bluuebunny/crossref_metadata_2025 huggingface dataset:
IBC-Oxford University2023_BJSOral_15Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass: Indications, Management and Results
Authors: Crozet J , Robert M
Published: December 2023

Introduction

Sleeve gastrectomy (SG) represents more than 60% of bariatric procedures worldwide. Conversion of SG to Roux-en-Y gastric bypass (RYGB) for weight loss failure (WLF) or gastro-oesophageal reflux disease (GERD) is increasing. Intrathoracic migration of the sleeve often seems associated.

Aim

The aim of our study was to analyse the relevance of the indications, the prevalence of an associated de novo hiatal hernia, and the outcomes of the conversion of SG to RYGB.

Methods

This is a retrospective study of prospectively collected data including all the patients who underwent a conversion of SG to RYGB from August 2013 to December 2022. 2 groups were compared: patients operated on because of weight loss failure (WLF group) and those operated on for GERD (GERD group).

Results

We analysed in both groups demographic data, the incidence of an associated hiatal hernia, morbidity, weight loss outcomes and resolution of symptoms. 59 patients were included with an average follow-up of 30.5 months: 46 patients in the GERD group (78%) were compared to 13 patients (22%) in the WLF group. Groups were comparable regarding age (47) and gender (women: 74%); BMI at conversion and prevalence of comorbidities were significantly higher in the WLF group (41.8 kg/m² vs 33.3, p=0.0001). In the GERD group: on preoperative gastroscopy, 30% (14/46) had a grade B esophagitis, 48% (22/46) had a significant hiatal hernia which required a posterior crural closure versus 23% (3/13) in the WLF group, not requiring a surgical treatment (p = 0.02). Conversion was very effective on GERD symptoms (93% of improvement), 52% of the patients stopped proton pump inhibitor treatment. In the WLF group, mean percentage total weight loss (% TWL) was 15.3%, significantly greater than in the GERD group (% TWL=4.6%, p = 0.01). The complication rate was 10% at 30 days and 3.4% after 30 days, not significantly different between groups (p = 1 and 1 respectively).

Conclusions

The main indication of conversion of SG to RYGB was because of GERD: in these indications, the incidence of intrathoracic migration of the sleeve is high requiring a surgical treatment with a very good efficacy on resolution of symptoms. Weight loss results were disappointing.
IBC-Oxford University2023_BJSOral_17The Endoscopic Sleeve Megaplication (ESM): Preliminary Results of a Modification of a Standard Procedure to Reduce the Cost with Maintaining the Effectiveness. A six-month follow-up.
Authors: Turro R , Ortega A , Uchima H , Mata A , Rosinach M , Andres S , Vila A , Vergara H , Espinós J
Published: December 2023

Aims

The cost of POSE 2.0 is very high, being one of the limitations of the accessibility of this procedure. The Endoscopic Sleeve Megaplication (ESM) procedure involves a novel pattern of full-thickness gastric body plications to shorten and narrow the stomach using the IOP platform (USGI Medical, San Clemente, CA) and durable suture anchor pairs g-Cath and two g-Lix simultaneously to achieve larger folds, reducing the number of sutures per procedure. Our prospective trial examined the safety and durability of ESM in adults with obesity grade I and II.

Methods

Adults suffering obesity underwent ESM in our centre. A single line of double plications in the greater curvature from incisura till 3-4 cm from gastro-oesophageal junction, single plications were placed in distal body anterior and posterior walls to close the diameter of the distal body under 10 mm. Primary outcomes were safety, durability of plications at 3-, 6-, 12- and 24-month follow-up and the cost effectiveness of the technique. Safety will be determined by the incidence of any serious adverse events reported either by the subject or observed by the investigator, relating to the procedure either peri-procedurally or in the follow-up period. All adverse events will be documented. Secondary outcomes were total body weight loss (%TBWL), proportion of patients achieving > 5% TBWL at 12 months and reduction of the cost of the procedure compared to standard POSE 2.0 technique, based on the average number of plications placed.

Results

13 patients (7F, age 45 ± 9.9 years) underwent ESM between February 2022 to September 2022. Baseline BMI was 37.2 ± 3.1 kg/m2. Technical success was 100%. An average of 10 ± 2 suture anchor pairs were placed in each case. At six months, patients (n=13) achieved a 16.1 ± 3.9 % total weight loss (%TWL), with 84,61 % achieving more than 10 % TWL. Blood test results, state that insulin resistance and liver enzymes improved. No serious adverse events were reported. The reduction of an average of 8 plications compared to the standard POSE 2.0 pattern brings a significant reduction of the cost of the procedure.

Conclusions

ESM procedure happens to be effective for treating obesity and its related comorbidities. It is a safe, durable and a cost-effective procedure however, it is necessary to complete a long-term follow-up and carry out studies with larger samples to proclaim those benefits.
IBC-Oxford University2023_BJSOral_20Video Presentation: Fundectomy and Indocyanine green fluorescence angiography in revisional laparoscopic Roux-en-Y gastric bypass
Authors: Latif J , Awan A
Published: December 2023

Introduction

Revisional bariatric procedures are increasingly prevalent. These procedures are more complex with higher risk of complications as compared to primary procedures. The potential indications for revisional laparoscopic gastric bypass (R-LRYGB) may include weight regain and gastroesophageal reflux disease (GORD). This video abstract presents role of fundectomy and Indocyanine green fluorescence angiography (ICG-FA) for perfusion assessment of gastric pouch in R-LRYGB.

Methods and Operative technique

A 40-year-old female with previous laparoscopic adjustable gastric band (LAGB) surgery underwent R-LRYGB procedure following approval at bariatric multidisciplinary team meeting. LAGB was removed due to band slippage and chronic pouch dilatation, 2 years prior to the revisional procedure. Preoperative BMI was 53 kg/m2. Pre-operative upper gastrointestinal endoscopy was normal. The operative technique included dissection of angle of His, access into lesser sac along lesser curve below 2nd vessel off left gastric artery (LGA) and division of short gastric vessels to gain access to leaser sac from lateral aspect. The stomach was divided horizontally with linear stapler (EndoGIA 60 Gold cartridge), level with second vessel off LGA followed by creation of vertical gastric pouch over a size 34 Oro-gastric tube, that included excision of gastric fundus. ICG was administered intravenously according to an agreed protocol for the study. Karl Storz Image1 STM Rubina system with overlay and monochromatic modes was used for perfusion assessment. ICG-FA was utilised for qualitative assessment of gastric pouch perfusion before and after linear stapled gastro-jejunal anastomosis.

Results

Operative time was 240 minutes. Adhesions were encountered in the lesser sac at the site of previous LAGB. Fundectomy allowed better visualisation of lesser sac, adhesiolysis and facilitated creation of gastric pouch. ICG perfusion of gastric pouch was satisfactory. The postoperative length of stay was 2 days. There were nopostoperative complications at 6 months follow-up. The patient achieved 42% excess weight loss (BMI 43) over 6 months period.

Conclusions

Fundectomy is a safe and feasible operative step in R-LRYGB in patients with previous primary LAGB. ICG-FA is a promising qualitative assessment tool in revisional bariatric procedures.
IBC-Oxford University2023_BJSOral_21Video Presentation: Bikini Line Access in Bariatric Surgery - 8 years’ experience
Authors: Abdelbaki T
Published: December 2023

Laparoscopic bariatric surgery is constantly advancing to minimize surgical trauma and enhance cosmetic outcomes, particularly among young women and patients who are concerned about the appearance of their scars. In line with this, we developed the Bikini Line Sleeve Gastrectomy (BLSG) approach to make the port site scars from LSG less noticeable. This approach involves placing the trocars at the lower abdomen, along the curved line just above the symphysis pubis. The aim of this placement is to achieve a more aesthetically pleasing outcome, as the scars are concealed within the bikini line. During the implementation of the BLSG technique, it was observed that some patients would come back with gallstones. So we started performing Bikini Line Cholecystectomy. Furthermore, some patients also had a concurrent hiatal hernia that needed to be addressed. The challenge was to perform the hiatal hernia repair using the same access points without compromising the safety or efficiency of the repair. Finally, we started exploring the bikini line access during one anastomosis gastric bypass.
IBC-Oxford University2023_BJSPoster_2Gastric Bypass and Bone Health: A Systematic Review and Meta-analysis
Authors: Danif E , Santos-Sousa H , Roxo L , Bouça-Machado R , Resende F , Costa-Pinho A , Preto J , Lima da Costa E , Sousa-Pinto B , Carneiro S
Published: December 2023

Introduction

Roux-en-Y gastric bypass (RYGB) is a technique widely used in the management of obesity. Changes in bone analytic parameters and areolar bone mineral density (aBMD) are not yet fully understood in patients that underwent RYGB.

The aim of this study is to assess the changes in parameters involved in bone metabolism that occur after RYGB and to understand how these changes contribute to the development of osteoporosis, and occurrence of bone fractures.

Methods

The electronic search included three databases. Inclusion criteria were prospective or retrospective cohort studies, case-control studies, patients with obesity undergoing RYGB, evaluation of changes in bone metabolism parameters, aBMD, osteoporosis and fracture risk. Bone metabolism analytic parameters and aBMD were extracted and analysed. Data is presented in two sets, one year data set and long-term data (≥1 year) set.

Results

Fifteen studies were included in the review, 11 were included in the meta-analysis. In the long-term analysis parathyroid hormone (PTH) serum concentration increased and calcium serum concentration decreased. Vitamin D serum concentration increased only in the first-year post-surgery. Carboxy-terminal collagen crosslinks (CTX) increased substantially both in the first-year post-op and in the long-term analysis. There was a global decrease on aBMD in all the studied anatomical regions. No study showed a significant increase in the risk of osteoporosis or bone fracture.

Conclusion

RYGB is associated with a prolonged increase in bone turnover which in turn results in long term loss of bone mass. Greater reductions in aBMD were seen in areas associated with greater biomechanical stress. Despite the bone changes described the occurrence of pathological fractures in the several studies was minimal, this complication remains rare in patients undergoing RYGB.
IBC-Oxford University2023_BJSPoster_9Causes of re-hospitalization according to the bariatric procedures, single center experience
Authors: Foula M S
Published: December 2023

The numbers of bariatric procedures are increasing dramatically worldwide. Despite the international guidelines and recommended preventive perioperative steps, postoperative complications still occur with significant numbers. Postoperative complications differ and represent a heterogeneous group of diseases with different pathophysiology, severity and management plans reaching up to major revisional surgery. Many patients require rehospitalization for managing these complications. The observed increasing numbers of rehospitalization prompted us to study and analyse the causes of readmission. This retrospective descriptive study aimed to report our experience, as a tertiary university institute in managing various complications after different bariatric procedures that necessitated hospital readmission. All patients who have been admitted in a university tertiary hospital in Saudi Arabia with any post-bariatric surgery complication for the last five years were included. A total of 228 admitted patients were included due to any post-bariatric complications. Most of them was diagnosed with more than one clinical entity. These patients underwent different bariatric procedures either performed in our institution or referred to us from other hospitals. Demographic data revealed that both genders were equally involved, the age ranged from 15-68 years. Most of bariatric procedures were reported. The length of hospital stay ranged from 1 – 84 days. Postoperative leakage was found in 23 patients after sleeve gastrectomy. Therefore, better recognition and diagnosis of postoperative complications is mandatory. Analysis of the common causes could prompt a clinical pathway and preventing programs.
IBC-Oxford University2023_BJSPoster_14Short-Term Outcomes of Single-Anastomosis Sleeve-Ileal Bypass (SASI)
Authors: Kavlakoglu B , Senol M
Published: December 2023

Background

The SASI bypass, which is a simplified version of sleeve gastrectomy with transit bipartition, is based on the same metabolic principles, particularly the early postprandial ileal brake. Compared to SASI bypass, sleeve gastrectomy offers advantages such as shorter operation time and lower incidence of internal herniation. The aim of this study was to assess the safety and outcomes of SASI bypass over a 3-year follow-up period.

Methods

A retrospective study was conducted on all patients who underwent SASI bypass between January 2018 and June 2023. The primary endpoints were weight loss and diabetic remission.

Results

A total of 54 patients, with a mean age of 39,4 ± 15 years and a mean body mass index of 38,5 ± 6,8 kg/m2, underwent SASI bypass. There was no significant early postoperative complications. At the end of the first year, the average percentage of excess weight loss (%EWL) was 82,6 ± 7,4, and the rate of diabetic remission was 96,1 %. After 3 years, the %EWL was 97,4 ± 4,1, and the diabetic remission rate was 98,8%. Severe protein-energy malnutrition occurred in 4 patients(7,4%), and reversal of the bypass were made in 3 of 4 patients. Technical variations did not significantly affect %EWL or diabetic remission.

Conclusion

SASI bypass demonstrated promising outcomes in terms of 3-year %EWL and diabetic remission. While the double-outlet for gastric content allows access to the duodenum, it may hinder the standardization of postoperative care. Furthermore, the presence of a double-outlet does not guarantee the absence of malnutrition.
Review of dermoscopic features in hypopigmentary disorders
Authors: Morriss Samuel , Rodrigues Michelle
Published: December 2023

Dermoscopy has seen increased use in the diagnosis of hypopigmentary disorders. As a quick and effective adjunct to the clinician’s toolbox, dermoscopy offers the opportunity to differentiate between hypopigmentary lesions that ostensibly present with clinically similar morphology on the macroscopic scale. The focus of this article is to review the various dermoscopic signs and patterns that have been elucidated for these disorders.
Medea/Media: a glitchy counterfactual
Authors: Telò Mario , Conybeare Catherine
Published: December 2023

James Ijames, the winner of a 2022 Pulitzer prize for Fat Ham, loosely based on Hamlet, has just presented a new realization of Medea, Media/Medea, which had its world premiere at Bryn Mawr College and the Community College of Philadelphia in April 2023. This article provides a reading of it, addressing the themes of irony, queer ‘authenticity’, acting, and mothering through the framing of the ‘glitchy counterfactual’ — a conceit we borrow from Legacy Russell’s manifesto for a new Black cyberfeminism to approach the most blatant innovation in Ijames’s version, the unfulfilled infanticide. This astonishing change in the script, which tightly connects Medea with her onomastic negativity and queer unbecoming, urges us to reflect upon survival and survivance in an anti-Black world; it might yield a reckoning in line with Kevin Quashie’s notion of ‘subjunctivity’, Black ‘aliveness’.
The role of N-glycosylation in spike antigenicity for the SARS-CoV-2 gamma variant
Authors: Pegg Cassandra L , Modhiran Naphak , Parry Rhys H , Liang Benjamin , Amarilla Alberto A , Khromykh Alexander A , Burr Lucy , Young Paul R , Chappell Keith , Schulz Benjamin L , Watterson Daniel
Published: December 2023

The emergence of SARS-CoV-2 variants alters the efficacy of existing immunity towards the viral spike protein, whether acquired from infection or vaccination. Mutations that impact N-glycosylation of spike may be particularly important in influencing antigenicity, but their consequences are difficult to predict. Here, we compare the glycosylation profiles and antigenicity of recombinant viral spike of ancestral Wu-1 and the Gamma strain, which has two additional N-glycosylation sites due to amino acid substitutions in the N-terminal domain (NTD). We found that a mutation at residue 20 from threonine to asparagine within the NTD caused the loss of NTD-specific antibody COVA2-17 binding. Glycan site-occupancy analyses revealed that the mutation resulted in N-glycosylation switching to the new sequon at N20 from the native N17 site. Site-specific glycosylation profiles demonstrated distinct glycoform differences between Wu-1, Gamma, and selected NTD variant spike proteins, but these did not affect antibody binding. Finally, we evaluated the specificity of spike proteins against convalescent COVID-19 sera and found reduced cross-reactivity against some mutants, but not Gamma spike compared to Wuhan spike. Our results illustrate the impact of viral divergence on spike glycosylation and SARS-CoV-2 antibody binding profiles.
Uncovering the Nature of ECHR Rights: An Analytical and Methodological Framework
Authors: Tripkovic Bosko , Zysset Alain
Published: December 2023

How does the European Court of Human Rights (ECtHR) understand the nature of human rights? The article develops a framework for the analysis of this question and shows how it can be applied. The first part identifies a gap at the intersection of doctrinal and philosophical approaches to human rights practice that leaves the ECtHR’s understanding of the nature of rights unaccounted for. The second part develops an analytic and methodological framework based on the idea of grounds, content and scope of human rights to bridge this disciplinary divide and facilitate a more perspicuous analysis of the Court’s conception of the nature of human rights. The third part tests this framework by examining the Court’s doctrines in relation to freedom of thought, conscience and religion and the right to free elections.
Peaceful settlement of inter-state energy disputes: applicable law, defence arguments, and remedies in the ICC arbitration between Iraq and Turkey
Authors: Demirkol Berk
Published: December 2023

At this critical juncture in the energy transition dominated by debates over armed conflicts, advisory opinions on climate changes, and investor-State arbitration, it is critical to also consider developments in the peaceful settlement of inter-State energy disputes. One central dispute between the Republic of Iraq and the Republic of Turkey arose out of the Crude Oil Pipeline Agreement for the supply and purchase of crude oil. Iraq filed a request for arbitration in May 2014 under the International Chamber of Commerce Rules of Arbitration. The Tribunal awarded Iraq nearly United States Dollars (USD) 1.5 billion. The Tribunal’s unanimous final award in 2023 discusses fascinating aspects of international energy transactions, including the choice of domestic law in a treaty dispute, defences under the law of treaties, a putative norm of jus cogens to prevent genocide, and possible remedies in an inter-State pipeline arbitration.
Frequency of serological markers of rheumatoid arthritis in patients with Hashimoto’s thyroiditis
Authors: Ghozzi Mariam , Mankai Amani , Melayah Sarra , Mechi Fatma , Chedly Zeineb , Trabelsi Abdelhalim , Ghedira Ibtissem
Published: December 2023

Background

Hashimoto’s thyroiditis (HT) is an autoimmune disease that is frequently associated with other autoimmune conditions.

Objective

To perform serological screening for rheumatoid arthritis (RA) in patients with HT.

Methods

Our study included 88 consecutive serum specimens of patients with confirmed HT and 88 sex- and age-matched healthy subjects. All study participants were tested for anti-cyclic citrullinated peptides antibodies (CCP-Ab) and rheumatoid factor (RF). CCP-Ab and RF were performed using ELISA commercial kits. Statistical analysis was conducted using Epi Info, version 3.

Results

Out of 88 patients with HT, 15 (17.0%) had CCP-Ab or RF. The frequency of serological markers of RA was significantly higher in patients than in control individuals (17.0% vs 4.5%; P = .007). RF was more frequent in patients than in the control group, and the difference was statistically significant (13.6% vs 3.4%; P = .01). Isolated RF-IgM was absent in all controls and present in 6 patients with HT (6.8% vs 0%; P = .02). Out of 14 male patients, 3 (21.4%) had antibodies of RA. There was no significant difference in age between patients with CCP-Ab or RF and those without.

Conclusion

A high frequency of serological markers of RA was highlighted in patients with HT.
Observational chemical signatures of the past FU Ori outbursts
Authors: Zwicky Lis , Molyarova Tamara , Akimkin Vitaly , Smirnov-Pinchukov Grigorii V , Semenov Dmitry , Kóspál Ágnes , Ábrahám Péter
Published: December 2023

FU Ori-type stars (FUors) are young stellar objects (YSOs) experiencing luminosity outbursts by a few orders of magnitude, which last for ∼102 yr. A dozen of FUors are known up to date, but many more currently quiescent YSOs could have experienced such outbursts in the last ∼103 yr. To find observational signatures of possible past outbursts, we utilize andes, radmc-3d code as well as casa ALMA simulator to model the impact of the outburst on the physical and chemical structure of typical FU Ori systems and how it translates to the molecular lines’ fluxes. We identify several combinations of molecular lines that may trace past FU Ori objects both with and without envelopes. The most promising outburst tracers from an observational perspective are the molecular flux combinations of the N2H+J = 3–2, C18O J = 2–1, H2CO $(J_{\rm K_a, K_c}) = 4_{04}-3_{03}$, and HCN J = 3–2 lines. We analyse the processes leading to molecular flux changes and show that they are linked with either thermal desorption or enhanced chemical reactions in the molecular layer. Using observed CO, HCN, N2H+, and H2CO line fluxes from the literature, we identify ten nearby disc systems that might have undergone FU Ori outbursts in the past ∼103 yr: [MGM2012] 556, [MGM2012] 371, and [MGM2012] 907 YSOs in L1641, Class II protoplanetary discs around CI Tau, AS 209, and IM Lup and transitional discs DM Tau, GM Aur, LkCa 15, and J1640-2130.
Could the TeV emission of starburst galaxies originate from pulsar wind nebulae?
Authors: Chen Xiao-Bin , Liu Ruo-Yu , Wang Xiang-Yu , Chang Xiao-Chuan
Published: December 2023

While the GeV γ-ray emission of starburst galaxies (SBGs) is commonly thought to arise from hadronic interactions between accelerated cosmic rays and interstellar gas, the origin of the TeV γ-ray emission is more uncertain. One possibility is that a population of pulsar wind nebulae (PWNe) in these galaxies could be responsible for the TeV γ-ray emission. In this work, we first synthesize a PWNe population in the Milky Way and assess their contribution to the γ-ray emission of the Galaxy, using a time-dependent model to calculate the evolution of the PWN population. Such a synthetic PWN population can reproduce the flux distribution of PWNe identified in the Milky Way given a distribution of the initial state of the pulsar population. We then apply it to starburst galaxies and quantitatively calculate the spectral energy distribution of all PWNe in the SBGs NGC 253 and M82. We propose that TeV γ-ray emission in starburst galaxies can be dominated by PWNe for a wide range of parameter space. The energetic argument requires that ηe × vSN > 0.01 yr−1, where ηe is the fraction of spin-down energy going to electrons and vSN is the supernova rate. By requiring the synchrotron emission flux of all PWNe in the galaxy not to exceed the hard X-ray measurement of NGC 253, we constrain the initial magnetic field strength of PWNe to be $\lesssim 400\,\mu{\rm G}$. Future observations at higher energies with the Large High Altitude Air Shower Observatory (LHAASO) or the next-generation neutrino observatory IceCube-Gen2 will help us to understand the origin of the TeV γ-ray emission in SBGs better.
Aggregated chromosomes/chromatin transfer: a novel approach for mitochondrial replacement with minimal mitochondrial carryover: the implications of mouse experiments for human aggregated chromosome transfer
Authors: Okamoto Ryota , Xiao Wei , Fukasawa Hiroko , Hirata Shuji , Sankai Tadashi , Masuyama Hisashi , Otsuki Junko
Published: December 2023

Nuclear transfer techniques, including spindle chromosome complex (SC) transfer and pronuclear transfer, have been employed to mitigate mitochondrial diseases. Nevertheless, the challenge of mitochondrial DNA (mtDNA) carryover remains unresolved. Previously, we introduced a method for aggregated chromosome (AC) transfer in human subjects, offering a potential solution. However, the subsequent rates of embryonic development have remained unexplored owing to legal limitations in Japan, and animal studies have been hindered by a lack of AC formation in other species. Building upon our success in generating ACs within mouse oocytes via utilization of the phosphodiesterase inhibitor 3-isobutyl 1-methylxanthine (IBMX), this study has established a mouse model for AC transfer. Subsequently, a comparative analysis of embryo development rates and mtDNA carryover between AC transfer and SC transfer was conducted. Additionally, the mitochondrial distribution around SC and AC structures was investigated, revealing that in oocytes at the metaphase II stage, the mitochondria exhibited a relatively concentrated arrangement around the spindle apparatus, while the distribution of mitochondria in AC-formed oocytes appeared to be independent of the AC position. The AC transfer approach produced a marked augmentation in rates of fertilization, embryo cleavage, and blastocyst formation, especially as compared to scenarios without AC transfer in IBMX-treated AC-formed oocytes. No significant disparities in fertilization and embryo development rates were observed between AC and SC transfers. However, relative real-time PCR analyses revealed that the mtDNA carryover for AC transfers was one-tenth and therefore significantly lower than that of SC transfers. This study successfully accomplished nuclear transfers with ACs in mouse oocytes, offering an insight into the potential of AC transfers as a solution to heteroplasmy-related challenges. These findings are promising in terms of future investigation with human oocytes, thus advancing AC transfer as an innovative approach in the field of human nuclear transfer methodology.
MutSβ protects common fragile sites by facilitating homology-directed repair at DNA double-strand breaks with secondary structures
Authors: Li Youhang , Zhang Yunkun , Shah Sameer Bikram , Chang Chia-Yu , Wang Hailong , Wu Xiaohua
Published: December 2023

Common fragile sites (CFSs) are regions prone to chromosomal rearrangements, thereby contributing to tumorigenesis. Under replication stress (RS), CFSs often harbor under-replicated DNA regions at the onset of mitosis, triggering homology-directed repair known as mitotic DNA synthesis (MiDAS) to complete DNA replication. In this study, we identified an important role of DNA mismatch repair protein MutSβ (MSH2/MSH3) in facilitating MiDAS and maintaining CFS stability. Specifically, we demonstrated that MutSβ is required for the increased mitotic recombination induced by RS or FANCM loss at CFS-derived AT-rich and structure-prone sequences (CFS-ATs). We also found that MSH3 exhibits synthetic lethality with FANCM. Mechanistically, MutSβ is required for homologous recombination (HR) especially when DNA double-strand break (DSB) ends contain secondary structures. We also showed that upon RS, MutSβ is recruited to Flex1, a specific CFS-AT, in a PCNA-dependent but MUS81-independent manner. Furthermore, MutSβ interacts with RAD52 and promotes RAD52 recruitment to Flex1 following MUS81-dependent fork cleavage. RAD52, in turn, recruits XPF/ERCC1 to remove DNA secondary structures at DSB ends, enabling HR/break-induced replication (BIR) at CFS-ATs. We propose that the specific requirement of MutSβ in processing DNA secondary structures at CFS-ATs underlies its crucial role in promoting MiDAS and maintaining CFS integrity.
Functional analysis of the AUG initiator codon context reveals novel conserved sequences that disfavor mRNA translation in eukaryotes
Authors: Hernández Greco , García Alejandra , Weingarten-Gabbay Shira , Mishra Rishi Kumar , Hussain Tanweer , Amiri Mehdi , Moreno-Hagelsieb Gabriel , Montiel-Dávalos Angélica , Lasko Paul , Sonenberg Nahum
Published: December 2023

mRNA translation is a fundamental process for life. Selection of the translation initiation site (TIS) is crucial, as it establishes the correct open reading frame for mRNA decoding. Studies in vertebrate mRNAs discovered that a purine at −3 and a G at +4 (where A of the AUG initiator codon is numbered + 1), promote TIS recognition. However, the TIS context in other eukaryotes has been poorly experimentally analyzed. We analyzed in vitro the influence of the −3, −2, −1 and + 4 positions of the TIS context in rabbit, Drosophila, wheat, and yeast. We observed that −3A conferred the best translational efficiency across these species. However, we found variability at the + 4 position for optimal translation. In addition, the Kozak motif that was defined from mammalian cells was only weakly predictive for wheat and essentially non-predictive for yeast. We discovered eight conserved sequences that significantly disfavored translation. Due to the big differences in translational efficiency observed among weak TIS context sequences, we define a novel category that we termed ‘barren AUG context sequences (BACS)’, which represent sequences disfavoring translation. Analysis of mRNA-ribosomal complexes structures provided insights into the function of BACS. The gene ontology of the BACS-containing mRNAs is presented.
Phosphorus balance calculator: an individualized tool for treatment of hyperphosphatemia in hemodialysis patients
Authors: Wang Mengjing , Xiao Jing , Du Qiuna , Zhang Weichen , Zhang Jiaying , Yan Zhenwen , Luo Jianfeng , Yu Chen , Ye Zhibin , Chen Jing
Published: December 2023

Background

Lack of evaluations of the dietary phosphorus and dialysis phosphorus removal in daily clinical practice are common obstacles to assessing phosphorus balance and controlling phosphorus in hemodialysis patients. We aimed to investigate whether individualized therapy using a phosphorus balance calculator improves phosphorus control.

Methods

A randomized, open-label, multicenter, 4-week clinical trial was conducted. A total of 119 maintenance hemodialysis patients aged 18–85 years old and with serum phosphorus level >1.45 mmol/L from three university teaching hospitals in Shanghai were enrolled. Patients were randomized in a 1:1 ratio to individualized therapy (n = 60) or conventional therapy (n = 59). The primary outcome was the serum phosphorus concentration after 4-week treatment. Secondary outcomes included the serum calcium and parathyroid hormone (PTH) concentrations, changes in serum phosphorus, calcium and PTH concentrations, and the proportion of patients achieving target ranges of serum phosphorus, calcium and PTH after 4-week treatment.

Results

Among 119 randomized participants [mean age 62 years; 68 male (57%)], 116 completed the trial. Using the phosphorus balance calculator, the individualized group achieved a better phosphorus balance state and significantly reduced serum phosphorus (1.62 ± 0.45 mmol/L versus 1.85 ± 0.45 mmol/L, P = .006), increased the proportions of patients achieving target serum phosphorus range (41% versus 18%, P = .006) and had greater adjusted mean difference in change in serum phosphorus over the 4 weeks (−0.47 versus −0.23 mmol/L, P = .010) when compared with conventional therapy. No significant changes were observed in serum calcium and PTH levels, the proportion of patients achieving target serum calcium or PTH levels, or the adjusted mean difference of serum calcium and PTH levels over the treatment period.

Conclusion

Phosphorus balance calculator was proved to improve serum phosphorus control in patients undergoing maintenance hemodialysis, offering a new tool for managing hyperphosphatemia.
Long-term dynamics, population structure and connectivity of the helmet jellyfish Periphylla periphylla in a Norwegian fjord and adjacent waters
Authors: Aberle Nicole , Volpe Charlotte , Østensen Mari-Ann , Majaneva Sanna
Published: December 2023

Mass occurrences of Periphylla periphylla in Norwegian fjords cause major concerns related to potential regime shifts that could affect ecosystem stability. 15 years of trawl data (2006–2015), complemented with comprehensive sampling in different areas and seasons (2018–2021) allowed new insights on the dynamics, structure and connectivity of P. periphylla populations within and beyond Trondheimsfjorden. Despite assumed population bursts, no clear trend on P. periphylla population size in Trondheimsfjorden were identified. Sampling frequency and population size suggest a local reproduction of P. periphylla, especially in the inner part of the fjord where young-of-the-year (YOY) individuals occur. Size variations occurred in relation to sampling month, thus pointing at seasonal patterns in growth and reproduction. No distinct population structure of P. periphylla populations within Trondheimsfjorden and over larger spatial scales (> 100 km) along the Norwegian coast was observed. Such poor geographic population structure provides evidence for a strong dispersal of P. periphylla, potentially triggered by frequent deep-water renewals of the fjords’ basins that enable a high gene flow. Data on P. periphylla long-term dynamics, population structure and connectivity provide valuable information for ecosystem state assessments and enable the advancement of ecosystem management approaches, thus accounting for both stakeholder and ecosystem demands.
Mastering Our Own Magic in the Evolution Toward Precision Practice
Authors: Field-Fote Edelle Carmen
Published: December 2023

Edelle (Edee) Field-Fote, PT, PhD, FASIA, FAPTA, the 54th Mary McMillan lecturer, is director of the Shepherd Center Spinal Cord Injury Research Program & Hulse Laboratory; professor in the division of physical therapy at Emory University School of Medicine; and professor of the practice in the school of biological sciences at the Georgia Institute of Technology. In her role as the director of spinal cord injury (SCI) research at Shepherd Center, Field-Fote leads a team dedicated to improving motor function in people with SCI through the development of neuromodulation and neurorehabilitation approaches informed by the latest neuroscience research and guided by outcomes that have meaning for people with SCI. With a clinical background as a physical therapist, PhD training in a preclinical model of SCI, and postdoctoral training in motor control physiology, her 25-plus years of SCI research have spanned the breadth of basic and clinical/translational research related to SCI. Dr Field-Fote has conducted randomized clinical trials with funding from the National Institutes of Health since 1997; other clinical trials in her lab have been funded by the Department of Defense, the National Institute on Disability Independent Living and Rehabilitation Research, and numerous foundations. Field-Fote is the recipient of multiple honors from the American Physical Therapy Association (APTA) and its components. She is a Fellow of APTA and a Fellow of the American Spinal Injury Association. She has also served in numerous APTA and APTA component appointed or elected positions and as a member and president of the Foundation for Physical Therapy Research Board of Trustees.
Disentangling Shifts in the Soil Microbiome of Potatoes Infected with Rhizoctonia solani Anastomosis Group 3-PT in Search of Potential Biocontrol Agents
Authors: Gush S. , Lebre P. , Couthino T. A. , Cowan D. A. , van der Waals J. E.
Published: December 2023

Rhizoctonia solani anastomosis group (AG) 3-PT is a devastating pathogenic fungus that causes several diseases in potatoes both in South Africa and globally. The removal of various fungicides from the market and strict regulations on the use of synthetic chemicals make disease management difficult. Therefore, alternative, environmentally safe control measures are being considered, such as the use of biological control agents (BCAs). BCAs are an attractive alternative for improving plant and soil health of economically important crops. To identify key microbial indicators of disease suppression against R. solani AG 3-PT, a greenhouse pot trial experiment was conducted using soil from a potato-growing region in KwaZulu-Natal, South Africa. High-throughput sequencing of fungal internal transcribed spacer and bacterial 16S ribosomal RNA was used to characterize the respective fungal and bacterial community composition in the soil with and without artificial inoculation with R. solani AG 3-PT. Results indicated that the pathogen caused dysbiosis in the potato soil microbiome, leading to a shift in fungal and bacterial community composition. Differentially abundant microbial taxa in R. solani AG 3-PT inoculated soils suggest a promising potential for disease-suppressive activity. Network analysis also confirmed the presence of key taxa involved in the microbial community shifts, which could support their role in the suppression of R. solani AG 3-PT. The identification of key microbial indicators against Rhizoctonia diseases can contribute to the development of environmentally sustainable potato production systems, which are particularly important considering the implementation of the European Green Deal.
Pain assessment and management among adult patients in a gynecology ward: a best practice implementation project
Authors: Bernués-Caudillo Leticia , Albornos-Muñoz Laura , Rodrigo M. Paz Fernández , García Marta Álvarez , Benito Marta De Rioja , Serrano María Jesús Ruano , Navarro Paloma García , Pérez Patricia Ledesma , Sotelo Sonia González , Moreno-Casbas M. Teresa , Vrbová Tereza , Klugar Miloslav , Klugarová Jitka , Gonzalez-María Esther
Published: December 2023

Objectives:

This project aimed to improve compliance with evidence-based practice in pain assessment and management in a gynecology ward.

Introduction:

Effective pain control is important to prevent the negative consequences of pain that is poorly managed. However, it remains undervalued and inadequately treated. Applying evidence-based practices to correctly evaluate and manage pain is essential to improve pain relief.

Methods:

This project followed the JBI Evidence Implementation Framework. A baseline audit of 41 women admitted to the gynecology ward was conducted and measured against 5 best practice criteria, along with a patient satisfaction questionnaire. Targeted strategies were then implemented and a follow-up audit was conducted using the same criteria, methods, and sample size as the baseline audit.

Results:

The baseline audit revealed gaps between current and best practice. Barriers to implementation were identified and strategies to resolve the barriers were designed and implemented (nurse education, informative materials, electronic patient records system improvements). Comprehensive pain assessment, including dynamic and static pain assessment, use of a validated tool, and education provided to patients and carers, improved in the follow-up audit. There was no change in patient satisfaction levels; however, the discrepancy between pain measured by nurses and pain measured by patients was reduced.

Conclusions:

The JBI methodology was useful in improving compliance with evidence-based practice criteria. It also facilitated adaptation to new barriers, such as the COVID-19 pandemic. Improving nurses’ knowledge of pain assessment can lead to more accurate assessment. Inadequate records systems also made it difficult to record the care that was provided. Subsequent audits will assess sustainability and the project will be escalated to other wards.
Pharmacogenomics in Tailoring First-Line Therapy for Breast Cancer: PharmGKB Database Insights
Authors: Porfírio de Aguiar Murilo
Published: December 2023

This study delves into the role of pharmacogenomics in optimizing first-line breast cancer treatments, leveraging insights from the PharmGKB database. It emphasizes the importance of understanding genetic variations and their influence on the efficacy and side effects of key drugs like Letrozole, Anastrozole, Tamoxifen, Trastuzumab, and Pertuzumab. By analyzing these drugs in the context of genetic profiles, the research highlights the necessity of incorporating genetic testing into treatment planning. The findings underscore the potential of pharmacogenetics to personalize therapy, aiming to improve outcomes and reduce adverse reactions in breast cancer patients. This approach marks a significant stride towards tailored cancer treatments, underscoring the need for continued research in this field.
Investigating the Influence of prolonged Stroop task on mental fatigue and the consequences on corticospinal and corticocortical excitability: A pilot study
Authors: Salihu Abubakar Tijjani , Hill Keith D. , Zoghi Maryam , Jaberzadeh Shapour
Published: December 2023

Changes in the corticospinal (CSE) and cortico-cortical (CCE) excitability of the primary motor cortex (M1) may underlie the effect of mental fatigue on physical performance. To date, research on this subject has predominantly focused on the examination of CSE, with limited exploration of effects of mental fatigue on CCE. This study aims to investigate the influence of mental fatigue induced through prolonged cognitive activity on both CSE and CCE. Fifteen healthy adults (aged 29.13±7.15 years) participated in assessments of CSE (Motor evoked potential - MEP amplitude) and CCE (Intracortical facilitation - ICF, short-interval intracortical inhibition - SICI, and long-interval intracortical inhibition - LICI) before and after a 60-minute Stroop task (experimental condition) or watching a documentary (control condition). Subjective mental fatigue was measured using the mental fatigue visual analogue scale (M-VAS), and workload associated with the tasks was assessed using the National Aeronautics and Space Administration (NASA) task load index. Objective mental fatigue was defined by the time-related decline in Stroop task performance. The study results revealed no significant differences in M-VAS, CSE and CCE between the two conditions. Stroop task performance did not exhibit significant changes over time. However, participants perceived the Stroop task to be more mentally demanding and effortful than watching the documentary (p<0.05). Further analysis of Stroop task performance at individual participants level identified two sub-groups of participants: one exhibiting deteriorating performance with time (fatigued subgroup) and the other showing improved performance (non-fatigued subgroup). Descriptively, cortical inhibition increased (reduced SICI and ICF values) from pre to post Stroop task in the fatigued subgroup, while the non-fatigued group displayed an opposite pattern. The findings suggest that mental fatigue may lead to increased cortical inhibition, highlighting the need for further investigation with a larger sample size.
Consistent signatures in the human gut microbiome of old- and young-onset colorectal cancer
Authors: Qin Youwen , Tong Xin , Mei Wei-Jian , Cheng Yanshuang , Zou Yuanqiang , Han Kai , Yu Jiehai , Jie Zhuye , Zhang Tao , Zhu Shida , Jin Xin , Wang Jian , Yang Huanming , Xu Xun , Zhong Huanzi , Xiao Liang , Ding Pei-Rong
Published: December 2023

The incidence of young-onset colorectal cancer (yCRC) has been increasing in recent decades, but little is known about the gut microbiome of these patients. Most studies have focused on old-onset CRC (oCRC), and it remains unclear whether CRC signatures derived from old patients are valid in young patients. To address this, we assembled the largest yCRC gut metagenomes to date from two independent cohorts and found that the CRC microbiome had limited association with age across adulthood. Differential analysis revealed that well-known CRC-associated taxa, such asClostridium symbiosum,Peptostrptococcus stomatis,Parvimonas micraandHungatella hathewayi, were significantly enriched (false discovery rate <0.05) in both old- and young-onset patients. Almost all oCRC-associated metagenomic pathways had directionally concordant changes in young patients. Importantly, CRC-associated virulence factors (fadA,bft) were enriched in both oCRC and yCRC compared to their respective controls. Moreover, the microbiome-based classification model had similar predication accuracy for CRC status in old- and young-onset patients, underscoring the consistency of microbial signatures across different age groups.
The Natural History of Vision-Related Quality of Life after Unilateral Occipital Stroke
Authors: Dogra Neil , Redmond Bryan V. , Lilley Selena , Johnson Brent A. , Lam Byron L. , Tamhankar Madhura , Feldon Steven E. , Fahrenthold Berkeley , Yang Jingyi , Huxlin Krystel R. , Cavanaugh Matthew R.
Published: December 2023

Background/Objectives

Stroke damage to the primary visual cortex induces large, homonymous visual field defects that impair daily living. Here, we asked if vision-related quality of life (V-QoL) is impacted by time since stroke.

Subjects/Methods

We conducted a retrospective meta-analysis of 95 occipital stroke patients (F/M=26/69, 27-78 years old, 0.5 to 373.5 months post-stroke) in whom V-QoL was estimated using the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ) and its 10-item neuro-ophthalmic supplement (Neuro10). Visual deficit severity was represented by the Perimetric Mean Deviation (PMD) calculated from 24-2 Humphrey visual fields. Data were compared with published cohorts of visually-intact controls. The relationship between V-QoL and time post-stroke was assessed across participants, adjusting for deficit severity and age with a multiple linear regression analysis.

Results

Occipital stroke patients had significantly lower NEI-VFQ and Neuro10 composite scores than controls. All subscale scores describing specific aspects of visual ability and functioning were impaired except for ocular pain and general health, which did not differ significantly from controls. Surprisingly, visual deficit severity was not correlated with either composite score, both of which increased with time post-stroke, even when adjusting for PMD and age.

Conclusions

V-QoL appears to improve with time post-occipital stroke, irrespective of visual deficit size or patient age at insult. This may reflect the natural development of compensatory strategies and lifestyle adjustments. Thus, future studies examining the impact of rehabilitation on daily living in this patient population should consider the possibility that their V-QoL may change gradually over time, even without therapeutic intervention.