bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing the quality of ChatGPT- and physician-generated responses to patients’ dermatology questions in the electronic medical record
Authors: Reynolds Kelly , Nadelman Daniel , Durgin Joseph , Ansah-Addo Stephen , Cole Daniel , Fayne Rachel , Harrell Jane , Ratycz Madison , Runge Mason , Shepard-Hayes Amanda , Wenzel Daniel , Tejasvi Trilokraj
Published: January 2024

Background

ChatGPT is a free artificial intelligence (AI)-based natural language processing tool that generates complex responses to inputs from users.

Objectives

To determine whether ChatGPT is able to generate high-quality responses to patient-submitted questions in the patient portal.

Methods

Patient-submitted questions and the corresponding responses from their dermatology physician were extracted from the electronic medical record for analysis. The questions were input into ChatGPT (version 3.5) and the outputs extracted for analysis, with manual removal of verbiage pertaining to ChatGPT’s inability to provide medical advice. Ten blinded reviewers (seven physicians and three nonphysicians) rated and selected their preference in terms of ‘overall quality’, ‘readability’, ‘accuracy’, ‘thoroughness’ and ‘level of empathy’ of the physician- and ChatGPT-generated responses.

Results

Thirty-one messages and responses were analysed. Physician-generated responses were vastly preferred over the ChatGPT ­responses by the physician and nonphysician reviewers and received significantly higher ratings for ‘readability’ and ‘level of empathy’.

Conclusions

The results of this study suggest that physician-generated responses to patients’ portal messages are still preferred over ChatGPT, but generative AI tools may be helpful in generating the first drafts of responses and providing information on education resources for patients.
A necessity that arises during natural disasters: lice treatment without water
Authors: Yürekli Aslan , Durdu Murat , Abul Baran , Demir Pektaş Suzan , Alataş Emine Tuğba , Aydoğdu Ceyda Tetik , Daşgin Dilek
Published: January 2024

Current treatment agents for pediculosis capitis are used during bathing and require rinsing after application. After the recent earthquake disaster in Turkey, there has been a need for a treatment that does not require rinsing in areas where there is no or limited access to water. In this context, we designed a study to find a treatment that does not require rinsing. We aimed to investigate the in vitro lethal effect of ivermectin solution on the parasite and to compare this effect with immersion oil and pure water.
A suspicious mole under the knee
Authors: de Vanssay de Blavous Pauline M , Anketell Priscilla , Fernandez Carolina P
Published: January 2024

This clinicopathological case describes a rare type of pigmented skin lesion. Pigmented trichoblastomas constitute an extremely rare type of benign primary neoplasm of the skin that can clinically resemble more common malignant neoplasms but present characteristic histological features.
Immunogenicity, Reactogenicity, and Safety of AS01E-adjuvanted Respiratory Syncytial Virus (RSV) Prefusion F Protein-based Candidate Vaccine (RSVPreF3 OA) When Co-administered With a Seasonal Quadrivalent Influenza Vaccine in Older Adults: Results of a Phase 3, Open-Label, Randomized Controlled Trial
Authors: Chandler Reynaldo , Montenegro Nathali , Llorach Cecilia , Aguirre Lorena Noriega , Germain Sophie , Kuriyakose Sherine O , Lambert Axel , Descamps Dominique , Olivier Aurélie , Hulstrøm Veronica
Published: January 2024

Background

Co-administration of vaccines against respiratory syncytial virus (RSV) and influenza can be considered given their overlapping seasonality and may increase vaccine uptake and compliance. In this phase 3, open-label, randomized study, we evaluated the immunogenicity, reactogenicity, and safety of the AS01E-adjuvanted RSV prefusion F protein–based candidate vaccine (RSVPreF3 OA) when co-administered with a seasonal quadrivalent influenza vaccine (FLU-QIV) in older adults.

Methods

Participants aged ≥60 years (randomized 1:1) received either RSVPreF3 OA and FLU-QIV simultaneously on day 1 (Co-Ad group) or FLU-QIV on day 1 followed by RSVPreF3 OA on day 31 (sequential administration [SA] group). The co-primary objectives were to demonstrate noninferiority of RSVPreF3 OA in terms of RSV-A neutralization geometric mean titer (GMT) ratio and FLU-QIV in terms of hemagglutination inhibition GMT ratio for each FLU-QIV strain, when co-administered versus when administered alone at 1 month post-vaccination. Noninferiority was demonstrated if the upper limit of the 95% confidence interval of the group GMT ratio (SA/Co-Ad) was ≤1.5. Secondary descriptive objectives comprised additional immunogenicity assessments, reactogenicity, and safety.

Results

Of the 885 participants who received 1 dose of the study vaccines, 837 were included in the per protocol set. Demographic and baseline characteristics were balanced between the groups. Both co-primary objectives were met for both vaccines. Reported adverse events in both groups were mild to moderate, with a low frequency of grade 3 events.

Conclusions

Data from this study demonstrate that RSVPreF3 OA can be co-administered with FLU-QIV. Co-administration is well tolerated, with an acceptable safety profile.

Clinical Trials Registration. NCT04841577.
High-Sensitivity Cardiac Troponin and the Management of Congenital Heart Disease in Newborns and Infants
Authors: Ferraro Simona , Biganzoli Elia , Mannarino Savina , Lanzoni Monica , Zuccotti Gianvincenzo , Plebani Mario , Kavsak Peter
Published: January 2024

Background

Early cardiac interventions in newborns and infants suspected for congenital heart disease (CHD) decrease morbidity and mortality. After updating current evidence on the use of cardiac troponins (cTn) in the context of CHD for risk stratification at early ages, we discuss relevant issues, starting from the evidence that only the measurement of the cTnT form is useful in this population.

Content

In newborns/infants with CHD, the cTnT concentration increase is correlated with: (a) cardiac stress and hemodynamic parameters, but not with the type of CHD; (b) volume overload/right ventricular pressure overload; (c) postoperative hypoperfusion injury and mortality; and (d) effects of cardioprotective strategies. For infants with CHD, high-sensitivity cTnT (hs-cTnT) concentrations >25 ng/L are an independent predictor of poor outcomes. Transitioning from cTnT to hs-cTnT in newborns/infants improves the identification of: (a) physiopathological mechanisms and factors that increased hs-cTnT early after birth; (b) myocardial injury, even when subclinical; (c) identification of patients requiring immediate therapeutic interventions; and (d) 99th percentile upper reference limits (URLs). However, no reliable URLs are currently available to allow the detection of myocardial injury associated with CHD in newborns/infants.

Additional data evaluating the clinical value of hs-cTnT in the risk stratification of newborns/infants with CHD who may suffer myocardial injury is needed. Validating the measurement, possibly in amniotic fluid samples, and improving the interpretation of hs-cTnT concentrations in the prenatal period, at birth and within 1 year of age are crucial to change CHD mortality/morbidity trends in the pediatric population.
Writing instruction with grade-level/college-bound secondary deaf students
Authors: Wolbers Kimberly , Dostal Hannah , Holcomb Leala , Spurgin Kelsey
Published: January 2024

In the current study, we used a sequential explanatory design to examine secondary writing instruction for deaf students in various school settings. An examination of secondary writing instruction was carried out in two cycles using a survey and subsequent focus group discussions. The first cycle (n = 222) presented an overview of secondary writing instruction for deaf students with diverse skill levels. The second cycle (n = 18) focused on writing instruction specific to grade-level or college-bound deaf students. We compared results from both cycles to investigate the similarities and differences in instructional practices and research needs between the two groups. We found that teachers are generally more prepared to instruct deaf students who are at grade level due to widely available curricula aligned with grade-level benchmarks. This contrasts with the challenges teachers face with creating or adapting materials for those who have experienced language deprivation. According to teachers, grade-level students receive 1.5 hr more weekly in writing instruction compared to the full sample. This study also indicates the importance of training teachers to teach skills in crafting arguments through writing, given its applicability to deaf students’ future academic and personal goals.
Diagnostic accuracy of ultrasonography in relation to salivary gland biopsy in Sjögren’s syndrome: a systematic review with meta-analysis
Authors: Martins Fernanda B , Oliveira Millena B , Oliveira Leandro M , Lourenço Alan Grupioni , Paranhos Luiz Renato , Motta Ana Carolina F
Published: January 2024

Objectives

To evaluate the accuracy of major salivary gland ultrasonography (SGUS) in relation to minor salivary gland biopsy (mSGB) in the diagnosis of Sjögren’s syndrome (SS).

Methods

A systematic review and meta-analysis were performed. Ten databases were searched to identify studies that compared the accuracy of SGUS and mSGB. The risk of bias was assessed, data were extracted, and univariate and bivariate random-effects meta-analyses were done.

Results

A total of 5000 records were identified; 13 studies were included in the qualitative synthesis and 10 in the quantitative synthesis. The first meta-analysis found a sensitivity of 0.86 (95% CI: 0.74-0.92) and specificity of 0.87 (95% CI: 0.81-0.92) for the predictive value of SGUS scoring in relation to the result of mSGB. In the second meta-analysis, mSGB showed higher sensitivity and specificity than SGUS. Sensitivity was 0.80 (95% CI: 0.74-0.85) for mSGB and 0.71 (95% CI: 0.58-0.81) for SGUS, and specificity was 0.94 (95% CI: 0.87-0.97) for mSGB and 0.89 (95% CI: 0.82-0.94) for SGUS.

Conclusions

The diagnostic accuracy of SGUS was similar to that of mSGB. SGUS is an effective diagnostic test that shows good sensitivity and high specificity, in addition to being a good tool for prognosis and for avoiding unnecessary biopsies. More studies using similar methodologies are needed to assess the accuracy of SGUS in predicting the result of mSGB. Our results will contribute to decision-making for the implementation of SGUS as a diagnostic tool for SS, considering the advantages of this method.
Use of a steerable delivery sheath to obtain coaxial alignment in left atrial appendage occlusion after mitral transcatheter edge-to-edge repair: a case report
Authors: Maiani Silvia , Nardi Giulia , Ristalli Francesca , Di Mario Carlo , Meucci Francesco
Published: January 2024

Background

Patients with atrial fibrillation (AF) have a five-fold increase in stroke events, and ∼90% of the thrombi develop in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) has emerged as a safe and feasible alternative to oral anticoagulation (OAC) for stroke prevention in selected patients with non-valvular AF and contraindications to OAC. Atrial fibrillation is closely associated with mitral disease, and there is a growing interest in combined procedures. More than half of patients undergoing a mitral transcatheter edge-to-edge repair (M-TEER) suffer of AF and many have high or unacceptable bleeding risk.

Case summary

We present a case of an 80-year-old woman suffering from paroxysmal AF, right carotid siphon aneurysm, and primary mitral regurgitation, with a high bleeding risk, who underwent a combined intervention of M-TEER and LAAO.

Discussion

The combination of these two procedures is a logical step once the access to the left atrium is obtained with a transseptal puncture (TSP) and a transesophageal echocardiography (TEE) is in place to guide both procedures. The turning point in LAAO procedure is a correct TSP allowing coaxial alignment of the sheath with the LAA neck. Steerable delivery sheaths are promising dedicated tools, particularly in challenging anatomy or during combined procedures requiring different TSP positions.
A giant left atrial appendage: a case report on the feasibility of closure with a custom-made device
Authors: Barocelli Federico , Gurgoglione Filippo Luca , Covani Marco , Cattabiani Maria Alberta , Vignali Luigi
Published: January 2024

Background

Transcatheter left atrial appendage occlusion (LAAO) is a valuable therapeutic option for stroke prevention in patients with atrial fibrillation (AF) at high bleeding risk. However, complex LAA anatomies sometimes preclude the adoption of commercially available LAAO devices. The design of a custom-made LAAO device is a promising strategy in these cases. However, few examples of custom-made devices in case of giant LAAs have been reported.

Case summary

An 85-year-old man with permanent AF with CHA2DS2-VASc 4 and recurrent active gastrointestinal major bleedings was referred for transcatheter LAAO at Parma University Hospital after multidisciplinary team evaluation. Pre-procedural coronary computed tomography angiography revealed a giant windsock LAA, with a maximum ostium diameter of 44 mm, a landing zone diameter of 34 mm, and maximal length of 49 mm. Patient’s management was particularly challenging given that available LAAO devices were too small to completely exclude the LAA. In accordance with the manufacturer, a custom-made LAmbre™ Closure System (Lifetech Scientific, Shenzhen, China), which specifically fitted with patient’s LAA anatomy, was designed and successfully deployed under transoesophageal echocardiography (TEE) and fluoroscopic guidance. Periprocedural TEE confirmed the appropriate position of the device and the absence of peri-device leaks. No adverse ischaemic and haemorrhagic events were reported at 3-months follow-up.

Discussion

We present a case of a successful transcatheter LAAO procedure by deploying a custom-made LAmbre device 38/46 mm to mechanically exclude a giant windsock LAA. This case illustrates the effectiveness of a custom-made device strategy, which potentially enables the closure of all complex LAA anatomies.
Key features in telehealth-delivered cardiac rehabilitation required to optimize cardiovascular health in coronary heart disease: a systematic review and realist synthesis
Authors: Gallegos-Rejas Victor M , Rawstorn Jonathan C , Gallagher Robyn , Mahoney Ray , Thomas Emma E
Published: January 2024

Telehealth-delivered cardiac rehabilitation (CR) programmes can potentially increase participation rates while delivering equivalent outcomes to facility-based programmes. However, key components of these interventions that reduce cardiovascular risk factors are not yet distinguished. This study aims to identify features of telehealth-delivered CR that improve secondary prevention outcomes, exercise capacity, participation, and participant satisfaction and develop recommendations for future telehealth-delivered CR. The protocol for our review was registered with the Prospective Register of Systematic Reviews (#CRD42021236471). We systematically searched four databases (PubMed, Scopus, EMBASE, and Cochrane Database) for randomized controlled trials comparing telehealth-delivered CR programmes to facility-based interventions or usual care. Two independent reviewers screened the abstracts and then full texts. Using a qualitative review methodology (realist synthesis), included articles were evaluated to determine contextual factors and potential mechanisms that impacted cardiovascular risk factors, exercise capacity, participation in the intervention, and increased satisfaction. We included 37 reports describing 26 randomized controlled trials published from 2010 to 2022. Studies were primarily conducted in Europe and Australia/Asia. Identified contextual factors and mechanisms were synthesized into four theories required to enhance participant outcomes and participation. These theories are as follows: (i) early and regular engagement; (ii) personalized interventions and shared goals; (iii) usable, accessible, and supported interventions; and (iv) exercise that is measured and monitored. Providing a personalized approach with frequent opportunities for bi-directional interaction was a critical feature for success across telehealth-delivered CR trials. Real-world effectiveness studies are now needed to complement our findings.
General practice pharmacist-led antipsychotic physical health monitoring: a prospective intervention scoping study
Authors: Johnson Chris F , Ingram Fiona , Thomson Fiona , Srireddy Pavan , Jani Bhautesh D , Greenlaw Nicola
Published: January 2024

Background

People with severe mental health illness die prematurely, often due to preventable cardiometabolic disease, which can be exacerbated by antipsychotic medicines that are effective for treating mental illness. Literature demonstrates that physical health monitoring, as recommended in guidelines, for people receiving antipsychotics is substandard. Therefore, we aimed to scope the potential of a general practice clinical pharmacist (GPCP)-led multidisciplinary intervention optimising adherence to cardiometabolic monitoring guidelines and delivering polypharmacy reviews.

Method

Prospective intervention scoping study in three urban general practices; one usual care, two intervention. Patients 18–65 years old prescribed oral antipsychotics were identified from records, and invited for cardiometabolic monitoring and GPCP medication review, from January to December 2022. Interventions and onward referrals were recorded and collated. Anonymised pre- and post-review data were analysed, and actions were graded for clinical importance.

Results

In total 1.5% (210/14,159) of patients aged 18–65 years met inclusion criteria; usual care practice (n = 58); and intervention practices (n = 152). From baseline, the usual care practice achieved an absolute 7% increase in the cardiometabolic monitoring care bundle (glucose/glycosylated haemoglobin, lipids, blood pressure plus body mass index) versus 19–58% in the intervention practices. Two-thirds (92/152) of patients participated in medication reviews, requiring pharmacological and/or non-pharmacological clinical actions. The majority of actions were graded as moderate importance. Seven percentage of patients were identified as new pre-diabetic/diabetic and 6% were at high risk of cardiovascular disease requiring statin initiation.

Conclusion

A pharmacist-led multidisciplinary general practice-based approach may be effective at optimising cardiometabolic monitoring; identifying and treating diabetic and cardiovascular risk factors.
Sweetening the Deal: The Strategic Value of Combining Inducements with Militarized Compellent Threats
Authors: Kwon Yewon
Published: January 2024

This study examines the impact of combining conditional inducements with threats in the context of militarized compellence. It introduces a novel variable to measure the presence of inducements and presents a theory and empirical tests supporting the hypothesis of an increased likelihood of successful outcomes when combining militarized compellent threats with inducements. This integration provides the target with a face-saving opportunity to exit impending militarized conflicts gracefully, and effectively signaling the coercer's sincere commitment and intention to bear associated implement costs. Statistical analysis addresses potential endogeneity and reveals a significant, positive association between inducement use and successful outcomes. Empirical evidence from a comprehensive statistical analysis underscores the effectiveness of adopting a simultaneous carrot-and-stick approach in militarized compellence. The result implies that perceived weaknesses linked to inducements can be mitigated by their combination with strong threats.
Forensic efficiency and population genetic construction of Guizhou Gelao minority from Southwest China revealed by a panel of 23 autosomal STR loci
Authors: Chai Siyu , Li Shuhua , Zhu Ruxin , Luo Li , Chen Kaiqin , Lei Yinlei , Wan Weihong , Hu Xijie , Liu Shiquan , Chen Pengyu
Published: January 2024

Short tandem repeats (STRs) are the most common genetic markers in forensic and human population genetics due to their high polymorphism, rapid detection, and reliable genotyping. To adapt the rapid growth of forensic DNA database and solve problems in disputed cases, a panel of 23 autosomal STR loci with high discriminating ability was constructed recently. The Tai-Kadai-speaking Gelao is the most ancient indigenous minority in Guizhou province, however, the forensic efficiency and population genetic structure remain poorly explored. Here, 490 Guizhou Gelao individuals from Southwest China were genotyped with the panel of 23 STRs using the Huaxia Platinum Kit. A total of 265 alleles were screened. The combined discrimination power and the combined probability of paternity were 0.9999 and 0.9999, respectively. This indicated the 23 loci had higher discrimination power in Guizhou Gelao and could be applied to forensic practice. Comprehensive population structures with reference populations from China and abroad using the neighbour-joining phylogenetic tree (N-J tree), multidimensional scaling, principal component analysis and heatmap demonstrated that Guizhou Gelao was genetically closer to Guizhou Han than other populations. Moreover, our results showed that a complex phylogenetic model was influenced by ethnic, geographic, and linguistic factors.

Key points
How new nanotechnologies are changing the opioid analysis scenery? A comparison with classical analytical methods
Authors: Usman Muhammad , Baig Yawar , Nardiello Donatella , Quinto Maurizio
Published: January 2024

Opioids such as heroin, fentanyl, raw opium, and morphine have become a serious threat to the world population in the recent past, due to their increasing use and abuse. The detection of these drugs in biological samples is usually carried out by spectroscopic and/or chromatographic techniques, but the need for quick, sensitive, selective, and low-cost new analytical tools has pushed the development of new methods based on selective nanosensors, able to meet these requirements. Modern sensors, which utilize “next-generation” technologies like nanotechnology, have revolutionized drug detection methods, due to easiness of use, their low cost, and their high sensitivity and reliability, allowing the detection of opioids at trace levels in raw, pharmaceutical, and biological samples (e.g. blood, urine, saliva, and other biological fluids). The peculiar characteristics of these sensors not only have allowed on-site analyses (in the field, at the crime scene, etc.) but also they are nowadays replacing the gold standard analytical methods in the laboratory, even if a proper method validation is still required. This paper reviews advances in the field of nanotechnology and nanosensors for the detection of commonly abused opioids both prescribed (i.e. codeine and morphine) and illegal narcotics (i.e. heroin and fentanyl analogues).
Bootstrapping for parameter uncertainty in the space–time epidemic-type aftershock sequence model
Authors: Dutilleul P , Genest C , Peng R
Published: January 2024

This paper proposes the use of the parametric bootstrap as a simple way of obtaining reliable confidence intervals for the parameters in the space–time epidemic-type aftershock sequence (ETAS) model. Using an earthquake data catalogue spanning almost 20 yr of seismic activity in the Pacific Ocean off the shores of Vancouver Island (British Columbia, Canada), the authors show through simulation that the confidence intervals based on asymptotic maximum-likelihood theory can sometimes be misleading. In contrast, confidence intervals based on empirical quantiles from bootstrap samples have reliable nominal coverage, provided that edge effects are properly taken into account, both in the bootstrap procedure and in simulation studies. An R package called ETASbootstrap, developed by the authors, facilitates the use of this resampling procedure.
Targeting the heparan sulfate-binding site of RAGE with monoclonal antibodies
Authors: Ong Chihyean , Li Miaomiao , Xu Ding
Published: January 2024

Heparan sulfate (HS) plays its biological functions by interacting with hundreds of secreted extracellular and transmembrane proteins. Interaction with HS has been shown to be required for the normal function of many HS-binding proteins. Receptor for advanced glycation end-product (RAGE) is such a protein, whose activation requires HS-induced oligomerization. Using RAGE as an exemplary protein, we show here the workflow of a simple method of developing and characterizing mAbs that targets the HS-binding site. We found that HS-binding site of RAGE is quite immunogenic as 18 out of 94 anti-RAGE mAbs target various epitopes within the HS-binding site. Sequence analysis found that a common feature of anti-HS-binding site mAbs is the presence of abundant acidic residues (range between 6 to 11) in the complementarity determining region, suggesting electrostatic interaction plays an important role in promoting antigen-antibody interaction. Interestingly, mAbs targeting different epitopes within the HS-binding site blocks HS-RAGE interaction to different degrees, and the inhibitory effect is highly consistent among mAbs that target the same epitope. Functional assay revealed that anti-HS-binding site mAbs show different potency in inhibiting osteoclastogenesis, and the inhibitory potency does not have a simple correlation with the affinity and the epitope. Our study demonstrates that developing HS-binding site targeting mAbs should be applicable to most HS-binding proteins. By targeting this unique functional site, these mAbs might find therapeutic applications in treating various human diseases.
Factors affecting Accountable Care Organizations’ decisions to remain in or exit the Medicare Shared Savings Program following Pathways to Success
Authors: Ying Meiling , Forman Jane H , Murali Sitara , Gauntlett Lauren E , Krein Sarah L , Hollenbeck Brent K , Hollingsworth John M
Published: January 2024

The Medicare Shared Savings Program (MSSP) is an alternative payment model launched in 2012, creating Accountable Care Organizations (ACOs) to improve quality and lower costs for Traditional Medicare patients. Most MSSP participants were expected to shift from bearing no financial risk to a 2-sided risk model (ie, bonus if spending reduced below historical benchmarks, penalty if not), yet fewer than 20% did. Therefore, in 2019, the Centers for Medicare and Medicaid Services launched the Pathways to Success program, which required shifting to a 2-sided model within 12 months. For the first time, more ACOs exited than entered the MSSP. To understand these participation decisions, we conducted qualitative interviews with ACO leaders. Pathways caused ACOs to reassess their potential shared savings vs losses, particularly in light of benchmarking methodology changes; reconsider perceived nonrevenue benefits; and reassess participation in the MSSP vs other programs. As ACOs, particularly those assuming downside risk, have contained costs and enhanced care quality, policymakers should strive to improve MSSP enrollment rates in downside-risk models through strategies that allow ACOs to achieve shared savings and deliver accountable care.
Characterization of novel mutations in the TEL-patch domain of the telomeric factor TPP1 associated with telomere biology disorders
Authors: Bertrand Alexis , Ba Ibrahima , Kermasson Laëtitia , Pirabakaran Vithura , Chable Noémie , Lainey Elodie , Ménard Christelle , Kallel Faten , Picard Capucine , Hadiji Sondes , Coolen-Allou Nathalie , Blanchard Elodie , de Villartay Jean-Pierre , Moshous Despina , Roelens Marie , Callebaut Isabelle , Kannengiesser Caroline , Revy Patrick
Published: January 2024

Telomeres are nucleoprotein structures that protect the chromosome ends from degradation and fusion. Telomerase is a ribonucleoprotein complex essential to maintain the length of telomeres. Germline defects that lead to short and/or dysfunctional telomeres cause telomere biology disorders (TBDs), a group of rare and heterogeneous Mendelian diseases including pulmonary fibrosis, dyskeratosis congenita, and Høyeraal-Hreidarsson syndrome. TPP1, a telomeric factor encoded by the gene ACD, recruits telomerase at telomere and stimulates its activity via its TEL-patch domain that directly interacts with TERT, the catalytic subunit of telomerase. TBDs due to TPP1 deficiency have been reported only in 11 individuals. We here report four unrelated individuals with a wide spectrum of TBD manifestations carrying either heterozygous or homozygous ACD variants consisting in the recurrent and previously described in-frame deletion of K170 (K170∆) and three novel missense mutations G179D, L184R, and E215V. Structural and functional analyses demonstrated that the four variants affect the TEL-patch domain of TPP1 and impair telomerase activity. In addition, we identified in the ACD gene several motifs associated with small deletion hotspots that could explain the recurrence of the K170∆ mutation. Finally, we detected in a subset of blood cells from one patient, a somatic TERT promoter-activating mutation that likely provides a selective advantage over non-modified cells, a phenomenon known as indirect somatic genetic rescue. Together, our results broaden the genetic and clinical spectrum of TPP1 deficiency and specify new residues in the TEL-patch domain that are crucial for length maintenance and stability of human telomeres in vivo.
Five-year outcomes of surgical aortic valve replacement with a novel bovine pericardial bioprosthesis
Authors: Chen Jinmiao , Lv Minzhi , Fu Jiahui , He Chen , Guo Yingqiang , Tao Liang , Zhou Xinmin , Gu Tianxiang , Bartus Krzysztof , Wei Lai , Hong Tao , Wang Chunsheng
Published: January 2024

OBJECTIVES

The short-term performance of the Cingular bovine pericardial aortic valve was proven. This study evaluated its 5-year safety and haemodynamic outcomes.

METHODS

It enrolled 148 patients who underwent surgical aortic valve replacement with the Cingular bovine pericardial aortic valve between March 2016 and October 2017 in 5 clinical centres in China. Safety and haemodynamic outcomes were followed up to 5 years. The incidence of all-cause mortality, structural valve deterioration and reintervention was estimated by Kaplan–Meier analysis.

RESULTS

The mean age of patients was 67.7 [standard deviation (SD) 5.1] years, and 36.5% of patients were female. The mean follow-up was 5.3 (SD 1.2) years. Five-year freedom from all-cause mortality, structural valve deterioration and all-cause reintervention were 91.2%, 100% and 99.3%, respectively. At 5 years, the mean gradient and effective orifice area of all sizes combined were 14.0 (SD 5.5) mmHg and 1.9 (SD 0.3) cm2, respectively. For 19- and 21-mm sizes of aortic prostheses, the mean gradients and effective orifice area at 5 years were 17.5 (SD 7.0) mmHg and 1.6 (SD 0.2) cm2 and 13.7 (SD 6.7) mmHg and 1.8 (SD 0.3) cm2, respectively. The incidence of moderate or severe patient–prosthesis mismatch was 4.1% and 0.0% patients at 5 years, respectively.

CONCLUSIONS

The 5-year safety and haemodynamic outcomes of Cingular bovine pericardial aortic valve are encouraging. Longer-term follow-up is warranted to assess its true durability.
Risk predictors of race disparity in patients undergoing coronary artery bypass grafting: a propensity-matched analysis
Authors: Dokollari Aleksander , Sicouri Serge , Ramlawi Basel , Arora Rakesh C , Lodge Daniel , Wanamaker Kelly M , Hosseinian Leila , Erten Ozgun , Torregrossa Gianluca , Sutter Francis P
Published: January 2024

OBJECTIVES

The aim of this study was to compare long-term prognosis after isolated coronary artery bypass grafting between white and black patients and to investigate risk factors for poorer outcomes among the latest.

METHODS

All consecutive 4766 black and white patients undergoing isolated coronary artery bypass grafting between May 2005 and June 2021 at our institution were included. Primary outcomes were long-term incidence of all-cause death and major adverse cardiovascular and cerebrovascular events in black versus white patients. A propensity-matched analysis was used 2 compare groups.

RESULTS

After matching, 459 patients were included in each black and white groups while groups were correctly balanced. The mean age was 70.4 vs 70.6 years old (P = 0.7) in black and white groups, respectively. Intraoperatively, mean operating room time and blood product transfusion, were higher in the black group while incidence of extubation in the operating room was higher in the white one. Postoperatively, hospital length of stay was higher in the black cohort. Thirty-day all-cause mortality was not different among groups. The median follow-up time was 4 years. Primary outcome of all-cause death was higher in the black versus the white, respectively. Major adverse cardiovascular and cerebrovascular events incidence was twice higher in the black compared to the white cohort (7.6% vs 3.7%, P = 0.013). Risk predictors for all-cause death and major adverse cardiovascular and cerebrovascular events in blacks were creatinine level, chronic obstructive pulmonary disease, ejection fraction <50% and preoperative atrial fibrillation.

CONCLUSIONS

Racial disparities persist in a high-volume centre. Despite no preoperative difference, black minority has a higher incidence of major adverse cardiovascular and cerebrovascular events.
Metabolomic Signatures Differentiate Immune Responses in Avian Influenza Vaccine Recipients
Authors: Howard Leigh M , Jensen Travis L , Goll Johannes B , Gelber Casey E , Bradley Matthew D , Sherrod Stacy D , Hoek Kristen L , Yoder Sandra , Jimenez-Truque Natalia , Edwards Kathryn , Creech C Buddy
Published: January 2024

Background

Avian influenza viruses pose significant risk to human health. Vaccines targeting the hemagglutinin of these viruses are poorly immunogenic without the use of adjuvants.

Methods

Twenty healthy men and women (18–49 years of age) were randomized to receive 2 doses of inactivated influenza A/H5N1 vaccine alone (IIV) or with AS03 adjuvant (IIV-AS03) 1 month apart. Urine and serum samples were collected on day 0 and on days 1, 3, and 7 following first vaccination and subjected to metabolomics analyses to identify metabolites, metabolic pathways, and metabolite clusters associated with immunization.

Results

Seventy-three differentially abundant (DA) serum and 88 urine metabolites were identified for any postvaccination day comparison. Pathway analysis revealed enrichment of tryptophan, tyrosine, and nicotinate metabolism in urine and serum among IIV-AS03 recipients. Increased urine abundance of 4-vinylphenol sulfate on day 1 was associated with serologic response based on hemagglutination inhibition responses. In addition, 9 DA urine metabolites were identified in participants with malaise compared to those without.

Conclusions

Our findings suggest that tryptophan, tyrosine, and nicotinate metabolism are upregulated among IIV-AS03 recipients compared with IIV alone. Metabolites within these pathways may serve as measures of immunogenicity and may provide mechanistic insights for adjuvanted vaccines.

Clinical Trials Registration

NCT01573312.
Association of Oral Microbiome With Oral Human Papillomavirus Infection: A Population Study of the National Health and Nutrition Examination Survey, 2009–2012
Authors: Feng Xinyi , Patel Eshan U , White Jodie L , Li Shilan , Zhu Xianming , Zhao Ni , Shi Jianxin , Park Daniel E , Liu Cindy M , Kaul Rupert , Prodger Jessica L , Quinn Thomas C , Grabowski M Kate , Tobian Aaron A R
Published: January 2024

Background

Oral human papillomavirus (HPV) infection and the oral microbiome are associated with oropharyngeal cancer. However, population-based data on the association of oral microbiome with oral HPV infection are limited.

Method

A cross-sectional analysis of 5496 20–59-year-old participants in the 2009–2012 National Health and Nutrition Examination Survey was performed. Associations with oral HPV infection were assessed using multivariable logistic regression for oral microbiome α-diversity (within-sample diversity), and using principal coordinate analysis and permutational multivariate analysis of variance for β-diversity (between-sample heterogeneity).

Results

Overall, for α-diversity, a lower number of observed amplicon sequence variants (adjusted odds ratio [aOR] = 0.996; 95% confidence interval [CI] = .992–.999) and reduced Faith's phylogenetic diversity (aOR = 0.95; 95% CI = .90–.99) were associated with high-risk oral HPV infection. β-diversity showed differentiation of oral microbiome community by high-risk oral HPV infection as measured by Bray-Curtis dissimilarity (R2 = 0.054%; P = .029) and unweighted UniFrac distance (R2 = 0.046%; P = .045). There were differential associations when stratified by sex.

Conclusions

Both oral microbiome α-diversity and β-diversity were marginally associated with oral HPV infection. Longitudinal studies are needed to characterize the role of the microbiome in the natural history of oral HPV infection.
Blue Black Ecstasy: Ellen Gallagher’s Watery Ecstatic, Oceanic Feeling, and Mysticism in the Flesh
Authors: Bakker Justine M
Published: January 2024

Since 2001, visual artist Ellen Gallagher has been working on “Watery Ecstatic,” an ongoing, expansive project that depicts real and imaginary underwater life through drawings, films, reliefs, and paintings. Thus far, this series—indeed, Gallagher’s oeuvre—has not been studied by scholars of religion. Arguing that the series provokes an extended conversation about mysticism, (para)religion, and constructions of blackness, humanness, and animality, this article addresses this lacuna. Placing the series in conversation with Sigmund Freud and Fred Moten, I argue that “Watery Ecstatic” displays a particular kind of mysticism that I call blue black mysticism: an experience of sociality that, in and through the oceanic, refuses the categorical distinctions and modes of identification that ground and mark normative and racialized ideations of humanness and subjectivity. I suggest, further, that blue black mysticism, because it engages the alterity of the ocean, offers a prime site to trouble the racialized, hierarchical boundary between human and nonhuman animals.
Successful prophylaxis of ESBL Enterobacteriaceae repetitive urinary tract infections with subcutaneous temocillin: a case report
Authors: Delpierre Eloïse , Lanoix Jean-Philippe
Published: January 2024

Objectives

Temocillin is an antibiotic belonging to the β-lactam family, introduced in 1988 but soon forgotten because of its narrow spectrum. Recently, it has been repurposed for its effectiveness against ESBL Enterobacteriaceae, and represents an alternative of choice to carbapenems due to its limited impact on the microbiota.

Patient

We present here a successful case of antibiotic prophylaxis of recurrent ESBL urinary tract infections with subcutaneously administered temocillin.

Conclusions

Temocillin is rarely administered subcutaneously and even more rarely in prophylactic situations. However, its tolerance profile and low impact on the microbiota should help reconsideration of its use in particular cases like this one.
Urine Immunofixation Electrophoresis for Diagnosis of Monoclonal Gammopathy: Evaluation of Methods for Urine Concentration
Authors: Ye Mon May , Ufondu Obiora , Mortley Shanee , Bollag Roni J , Singh Gurmukh
Published: January 2024

Background

Examination of urine by immunofixation electrophoresis (UIFE) is one of the tests recommended for screening and monitoring of monoclonal gammopathies, especially multiple myeloma. Unlike the serum free light chain measurement, a positive result on urine immunofixation is diagnostic for monoclonal immunoglobulin light chains. Urine is usually concentrated, generally by membrane filtration, prior to electrophoresis.

Methods

Alternative methods to membrane filtration for urine concentration were examined. Residual urine specimens submitted for urine protein electrophoresis were concentrated by precipitation of the proteins by ammonium sulfate salt precipitation, precipitation with ethanol and acetonitrile, and by desiccation. The concentrated specimens were subjected to immunofixation electrophoresis using antisera to free light chains (FLC). The results were compared with those from conventional immunofixation electrophoresis using specimens concentrated by membrane filtration.

Results

Ammonium sulfate, ethanol, and acetonitrile precipitation results were less than satisfactory. Concentration by desiccation provided results comparable, if not better than, those by membrane filtration and conventional UIFE. The cost of desiccation is minimal compared to more than $5.00/specimen cost of concentration by membrane filtration. The differences in the results with conventional UIFE and the method described here are likely due to (a) variability in the reactivity of different antisera to free monoclonal light chains, and (b) obscuration of monoclonal free light chains by co-migration with intact immunoglobulin monoclonal proteins.

Conclusions

Concentrating urine by desiccation for immunofixation electrophoresis is technically simple, inexpensive, and provides results comparable to concentrating by membrane filtration. Using FLC provides a more sensitive assay than using conventional antisera.
International Nuclear Security Law: The Use of ‘Soft Law’
Authors: Fukui Yasuhito
Published: January 2024

International nuclear security law includes treaties such as the Convention on the Physical Protection of Nuclear Material and its amendment (A/CPPNM), as well as a series of soft law instruments, such as the International Atomic Energy Agency’s (IAEA) Nuclear Security Series (NSS). These treaties and law instruments function as guidelines providing policy direction and ensuring that the various nuclear facilities are properly protected. Traditionally, soft law has been typified by its flexibility and normativity. However, within the field of nuclear security law, nuclear security is mainly assessed using instruments that are properly implemented by relevant regulatory authorities or operators (in the case of soft law instruments), and regulatory bodies are given the authority to order operators to comply with mandatory instruction on the level of municipal law. This delegation of authority is necessitated by the potentially serious consequences of nuclear and radioactive material, as well as the associated facilities and activities. When the provisions of such instruments are transposed into municipal law, they somewhat function as hard laws despite having originated in international soft law. This is because nuclear security is a sensitive topic intimately related to national security. In conclusion, this unique combination of legally binding instruments and non-legally binding ones, which are often converted into legally binding documents as per municipal law in the case of Japan, enables robust control over nuclear security while also providing sufficient flexibility to ensure that a variety of nuclear facilities can fully adapt to the conditions required to protect these facilities.
Delayed spinetoram application is useful in managing Scirtothrips dorsalis Hood (Thysanoptera: Thripidae) in Florida strawberry
Authors: Panthi Babu Ram , Renkema Justin M , Lahiri Sriyanka , Abd-Elrahman Amr , Liburd Oscar E
Published: January 2024

Scirtothrips dorsalis Hood (Thysanoptera: Thripidae) is an invasive, early-season pest of strawberry in Florida, causing feeding injury to young foliage that results in stunted plant growth and yield loss. Spinetoram, an effective insecticide for thrips pests with up to 3 applications per season permitted in strawberry, is often applied repeatedly during the early-season (Oct–Nov) to manage S. dorsalis, leaving few or no applications for flower thrips pests later in the season (Dec–Mar). Therefore, new strategies are needed to manage S. dorsalis with less insecticide, with the hypothesis that the first insecticide application can be delayed because young strawberry plants can compensate for minor feeding injury without compromising strawberry yield. Experiments conducted in strawberry field plots in Balm, FL, during 2018 and 2019 showed that delaying a spinetoram application for 14 days after infesting a plant with zero, 5, 10, or 20 S. dorsalis adults did not reduce the plant vigor and yield compared to spinetoram application after 4 days. Furthermore, young plants recovered from injury (10–30% bronzing injury on leaf veins and petioles) due to 1 or 2 S. dorsalis adults or larvae per trifoliate. A strategy of delaying the first spinetoram application when plants have 4–5 trifoliates should help reduce the number of insecticide applications needed for S. dorsalis management and reserve spinetoram applications for later in the season. Lower input costs in Florida strawberry without compromising yields due to thrips damage will improve the economics and sustainability of production systems.
A new species of the Anopheles barbirostris complex (Diptera: Culicidae) from Bhutan
Authors: Somboon Pradya , Saeung Atiporn , Saingamsook Jassada , Namgay Rinzin , Harbach Ralph E
Published: January 2024

Anopheles sarpangensis Somboon, Namgay & Harbach is described as a new species of the Barbirostris Complex of the subgenus Anopheles Meigen. The adults differ from other species of the complex in having wings with a prehumeral pale spot on the costa, foretarsomere 1 with an apical pale band more than half as long as foretarsomere 5, midtarsomeres 1 and 2, and occasionally 3 and 4, with incomplete apical pale bands, and abdominal sterna with many white scales as in An. campestris Reid, An. saeungae Taai & Harbach, and An. wejchoochotei Taai & Harbach. The pupa and larva are indistinguishable from the pupae and larvae of other species of the complex. Phylogenetic analysis revealed that COI sequences form a clade separate from clades consisting of the sequences of other species of the complex. The immature stages were commonly found in fishery ponds in foothills at low to moderately high altitudes in the Sarpang District of Bhutan.
Initial blow fly (Diptera: Calliphoridae) colonization of cats (Felis catus) in Indiana
Authors: Bagsby Kelly , Byrd Jason , Stern Adam , Hans Krystal R
Published: January 2024

Many disciplines are utilized within the field of veterinary forensic sciences, including forensic entomology. Understanding the initial colonization period by flies of forensic importance can contribute to estimating the minimum postmortem interval. There is limited data regarding the time of colonization of animals with fur, and the interpretation of this data is difficult due to the variation in animal models used. The purpose of this study was to examine the initial insect colonization of cats (Felis catus), with light and dark fur. Twelve domestic short-haired cats were placed in cages 15.2 m apart in a grassy field in West Lafayette, IN, United States. Weather data (temperature, precipitation, sun/cloud exposure, humidity), insect activity, time to oviposition, and decomposition changes were documented. Eggs from initial oviposition events were collected and reared to identify the primary colonizing species. Although the time of first oviposition event was not different between the treatments, fur color did affect fly colonization, and cats with dark fur had more oviposition events than cats with light fur (t = 2.639, df = 4, P = 0.029). Three species of Lucilia (Diptera: Calliphoridae) colonized the cats on the initial day of placement. Further studies in cats should include the decompositional studies to understand the unique characteristics that occur during each stage of decomposition, which could aid in developing a scoring system for animals with fur. Additional studies could include analyzing how fur length would affect colonization.