bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular and biochemical characterization of a plant-like iota-class glutathione S-transferase from the halotolerant cyanobacterium Halothece sp. PCC7418
Authors: Samsri Sasiprapa , Kortheerakul Chananwat , Kageyama Hakuto , Waditee-Sirisattha Rungaroon
Published: September 2024

Aims

This study identifies a unique glutathione S-transferase (GST) in extremophiles using genome, phylogeny, bioinformatics, functional characterization, and RNA sequencing analysis.

Methods and Results

Five putative GSTs (H0647, H0729, H1478, H3557, and H3594) were identified in Halothece sp. PCC7418. Phylogenetic analysis suggested that H0647, H1478, H0729, H3557, and H3594 are distinct GST classes. Of these, H0729 was classified as an iota-class GST, encoding a high molecular mass GST protein with remarkable features. The protein secondary structure of H0729 revealed the presence of a glutaredoxin (Grx) Cys-Pro-Tyr-Cys (C-P-Y-C) motif that overlaps with the N-terminal domain and harbors a topology similar to the thioredoxin (Trx) fold. Interestingly, recombinant H0729 exhibited a high catalytic efficiency for both glutathione (GSH) and 1-chloro-2, 4-dinitrobenzene (CDNB), with catalytic efficiencies that were 155- and 32-fold higher, respectively, compared to recombinant H3557. Lastly, the Halothece gene expression profiles suggested that antioxidant and phase II detoxification encoding genes are crucial in response to salt stress.

Conclusion

Iota-class GST was identified in cyanobacteria. This GST exhibited a high catalytic efficiency toward xenobiotic substrates. Our findings shed light on a diversified evolution of GST in cyanobacteria and provide functional dynamics of the genes encoding the enzymatic antioxidant and detoxification systems under abiotic stresses.
Breast Density Status Changes: Frequency, Sequence, and Practice Implications
Authors: Maloney Caitlin M , Paul Shirlene , Lieberenz Jordan L , Stempel Lisa R , Levy Mia A , Alvarado Rosalinda
Published: September 2024

Objective

Changes in a patient’s reported breast density status (dense vs nondense) trigger modifications in their cancer risk profile and supplemental screening recommendations. This study tracked the frequency and longitudinal sequence of breast density status changes among patients who received serial mammograms.

Methods

This IRB-approved, HIPAA-compliant retrospective cohort study tracked breast density changes among patients who received at least 2 mammograms over an 8-year study period. BI-RADS density assessment categories A through D, visually determined at the time of screening, were abstracted from electronic medical records and dichotomized into either nondense (categories A or B) or dense (categories C or D) status. A sequence analysis of longitudinal changes in density status was performed using Microsoft SQL.

Results

A total of 58 895 patients underwent 231 997 screening mammograms. Most patients maintained the same BI-RADS density category A through D (87.35% [51 444/58 895]) and density status (93.35% [54 978/58 859]) throughout the study period. Among patients whose density status changed, the majority (97% [3800/3917]) had either scattered or heterogeneously dense tissue, and over half (57% [2235/3917]) alternated between dense and nondense status multiple times.

Conclusion

Our results suggest that many cases of density status change may be attributable to intra- and interradiologist variability rather than to true underlying changes in density. These results lend support to consideration of automated density assessment because breast density status changes can significantly impact cancer risk assessment and supplemental screening recommendations.
Post-stack fracture prediction technique based on improved phase decomposition
Authors: Li Hailiang , Pan Hui , Gao Jianhu , Gui Jinyong
Published: September 2024

Amplitude variation with azimuth methods have a huge advantage in predicting small-scale fractures. However, the technique of using post-stack seismic data to predict fractures has rarely been investigated, with the main limiting factor being the degradation of resolution due to the stacking process, which makes it difficult to effectively identify small fractures. With the exploration and development of oil and gas fields entering into deeper levels, the traditional post-stack fracture prediction techniques often fail to meet the requirements of fine development. In this study, we propose a post-stack fracture enhancement technique based on phase decomposition. The technique advances parity phase decomposition based on the matched pursuit algorithm to extract the dominant phases in the seismic record, and the filtering process is carried out by the bidimensional empirical mode decomposition, which in turn computes the improved post-stack coherence and similarity attributes. Applying this method to 3D seismic datasets in the Sichuan region, the results indicate that the approach improves the seismic data quality and enhances the seismic attribute identification of fractures. The phase decomposition-based post-stack fracture enhancement technique shows significant potential in improving the signal quality of multidimensional seismic features such as texture, dip, and likelihood compared to traditional methods. This new technique provides a new way for fracture detection and characterization using post-stack seismic data, which can help to meet the needs of fine oilfield exploration and development.
Global Models, Victim Disconnect and Demands for International Intervention: The Dilemma of Decoloniality and Transitional Justice in Sri Lanka
Authors: Mihlar Farah
Published: September 2024

This article uses Sri Lanka as a case study to impel engagement of decoloniality with transitional justice. It identifies gaps in the literature critical of transitional justice, specifically structural interpretations of power hierarchies, state-centrism and disregard of ethnicity and religion. It thereby uses a decolonial analytical lens on empirical findings from Sri Lanka’s failed transitional justice process to identify and understand continuing colonial power structures, including epistemic coloniality. The empirical findings offer three new insights. First, an ideational, structural and procedural disconnection between victims and the global transitional justice model is noted. The article traces how victim positioning and this disconnection were disregarded in favour of an internationally authoritative, credible and universal model of transitional justice. Second, the ethno-religious challenges to transitional justice, which include its reliance on the state as a neutral provider of justice, are highlighted. The third finding, however, on victim demands for greater international involvement, presents a dilemma to future decolonial consideration of transitional justice. Despite only using decoloniality as an analytical tool, the article nevertheless demonstrates the need for deeper reform, including at the epistemic level, for transformation to occur within the field.
Survey of complex organic molecules in starless and pre-stellar cores in the Perseus molecular cloud
Authors: Scibelli Samantha , Shirley Yancy , Megías Andrés , Jiménez-Serra Izaskun
Published: September 2024

Cold ($\sim$10 K) and dense ($\sim 10^{5}$ cm$^{-3}$) cores of gas and dust within molecular clouds, known as starless and dynamically evolved pre-stellar cores, are the birthplaces of low-mass (M$\le$ few M$_\odot$) stars. As detections of interstellar complex organic molecules, or COMs, in starless cores has increased, abundance comparisons suggest that some COMs might be seeded early in the star formation process and inherited to later stages (i.e. protostellar discs and eventually comets). To date observations of COMs in starless cores have been limited, with most detections reported solely in the Taurus molecular cloud. It is therefore still a question whether different environments affect abundances. We have surveyed 35 starless and pre-stellar cores in the Perseus molecular cloud with the Arizona Radio Observatory (ARO) 12 m telescope detecting both methanol, CH$_3$OH, and acetaldehyde, CH$_3$CHO, in 100 per cent and 49 per cent of the sample, respectively. In the sub-sample of 15 cores where CH$_3$CHO was detected at $\gt 3\sigma$ ($\sim$18 mK) with the ARO 12 m, follow-up observations with the Yebes 40 m telescope were carried out. Detections of formic acid, t-HCOOH, ketene, H$_2$CCO, methyl cyanide, CH$_3$CN, vinyl cyanide, CH$_2$CHCN, methyl formate, HCOOCH$_3$, and dimethyl ether, CH$_3$OCH$_3$, are seen in at least 20 per cent of the cores. We discuss detection statistics, calculate column densities, and compare abundances across various stages of low-mass star formation. Our findings have more than doubled COM detection statistics in cold cores and show COMs are prevalent in the gas before star and planet formation in the Perseus molecular cloud.
The rates and host galaxies of pair-instability supernovae through cosmic time: predictions from BPASS and IllustrisTNG
Authors: Briel Max M , Metha Benjamin , Eldridge Jan J , Moriya Takashi J , Trenti Michele
Published: September 2024

Pair-instability supernovae (PISNe) have long been predicted to be the final fates of near-zero-metallicity very massive stars ($Z \lt Z_\odot /3$, M$_\mathrm{ZAMS} \gtrsim 140\, \text{M}_\odot$). However, no definite PISN has been observed to date, leaving theoretical modelling validation open. To investigate the observability of these explosive transients, we combine detailed stellar evolution models for PISNe formation, computed from the binary population and spectral synthesis code suite, bpass, with the star formation history of all individual computational elements in the Illustris-TNG simulation. This allows us to compute comic PISN rates and predict their host galaxy properties. Of particular importance is that IllustrisTNG galaxies do not have uniform metallicities throughout, with metal-enriched galaxies often harbouring metal-poor pockets of gas where PISN progenitors may form. Accounting for the chemical inhomogeneities within these galaxies, we find that the peak redshift of PISNe formation is $z=3.5$ instead of the value of $z=6$ when ignoring chemical inhomogeneities within galaxies. Furthermore, the rate increases by an order of magnitude from 1.9 to 29 PISN Gpc$^{-3}$ yr$^{-1}$ at $z=0$, if the chemical inhomogeneities are considered. Using state-of-the-art theoretical PISN light curves, we find an observed rate of 13.8 (1.2) visible PISNe per year for the Euclid-Deep survey, or 83 (7.3) over the 6-yr lifetime of the mission when considering chemically inhomogeneous (homogenous) systems. Interestingly, only 12 per cent of helium PISN progenitors are sufficiently massive to power a superluminous supernova event, which can potentially explain why PISN identification in time-domain surveys remains elusive and progress requires dedicated strategies.
Understanding the origin of early-type dwarfs: the spectrophotometric study of CGCG014−074
Authors: Guevara N , Escudero C G , Faifer F R
Published: September 2024

Early-type dwarf galaxies constitute a prevalent population in the central regions of rich groups and clusters in the local Universe. These low-luminosity and low-mass stellar systems play a fundamental role in the assembly of the luminous galaxies observed today, according to the Lambda cold dark matter hierarchical theory. The origin of early-type dwarfs has been linked to the transformation of disc galaxies interacting with the intracluster medium, especially in dense environments. However, the existence of low-luminosity early-type galaxies in low-density environments presents a challenge to this scenario. This study presents a comprehensive photometric and spectroscopic analysis of the early-type dwarf galaxy CGCG014−074 using deep Gemini GMOS (Gemini Multi-Object Spectrograph) data, focusing on its peculiarities and evolutionary implications. CGCG014−074 exhibits distinct features, including a rotating inner disc, an extended stellar formation with a quiescent phase since about 2 Gyr ago, and the presence of boxy isophotes. From the kinematic analysis, we confirm CGCG014−074 as a nucleated early-type dwarf galaxy with embedded disc. The study of its stellar population parameters using different methods provides significant insights into the galaxy’s evolutionary history. These results show an old and metal-poor nucleus (${\sim}9.3$ Gyr and $\mathrm{[Z/H]}\sim -0.84$ dex), while the stellar disc is younger (${\sim}4.4$ Gyr) with a higher metallicity ($\mathrm{[Z/H]}\sim -0.40$ dex). These distinctive features collectively position CGCG014−074 as a likely building block galaxy that has evolved passively throughout its history.
Emission-line galaxies at z ∼ 1 from near-IR HST slitless spectroscopy: metallicities, star formation rates, and redshift confirmations from VLT/FORS2 spectroscopy
Authors: Boyett K , Bunker A J , Chevallard J , Battisti A , Henry A L , Wilkins S , Malkan M A , Caruana J , Atek H , Baronchelli I , Colbert J , Dai Y S , Gardner Jonathan P , Rafelski M , Scarlata C , Teplitz H I , Wang X
Published: September 2024

We follow up emission line galaxies identified through the near-infrared slitless HST/WFC3 WISP survey with VLT/FORS2 optical spectroscopy. Over 4 WISP fields, we targeted 85 of 138 line emission objects at $0.4\lt z\lt 2$ identified in WFC3 spectroscopy. Half the galaxies are fainter than $H_{AB}=24$ mag, and would not have been included in many well-known surveys based on broad-band magnitude selection. We confirm 95 per cent of the initial WFC3 grism redshifts in the 38 cases where we detect lines in FORS2 spectroscopy. However, for targets which exhibited a single emission line in WFC3, up to 65 per cent at $z\lt 1.28$ did not have expected emission lines detected in FORS2 and hence may be spurious (although this false-detection rate improves to 33 per cent using the latest public WISP emission line catalogue). From the Balmer decrement, the extinction of the WISP galaxies is consistent with $A($H $\alpha)=1$ mag. From SED fits to multiband photometry including Spitzer$3.6\, \mu$m, we find a median stellar mass of $\log _{10}(M_\star /{\rm M}_{\odot })=8.94$. Our emission-line-selected galaxies tend to lie above the star-forming main sequence (i.e. higher specific star formation rates). Using [O iii], [O ii], and H β lines to derive gas-phase metallicities, we find typically sub-solar metallicities, decreasing with redshift. Our WISP galaxies lie below the $z=0$ mass–metallicity relation, and galaxies with higher star formation rates tend to have lower metallicity. Finally, we find a strong increase with redshift of the H α rest-frame equivalent width in this emission-line selected sample, with higher $EW_0$ galaxies having larger [O iii]/H β and O32 ratios on average, suggesting lower metallicity or higher ionization parameter in these extreme emission line galaxies.
Ultra-broadband near-field Josephson microwave microscopy
Authors: Zhang Ping , Lyu Yang-Yang , Lv Jingjing , Wei Zihan , Chen Shixian , Wang Chenguang , Du Hongmei , Li Dingding , Wang Zixi , Hou Shoucheng , Su Runfeng , Sun Hancong , Du Yuan , Du Li , Gao Liming , Wang Yong-Lei , Wang Huabing , Wu Peiheng
Published: September 2024

Advanced microwave technologies constitute the foundation of a wide range of modern sciences, including microwave integrated circuits, quantum computing, microwave photonics, spintronics, etc. To facilitate the design of chip-based microwave devices, there is an increasing demand for state-of-the-art microscopic techniques that are capable of characterizing near-field microwave distribution and performance. In this work, we integrate Josephson junctions onto a nanosized quartz tip, forming a highly sensitive microwave mixer on-tip. This allows us to conduct spectroscopic imaging of near-field microwave distributions with high spatial resolution. By leveraging its microwave-sensitive characteristics, our Josephson microscopy achieves a broad detecting bandwidth of ≤200 GHz, as well as remarkable frequency and intensity resolutions. Near-field characterizations of microwave circuits are also conducted to demonstrate the capabilities of Josephson microscopy. Our work emphasizes the benefits of utilizing Josephson microscopy as a real-time, non-destructive technique to advance integrated microwave devices.
Disease-associated microbiome signature species in the gut
Authors: Li Junhui , O’Toole Paul W
Published: September 2024

There is an accumulation of evidence that the human gut microbiota plays a role in maintaining health, and that an altered gut microbiota (sometimes called dysbiosis) associates with risk for many noncommunicable diseases. However, the dynamics of disease-linked bacteria in the gut and other body sites remain unclear. If microbiome alterations prove causative in particular diseases, therapeutic intervention may be possible. Furthermore, microbial signature taxa have been established for the diagnosis of some diseases like colon cancer. We identified 163 disease-enriched and 98 disease-depleted gut microbiome signature taxa at species-level resolution (signature species) from 10 meta-analyses of multiple diseases such as colorectal cancer, ulcerative colitis, Crohn's disease, irritable bowel syndrome, pancreatic cancer, and COVID-19 infection. Eight signature species were enriched and nine were depleted across at least half of the diseases studied. Compared with signature species depleted in diseases, a significantly higher proportion of disease-enriched signature species were identified as extra-intestinal (primarily oral) inhabitants, had been reported in bacteremia cases from the literature, and were aerotolerant anaerobes. These findings highlight the potential involvement of oral microbes, bacteremia isolates, and aerotolerant anaerobes in disease-associated gut microbiome alterations, and they have implications for patient care and disease management.
Effectiveness of probabilistic contact tracing in epidemic containment: The role of superspreaders and transmission path reconstruction
Authors: Muntoni Anna Paola , Mazza Fabio , Braunstein Alfredo , Catania Giovanni , Dall’Asta Luca
Published: September 2024

The recent COVID-19 pandemic underscores the significance of early stage nonpharmacological intervention strategies. The widespread use of masks and the systematic implementation of contact tracing strategies provide a potentially equally effective and socially less impactful alternative to more conventional approaches, such as large-scale mobility restrictions. However, manual contact tracing faces strong limitations in accessing the network of contacts, and the scalability of currently implemented protocols for smartphone-based digital contact tracing becomes impractical during the rapid expansion phases of the outbreaks, due to the surge in exposure notifications and associated tests. A substantial improvement in digital contact tracing can be obtained through the integration of probabilistic techniques for risk assessment that can more effectively guide the allocation of diagnostic tests. In this study, we first quantitatively analyze the diagnostic and social costs associated with these containment measures based on contact tracing, employing three state-of-the-art models of SARS-CoV-2 spreading. Our results suggest that probabilistic techniques allow for more effective mitigation at a lower cost. Secondly, our findings reveal a remarkable efficacy of probabilistic contact-tracing techniques in performing backward and multistep tracing and capturing superspreading events.
The relationship between REM sleep prior to analog trauma and intrusive memories
Authors: Alkalame Lawra , Ogden Jessica , Clark Jacob W , Porcheret Kate , Risbrough Victoria B , Drummond Sean P A
Published: September 2024

Intrusive memories are a common experience following trauma exposure but can develop into a symptom of posttraumatic stress disorder (PTSD). Recent research has observed a relationship between sleep disturbance and intrusive memory frequency following analog trauma exposure and disruptions in rapid eye movement (REM) sleep are found to contribute to emotional dysregulation and an amplified reaction to negative emotional stimuli. The current study examined the association between REM sleep prior to analog trauma and intrusive memories. To manipulate REM sleep, 27 healthy adults (MAge = 25.4, standard deviation = 2.89) were randomized to either a circadian misalignment (CM) condition or normal control (NC) condition for 4 nights. In CM, participants slept normally for 2 nights followed by a 4-hour phase advance on night 3 and an additional 4-hour phase advance on night 4. In NC, participants had 8-hour sleep opportunities each night. On day 5, participants watched a trauma film and kept an intrusive memory diary for the next 3 days. Greater REM sleep percentage (p = .004) and REM efficiency (p = .02) across 4 nights prior to analog trauma, independent of the group, were significantly associated with fewer intrusive memories in the 3 days after viewing the film. Findings suggest REM sleep may serve to protect individuals against experiencing intrusive memories. This is consistent with evidence suggesting REM sleep influences emotional memory regulation. Occupations (e.g. emergency services/military personnel) who experience circadian disruptions likely to decrease REM sleep (e.g. from shift work) may be at heightened risk of experiencing intrusive memories after trauma exposure, and thus at increased risk of developing PTSD.
Identifying implementation barriers and facilitators in an integrated behavioral health training program to improve workforce development
Authors: Callejas Linda M , Scarimbolo Katrina , Chou Chih-Chin , Hammond Kelly , Agazzi Heather
Published: September 2024

Integrated behavioral health (IBH) in pediatric primary care settings can improve access to needed care and outcomes. Behavioral Health Workforce Education and Training (BHWET) programs can better prepare the workforce and support improved care access. This case study identified factors that impede and facilitate the implementation of practice-based training in a BHWET program using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Surveys were administered to BHWET trainees and primary care partners to assess stakeholder perspectives on field-based training processes. Qualitative data were extracted from surveys and trainee clinical logs. Providers reported high levels of satisfaction with IBH care training experiences. Data analysis identified several implementation facilitators and barriers. Implementation facilitators were associated with two EPIS outer context factors (leadership and collaboration) and one inner context factor (partner staffing). Identified barriers were associated with two inner context factors (organizational characteristics and data collection). Although the facilitators and barriers identified in this study were program specific, they have relevance for similar programs. Barriers identified at the organizational level reflect those identified in the research literature and provide insights for university programs regarding factors that must be considered when integrating IBH training components in primary care settings.
Deficiency of geranylgeranyl biphosphate synthase in kidney tubules causes cystic kidney disease
Authors: Shao Xiaoyan , Wang Kai , Wu Jing , Ma Xiaopen , Zhao Yinjuan , Xu Tao , Dai Chunsun , Zhang Furong , Wang Yuqi , Ren Xianguo , Lu Ke , Yin Zicheng , Guo Baosheng , Cao Changchun , Xu Xianlin , Xue Bin
Published: September 2024

Polycystic kidney disease (PKD) is a common hereditary kidney disease. Although PKD occurrence is associated with certain gene mutations, its onset regulatory mechanisms are still not well understood. Here, we first report that the key enzyme geranylgeranyl diphosphate synthase (GGPPS) is specifically expressed in renal tubular epithelial cells of mouse kidneys. We aimed to explore the role of GGPPS in PKD. In this study, we established a Ggppsfl/fl:Cdh16cre mouse model and compared its phenotype with that of wild‐type mice. A Ggpps‐downregulation HK2 cell model was also used to further determine the role of GGPPS. We found that GGPPS was specifically expressed in renal tubular epithelial cells of mouse kidneys. Its expression also increased with age. Low GGPPS expression was observed in human ADPKD tissues. In the Ggppsfl/fl:Cdh16cre mouse model, Ggpps deletion in renal tubular epithelial cells induced the occurrence and development of renal tubule cystic dilation and caused the death of mice after birth due to abnormal renal function. Enhanced proliferation of cyst‐lining epithelial cells was also observed after the knockout of Ggpps. These processes were related to the increased rate of Rheb on membrane/cytoplasm and hyperactivation of mTORC1 signaling. In conclusion, the deficiency of GGPPS in kidney tubules induced the formation of renal cysts. It may play a critical role in PKD pathophysiology. A novel therapeutic strategy could be designed according to this work.
Lycium barbarum polysaccharide increases thermogenesis and energy metabolism through modulation of the gut microbiota to confer resistance to cold temperatures
Authors: Sun Chuanxin , Su Juan , Wang Jiarui , Ding Kan , Chen Chang
Published: September 2024

Traditional Chinese medical literature contains numerous records of many traditional Chinese herbal medicines that exhibit efficacy in enhancing resistance to cold, yet there is a lack of scientific explanation. Lycium barbarum is among the herbal medicines that are explicitly documented to enhance resistance to cold in the “Ben Cao Gang Mu (Compendium of Materia Medica)”. Herein, we investigated L. barbarum polysaccharide (LBP)‐induced browning of inguinal white adipose tissue (iWAT), energy expenditure and thermogenic function in a long‐term (4 months) treatment mouse model. LBP supplementation resulted in a significant reduction in weight and adipocyte size in iWAT, along with increased gut microbiota diversity. Specifically, the levels of Lachnospiraceae, Ruminococcaceae and Bacteroidaceae (short‐chain fatty acid‐producing bacteria) were elevated, leading to a higher level of short‐chain fatty acids (SCFAs) in the caecal content. These effects subsequently triggered the release of glucagon‐like peptide‐1 (GLP‐1) and activated the CREB/PGC1α signaling pathway in iWAT, thereby increasing energy expenditure and enhancing thermogenic function. The antibiotic treatment experiments confirmed that the LBP‐mediated gut microbiota participated in the process of iWAT browning. In summary, our findings provide the first scientific explanation and mechanistic insights into the cold resistance of L. barbarum and identify potentially safe natural product supplements for individuals in alpine areas.
Naloxone Stigma Among People Who Use Drugs: Characteristics and Associations With Stigma Toward Medication for Opioid Use Disorder
Authors: Banks Devin E. , Li Xiao , Park Brandon , Winograd Rachel P. , Cavazos-Rehg Patricia
Published: September 2024

Objectives

Widespread naloxone distribution is key to mitigating opioid-related morbidity, but stigma remains a barrier. Naloxone stigma among providers, emergency responders, and the public is well-documented and associated with treatment and policy preferences, but little is known about naloxone stigma among people who use drugs (PWUD), who may be overdose first responders. This study examines naloxone stigma, its correlates, and its association with stigma toward medication for opioid use disorder (MOUD) among PWUD.

Methods

We recruited 293 individuals with a history of substance misuse from facilities that provide substance use and/or health care services (retained n = 195, 54% women, 75% White). Participants completed self-report measures, including the 5-item Naloxone-Related Risk Compensation Beliefs scale.

Results

One in 5 respondents agreed with beliefs that access to naloxone leads to more opioid use and less treatment seeking and is “enabling.” Those with nonopioid drug misuse, without prior overdose, and with fewer recovery attempts endorsed more naloxone stigma. Opioid misuse, prior overdose, and MOUD utilization were also inversely associated with MOUD stigma. There were no demographic differences in either stigma type. Naloxone stigma was positively associated with MOUD stigma in adjusted models.

Conclusions

This is the first study to quantitatively examine naloxone stigma among PWUD. Findings emphasize the potential role of overdose education and naloxone distribution among those earlier in the substance use disorder course and who use nonopioid drugs. They support integrating MOUD stigma interventions into current overdose education and naloxone distribution targeted at PWUD to increase the acceptance and uptake of both medications.
Surgical Outcomes Following Neoadjuvant Treatment for Locally Advanced and Borderline Resectable Pancreatic Ductal Adenocarcinoma
Authors: Yeung Kai Tai Derek , Kumar Sacheen , Cunningham David , Jiao Long R. , Bhogal Ricky Harminder
Published: September 2024

Objective:

To assess overall survival (OS), compare the effects of neoadjuvant treatment, and describe surgical outcomes for patients undergoing pancreatic resection following chemotherapy and/or chemoradiotherapy (CRT) for borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC).

Background:

We approach BR/LA PDAC using chemotherapy followed by selective CRT to the primary site of disease where either the surgical margin remains radiologically threatened following chemotherapy or as a further downstaging treatment.

Methods:

Retrospective study of patients between December 2005 and June 2023 at the Royal Marsden Hospital, London, United Kingdom.

Results:

A total of 54 patients were included. The OS between R1 and R0 patients was significantly different: 7.5 versus 23 versus 42 versus 51 months for R1 chemo, R1 chemo and CRT, R0 chemo and R0 chemo, and CRT groups, respectively, P < 0.001. Similarly, 9 versus 18 versus 42 versus 41 months for N1 chemo, N1 chemo and CRT, N0 chemo and N0 chemo, and CRT groups, respectively, P = 0.0026. Multivariable Cox regression model demonstrated that perineural invasion (hazard ratio: 2.88, 95% confidence interval: 1.06–7.81; P = 0.038) and perivascular invasion (PVI) (HR: 2.76, 95% CI: 1.24–6.13; P = 0.013) were associated with significantly worse OS. Chemo and CRT conferred OS benefit compared to chemo only (7 vs 23 months, P = 0.004) in PVI-positive patients.

Conclusions:

Neoadjuvant chemotherapy followed by CRT compared to chemotherapy alone for resected BD and LA PDAC was demonstrated to significantly improve median OS, in particular, in patients with R1 resection margins, ypN1 nodal status, and perivascular invasion.
Clinical outcomes of gradual reduction of late-detected developmental dysplasia of the hip using ultrasound-guided flexion abduction continuous traction: a midterm follow up study
Authors: Okuzu Yaichiro , Tsukanaka Masako , Shimozono Fusako , Soen Mitsuru , Miwa Akiko , Kuroda Yutaka , Kawai Toshiyuki , Morita Yugo , Matsuda Shuichi , Futami Tohru
Published: September 2024

Reducing the avascular necrosis (AVN) rate in infants treated for developmental dysplasia of the hip (DDH) is important. We previously reported the clinical outcomes of gradual reduction via ultrasound-guided flexion abduction continuous traction (FACT-R), which achieved a 99% reduction with an AVN rate of 1.0% in infants <12 months. Here, we investigated the clinical outcomes of late-detected DDH after FACT-R. Infants ≥12 months who were treated with FACT-R for DDH from January 1995 to 2007 and followed up for 6 years were enrolled. Treatment comprised continuous traction, a hip-spica cast, and an abduction brace. The rates of reduction, redislocation, AVN, and secondary osteotomy surgery were evaluated. In the study patients (n = 26, hips 30), the mean age at the time of traction therapy was 23 months (range: 13–44) and the mean follow-up was 12.5 years (range: 6–16.4). Female gender and the left side were predominant. The rates of reduction, redislocation, and AVN were 100%, 0%, and 0%, respectively. However, 25 hips (83%) required secondary osteotomy surgery, including Salter innominate osteotomy in 21 hips, Salter innominate osteotomy combined with femoral osteotomy in 3 hips, and triple pelvic osteotomy in 1 hip. They had a larger acetabular index after FACT-R (P = 0.04) and a longer duration of FACT-R (P = 0.05). All hips were successfully reduced, with no redislocation or AVN. However, most hips required a secondary osteotomy surgery because of residual dysplasia. Careful follow-up and informed consent for secondary osteotomy surgery is thus essential.
Does postoperative immobilization affect final alignment of pediatric femur fractures treated with flexible intramedullary nailing?
Authors: Miller Adam Michael , Clement Rutledge Carter , Leonardi Claudia
Published: September 2024

Flexible intramedullary nail (FIN) fixation of pediatric femur fractures is a popular method of fixation in children. Typical immobilization options include spica casting, long leg cast, knee immobilizers, or no immobilization and the decision to use each is usually left to surgeon preference. Our primary aim is to evaluate whether different postoperative immobilization status influences outcomes, namely radiographic alignment at the time of healing. A retrospective chart review was conducted of all patients with femur fractures treated with FIN fixation at a pediatric hospital from April 2018 through July 2022. Postoperative immobilization protocols were recorded and separated into two groups, patients who were immobilized (IMM) and patients who were not immobilized (NoIMM). Radiographs were evaluated for fracture alignment immediately following surgery and at the time of healing. Patients demographic, fracture, and postoperative clinical characteristics were compared between the two groups (NoIMM vs. IMM). A total of 41 patients were treated for diaphyseal femur fractures with FINs at our institution during the study period. No significant difference was observed in alignment at healing. Our results suggest that either immobilization or no immobilization after flexible intramedullary nailing of pediatric femoral shaft fractures are viable options when postoperative immobilization status is left to the surgeon’s discretion.
Epidemiology, diagnosis, and treatment of Takotsubo syndrome: a comprehensive review
Authors: Shou Xinyang , Lyu Lingchun , Wang Yucheng , Cheng Zeyi , Meng Yunchong , Chen Jun , Liu Kan , Liu Qiang
Published: September 2024

Takotsubo syndrome (TTS) is characterized by apical or left ventricular (LV) ballooning and impaired wall motion as its primary features. Although women over 55 years make up the majority of TTS patients, male patients have a greater incidence of in-hospital mortality. TTS also impacts pregnant women and children, with conflicting information regarding racial differences. TTS has an in-hospital mortality rate comparable to that of acute ST-segment elevation myocardial infarction, and higher than that in patients with myocarditis. More than 10% of patients may experience a subsequent acute episode within 5 years after the initial event. TTS exhibits symptoms such as chest pain, electrocardiograph (ECG) abnormalities, elevated B-type natriuretic peptide (BNP), and N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP) levels, and changes in several imaging approaches, which may aid in early diagnosis. Fluid resuscitation, β-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), anti-anxiety or depression drugs, and cardiac rehabilitation may be employed to treat TTS, reduce recurrence rates, and improve functional exercise capacity and exercise time. After searching PubMed, Research Gate, Science Direct, and Web of Science, we summarized recent researches on epidemiology, diagnosis, treatments, and prognosis. These findings provide a theoretical basis for future clinical practice and will aid doctors and researchers investigating the unknown aspects of TTS.
History of infertility and anti-Müllerian hormone levels among participants in the Nurses' Health Study II
Authors: Farland Leslie V. , Degnan William J. , Bertone-Johnson Elizabeth R. , Eliassen A. Heather , Wang Siwen , Gaskins Audrey J. , Chavarro Jorge E. , Rich-Edwards Janet W. , Missmer Stacey A.
Published: September 2024

Objectives

To better understand whether history of infertility is associated with anti-Müllerian hormone (AMH) levels later in life, outside of reproduction.

Methods

Among 1,758 premenopausal women in the Nurses' Health Study II with measured AMH, we used multivariable generalized linear models to compare log-transformed plasma AMH for women with a history of infertility compared with fertile women. We investigated AMH levels by cause of infertility and effect modification by menstrual cycle regularity. Lastly, we investigated AMH levels by history of primary and secondary infertility and age at reported infertility.

Results

Mean age at blood collection was 40 years. We observed no association between overall history of infertility and AMH levels (% difference AMH: −8.1% [CI, −19.4 to 4.8]). The association between overall infertility and AMH was strongest among women who first reported infertility at >30 years (−17.7% [CI, −32.1 to −0.3]).

Conclusions

Overall, we observed no association between the history of infertility and AMH levels later in life. However, specific subgroups of women with a history of infertility may have lower AMH levels throughout life compared with fertile women. This association was observed among subgroups, such as those who first experienced infertility at >30 years. These findings have implications for mechanisms through which infertility may be associated with premature menopause and chronic disease risk.
Vaginal microbiota, menopause, and the use of menopausal hormone therapy: a cross-sectional, pilot study in Chinese women
Authors: Lan Yibing , Jin Bihui , Zhang Yue , Huang Yizhou , Luo Zhou , Su Chang , Li Jingjing , Ma Linjuan , Zhou Jianhong
Published: September 2024

Objective

To compare the vaginal microbiota of premenopausal and postmenopausal women and postmenopausal women undergoing menopausal hormone therapy (MHT) and examine the association between vaginal microbiota and genitourinary syndrome of menopause (GSM).

Methods

This cross-sectional study classified 94 women aged 40 to 60 years into three groups: premenopausal (Pre, n = 32), postmenopausal (Post, n = 30), and postmenopausal women who received MHT orally (Post + MHT, n = 32). Neither the Pre nor the Post group received hormone therapy within the past 6 months. Postmenopausal women who received vaginal MHT were not included. Vaginal swabs were obtained, and microbial composition was characterized by 16S rRNA gene sequencing targeting the V3 to V4 region. Clinical data were collected and serum sex hormones were measured. The most bothersome symptom approach and vaginal health index were used to evaluate GSM. Mann-Whitney U or Kruskal-Wallis ANOVA followed by multiple comparison tests were performed for comparison between or across groups. The correlations between GSM symptom scores and vaginal microbiota were determined using Spearman's correlation analysis.

Results

The vaginal community of postmenopausal women was characterized by a decreased abundance of Lactobacillus (Post 18% vs Pre 69%); an increased abundance of several anaerobic bacteria, including Prevotella, Escherichia-Shigella, and Bifidobacterium; and a higher microbial diversity (P < 0.001 for Shannon and Simpson indexes) than those of premenopausal women. The vaginal community of postmenopausal women who received MHT had an increased abundance of Lactobacillus (54%) and lower microbial diversity (P < 0.001 for Shannon and Simpson indexes) than the postmenopausal women. The vaginal microbial community composition of the Pre group shared more similarity with that of the Post + MHT group (Adonis P = 0.051) than with that of the Post group (Adonis P < 0.001). A decreased abundance of Lactobacillus and high diversity in the vaginal community were found in women with moderate to severe GSM symptoms.

Conclusions

Among Chinese postmenopausal women, those receiving MHT had higher Lactobacillus abundance but lower abundance of diverse anaerobes and diversity of the vaginal microbial community compared to non-MHT women. MHT in postmenopausal women may potentially contribute to reestablishing vaginal microbiota homeostasis. Findings in this pilot study, however, need to be examined in larger, prospective studies.
Effect of Cardiac Rehabilitation on Cardiorespiratory Fitness in Patients With Acute Myocardial Infarction
Authors: Yu Hui-Kung , Chen Chun-Yen , Chen Yu-Chi , Cheng Chu-Han , Chen Chi-Yen , Hu Gwo-Chi
Published: September 2024

Purpose:

Following acute myocardial infarction (AMI), patients with diabetes mellitus (DM) have a poorer prognosis than those without DM. This study aimed to investigate the benefit of cardiac rehabilitation on cardiorespiratory fitness in patients with AMI, examining whether this effect varied depending on DM and glycated hemoglobin (HbA1c) levels.

Methods:

Data were collected from the medical records of 324 patients diagnosed with AMI who were subsequently referred to participate in a supervised exercise-based cardiac rehabilitation program. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing before and at 3 and 6 mo after the start of cardiac rehabilitation. Linear mixed models were used to evaluate changes in cardiorespiratory fitness between patients with and without DM during the follow-up period.

Results:

In total, 106 patients (33%) had DM. Both patients with and without DM showed a significant improvement in cardiorespiratory fitness from baseline to the 6-mo follow-up. However, the improvement was significantly lower in patients with DM than in those without DM (1.9 ± 1.5 vs. 3.7 ± 3.2 mL/kg/min, P < .001). Among patients with DM, those with HbA1c levels < 7% showed a greater improvement in cardiorespiratory fitness than those with HbA1c ≥ 7% (2.7 ± 1.5 vs. 1.1 ± 1.8 mL/kg/min, P < .001) during the follow-up period.

Conclusions:

Improvements in cardiorespiratory fitness following cardiac rehabilitation were significantly lower in patients with AMI and DM. The response to cardiac rehabilitation in patients is influenced by HbA1c levels. These findings suggest potential implications for individualizing cardiac rehabilitation programming and ensuring optimal glycemic control in patients with AMI and DM.
Listening to the Voice of the Patient in RSV Research
Authors: Lee Andrew W. , Thomas Rachael , Chung Bowen , Bont Louis J.
Published: September 2024

Patient and public involvement in research refers to patients or caregivers with disease experience contributing to the design, conduct or dissemination of results from research. Patient and public involvement has given rise to new fields in healthcare-oriented research and has the potential to transform infectious diseases through interventional trials. Our recommendations and best practices from years of organizing respiratory syncytial virus parent networks are provided.
Cat Scratch Disease in Pediatrics: Who Has Systemic Involvement?
Authors: Martínez Lindado Mayra Alejandra , Praino María Laura , Caratozzolo Ana , Toledano Analía , Zambrano Cindy Toala , Tineo María Soledad , Cazes Claudia Inés , Contrini María Marta , López Eduardo Luis
Published: September 2024

Background:

Bartonella henselae is the agent responsible for cat scratch disease (CSD). Although lymphadenopathy is typically the defining symptom, some patients develop potentially severe systemic compromise. It is unknown why some patients progress to systemic disease. The objective of this study was to describe the clinical, epidemiologic and laboratory characteristics of children with CSD and to analyze the differences between systemic versus localized infections.

Methods:

Patients were identified by a retrospective review of medical records at a tertiary pediatric care hospital in Buenos Aires, Argentina, from January 2012 to July 2021. A CSD case was defined as any patient who presented compatible clinical findings with a positive serologic test (IgG >1/64 or IgM immunofluorescence) for B. henselae.

Results:

A total of 197 patients were identified, with a median age of 8 years (range: 1–17.4 years). The most frequent clinical symptoms were fever and lymphadenopathy. Systemic involvement was present in 34.5% (n = 68) of patients and the most common presentation was splenic abscess (n = 51), followed by liver abscess (n = 23), chorioretinitis (n = 9), osteomyelitis (n = 5) and pneumonitis (n = 3). Patients with invasive disease more frequently presented with fever (79.4% vs. 50.3%) (P<0.001) and had higher C-reactive protein levels (24.9 vs. 6.7 mg/L) (P<0.001). Antibiotic therapy was administered to 95.9% (n = 187) of patients and most with systemic disease (77%) used combination treatment. Most patients recovered fully, and there were no reported deaths.

Conclusions:

CSD must be considered a potential cause of lymphadenopathy. Patients with fever and elevated C-reactive protein should be evaluated to rule out systemic compromise.
Clinical Presentations of Parvovirus B19: A Case Series
Authors: Tricella Chiara , Pagliani Costanza , Quatrale Antonia , Poretti Giulia , Caiazzo Roberta , Coppola Crescenzo , Garcia Lorenzo Marc , Valentino Maria Sole , Giacomet Vania
Published: September 2024

Background:

Parvovirus B19 (PVB19) is a small, nonenveloped, single-stranded DNA virus commonly causing asymptomatic infections or mild, flu-like symptoms. In children, PVB19 can lead to various clinical conditions, including erythema infectiosum, arthropathy, transient aplastic crisis and papular-purpuric eruptions, among others.

Methods:

We present 3 pediatric cases treated at Luigi Sacco University Hospital in Milan, Italy, in March 2024, each demonstrating distinct manifestations of PVB19 infection. Case 1 involved a 7-year-old girl with a maculopapular rash and panniculitis-like symptoms. Case 2 described an 8-year-old boy with a maculopapular rash, vasculitis component and mild thrombocytopenia. Case 3 focused on a 7-year-old girl with petechial and purpuric eruptions and a mild decrease in platelets. Serological tests confirmed PVB19 infection in all cases.

Results:

The discussed cases highlight the heterogeneous clinical spectrum of PVB19 infection and emphasize its potential to cause thrombocytopenia even in healthy children. The recent surge in PVB19 cases in Europe, aligned with known epidemiological cycles, underscores the importance of vigilance in diagnosis, particularly during peak seasons. Additionally, concerning the role of serological testing in the diagnostic process, the potential for cross-reactivity among viral antigens is pointed out.

Conclusion:

PVB19 is a common infection with a broad range of clinical presentations. Awareness of its potential complications, including thrombocytopenia, even in nonimmunocompromised children, is crucial. Moreover, understanding the epidemiological patterns of PVB19 can aid in anticipating and managing outbreaks, thus minimizing its impact on pediatric health.