bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome analysis of the esca-associated Basidiomycetes Fomitiporia mediterranea, Fomitiporia polymorpha, Inonotus vitis, and Tropicoporus texanus reveals virulence factor repertoires characteristic of white-rot fungi
Authors: Garcia Jadran F , Figueroa-Balderas Rosa , Comont Gwenaëlle , Delmas Chloé E L , Baumgartner Kendra , Cantu Dario
Published: August 2024

Some Basidiomycete fungi are important plant pathogens, and certain species have been associated with the grapevine trunk disease esca. We present the genomes of 4 species associated with esca: Fomitiporia mediterranea, Fomitiporia polymorpha, Tropicoporus texanus, and Inonotus vitis. We generated high-quality phased genome assemblies using long-read sequencing. The genomic and functional comparisons identified potential virulence factors, suggesting their roles in disease development. Similar to other white-rot fungi known for their ability to degrade lignocellulosic substrates, these 4 genomes encoded a variety of lignin peroxidases and carbohydrate-active enzymes (CAZymes) such as CBM1, AA9, and AA2. The analysis of gene family expansion and contraction revealed dynamic evolutionary patterns, particularly in genes related to secondary metabolite production, plant cell wall decomposition, and xenobiotic degradation. The availability of these genomes will serve as a reference for further studies of diversity and evolution of virulence factors and their roles in esca symptoms and host resistance.
Vaccination to Prevent Lyme Disease: A Movement Towards Anti-Tick Approaches
Authors: Johnson Emily E , Hart Thomas M , Fikrig Erol
Published: August 2024

Lyme disease is caused by the spirochete, Borrelia burgdorferi, which is transmitted by Ixodes spp ticks. The rise in Lyme disease cases since its discovery in the 1970s has reinforced the need for a vaccine. A vaccine based on B burgdorferi outer surface protein A (OspA) was approved by the Food and Drug Administration (FDA) several decades ago, but was pulled from the market a few years later, reportedly due to poor sales, despite multiple organizations concluding that it was safe and effective. Newer OspA-based vaccines are being developed and are likely to be available in the coming years. More recently, there has been a push to develop vaccines that target the tick vector instead of the pathogen to inhibit tick feeding and thus prevent transmission of tick-borne pathogens to humans and wildlife reservoirs. This review outlines the history of Lyme disease vaccines and this movement to anti-tick vaccine approaches.
How to Prevent Rubella Epidemics and Congenital Rubella Syndrome: Lessons From 42 Years of Longitudinal Epidemiology in Osaka Prefecture, Japan (1982–2023)
Authors: Kanbayashi Daiki , Kurata Takako , Kaida Yuko , Miyoshi Tatsuya , Okayama Fumika , Kase Tetsuo , Komano Jun , Takahashi Kazuo , Ikuta Kazuyoshi , Motomura Kazushi
Published: August 2024

Background

Despite the introduction of rubella-containing vaccine into routine immunization in 1977, rubella has not been eliminated in Japan. This study aimed to validate the immunization strategy and highlight crucial elements of the elimination program.

Methods

We scrutinized cases of rubella and congenital rubella syndrome (CRS). Additionally, we analyzed the national vaccination coverage, seroprevalence, and number of maternal rubella-related spontaneous or artificial fetal deaths.

Results

The shift from selective to universal immunization significantly reduced rubella cases, coupled with increased seroprevalence in children. However, rubella resurged in 2012 to 2013 and 2018 to 2019, which was virologically and serologically confirmed to be associated with imported rubella virus and susceptible males. Although the disease burden of CRS may have been suppressed in the past by the large number of spontaneous or artificial fetal deaths, the incidence rate of CRS was comparable to that of the 1960s to 1980s. Cases of breakthrough infection and CRS were identified in females who were considered to have a history of single-dose vaccination.

Conclusions

Even with universal immunization, future epidemics and severe outcomes cannot be prevented unless immunization gaps are closed. Furthermore, CRS and breakthrough infection are not completely prevented by single-dose vaccination, indicating the need for second-dose vaccination.
Effect of Bladder Catheterization On Bacterial Interference With Asymptomatic Escherichia coli Strain 83972 in an Experimental Porcine Model of Urinary Tract Infection
Authors: Stærk Kristian , Andersen Karin , Hjelmager Janni Søvsø , Jensen Louise Kruse , Jørgensen Benjamin Meyer , Møller-Jensen Jakob , Lund Lars , Andersen Thomas Emil
Published: August 2024

Background

Urinary tract infection (UTI) is a common disease with a significant risk of relapse. Deliberate bladder colonization with asymptomatic Escherichia coli is being explored as a potential strategy to fend off invading uropathogens, thereby mitigating the risk of symptomatic UTI. Currently, one major obstacle is the low success rates for achieving persistent bladder colonization with asymptomatic bacteria and experimental challenge studies are lacking. Here, we assessed the influence of an indwelling bladder catheter on the ability of asymptomatic E. coli to colonize the bladder and to assess the protective efficacy of such colonization against experimental UTI with uropathogenic E. coli.

Methods

Pigs with or without indwelling bladder catheters were experimentally inoculated with the asymptomatic E. coli strain 83972 and subsequently challenged by inoculation with a uropathogenic E. coli isolate, UTI89. The animals were monitored with regular urine and blood samples and bladders and kidneys were harvested at termination.

Results

All pigs with indwelling catheters were colonized by E. coli 83972 in response to inoculation, compared to pigs without catheters in which only 1 of 8 animals were colonized. When removing the catheter, E. coli 83972 were spontaneously cleared. Colonization with E. coli 83972 prevented experimental infection in 50% of animals, whereas all control animals became infected.

Conclusions

The presence of indwelling bladder catheters strongly facilitates the colonization of E. coli 83972, indicating that individuals with catheters may be particularly suited for receiving this treatment. The research supports prophylactic colonization with E. coli 83972 as a potential strategy to reduce the risk of UTIs.
Impact of the COVID-19 Pandemic on the Delivery of Congenital Syphilis Care in the Military Health System
Authors: Teng Jennifer , Prabhakar Sarah , Rajnik Michael , Susi Apryl , Hisle-Gorman Elizabeth , Nylund Cade M , Brown Jill
Published: August 2024

Introduction

Congenital syphilis (CS) case rates have increased significantly in the United States over the past 20 years, accelerating during the COVID-19 pandemic. Increasing rates may relate to access to care but have not been evaluated in a fully-insured population, such as the Military Health System.

Materials and Methods

We performed a repeated monthly cross-sectional study of CS cases and total encounters (care rates) using the queried Military Health System database. We defined CS by International Classifications of Diseases 10th Revision Clinical Modification diagnosis codes in beneficiaries  ≤ 2 years old. We evaluated pre-COVID-19 (March 2018 to February 2020), pandemic year 1 (March 2020 to February 2021), and pandemic year 2 (March 2021 to February 2022) periods. We performed change-point and trend analyses and Poisson regression to evaluate differences by sponsor rank, TRICARE region, and pandemic period. The Uniformed Services University Institutional Review Board approved the study.

Results

A total of 69 unique CS cases were identified with a median monthly care rate of 0.90/100,000 eligible beneficiaries. The CS care rate showed a 5.8% average monthly percent increase throughout the study period (P < .001) and a 20.8% average monthly percent increase in year 2 (P < .05). Compared to the pre-pandemic era, CS care rates increased in pandemic years 1 and 2 (adjusted rate ratio [aRR] 2.76 [95% CI: 1.95-3.92], 5.52 [95% CI: 4.05-7.53], respectively). Congenital syphilis care rates were lower in children of senior enlisted sponsors versus junior enlisted, aRR 0.24 (95% CI: 0.17-0.33), and higher in the West and North regions versus South, aRR 2.45 (95% CI: 1.71-3.53) and aRR 2.88 (95% CI: 2.01-4.12), respectively.

Conclusions

Congenital syphilis care rates were substantially lower in this insured group than national rates but increased significantly during the COVID-19 pandemic. Higher care rates were seen in children of military members of lower rank. Regional trends differed from national data. These findings suggest that, even in a fully-insured population, income and regional differences impact CS, and the COVID-19 pandemic may have exacerbated differences in care delivery.
MK-like spectral classification for hot subdwarf stars with LAMOST spectra
Authors: Zou Xuan , Lei Zhenxin
Published: August 2024

An MK-like spectral classification has been conducted for 1224 hot subdwarf stars with LAMOST DR9 low-resolution spectra. The whole sample was divided into four categories according to the spectral line characteristics: He-normal, He-weak, He-strong C, and He-strong. Each selected spectrum was assigned a spectral class, a luminosity class, and a helium class by comparing the line depth and width with standard spectra selected in LAMOST. Relationships between atmospheric parameters and spectral classification are also presented.
Deciphering the impairment of perimenopausal insomnia on visual search from a neurocognitive processing perspective
Authors: Yu Liyong , Luo Yucai , Lin Wenting , Dou Zeyang , Hu Daijie , Wei Wei , He Yuqi , Zhu Keli , Hong Xiaojuan , Zhang Qi , Yu Siyi
Published: August 2024

Study Objectives

Perimenopausal insomnia (PMI) is associated with observable performance impairments in visual search tasks. This study examines how various cognitive processing stages contribute to search performance delays in PMI compared to healthy controls (HCs).

Methods

We recruited 76 participants diagnosed with PMI and 63 HCs. Event-related potentials (ERPs) were recorded as participants engaged in a visual search task, reporting the orientation of a color popout target within an array of ellipses. We analyzed group differences in behavioral performance and ERP components across cognitive processing stages.

Results

Compared to HCs, PMI patients exhibited behavioral response delays, although accuracy was not different between groups. Electrophysiological analyses revealed group differences across several ERP components. Firstly, the N1 component’s amplitude increased bilaterally, suggesting enhanced visual sensory processing. Secondly, a slower and smaller N2pc indicated reduced attentional orienting. Thirdly, a decreased sustained posterior-contralateral negativity amplitude pointed to deficits in target discrimination. Fourthly, an increased amplitude of the stimulus-locked lateralized readiness potential (LRP), with unchanged latency, suggested heightened neural inputs for maintaining motor initiation speed. Fifthly, prolonged response-locked LRP latency indicated slower motor execution. Finally, these changes in ERP components, along with significant correlations between LRP components and insomnia symptoms, suggest potential neural biomarkers for PMI.

Conclusions

Our findings provide high-temporal-resolution insights into the neurocognitive disruptions associated with PMI, highlighting how sleep disturbances affect cognitive processing in visual tasks. These insights enhance our understanding of PMI and contribute to discussions on neural mechanisms driving behavioral performance in various conditions.
Assessment of in vivo chemical mutagenesis by long-read sequencing
Authors: Miranda Jaime A , Revollo Javier R
Published: August 2024

Evaluating the mutagenic properties of chemicals is crucial for understanding their potential cancer risks. Recent Illumina-based error-corrected sequencing techniques have enabled the direct detection of mutations induced de novo by mutagens. However, as the Illumina platform lacks intrinsic error-correction capabilities, complex library preparations and bioinformatic processes are necessary to identify these rare mutations. In this study, we evaluated whether long-read PacBio-based HiFi sequencing (HiFi seq), which has integrated error-correction, can detect de novo mutations induced by mutagens in C57BL/6 mouse tissues. Using HiFi seq, dose-dependent increases in mutation frequencies were found in tissues from mice exposed to 7,12-dimethylbenz[a]anthracene, procarbazine, and N-propyl-N-nitrosourea. Furthermore, the mutational signatures derived from these exposures were consistent with those previously reported for these mutagens. This study demonstrates that HiFi seq can complement established mutation detection assays to facilitate the identification of hazardous compounds.
Osteocalcin binds to a GPRC6A Venus fly trap allosteric site to positively modulate GPRC6A signaling
Authors: Agarwal Rupesh , Ye Ruisong , Smith Micholas Dean , Smith Jeremy C. , Quarles L. Darryl , Pi Min
Published: August 2024

GPRC6A, a member of the Family C G‐protein coupled receptors, regulates energy metabolism and sex hormone production and is activated by diverse ligands, including cations, L‐amino acids, the osteocalcin (Ocn) peptide and the steroid hormone testosterone. We sought a structural framework for the ability of multiple distinct classes of ligands to active GPRC6A. We created a structural model of GPRC6A using Alphafold2. Using this model we explored a putative orthosteric ligand binding site in the bilobed Venus fly trap (VFT) domain of GPRC6A and two positive allosteric modulator (PAM) sites, one in the VFT and the other in the 7 transmembrane (7TM) domain. We provide evidence that Ocn peptides act as a PAM for GPRC6A by binding to a site in the VFT that is distinct from the orthosteric site for calcium and L‐amino acids. In agreement with this prediction, alternatively spliced GPRC6A isoforms 2 and 3, which lack regions of the VFT, and mutations in the computationally predicted Ocn binding site, K352E and H355P, prevent Ocn activation of GPRC6A. These observations explain how dissimilar ligands activate GPRC6A and set the stage to develop novel molecules to activate and inhibit this previously poorly understood receptor.
Liver kinase B1 (LKB1) regulates the epigenetic landscape of mouse pancreatic beta cells
Authors: Haberman Nejc , Cheung Rebecca , Pizza Grazia , Cvetesic Nevena , Nagy Dorka , Maude Hannah , Blazquez Lorea , Lenhard Boris , Cebola Inês , Rutter Guy A. , Martinez‐Sanchez Aida
Published: August 2024

Liver kinase B1 (LKB1/STK11) is an important regulator of pancreatic β‐cell identity and function. Elimination of Lkb1 from the β‐cell results in improved glucose‐stimulated insulin secretion and is accompanied by profound changes in gene expression, including the upregulation of several neuronal genes. The mechanisms through which LKB1 controls gene expression are, at present, poorly understood. Here, we explore the impact of β cell‐selective deletion of Lkb1 on chromatin accessibility in mouse pancreatic islets. To characterize the role of LKB1 in the regulation of gene expression at the transcriptional level, we combine these data with a map of islet active transcription start sites and histone marks. We demonstrate that LKB1 elimination from β‐cells results in widespread changes in chromatin accessibility, correlating with changes in transcript levels. Changes occurred in hundreds of promoter and enhancer regions, many of which were close to neuronal genes. We reveal that dysregulated enhancers are enriched in binding motifs for transcription factors (TFs) important for β‐cell identity, such as FOXA, MAFA or RFX6, and we identify microRNAs (miRNAs) that are regulated by LKB1 at the transcriptional level. Overall, our study provides important new insights into the epigenetic mechanisms by which LKB1 regulates β‐cell identity and function.
The Effect of Swaddling and Oropharyngeal Colostrum During Endotracheal Suctioning on Procedural Pain and Comfort in Premature Neonates
Authors: Karadede Huriye , Mutlu Birsen
Published: August 2024

Background:

Endotracheal suctioning (ES) is a painful procedure frequently performed in the neonatal intensive care unit. This procedure negatively affects the comfort level of premature neonates.

Purpose:

To determine the effect of 2 nonpharmacologic methods, swaddling and the administration of oropharyngeal colostrum, on the pain and comfort levels of preterm neonates during ES.

Methods:

This randomized controlled experimental study comprised 48 intubated premature neonates (swaddling group n = 16; oropharyngeal colostrum group n = 16; and control group n = 16) at 26 to 37 weeks of gestation. The neonates were swaddled with a white soft cotton cloth or administered 0.4 mL of oropharyngeal colostrum 2 minutes before ES, according to the group in which they were included. Two observers evaluated the pain levels (Premature Infant Pain Profile-Revize [PIPP-R]) and comfort (Newborn Comfort Behavior Scale [COMFORTneo]) of the infants by observing video recordings of before, during, and after the procedure.

Findings/Results:

A significantly lower mean PIPP-R score was found in the swaddling group during ES compared with the control group (P = .002). The mean COMFORTneo scores of the swaddling and oropharyngeal colostrum groups during ES (P < .01, P = .002) and the mean PIPP-R and COMFORTneo scores immediately after ES and 5, 10, and 15 minutes later were significantly lower than the control group (P < .005).

Implications for Practice and Research:

Swaddling was effective both during and after the procedure, while oropharyngeal colostrum was effective only after the procedure in reducing ES-related pain in premature neonates. Swaddling and oropharyngeal colostrum were effective in increasing comfort both during and after the procedure.
Histopathologic Findings of Evolving Mpox Lesions
Authors: Mital Rohan , Fisher Kristopher , Korman Abraham M. , Plaza Jose A. , Kaffenberger Benjamin H. , Chung Catherine G.
Published: August 2024

This article reports two cases of the 2022 mpox virus with notable histopathology, and includes a novel description of mpox pseudotumor in the perianal region which is not previously described. This article additionally includes literature review of characteristic histopathology through evolving lesions, as it is sparsely described in relation to the 2022 mpox outbreak. Case one describes a 42-year-old man who presented with umbilicated, smooth papules on the trunk and extremities, and milia-like papules on the face. Histopathology of an umbilicated lesion revealed epidermal acanthosis with keratinocyte pallor, ballooning degeneration, keratinocyte necrosis, and neutrophilic epitheliotropism. Case two describes a 51-year-old man who presented with scattered eroded papules as well as a perianal mass. Histopathology of the mass revealed ulceration with keratinocyte enlargement and pallor with a mixed inflammatory cell infiltrate. It additionally revealed rare multinucleated keratinocytes with nuclear molding. These cases are remarkable and contribute to literature as reports of the histopathology of the atypical 2022 mpox outbreak are rare. A combination of clinical, laboratory, and histopathologic evidence is useful in diagnosing mpox, and these cases contribute to describing the evolution of viral lesions.
Comparison of Digital Pathology and Light Microscopy Among Dermatology Residents: A Reappraisal Following Practice Changes
Authors: Neal Donald E. , Johnson Emma F. , Agrawal Shruti , Todd Austin , Camilleri Michael J. , Wieland Carilyn N.
Published: August 2024

Background:

Following transition to digital pathology for primary diagnosis at our institution, dermatology residents have reduced exposure to light microscopy. This study compares resident competency with light microscopy versus digital pathology following practice changes.

Methods:

Twenty-one dermatology residents were administered a dermatopathology examination composed of 32 diagnoses evaluated using digital slides and 32 with light microscopy. Case difficulty was graded and balanced between modalities. Diagnostic accuracy was measured using the number of correct diagnoses for each modality. Participants were surveyed regarding their experience and preferences.

Results:

Diagnostic accuracy was higher with digital pathology than light microscopy (22/32 vs. 18/32, P < 0.001). Diagnostic accuracy with digital pathology increased with years of training, but accuracy with light microscopy did not. Residents with previous light microscopy experience achieved an average score of 19/32 on glass, as compared with 10/32 for those without experience (P = 0.039). Digital pathology was preferred over light microscopy (18/21, 85.7%).

Conclusions:

Trainees had better diagnostic proficiency with digital pathology and preferred this modality. Most practices at this time continue to use light microscopy. Therefore, we need to maintain proficiency in microscopy during training while concurrently preparing trainees for a digital future.
Nail as a Window to Diagnosing Multisystem Langerhans Cell Histiocytosis: A Case Report and Review of Literature
Authors: Somasundaram Arun , Periyasamy Senthil Kumar , Arunachalam Narayanan , Suyamprakasam Vimala Tirekha , Jinkala Sree Rekha , Dhandapany Gunasekaran , Sivaranjini Ramassamy
Published: August 2024

Nail involvement in Langerhans cell histiocytosis is rarely reported in the literature. According to the reported cases, it is believed that the involvement of nails has a poor prognosis because of multisystem involvement. Performing a nail bed biopsy might be challenging for children. We report a child in whom nail bed biopsy served as the sole clue to the diagnosis of Langerhans cell histiocytosis in absentia of skin clue on a background of advanced multisystem involvement.
Comparison of craniotomy and decompressive craniectomy for acute subdural hematoma: a meta-analysis of comparative study
Authors: Li Hua , Yao Yuqiang , Jiang Yuwen , Su Yibing , Wang Hanbin , Zhu Can , Gan Wenyi
Published: August 2024

Background:

Acute subdural hematoma (ASDH) necessitates urgent surgical intervention. Craniotomy (CO) and decompressive craniectomy (DC) are the two main surgical procedures for ASDH evacuation. This meta-analysis is to compare the clinical outcomes between the CO and DC procedures.

Materials and methods:

The authors performed a meta-analysis according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA, Supplemental Digital Content 1, http://links.lww.com/JS9/C513, Supplemental Digital Content 2, http://links.lww.com/JS9/C514) Statement protocol and assessing the methodological quality of systematic reviews (AMSTAR) (Supplemental Digital Content 3, http://links.lww.com/JS9/C515) guideline. The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Comparative studies reporting the outcomes of the CO and DC procedures in patients with ASDH were included.

Results:

A total of 15 articles with 4853 patients [2531 (52.2%) receiving CO and 2322 (47.8%) receiving DC] were included in this meta-analysis. DC was associated with higher mortality [31.5 vs. 40.6%, odds ratio (OR)=0.58, 95% CI: 0.43–0.77] and rate of patients with poorer neurological outcomes (54.3 vs. 72.7%; OR=0.43, 95% CI: 0.28–0.67) compared to CO. The meta-regression model identified the comparability of preoperative severity as the only potential source of heterogeneity. When the preoperative severity was comparable between the two procedures, the mortality (CO 35.5 vs. DC 38.1%, OR=0.80, 95% CI: 0.62–1.02) and the proportion of patients with poorer neurological outcomes (CO 64.8 vs. DC 66.0%; OR=0.82, 95% CI: 0.57–1.16) were both similar. Reoperation rates were similar between the two procedures (CO 16.1 vs. DC 16.0%; OR=0.95, 95% CI: 0.61–1.48).

Conclusion:

Our meta-analysis reveals that DC is associated with higher mortality and poorer neurological outcomes in ASDH compared to CO. Notably, this difference in outcomes might be driven by baseline patient severity, as the significance of surgical choice diminishes after adjusting for this factor. Our findings challenge previous opinions regarding the superiority of CO over DC and underscore the importance of considering patient-specific characteristics when making surgical decisions. This insight offers guidance for surgeons in making decisions tailored to the specific conditions of their patients.
Clinicopathologic Features of Primary Immunodeficiency Monogenic Disease-related Very Early Onset Inflammatory Bowel Disease: Focus on Gastrointestinal Histologic Features in IFIH1 Mutations
Authors: Santoro Luisa , Grillo Federica , D’Armiento Maria , Buccoliero Anna Maria , Rocco Michele , Ferro Jacopo , Vanoli Alessandro , Cafferata Barbara , Macciomei Maria Cristina , Mescoli Claudia , Cananzi Mara , Alaggio Rita , Fassan Matteo , Mastracci Luca , Francalanci Paola , Parente Paola
Published: August 2024

Very early onset inflammatory bowel disease (VEO-IBD) is a clinical term referring to IBD-like symptomatology arising in children younger than 6 years. VEO-IBD may be due to polygenic etiology in “pure” IBD (Crohn disease-CD and ulcerative colitis-UC), or it may be caused by primary immunodeficiency underlined by monogenic disease. Primary immunodeficiency monogenic diseases have a Mendelian inheritance and affect the immune system with multiorgan morbidity and possible effects on the gastrointestinal system. Primary Immunodeficiency monogenic diseases differ from “pure” IBD as the latter primarily affect the gastrointestinal tract with mitigated extraintestinal symptomatology. Since their first description, primary immunodeficiency monogenic diseases, although rare, have been the subject of increasing interest due to their dramatic phenotype, difficulty in reaching a timely diagnosis, and specific therapeutic approach. In this paper, we present a brief review of primary immunodeficiency monogenic diseases, focusing on to their clinicopathologic features as well as delving, in greater detail, into monogenic diseases caused by IFIH1 mutations. The clinicopathologic features of 4 patients with IFIH1, a gene involved in interferon pathway deficiency, will be described using a histologic pattern of damage approach confirming the need to avoid the histologic diagnosis of VEO-IBD in children younger than 6 years.
A Randomized Controlled Comparison of Guardian-Perceived Cosmetic Outcome of Simple Lacerations Repaired With Either Dermabond, Steri-Strips, or Absorbable Sutures
Authors: Barton Margaret S. , Chaumet Maureen Saint Georges , Hayes Jessica , Hennessy Cassandra , Lindsell Christopher , Wormer Blair A. , Kassis Salam A. , Ciener Daisy , Hanson Holly
Published: August 2024

Objectives

The aim of this study was to compare the guardian-perceived 3-month cosmetic outcome for pediatric lacerations repaired with absorbable sutures, Dermabond, or Steri-Strips. Secondarily, pain and satisfaction with the procedure from both guardian and provider perspectives were compared.

Methods

In this randomized controlled trial, we enrolled a convenience sample of children aged 0 to <18 years who presented with simple linear lacerations (≤5 cm in length, ≤0.5 cm in width, and <12 hours old) to a pediatric emergency department. Children were randomized to receive laceration repair with absorbable sutures, Dermabond, or Steri-Strips. Topical L.E.T. solution (lidocaine, epinephrine, tetracaine) was applied to wounds which were then closed by the primary team. Guardians and providers completed questionnaires regarding perceived pain and satisfaction with the procedure. Guardians were contacted 3 months after the repair and asked to email a picture of the scar with their perception of cosmesis rated on a visual analog scale from 0 to 100.

Results

Fifty-five patients were enrolled, of whom 30 completed 3-month follow-up (12 suture, 7 Dermabond, 11 Steri-strips). There was no statistical evidence of an association between scar appearance and closure method based on medians and interquartile ranges for cosmetic ratings of scar: suture median 70.5 (IQR 59.8–76.8), Dermabond median 85 (IQR 73–90), Steri-strips median 67 (IQR 55–78) (P = 0.254). Guardian satisfaction with length of stay, guardian and physician satisfaction with the procedure, and guardian and physician-perceived pain also showed no differences.

Conclusions

No differences were observed in guardian-perceived cosmesis of simple lacerations repaired with sutures, Dermabond, or Steri-Strips when evaluated 3 months after intervention. In addition, there were no differences in guardian or physician-perceived pain or satisfaction with the closure methods. The results of this study suggest that all 3 closure methods appear to be clinically equivalent, which is largely consistent with other evidence. Further study should be expanded to a larger demographic.
The Impact of Legalizing Recreational Cannabis on the Children of a Neighboring State
Authors: Chen Benny , Fullerton Lynne , Smolinske Susan , Seifert Steven , Tuuri Rachel
Published: August 2024

Objectives

In the United States, cannabis is legal for adult recreational use in 24 states and Washington, DC. Unintentional pediatric cannabis exposures have increased in many states following legalization.

We evaluated the relationship between recreational cannabis legalization and the rates of unintentional pediatric exposures in a neighboring state that had not undergone legalization.

Methods

We obtained cannabis exposure cases for children 0–12 years from the New Mexico Poison and Drug Information Center electronic database. Only deidentified patient data from closed-case exposure encounters were abstracted. Data were grouped as precommercial and postcommercial availability in neighboring Colorado, demarcated by January 2014. We coded cannabis products as edible, not edible, or unknown. For bivariable comparisons, we used odds ratios, risk ratio, χ2 test, and Wilcoxon rank sum test. We chose a type 1 error rate of 0.05 to determine significance.

Results

There were 269 exposures over 24 years of calls. Following neighboring legalization, the median number of exposures per year increased from 4 (interquartile range 2, 5) to 24.5 (16.5, 34), the median age increased from 1.9 to 3.0 (P = 0.007), and the relative risk of the exposure involving edible products was double (relative risk = 2.0, 95% confidence interval = 1.6, 2.6). The severity of the exposures' medical effects also increased (P = 0.008).

Conclusions

The number, severity, and type of pediatric cannabis exposures in New Mexico changed after neighboring recreational cannabis legalization. States neighboring those undergoing cannabis legalization should be prepared to respond to increased acute exposures in children.
The effect of vibration-hinged ankle foot orthoses on gait and spasticity in children with cerebral palsy: A randomized clinical trial design
Authors: Jiryaei Zahra , Amini Malek , Sanjari Mohammad Ali , Hajiaghaei Behnam , Babazadeh Roozbeh , Jalali Maryam
Published: August 2024

Background:

Hinged ankle foot orthoses (HAFO) are commonly prescribed for children with cerebral palsy (CP) to improve their ambulatory function.

Objectives:

The aim of this study was to compare the effect of vibration-HAFO with that of the same orthosis without vibration on gait, function, and spasticity in hemiplegic CP children.

Study Design:

Randomized Control Trial Design (a pilot study).

Methods:

Twenty-three children with hemiplegic CP participated in this study. The control group (n = 12) used HAFO, and the intervention group (n = 11) used vibration-HAFO for four weeks. Pre-post three-dimensional gait analysis was done. Calf muscle spasticity and function were also measured.

Results:

Results showed significant differences between the two groups in the one-minute walking test (p = 0.023) and spasticity (after intervention [p = 0.022], after follow-up [p = 0.020]). Also, significant differences were detected between the two groups in the step width (p = 0.042), maximum hip abduction (p = 0.008), stance maximum dorsiflexion (p = 0.036) and mean pelvic tilt (p = 0.004) in the barefoot condition. Gait cycle time (p = 0.005), maximum hip abduction (p = 0.042), and cadence (p = 0.001) were different between groups in the braced condition. We couldn't find any significant within and between groups differences in knee kinematic parameters. The mean time of using vibration was 16.83 minutes per day.

Conclusions:

The vibration-hinged AFO is feasible, safe, and acceptable for children with hemiplegic CP to be integrated into practice. Temporospatial and clinical parameters, especially spasticity, were improved. There were slight trends toward improvement in pelvic and knee kinematics. Vibration-HAFO is of benefit to ambulatory CP children with mild and moderate spasticity. It improved the walking capacity of the children.
Prolonged Time to Surgery in Patients with Residual Disease After Neoadjuvant Chemoradiotherapy for Esophageal Cancer
Authors: Overtoom Hidde C.G. , Eyck Ben M. , van der Wilk Berend J. , Noordman Bo J. , van der Sluis Pieter C. , Wijnhoven Bas P.L. , van Lanschot J. Jan B. , Lagarde Sjoerd M. ,   on behalf of the SANO study group*
Published: August 2024

Objective:

To investigate whether prolonged time to surgery negatively affects survival, pathological outcome or postoperative complications in patients with histologically proven residual disease after neoadjuvant chemoradiotherapy for locally advanced esophageal cancer.

Summary Background Data:

Historically, the standard time to surgery (TTS) has been six to eight weeks after completion of nCRT. The effect of prolonged TTS is gaining interest, with contradicting results on survival and surgical morbidity. It can be hypothesized that, in patients with residual disease six weeks after completion of nCRT, prolonged TTS might be associated with worse survival and higher morbidity.

Methods:

Patients with locally advanced esophageal cancer who had biopsy-proven residual disease six weeks after nCRT and underwent surgery, were categorized according to interval to surgery (TTS>12w vs. TTS≤12w). Primary outcome of this study was overall survival. Secondary outcomes were disease-free survival, surgical outcomes, pathological outcomes, and postoperative complications. Multivariable Cox regression was used for comparing survival and logistic regression for other outcomes, adjusted for the confounders age, cT, cN, Charlson comorbidity index, weight loss during nCRT, and WHO performance score after completion of nCRT.

Results:

Forty patients were included for TTS>12w and 127 for TTS≤12w. TTS>12w was associated with better overall survival (adjusted hazard ratio (aHR) 0.46, 95%CI 0.24-0.90), and disease-free survival (aHR 0.48, 95%CI 0.24-0.94), but also with more postoperative respiratory complications (aOR 3.66, 95%CI 1.52-9.59). Other outcomes were comparable between both groups.

Conclusion:

Prolonged TTS in patients with histologically proven residual disease after completion of nCRT for esophageal cancer did not have a negative effect on overall and disease-free survival, but patients did have a higher risk for postoperative respiratory complications.
Successful Implementation of a Multidisciplinary Weight Loss Program Including GLP1 Receptor Agonists for Liver Transplant Candidates With High Body Mass Index
Authors: Gonzalez Humberto C. , Myers Daniel T. , Venkat Deepak
Published: August 2024

Background.

Body mass index (BMI) >40 is considered a relative contraindication to liver transplant. However, there is little research regarding best practices for weight loss in this population. We hypothesized that providing multidisciplinary support, including the use of glucagon-like protein 1 receptor agonists would facilitate patients’ achievement of weight loss necessary for transplant eligibility.

Methods.

Patients 18 y or older were referred to the Henry Ford Health Liver Metabolic Clinic from August 2019 to September 2023, with either BMI >40 or >35 with abdominal adiposity that would complicate surgery. Patients were provided individualized support from hepatologists, dieticians, and counselors, as well as prescribed antiobesity medication and monitored closely for weight loss progress.

Results.

Among 19 patients referred to the Liver Metabolic Clinic, median baseline BMI was 42 (range, 34.6–48.8) with median goal weight loss of 14.1 kg (range, 4.1–31.4). Sixteen patients (84%) had metabolic dysfunction-associated steatohepatitis and 3 patients had alcohol-associated liver disease. Seven had comorbid hepatocellular carcinoma. Median Model for End-stage Liver Disease score was 14 (range, 7–22). Fifteen patients were treated with a glucagon-like peptide 1 receptor agonist (6 patients received liraglutide, 8 received semaglutide, and 1 received tirzepatide) and 4 received phentermine. Median weight loss was 11.7 kg for all 19 patients (range, 0–33). Eight patients received a transplant and 4 more patients were waitlisted. Time from baseline to waitlisting was ~5.5 mo (median 166 d; range, 68–840). Three patients remained on treatment, whereas 4 were deceased due to progressive liver disease or infection.

Conclusions.

Providing high BMI patients with individualized dietary and medical support can facilitate weight loss necessary to achieve liver transplant eligibility.
Exploring Methylphenidate-Induced Intraocular Pressure: A Cautionary Tale in Pediatric ADHD Management
Authors: Yıldırım Selman , Özel Mahya , Günay Murat , Hoşoğlu Esra , Turan Bahadir
Published: August 2024

Objectives

This case report explores the intricate relationship between methylphenidate (MTX) use and increased intraocular pressure (IOP) in a pediatric patient with a preexisting history of eye disease. Despite existing literature presenting cases of IOP elevation linked to MTX, a significant gap remains in understanding nuanced risk factors.

Methods

This case study used patients' medical records and a comprehensive literature review.

Results

A 6-year-old girl with attention deficit hyperactivity disorder and a family history of eye conditions exhibited elevated IOP after 12 days of MTX use, prompting discontinuation. The patient successfully transitioned to atomoxetine with normalized IOP and improved attention duration.

Conclusions

Existing cases emphasize the potential link between sympathetic nerve activity and IOP elevation induced by central nervous system stimulants like MTX. Notably, the patient's high hyperopia contributed to the impact of MTX on IOP, suggesting the need for cautious use in susceptible individuals. This case underscores the importance of individualized treatment strategies, particularly in attention deficit hyperactivity disorder patients with family history and additional eye findings, emphasizing safety and comprehensive patient care.
Range-wide salamander densities reveal a key component of terrestrial vertebrate biomass in eastern North American forests
Authors: Grant Evan H. Campbell , Fleming Jillian , Bastiaans Elizabeth , Brand Adrianne B. , Brooks Jacey L. , Devlin Catherine , Epp Kristen , Evans Matt , Fisher-Reid M. Caitlin , Gratwicke Brian , Grayson Kristine L. , Haydt Natalie T. , Hernández-Pacheco Raisa , Hocking Daniel J. , Hyde Amanda , Losito Michael , MacKnight Maisie G. , Matlaga Tanya J. H. , Mead Louise , Muñoz David , Peterman William , Puza Veronica , Shafer Charles , Sterrett Sean C. , Sutherland Chris , Thompson Lily M. , Warwick Alexa R. , Wright Alexander D. , Yurewicz Kerry , Miller David A. W.
Published: August 2024

Characterizing the population density of species is a central interest in ecology. Eastern North America is the global hotspot for biodiversity of plethodontid salamanders, an inconspicuous component of terrestrial vertebrate communities, and among the most widespread is the eastern red-backed salamander,
Plethodon cinereus
. Previous work suggests population densities are high with significant geographic variation, but comparisons among locations are challenged by lack of standardization of methods and failure to accommodate imperfect detection. We present results from a large-scale research network that accounts for detection uncertainty using systematic survey protocols and robust statistical models. We analysed mark–recapture data from 18 study areas across much of the species range. Estimated salamander densities ranged from 1950 to 34 300 salamanders ha
−1
, with a median of 9965 salamanders ha
−1
. We compared these results to previous estimates for
P. cinereus
and other abundant terrestrial vertebrates. We demonstrate that overall the biomass of
P. cinereus
, a secondary consumer, is of similar or greater magnitude to widespread primary consumers such as white-tailed deer (
Odocoileus virginianus
) and
Peromyscus
mice, and two to three orders of magnitude greater than common secondary consumer species. Our results add empirical evidence that
P. cinereus
, and amphibians in general, are an outsized component of terrestrial vertebrate communities in temperate ecosystems.
High-throughput functional analysis provides novel insight into type VII secretion in
Staphylococcus aureus
Authors: Yang Yaping , Scott Aaron A. , Kneuper Holger , Alcock Felicity , Palmer Tracy
Published: August 2024

Successful colonization by the opportunistic pathogen
Staphylococcus aureus
depends on its ability to interact with other microorganisms.
Staphylococcus aureus
strains harbour a T7b subtype of type VII secretion system (T7SSb), a protein secretion system found in a wide variety of Bacillota, which functions in bacterial antagonism and virulence. Assessment of T7SSb activity in
S. aureus
has been hampered by low secretion activity under laboratory conditions and the lack of a sensitive assay to measure secretion. Here, we have utilized NanoLuc binary technology to develop a simple assay to monitor protein secretion via detection of bioluminescence. Fusion of the 11 amino acid NanoLuc fragment to the conserved substrate EsxA permits its extracellular detection upon supplementation with the large NanoLuc fragment and luciferase substrate. Following miniaturization of the assay to 384-well format, we use high-throughput analysis to demonstrate that T7SSb-dependent protein secretion differs across strains and growth temperature. We further show that the same assay can be used to monitor secretion of the surface-associated toxin substrate TspA. Using this approach, we identify three conserved accessory proteins required to mediate TspA secretion. Co-purification experiments confirm that all three proteins form a complex with TspA.
Weakly nonlinear shape oscillations of viscoelastic drops
Authors: Zrnić Dino , Brenn Günter
Published: August 2024

Axisymmetric shape oscillations of a viscoelastic drop in a vacuum are studied by a weakly nonlinear analysis. The two-lobed initial drop deformation mode is studied. The Oldroyd-B model is used for characterizing the drop liquid rheological behaviour. The equations of motion and the solutions up to second order are developed, where elastic effects appear. Solutions of the characteristic equation are validated against the decay rate and frequency of damped shape oscillations of polymer solution drops in an acoustic levitator. The theory shows enhancing or dampening of the nonlinear behaviour and enhanced mode coupling, as compared with the Newtonian case. The study reveals an excess time in the prolate shape and a frequency change, together with a quasi-periodicity of the oscillations. The Fourier power spectra of traces of the drop north pole position in time show mode coupling as a nonlinear effect. At moderate stress-relaxation Deborah number, the resultant drop motion for large Ohnesorge number, suggesting aperiodic drop behaviour, may nonetheless be oscillatory, where the drop elasticity is owing to the liquid bulk elasticity instead of surface tension. A method is developed to predict the oscillatory or aperiodic behaviour of a drop of a given size from a rheologically characterized viscoelastic Oldroyd-B liquid.
Polynomial and rational convergence rates for Laplace problems on planar domains
Authors: Trefethen Lloyd N.
Published: August 2024

Laplace problems on planar domains can be solved by means of least-squares expansions associated with polynomial or rational approximations. Here it is shown that, even in the context of an analytic domain with analytic boundary data, the difference in convergence rates may be huge when the domain is non-convex. Our proofs combine the theory of the Schwarz function for analytic continuation, potential theory for polynomial and rational approximation rates and the theory of crowding of conformal maps.
Sequence-based detection of emerging antigenically novel influenza A viruses
Authors: Forna Alpha , Weedop K. Bodie , Damodaran Lambodhar , Hassell Norman , Kondor Rebecca , Bahl Justin , Drake John M. , Rohani Pejman
Published: August 2024

The detection of evolutionary transitions in influenza A (H3N2) viruses’ antigenicity is a major obstacle to effective vaccine design and development. In this study, we describe Novel Influenza Virus A Detector (NIAViD), an unsupervised machine learning tool, adept at identifying these transitions, using the HA1 sequence and associated physico-chemical properties. NIAViD performed with 88.9% (95% CI, 56.5–98.0%) and 72.7% (95% CI, 43.4–90.3%) sensitivity in training and validation, respectively, outperforming the uncalibrated null model—33.3% (95% CI, 12.1–64.6%) and does not require potentially biased, time-consuming and costly laboratory assays. The pivotal role of the Boman’s index, indicative of the virus’s cell surface binding potential, is underscored, enhancing the precision of detecting antigenic transitions. NIAViD’s efficacy is not only in identifying influenza isolates that belong to novel antigenic clusters, but also in pinpointing potential sites driving significant antigenic changes, without the reliance on explicit modelling of haemagglutinin inhibition titres. We believe this approach holds promise to augment existing surveillance networks, offering timely insights for the development of updated, effective influenza vaccines. Consequently, NIAViD, in conjunction with other resources, could be used to support surveillance efforts and inform the development of updated influenza vaccines.