bluuebunny/crossref_metadata_2025 huggingface dataset:
Narratives, Knowledge Objects, and the Making of Great Power Competition
Authors: Müller Thomas
Published: September 2024

What makes great power relations more (or less) competitive? One key argument in International Relations (IR) is that interpretations matter and shape how competitive great power relations are. This article seeks to further develop this argument. Drawing on objectual IR and the sociology of expectations, it proposes a constructivist framework that unpacks two crucial, yet surprisingly little studied aspects of the making of great power competition: (i) the constitution and organization of great power relations as a contest over scarce goods and (ii) the interplay of narratives and knowledge objects that underpins it. To illustrate the framework and contribute to theory development, the article reconstructs the dynamics of two prominent dimensions of great power competition in the past decade: The tensions between NATO and Russia in Europe and the economic competition between the United States and China. It shows that the making of great power competition involves three interrelated elements: the framing of relations among powerful states as contests over some valued goods, the production of knowledge about the distribution of these goods, and governance arrangements stipulating rules for the contests. What underpins the three elements is an interplay of narratives and knowledge objects: General narratives of what the competition is about and what is at stake preconfigure which knowledge objects are regarded as pertinent. The pertinent knowledge objects, in turn, shape the specific narratives that are told about how the competition unfolds.
The imperative of teamwork in antimicrobial stewardship (AMS) interventions: insights from an ethnographic study with practitioners in Spain
Authors: Moreno Lozano Cristina
Published: September 2024

Teamwork—the activity of working together in a group towards a similar goal—is a defining feature of the practice of clinical medicine carried out in hospitals and other healthcare facilities. This Viewpoint suggests that teamwork is a defining feature of antimicrobial stewardship (AMS) programmes, and identifies six elements that characterise AMS team dynamics. These insights arise from an original ethnographic study of AMS carried out in Spain, where these programmes are known as Programas para la Optimización de Antimicrobianos. The study used qualitative research methods including ethnographic observations in public hospitals and scientific and educational fora, in-depth interviews and archival research. It calls for a reflection on the part of the global community of AMS practitioners on the role of team dynamics in building sustainable AMS interventions and the inclusion of teamwork skills in training curricula aimed at future practitioners.
Genomic epidemiology and longitudinal sampling of ward wastewater environments and patients reveals complexity of the transmission dynamics of blaKPC-carbapenemase-producing Enterobacterales in a hospital setting
Authors: Stoesser N , George R , Aiken Z , Phan H T T , Lipworth S , Quan T P , Mathers A J , De Maio N , Seale A C , Eyre D W , Vaughan A , Swann J , Peto T E A , Crook D W , Cawthorne J , Dodgson A , Walker A S ,   TRACE Investigators Group, Aiken Zoie , Akinremi Oluwafemi , Ali Aiysha , Cawthorne Julie , Cleary Paul , Crook Derrick W , Decraene Valerie , Dodgson Andrew , Doumith Michel , Ellington Matthew J , George Ryan , Grimshaw John , Guiver Malcolm , Hill Robert , Hopkins Katie L , Jones Rachel , Lenney Cheryl , Mathers Amy J , McEwan Ashley , Moore Ginny , Mumford Andrew , Neilson Mark , Neilson Sarah , Peto Tim E A , Phan Hang T T , Regan Mark , Seale Anna C , Stoesser Nicole , Turner-Gardner Jay , Watts Vicky , Sarah Walker A , Walker Jimmy , Welfare William , Woodford Neil , Wyllie David H
Published: September 2024

Background

Healthcare-associated wastewater and asymptomatic patient reservoirs colonized by carbapenemase-producing Enterobacterales (CPE) contribute to nosocomial CPE dissemination, but the characteristics and dynamics of this remain unclear.

Methods

We systematically sampled wastewater sites (n = 4488 samples; 349 sites) and patients (n = 1247) across six wards over 6–12 months to understand blaKPC-associated CPE (KPC-E) diversity within these reservoirs and transmission in a healthcare setting. Up to five KPC-E-positive isolates per sample were sequenced (Illumina). Recombination-adjusted phylogenies were used to define genetically related strains; assembly and mapping-based approaches were used to characterize antimicrobial resistance genes, insertion sequences (ISs) and Tn4401 types/target site sequences. The accessory genome was evaluated in some of the largest clusters, and those crossing reservoirs.

Results

Wastewater site KPC-E-positivity was substantial [101/349 sites (28.9%); 228/5601 (4.1%) patients cultured]. Thirteen KPC-E species and 109 strains were identified using genomics, and 24% of wastewater and 26% of patient KPC-E-positive samples harboured one or more strains. Most diversity was explained by the individual niche, suggesting localized factors are important in selection and spread. Tn4401 + flanking target site sequence diversity was greater in wastewater sites (P < 0.001), which might favour Tn4401-associated transposition/evolution. Shower/bath- and sluice/mop-associated sites were more likely to be KPC-E-positive (adjusted OR = 2.69; 95% CI: 1.44–5.01; P = 0.0019; and adjusted OR = 2.60; 95% CI: 1.04–6.52; P = 0.0410, respectively). Different strains had different blaKPC dissemination dynamics.

Conclusions

We identified substantial and diverse KPC-E colonization of wastewater sites and patients in this hospital setting. Reservoir and niche-specific factors (e.g. microbial interactions, selection pressures), and different strains and mobile genetic elements likely affect transmission dynamics. This should be considered in surveillance and control strategies.
DxGoals: A Software Tool for Determining and Analyzing Clinically Meaningful Classification Accuracy Goals for Diagnostic Tests
Authors: Nguyen Ngoc-Ty , Pennello Gene A
Published: September 2024

Background

To evaluate diagnostic tests for low prevalence conditions, classification accuracy metrics such as sensitivity, specificity, and positive likelihood ratio (PLR) and negative likelihood ratio (NLR) are advantageous because they are prevalence-independent and thus estimable in studies enriched for the condition. However, classification accuracy goals are often chosen without a clear understanding of whether they are clinically meaningful. Pennello (2021) proposed a risk stratification framework for determining classification accuracy goals. A software application is needed to determine the goals and provide data analysis.

Methods

We introduce DxGoals, a freely available, R-Shiny software application for determining, visualizing, and analyzing classification accuracy goals for diagnostic tests. Given prevalence p for the target condition and specification that a test's positive and negative predictive values PPVand NPV=1−cNPV should satisfy PPV>PPV* and cNPV<cNPV*, DxGoals uses Bayes Theorem to determine equivalent goals for PLR and NLR and implied goals for sensitivity and specificity. When study data are provided, DxGoals analyzes whether the determined goals are met with statistical significance. When comparing 2 tests, DxGoals translates a superiority or noninferiority goals for the differences PPV−p and p−cNPV to equivalent goals for PLR and NLR and analyzes the goals when data are provided.

Results

We illustrate DxGoals on tests for penicillin allergy, ovarian cancer, and cervical cancer. The inputs cNPV*,p, and PPV* were informed by clinical management guidelines.

Conclusions

DxGoals facilitates determination, visualization, and analysis of clinically meaningful standalone and comparative classification accuracy goals. It is a potentially useful tool for diagnostic test evaluation.
Total Copper and Labile Bound Copper Fraction as a Selective and Sensitive Tool in the Evaluation of Wilson Disease
Authors: Bornhorst Joshua A , Bitzer Anna C , Day Patrick L , Wermers Michelle , Smith Carin Y , Pazdernik Vanessa K , Pelto Ryan , Sankaran Banu , Quicquaro Adam , Jannetto Paul J
Published: September 2024

Background

A dual filtration-based method for determination of serum labile bound copper (LBC) and LBC fraction (LBC/total copper) was developed. Reduced total copper, elevated LBC, and elevated LBC fraction have been reported in Wilson disease (WD).

Methods

To evaluate the diagnostic performance of these markers, samples were obtained from 21 WD treatment-naïve (WD-TN, no WD treatment or <28 days of treatment) patients, 46 WD standard-of-care–treated (WD-SOC) patients, along with 246 patients representing other potential disorders of copper status. These were then compared to 213 reference interval population patients.

Results

Receiver operating characteristic curves for the reference population vs WD-TN yielded areas under the curve for total copper, LBC, and LBC fraction, of 0.99, 0.81, and 0.98, respectively. Using Youden cutoffs, sensitivity/specificity for WD-TN was 95%/97% for total copper, 71%/85% for LBC, and 95%/94% for LBC fraction. LBC values, but not total copper and LBC fraction, differed substantially between WD-TN and WD-SOC cohorts.

We propose a dual model wherein total copper and LBC fraction results must agree to be classified as a “positive” or “negative” result for WD. This correctly classified 19/21 WD-TN patients as positive, and 194/213 reference interval patients as negative. The remaining “indeterminate” patients (representing approximately 9% of the reference and the WD-TN populations) exhibited conflicting total copper and LBC fraction results. When indeterminate results are excluded, this model exhibited apparent 100% sensitivity/specificity.

Conclusions

Agreement of total serum copper and LBC fraction classification may constitute an effective “rule-in” and “rule-out” assessment for WD-TN patients.
Cardiac Troponin to Adjudicate Subclinical Heart Failure in Diabetic Patients and a Murine Model of Metabolic Syndrome
Authors: Brown Hannah M , Spies Nicholas C , Jia Wentong , Moley John , Lawless Sydney , Roemmich Brittany , Brestoff Jonathan R , Zaydman Mark A , Farnsworth Christopher W
Published: September 2024

Background

Cardiovascular disease, kidney health, and metabolic disease (CKM) syndrome is associated with significant morbidity and mortality, particularly from congestive heart failure (CHF). Guidelines recommend measurement of cardiac troponin (cTn) to identify subclinical heart failure (HF) in diabetics/CKM. However, appropriate thresholds and the impact from routine screening have not been elucidated.

Methods

cTnI was assessed using the Abbott high sensitivity (hs)-cTnI assay in outpatients with physician-ordered hemoglobin A1c (Hb A1c) and associated with cardiac comorbidities/diagnoses, demographics, and estimated glomerular filtration rate (eGFR). Risk thresholds used in CKM staging guidelines of >10 and >12 ng/L for females and males, respectively, were used. Multivariate logistic regression was applied. hs-cTnI was assessed in a high-fat-diet induced murine model of obesity and diabetes.

Results

Of 1304 patients, 8.0% females and 15.7% males had cTnI concentrations above the risk thresholds. Thirty-one (4.2%) females and 23 (4.1%) males had cTnI above the sex-specific 99% upper reference limit. A correlation between hs-cTnI and Hb A1c (R = 0.2) and eGFR (R = −0.5) was observed. hs-cTnI concentrations increased stepwise based on A1C of <5.7% (median = 1.5, IQR:1.3–1.8), 5.7%–6.4% (2.1, 2.0–2.4), 6.5%–8.0% (2.8, 2.5–3.2), and >8% (2.8, 2.2–4.3). Male sex (P < 0.001), eGFR (P < 0.001), and CHF (P = 0.004) predicted elevated hs-cTnI. Obese and diabetic mice had increased hs-cTnI (7.3 ng/L, 4.2–10.4) relative to chow-fed mice (2.6 ng/L, 1.3–3.8).

Conclusion

A high proportion of outpatients with diabetes meet criteria for subclinical HF using hs-cTnI measurements. Glucose control is independently associated with elevated cTnI, a finding replicated in a murine model of metabolic syndrome.
The effect of vitamin D3 and omega-3 combination, taken orally, on triglycerides, lining of intestine, and the biodiversity of gut microbiota in healthy rats
Authors: Abdulrazzaq Shaymaa B , Abu-Samak Mahmoud , Omar Amin , Barakat Muna , Alzaghari Lujain F , Mosleh Ibrahim , Al-Najjar Moath , Al-Najjar Mohammad A A
Published: September 2024

Aim

The gut microbiota plays a key role in host health. An intake of omega-3 and vitamin D3 in a separate manner is vital for maintaining good health of gut microbiota and controlling some illness manifestations. The aim of this study is to investigate the potential change in biodiversity of the gut microbiome in healthy rats supplemented with vitamin D3, omega-3 alone and their combination and to reflect onto the triglyceride levels in serum and fecal samples.

Methods and results

Using the 16S rRNA gene Miseq Illumina NGS, and monitoring triglyceride levels in serum and fecal samples coupled with several clinical parameters, we examined the effect of orally taken combination of omega-3 and vitamin D3 alongside the separate intake of supplements on gut microbiota in 24 healthy white Wistar rats for six weeks. The study findings showed that combination treatment encouraged the growth of opportunistic Clostridia class during day 21 and 42 of treatment by 7.7 and 7.4 folds, respectively, exhibited incomplete absorption levels for both supplements when used concomitantly, demonstrated a damaging effect on the gut intestinal lining wall thickness (126 µm) when compared to control group (158  µm), increasing lumen diameter (400 µm), and showed higher triglyceride level in fecal samples.

Conclusions

These findings indicate that omega-3 and vitamin D3 supplements as combination intake reveal unfavorable effects, thus, it is advised to conduct further in-depth studies to clarify the presence or absence of any chemical interaction between both supplements’ molecules and to investigate based on human model to attain a superior perspective.
Sheep and goats as reservoirs of colistin-resistant E. coli: first detection of ETEC ST10 and E. coli ST6396 mcr-1 positive strains in North Africa
Authors: Boukli-Hacene Fella , Djouadi Lydia Neïla , Raddaoui Anis , Hachem Yousra , Boumerdassi Hanane , Achour Wafa , Nateche Farida
Published: September 2024

Aim

This study aimed to screen and characterize colistin-resistant strains isolated from different livestock species in Algeria, including sheep, goats, and dromedaries.

Methods and results

A total of 197 rectal and nasal swabs were screened for colistin-resistant Gram-negative bacilli. Twenty one isolates were selected, identified, and their antibiotic resistance was phenotypically and genotypically characterized. The majority (15/21) were affiliated to Escherichia coli, from which 4 strains isolated from sheep (n = 2) and goats (n = 2) and belonging to phylogroup A and ST10 and ST6396 lineages, respectively, carried the mcr-1 gene. The remaining isolates were identified as belonging to the following genera: Raoultella, Enterobacter, Klebsiella, and Pseudomonas.

Conclusion

This study highlights the presence of virulent and multiresistant Gram-negative bacilli in farm animals, increasing the risk of transmitting potentially fatal infections to humans.
Language, 6-mercaptopurine adherence, and relapse in children with acute lymphoblastic leukemia
Authors: Robles Joanna , Chen Yanjun , Hageman Lindsey , Aristizabal Paula , Landier Wendy , Bhatia Smita , Wadhwa Aman
Published: September 2024

Hispanic children with acute lymphoblastic leukemia (ALL) have lower 6-mercaptopurine (6MP) adherence and greater hazard of relapse compared with non-Hispanic White children. We examined the association between Spanish language and 6MP adherence, and hazard of relapse. 6MP adherence was measured electronically over a 6-month period. Participants were grouped by the language of demographic questionnaire completion: Non-Hispanic White-English Speaking (ES, n = 159), Hispanic-Spanish Speaking (Hispanic-SS, n = 59), and Hispanic-ES (n = 109). Hispanic-ES had significantly lower fitted median 6MP adherence compared with non-Hispanic White-ES participants (88.3%, 95% CI = 84.7% to 91.2% vs 95.0%, 95% CI = 93.6% to 96.2%, P < .001). There was no difference in fitted median 6MP adherence between Hispanic-ES and Hispanic-SS participants (88.3%, 95% CI = 84.1% to 91.5% vs 88.3%, 95% CI = 84.7% to 91.2%, P = .9) or adjusted hazard of relapse for Hispanic-SS participants (HR = 0.9, 95%CI = 0.3 to 2.4, P = .8). Spanish language use among Hispanic patients with ALL is not associated with lower 6MP adherence or greater relapse risk. Factors related to Hispanic ethnicity, apart from language, appear to influence adherence.
Machine learning of metabolite–protein interactions from model-derived metabolic phenotypes
Authors: Habibpour Mahdis , Razaghi-Moghadam Zahra , Nikoloski Zoran
Published: September 2024

Unraveling metabolite–protein interactions is key to identifying the mechanisms by which metabolism affects the function of other cellular layers. Despite extensive experimental and computational efforts to identify the regulatory roles of metabolites in interaction with proteins, it remains challenging to achieve a genome-scale coverage of these interactions. Here, we leverage established gold standards for metabolite–protein interactions to train supervised classifiers using features derived from genome-scale metabolic models and matched data on protein abundance and reaction fluxes to distinguish interacting from non-interacting pairs. Through a comprehensive comparative study, we explore the impact of different features and assess the effect of gold standards for non-interacting pairs on the performance of the classifiers. Using data sets from Escherichia coli and Saccharomyces cerevisiae, we demonstrate that the features constructed by integrating fluxomic and proteomic data with metabolic phenotypes predicted from genome-scale metabolic models can be effectively used to train classifiers, accurately predicting metabolite–protein interactions in the context of metabolism. Our results reveal that the high performance of classifiers trained on these features is unaffected by the method used to generate gold standards for non-interacting pairs. Overall, our study introduces valuable features that improve the performance of identifying metabolite–protein interactions in the context of metabolism.
Diagnostic Dilemmas: A Review of Reported Cases of Human Herpesvirus 6 Encephalitis in Immunocompetent Adults
Authors: Webb Gemma , Leong Mei Yen Michelle , Bishop Emma , Sehu Marjoree
Published: September 2024

Human herpesvirus 6 (HHV-6) is associated with its presentation in the pediatric population as roseola infantum. Rarely, it is the causative agent of encephalitis, with most cases reported among the immunocompromised population due to reactivation. This review article analyzes the published records of cases labeled HHV-6 encephalitis in immunocompetent adults, aiming to understand the diagnostic methods behind each case and explore the complexities of such a diagnosis. We note significant variability in the methods used to come to a diagnosis of HHV-6 encephalitis, as well as inconsistent approaches to treatment of this condition. Given the rarity of HHV-6 encephalitis in immunocompetent adults, there are no clearly structured diagnostic guidelines for this condition in this patient population. We highlight several diagnostic methods that provide more convincing evidence of true HHV-6 encephalitis and may provide a basis for further development of guidelines for the diagnosis and treatment of this condition.
Multispecies Cocirculation of Adenoviruses Identified by Next-Generation Sequencing During an Acute Gastroenteritis Outbreak in Coastal Kenya in 2023
Authors: Lambisia Arnold W , Mutunga Martin , Katama Esther N , Agoti Charles N , Houldcroft Charlotte J
Published: September 2024

Background

Although 7 human adenovirus (HAdV) species are known to exist, only F (types 40 and 41) and G are identified as diarrheal disease agents. The role of other HAdV species in diarrheal disease remains unclear, and data on their prevalence are limited. We describe HAdV species and types in hospitalized children with diarrhea in coastal Kenya.

Methods

Three hundred twenty-nine stool samples collected between June 2022 and August 2023 from children aged <13 years were screened for HAdV using quantitative polymerase chain reaction (qPCR). Positive HAdV cases were genotyped by adenovirus primers from the RespiCoV panel by amplification, next-generation sequencing, and phylogenetic analysis.

Results

Sixty-five samples (20%) tested HadV positive, of which 5 HAdV species were identified. Other than HAdV F, other species included A, B, C, and D; these were detected as either mono-detections or coinfections. Six HAdV F identified by NGS had been missed by our qPCR typing method. This appeared to be as a result of a 133-nucleotide deletion in the long fiber protein, which abrogated a primer and probe binding site. Based on grading of diarrheal disease severity using VESIKARI scores, 93% of the HAdV cases presented with severe disease. One child with an HAdV F infection died.

Conclusions

Our study shows the enormous diversity and clinical characteristics of HAdV species in children with diarrhea in coastal Kenya. These data offer an opportunity to improve current diagnostic assays and increase knowledge of HAdV in Africa for control of outbreaks in the future.
Sendai virus-mediated RNA delivery restores fertility to congenital and chemotherapy-induced infertile female mice
Authors: Kanatsu-Shinohara Mito , Morimoto Hiroko , Liu Tianjiao , Tamura Masaru , Shinohara Takashi
Published: September 2024

Current infertility treatment strategies focus on mature gametes, leaving a significant proportion of cases with gamete progenitors that stopped complete differentiation. On the other hand, recent advancements in next-generation sequencing have identified many candidate genes that may promote maturation of germ cells. Although gene therapy has shown success in mice, concerns about the integration of DNA vectors into oocytes hinder clinical applications. Here, we present the restoration of fertility in female mice through Sendai virus (SeV)-mediated RNA delivery. Ovaries lacking Kitl expression exhibit only primordial follicles due to impaired signaling to oocytes expressing the KIT tyrosine kinase. Despite SeVs being immunogenic and larger than the blood-follicle barrier, the administration of Kitl-expressing SeVs reinitiated oogenesis in genetically infertile mice that have only primordial follicles, resulting in the birth of normal offspring through natural mating. This virus also effectively addressed iatrogenic infertility induced by busulfan, a widely used cancer chemotherapy agent. Offspring born through SeV administration and natural mating displayed normal genomic imprinting patterns and fertility. Since SeVs pose no genotoxicity risk, the successful restoration of fertility by SeVs represents a promising approach for treating congenital infertility with somatic cell defects and protecting fertility of cancer patients who may become infertile due to loss of oocytes during cancer therapy.
Subclass IId bacteriocins targeting mannose phosphotransferase system—Structural diversity and implications for receptor interaction and antimicrobial activity
Authors: Tymoszewska Aleksandra , Aleksandrzak-Piekarczyk Tamara
Published: September 2024

The bacterial mannose phosphotransferase system (Man-PTS) mediates uptake of selected monosaccharides. Simultaneously, it is a receptor for diverse bacteriocins such as subclass IIa pediocin-like bacteriocins and some subclass IId ones (garvicins ABCQ, lactococcins ABZ, BacSJ, ubericin K, and angicin). So far, no attempt has been made to categorize this ever-expanding group of bacteriocins. Here, we identified Man-PTS as a receptor for a number of previously uncharacterized bacteriocins, and demonstrated that they all belong to a large family of Man-PTS-binding nonpediocin-like peptides, providing new insights into their structure and function. Based on amino acid sequence similarities between members of this family, we propose their classification into five groups. This classification conveniently distinguishes bacteriocins with specific structures and properties regarding their spectrum of antimicrobial activity and pattern of interaction with Man-PTS. With respect to the latter, we indicate individual amino acid residues or regions of Man-PTS and the bacteriocin responsible for their interaction. In Man-PTS, these residues localize to the exterior of the transport complex, specifically the extracellular loop of the so-called Vmotif domain-containing regions γ and/or γ+, and to the interior of the transport complex, specifically the interface between the Core and Vmotif domains. Finally, we propose that while the bacteriocins from separate groups display specific binding patterns to Man-PTS, the general mechanism of their interaction with the receptor is universal despite significant differences in their predicted structures, i.e. after initial docking on the bacterial cell through an interaction with the Man-PTS regions γ and/or γ+, they pull away its Core and Vmotif from one another to form a pore across the membrane.
Large mammal behavioral defenses induced by the cues of human predation
Authors: Slovikosky Sandy A , Montgomery Robert A
Published: September 2024

Large mammals respond to human hunting via proactive and reactive responses, which can induce subsequent nonconsumptive effects (NCEs). Thus, there is evidence that large mammals exhibit considerable behavioral plasticity in response to human hunting risk. Currently, however, it is unclear which cues of human hunting large mammals may be responding to. We conducted a literature review to quantify the large mammal behavioral responses induced by the cues of human hunting. We detected 106 studies published between 1978 and 2022 of which 34 (32%) included at least one measure of cue, typically visual (n = 26 of 106, 25%) or auditory (n = 11 of 106, 10%). Space use (n = 37 of 106, 35%) and flight (n = 31 of 106, 29%) were the most common behavioral responses studied. Among the 34 studies that assessed at least one cue, six (18%) measured large mammal behavioral responses in relation to proxies of human hunting (e.g. hunting site or season). Only 14% (n = 15 of 106) of the studies quantified an NCE associated with an animal's response to human hunting. Moreover, the association between cues measured and antipredator behaviors is unclear due to a consistent lack of controls. Thus, while human hunting can shape animal populations via consumptive effects, the cues triggering these responses are poorly understood. There hence remains a need to link cues, responses, NCEs, and the dynamics of large mammal populations. Human activities can then be adjusted accordingly to prevent both overexploitation and unintended NCEs in animal populations.
Multifunctional bioactive glass nanoparticles: surface–interface decoration and biomedical applications
Authors: Chen Mi , Wang Yidan , Yuan Pingyun , Wang Lan , Li Xiaocheng , Lei Bo
Published: September 2024

Developing bioactive materials with multifunctional properties is crucial for enhancing their biomedical applications in regenerative medicine. Bioactive glass nanoparticle (BGN) is a new generation of biomaterials that demonstrate high biocompatibility and tissue-inducing capacity. However, the hard nanoparticle surface and single surface property limited their wide biomedical applications. In recent years, the surface functional strategy has been employed to decorate the BGN and improve its biomedical applications in bone tissue repair, bioimaging, tumor therapy and wound repair. This review summarizes the progress of surface–interface design strategy, customized multifunctional properties and biomedical applications in detail. We also discussed the current challenges and further development of multifunctional BGN to meet the requirements of various biomedical applications.
Bladder sparing options for muscle-invasive bladder cancer
Authors: Laukhtina Ekaterina , Moschini Marco , Teoh Jeremy Yuen-Chun , Shariat Shahrokh F.
Published: September 2024

Purpose of review

This review critically evaluates the current state of bladder-sparing options in muscle-invasive bladder cancer (MIBC) and provides an overview of future directions in the field.

Recent findings

Bladder-sparing treatments have emerged as viable alternatives to radical cystectomy (RC) for selected patients with MIBC, especially in those who are unfit for RC or elect bladder preservation. Numerous studies have assessed the efficacy of trimodal therapy (TMT), with outcomes comparable to RC in a subgroup of well selected patients. Combining immunotherapy with conventional treatments in bladder-sparing approaches can yield promising outcomes. Current research is making significant progress in optimizing treatment protocols by exploring new combinations of systemic therapy agents, innovative drug delivery methods, and biomarker-based approaches. Furthermore, clinical markers of response are being tested to ensure adequate response assessment.

Bladder preservation promise to offer a viable alternative to RC for selected patients with MIBC with the potential to improve patient quality of life. Careful patient selection and ongoing research are essential to optimize patient selection, response assessment, and salvage strategies. As evidence continues to evolve, the role of bladder preservation in MIBC is likely to expand, providing patients with more treatment options tailored to their needs and preferences.
The Eaton–Littler Ligament Reconstruction in Thumb Carpometacarpal Joint Instability: Outcomes and Prognostic Factors in 74 Patients
Authors: Nieuwdorp Niek J. , Jongen Isabel C. , Hundepool Caroline A. , van der Oest Mark J. W. , Moojen Thybout M. , Selles Ruud W. ,   Hand-Wrist Study Group, Zuidam J. Michiel
Published: September 2024

Background:

The Eaton–Littler ligament reconstruction is widely used for thumb carpometacarpal instability, yet the existing literature lacks a thorough analysis of the outcomes for nontraumatic instability. This study aimed to assess the outcomes of the Eaton–Littler ligament reconstruction and to identify prognostic factors associated with postoperative pain.

Methods:

Patients with nontraumatic carpometacarpal joint instability, unresponsive to conservative treatment, were included in this prospective study. The visual analog scale (range 0 to 100) for pain and the Michigan Hand Outcome Questionnaire (MHQ; range 0 to 100) total score were measured at intake and 3 and 12 months postoperatively. Multivariable linear regression was used to analyze the association between preoperative variables and the 12-month MHQ pain score.

Results:

Seventy-four patients undergoing Eaton–Littler ligament reconstruction were included. The median visual analog scale pain score improved significantly (P < 0.001) from intake (70 [interquartile range, 63 to 78]) to 12 months postoperatively (27 [interquartile range, 7 to 56]). The mean MHQ total score also improved significantly (P < 0.001) from intake (52; SD, 13) to 12 months (74; SD, 17). All thumbs were stable at follow-up with preserved range of motion. Grip and pinch strength also improved significantly after surgery. Undergoing a concurrent surgery during ligament reconstruction and a better MHQ pain score at intake were found to be predictors of a favorable postoperative MHQ pain score.

Conclusions:

Patient- and clinician-reported outcomes improved significantly at 3 and 12 months after Eaton–Littler ligament reconstruction. The authors advise concurrent hand pathologies resulting from instability (eg, tendinitis, synovitis) to be treated simultaneously during ligament reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Atraumatic Release of Incarcerated Inferior Rectus Muscle in Trapdoor Fracture Can Lead to Better Functional Outcome
Authors: Abdelazeem Mohamed H. , Barhoma Mohamed G.
Published: September 2024

Deciding the proper surgical approach for repairing blowout fractures with entrapped soft tissue are among one of the most challenging decisions for maxillofacial surgeons. This is due to multiple factors including the type and site of fracture, time elapsed from trauma. Tranconjunctival, subciliary, and/or transantral endoscopic has been described before. The authors report here a case of a young adult, presenting with diplopia, pain, and enophthalmos after being exposed to a blunt trauma on the left side. Computed tomography (CT) scan confirmed diagnosis of left orbital floor fracture with trapped inferior rectus in a trapdoor manner. Although presentation was later than 48 hours from trauma, yet incorporating, minimally traumatic dual, transconjunctival-transantral endoscopic approach the inferior rectus muscle was preserved and regained full range of movement, after <3 months postoperatively.
Emergency Medicaid enrollment after traumatic injury predicts long-term health care utilization
Authors: Haddad Diane N. , Eisinger Ella , Hatchimonji Justin S. , Chen Angela T. , Ramadan Omar I. , Morgan Anna U. , Lile Deacon J. , Delgado M. Kit , Reese James , Seamon Mark J. , Martin Niels D. , Reilly Patrick M. , Knowlton Lisa M. , Kaufman Elinore J.
Published: September 2024

BACKGROUND

Injured patients have high rates of uninsurance, which is associated with worse outcomes. Insurance linkage programs that connect patients to Medicaid coverage can prevent catastrophic costs for patients. Less is known about the long-term impact of insurance enrollment. We examined health care utilization for previously uninsured patients, hypothesizing that newly insured patients postinjury would use health care more than those remaining uninsured.

METHODS

We linked institutional trauma registry data to the electronic medical record to identify injured patients aged 18 to 64 years from 2017 to 2021. Patients admitted without insurance and then retroactively insured (RI) during hospitalization were compared with patients with preestablished Medicaid (Medicaid insured [MI]) and those remaining uninsured. We compared demographic and injury characteristics and future health care utilization, including hospitalizations, emergency department (ED) visits, and clinic visits, among groups at 30 days and 12 months postinjury. Patient-reported outcomes (PROs) 6 months after injury were compared by group for a subset of patients participating in an ongoing study of long-term PROs.

RESULTS

We compared 494 RI patients with 1,706 MI and 148 uninsured patients. Retroactively insured patients were younger, more likely to have penetrating injuries, and longer hospitalization than other groups. There was a significant increase in ED and clinic visits and hospital admissions at 30 days and 12 months between RI and uninsured patients (p < 0.001). Using multivariable logistic regression, RI was associated with higher future ED utilization, hospital admissions, and specialist visits at 30 days and 12 months compared with uninsured patients. Of the 265 patients with 6-month PROs, Medicaid coverage was not associated with any significant difference in physical function or anxiety.

CONCLUSION

Patients enrolled in insurance postinjury are more likely to use health care in the future than patients without insurance, but the downstream effects are less clear. Health insurance is a necessary step but not independently sufficient to optimize care and improve health outcomes.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.
Dogs with a vocabulary of object labels retain them for at least 2 years
Authors: Dror Shany , Miklósi Ádám , Fugazza Claudia
Published: September 2024

Long-term memory of words has a crucial role in the developing abilities of young children to acquire language. In dogs, the ability to learn object labels is present in only a small group of uniquely gifted word learner (GWL) dogs. As they are very rare, little is known about the mechanisms through which they acquire such large vocabularies. In the current study, we tested the ability of five GWL dogs to retrieve 12 labelled objects 2 years after the object-label mapping acquisition. The dogs proved to remember the labels of between three and nine objects. The results shed light on the process by which GWL dogs acquire an exceptionally large vocabulary of object names. As memory plays a crucial role in language development, these dogs provide a unique opportunity to study label retention in a non-linguistic species.
Beneath the surface: DNA barcoding of shark fins in Singapore
Authors: Saigal Manisha , Shueh Yi Hannah Ng , Rameez Nageen Ayesha , van Manen Siebe , Van Anh Bui Tr , Arora Vidhi P. , Han Kai Ding Max , Lee Jenelle Qian Tong , Syaddad Adlan , Tan Claudia Kexin , Lim Elisa X. Y. , Wainwright Benjamin J.
Published: September 2024

The global decline of shark populations, largely driven by overfishing to supply the shark fin trade, poses a significant threat to marine ecosystems. Southeast Asia, and particularly Singapore, is a key hub for the transit and trade of shark fins that contribute to the exploitation of these apex predators. Through the use of DNA barcoding techniques, this study aimed to determine what species of shark are involved in the Singapore shark fin trade. Fins were collected from markets, dried goods shops and traditional Chinese medicine halls throughout Singapore. In total, DNA was extracted from 684 fins collected in January 2024 and PCR amplification targeted a fragment of the mitochondrial COI gene for species identification. Results revealed fins from 24 species across 16 genera, with 19 species listed on CITES Appendices II, and 16 listed as threatened on the IUCN Red List (critically endangered = 2, endangered = 4, vulnerable = 10). The top five most frequently identified species were
Carcharhinus falciformis
,
Galeorhinus galeus
,
Rhizoprionodon oligolinx, Sphyrna lewini
and
Rhizoprionodon acutus
. Of these, four are listed on CITES Appendix II and four are listed as threatened on the IUCN Red List.
Theory of paraxial optical skyrmions
Authors: Ye Z. , Barnett S. M. , Franke-Arnold S. , Götte J. B. , McWilliam A. , Speirits F. C. , Cisowski C. M.
Published: September 2024

Vector light beams, characterized by a spatially varying polarization, can exhibit localized structures reminiscent of the skyrmions familiar from the study of magnetic media. We present a theory of such skyrmions within paraxial optics, exploiting mathematical analogies with the study of superfluids, especially the A phase of superfluid

He

3

. The key feature is the skyrmion field, which, together with the underlying skyrmion vector potential, determines the properties of the skyrmions and, more generally, the polarization structure of every paraxial vector beam. In addition to structures with integer skyrmion numbers, we find polarization patterns with non-integer skyrmion numbers; these seem to have no analogue in other fields of physics.
Monitoring soil fauna with ecoacoustics
Authors: Robinson Jake M. , Annells Amy , Cavagnaro Timothy R. , Liddicoat Craig , Rogers Heidi , Taylor Alex , Breed Martin F.
Published: September 2024

Ecoacoustics—or acoustic ecology—aids in monitoring elusive and protected species in several ecological contexts. For example, passive acoustic monitoring (PAM), which involves autonomous acoustic sensors, is widely used to detect various taxonomic groups in terrestrial and aquatic ecosystems, from birds and bats to fish and cetaceans. Here, we illustrate the potential of ecoacoustics to monitor soil biodiversity (specifically fauna)—a crucial endeavour given that 59% of species live in soil yet 75% of soils are affected by degradation. We describe the sources of sound in the soil (e.g. biological, geological and anthropogenic) and the ability of acoustic technology to detect and differentiate between these sounds, highlighting opportunities and current gaps in knowledge. We also propose a roadmap for the future development of optimized hardware, analytical pipelines and experimental approaches. Soil ecoacoustics is an emerging field with considerable potential to improve soil biodiversity monitoring and ‘soil health’ diagnostics. Indeed, early studies suggest soil ecoacoustics can be successfully applied in various ecosystems (e.g. grasslands, temperate, tropical and arid forests) and land uses (e.g. agriculture, viticulture, natural and restored ecosystems). Given the low cost, minimal intrusiveness, and effectiveness in supporting soil biodiversity assessments and biosecurity risks, we advocate for the advancement of soil ecoacoustics for future land management applications.
Connectome-based predictive modeling of brain pathology and cognition in Autosomal Dominant Alzheimer’s Disease
Authors: Tripathi Vaibhav , Fox-Fuller Joshua , Malotaux Vincent , Baena Ana , Felix Nikole Bonillas , Alvarez Sergio , Aguillon David , Lopera Francisco , Somers David C , Quiroz Yakeel T.
Published: September 2024

INTRODUCTION

Autosomal Dominant Alzheimer’s Disease (ADAD) through genetic mutations can result in near complete expression of the disease. Tracking AD pathology development in an ADAD cohort of Presenilin-1 (PSEN1)E280A carriers’ mutation has allowed us to observe incipient tau tangles accumulation as early as 6 years prior to symptom onset.

METHODS

Resting-state functional Magnetic Resonance Imaging (fMRI) and Positron-Emission Tomography (PET) scans were acquired in a group ofPSEN1carriers (n=32) and non-carrier family members (n=35). We applied Connectome-based Predictive Modeling (CPM) to examine the relationship between the participant’s functional connectome and their respective tau/amyloid-β levels and cognitive scores (word list recall).

RESULTS

CPM models strongly predicted tau concentrations and cognitive scores within the carrier group. The connectivity patterns between the temporal cortex, default mode network, and other memory networks were the most informative of tau burden.

DISCUSSION

These results indicate that resting-state fMRI methods can complement PET methods in early detection and monitoring of disease progression in ADAD.
Unsupervised learning for labeling global glomerulosclerosis
Authors: Weishaupt Hrafn , Besusparis Justinas , Weis Cleo-Aron , Porubsky Stefan , Laurinavičius Arvydas , Leh Sabine
Published: September 2024

Current deep learning models for classifying glomeruli in nephropathology are trained almost exclusively in a supervised manner, requiring expert-labeled images. Very little is known about the potential for unsupervised learning to overcome this bottleneck. To address this open question in a proof-of-concept, the project focused on the most fundamental classification task: globally sclerosed versus non-globally sclerosed glomeruli. The performance of clustering between the two classes was extensively studied across a variety of labeled datasets with diverse compositions and histological stains, and across the feature embeddings produced by 34 different pre-trained CNN models. As demonstrated by the study, clustering of globally and non-globally sclerosed glomeruli is generally highly feasible, yielding accuracies of over 95% in most datasets. Further work will be required to expand these experiments towards the clustering of additional glomerular lesion categories. We are convinced that these efforts (i) will open up opportunities for semi-automatic labeling approaches, thus alleviating the need for labor-intensive manual labeling, and (ii) illustrate that glomerular classification models can potentially be trained even in the absence of expert-derived class labels.
CD300e as a Driver of Immunosuppressive Tumor Microenvironment in Colorectal Cancer
Authors: Barizza Annica , Vassallo Stefania , Masatti Laura , Lonardi Silvia , Bugatti Mattia , Coletta Sara , Giacometti Sofia , Pizzini Simone , Vermi William , Munari Fabio , Gnoato Nicolò , Fassan Matteo , Nigro Giulia , Spolverato Gaya , Calura Enrica , Codolo Gaia
Published: September 2024

Tumor-associated macrophages (TAMs) are the predominant immune population within the tumor microenvironment (TME), playing a key role in promoting tumor growth and establishing an immunosuppressive environment that facilitate immune evasion. Here we report that the immune receptor CD300e is highly expressed by TAM in colorectal (CRC) and drives their immunosuppressive and pro-tumorigenic, correlating with reduced expression of MHC-II molecules, essential for antigen presentation. In vitro, CD300e-deficient macrophages exhibit enhanced pro-inflammatory activity and phagocytic capacity, coupled with reduced efferocytosis, suggesting a critical role for CD300e in promoting tumor progression. The depletion of CD300e, in vivo, results in a reduced tumor burden and enhanced survival in CRC mouse models, accompanied by a more robust anti-tumor immune response characterized by increased infiltration of activated CD4+ and CD8+ T cells producing IFN-γ. Our study provides comprehensive insights into the roles of CD300e in myeloid cells in CRC, highlighting its potential as a therapeutic target for reprogramming TAMs to support anti-tumor immunity.
Automatic diagnostics of electroencephalography pathology based on multi-domain feature fusion
Authors: Chen Shimiao , Huang Dong , Liu Xinyue , Chen Jianjun , Kong Xiangzeng , Zhang Tingting
Published: September 2024

Electroencephalography (EEG) serves as a practical auxiliary tool deployed to diagnose diverse brain-related disorders owing to its exceptional temporal resolution, non-invasive characteristics, and cost-effectiveness. In recent years, with the advancement of machine learning, automated EEG pathology diagnostics methods have flourished. However, most existing methods usually neglect the crucial spatial correlations in multi-channel EEG signals and the potential complementary information among different domain features, both of which are keys to improving discrimination performance. In addition, latent redundant and irrelevant features may cause overfitting, increased model complexity, and other issues. In response, we propose a novel feature-based framework designed to improve the diagnostic accuracy of multi-channel EEG pathology. This framework first applies a multi-resolution decomposition technique and a statistical feature extractor to construct a salient time-frequency feature space. Then, spatial distribution information is channel-wise extracted from this space to fuse with time-frequency features, thereby leveraging their complementarity to the fullest extent. Furthermore, to eliminate the redundancy and irrelevancy, a two-step dimension reduction strategy, including a lightweight multi-view time-frequency feature aggregation and a non-parametric statistical significance analysis, is devised to pick out the features with stronger discriminative ability. Comprehensive examinations of the Temple University Hospital Abnormal EEG Corpus V. 2.0.0 demonstrate that our proposal outperforms state-of-the-art methods, highlighting its significant potential in clinically automated EEG abnormality detection.