brazilian Pantoea ananatis strains isolated from diseased tissue of corn leaves with bacterial leaf streak (BLS) and maize white spot (MWS) to confirm the bacterial identity and to understand the relationship among these strains, as well as with three P. ananatis genomes from different plant hosts. In pathogenicity tests, the strains 4.2 and 13.3 isolated from BLS symptomatic leaves were not able to cause disease on corn. In contrast, the strain B13 isolated from MWS diseased leaf tissue caused typical symptoms of MWS. Our comparative analysis revealed that the genomes have several differences. The G+C (%) content of the strains 4.2 and 13.3 were 53.5% while for B13 was 53.7%. The average nucleotide identity (ANI) between B13 and 13.3, and B13 and 4.2 were 99.17 and 99.15%, respectively, and between 13.3 and 4.2 was 99.99%. To our knowledge, this is the first draft genome sequence of P. ananatis corn strains from Brazil.
Peptoniphilus equinus sp. nov., a novel Gram-stain-positive anaerobic coccus isolated from the faeces of a thoroughbred racehorse
Authors: Jung Hye Su , Yun Jeong Ui , Jung Mi-Ja , Song Hye Seon , Kim Yeon Bee , Kim Yujin , Kim Joon-Gyu , Jeon Che Ok , Roh Seong Woon , Whon Tae Woong , Lee Se Hee
Published: September 2023

A novel, anaerobic, Gram-stain-positive coccoid strain, CBA3646T, was isolated from the faeces of a thoroughbred racehorse. Phylogenetic analysis based on 16S rRNA gene sequencing yielded results indicative of CBA3646T representing a member of the genus

Peptoniphilus

, with the species most closely related to it being

Peptoniphilus asaccharolyticus

DSM 20463T, with a similarity of 94.79 %. DNA–DNA relatedness and average nucleotide identity values between CBA3646T and

P. asaccharolyticus

DSM 20463T were 21.4 and 67.6 %, respectively. CBA3646T has a circular chromosomal genome of 1 709 189 bp (45.5 mol% DNA G+C content), containing 1652 genes in total, 1584 predicted protein-coding genes, 3 complete rRNA loci and 47 tRNA genes. The cells were non-motile diplococci, catalase-positive and oxidase-negative. Growth of CBA3646T was observed at 20–40 °C (optimal temperature, 35 °C) and in the presence of 0–4 % (w/v) NaCl (optimum concentration, 1 %). The major fatty acids (>10 %) of CBA3646T were C16 : 0, C18 : 1ω9c and C18 : 1ω9c dimethyl acetal, with its major polar lipids being diphosphatidylglycerol and phosphatidylglycerol. The elucidated phylogenetic, physiological, chemotaxonomic and molecular properties are indicative of strain CBA3646T representing a novel species of the genus

Peptoniphilus

, or which the name Peptoniphilus equinus sp. nov. is proposed. The type strain is CBA3646T (= KACC 22890T = JCM 35845T).