bluuebunny/crossref_metadata_2025 huggingface dataset:
Egg hatching success is influenced by the time of thermal stress in four hard tick species
Authors: Ajayi Oluwaseun M , Oyen Kennan J , Davies Benjamin , Finch Geoffrey , Piller Benjamin D , Harmeyer Alison A , Wendeln Katherine , Perretta Carlie , Rosendale Andrew J , Benoit Joshua B
Published: October 2023

Ticks are blood-feeding arthropods responsible for the transmission of disease-causing pathogens to a wide range of vertebrate hosts, including livestock and humans. Tick-borne diseases have been implicated in significant economic losses to livestock production, and this threat will increase as these obligate parasites widen their geographical ranges. Similar to other ectotherms, thermal stress due to changing global temperatures has been shown to influence tick survival and distribution. However, studies on the influence of extreme temperatures in ticks have focused on advanced, mobile stages, ignoring immobile stages that cannot move to more favorable microhabitats. In this study, low- and high-temperature regimens were assessed in relation to egg viability for hard tick species—Amblyomma maculatum (Gulf Coast tick), Ixodes scapularis (black-legged tick), Dermacentor variabilis (American dog tick), and Rhipicephalus sanguineus (Brown dog tick). Tick eggs exposed early in development (freshly laid during early embryo development) were significantly more susceptible to thermal stress when compared with those exposed later in development (late embryo development denoted by a fecal spot). Based on our studies, differences in egg hatching success among treatments were greater than in hatching success when comparing species. Lastly, there was evidence of extreme thermal exposure significantly altering the hatching times of tick eggs for specific treatments. These results provide insights into the critical period for tick egg viability in relation to thermal exposure and tick survival associated with stress and climate change.
Paediatric Cogan Syndrome masquerading as IgA vasculitis
Authors: Ramani Praveen K , Grigorian Florin , Lightle Heidi , Joshi Saumya V
Published: October 2023

Paediatric Cogan Syndrome is a rare and underrecognised autoimmune vasculitis characterised by ocular inflammation and sensorineural hearing loss. Its etiopathogenesis, diagnosis, and management are not well defined. We report a 12-year-old girl who initially presented with symptoms of IgA vasculitis formerly called Henoch Schoenlein Purpura (HSP) and eventually developed anterior uveitis and bilateral sensorineural hearing loss leading to the diagnosis of atypical Cogan Syndrome. The workup for infectious etiologies and other systemic rheumatologic disorders was negative. The management was multidisciplinary involving Rheumatology, Ophthalmology, Otorhinolaryngology, and Audiology. The anterior uveitis responded well to systemic glucocorticoids and Methotrexate, but the hearing loss was grossly progressive warranting a cochlear implant. We are not aware of Paediatric Cogan Syndrome being reported as a mimicker of IgA vasculitis previously in the literature. It is an important finding as IgA vasculitis is prevalent in the paediatric age group and new-onset ocular or vestibular symptoms after IgA vasculitis should alert the clinician to the possibility of Cogan Syndrome. In the absence of well-defined diagnostic criteria, it is crucial to recognise the clinical symptoms of Paediatric Cogan Syndrome for early diagnosis and treatment since the delay in diagnosis can lead to permanent disability.
Poly(l-lactic acid)-based double-layer composite scaffold for bone tissue repair
Authors: Ren Yixing , Ma Chunyang , Yu Yao , Yang Dandan , Zhang Lingling , Wang Huitao , Sun Lei
Published: October 2023

Bone defect is a serious threat to human health. Osteopractic total flavone (OTF) extracted from Rhizoma Drynariae has the effects of promoting bone formation. Panax notoginseng saponin (PNS) has the function of activating blood circulation and removing blood stasis. Therefore, combining OTF and PNS with poly(l-lactic acid) (PLLA) to prepare scaffolds containing PNS in the outer layer and OTF in the inner layer is a feasible solution to rapidly remove blood stasis and continue to promote bone formation. In addition, degradation rate of the scaffold can affect the release time of two drugs. Adding Mg particles in outer layer can control the degradation rate of the scaffold and the drug release. Therefore, a double-layer drug-loaded PLLA scaffold containing OTF in the inner layer, PNS and Mg particles in the outer layer was prepared and characterized to verify its feasibility. The experimental results showed that the scaffold can realize the rapid release of PNS and the continuous release of OTF. With the increase of Mg content, the drug release rate became faster. Animal experiments showed that the scaffold containing 5% Mg particles could effectively promote the formation of new bone in the bone defect of male New Zealand white rabbits, and the area and density of new bone formed were much better than those in the control group. These results demonstrated that the double-layer drug-loaded scaffold had good ability to promote bone repair.
Additive and Specific Effects of Elicitor Treatments on the Metabolic Profile of Arabidopsis thaliana
Authors: Cabre Lisa , Jing Lun , Makechemu Moffat , Heluin Kylhan , El Khamlichi Sarah , Leprince Jérôme , Kiefer-Meyer Marie Christine , Pluchon Sylvain , Mollet Jean-Claude , Zipfel Cyril , Nguema-Ona Eric
Published: October 2023

Several elicitors of plant defense have been identified and numerous efforts to use them in the field have been made. Exogenous elicitor treatments mimic the in planta activation of pattern-triggered immunity (PTI), which relies on the perception of pathogen-associated molecular patterns (PAMPs) such as bacterial flg22 or fungal chitins. Early transcriptional responses to distinct PAMPs are mostly overlapping, regardless of the elicitor being used. However, it remains poorly known if the same patterns are observed for metabolites and proteins produced later during PTI. In addition, little is known about the impact of a combination of elicitors on PTI and the level of induced resistance to pathogens. Here, we monitored Arabidopsis thaliana resistance to the bacterial pathogen Pseudomonas syringae pv. tomato DC3000 ( Pto DC3000) following application of flg22 and chitosan elicitors, used individually or in combination. A slight, but not statistically significant increase in induced resistance was observed when the elicitors were applied together when compared with individual treatments. We investigated the effect of these treatments on the metabolome by using an untargeted analysis. We found that the combination of flg22 and chitosan impacted a higher number of metabolites and deregulated specific metabolic pathways compared with the elicitors individually. These results contribute to a better understanding of plant responses to elicitors, which might help better rationalize their use in the field.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Photosynthetic Costs and Impact on Epidemiological Parameters Associated with Ht Resistance Genes in Maize Lines Infected with Exserohilum turcicum
Authors: Navarro Barbara Ludwig , Streit Sebastian , Nogueira Júnior Antonio Fernandes , von Tiedemann Andreas
Published: October 2023

Northern corn leaf blight, caused by Exserohilum turcicum, is mainly controlled by the use of resistant cultivars. Maize lines carrying individual resistance genes B37 Ht1, B37 Ht2, B37 Ht3, and B37 Htn1 express different defense symptoms having an impact on the photosynthetic activity, the accumulation of reactive oxygen species, and epidemiological parameters. Plants were inoculated with a race 0 isolate of E. turcicum conferring a compatible interaction with B37 and incompatible interactions with plants carrying resistance genes. Five days postinoculation (dpi), the resistant lines displayed a reduction in leaf CO2 assimilation of 30 to 80% compared with healthy plants. At 14 dpi, inoculated plants of B37 Ht1 showed a significant decrease in leaf CO2 assimilation, similar to B37 (up to 94%). The instantaneous carboxylation efficiency was significantly reduced on inoculated plants of the lines B37 Ht2, B37 Ht3, and B37 Htn1 (54 to 81%) at 5 dpi. Curiously, the reduction in carboxylation efficiency for B37 and B37 Ht1 (up to 95%) was higher at 14 dpi than at 5 dpi (up to 81%). At 6 dpi, low levels of H2O2 were detected in B37 Ht1, in contrast to B37 Htn1, where a high H2O2 level and peroxidase activity were observed. The sporulation rate on B37 Ht1, B37 Ht3, and B37 Htn1 decreased by 92% compared with the susceptible control, whereas strong sporulation occurred in lesions on line B37 Ht2. The resistance in maize to E. turcicum conferred by Ht resistance genes is associated with photosynthetic costs and may have quite contrasting effects on host physiology and major epidemiological parameters, such as sporulation, which contributes inoculum for secondary infections.
An Aphid-Transmitted Virus Reduces the Host Plant Response to Its Vector to Promote Its Transmission
Authors: Krieger Célia , Halter David , Baltenweck Raymonde , Cognat Valérie , Boissinot Sylvaine , Maia-Grondard Alessandra , Erdinger Monique , Bogaert Florent , Pichon Elodie , Hugueney Philippe , Brault Véronique , Ziegler-Graff Véronique
Published: October 2023

The success of virus transmission by vectors relies on intricate trophic interactions between three partners, the host plant, the virus, and the vector. Despite numerous studies that showed the capacity of plant viruses to manipulate their host plant to their benefit, and potentially of their transmission, the molecular mechanisms sustaining this phenomenon has not yet been extensively analyzed at the molecular level. In this study, we focused on the deregulations induced in Arabidopsis thaliana by an aphid vector that were alleviated when the plants were infected with turnip yellows virus (TuYV), a polerovirus strictly transmitted by aphids in a circulative and nonpropagative mode. By setting up an experimental design mimicking the natural conditions of virus transmission, we analyzed the deregulations in plants infected with TuYV and infested with aphids by a dual transcriptomic and metabolomic approach. We observed that the virus infection alleviated most of the gene deregulations induced by the aphids in a noninfected plant at both time points analyzed (6 and 72 h) with a more pronounced effect at the later time point of infestation. The metabolic composition of the infected and infested plants was altered in a way that could be beneficial for the vector and the virus transmission. Importantly, these substantial modifications observed in infected and infested plants correlated with a higher TuYV transmission efficiency. This study revealed the capacity of TuYV to alter the plant nutritive content and the defense reaction against the aphid vector to promote the viral transmission.
A practical perspective on how to develop, implement, execute, and reproduce high‐resolution respirometry experiments: The physiologist's guide to an Oroboros O2k
Authors: Walsh Maureen A. , Musci Robert V. , Jacobs Robert A. , Hamilton Karyn L.
Published: October 2023

The development of high‐resolution respirometry (HRR) has greatly expanded the analytical scope to study mitochondrial respiratory control relative to specific tissue/cell types across various metabolic states. Specifically, the Oroboros Oxygraph 2000 (O2k) is a common tool for measuring rates of mitochondrial respiration and is the focus of this perspective. The O2k platform is amenable for answering numerous bioenergetic questions. However, inherent variability with HRR‐derived data, both within and amongst users, can impede progress in bioenergetics research. Therefore, we advocate for several vital considerations when planning and conducting O2k experiments to ultimately enhance transparency and reproducibility across laboratories. In this perspective, we offer guidance for best practices of mitochondrial preparation, protocol selection, and measures to increase reproducibility. The goal of this perspective is to propagate the use of the O2k, enhance reliability and validity for both new and experienced O2k users, and provide a reference for peer reviewers.
A Prospective Cohort Protocol for the Remnant Investigation in Sepsis Study
Authors: Seymour Christopher W. , Urbanek Kelly Lynn , Nakayama Anna , Kennedy Jason N. , Powell Rachel , Robinson Renã A.S. , Kapp Kathryn L. , Billiar Timothy R. , Vodovotz Yoram , Gelhaus Stacy L. , Cooper Vaughn S. , Tang Lu , Mayr Flo , Reitz Katherine M. , Horvat Christopher , Meyer Nuala J. , Dickson Robert P. , Angus Derek , Palmer Octavia Peck
Published: October 2023

BACKGROUND:

Sepsis is a common and deadly syndrome, accounting for more than 11 million deaths annually. To mature a deeper understanding of the host and pathogen mechanisms contributing to poor outcomes in sepsis, and thereby possibly inform new therapeutic targets, sophisticated, and expensive biorepositories are typically required. We propose that remnant biospecimens are an alternative for mechanistic sepsis research, although the viability and scientific value of such remnants are unknown.

METHODS AND RESULTS:

The Remnant Biospecimen Investigation in Sepsis study is a prospective cohort study of 225 adults (age ≥ 18 yr) presenting to the emergency department with community sepsis, defined as sepsis-3 criteria within 6 hours of arrival. The primary objective was to determine the scientific value of a remnant biospecimen repository in sepsis linked to clinical phenotyping in the electronic health record. We will study candidate multiomic readouts of sepsis biology, governed by a conceptual model, and determine the precision, accuracy, integrity, and comparability of proteins, small molecules, lipids, and pathogen sequencing in remnant biospecimens compared with paired biospecimens obtained according to research protocols. Paired biospecimens will include plasma from sodium–heparin, EDTA, sodium fluoride, and citrate tubes.

CONCLUSIONS:

The study has received approval from the University of Pittsburgh Human Research Protection Office (Study 21120013). Recruitment began on October 25, 2022, with planned release of primary results anticipated in 2024. Results will be made available to the public, the funders, critical care societies, laboratory medicine scientists, and other researchers.
Providing Remote Aid During a Humanitarian Crisis
Authors: Kaplan Lewis J. , Levin Scott , Yelon Jay , Cannon Jeremy M. , Mehta Samir , Reilly Patrick M. , Kovach Stephen J. , Donegan Derek J. , Claycomb Kierstyn , Savchenko-Fullerton Maisie , Filonenko Evhen , Maiko Vyacheslav , Kuzmov Roman , Radega Yaroslav , Pashinskiy Viktor , Demyan Yuriy Yurievich , Plesha Petro , Demyan Yuriy , Vinnytskiy Dmytro , Gaulton Glen N. , Brennan Patrick J.
Published: October 2023

Humanitarian crises create opportunities for both in-person and remote aid. Durable, complex, and team-based care may leverage a telemedicine approach for comprehensive support within a conflict zone. Barriers and enablers are detailed, as is the need for mission expansion due to initial program success. Adapting a telemedicine program initially designed for critical care during the severe acute respiratory syndrome coronavirus 2 pandemic offers a solution to data transfer and data analysis issues. Staffing efforts and grouped elements of patient care detail the kinds of remote aid that are achievable. A multiprofessional team-based approach (clinical, administrative, nongovernmental organization, government) can provide comprehensive consultation addressing surgical planning, critical care management, infection and infection control management, and patient transfer for complex care. Operational and network security create parallel concerns relevant to avoid geolocation and network intrusion during consultation. Deliberate approaches to address cultural differences that influence relational dynamics are also essential for mission success.
Cefepime Daily Exposure and the Associated Impact on the Change in Sequential Organ Failure Assessment Scores and Vasopressors Requirement in Critically Ill Patients Using Repeated-Measures Mixed-Effect Modeling
Authors: Alshaer Mohammad H. , Williams Roy , Mousa Mays J. , Alexander Kaitlin M. , Maguigan Kelly L. , Manigaba Kayihura , Maranchick Nicole , Shoulders Bethany R. , Felton Timothy W. , Mathew Sumith K. , Peloquin Charles A.
Published: October 2023

IMPORTANCE:

Sepsis and septic shock are major healthcare problems that need early and appropriate management.

OBJECTIVES:

To evaluate the association of daily cefepime pharmacokinetic/pharmacodynamic (PK/PD) parameters with change in Sequential Organ Failure Assessment (SOFA) score and vasopressors requirement.

DESIGN, SETTING, AND PARTICIPANTS:

This is a retrospective study. Adult ICU patients who received cefepime for Gram-negative pneumonia or bloodstream infection (BSI) and had cefepime concentrations measured were included. Daily cefepime exposure was generated and PK/PD parameters calculated for patients. Repeated-measures mixed-effect modeling was used to evaluate the impact of PK/PD on the outcomes.

MAIN OUTCOMES AND MEASURES:

Change in daily SOFA score and vasopressors requirement.

RESULTS:

A total of 394 and 207 patients were included in the SOFA and vasopressors analyses, respectively. The mean (±sd) age was 55 years (19) and weight 81 kg (29). For the change in SOFA score, daily SOFA score, mechanical ventilation, renal replacement therapy, and number of vasopressors were included. In the vasopressors analysis, daily SOFA score, day of therapy, and hydrocortisone dose were significant covariates in the final model. Achieving cefepime concentrations above the minimum inhibitory concentration (MIC) (T>MIC) for 100% of the dosing interval was associated with 0.006 µg/kg/min decrease in norepinephrine-equivalent dose. Cefepime PK/PD did not have an impact on the daily change in SOFA score.

CONCLUSIONS AND RELEVANCE:

Achieving 100% T>MIC was associated with negligible decrease in vasopressors requirement in ICU patients with Gram-negative pneumonia and BSI. There was no impact on the change in SOFA score.
Validation of the “Indication for Use” (INDO) Variable in the Danish National Prescription Registry
Authors: Harbi Hanin , Pottegård Anton
Published: October 2023

Background:

Despite its potential value in register-based pharmacoepidemiologic research, recorded information on “indication for use” (INDO) in the Danish National Prescription Registry has rarely been used, likely because of questions about the variable’s validity, which to our knowledge no study has systematically assessed.

Methods:

We extracted data on 80,814 prescriptions from the software systems (PharmaNet and C2) of five Danish community pharmacies filled between 4 and 16 February 2019 and 2020. Using the indication information recorded in the pharmacy software systems as the gold standard, we evaluated the extent and quality of the corresponding information from the Prescription Registry.

Results:

Of all prescriptions identified, we captured >99% in the Prescription Registry. The proportion of prescriptions with recorded indication codes in the Prescription Registry was 82% (n = 66,164) but was lower for C2 than PharmaNet. Correcting for the overrepresentation of C2 data in our sample, the estimated proportion of registration was ≈88%. Almost 100% (66,158 of 66,164) of the prescriptions with recorded indication codes in the Prescription Registry had correctly recorded indication codes. Nonspecific indication codes were present in 5.6%–36% of selected drugs and drug classes.

Conclusions:

Prescriptions filled at Danish community pharmacies are accurately captured by the Danish National Prescription Registry, and the recorded information on indication is generally valid and usable in research. However, minor concerns remain about missingness, nonspecific recorded indication codes, and lower validity, and a higher proportion of missingness of recorded indication codes is expected before 2017.

A supplementary digital video by the article’s co-author, Hanin Harbi, is available at http://links.lww.com/EDE/C89
Using three-dimensional versus two-dimensional laparoscopy in sleeve gastrectomy: A case matched comparison
Authors: Kang Lung-Yun , Lee Wei-Jei , Chen Sheng-Shih
Published: October 2023

Background

Laparoscopic sleeve gastrectomy using two-dimensional (2-D) systems has been proven to be a safe and effective treatment for obesity. Three-dimensional (3-D) systems have recently been introduced in the general field. We hypothesized that using a 3-D system offers more benefits than using 2-D laparoscopy in sleeve gastrectomy.

Materials and Methods

Patients who underwent laparoscopic sleeve gastrectomy (LSG) without any other surgeries between January 1, 2017, and February 28, 2019, were included. Characteristic factors and outcomes were reviewed and compared between the groups using the 2-D system and the 3-D system, including sex, age, length of stay, body mass index, operative time, blood loss, morbidity, total body weight loss, and excess weight loss.

Results

Seventy-five patients underwent LSG and were included in the study. Among them, 42 patients used the 3-D system, while 33 patients used the 2-D system. There were no significant differences between the two groups in terms of basic characteristics, including age, sex, and body mass index. The morbidity rate did not differ, but the 3-D group experienced less blood loss (25.12 vs 47.27 mL; P = 0.001) and shorter operative times (105.93 ± 30.645 minutes vs. 128.94 ± 28.566 minutes; P = 0.001) compared with the 2-D group (25.12 vs 47.27 mL; P = 0.001). Weight loss at 6 months was similar between the two groups.

Conclusions

Three-dimensional LSG shows promise in reducing both blood loss and operative time. Nevertheless, further prospective trials are essential to definitively establish its efficacy.
Severe Thrombocytopenia Due to Bone Marrow Failure in Children With Dyskeratosis Congenita Does Not Respond to Eltrombopag Treatment: Case Series
Authors: Pramanik-Jonsson Lotta , Borssén Magnus , Vonlanthen Sofie , Nilsson Frans , Sundin Mikael
Published: October 2023

Dyskeratosis congenita is a rare inherited disease with classic cutaneous symptoms, sometimes accompanied with more severe extracutaneous manifestations such as bone marrow failure, which can be lethal. Eltrombopag is an orally available thrombopoietin receptor agonist in clinical use for increasing platelet levels in patients with immune thrombocytopenia and aplastic anemia. Here, 3 pediatric patients with dyskeratosis congenita are presented with varying disease severity, in which off-label eltrombopag treatment had no clinical effect on bone marrow failure. This, in addition to the negative results in a previous case report, supports the preclusion of eltrombopag use in dyskeratosis congenita.
The impact of impaired insulin regulation on severity of SARS-CoV-2 infection: a 2-year retrospective single-center analysis
Authors: Phan Alexander T. , Ucar Ari , Malkoc Aldin , Nagori Essam , Qadir Aftab , Khosravi Chayanne , Tseng Alan , Nguyễ˜ên Julie P. T. , Modi Arnav P. , Deshpande Ojas , Lay Johnson , Ku Andrew , Dong Fanglong , Ogunyemi Dotun , Arabian Sarkis
Published: October 2023

Background:

The COVID-19 pandemic has caused an international healthcare crisis and produced a large healthcare burden. Diabetes mellitus (DM) is a common disease that can be controlled via pharmacologic agents; however, many patients have poor glycemic control, leading to disease-related complications. DM has been reported in the literature to be associated with increasing morbidity and mortality in COVID-19 patients. The authors aim to assess the associations between glucose homoeostasis and COVID-19 disease severity and mortality.

Methods:

A retrospective chart review of patients ages 18–100 years of age admitted with COVID-19 between January 2020 and December 2021 was performed. The primary outcome was COVID-19 mortality with respect to haemoglobin A1C levels of less than 5.7%, 5.7–6.4%, and 6.5% and greater. Disease severity was determined by degree of supplemental oxygen requirements (ambient air, low-flow nasal cannula, high-flow nasal cannula, non-invasive mechanical ventilation, and invasive mechanical ventilation). COVID-19 mortality and severity were also compared to blood glucose levels on admission as grouped by less than 200 mg/dl and greater than or equal to 200 mg/dl.

Results:

A total of 1156 patients were included in the final analysis. There was a statistically significant association between diabetic status and mortality (P=0.0002). Statistical significance was also noted between admission blood glucose ≥200 mg/dl and mortality (P=0.0058) and respiratory disease severity (P=0.0381). A multivariate logistic regression for predicting mortality showed increasing haemoglobin A1C was associated with increased mortality (odds ratio 1.72 with 95% CI of 1.122–2.635).

Conclusions:

In our 2-year retrospective analysis, there was an association between a diagnosis of DM and COVID-19-related mortality. Hyperglycaemia on admission was found to be statistically significant with mortality in patients diagnosed with COVID-19. Glucose homoeostasis and insulin dysregulation likely play a contributing factor to COVID-19 disease severity and mortality.
The prevalence and pattern of complementary and alternative medicine use among cancer patients in a tertiary oncology center: a cross-sectional study
Authors: Almouaalamy Nabil Abdullah , Banjar Lama A. , Alshaikh Haifa M. , Altowairqi Jood M. , Alharbi Nuha M. , Alghamdi Waad A.
Published: October 2023

Background:

Complementary and alternative medicine (CAM) is widely used nationally and internationally for multiple medical conditions, including different stages of cancer. It is used by the patients for multiple purposes, including to cure diseases or resolve symptoms, as patients have the misconception that natural remedies are safer than radiotherapy and chemotherapy.

Objectives:

The aim of this research is to investigate the prevalence, pattern, and purpose of CAM use by cancer patients at Princess Noorah Oncology Center (PNOC), King Abdulaziz Medical City, in Jeddah (KAMC-JD).

Methods:

This was a cross-sectional study that examined 293 patients (selected through random computerized sampling) who were seen at PNOC during the study period. To be eligible for the study, participants had to be cancer patients over the age of 18 who were seen at PNOC. The authors excluded patients who had privacy requests or did not fit our inclusion criteria.

Results:

Of the sample, 52.9% [95% confidence interval (CI), 47.0–58.7] used CAM. Only 5.8% of patients delayed their medical treatment to use CAM. A significantly higher proportion of females used CAM than males (61.8% vs. 40.0%, P<0.001). The most common types of CAM were Zamzam water (67.7%), Quran recitation (42.6%), water read upon Quran (41.3%), and black seed (Nigella sativa) (41.3%). The most frequently reported reasons for CAM use were to treat cancer (53.5%), increase immunity (34.2%), and religious beliefs (23.9%). Generally, 57.4% of CAM users felt improvement with CAM modalities.

Conclusion:

In conclusion, more than 50% of our sample used CAM; 5.8% of patients delayed the medical treatment to use CAM. The most common type of CAM was Zamzam water, and the most frequently reported reason for CAM use was to treat cancer. Of CAM users, 57.4% felt improvement with CAM modalities. Further studies that involve qualitative designs and include a more diverse sample are recommended in the Kingdom of Saudi Arabia to understand CAM utilization patterns.
ALS in Africa: current knowledge and exciting opportunities for future study – short communication
Authors: Kassahun Bekele Bezawit , Kwizera Lambert , Abdul Razzak Rawane , Alfadul Esraa S.A. , Anand Ayush , Wojtara Magda , Nazir Abubakar , Uwishema Olivier
Published: October 2023

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that can present with motor and extra-motor manifestations. Its global prevalence is 4.42 per 1 000 000, and it has a high mortality rate. In sub-Saharan Africa alone, 15 per 100 000 develop ALS mainly between their 40s and 60s and only one-fourth of them have access to treatment. ALS was found to be not only affected by genetic variation but also by the patient’s mood and lifestyle. In Africa, males and younger people tend to be affected with ALS and rarely present with bulbar onset. ALS diagnosis is very challenging due to the lack of ALS-specific biomarkers and the sharing of some clinical features with other syndromes. ALS treatment is mainly riluzole and supportive treatment via nasogastric tube and ventilatory support. The access to treatment in Africa is very limited, thus a very bad prognosis with a median survival time of 14 months post-diagnosis. Further research is needed to assess the real situation in Africa and to try to closely monitor patients suffering from ALS.
Association between Covid-19 infection and platypnea–orthodeoxia syndrome
Authors: Saeed Sahrai , Hoxha Besnik , Rajani Ronak , Mohamed Ali Abukar , Lehmann Sverre
Published: October 2023

Introduction and importance:

Platypnea–orthodeoxia syndrome is defined as dyspnoea and deoxygenation when changing from a recumbent to an upright position. Post-Covid-19 sequelae can induce or exacerbate pulmonary hypertension and thereby render a previously mild and asymptomatic platypnea–orthodeoxia syndrome to manifest with new or worsening symptoms.

Case presentation:

The authors present the case of an 80-year-old man who following an episode of moderate-severe Covid-19 infection developed type I respiratory failure that required hospital discharge with long-term oxygen therapy. He had a background history of postural paroxysmal hypoxaemia which had previously raised the suspicion of a right-to-left shunt through either a patent foramen ovale, atrial septal defect or an intrapulmonary arteriovenous malformation. However, given the low burden of symptoms this was not explored further. Following recovery from Covid-19 infection, the patient experienced marked dyspnoea and oxygen desaturation in an upright position that was relieved by a return to a supine position.

Discussion and conclusion:

Persistent dyspnoea and hypoxia are common symptoms in patients who experience post‐Covid‐19 syndrome. However, when patients with prior moderate-to-severe Covid-19 illness present with new onset breathlessness and/or desaturation that is worsened in an upright position, platypnea–orthodeoxia syndrome should be considered.
Infant feeding: emerging concepts to prevent HIV transmission
Authors: Bamford Alasdair , Foster Caroline , Lyall Hermione
Published: October 2023

Purpose of review

HIV screening in pregnancy, universal suppressive antiretroviral therapy (ART) and breastfeeding avoidance can almost completely prevent vertical transmission of HIV. Breastfeeding is associated with an additional risk of transmission, although this risk is extremely low with suppressive maternal ART. This minimal risk must be balanced with the benefits of breastfeeding for women living with HIV (WLHIV) and their infants. Guidance in high-income countries has evolved, moving towards supported breast feeding for women on suppressive ART.

Recent findings

Breastmilk transmission accounts for an increasing proportion of new infant infections globally. The majority of transmission data comes from studies including women not on suppressive ART. Breastmilk transmissions in the context of undetectable viral load have rarely occurred, although risk factors remain unclear. Outcome data on supported breastfeeding are accumulating, providing evidence for guidelines and informing infant feeding decisions. Long-acting ART for maternal preexposure prophylaxis or treatment, and infant postnatal prophylaxis are promising future options.

Breastfeeding on suppressive ART has a very low risk of vertical transmission and can have multiple benefits for WLHIV and their infants. However, caution is advised with relaxation of breastfeeding guidance so as not to jeopardise the global goal of elimination of vertical transmission by 2030.
Frontal Sinus Fractures: An Evaluation of Patient Demographics, Mechanisms of Injury, Classification, and Management Strategies in Patients Referred to a Trauma Center, From 2014 to 2019
Authors: Khojastepour Leila , Iravani Shabnam , Khaghaninejad Mohamadsaleh , Hasani Mahvash , Moayyedi Seddigheh , Ahrari Farzaneh
Published: October 2023

This retrospective study aimed to present demographic data, mechanisms of injury, anatomical locations, and management strategies in patients with frontal sinus fractures. The study included 91 patients with frontal sinus fractures attending the Rajaee Hospital of Shiraz between 2014 and 2019. The data recorded for each patient included age, sex, injury mechanism, fracture classification, associated craniofacial fractures, nasofrontal duct injury, cerebrospinal fluid leak, and treatment approach. The mean age of patients was 31.0±14.0 years, with male predominance (95.6%). Car crashes represented the most frequent mechanism of frontal sinus fracture, involving 31 subjects (34%). Isolated anterior and posterior table fractures were seen in 32 (35.2%) and 5 (5.5%) patients. Fifty-four patients (59.3%) presented both tables’ involvement. Frontal sinus injuries occurred frequently (74.7%) with other facial fractures. Nasofrontal duct injury was found in 7 patients (7.7%), and 13 (14.3%) exhibited cerebrospinal fluid leakage. Fifty patients (55%) were treated with observation alone; 16 (17.5%) underwent sinus preservation, 12 (13.2%) experienced sinus obliteration, and 13 (14.3%) endured cranialization. Fisher’s exact test revealed no significant association between the classification of fracture and the mechanism of injury (P=0.591). However, a significant association was observed between the fracture classification and the treatment applied (P=0.023). Frontal sinus fractures were most often caused by car crashes in young adults. Combined anterior and posterior table fractures were more commonly found than isolated anterior or posterior table involvement. Most frontal sinus fractures were treated conservatively without DDS surgical operation.
Tags for Tears: The Obstetric Anal Sphincter Injury Hashtag Ontology Project
Authors: Maliakal Cima , Dieter Alexis , Iglesia Cheryl , Davenport Abigail
Published: October 2023

Importance

Social media is a powerful outlet for the dissemination of health care information. Adoption of a hashtag ontology—a standardized list of terms—may help better organize information and improve access to educational materials for health care providers (HCPs) and patients.

Objectives

The primary objective was to create a hashtag ontology specific to obstetric anal sphincter injuries (OASIS) based on Twitter usage. Secondary objectives included (1) performing a thematic analysis of OASIS-related tweet content and (2) reporting the type of users posting about OASIS.

Study Design

This study was an analysis of tweets related to OASIS posted between June 1, 2019, and June 1, 2022. Symplur Signals (a Twitter analytics software) (Symplur LLC, Los Angeles, CA) was used to identify relevant tweets based on predetermined search terms. Hashtags were reviewed by social media influencers to create a finalized ontology list. The top 100 tweets underwent thematic analysis and were grouped based on emergent themes. Types of users posting about OASIS were also analyzed.

Results

Symplur identified 660 tweets related to OASIS. The final ontology included the following 8 hashtags: #OASIS, #perinealtrauma, #birthtrauma, #3rddegreetear, #4thdegreetear, #episiotomy, #operativedelivery, and #postpartumbody. Major tweet content themes included education, self-promotion, patient experience, medical-legal, research, and opinions. Educational tweets surrounded prevention, risk factors, complications, and educational events related to OASIS and perineal trauma. Of the educational tweets, only 30% were posted by HCPs.

Conclusion

This study created a standardized hashtag ontology related to OASIS. Less than one third of educational tweets were posted by HCPs.
Incidental Finding of a Skene Gland Cyst in the Emergency Department
Authors: Hellier Susan
Published: October 2023

A Skene gland cyst is one of several benign anterior wall masses that may not be identified until a woman's first pelvic examination. The Skene gland cyst may confound emergency provider's differential diagnosis if the female patient presents with gynecological or urologic complaints. A patient with a Skene gland cyst is presented in this article. The purpose of this case study is to review information about the Skene gland to enable emergency providers to identify and consider the Skene gland cyst or abscess in the list of differential diagnoses for urological and gynecological symptoms or as an incidental finding that has no relationship to the presenting complaint. Accurate diagnosis of a Skene gland cyst, infected cyst, or another anterior vaginal wall mass allows the emergency provider to decide whether any immediate treatment is needed and appropriate gynecological referral for definitive treatment.
An Obstetric and Psychiatric Emergency: Managing Acute Agitation Among Pregnant Patients in the Emergency Department
Authors: Woo Mei Yan , Gantioque Raymund
Published: October 2023

New onset of agitation during pregnancy is an obstetric and behavioral emergency that demands careful evaluation and prompt treatment. This article provides an overview of clinical evaluation and types of nonpharmacologic and pharmacologic interventions when managing acute agitation during pregnancy. Rapid clinical evaluation and behavioral management are keys to preventing detrimental maternal and fetal complications. Clinicians must seek out medical etiologies of agitation and always attempt verbal de-escalation before initiating chemical or physical restraints. Should medication be necessary, first-generation antipsychotics, second-generation antipsychotics, antihistamines, or benzodiazepines may be considered. Managing agitation in pregnancy is a challenging dilemma due to the fear of adverse maternal and neonatal outcomes as well as the legal risk involved. Nevertheless, clinicians should continue to assess the patient without delay, differentiate underlying causes of agitation, treat the mother and fetus aggressively, and consult obstetric and psychiatric services early.
Perspectives From Black and White Participants and Care Partners on Return of Amyloid and Tau PET Imaging and Other Research Results
Authors: Rahman-Filipiak Annalise , Lesniak Mary , Sadaghiyani Shima , Roberts Scott , Lichtenberg Peter , Hampstead Benjamin M.
Published: October 2023

Purpose:

Alzheimer disease (AD) biomarker testing is now common in research and approaching clinical translation. Disclosure protocols must be informed by diverse participants’ perspectives on if/how the information would be useful.

Methods:

This study utilized semistructured interviews assessing interest in receiving positron emission tomography (PET) amyloid and tau results, as well as perceived risks and benefits of hypothetical PET disclosure as a function of race and participant diagnosis.

Participants:

Participants [39% Black; 61% White; M
age=74.28 (5.98)] included 57 adults diagnosed as either cognitively healthy (58%) or with mild cognitive impairment (42%) and their respective care partners [33% Black; 67% White; M
age=66.93 (10.92)].

Results:

Most dyads endorsed strong interest in PET results (82.5% of both participants and partners) regardless of race or diagnosis. Black care partners were less interested in receiving the participant’s results than White care partners (χ
2
(4)=8.31, P=0.047). Reasons for disclosure were diverse and highly personalized, including access to treatments or clinical trials (23.2% participants; 29.8% partners), advance planning (14.3% participants; 17.5% partners), and improved health knowledge (12.5% participants; 15.8% partners). In contrast, over 80% of respondents denied any risks of disclosure.

Discussion:

Results suggest that predisclosure education, decisional capacity assessment, and a flexible disclosure approach are needed.
The gems of the Middle-East: Unveiling the biodiversity of Monogonont rotifers in temporary waterbodies of Israel
Authors: Hirshberg Ofir , Paraskevopoulou Sofia , Kiemel Katrin , Ben-Ami Frida
Published: October 2023

Temporary ponds represent ecologically important habitats that support high species diversity and provide essential ecosystem services, particularly in certain countries surrounding the Mediterranean Sea, where natural lakes are scarce. Israel is located along the southeastern Mediterranean coast and features Mediterranean and arid climatic zones that vary in a variety of meteorological parameters. Temporary ponds are prevalent throughout Israel, including the Mediterranean coast, Mediterranean mountain (i.e., Galilee region), and arid climatic zones. These temporal ponds harbor diverse invertebrate communities that exhibit significant spatial and temporal variations. Among these communities, Monogonont rotifers are notably one of the most diverse and abundant groups. Despite their significant role in aquatic food webs, rotifers are often overlooked in environmental studies, likely due to their small size and difficulties associated with their taxonomy. Resilient resting eggs produced by Monogonont rotifers during periods of unsuitable environmental conditions serve as significant source of propagules that drive the recolonization of temporary ponds upon rehydration, thereby influencing the dynamics of the pond community and metacommunity organization. Here, we examined the diversity of Monogonont rotifers by rehydrating sediment from 30 temporary ponds across Israel. Our analysis identified 39 species, with 25 (64%) of them being reported for the first time in Israel. We found the highest diversity of Monogonont rotifers in the Mediterranean coast region, which is characterized by low altitude, long hydroperiod, and relatively low mean summer daily maximum temperature, while the lowest diversity was found in the Arid region which is characterized by high altitude, short hydroperiod, and high mean summer daily maximum temperature. Our findings suggest that altitude, hydroperiod and mean summer daily maximum temperature are important parameters associated with the observed biodiversity patterns. Our metacommunity analysis further revealed a small contribution of geographic distance (2%) and environmental factors (1%) in shaping rotifer metacommunities. We also found a significant positive correlation among community composition, environmental distance (i.e., Gower’s distance) and geographic distance, possibly due to a linearity in the sampling set-up. Overall, our study highlights the importance of temporary ponds as significant habitats for diverse rotifer communities and emphasizes the need to further study “micro” invertebrate diversity in these unique ecosystems.
NetREm Network Regression Embeddings reveal cell-type transcription factor coordination for gene regulation
Authors: Khullar Saniya , Huang Xiang , Ramesh Raghu , Svaren John , Wang Daifeng
Published: October 2023

Transcription factor (TF) coordination plays a key role in target gene (TG) regulation via protein-protein interactions (PPIs) and DNA co-binding to regulatory elements. Single-cell technologies facilitate gene expression measurement for individual cells and cell-type identification, yet the connection between TF coordination and TG regulation of various cell types remains unclear. To address this, we have developed a novel computational approach, Network Regression Embeddings (NetREm), to reveal cell-type TF-TF coordination activities for TG regulation. NetREm leverages network-constrained regularization using prior knowledge of direct and/or indirect PPIs among TFs to analyze single-cell gene expression data. We test NetREm by simulation data and benchmark its performance in 4 real-world applications that have gold standard TF-TG networks available: mouse (mESCs) and simulated human (hESCs) embryonic stem (ESCs), human hematopoietic stem (HSCs), and mouse dendritic (mDCs) cells. Further, we showcase NetREm’s ability to prioritize valid novel TF-TF coordination links in human Peripheral Blood Mononuclear cell (PBMC) sub-types. We apply NetREm to analyze various cell types in both central (CNS) and peripheral (PNS) nerve system (NS) (e.g. neuronal, glial, Schwann cells (SCs)) as well as in Alzheimer’s disease (AD). Our findings uncover cell-type coordinating TFs and identify new TF-TG candidate links. We validate our top predictions using Cut&Run and knockout loss-of-function expression data in rat/mouse models and compare results with additional functional genomic data, including expression quantitative trait loci (eQTL) and Genome-Wide Association Studies (GWAS) to link genetic variants (single nucleotide polymorphisms (SNPs)) to TF coordination. NetREm is open-source available on GitHub as a software package.
Dealing with lipid effects and lipid-extraction biases in δ13C and δ15N isotopic studies: a solution based on 28 marine invertebrate, fish and mammal species
Authors: Ouellet Jean-François , Cabrol Jory , Rioux Ève , Bordeleau Xavier , Lesage Véronique
Published: October 2023

Lipids are naturally depleted in13C isotope in relation to its C sources, causing a bias in δ13C in bulk samples that varies with lipid content. Failure to take this issue into account results in inaccurate conclusions in food web and habitat use studies. Two approaches to resolve this issue are 1) to extract lipids from samples prior to measurement, a resource-intensive process that also can alter δ15N or 2) estimating a lipid-free δ13C using one of several equations that differ in levels of sophistication and generalization across taxa. Here δ13C and δ15N were measured on bulk and lipid-extracted muscle samples of a dataset of over 2000 specimens of 28 species of marine invertebrates, fishes and mammals. Our objectives were to 1) compare the effect of lipid extraction on δ13C and δ15N across taxa; 2) compare the performance of five normalization models, overall and on subsets of species; 3) propose a model to revert lipid-extracted δ15N back to their bulk values; and 4) identify the most suitable approach for dealing with lipid biases in isotopic ratios. Extraction caused an uneven enrichment in δ13C and δ15N across species. Model taxonomic specificity increased estimate accuracy in both isotopes. Models from Logan et al. (2008) and McConnaughey and McRoy (1979) performed better than the other models tested. δ15Nbulkcould be reliably estimated based on δ15Nlipid-extractedusing a linear model. This study provides a way forward for obtaining reliable δ13C and δ15N values in muscle tissue without the costs of duplicate analyses and represents a major step toward the harmonization of datasets collected under the two different approaches.