bluuebunny/crossref_metadata_2025 huggingface dataset:
The clinical implications of choroidal thickness combined with tear VEGFA in coronary artery disease
Authors: Zhou Tingquan , Wan Ting , Jin Xian , Chen Yu , Shen Chengxing
Published: September 2023

Objective

The purpose of this study was to evaluate the effect of choroidal thickness and tear vascular endothelial growth factor A (VEGFA) as biomarkers of coronary artery disease (CAD).

Methods

This study was a retrospective observational case–control trial. A total of 637 patients who underwent coronary angiography to assess their coronary artery status were included. The patients were divided into two groups: 200 people in the No CAD group and 437 people in the CAD group. We evaluated the choroidal thickness of the right foveal membrane in all patients through optical coherence tomography angiography examination. We also collected tear samples from patients to measure VEGFA. The ROC curve and its area under the curve (AUC) were used for analysis.

Results

The central foveal choroid in the No CAD group was significantly thicker than that in the CAD group (289.09 μm ± 38.41; 229.03 μm ± 33.44, P < 0.01). The tear VEGFA in the CAD group was higher than that in the No CAD group (706.15 ng/mL ± 147.42; 419.66 ng/mL ± 105.85, P < 0.01). Spearman analysis showed that the correlation between choroidal thickness and Gensini score was –0.7387 (P < 0.01). The correlation between tear VEGFA level and Gensini score was 0.8636 (P < 0.01). Taking choroidal thickness and tear VEGFA as independent variables, we obtained AUC = 0.9647 (95% CI 0.9506–0.9789, P < 0.01) through binary logic regression and ROC curve analysis.

Conclusion

The combination of choroidal thickness and tear VEGFA in patients can serve as a clinical marker of CAD and its severity.
Immediate versus MOdified DElayed coloanal anastomosis after total mesorectal excision: A protocol for a randomized controlled trial
Authors: Bendib Hani , Anou Abdelkrim , Djelali Nabil , Oukrine Hind , Alikhodja Hassan , Azzouz Abdelghani , Djennaoui Azeddine , Chekman Chemseddine
Published: September 2023

Background:

Immediate coloanal anastomosis (ICA) remains the standard technique for restoring the digestive tract after proctectomy for low rectal cancer. Often, it requires a temporary diversion stoma, thus increasing the risk of complications. Recent data have shown a great potential of the delayed coloanal anastomosis both in decreasing anastomosis morbidity and in avoiding ileostomy to the patients. More recently, a modified delayed coloanal anastomosis (mDCA) has been described and seems to have promising results. This study aims to determine whether mDCA is non-inferior to ICA.

Methods:

The IMODE trial is a randomized, controlled, non-inferiority trial designed to enroll 70 adults with mid or low rectal cancer. Participants are randomized to ICA or mDCA. The primary endpoint is the anastomotic fistulas rate at 6 months.

Conclusions:

The mDCA can constitute an interesting modality to restore the digestive tract following proctectomy for mid and low rectal cancer; this by decreasing the morbidity of the coloanal anastomosis on the one hand and by avoiding ileostomy on the other hand.
Effectiveness of respiratory training in home-based pulmonary rehabilitation for elderly patients with stable COPD: Study protocol for a randomized controlled trial
Authors: Shen Xiaoyu , Zhong Jianguo , Shan Cuihua , Zhang Dailiang
Published: September 2023

Introduction:

Chronic Obstructive Pulmonary Disease (COPD) brought a heavy risk of morbidity, hospital admission, and death. Respiratory training as an important part of pulmonary rehabilitation has not been validated in home-based elderly patients with stable COPD. This study aims to demonstrate the efficacy of a standardized respiratory training in home-based elderly patients with stable COPD.

Methods:

The prospective, randomized controlled trial will be designed and conduced in the Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital),China. Eligible patients with stable COPD will be randomly divided into experimental group and control group, both of the 2 groups will carry out regular home-based pulmonary rehabilitation for 3 months, additionally experimental group will receive a standardized respiratory training for 3 months. The primary outcome is the pulmonary function test before and after 3 months exercises.

Discussion:

The study will provide a objective basis for the use of respiratory training in home-based pulmonary rehabilitation for elderly patients with stable COPD.
Renal osteodystrophy: something old, something new, something needed
Authors: David Valentin , Salusky Isidro B. , Malluche Hartmut , Nickolas Thomas L.
Published: September 2023

Purpose of review

Renal osteodystrophy (ROD) is a complex disorder of bone metabolism that affects virtually all adults and children with chronic kidney disease (CKD). ROD is associated with adverse clinical outcomes including bone loss, mineralization and turnover abnormalities, skeletal deformities, fractures, cardiovascular events, and death. Despite current therapies, fracture incidence is 2-fold to 100-fold higher in adults and 2-fold to 3-fold higher in children when compared to without CKD. Limited knowledge of ROD pathogenesis, due to the lack of patient-derived large-scale multimodal datasets, impedes development of therapeutics aimed at reducing morbidity and mortality of CKD patients. The purpose of the review is to define the much needed infrastructure for the advancement of RDO treatment.

Recent findings

Recently, we created a large-scale data and tissue biorepository integrating clinical, bone quality, transcriptomic, and epigenomic data along with stored urine, blood, and bone samples. This database will provide the underpinnings for future research endeavors leading to the elucidation and characterization of the pathogenesis of ROD in CKD patients with and without dialysis.

The availability of an open-access NIH-funded resource that shares bone-tissue-based information obtained from patients with ROD with the broad scientific community represents a critical step in the process of discovering new information regarding unrecognized bone changes that have severe clinical complications. This will facilitate future high-impact hypothesis-driven research to redefine our understanding of ROD pathogenesis and pathophysiology and inform the development of disease-modifying and prevention strategies
Blood pressure targets in chronic kidney disease: still no consensus
Authors: Lucas Bethany , Taal Maarten W.
Published: September 2023

Purpose of review

Despite a strong consensus that treatment of hypertension is fundamental to strategies seeking to slow chronic kidney disease (CKD) progression and reduce the associated risk of cardiovascular events (CVE), controversy persists regarding optimal blood pressure (BP) targets. This article reviews the evidence for different targets, discusses associated controversies and suggests approaches to improve BP control.

Recent findings

Landmark clinical trials established the principle that lower BP targets are associated with slower progression of CKD in people with a greater magnitude of proteinuria and previous guidelines recommended a target BP of <130/80 mmHg for those with proteinuria. However, the Systolic Blood Pressure Intervention Trial provided new evidence that a systolic BP target of <120 mmHg was associated with a reduced risk of CVE, though there was no impact on CKD progression and there was concern about an increase in renal adverse events. Nevertheless, 2021 Kidney Disease Improving Global Outcomes guidelines recommended systolic BP <120 mmHg, though other updated guidelines did not follow this trend. All guidelines emphasise the importance of standardised BP measurement and a personalised approach.

An individualised and shared decision-making approach to BP target setting and management is recommended, guided by standardised BP measurement.
The mediating effect of the built environment on the relationship between socioeconomic status and mental health: findings from the 2019 Shanghai Community Survey
Authors: Xiaohua Zhong , Fuqin Wang
Published: September 2023

Objective:

Based on the theory of spatial production, the built environment is considered a mediating mechanism for health inequality. This study tested the hypothesis that communities, where populations with a higher socioeconomic status live, have a higher-quality built environment, which, in turn, promotes their mental health.

Methods:

Based on data from the 2019 Shanghai Community Survey (n = 3233), the general linear regression model (Ordinary Least Squares) and the classic three-step method developed by Baron and Kenny (1986) were used to test the mediation effects; subsequently, a structural equation model (bootstrap) was used to examine average direct effects and average causal mediation effects.

Results:

There were fewer types of aversive facilities, more green spaces or sports fields conducive to leisure and exercise, and better environmental hygiene in communities with higher-income populations, all of which improved their mental health. The total effect of income on mental health was 0.145 (P < 0.001), of which the average causal mediation effect through the built environment was 0.013 (P < 0.05), accounting for ~8.97%. Among the 3 dimensions of the built environment, the sanitation environment had a greater effect, accounting for 55.07% of the total mediation effect. Surrounding facilities accounted for 34.73%, whereas community green and sports spaces accounted for ~10.19%.

Conclusions:

The built environment quality of communities where low-income groups reside is worse, resulting in lower levels of their mental health. In the spatial planning of built environments, the socioeconomic characteristics of different residential groups should be considered, and the environmental quality of low-income communities should be improved using targeted measures.
Circulating Tumor HPV DNA in Patients With Head and Neck Carcinoma
Authors: Mijares Kevin , Ferrandino Rocco , Chai Raymond , Roof Scott , Bhardwaj Swati , Posner Marshall , Westra William H.
Published: September 2023

Circulating tumor human papillomavirus DNA (ctHPVDNA) testing using digital-droplet polymerase chain reaction (PCR) detects fragments of tumor-modified human papillomavirus (HPV) in the plasma of patients with HPV-associated head and neck squamous cell carcinomas (HNSCCs). Its impact on tumor surveillance and primary diagnosis is limited by unresolved issues relating to sensitivity and specificity. The study population consisted of patients with HNSCC who had undergone ctHPVDNA testing. HPV status was determined by p16 immunohistochemistry and PCR-HPV genotyping on the tumor samples. For discrepant cases (HPV-positive/ctHPVDNA-negative), HPV status was confirmed by RNA in situ hybridization and, when possible, targeted single-nucleotide polymorphisms genotyping. A total of 167 patients had ctHPVDNA testing, and 141 tumors were HPV positive by p16 immunohistochemistry and PCR genotyping. Genotypes included types 16 (91.5%), 33 (4.3%), 35 (2.1%), and 18 (2.1%). ctHPVDNA was detected in 133 (94.3%) of HPV-positive HNSCCs but in none of the HPV-negative HNSCCs. Four of the 5 p16-positive cases that were negative by PCR and ctHPVDNA were positive by RNA in situ hybridization, and in 2 of these cases, rare high-risk genotypes were identified. ctHPVDNA had a sensitivity of 91.7%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 63.6%. The likelihood that patients with HPV-positive HNSCC have detectable ctHPVDNA is high. Non-HPV16 genotypes contribute to discrepancies but only in a small subset of cases. This finding validates ongoing efforts to use ctHPVDNA as a surveillance tool, and even as a primary diagnostic assay in patients presenting with masses in the neck and/or oropharynx.
Predictors of the social participation of adults with Down syndrome: an analysis based on the biopsychosocial model of the International Classification of Functioning, Disability, and Health
Authors: Lacerda de Andrade Michele , Silva Soraia Micaela , Ferreira de Moraes Janaina , Cardoso de Jesus Stephanie , dos Santos Pedro Emily , Ferrari Corrêa João Carlos , Corrêa Fernanda Ishida
Published: September 2023

Objective

Identify the predictors of social participation in Down Syndrome (DS) adults from the biopsychosocial model of the International Classification of Functioning, Disability, and Health (ICF).

Methods

An exploratory, analytical, cross-sectional study was conducted with DS adults. The social participation was assessed using the Life Habits Assessment (LIFE-H 3.1). The independent variables were determined using the ICF biopsychosocial model: Body functions were assessed by body mass index (BMI), cognition function (Mini-Mental State Examination-MMSE), and lower limbs muscle strength (Sit to Stand Test). Activities were assessed by the 8-Foot Up and Go Test (8-FUGT). Environmental factors were assessed by the measure of the quality of the environment (MQE), and personal factors were assessed by age, sex, and education level.

Results

The total LIFE-H score indicates that individuals show moderate restriction in social participation, with major restriction in the education, employment, and responsibilities domains. The 8-FUGT was the best social participation predictor variable, followed by MMSE, and the Sit-to-Stand Test. Contextual factors were not predictors of participation.

Conclusion

It was concluded that individuals with DS present the most restrictions to social participation in activities that involve social roles. The predictors influencing social participation are functional mobility, cognition, and lower limb muscle strength.
Dynamic CZT-SPECT
Authors: Bailly Matthieu , Courtehoux Maxime , Metrard Gilles , Angoulvant Denis , Ribeiro Maria Joao
Published: September 2023

CZT-SPECT myocardial perfusion enables quantification of myocardial blood flow (MBF). Normal values and thresholds have been accurately defined in PET but remain unclear in SPECT. The aim of this study was to report normal MBF and myocardial flow reserve values in very low-risk patients referred for coronary artery disease screening with dynamic SPECT, in comparison with patients experiencing coronary artery disease. Eighty-four patients (31 male) were analyzed. The mean 10 years risk of fatal cardiovascular events score was 2.7% ± 1.4%. The mean global stress MBF and myocardial flow reserve were 1.6 ± 0.6 mL/min/g and 2.7 ± 0.7.
Could 68Ga-DOTA-UBI-29-41 Help Identify Chronic Osteomyelitis on PET/CT Images? A Pilot Study
Authors: Nogueira Solange Amorim , de Barboza Marycel F. , Dell’Aquila Adriana M. , Santos Durval C. B , Osawa Akemi
Published: September 2023

This pilot study aimed to confirm the presence of infectious agents in infection foci using PET/CT imaging with 68Ga-DOTA-UBI (29–41) in 7 patients with chronic osteomyelitis and with indications for surgical cleaning at the site of the infection focus. The whole-body PET/CT was performed on Biograph mCT 40 PET/CT scanner (Siemens Healthineers); the image began 45–60 minutes postinjection of the radiotracer (148–260 MBq). This study demonstrated that, in 6 patients in whom the PET/CT was classified as positive for identified infectious foci, confirmed by culture of the secretion sample collected during surgery, only 1 patient in antibiotic therapy was negative.
Epidemiology and Pattern of Pediatric Maxillofacial Trauma: A 5-Year Retrospective Study
Authors: Kelimu Keyimu , Wusiman Patiguli , Li Weidong , Huang Bi , Wu Jianming , Zhan Jinliang , Moming Adili
Published: September 2023

Purpose:

To analyze the epidemiology, pattern, and prevent measurement of pediatric maxillofacial trauma in Xinjiang, China.

Patients and Methods:

Clinical records of patients aged 0 to 18 years with maxillofacial trauma over the 5 years were reviewed. Epidemiological features of data were collected for the cause of injury, age and sex distribution, frequency and type of injury, localization and frequency of soft tissue injuries, facial bone fractures, and presence of associated injuries. Statistical analyses performed included descriptive analysis, χ2 test, and logistic regression analyses.

Results:

Among the 450 patients, 333 were male and 117 were female, with a male-to-female ratio of 3.8:1, the mean age was 9.2±5.4 years; 223 cases were soft tissue injuries and 227 cases were maxillofacial fractures. The 16 to 18-year-old group was the highest, with the prevalence of maxillofacial fractures. The most common cause of pediatric maxillofacial trauma was traffic injuries.

Conclusion:

The incidence of maxillofacial trauma in pediatric patients correlates with a number of factors, including age, sex, and etiology of trauma. The 16 to 18-year-old group is the most prevalent group for maxillofacial trauma in pediatric patients, and traffic accidents are the leading cause of maxillofacial trauma in pediatric patients.
An Updated Systematic Review and Meta-Analysis of the Impact of Graduated Compression Stockings in Addition to Pharmacological Thromboprophylaxis for Prevention of Venous Thromboembolism in Surgical Inpatients
Authors: Turner Benedict R H , Machin Matthew , Salih Marwah , Jasionowska Sara , Lawton Rebecca , Siracusa Francesca , Gwozdz Adam M , Shalhoub Joseph , Davies Alun H
Published: September 2023

Objective:

This systematic review and meta-analysis compares the rate of venous thromboembolism (VTE) in surgical inpatients with pharmacological thromboprophylaxis and additional graduated compression stockings (GCS) versus pharmacological thromboprophylaxis alone.

Summary Background Data:

Surgical inpatients have elevated VTE risk; recent studies cast doubt whether GCS confer additional protection against VTE, compared to pharmacological thromboprophylaxis alone.

Methods:

The review followed PRISMA guidelines using a registered protocol (CRD42017062655). The MEDLINE and Embase databases were searched to November 2022. Randomised trials reporting VTE rate after surgical procedures, utilising pharmacological thromboprophylaxis, with or without GCS, were included. The rates of deep venous thrombosis (DVT), pulmonary embolism (PE), VTE-related mortality were pooled via fixed and random effects.

Results:

In head-to-head meta-analysis, the risk of DVT for GCS and pharmacological thromboprophylaxis was 0.85 (95% CI 0.54-1.36) versus for pharmacological thromboprophylaxis alone (2 studies, 70 events, 2653 participants). The risk of DVT in pooled trial arms for GCS and pharmacological thromboprophylaxis was 0.54 (95% CI 0.23-1.25) versus pharmacological thromboprophylaxis alone (33 trial arms, 1228 events, 14,108 participants). The risk of PE for GCS and pharmacological prophylaxis versus pharmacological prophylaxis alone was 0.71 (95% CI 0.0-30.0) (27 trial arms, 32 events, 11,472 participants). There were no between-group differences in VTE-related mortality (27 trial arms, 3 events, 12,982 participants).

Conclusions:

Evidence from head-to-head meta-analysis and pooled trial arms demonstrates no additional benefit for GCS in preventing VTE and VTE-related mortality. GCS confer a risk of skin complications and an economic burden; current evidence does not support their use for surgical inpatients.
Are Metastatic Central Lymph Nodes (D3 volume) in right-sided Colon Cancer a Sign of Systemic Disease? A sub-group Analysis of an Ongoing Multicenter Trial
Authors: Banipal Gurpreet Singh , Stimec Bojan Vladimir , Andersen Solveig Norheim , Edwin Bjorn , Nesgaard Jens Marius , Šaltytė Benth Jurate , Ignjatovic Dejan ,   For the RCC study group
Published: September 2023

Objective:

Assess outcomes of patients with right-sided colon cancer with metastases in the D3 volume after personalized surgery.

Background:

Patients with central lymph node metastasis (D3-PNG) are considered to have a systemic disease with a poor prognosis. A 3-dimensional definition of the dissection volume allows the removal of all central nodes.

Methods:

D3-PNG includes consecutive patients from an ongoing clinical trial. Patients were stratified into residual disease negative (D3-RDN) and residual disease positive (D3-RDP) groups. D3-RDN was further stratified into four periods to identify a learning curve. A personalized D3 volume (defined through arterial origins and venous confluences) was removed “en bloc” through medial-to-lateral dissection, and the D3 volume of the specimen was analyzed separately.

Results:

D3-PNG contained 42(26 females, 63.1SD9.9 y) patients, D3-RDN:29(17 females, 63.4SD10.1 y), and D3-RDP:13(9 females, 62.2SD9.7 y). Mean overall survival (OS) days D3-PNG:1230, D3-RDN:1610, D3-RDP:460. Mean disease-free survival (DFS) was D3-PNG:1023, D3-RDN:1461, D3-RDP:74 days. The probability of OS/ DFS in D3-PNG:52.1%/50.2%, D3-RDN:72.9%/73.1%, D3-RDP: 7.7%/0%. There is a significant change in OS/DFS in the D3-RDN from 2011-2013 to 2020-2022(both P=0.046) and from 2014-2016 to 2020-2022 (P=0.028 and P=0.005,respectively).

Conclusion:

Our results indicate that surgery can achieve survival in most patients with central lymph node metastases by removing a personalized and anatomically defined D3 volume. The extent of mesenterectomy and the quality of surgery are paramount since a learning curve has demonstrated significantly improved survival over time, despite the low number of patients. These results imply a place for the centralization of this patient group, where feasible.
Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes
Authors: Awtry Jake A. , Abernathy James H. , Wu Xiaoting , Yang Jie , Zhang Min , Hou Hechuan , Kaneko Tsuyoshi , de la Cruz Kim I. , Stakich-Alpirez Korana , Yule Steven , Cleveland Joseph C. , Shook Douglas C. , Fitzsimons Michael G. , Harrington Steven D. , Pagani Francis D. , Likosky Donald S. ,   on behalf of the Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators
Published: September 2023

Objective:

To associate surgeon-anesthesiologist team familiarity with cardiac surgery outcomes.

Background:

Team Familiarity (TF), a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited.

Methods:

This retrospective cohort study included Medicare beneficiaries undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), or both (CABG+SAVR) between 01/01/2017-09/30/2018. Team familiarity was defined as the number of shared procedures between the cardiac surgeon and anesthesiologist within six months of each operation. Primary outcomes were 30- and 90-day mortality, composite morbidity, and 30-day mortality or composite morbidity, assessed before and after risk adjustment using multivariable logistic regression.

Results:

The cohort included 113,020 patients (84,397 CABG; 15,939 SAVR; 12,684 CABG+SAVR). Surgeon-anesthesiologist dyads in the highest [31631 patients, TF median(interquartile range)=8(6,11)] and lowest [44307 patients, TF=0(0,1)] TF terciles were termed familiar and unfamiliar, respectively. The rates of observed outcomes were lower among familiar versus unfamiliar teams: 30-day mortality (2.8% vs. 3.1%, P=0.001), 90-day mortality (4.2% vs. 4.5%, P=0.023), composite morbidity (57.4% vs. 60.6%, P<0.001), and 30-day mortality or composite morbidity (57.9% vs. 61.1%, P<0.001). Familiar teams had lower overall risk-adjusted odds of 30-day mortality or composite morbidity [aOR 0.894(0.868,0.922), P<0.001], and for SAVR significantly lower 30-day mortality [aOR 0.724(0.547,0.959), P=0.024], 90-day mortality [aOR 0.779(0.620,0.978), P=0.031], and 30-day mortality or composite morbidity [aOR 0.856(0.791,0.927), P<0.001].

Conclusions:

Given its relationship with improved 30-day cardiac surgical outcomes, increasing TF should be considered among strategies to advance patient outcomes.
Rate of Emergency Lower Extremity Amputations in the United States among Medicare Beneficiaries
Authors: Dualeh Shukri H.A. , Powell Chloe A. , Kunnath Nicholas , Corriere Matthew A. , Ibrahim Andrew M.
Published: September 2023

Objective:

To determine the rate of emergency versus elective lower extremity amputations in the United States

Background:

Lower extremity amputation is a common endpoint for patients with poorly controlled diabetes and multilevel peripheral vascular disease. While the procedure is ideally performed electively, patients with limited access may present later and require an emergency operation. To what extent rates of emergency amputation for lower extremity vary across the United States is unknown.

Methods:

Evaluation of Medicare beneficiaries who underwent lower extremity amputation between 2015-2020. The rate was determined for each zip code and placed into rank order from lowest to highest rate. We merged each beneficiary’s place of residence and location of care with the American Hospital Association Annual Survey using Google Maps Application Programming Interface to determine the travel distance for patients to undergo their procedure.

Results:

Of 233,084 patients, 66.3%(154,597) were men, 69.8%(162,786) were White. Average age(SD) was 74 year(8). There was wide variation in rates of emergency lower extremity amputation. The lowest quintile of zip codes demonstrated an emergency amputation rate of 3.7% while the highest quintile demonstrated 90%. Median travel distance in the lowest emergency surgery rate quintile was 34.6 miles compared to 10.5 miles in the highest quintile of emergency surgery (P<0.001).

Conclusion:

There is wide variation in the rate of emergency lower extremity amputations among Medicare beneficiaries, suggesting variable access to essential vascular care. Travel distance and rate amputation have an inverse relationship, suggesting that barriers other than travel distance are playing a role.
EEG Source Localization in Temporal Encephaloceles: Concordance With Surgical Resection and Clinical Outcomes
Authors: Cox Benjamin C. , Agashe Shruti H. , Smith Kelsey M. , Kanth Kiran M. , Van Gompel Jamie J. , Krecke Karl N. , Witte Robert J. , Wong-Kisiel Lily C. , Brinkmann Benjamin H.
Published: September 2023

Purpose:

Temporal encephaloceles are a cause of drug-resistant temporal lobe epilepsy; however, their relationship with epileptogenesis is unclear, and optimal surgical resection is uncertain. EEG source localization (ESL) may guide surgical decision-making.

Methods:

We reviewed patients at Mayo Clinic Rochester with drug-resistant temporal lobe epilepsy and temporal encephaloceles, who underwent limited resection and had 1-year outcomes. EEG source localization was performed using standard density scalp EEG of ictal and interictal activity. Distance from dipole and standardized low-resolution brain electromagnetic tomography (sLORETA) solutions to the encephalocele were measured. Concordance of ESL with encephalocele and surgical resection was compared with 1-year surgical outcomes.

Results:

Seventeen patients met criteria. The mean distances from ESL results to encephalocele center for dipole and sLORETA analyses were 23 mm (SD 9) and 22 mm (SD 11), respectively. Ten patients (55.6%) had Engel I outcomes at 1 year. Dipole-encephalocele distance and sLORETA-encephalocele distance were significantly longer in patients with Engel I outcome and patients whose encephalocele was contained by sLORETA had worse outcome as well; however, multiple logistic regression analysis found that only containment of encephalocele by the sLORETA current density was significant (P < 0.05), odds ratio 0.12 (95% confidence interval [0.021, 0.71]).

Conclusions:

EEG source localization of scalp EEG localizes near encephaloceles, however, typically not in the encephalocele itself; this may be due to scalp EEG sampling propagated activity or alternatively that the seizure onset zone extends beyond the herniated cortex. Surprisingly, we observed increased ESL to encephalocele distances in patients with excellent surgical outcomes. Larger cohort studies including intracranial EEG data are needed to further explore this finding.
Disrupted functional connectivity of the striatum in patients with diffuse axonal injury: a resting-state functional MRI study
Authors: Xu Zhigang , Li Ye , Fan Xiaole , Xu Wenhua , Liu Jinliang , Li Jian
Published: September 2023

Diffuse axonal injury (DAI) disrupts the integrity of white matter microstructure and affects brain functional connectivity, resulting in persistent cognitive, behavioral and affective deficits. Mounting evidence suggests that altered cortical-subcortical connectivity is a major contributor to cognitive dysfunction. The functional integrity of the striatum is particularly vulnerable to DAI, but has received less attention. This study aimed to investigate the alteration patterns of striatal subdivision functional connectivity. Twenty-six patients with DAI and 27 healthy controls underwent resting-state fMRI scans on a 3.0 T scanner. We assessed striatal subdivision functional connectivity using a seed-based analysis in DAI. Furthermore, a partial correlation was used to measure its clinical association. Compared to controls, patients with DAI showed decreased functional connectivity between the right inferior ventral striatum and right inferior frontal gyrus, as well as the right inferior parietal lobule, between the left inferior ventral striatum and right inferior frontal gyrus, between the right superior ventral striatum and bilateral cerebellar posterior lobe, between the bilateral dorsal caudal putamen and right anterior cingulate gyrus, and between the right dorsal caudal putamen and right inferior parietal lobule. Moreover, decreased functional connectivity was observed between the left dorsal caudate and the right cerebellar posterior lobe, while increased functional connectivity was found between the left dorsal caudate and right inferior parietal lobule. Correlation analyses showed that regions with functional connectivity differences in the DAI group correlated with multiple clinical scoring scales, including cognition, motor function, agitated behavior, and anxiety disorders. These findings suggest that abnormalities in cortico-striatal and cerebellar-striatal functional connectivity are observed in patients with DAI, enriching our understanding of the neuropathological mechanisms of post-injury cognitive disorders and providing potential neuroimaging markers for the diagnosis and treatment of DAI.
Expanding ocean protection and peace: a window for science diplomacy in the Gulf
Authors: Fieseler Clare M. , Al-Mudaffar Fawzi Nadia , Helmuth Brian , Leitão Alexandra , Al Ainsi Mehsin , Al Mukaimi Mohammad , Al-Saidi Mohammad , Al Senafi Fahad , Bejarano Ivonne , Ben-Hamadou Radhouan , D'Addario Josh , Mujthaba Dheen Mohamed Ahmad , Giraldes Bruno W. , Glowka Lyle , Johnson Maggie D. , Lyons Brett P. , Mateos-Molina Daniel , Marshall Christopher D. , Mohammed Sayeed , Range Pedro , Reza Shokri Mohammad , Wong John M. K. , Pyenson Nicholas D.
Published: September 2023

The ecological state of the Persian or Arabian Gulf (hereafter ‘Gulf') is in sharp decline. Calls for comprehensive ecosystem-based management approaches and transboundary conservation have gone largely unanswered, despite mounting marine threats made worse by climate change. The region's long-standing political tensions add additional complexity, especially now as some Gulf countries will soon adopt ambitious goals to protect their marine environments as part of new global environmental commitments. The recent interest in global commitments comes at a time when diplomatic relations among all Gulf countries are improving. There is a window of opportunity for Gulf countries to meet global marine biodiversity conservation commitments, but only if scientists engage in peer-to-peer diplomacy to build trust, share knowledge and strategize marine conservation options across boundaries. The Gulf region needs more ocean diplomacy and coordination; just as critically, it needs actors at its science-policy interface to find better ways of adapting cooperative models to fit its unique marine environment, political context and culture. We propose a practical agenda for scientist-led diplomacy in the short term and lines of research from which to draw (e.g. co-production, knowledge exchange) to better design future science diplomacy practices and processes suited to the Gulf's setting.
The effect of fast and slow decision-making on equity–efficiency tradeoffs and moral repugnance
Authors: Persson Emil , Tinghög Gustav
Published: September 2023

Fast-and-slow models of decision-making are commonly invoked to explain economic behaviour. However, past research has focused on human cooperation and generosity and thus largely overlooked situations where there are sharp conflicts between efficiency and equality, or between efficiency and more intuitive moral values (repugnance). Here, we contribute to fill this gap in the literature. We conducted a preregistered experiment (n= 1500 recruited from Prolific) to assess the effects of fast, intuitive decisions, under time pressure versus slow, deliberate decisions, under time delay, on (i) people's distributional preferences and (ii) their attitudes toward repugnant transactions. The results show increased preference for equality and decreased preference for efficiency under time pressure, but no effects on moral repugnance. Exploratory analyses revealed that most of the observed treatment effects in our data were accounted for by women. Our results provide some support for theories that associate controlled cognition with concern for efficiency, and intuitive, emotional responses with inequality aversion.
Accurately summarizing an outbreak using epidemiological models takes time
Authors: Case B. K. M. , Young Jean-Gabriel , Hébert-Dufresne Laurent
Published: September 2023

Recent outbreaks of Mpox and Ebola, and worrying waves of COVID-19, influenza and respiratory syncytial virus, have all led to a sharp increase in the use of epidemiological models to estimate key epidemiological parameters. The feasibility of this estimation task is known as the practical identifiability (PI) problem. Here, we investigate the PI of eight commonly reported statistics of the classic susceptible–infectious–recovered model using a new measure that shows how much a researcher can expect to learn in a model-based Bayesian analysis of prevalence data. Our findings show that the basic reproductive number and final outbreak size are often poorly identified, with learning exceeding that of individual model parameters only in the early stages of an outbreak. The peak intensity, peak timing and initial growth rate are better identified, being in expectation over 20 times more probable having seen the data by the time the underlying outbreak peaks. We then test PI for a variety of true parameter combinations and find that PI is especially problematic in slow-growing or less-severe outbreaks. These results add to the growing body of literature questioning the reliability of inferences from epidemiological models when limited data are available.
Maker communities and the COVID-19 pandemic: a longitudinal analysis of Thingiverse’s response to supply shortages
Authors: Felton H. , Schiffmann O. , Goudswaard M. , Gopsill J. , Snider C. , Real R. , McClenaghan A. , Hicks B.
Published: September 2023

The COVID-19 pandemic profoundly affected various aspects of daily life, particularly the supply and demand of essential goods, resulting in critical shortages. This included personal protective equipment for medical professionals and the general public. To address these shortages, online ‘maker communities’ emerged, aiming to develop and locally manufacture critical products. While some organized efforts existed, the majority of initiatives originated from individuals and groups on platforms like Thingiverse. This paper presents a longitudinal analysis of Thingiverse, one of the largest maker community websites, to examine the pandemic’s effects. Our findings reveal a surge in community output during the initial lockdown periods in major contributing nations (primarily those in the Western Hemisphere), followed by a subsequent decline. Additionally, throughout 2020, pandemic-related products dominated uploads and interactions during this period. Based on these observations, we propose recommendations to expedite the community’s ability to support local, national and international responses to future disasters.
Male reproductive success is not strongly affected by phenological changes in mate availability in monoecious
Sagittaria latifolia
Authors: Kwok Allison , Stephens Samantha , Dorken Marcel
Published: September 2023

Many plants express their female and male sex roles at different times (dichogamy), with important consequences for mating. Dichogamy can yield mate limitation via biased floral sex ratios, particularly at the beginning and end of the flowering season when many plants simultaneously function as the same sex. This form of mate limitation should be reduced if plants adjust their allocations to female versus male sex functions in a manner that tracks seasonal variability in mating opportunities. For example, under protogyny (i.e. dichogamy with female function expressed first) plants with male-biased sex expression should have enhanced mating opportunities early in the flowering season as other plants begin to flower (in female sex phase). We quantified seasonal changes in sex allocation, patterns of mate availability and realized siring success in a population of protogynous
Sagittaria latifolia
. Our results were consistent with previous findings that seasonal changes in sex allocation should compensate for lost mating opportunities under the temporally variable mating environments caused by dichogamy. However, patterns of siring success in the population were inconsistent with this interpretation. We suggest that realized siring success might depend more strongly on spatial than on temporal aspects of mate availability.
Antiviral activity of salt-coated materials against SARS-CoV-2
Authors: Coleman Christopher M. , Wang Belinda , Wang Yixin , Tapia-Brito Emmanuel , Chen Ziwei , Riffat James , Riffat Saffa , Tarlinton Rachael , Ghaemmaghami Amir
Published: September 2023

The SARS-CoV-2 pandemic demonstrated the importance of human coronaviruses and the need to develop materials to prevent the spread of emergent respiratory viruses. Coating of surfaces with antiviral materials is a major interest in controlling spread of viruses, especially in high-risk or high-traffic areas. A number of different coatings for surfaces have been proposed, each with their own advantages and disadvantages. Here we show that simple salt coating on a range of surfaces, including a novel biomass aerogel can reduce the infectivity of SARS-CoV-2 placed onto the surface. This suggests that a simple to apply coating could be applied to a range of materials and have an antiviral effect against SARS-CoV-2, as well as other potential emerging viruses.
Unveiling Neurobrucellosis: A Case Report Emphasizing Early Diagnosis for Better Outcomes
Authors: SIVAKUMAR HARIPRIYA , MALHOTRA SHIKHIR , GADEPALLI RAVISEKHAR , TAK VIBHOR , KUMAR BHARAT
Published: September 2023

Introduction:Brucellosis is a pervasive zoonotic disease causing considerable human morbidity worldwide. This report focuses on a case of Neurobrucellosis in a rural Indian patient, emphasizing the need for timely microbiological confirmation given its nonspecific clinical presentation.
Case Presentation: A 55-year-old rural Indian farmer presented with a three-week history of insidious, low-grade fever, myalgia, and arthralgia. He developed acute right-sided weakness and neurological symptoms, including disorientation and neck rigidity. Laboratory tests indicated abnormal blood counts, elevated inflammatory markers, and liver dysfunction. Cerebrospinal fluid analysis showed pleocytosis with lymphomononuclear cells and elevated protein levels. Blood cultures eventually grew Gram-negative coccobacilli. Serological tests confirmed neurobrucellosis. Prompt antibiotic therapy led to clinical and laboratory improvement.
Conclusion: This case underscores the importance of recognizing neurobrucellosis, particularly in endemic areas, given its nonspecific clinical presentation. Early microbiological diagnosis, supported by positive blood cultures and serological tests, was crucial. The patient's rapid response to appropriate antibiotics emphasizes the significance of timely recognition and management.
Streptomyces fuscus sp. nov., a brown-black pigment producing actinomycete isolated from dry mudflat sand
Authors: Xie Junjie , Zhang Hongyan , Xu Xia , Yang Kexin , Ou Junchao , Yang Dengfeng , Jiang Yi , Jiang Mingguo , Shen Naikun
Published: September 2023

A novel Gram-stain-positive, aerobic actinobacterial strain, designated GXMU-J15T, was isolated from dry mudflat sand. A polyphasic approach was employed for its taxonomic characterization. The strain developed extensively branched yellowish white to light yellow substrate mycelia and white aerial mycelia, and produced smooth cylindrical spores in a loose straight spore chain on International

Streptomyces

Project 2–7 agar media. Strain GXMU-J15T grew at 20–50 °C (optimum, 35 °C), at pH 5.0–8.0 (optimum, pH 7.0) and in the presence of 0–8 % (w/v) NaCl. Analysis of 16S rRNA gene sequences indicated that strain GXMU-J15T represents a member of the genus

Streptomyces

. Strain GXMU-J15T showed the highest 16S rRNA gene sequence similarity to

Streptomyces lusitanus

CGMCC 4.1745T (99.1 %) and

Streptomyces thermocarboxydus

CGMCC 4.1883T (98.8 %). Phylogenetic tree analysis based on multilocus sequence analysis (MLSA) and whole genome sequence construction revealed that strain GXMU-J15T was most closely related to Streptomyces cupreus PSKA01T,

Streptomyces cinnabarinus

DSM 40467T and

Streptomyces davaonensis

JCM 4913T. The MLSA and genome-to-genome distances between strain GXMU-J15T and its relatives were 0.0418, 0.0443 and 0.0485 and 0.1237, 0.1188 and 0.1179, respectively. The results of orthologous average nucleotide identity and digital DNA–DNA hybridization analysis corroborated the results of the MLSA and whole genome sequence evolution analysis, indicating that the novel isolate represents a distinct species of the genus

Streptomyces

. The whole-cell sugars of strain GXMU-J15T were xylose, glucose and galactose. The characteristic diamino acid in the cell-wall hydrolysate was ll-diaminopimelic acid. The lipids contained diphosphatidylglycerol, phosphatidylmethylethanolamine, phosphatidylethanolamine, phosphatidylinositol, phosphatidylglycerol, phosphatidylglycerides, phosphatidylcholine, two phospholipids of an unknown structure containing glucosamine, one unknown phospholipid and two unknown lipids. The major cellular fatty acid components were iso-C15 : 0, anteiso-C15 : 0, iso-C16 : 0 and anteiso-C17 : 0. The main respiratory quinone types were MK-9(H6) and MK-9(H8). The whole genome size of strain GXMU-J15T was 8.68 Mbp, with 71.23 mol% G+C content. Genomic analysis indicated that strain GXMU-J15T has the potential to synthesize polyketides, terpenes and a series of important antibiotics besides the gene cluster for melanin synthesis. Based on these genotypic and phenotypic data, strain GXMU-J15T is proposed to represent a new species of the genus

Streptomyces

named Streptomyces fuscus sp. nov. The type strain is GXMU-J15T (=MCCC 1K08211T=JCM 35917T).
Sphingomonas oryzagri sp. nov., isolated from a rice field
Authors: Huq Md. Amdadul , Lee Sun-Young , Rahman Md. Shahedur , Akter Shahina
Published: September 2023

A Gram-stain-negative, aerobic, short rod-shaped and motile novel bacterial strain, designated MAHUQ-71T, was isolated from the soil of a rice field. The colonies were observed to be milky yellow-coloured, smooth, spherical and 0.1–0.4 mm in diameter when grown on Reasoner's 2A agar medium for 2 days. Strain MAHUQ-71T was found to be able to grow at 15–37 °C, pH 5.0–10.0 and with 0–3.0 % NaCl (w/v). The strain was found to be positive for the catalase test, but negative for the oxidase test. The strain was positive for hydrolysis of aesculin and Tween 20. According to the 16S rRNA gene sequence comparisons, the isolate was identified as a member of the genus

Sphingomonas

and to be closely related to

Sphingomonas chungangi

MAH-6T (98.5 % sequence similarity),

Sphingomonas polyaromaticivorans

B2-7T (98.4 %) and

Sphingomonas oligoaromativorans

SY-6T (96.6 %). Strain MAHUQ-71T has a draft genome size of 4 255 278 bp (10 contigs), annotated with 4098 protein-coding genes, 47 tRNA and three rRNA genes. The average nucleotide identity (ANI) and digital DNA–DNA hybridization (dDDH) values between strain MAHUQ-71T and the closest type strain

S. chungangi

MAH-6T were in the range of 85.6 and 30.6 %, respectively. The genomic DNA G+C content was determined to be 66.7 mol%. The predominant isoprenoid quinone was ubiquinone 10. The major fatty acids were identified as summed feature 8 (C18 : 1
 ω7c and/or C18 : 1
 ω6c), C16 : 0 and C14 : 0 2OH. The main polar lipids were phosphatidylcholine, phosphatidylethanolamine, diphosphatidylglycerol and sphingoglycolipid. On the basis of dDDH and ANI values, as well as the results of genotypic, chemotaxonomic and physiological analyses, strain MAHUQ-71T represents a novel species within the genus

Sphingomonas

, for which the name Sphingomonas oryzagri sp. nov. is proposed, with MAHUQ-71T (=KACC 22252T=CGMCC 1.19065T) as the type strain.
Major distinctions between the two oligopeptide permease systems of Bacillus subtilis with respect to signaling, development and evolutionary divergence
Authors: Bareia Tasneem , Pollak Shaul , Guler Polina , Puyesky Shani , Eldar Avigdor
Published: September 2023

Oligopeptide-permeases (Opps) are used by bacteria to import short peptides. In addition to their metabolic benefit, imported short peptides are used in many Gram-positive bacteria as signalling molecules of the RRNPP super-family of quorum-sensing systems, making Opps an integral part of cell–cell communication. In some Gram-positive bacteria there exist multiple Opps and the relative importance of those to RRNPP quorum sensing are not fully clear. Specifically, in

Bacillus subtilis

, the Gram-positive model species, there exist two homologous oligopeptide permeases named Opp and App. Previous work showed that the App system is mutated in lab strain 168 and its recovery partially complements an Opp mutation for several developmental processes. Yet, the nature of the impact of App on signalling and development in wild-type strains, where both permeases are active was not studied. Here we re-examine the impact of the two permease systems. We find that App has a minor contribution to biofilm formation, surfactin production and phage infection compared to the effect of Opp. This reduced effect is also reflected in its lower ability to import the signals of four different Rap-Phr RRNPP systems. Further analysis of the App system revealed that, unlike Opp, some App genes have undergone horizontal transfer, resulting in two distinct divergent alleles of this system in

B. subtilis

strains. We found that both alleles were substantially better adapted than the Opp system to import an exogenous RRNPP signal of the

Bacillus cereus

group PlcR-PapR system. In summary, we find that the App system has only a minor role in signalling but may still be crucial for the import of other peptides.