bluuebunny/crossref_metadata_2025 huggingface dataset:
SOMATISATION DISORDER IN A BRITISH TEACHING HOSPITAL
Authors: Bass C , Murphy M
Published: April 2023

SUMMARY We describe 33 patients (31 women, 2 men; mean age 47 years) who satisfied research criteria for somatization disorder (SD), a disorder characterised by persistent or recurrent unexplained somatic symptoms beginning before the age of 30. The mean duration of symptoms was 30 years (range 12–57). Twenty patients had co‐existing physical disease: seven (21%) had histories of chronic physical disease in childhood, whereas in 13 (39%) the physical disorders began in adult life, after many years of somatic complaints, and were largely coincidental. All had been repeatedly investigated for their symptoms. Twenty‐one patients (64%) were receiving medication for spurious physical disorders, most commonly ‘angina’ and ‘asthma‘. Hysterectomies had been performed in 16 (52%) of the 31 women at a mean age of 37 years, but pathology was detected in only two. Twenty‐nine patients (88%) had received previous treatment for psychiatric illness, and 20 (61%) were receiving invalidity benefits.

British psychiatrists do not usually diagnose SD, but focus selectively on symptoms that suggest more familiar psychiatric syndromes. Similarly, medical specialists often diagnose 'functional syndromes' affecting the system that interests them. Over time these patients acquire spurious organic diagnoses and develop physical disorders that make the assessment of new symptoms more difficult. Disability is invariably in excess of what might be predicted from physical findings. We conclude that a diagnosis of SD draws attention to a group of patients who are chronically ill and unresponsive to conventional medical and psychiatric treatment. They use a lot of resources to little avail and thus merit more research.
A DOUBLE‐BUND, RANDOMISED COMPARISON OF FLUVOXAMINE WITH DOTHIEPIN IN THE TREATMENT OF DEPRESSION IN ELDERLY PATIENTS
Authors: Rahman M K , Akhtar M J , Savla N C , Sharma R R , Kellett J M , Ashford J J
Published: April 2023

SUMMARY The efficacy and tolerability of the selective 5‐HT reuptake inhibitor fluvoxamine were compared with the tricyclic dothiepin in 52 elderly (age > 64 years) hospital patients in a multi‐centre double‐blind randomised trial. Patients met DSM‐III criteria for ‘major depressive episode’ and scored > 29 on the Montgomery Asberg Depression Rating Scale (MADRS) after a one‐week placebo baseline. Active treatment was for six weeks. The dosage of both drugs was 50 mg nocte for three days, 100 mg nocte for the remainder of the first week, thereafter increasing to a maximum of 200 mg/day according to response/tolerance.

MADRS scores improved by 63.5% with fluvoxamine and 60.0% with dothiepin; there were no significant differences between treatments at any assessment.

Nausea, dizziness, headache, somnolence and constipation in both groups, plus dry mouth and asthenia in the dothiepin group were more frequent than single reports. Two patients in each group discontinued treatment owing to unwanted effects. There were no clinically significant changes in haematological, biochemical or cardiovascular parameters.
THE EFFECTS OF PSYCHOMOTOR PERFORMANCE OF FLUVOXAMINE VERSUS MIANSERIN IN DEPRESSED PATIENTS IN GENERAL PRACTICE
Authors: Moon C A L , Jesinger D K
Published: April 2023

SUMMARY This study examined the psychomotor and antidepressant effects of fluvoxamine in a depressed, GP patient population, compared to those of mianserin. It was a single centre, double‐blind, six‐week study, preceded by a one‐week pre‐treatment placebo washout, in 59 patients suffering from major depressive episode (DSM III) and scoring over 24 on MADRS. The starting dose was 100 mg fluvoxamine or 60 mg mianserin daily for one week, rising to 300 mg fluvoxamine or 180 mg mianserin.

Both treatment groups showed significant improvement overtime with no differences between drugs in terms of efficacy. Fluvoxamine and mianserin were both shown to be effective in the treatment of depressive illness. Some psychomotor impairment in the first few days and weight gain over a longer period could affect compliance with mianserin. Fluvoxamine does not reduce psychomotor performance or cause weight gain.
DELAYED SCIATIC NERVE PALSY FOLLOWING TOTAL HIP ARTHROPLASTY
Authors: Cohen B , Bhamra M , Ferris B D
Published: April 2023

SUMMARY Peripheral neuropathy, following total hip arthroplasty, has a reported incidence of 0.7%.1 However, delayed sciatic nerve palsy has only been reported twice in the literature.2,3 We report on two further cases, both of whom developed clinical sciatic nerve palsy at 72 hours after surgery.
IMPROVED TOLERABILITY OF FELODIPINE COMPARED WITH AMLODIPINE IN ELDERLY HYPERTENSIVES: A RANDOMISED, DOUBLE‐BLIND STUDY IN 535 PATIENTS, FOCUSING ON VASODILATORY ADVERSE EVENTS
Authors: Schaefer RM , Aldons PM , Burgess ED , Tilvis R , Girerd X , Singh GP , Rehn L , Morgan TO ,   International Study Group
Published: April 2023

SUMMARY The primary aim of this double‐blind, parallel group trial was to compare incidence of newly occurring vasodilatory adverse events in elderly patients treated with recommended once‐daily doses of felodipine extended release (ER) or amlodipine. A total of 535 patients over 65 years old with a sitting diastolic blood pressure of 90‐115 mmHg and/or systolic blood pressure 160‐220 mmHg, were recruited at 46 centres worldwide. Patients were randomised to felodipine ER 2.5 mg or amlodipine 5 mg. If blood pressure was >160/90 mmHg after three or six weeks, felodipine ER was increased to 5 and 10 mg and amlodipine to 10 mg. After nine weeks, average doses of felodipine ER and amlodipine were 5.5 mg and 7.3 mg, respectively. Newly occurring vasodilatory adverse events were reported by 32% of felodipine ER patients and 43% of amlodipine patients (p=0.007). Both treatments effectively reduced blood pressure 24 hours post‐dose. Using a low starting dose and individual titration, felodipine ER achieves good control of blood pressure with few vasodilatory side‐effects.
BILATERAL BREAST METASTASES FROM A RENAL CARCINOMA
Authors: Heggarty P , McCusker G , Clements WDB
Published: April 2023

SUMMARY Metastatic involvement of the breast is rare. The commonest cause is spread from a contralateral breast carcinoma. However, metastatic malignant melanoma, lymphoma and lung carcinoma have all been reported sporadically in the literature. Renal carcinoma is well recognised for its protean clinical manifestations ranging from loin pain, haematuria and an abdominal mass to less obvious metastatic effects such as pathological fracture of a long bone or one of a variety of associated paraneoplastic syndromes. We present a case of a renal carcinoma presenting with bilateral breast masses with literature review, and discuss the efficacy of the standard gamut of investigations in a breast mass of non‐primary origin.
PRIMARY CEREBRAL MALIGNANT MELANOMA: AN UNUSUAL CAUSE OF DYSPRAXIA
Authors: Farnsworth TA
Published: April 2023

SUMMARY Primary intracranial melanomas are rare and occur mainly in young adults. Originating from leptomeningeal melanoblasts and extending into the parenchyma, the tumours closely resemble meningiomas, from which they are radiologically difficult to distinguish despite progress in neuroimaging. Definitive diagnosis is usually made on histopathological examination, though confirmed only after post‐mortem examination in some cases. Prolonged disease‐free periods, and in rare cases long‐term survival, are possible following successful total surgical excision. This case presented with typical clinical features but, at 79 years old, an unusual age.
SKIN AND SOFT TISSUE INFECTIONS: DEVELOPMENT OF A COLLABORATIVE MANAGEMENT PLAN BETWEEN COMMUNITY AND HOSPITAL CARE
Authors: Nathwani D , Moitra S , Dunbar J , Crosby G , Peterkin G , Davey P
Published: April 2023

SUMMARY The commonest indication in the US for referral to an outpatient/home i.v. antibiotic therapy programme is the management of skin and soft tissue infections. In the UK, however, these infections account for 10% or more of admissions to infection units. The main indication for hospitalisation is to receive parenteral antibiotics. A retrospective audit of one year of admissions to a regional infection unit revealed that, although most of these patients do not progress to complications (‘low risk‘), they occupy a mean time of five days in hospital and for nearly half of that time they receive parenteral antibiotics. This period in hospital reflected 11.4% of the unit's bed occupancy. Even if 75% of these patients were treated in the community with parenteral therapy, this would result in bed savings of 8.55%, nearly one‐tenth of the unit's occupied capacity. This type of audit should help key decision makers thinking of developing similar services in their region. Outpatient or home parenteral antimicrobial therapy (OHPAT) should be delivered as part of a complete disease management programme in collaboration with primary care.
RENAL FUNCTION IN JAUNDICED PATIENTS: A PROSPECTIVE ANALYSIS
Authors: Parks RW , Rowlands BJ , Diamond T
Published: April 2023

SUMMARY A prospective analysis was undertaken to assess renal function in patients with obstructive jaundice. A total of 59 jaundiced patients (serum bilirubin >100 μmol/l) undergoing biliary decompression by surgical, endoscopic or radiological means received prophylactic fluid volume expansion (3 litres crystalloid fluid intravenously) during the 24 hours before intervention. Renal function (urea and electrolytes, creatinine, creatinine clearance, urinary output) was assessed preoperatively and on days 1‐7 and on day 28 postoperatively. Two jaundiced patients (3.4%) developed renal failure (urinary output <400 ml in 24 hours in the presence of an increased serum urea and/or creatinine) and subsequently died. The overall incidence of post‐procedural renal impairment (urinary output <800 ml in 24 hours) was 10.2%. It is concluded that, with vigilant control of fluid and electrolyte balance and pre‐procedural intravenous volume expansion, the incidence of renal dysfunction in patients with obstructive jaundice is not as high as previously reported.
MANAGEMENT OF HYPERTENSION AND ITS SEQUELAE WITH ACE INHIBITORS: BIOCHEMICAL, PHARMACOLOGICAL AND CLINICAL ASPECTS
Authors: Rangoonwala B , Rosenthal J
Published: April 2023

SUMMARYACE inhibitors are a widely prescribed class of drug for the management of hypertension. Their therapeutic role in the treatment of heart failure, diabetic nephropathy and post myocardial infarction with left ventricular dysfunction is steadily increasing. Although ACE inhibitors have a similar mechanism of action ‐ namely, inhibition of circulatory ACE, thereby decreasing the formation of angiotensin II ‐ individual members differ in their physicochemical properties, enzyme‐binding kinetics, pharmacokinetic profile, organ‐specific affinity and selectivity, as well as in their bradykinin potentiating effect. These factors play an important part in influencing the pharmacological profile of an agent and its clinical efficacy, especially in the treatment of hypertension. It is therefore prudent to take into account the existing pharmacological and clinically relevant differences between the individual members of this drug class before making the decision to select a particular ACE inhibitor for the long‐term management of arterial hypertension.
Upper limits of water contents in olivine and orthopyroxene of equilibrated chondrites and several achondrites
Authors: Harries Dennis , Zhao Xuchao , Franchi Ian
Published: April 2023

Hydroxyl defects in nominally anhydrous minerals (NAMs) were potential carriers of water in the early Solar System and might have contributed to the accretion of terrestrial water. To better understand this, we have conducted a nanoscale secondary ion mass spectrometry survey of water contents in olivine and orthopyroxene from a set of equilibrated ordinary chondrites of the L and LL groups (Baszkówka, Bensour, Kheneg Ljouâd, and Tuxtuac) and several ultramafic achondrites (Zakłodzie, Dhofar 125, Northwest Africa [NWA] 4969, NWA 6693, and NWA 7317). For calibration, we used terrestrial olivine and orthopyroxene with H2O contents determined by Fourier transform infrared. Our 99.7% (~3SD) detection limits are 3.6–5.4 ppmw H2O for olivine and 7.7–10.9 ppmw H2O for orthopyroxene. None of the meteoritic samples studied consistently shows water contents above the detection limits. A few exceptions slightly above the detection limits are suspected of terrestrial contamination by ferric oxyhydroxides. If the meteorite samples investigated accreted in the presence of small amounts of water ice, the upper limits of water contents provided by our survey suggest that the retention of hydrogen during thermal metamorphism and differentiation was ineffective. We suggest that loss occurred through combinations of low internal pressures, high permeability along grain boundaries, and speciation of hydrogen into reduced compounds such as H2 and methane, which are less soluble in NAMs than in water.
Empathy of dental students and educators in French hospitals: A cross‐sectional study
Authors: Haddad Yara‐Gaëlle , Sturzu Livia , Bisch Michaël , Yasukawa Kazutoyo , Baudet Alexandre
Published: April 2023

Empathy is a key factor in the dentist–patient relationship. The aim of this study was to determine empathy in dental students and educators in French hospital dental services. A cross‐sectional study was conducted among dental students and educators who practiced in 10 hospital dental services affiliated with the Faculty of Dentistry of the University of Lorraine in France. A questionnaire was self‐administered online using the Jefferson Scale of Physician Empathy (JSPE). The study included 209 participants comprising 50 students in fourth year, 66 students in fifth year, 48 students in sixth year, and 45 educators. Participants were 63.6% females, aged 27 ± 8 years. The mean empathy score was 109.40 ± 11.65. The sub‐scores of the three dimensions were 57.02 ± 6.64 for Perspective Taking, 42.56 ± 6.22 for Compassionate Care, and 9.78 ± 2.61 for Walking in the Patient's Shoes. Females showed significant higher empathy scores than males (111.36 vs. 105.84). The empathy score was correlated with age and insignificantly decreased during clinical training (from 110.06 in fourth year to 106.63 in sixth year). French dental students and educators showed high levels of empathy.
The epidemiology and psychological comorbidity of disorders of gut–brain interaction in Australia: Results from the Rome Foundation Global Epidemiology Study
Authors: Knowles Simon R. , Apputhurai Pragalathan , Palsson Olafur S. , Bangdiwala Shrikant , Sperber Ami D. , Mikocka‐Walus Antonina
Published: April 2023

Background

The Rome Foundation Global Epidemiology Study on the disorders of gut–brain interaction (DGBI) was used to assess the national prevalence of all 22 DGBI, the percentage of respondents meeting diagnostic criteria for at least one DGBI, and the rates of comorbid anxiety, depression, and somatization in Australia and 25 other countries.

Methods

The survey was conducted in Australia and 25 other countries through the Internet and included the Rome IV Diagnostic Questionnaire and an in‐depth supplemental questionnaire.

Key Results

Two thousand thirty‐six Australian adults completed the survey nationwide: mean age 47.34 ± 17.00 years, 50.15% males. Overall, 38.67% of Australians met criteria for at least one DGBI, with unspecified functional bowel disorder (8.01%) and then functional constipation (7.71%) being the most prevalent. For those Australians with at least one DGBI, rates of anxiety, depression, and somatization where high (26.58%, 28.96%, and 63.10%, respectively), with functional chest pain having the highest rates of anxiety (55.00%) and depression (57.50%), and irritable bowel syndrome (mixed) having the highest somatization rate (75.86%). The odds of having a DGBI increased with greater anxiety (OR: 1.09, CI 95%: 0.97, 1.23), depression (OR: 1.17, CI 95%: 1.04, 1.32), and somatization (OR: 1.17, CI 95%: 1.14, 1.20) symptom severity.

Conclusions and Inferences

The current study represents the most comprehensive epidemiological exploration of DGBI and mental health in Australia to date, including their prevalence and distributions across sex and age, associations between DGBI and anxiety, depression, and somatization. The findings warrants future comparisons between population characteristics and health care systems differences in order to reduce the burden of DGBI and mental illness worldwide.
Defecatory disorders in patients with type 1 diabetes and chronic constipation
Authors: Xiao Alexander H. , Kathavarayan Ramu Shivabalan , Gautam Misha , Bharucha Adil E.
Published: April 2023

Background and objectives

Chronic constipation (CC) may be caused by defecatory disorders (DDs) and associated with reduced rectal sensation. Among patients with type 1 diabetes (T1D) and CC (T1DCC patients), the prevalence of DDs and reduced rectal sensation is unknown. We sought to compare complications of T1D, anorectal dysfunction, and CC symptoms, among T1DCC patients with versus without a DD.

Methods

Anorectal pressures at rest and during squeeze and evacuation, as well as rectal sensation and rectal balloon expulsion time (BET) were measured with high‐resolution anorectal manometry in 114 consecutive T1DCC patients.

Results

Thirty‐seven patients (32%) had prolonged BET, suggestive of a DD. Complications of T1D included peripheral neuropathy (n = 67, 59%), retinopathy (n = 42, 37%), and nephropathy (n = 26, 23%). Among these complications, only retinopathy was associated with, that is, more prevalent in patients with normal (45%) than prolonged BET (19%). Compared with patients with normal BET, patients with prolonged BET had a lower rectal pressure (mean [SD], 32 [23] mm Hg vs. 23 [19] mm Hg,p = 0.03), greater anal pressure (91 [23] mm Hg vs. 68 [36] mm Hg,p < 0.001), and lower rectoanal gradient (−67 [30] mm Hg vs. −36 [32] mm Hg,p < 0.0001) during evacuation. Anal resting pressure and anal squeeze increment were below normal in 14 (13%) and 32 (29%) of patients and one or more rectal sensory thresholds were above normal in 34 (30%) patients; these abnormalities affected similar proportions in the normal and prolonged BET cohorts.

Conclusions

Among T1DCC patients, 37 (32%) had prolonged BET, which was associated with anorectal pressures indicative of a DD but was not associated with reduced rectal sensation, suggesting that DDs are more likely explained by abdomino‐anal dyscoordination than visceral disturbance.
A Mendelian randomization study on the association of bone mineral density with periodontitis
Authors: Yu Yang , Chu Tengda , Dong Jingya , Deng Hui , Pan Yihuai , Wang Yi
Published: April 2023

Objective

Observational studies indicated that individuals with osteoporosis could be at an increased risk of periodontitis. This study aimed to investigate whether there is a causal association of bone mineral density (BMD) with periodontitis using Mendelian randomization (MR).

Materials and Methods

Summary statistics were sourced from genome‐wide association study on BMD measured at different skeletal sites, including estimated heel BMD (eBMD, N = 426,824), forearm BMD (FA‐BMD, N = 8143), femoral neck BMD (FN‐BMD, N = 32,735), and lumbar spine BMD (LS‐BMD, N = 28,498). Genetic variants of periodontitis (N = 45,563) and loose teeth (N = 461,031) were used as outcome surrogates. Inverse variance weighted meta‐analysis (IVW) was adopted as main analyses. Other sensitivity MR approaches were used to boost power and account for pleiotropy.

Results

IVW results suggested no evidence for a causal association of any phenotypes of BMD with periodontitis (eBMD, odds ratio [OR] = 0.984, 95% confidence interval [CI] = 0.885–1.083; FA‐BMD, OR = 1.028, 95%CI = 0.864–1.193; FN‐BMD, OR = 1.033, 95%CI = 0.896–1.169; LS‐BMD, OR = 0.991, 95%CI =0.878–1.103; all P > 0.65). Such null associations were consistent through other sensitivity MR approaches. Similarly, no significant causal effects of BMD on loose teeth were found.

Conclusions

Within the limitation of the study, our MR estimates suggested that a decreased BMD is unlikely to substantially increase the risk of periodontitis.
Elbow Kinematics and Function Following Treatment with Open Arthrolysis and Hinged External Fixator
Authors: Ling Ming , Liang Zhenming , Wang Yanmao , Cheng Mengqi , Lu Shengdi , Pan Yao , Hu Hai , Chen Bin , Ding Jian
Published: April 2023

Objective

Open arthrolysis (OA) combined with hinged external fixator (HEF) is a promising surgical option for patients with elbow stiffness. This study aimed to investigate elbow kinematics and function following a combined treatment with OA and HEF in elbow stiffness cases.

Methods

Patients treated with OA with or without HEF due to elbow stiffness were recruited between August 2017 and July 2019. Elbow flexion‐extension motion and function (Mayo elbow performance scores, MEPS) were recorded and compared between patients with and without HEF during a 1‐year follow‐up period. Additionally, those with HEF were assessed by dual fluoroscopy at week 6 postoperatively. Flexion‐extension and varus‐valgus motions, as well as ligament insertion distances of the anterior medial collateral ligament (AMCL) and lateral ulnar collateral ligament (LUCL), were compared between the surgical and intact sides.

Results

This study included 42 patients, of which 12 with HEF demonstrated a similar flexion‐extension angle and range of motion (ROM) and MEPS as the other patients. In patients with HEF, the surgical elbows showed limitations in flexion‐extension (maximal flexion, 120.5° ± 5.3° vs 140.4° ± 6.8°; maximal extension, 13.1° ± 6.0° vs 6.4° ± 3.0°; ROM, 107.4° ± 9.9° vs 134.0° ± 6.8°; all Ps < 0.01) compared with the contralateral sides. During elbow flexion, a gradual valgus‐to‐varus transition of the ulna, increase in the AMCL insertion distance, and steady change in the LUCL insertion distance were observed, with no significant differences between the bilateral sides.

Conclusions

Patients treated with OA and HEF demonstrated similar elbow flexion‐extension motion and function to those treated with OA alone. Although the use of HEF could not restore an intact flexion‐extension ROM and might result in some minor but not significant changes in kinematics, it contributed to clinical outcomes comparable to that of the treatment with OA alone.
Is There a “Black Friday” for Geriatric Hip Fracture Surgery?
Authors: Tian Chuwei , Zhu Huanyi , Shi Liu , Chen Xiangxu , Xie Tian , Rui Yunfeng
Published: April 2023

Objectives

Reports show an increase in the short‐term mortality rates of hip fracture patients admitted on weekends. However, there are few studies on whether there is a similar effect in Friday admissions of geriatric hip fracture patients. The aim of this study was to evaluate the effects of Friday admission on mortality and clinical outcomes in elderly patients with hip fractures.

Methods

A retrospective cohort study was performed at a single orthopaedic trauma centre and included all patients who underwent hip fracture surgery between January 2018 and December 2021. Patient characteristics, including age, sex, BMI, fracture type, time of admission, ASA grade, comorbidities, and laboratory examinations, were collected. Data pertaining to surgery and hospitalization were extracted from the electronic medical record system and tabulated. The corresponding follow‐up was performed. The Shapiro–Wilk test was applied to evaluate the distributions of all continuous variables for normality. The overall data were analyzed by Student's t test or the Mann–Whitney U test for continuous variables and the chi‐square test for categorical variables, as appropriate. Univariate and multivariate analyses were used to further test for the independent influencing factors of prolonged time to surgery.

Results

A total of 596 patients were included, and 83 patients (13.9%) were admitted on Friday. There was no evidence supporting that Friday admission had an effect on mortality and outcomes, including length of stay, total hospital costs and postoperative complications. However, the patients admitted on Friday had delayed surgery. Then, patients were regrouped into two groups according to whether surgery was delayed, and 317 patients (53.2%) underwent delayed surgery. The multivariate analysis showed that younger age (p = 0.014), Friday admission (p < 0.001), ASA classification III‐IV (p = 0.019), femoral neck fracture (p = 0.002), time from injury to admission more than 24 h (p = 0.025), and diabetes (p = 0.023) were risk factors for delayed surgery.

Conclusions

Mortality and adverse outcome rates for elderly hip fracture patients admitted on Friday were similar to those admitted at other time periods. However, Friday admission was identified as one of the risk factors for delayed surgery.
The VR leadless pacemaker: Results of an expert panel using the RAND/UCLA method
Authors: Molina‐Linde Juan Máximo , Díaz‐Infante Ernesto , Tercedor‐Sánchez Luis , Baños‐Álvarez Elena , Piedad‐Rosario María , Blasco‐Amaro Juan Antonio
Published: April 2023

Background

Leadless pacemakers were developed to reduce complications associated with transvenous pacemaker implantation and long‐term follow‐up. Existing international guidelines lack detailed instructions on patients suitable for leadless pacemaker implantation. Our aim was to develop a consensus document that provides medical guidance for all health professionals involved in the indication and implantation of Transcatheter Pacing System single‐chamber device (VR leadless) pacemakers for patients with atrial fibrillation or in sinus rhythm.

Methods

A panel of experts, including interventional and non‐interventional cardiologists, used the Research ANd Development/University of California at Los Angeles (RAND/UCLA) method to rate the appropriateness of leadless pacemaker implantation for 64 scenarios in patients with atrial fibrillation and 192 scenarios in sinus rhythm. The scenarios were rated individually and again during a moderated group session. Median ratings and level of agreement were calculated to classify each scenario as appropriate, inappropriate, or questionable.

Results

This consensus statement, based on available literature and the experts’ opinions, summarizes recommendations for standardizing and optimizing leadless pacemaker implantation. The limitation for vascular access via the superior vena cava was the most influential variable when indicating leadless pacemaker implantation in both patients with atrial fibrillation and patients in sinus rhythm.

Conclusions

Life expectancy, risk of infection, prosthetic valve, left ventricular ejection fraction (LVEF), limitation for vascular access via the superior vena cava, and mobility and exercise capacity determine who is advised to undergo VR leadless pacemaker implantation. More prospective studies are needed to optimize existing recommendations.
Successful low‐dose immunotherapy after kidney transplantation in a 10‐year‐old girl with Schimke immuno‐osseous dysplasia
Authors: Finsen Stine Høyer , Tepel Martin , Neland Mette , Rittig Søren , Thiesson Helle Charlotte
Published: April 2023

Background

This case report highlights a successful steroid‐free, low‐dose immunosuppressive protocol for renal transplantation in a pediatric patient with Schimke immuno‐osseous dysplasia with excellent 7‐year patient and graft survival. Schimke immuno‐osseous dysplasia is a rare multisystem disorder involving the kidney. Renal transplantation is a therapeutic option, but posttransplant mortality is high due to severe infections and posttransplant lymphoproliferative disease.

Methods

A 10‐year‐old girl diagnosed with Schimke immuno‐osseous dysplasia and end‐stage renal disease underwent an AB0‐compatible living‐related kidney transplantation, with no donor‐specific antibodies. Our standard immunosuppression protocol was modified due to the risk of infection. Basiliximab was used as induction therapy, and a reduced dose of mycophenolate mofetil and tacrolimus was initiated following transplantation, maintaining the patient on a low tacrolimus target (3–5 μg/L). Mycophenolate mofetil was discontinued after 8 weeks due to neutropenia and the patient was kept on tacrolimus as monotherapy. Five years posttransplant the patient developed acute onset of neurological symptoms, consisting of ataxia, lack of voluntary coordination, balance, aphasia and dysphagia, and diplopia. She recovered without neurological deficits within 6 weeks. Extensive evaluation revealed no pathology. To avoid a possible a component of tacrolimus‐induced cerebral vasoconstriction, the immunosuppressive therapy was changed to everolimus.

Results

Seven years posttransplant, the patient has experienced no serious infections, no rejections, and had excellent graft function, and no de novo donor‐specific antibodies.

Conclusions

The present results indicate that low‐dose immunosuppressive therapy after renal transplantation with low immunological risk should be considered for patients with Schimke immuno‐osseous dysplasia.
Interpersonal stress and nonsuicidal self‐injury disorder in veterans: An ecological momentary assessment study
Authors: Halverson Tate F. , Dillon Kirsten H. , Weber Danielle M. , Dennis Paul A. , Beckham Jean C. , Calhoun Patrick S. , Kimbrel Nathan A.
Published: April 2023

Intro

Nonsuicidal self‐injury (NSSI) is associated with marked functional impairment and is a robust predictor of suicide attempts. Prevalence rates of NSSI, and self‐directed violence more broadly, are elevated among military veterans. Despite the inclusion of interpersonal difficulty in the diagnostic criteria for NSSI disorder, the relationship between interpersonal risk factors and NSSI is not well‐characterized, especially among veterans. This ecological momentary assessment (EMA) study investigated the hypothesis that interpersonal stressors and associated distress would precede and predict NSSI urge and engagement—but not vice versa—via cross‐lagged multilevel modeling.

Method

Forty veterans with NSSI disorder completed a 28‐day EMA protocol with three daily prompts assessing NSSI urges, NSSI engagement, the occurrence of interpersonal stressors, and associated subjective interpersonal distress.

Results

Interpersonal stressors preceded and predicted subsequent NSSI urges, but not NSSI engagement, whereas subjective interpersonal distress preceded and predicted both NSSI urges and NSSI engagement.

Conclusion

Results identified interpersonal stressors as a risk factor for NSSI urges, and interpersonal distress as a risk factor for both NSSI urges and NSSI engagement. Findings highlight the importance of temporally assessing interpersonal factors related to NSSI and suggest that interpersonal distress may be a modifiable risk factor for NSSI.
Predictors of intentions of adults over 35 years to participate in walking sport programs: A social‐ecological mixed‐methods approach
Authors: Sivaramakrishnan Hamsini , Quested Eleanor , Cheval Boris , Thøgersen‐Ntoumani Cecilie , Gucciardi Daniel F. , Ntoumanis Nikos
Published: April 2023

There is a growing need to identify acceptable and feasible opportunities to engage adults over 35 years in physical activity. Walking sports may be a potential means to engage adults in sport; however, there is limited evidence regarding appeal and feasibility to support its implementation and delivery. Using a two‐step mixed‐methods approach, we aimed (1) to quantitively identify significant predictors of intentions of adults over 35 years to participate in walking sports and (2) to understand why and how these identified predictors may be contextually relevant to the target group. In phase one, 282 adults over 35 years (Mage = 46.08, SD = 9.75) without prior experience of walking sports completed an online questionnaire assessing personal, psychosocial, program‐related, and environmental predictors, and intentions to participate in walking sports. Hierarchical multiple linear regressions showed that perceived health status, attitudes, subjective norms, and distance of venue were significant predictors of intentions. In phase two, interviews with a subset of 17 participants indicated that, when implementing walking sport programs, program labeling, fear of the unknown, and individual differences in the appeal of walking sport warrant consideration. Together, these findings offer insight into the complex interplay of personal, psychosocial, program‐related, and environmental predictors of adults' intentions to participate in walking sports. Addressing these elements of a walking sport program would make such programs more appealing to potential participants, and ultimately, more feasible and sustainable to conduct in the long run.
Controlling electron beam induced deposition of iron from Fe(CO)5: Inhibition of autocatalytic growth by NH3 and reactivation by electron irradiation
Authors: Martinović Petra , Barnewitz Lars , Rohdenburg Markus , Swiderek Petra
Published: April 2023

Focused electron beam induced deposition (FEBID) is a versatile direct-write approach to produce nanostructures from organometallic precursor molecules. Ideally, the material is deposited only when precursors interact with and are dissociated by the impinging electrons so that the process is spatially defined by the electron beam. In reality, however, thermal surface reactions as known from chemical vapor deposition can also contribute to the dissociation of the precursors. They often produce material with higher purity but can also impair the spatial selectivity of the electron-induced deposit growth. This work aims at an approach to suppress such thermal chemistry and to re-enable it within an area defined by the electron beam. We have, thus, used a surface science approach to study the inhibition of autocatalytic growth (AG) of Fe from Fe(CO)5 by NH3 and the reactivation of AG on the surface by electron irradiation. The experiments were performed under ultrahigh vacuum conditions using thermal desorption spectrometry to characterize adsorption and reactivity of Fe(CO)5 on Fe seed layers that were prepared by dosing Fe(CO)5 during electron irradiation of the entire sample surface (referred to as EBID herein). Auger electron spectroscopy was used to monitor deposit growth and to reveal the potential inhibition of AG by NH3 as well as the reactivation of the surface by electron irradiation. The results show that adsorption of NH3 slows down AG on deposits prepared by EBID but not on Fe layers produced by AG. Electron irradiation after adsorption of NH3 reactivates the surface and thus re-establishes AG. We propose that co-injection of NH3 during FEBID from Fe(CO)5 could be a viable strategy to suppress unwanted AG contributions and, therefore, enhance the spatial control of the deposition process.
The origins and functional effects of postzygotic mutations throughout the human life span
Authors: Rockweiler Nicole B. , Ramu Avinash , Nagirnaja Liina , Wong Wing H. , Noordam Michiel J. , Drubin Casey W. , Huang Ni , Miller Brian , Todres Ellen Z. , Vigh-Conrad Katinka A. , Zito Antonino , Small Kerrin S. , Ardlie Kristin G. , Cohen Barak A. , Conrad Donald F.
Published: April 2023

Postzygotic mutations (PZMs) begin to accrue in the human genome immediately after fertilization, but how and when PZMs affect development and lifetime health remain unclear. To study the origins and functional consequences of PZMs, we generated a multitissue atlas of PZMs spanning 54 tissue and cell types from 948 donors. Nearly half the variation in mutation burden among tissue samples can be explained by measured technical and biological effects, and 9% can be attributed to donor-specific effects. Through phylogenetic reconstruction of PZMs, we found that their type and predicted functional impact vary during prenatal development, across tissues, and through the germ cell life cycle. Thus, methods for interpreting effects across the body and the life span are needed to fully understand the consequences of genetic variants.
Understanding the genetics of human infertility
Authors: Sang Qing , Ray Pierre F. , Wang Lei
Published: April 2023

Reproduction involves a wide range of biological processes, including organ formation and development, neuroendocrine regulation, hormone production, and meiosis and mitosis. Infertility, the failure of reproduction, has become a major issue for human reproductive health and affects up to one in seven couples worldwide. Here, we review various aspects of human infertility, including etiology, mechanisms, and treatments, with a particular emphasis on genetics. We focus on gamete production and gamete quality, which is the core of successful reproduction. We also discuss future research opportunities and challenges to further expand our understanding of human infertility and improve patient care by providing precision diagnosis and personalized treatments.
CDBN-YGXZ, a Novel Small-Molecule Drug, Shows Efficacy against Clostridioides difficile Infection and Recurrence in Mouse and Hamster Infection Models
Authors: Hu Xiaojun , Dong Renhan , Huang Sheng , Zeng Yisheng , Zhan Wei , Gao Xiaofang , Tian Dong , Peng Jian , Xu Jiewei , Wang Ting , Zhang Yaying , Wang Xiaohui , Zhang Xiaoxia , Liu Jin , Guang Bing , Yang Tai
Published: April 2023

Clostridioides difficile
infection (CDI) causes severe diarrhea and colitis, leading to significant morbidity, mortality, and high medical costs worldwide. Oral vancomycin, a first-line treatment for CDI, is associated with a high risk of recurrence, necessitating novel therapies for primary and recurrent CDI.
TCS01 Two-Component System Influenced the Virulence of Streptococcus pneumoniae by Regulating PcpA
Authors: Yu Wei-Li , Pan Jin-Ge , Qin Ru-Xue , Lu Zhong-Hua , Bai Xiao-Hui , Sun Yun
Published: April 2023

Streptococcus pneumoniae
relies on two-component systems (TCSs) to regulate the processes of pathogenicity, osmotic pressure, chemotaxis, and energy metabolism. The TCS01 system of
S. pneumoniae
is composed of HK01 (histidine kinase) and RR01 (response regulator).
Infection Defects of RNA and DNA Viruses Induced by Antiviral RNA Interference
Authors: Liu Si , Han Yanhong , Li Wan-Xiang , Ding Shou-Wei
Published: April 2023

Immune recognition of viral genome-derived double-stranded RNA (dsRNA) molecules and their subsequent processing into small interfering RNAs (siRNAs) in plants, invertebrates, and mammals trigger specific antiviral immunity known as antiviral RNA interference (RNAi). Immune sensing of viral dsRNA is sequence-independent, and most regions of viral RNAs are targeted by virus-derived siRNAs which extensively overlap in sequence.
Genome Organization of Four Brazilian Xanthomonas albilineans Strains Does Not Correlate with Aggressiveness
Authors: Miranda Raquel P. , Turrini Paula C. G. , Bonadio Dora T. , Zerillo Marcelo M. , Berselli Arthur P. , Creste Silvana , Van Sluys Marie-Anne
Published: April 2023

An integrative approach is presented which combines genomics, transcriptomics, and cell biology to address leaf scald disease. The results presented here disclose that the disease is not associated with a single shared characteristic between the most pathogenic strains or a unique genomic pattern.
What’s the Matter with MICs: Bacterial Nutrition, Limiting Resources, and Antibiotic Pharmacodynamics
Authors: Berryhill Brandon A. , Gil-Gil Teresa , Manuel Joshua A. , Smith Andrew P. , Margollis Ellie , Baquero Fernando , Levin Bruce R.
Published: April 2023

For studies of antibiotics and how they work, the most-often used measurement of drug efficacy is the MIC. The MIC is the concentration of an antibiotic needed to inhibit bacterial growth.
Mid-Proterozoic geomagnetic field was more consistent with a dipole than a quadrupole
Authors: Gong Zheng , Evans David A.D. , Zhang Zhongtian , Yan Chi
Published: April 2023

The current morphology of Earth’s time-averaged magnetic field can be approximated to a geocentric axial dipole (GAD), but whether such an approximation remains valid in deep time needs to be investigated. Studies have used paleomagnetic data to reconstruct the ancient field and generally support a GAD morphology since 2 Ga. Recently, the GAD model for mid-Proterozoic time has been challenged, and an alternative model was proposed wherein the mid-Proterozoic field was dominated by a normal-tesseral quadrupole (NTQ) with spherical harmonics of degree l = 2 and order m = 1. We performed forward modeling to quantitatively compare whether a GAD or an NTQ could provide a better fit to mid-Proterozoic paleomagnetic directions. To deal with the ambiguity in plate reconstruction, we first considered data only from Laurentia, and then we expanded the analysis to Baltica by reconstructing its position relative to Laurentia using the geologically based Northern Europe–North America (NENA) configuration. Finally, we included data from Siberia using two reconstruction models. Results showed that in three mid-Proterozoic intervals (1790–1740 Ma, 1485–1425 Ma, 1095–1080 Ma), a GAD morphology gives better, or equally good, fits compared to the NTQ morphology. In addition, a stable NTQ that persisted for hundreds of millions of years is disfavored from a geodynamic perspective. Overall, mid-Proterozoic paleomagnetic directions are more consistent with a dipolar field. We suggest that the GAD remains the most parsimonious model to describe the morphology of the mid-Proterozoic magnetic field.
Geochemical significance of lithium and boron isotopic heterogeneity evolving during the crystallization of granitic melts
Authors: Lei Xiu-Fang , Romer Rolf L. , Glodny Johannes , Jiang Shao-Yong
Published: April 2023

We present Li and B isotope data for muscovite, biotite, and feldspar + quartz separated from two-mica granite and biotite granite samples from the Huayang-Wulong granite suite (south Qinling, central China). Our data demonstrate systematic differences in the Li and B isotopic compositions among these minerals. Our results indicate that early-crystallizing minerals have lower δ7Li and δ11B values than the original melt and that residual melts and late magmatic fluids may acquire anomalously high δ7Li and δ11B values. Furthermore, our data imply that (1) late melts and magmatic fluids do not reflect the composition of their source melt, (2) minerals that crystallized over a large segment of magma evolution may be isotopically zoned, and (3) mineral-selective alteration by late magmatic fluids camouflages the source of the fluid, whose δ7Li and δ11B values reflect the isotopic compositions of the altered minerals rather than the composition of the remaining rock.
Roadblocks and speed limits: Mantle-to-surface volatile flux through the lithospheric-scale Denali fault, Alaska
Authors: Newell Dennis L. , Benowitz Jeff A. , Regan Sean P. , Hiett Coleman D.
Published: April 2023

Helium and carbon isotopic data from 12 springs along a ~400 km segment of the Denali fault system (Alaska, USA), inform mantle-to-surface connections of this enigmatic structure. Warm springs on the main strand, west of the 2002 M7.9 Denali fault earthquake rupture, have 3He/4He as high as 2.4 RC/RA (air-corrected 3He/4He relative to air ratio) indicating ~30% mantle He. Corresponding δ13C values are −9.1‰ to −7.8‰ (relative to Vienna Peedee belemnite), suggesting that the CO2 at these western springs is partially mantle derived. At the eastern end of the 2002 rupture, Totschunda fault springs have 3He/4He of 0.65–0.99 RC/RA (~8%–12% mantle He), with δ13C values (~0‰) from carbonates. Results confirm the Denali fault system is a lithosphericscale feature tapping mantle volatiles. Springs along the 2002 rupture yield air-like 3He/4He of 1 R/RA and δ13C values from −9.2‰ to −3.4‰, interpreted as representing shallow groundwater circulation through shales and carbonates without mantle contributions. A thrust splay parallel to the rupture zone has air-like 3He/4He, whereas an along-strike high-angle normal splay yields 3He/4He of 1.3 RC/RA (~16% mantle He), implying that flow paths along the ruptured strand are disrupted in the upper 10 km of the fault zone. Because the Denali fault is a lithospheric-scale, transcurrent structure separating North America from independently moving southern Alaska, we suggest that it has characteristics of a transform boundary. The similarity of our results to helium isotope values at analogous tectonic settings suggest that without magmatism influence, there is a maximum mantle fluid flux through continental strike-slip faults.
Formation of Various Antimicrobial Peptide Emericellipsin Isoforms in Emericellopsos alkalina under Different Cultivation Conditions
Authors: Kuvarina A. E. , Sukonnikov M. A. , Rogozhin E. A. , Serebryakova M. V. , Timofeeva A. V. , Georgieva M. L. , Sadykova V. S.
Published: April 2023

Microbiological screening of the target component of emericellipsin A of the Emericellopsis alkalina E101 strain has been carried out in various biotechnological systems at various pHs. The content of emericellipsin A was quantified under these conditions. It has been established that the new approved membrane-liquid cultivation method at pH 10 contributes to an increase in the yield of the main component of emericellipsin A. It has been shown that the new method of cultivating the strain E. alkalina E101 also promotes the synthesis of various isoforms of the main component of emericellipsin A. Some comparative analysis has been carried out.
Complications following dental treatment in a child with haemophilia A: lessons to be learnt
Authors: Paul Rebecca , George Christina , Chandrasekhar Ajit , Chacko Rabin
Published: April 2023

A boy in his middle childhood with severe haemophilia reported with facial swelling following dental treatment for a carious upper primary molar done at a private dental clinic elsewhere. On presentation, he had a large, tense and tender swelling of the left cheek and a haematoma on the buccal mucosa adjacent to the treated tooth. The child was found to have a low haemoglobin level. He was taken for an emergency procedure under general anaesthesia for dental extraction with incision and drainage, and simultaneously underwent packed cells and factor replacement. He recovered in the ward postoperatively with no complications and with a gradual reduction of the swelling. This report highlights the importance of caries prevention in children, especially those with haemophilia. They need to be educated about restricting cariogenic foods in their diet and maintaining good oral hygiene. Management of such patients should be carefully coordinated to minimise undesirable outcomes.
Rectosigmoid intussusception due to large submucosal lipoma mimicking rectal prolapse
Authors: Cao Tian Qin Kerry , Yeo Jia Yi , Ong Chern Yue Glen , Tan Ming Ngan Aloysius
Published: April 2023

Rectosigmoid intussusception is a rare cause of bowel obstruction, accounting for only approximately 1%–2% of all bowel obstruction cases. While intussusception in adults typically occurs intra-abdominally and presents with signs and symptoms of intestinal obstruction, in rare cases, it can mimic a rectal prolapse if the intussusceptum protrudes through the anal canal. We herein report a case where an octogenarian woman presented with rectosigmoid intussusception through the anal canal, due to a sigmoid colon submucosal lipoma, who eventually required an open Hartmann’s procedure. Patients with rectal prolapse symptoms should be carefully examined to rule out intussuscepting masses as a differential, as it would necessitate earlier surgical intervention.