bluuebunny/crossref_metadata_2025 huggingface dataset:
Unraveling molecular and clinical aspects of ALKBH5 as dual role in colorectal cancer
Authors: Memon Furqan , Nadeem Momina , Sulaiman Muhammad , Arain Mudassar Iqbal , Hani Umm-E- , Yuan Shengtao
Published: September 2024

Objectives

This study investigates the dual role of ALKBH5, an eraser enzyme, in colorectal cancer (CRC), focusing on how N6-methyladenosine (m6A) mutations influence CRC development and progression.

Methods

We reviewed various studies that highlighted the role of ALKBH5 in colorectal cancer (CRC). This includes the impact of ALKBH5 on tumor cell behavior including immune system interactions, invasion, and proliferation in CRC. We also looked into how ALKBH5 acts as a tumor suppressor under different conditions analyzed clinical data to assess the impact of ALKBH5 expression on outcomes in colorectal cancer patients.

Key findings

In CRC, ALKBH5 plays a dual role. In certain situations, it inhibits the progression of the tumor, but in other circumstances, it promotes tumor growth and immunosuppression. The interaction with RABA5 plays a role in the development of CRC. Having elevated levels of ALKBH5 has been associated with unfavorable patient outcomes, such as reduced survival rates and more advanced cancer stages. Various factors, including tumor differentiation, TNM stages, and carcinoembryonic antigen (CEA) levels, be linked to ALKBH5 expression.

Conclusions

ALKBH5 plays a complicated and situation-specific role in colorectal cancer (CRC). Targeting ALKBH5 could result in novel therapy options that balance its tumor-promoting and tumor-fighting properties in CRC. Further research into m6A alterations and ALKBH5 could enhance CRC treatment approaches and patient outcomes.
Trisomy 18
Authors: Clark Robin D. , Curry Cynthia J.
Published: September 2024

This chapter reviews the incidence, etiology, and chromosomal nature of trisomy 18 syndrome. Prenatal findings on US include the almost universal findings of significant structural abnormalities. The utility of cell free DNA in prenatal diagnosis isare reviewed. The importance of a coordinated birth plan for these infants and families is emphasized and the parents desires should be considered. The key clinical findings seen at birth are enumerated. The prognosis for trisomy 18 survival is low with a uniform expectation of severe intellectual disability. Nonetheless, the recent availability of palliative cardiac surgery for infants surviving the neonatal period may be considered on an individual basis.
Trisomy 13
Authors: Clark Robin D. , Curry Cynthia J.
Published: September 2024

This chapter reviews the incidence, etiology, and chromosomal nature of Trisomy 13. Prenatal findings on US and the utility of cfcell free DNA for diagnosis and management of Trisomy 13 is discussed. The differential diagnosis for Trisomy 13 is not extensive and the diagnosis is usually possible on a clinical basis after assessment of the characteristic dysmorphic findings in this condition. The prognosis for trisomy 13 is poor for life and mental development. However some infants without major anomalies can be discharged to home care or hospice. A multidisciplinary care team with full involvement of the family is indicated for infants surviving the neonatal period.
Chromosome 5p Deletion Syndrome
Authors: Clark Robin D. , Curry Cynthia J.
Published: September 2024

This chapter reviews the incidence, etiology, and chromosomal etiology of cri du chat syndrome or chromosome 5p minus syndrome. Most of the time this deletion is de novo but about 10-15% of cases are inherited from a carrier parent. Chromosomal analysis or FISH for 5p are indicated in both parents. The cry is the most striking finding in infancy and persists until about age one. Associated medical problems include are feeding problems, respiratory illnesses and failure to thrive. Children with this deletion do learn to walk and most eventually talk. They are affectionate but ~50% have hyperactivity. Lifespan in those without major anomalies is near normal.
Beckwith–Wiedemann Syndrome
Authors: Clark Robin D. , Curry Cynthia J.
Published: September 2024

This chapter reviews background information about the incidence genetics, family history, recurrence risk and etiology of Beckwith–Wiedemann syndrome, an overgrowth and cancer predisposition disorder. The molecular subtypes of Beckwith-Wiedemann syndrome, all of which involve 2 imprinted gene clusters of chromosome 11p15.5, are listed. The relationship between Beckwith-Wiedemann syndrome, ART and hypomethylation of maternal alleles on 11p15.5, are described. The clinical presentation during infancy is described including characteristic features: polyhydramnios, large size, macroglossia, ear creases, hypoglycemia, macrosomia, abdominal wall defect. The differential diagnosis includes overgrowth syndromes and syndromes that feature omphalocele. Testing recommendations for diagnosis and tumor surveillance are also reviewed.
Fetal Alcohol Spectrum Disorder
Authors: Clark Robin D. , Curry Cynthia J.
Published: September 2024

This chapter reviews background information about the incidence etiology, the effects of dose and timing of exposure, and the range of phenotypic traits associated with fetal alcohol spectrum disorder. High risk groups for in utero alcohol exposure, common co-morbidities (inadequate prenatal care, malnutrition) and high prevalence regions are summarized. The synergistic effects of maternal alcohol use and smoking are discussed. The clinical presentation during infancy includes small size for gestational age, short palpebral fissures, smooth philtrum, thin upper lip, hypotonia, poor suck, shrill cry and malformations of CNS, cardiac, musculoskeletal and renal systems. The differential diagnosis, including chromosome anomalies, other teratogenic exposures, monogenic syndromes is presented. Later manifestations of fetal alcohol spectrum disorder are reviewed to facilitate family counseling. Recommendations for testing, evaluation, and management are provided.
Incontinentia Pigmenti
Authors: Clark Robin D. , Curry Cynthia J.
Published: September 2024

This chapter reviews the incidence, etiology, and genetic cause chromosomal nature of incontinenti pigmenti syndrome. This is a multisystem disorder primarily affecting females. These females have skewed X inactivation. The skin changes evolve through 4 phases; blistering, verruous changes, swirling hyper and hypopigmentation along the lines of Blaschko, and later hypochromic streaks on the backs of carrier females’ legs. Other ectodermal systems are involved including the hair, teeth and nails. Seizures, eye problems, and intellectual disability are variably present. Molecular testing can confirm the diagnosis by demonstrating pathogenic variants in IKBKG in most families. Genetic assessment is helpful in estimating recurrence risks and suggesting appropriate surveillance.
Prader–Willi Syndrome
Authors: Clark Robin D. , Curry Cynthia J.
Published: September 2024

This chapter reviews background information about the incidence and etiology of Prader–Willi syndrome, a congenital hypotonia syndrome caused by lack of expression of genes from the paternally derived chromosome 15q11.2. The clinical presentation during infancy includes hypotonia, poor feeding and hypogenitalism. The facial features are subtly dysmorphic with bitemporal narrowing and almond shaped eyes. The benefits of early treatment with growth hormone are reviewed. Later findings (hyperphagia, obesity) are included to facilitate family counseling. Details regarding the molecular diagnosis and testing recommendations are provided. Thedifferential diagnosis, which includes chromosome anomalies and other hypotonia syndromes, is reviewed. Recommendations for evaluation, and management are provided.
Painting Rocks with Polarized Light
Authors: Cesare Bernardo
Published: September 2024

Exploring the intersection between science and art — Sciart — inevitably involves microscopy because of its intrinsic ability to reveal microscopic hidden worlds not normally accessible to the public. Aesthetic microscopy, mainly performed in the biosciences using optical and electron devices, has more recently included the world of rocks and minerals as viewed with polarized light microscopy. In this contribution, all images are only from quartz to demonstrate the project micROCKScopica, where thin slices of rocks are “painted” with polarized light. The results resemble abstract or impressionist works of art. Who would have imagined?
G4LDB 3.0: a database for discovering and studying G-quadruplex and i-motif ligands
Authors: Yang Qian-Fan , Wang Xu-Rui , Wang Yu-Huan , Wu Xing-Hong , Shi Run-Yu , Wang Yan-Xi , Zhu Hao-Ning , Yang Shu , Tang Ya-Lin , Li Feng
Published: September 2024

Non-canonical nucleic acid structures, such as G-quadruplex (G4) and i-Motif (iM), have garnered significant research interest because of their unique structural properties and biological activities. Thousands of small molecules targeting G4/iM structures have been developed for various chemical and biological applications. In response to the growing interest in G4-targeting ligands, we launched the first G4 Ligand Database (G4LDB) in 2013. Here, we introduce G4LDB 3.0 (http://www.g4ldb.com), an upgraded version featuring extensive enhancements in content and functionality. The new version includes over 4800 G4/iM ligands and approximately 51 000 activity entries. Key upgrades include advanced search capabilities, dynamic knowledge graphs, enhanced data visualization, along with a new dynamic analysis function that automatically displays ligand structure clustering results and chemical space distribution. With these updates, G4LDB 3.0 further evolves into a comprehensive resource and valuable research tool. The significant improvements address the increasing demand for efficient data handling and user experience, highlighting the critical role of G4LDB in advancing research on G-quadruplexes and i-motifs.
The Pediatric Physiatric Posterior Fossa Symptoms scale: Impairments and outcome in pediatric inpatient rehabilitation for posterior fossa brain tumors
Authors: Wu Jennifer , Wishart Brian D , Cohen Stephanie E , Orme Patricia , Quinn Susan S , Nimec Donna
Published: September 2024

Background

Clinical recognition of the postoperative neurologic sequelae of posterior fossa tumors is inconsistent. This study aimed to characterize functional impairments and recovery trajectories in pediatric patients admitted to inpatient rehabilitation following surgical resection of posterior fossa brain tumors. This study also introduces the Pediatric Physiatric Posterior Fossa Symptom scale (3PFSs) for serial assessment of postoperative symptoms in pediatric posterior fossa brain tumors.

Methods

This retrospective cohort study included 49 patients aged 1.1 to 19.9 years admitted to a pediatric unit of a free-standing rehabilitation hospital following resection of a posterior fossa brain tumor. Functional Independence Measure for Children (WeeFIM) and 3PFSs scores at admission and discharge were the primary outcome measures.

Results

Across the group, WeeFIM score improved from 51.5 ± 23.5 points at admission to 74.2 ± 28.2 points at discharge (t = 4.34, P < .001). The 3PFSs score also showed improvement from 10 [Interquartile range (IQR) = 9–12] points at admission to 8 [7–10] points at discharge (t = 9.3, P < .0001). While change in both the WeeFIM and 3PFSs captured statistically significant improvement in function, there was low interrating correlation (P > .7). In addition, mortality was correlated with a higher discharge 3PFSs score (P = .007) but not discharge WeeFIM score.

Conclusions

In pediatric patients with postoperative neurologic sequelae due to posterior fossa brain tumors, inpatient rehabilitation resulted in global and domain-specific functional improvements. This initial application of the 3PFSs demonstrates potential applicability for stratifying patients to appropriate levels of rehabilitation, capturing functionally relevant response to rehabilitation treatment, and prognosticating long-term outcomes. These initial results are promising but require additional validation in a larger cohort.
Infectious Diseases Fellowship Training in Caring for People Who Use Drugs: A National Assessment of an Emerging Training Need
Authors: Vasishta Shilpa , Jawa Raagini , Kurz Sarah , Nolan Nathanial S
Published: September 2024

Background

Infectious complications of substance use are increasingly encountered in infectious diseases (ID) clinical care. In this study, we surveyed ID fellows in the United States to assess training experiences, clinical practices, and perspectives in caring for people who use drugs (PWUD).

Methods

An 18-item survey was distributed to ID fellows via email and social media platforms. Four focus groups were conducted with a subset of participants to elucidate themes in fellowship experiences and training needs.

Results

Among 196 survey respondents (estimated 24% response rate), all reported caring for PWUD in ID fellowship. Forty-nine percent received some formal fellowship-based didactics around care of PWUD, and 64% worked with faculty seen as advocates for PWUD. Integrated care practices for PWUD were infrequently employed: 50% offered risk reduction counseling, and 33% discussed medications for opioid use disorders, naloxone, or HIV preexposure prophylaxis. Risk reduction counseling was felt to be “extremely” within scope of ID practice (69%), although comfort level with this skill was low; fellows’ likelihood of offering counseling was significantly associated with their comfort (P ≤ .0001). Common themes in caring for PWUD included an expanded role for ID consultants, a lack of formalized training, and benefits of developing dedicated opportunities in this field.

Conclusions

ID fellows frequently care for PWUD but may have gaps in knowledge or comfort that affect care practices. Increased fellowship training in the care of PWUD has potential to improve clinical practices and support growing interest in this field among current and prospective ID fellows.
Engineering a conserved immune coreceptor into a primed state enhances fungal resistance in crops without growth penalty
Authors: Li Chong , Gong Ben-Qiang , Luo Shuyi , Wang Tong , Long Ruhui , Jiang Xianya , Deng Yi Zhen , Li Jian-Feng
Published: September 2024

Plants must tactically balance immunity and growth when combating lethal pathogens like fungi. CHITIN ELICITOR RECEPTOR KINASE 1 (CERK1), a conserved cell-surface co-receptor for the fungal elicitor chitin, enables plants to induce chitin-triggered immunity to counteract fungal invasion. Previously, we reported that bacterial infection can prime CERK1 through juxtamembrane (JM) phosphorylation to enhance fungal resistance, which only occurs in Arabidopsis (Arabidopsis thaliana) and its close relatives in Brassicaceae. Here, we aim to transfer the priming mechanism of Arabidopsis CERK1 (AtCERK1) to crop CERK1 via JM substitution. We revealed in protoplasts that the entire AtCERK1 JM variable region (AtJM) is essential for imparting the bacterial elicitor flg22-induced primed state to the Nicotiana benthamiana CERK1 (NbCERK1). The NbCERK1 chimera containing AtJM (NbCERK1AtJM) and similarly constructed rice (Oryza sativa) OsCERK1AtJM could undergo flg22-induced JM phosphorylation and confer enhanced antifungal immunity upon bacterial coinfection. Moreover, the NbCERK1AtJM+3D derivative with AtJM phosphomimetic mutations to mimic a constant primed state and similarly constructed OsCERK1AtJM+3D were sufficient to mediate strengthened chitin responses and fungal resistance in transgenic plants independent of bacterial infection. Importantly, no growth and reproduction defects were observed in these plants. Taken together, this study demonstrates that manipulating the primed state of a cell-surface immune receptor offers an effective approach to improve disease resistance in crops without compromising growth and yield and showcases how fundamental insights in plant biology can be translated into crop breeding applications.
The multiple dimensions of resilience in agricultural trade networks
Authors: Jafari Yaghoob , Engemann Helena , Zimmermann Andrea
Published: September 2024

The global food and agricultural trade network is crucial for food security. Shocks such as those posed by extreme weather events, conflicts, pandemics, and economic crises can test the resilience of the trade network to the sudden interruption of trade flows. Depending on the level of connectivity in the trade network and its structure, such shocks have the potential to propagate through the entire network and can affect countries’ food availability and variety. This paper contributes to the literature on food and agricultural trade networks in two main ways: (1) understanding the global trade network as a complex system that can be affected by and responds to shocks, we define and operationalize its resilience as a multidimensional concept, which is shaped by the interdependencies in the network and their structure; and (2) applying techniques from network analysis to examine the evolution of three dimensions of resilience within the global food and agricultural trade network between 1995 and 2019. The main findings show that, between 1995 and 2007, trade connectivity among countries increased. Overall, this bolstered countries’ and the network's resilience to trade shocks. However, vulnerabilities persisted in terms of ensuring sufficient product variety and quantity. Adding to these vulnerabilities, trade integration stalled in the second half of the series, pointing to a slight tendency towards trade disintegration and potentially lower resilience of countries to trade shocks already in 2019.
VEXAS syndrome as a mimicker of ANCA-associated vasculitis
Authors: Murillo-Chavez Franco , Antiochos Brendan
Published: September 2024

Objectives

Differentiating VEXAS syndrome from cases of canonical forms of primary vasculitis remains a significant clinical challenge, particularly for ANCA-associated vasculitis (AAV). We reviewed the clinical features of VEXAS as an AAV mimicker, while adding three new cases to the existing literature.

Methods

We identified three cases of VEXAS with an AAV phenotype in our institution. We performed a comprehensive literature search of available similar cases and summarized and compared the findings. Inclusion criterion was a positive UBA1 mutation analysis.

Results

Patient 1 was referred for evaluation of eosinophilic granulomatosis with polyangiitis (GPA), but had no active respiratory symptoms, despite CT imaging showing widespread ground-glass opacities. Patient 2 had no history of sinus disease, despite being referred under the diagnostic construct of limited GPA. Patient 3 developed a novel inflammatory syndrome suspected to represent GPA. Six other cases were identified upon literature review. In all the cases, the most common findings were pulmonary infiltrates (67%), skin involvement (55%) and ocular manifestations (44%). Additionally, 44% of cases had renal involvement, with half of them displaying kidney lesions resembling the typical AAV pattern.

Conclusion

VEXAS can mimic different phenotypes of AAV and should be considered in atypical AAV presentations, especially when refractory to multiple treatments. Further studies are needed to explore the immunologic basis for an AAV phenotype within the spectrum of VEXAS.
The effects of heat and hydrogen peroxide treatment on the osteoinductivity of demineralized cortical bone: a potential method for preparing tendon/ligament repair scaffolds
Authors: He Shukun , Hu Ruonan , Yao Xuan , Cui Jing , Liu Huimin , Zhu Min , Ning Liangju
Published: September 2024

Recent studies have indicated that demineralized cortical bone (DCB) may be used to repair tendons and ligaments, such as the patellar tendon and anterior cruciate ligament (ACL). Hydrogen peroxide (H2O2) has been shown to reduce the osteoinductivity of DCB, and heat treatment may also decrease the osteoinductivity of DCB. The purpose of this study was (i) to determine whether heat treatment reduces the osteoinductivity of DCB and (ii) to compare the effectiveness of heat treatment and H2O2 treatment on BMP-2 inactivation. DCB was prepared by immersion in 0.6 N hydrochloric acid, and DCB-H and DCB-HO were prepared by heat treatment (70°C for 8 h) and H2O2 treatment (3% H2O2 for 8 h), respectively. The surface topographies, elemental distributions and histological structures of the scaffolds were observed by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR) and histological staining. The viability and osteogenic differentiation of TDSCs cultured on the scaffolds were evaluated via live/dead cell staining and Cell Counting Kit-8 (CCK-8) testing, real-time polymerase chain reaction (RT-PCR) and western bolt (WB) analysis, alkaline phosphatase activity (ALP) and alizarin red S (ARS) staining. The intramuscular implantation of the scaffolds in rats was also used to evaluate the effect of heat treatment and H2O2 treatment on the osteoinductivity of DCB. Our results demonstrated that both treatments removed BMP-2 and osteocalcin (OCN) within the DCB and that DCB-H and DCB-HO had good cytocompatibility and reduced the osteogenic differentiation of TDSCs. Moreover, the in vivo results indicated that the DCB-H and DCB-HO groups had smaller areas of osteoid formation than did the DCB group, and the DCB-HO group had the smallest area among the three groups. Our study demonstrated that heat treatment could reduce the osteoinductivity of DCB, and that H2O2 treatment was more effective than heat treatment.
Sleep state-dependent development of resting-state functional connectivity during the preterm period
Authors: Shiraki Anna , Kidokoro Hiroyuki , Watanabe Hama , Taga Gentaro , Ushida Takafumi , Narita Hajime , Mitsumatsu Takamasa , Kumai Sumire , Suzui Ryosuke , Sawamura Fumi , Ito Yuji , Yamamoto Hiroyuki , Nakata Tomohiko , Sato Yoshiaki , Hayakawa Masahiro , Takahashi Yoshiyuki , Natsume Jun
Published: September 2024

Study Objectives

The brains of preterm infants exhibit altered functional connectivity (FC) networks, but the potential variation in sleep states and the impact of breathing patterns on FC networks are unclear. This study explores the evolution of resting-state FC from preterm to term, focusing on breathing patterns and distinguishing between active sleep (AS) and quiet sleep (QS).

Methods

We recruited 63 preterm infants and 44 healthy-term infants and performed simultaneous electroencephalography and functional near-infrared spectroscopy. FC was calculated using oxy- and deoxyhemoglobin signals across eight channels. First, FC was compared between periodic breathing (PB) and non-PB segments. Then sleep state-dependent FC development was explored. FC was compared between AS and QS segments and between preterm infants at term and term-born infants in each sleep state. Finally, associations between FC at term, clinical characteristics, and neurodevelopmental outcomes in late infancy were assessed in preterm infants.

Results

In total, 148 records from preterm infants and 44 from term-born infants were analyzed. PB inflated FC values. After excluding PB segments, FC was found to be elevated during AS compared to QS, particularly in connections involving occipital regions. Preterm infants had significantly higher FC in both sleep states compared to term-born infants. Furthermore, stronger FC in specific connections during AS at term was associated with unfavorable neurodevelopment in preterm infants.

Conclusions

Sleep states play a critical role in FC development and preterm infants show observable changes in FC.
Identification of Fungal Species Associated with Gall Oak (Quercus infectoria) Decline in Iran
Authors: Ghobadi Armin , Jamali Samad
Published: September 2024

The gall oak (Quercus infectoria Oliv.) tree is one of the most important and valuable forestry species in the Northern Zagros forests in the west of Iran. Gall oak decline is considered to be one of the most important diseases currently affecting the Zagros oak forests in Iran. The main objective of the present study, conducted in the years 2021 to 2023, was to investigate the possible role of fungi as causative agents of gall oak dieback in the Zagros forests of Iran. Wood samples were taken from gall oak trees showing canker, dieback, and internal wood discoloration symptoms. Fungal isolates recovered from gall oak trees were identified based on cultural and morphological characteristics, as well as phylogenetic analyses using DNA sequencing of the internal transcribed spacer region of rDNA and partial beta-tubulin. Achaetomium aegilopis, Alternaria tenuissima, Apiospora intestini, Botrytis cinerea, Coniochaeta sp., Coniothyrium palmarum, Coniothyrium sp., Cytospora rhodophila, Dialonectria episphaeria, Diatrype sp., Diatrypella macrospora, Endoconidioma populi, Fonsecazyma sp., Fusarium ipomoeae, Jattaea discreta, Kalmusia variispora, Microsphaeropsis olivacea, Neoscytalidium dimidiatum, Paecilomyces lecythidis, Paramicrosphaeropsis eriobotryae, Paramicrosphaeropsis ellipsoidea, and Seimatosporium pezizoides were identified from diseased trees. Pathogenicity tests were performed by artificial inoculation of excised branches of healthy gall oak trees under controlled conditions and evaluated after 35 days by measuring the discolored lesion length at the inoculation site. N. dimidiatum was the most virulent species and caused the longest wood necrosis within 35 days of inoculation. In the greenhouse test, only some species induced typical symptoms of canker. All isolated fungi are reported for the first time on gall oak trees in the world.
Horizontal Transmission of the Rice Bacterial Pathogen Pantoea ananatis Among Plants by Rice Planthoppers
Authors: He Zi-Hao , Wang Ying-Xia , Jin Zhi , Niu Yue-Di , Song Cong-Feng , Hong Xiao-Yue , Bing Xiao-Li
Published: September 2024

Pantoea ananatis is a bacterium commonly found in various agronomic crops and agricultural pests. In this study, we present findings on a genome-reduced strain of P. ananatis, known as Lstr, which was initially isolated from Laodelphax striatellus (small brown rice planthopper [SBPH]). We identified Lstr as a plant pathogen causing disease in rice using Koch’s postulates. The pathogenicity of Lstr on rice is comparable to that of Xanthomonas oryzae pv. oryzae, the main causative agent of rice bacterial blight. Through a series of experiments involving live insects, molecular investigations, and microscopy, we find that Lstr can accumulate within SBPH. Subsequently, Lstr can be transmitted from SBPH to rice plants, resulting in leaf blight, and can also be transmitted to other SBPH individuals. Collectively, our results suggest that SBPH serves as a vector for P. ananatis Lstr in rice plants. P. ananatis may encounter susceptible insect populations and become endemic through horizontal transmission from these insects. This could also be valuable for predicting future occurrences of bacterial leaf blight in rice and other crops caused by P. ananatis.
Integrated Management of Sclerotinia Stem Rot of Soybean Including Organically Allowed Fungicides in the Midwest United States
Authors: Debbink Kelly , da Silva Camila Rocco , Silva Erin M. , Mueller Brian D. , Telenko Darcy E. P. , Smith Damon L.
Published: September 2024

Sclerotinia stem rot (SSR) is an economically important disease of soybean, especially in the Great Lakes region of the United States. Few studies on SSR have considered organic management practices and how integrated management techniques best apply in these systems. Trials in Wisconsin and Indiana aimed to evaluate management techniques available to organic farmers for their efficacy in SSR control while preserving yield. The practices evaluated included genetically resistant cultivars, tillage techniques, and the application of Organic Materials Review Institute (OMRI)-listed foliar fungicides. The resistant cultivar had significantly lower SSR than the susceptible cultivar in three site-years ( P < 0.01). The resistant cultivar also had significantly greater yield than the susceptible cultivar in two site-years ( P < 0.05). Using a roller-crimped rye cover crop resulted in mixed results on SSR and yield. No effect on SSR or yield by OMRI-listed foliar fungicides was observed ( P > 0.05). Overall, the results emphasize the importance of planting a resistant soybean cultivar to manage SSR in organic farming systems in the Midwestern United States.

[Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Lessons Learned From State-Based Efforts to Leverage Medicaid Funds for Graduate Medical Education
Authors: Fraher Erin P. , Rains Jacob A. , Bacon Thomas J. , Spero Julie , Hawes Emily
Published: September 2024

Purpose

Total Medicaid funds invested in graduate medical education (GME) increased from $3.78 billion in 2009 to $7.39 billion in 2022. States have flexibility in designing Medicaid GME payments to address population health needs. This study assessed states’ impetus for using Medicaid funds for GME, structure of state Medicaid payments, composition and charge of advisory bodies that guide these investments, and degree of transparency and accountability to track whether Medicaid GME investments achieved desired workforce outcomes.

Method

Structured interviews were conducted in 2015 to 2016 and 2020 to 2021 with subject matter experts representing 10 states. Interview transcripts were analyzed and coded in 6 thematic areas: impetus for using Medicaid funds, the structure of state Medicaid payments, the composition of advisory bodies, the degree of transparency of Medicaid investments, accountability of Medicaid investments, and challenges.

Results

States used Medicaid GME funding to address maldistribution of physicians by geography, setting, and specialty; respond to population growth and undergraduate medical education expansion; offset potential loss of teaching health center program funds; and launch new programs and sustain existing ones. States leveraged Medicaid funding by modifying state plan amendments and redesigning funding formulas to meet specific health workforce needs. Many states had advisory bodies to educate legislators, reach consensus on workforce needs, recommend how to disburse funds, and navigate competing stakeholder interests. States identified a need for improved data and analytic systems to understand workforce needs and monitor the outcomes of GME investments. Determining which accountability measures to use and implementing metrics were challenges.

Conclusions

States have much to learn from each other about strategies to best leverage Medicaid funds to develop and sustain residency programs to meet population health needs. Learning collaboratives should be developed to provide a forum for states to share best practices and strategies for overcoming challenges.
Addressing Low Scholarly Output in Residency With a Resident-Led Society for Innovation and Research
Authors: Raymond Caitlin , Gosnell Joseph , Zahner Christopher
Published: September 2024

Problem

Research in residency develops skills essential for the practice of medicine with many benefits for residents, residency programs, the community of medicine, and patients. However, resident participation in research and innovation remains limited, with barriers that are difficult to address without significant overhead or changes to curriculum.

Approach

In September 2021, the Society for Innovation and Research (SIR), a resident-led organization dedicated to promoting and supporting resident achievement in research and innovation, was founded. Using only 1 hour of protected didactic time a month, SIR workshops provide critical mentoring and feedback to make resident research a success, with education on various topics of interest to residents. In addition, SIR celebrates and publicizes resident research success and lays the groundwork for interested residents to participate in innovation.

Outcomes

The authors assessed for any increase in resident research productivity by analyzing PubMed-indexed publications for 11 semesters from fall 2018 to fall 2023. After the launch of SIR, the mean (SD) total number of publications increased from 5.3 (2.4) to 13.3 (1.6) (P = .01), the total mean (SD) number of residents publishing increased from 3.7 (1.3) to 10.0 (1.2) (P = .009), and the mean (SD) total number of coauthored articles increased from 0.1 (0.3) to 2.8 (1.3) (P = .007).

Next Steps

The skill set acquired from participation in research during residency is more critical than ever in the wake of the COVID-19 pandemic. SIR initiatives are generalizable to most residency programs in most specialties and require little overhead in terms of physical space, digital resources, and staffing. The authors are currently exploring expanding the SIR program to other residencies at U.S. institutions and have set up processes for the mantle of SIR leadership to be passed down among the pathology resident body.
The Association of Master Adaptive Learning With Less Burnout and More Resilience in Obstetrics and Gynecology Residents
Authors: Santen Sally A. , Ginzburg Samara B. , Pusic Martin V. , Richardson Judee , Banks Erika , George Karen E. , Hammoud Maya M. , Wolff Meg , Morgan Helen K.
Published: September 2024

Purpose

Medical education should prepare learners for complex and evolving work, and should ideally include the Master Adaptive Learner (MAL) model—meta-learning skills for continuous self-regulated learning. This study aimed to measure obstetrics and gynecology (OB/GYN) residents’ MAL attributes, assess associations with burnout and resilience, and explore learning task associations with MAL.

Method

OB/GYN residents were surveyed electronically at an in-training examination in January 2022. The survey included demographic information, the 2-item Maslach Burnout Inventory, the 2-item Connor–Davidson Resilience Scale, 4 MAL items (e.g., “I take every opportunity to learn new things”), and questions about training and learning experiences.

Results

Of 5,761 residents, 3,741 respondents (65%) were included. A total of 1,478 of 3,386 (39%) demonstrated burnout (responded positive for burnout on emotional exhaustion or depersonalization items). The mean (SD) Connor–Davidson Resilience Scale score was 6.4 (1.2) of a total possible score of 8. The mean (SD) MAL score was 16.3 (2.8) of a total possible score of 20. The MAL score was inversely associated with burnout, with lower MAL scores for residents with (mean [SD] MAL score, 16.5 [2.4]) vs without (mean [SD], 16.0 [2.3]) burnout (P < .001). Higher MAL scores were associated with higher resilience (R = 0.29, P < .001). Higher MAL scores were associated with the statement “I feel that I was well prepared for my first year of residency” (R = 0.19, P < .001) and a plan to complete subspecialty training after residency (mean [SD] of 16.6 [2.4] for “yes” and 16.2 [2.4] for “no,” P < .001).

Conclusions

Residents who scored higher on MAL showed more resilience and less burnout. Whether less resilient, burned-out residents did not have the agency to achieve MAL status or whether MAL behaviors filled the resiliency reservoir and protected against burnout is not clear.
Impact of Surveillance Imaging in Patients With HPV-Associated Oropharyngeal Carcinoma Treated With Definitive Radiation and Chemotherapy
Authors: Shang Trisha , Raab Gabriel , Chen Linda , Yu Yao , Shamseddine Achraff , Riaz Nadeem , McBride Sean M. , Gelblum Daphna , Morris Luc GT , Lee Nancy Y. , Zakeri Kaveh
Published: September 2024

Objectives:

Surveillance imaging for HPV-associated oropharyngeal carcinomas (OPCs) differs among physicians and institutions. Surveillance imaging can detect disease progression earlier, but can also contribute to anxiety and cost, without proven survival benefits. We sought to determine practice patterns of surveillance imaging and the number of surveillance scans needed to detect one recurrence in patients with HPV-associated OPCs.

Methods:

We performed a retrospective cohort study between 2017 and 2019 (median follow-up: 39.9 mo) of consecutive patients with locally advanced HPV-associated OPC who received definitive concurrent chemoradiotherapy (CRT) with 70 Gy at a single institution. Patients were followed post-CRT and their surveillance scans were recorded. Recurrences were classified as detected by first post-treatment scans, surveillance scans, clinical exams, or incidental findings. The number of surveillance scans needed to detect 1 recurrence was determined by dividing the number of surveillance scans by the number of recurrences detected by surveillance scans.

Results:

Among 276 patients with a median follow-up of 39.9 months, there were 28 recurrences. Of all recurrences, 11 (39.3%) were detected by the first post-treatment scan, 11 (39.3%) by surveillance scan, 5 (17.9%) by clinical exam, and 1 (3.6%) was incidentally found. A total of 694 surveillance scans were taken. The number of surveillance scans needed to detect 1 recurrence was 64 overall, 45 within 2 years, and 248 beyond 2 years from treatment.

Conclusions:

First post-treatment scans and surveillance scans detected more recurrences than clinical exams. A high burden of surveillance scans is needed to detect 1 recurrence, especially beyond 2 years from treatment.
The role of myeloperoxidase as a biomarker in atherosclerotic cardiovascular disease
Authors: Amirfakhryan Hamideh , New Karl James
Published: September 2024

Myeloperoxidase (MPO), a heme-containing protein integral to the innate immune system, plays a pivotal role in both bactericidal activity and inflammation regulation. In this comprehensive review, we aim to delve into the extensive literature on MPO’s involvement in cardiovascular disease. Through exhaustive searches of reputable databases such as PubMed, Scopus, and Web of Science, we conducted a thorough analysis to elucidate MPO’s potential as a predictor for cardiovascular disease risk. Evidence suggests that MPO serves as a valuable biomarker, particularly in identifying vulnerable lesions predisposed to rupture,leading to myocardial infarction, especially in the context of acute coronary syndrome. Its early release in response to symptom onset positions MPO as a promising tool for triaging chest pain patients in emergency departments, offering advantages over conventional markers like cardiac troponins. Moreover, studies have demonstrated a correlation between elevated MPO levels and higher mortality rates in patients with acute coronary syndrome, both in short- and long-term follow-up. However, the widespread adoption of MPO as a routine clinical biomarker faces significant challenges. Standardizing measurement techniques and determining the optimal timing of assessments are crucial for ensuring reliability and comparability across studies. Furthermore, while MPO shows promise as a complement to existing risk stratification protocols, questions remain regarding its superiority over troponins and its utility in stable coronary artery disease. Addressing these issues necessitates large-scale prospective cohort studies to clarify MPO’s comparative effectiveness alongside conventional biomarkers. Despite these challenges, MPO emerges as a potentially valuable addition to risk assessment strategies, particularly for patients with persistently negative troponin levels, helping guide therapeutic interventions and enhancing clinical decision-making in cardiovascular medicine.
Review of voice biomarkers in the screening of neurodegenerative diseases
Authors: Chen Siye , Li Linghan , Han Shuyu , Luo Wei , Wang Wenxia , Yang Yufan , Wang Xiaomeng , Zhang Wenmin , Chen Mo , Wang Zhiwen
Published: September 2024

Neurodegenerative diseases significantly impact patients and their families, making early identification crucial for improving patients’ quality of life and reducing care burdens. Current screening methods for neurodegenerative diseases, such as dementia and mild cognitive impairment, still rely on subjective assessments or expensive techniques like invasive cerebrospinal fluid analysis and magnetic resonance imaging. These factors make early identification challenging. Voice biomarkers present a promising alternative as convenient, noninvasive, and low-cost screening tools. With the application and development of artificial intelligence and big data, the prediction and screening of neurodegenerative diseases based on voice data have become a research focus. This article reviews the progress in voice biomarkers for neurodegenerative disease screening and classification. It summarizes relevant studies on both single and multimodal data, identifies existing challenges, and suggests future research directions to enhance the application of voice biomarkers in neurodegenerative disease contexts.
Altered serum transferrin levels are associated with pressure injury and its stages: A case-control study
Authors: Shan Hui , Guo Jinglin , Si Ruijuan , Wang Xiaoying , Zhang Ju
Published: September 2024

Background:

Despite the measures taken to the traditional risk factors for pressure injury (PI), there is still a great residual risk. Therefore, on the basis of managing traditional risk factors, it is necessary to find and interpret interventionable factors for predicting and treating PI.

Objective:

To investigate the relationship between serum transferrin level and the severity of PI.

Methods:

PI patients from The Affiliated Hospital of Qingdao University between July 2020 and June 2021 were selected as the case group, which was further divided into stage 1 (30 patients), stage 2 (59 patients), stage 3 (64 patients), and stage 4 (43 patients) according to PI stage. The control group consisted of 196 bedridden patients of similar age who did not have a PI and were matched to the cases by sex and age. This study evaluated the serum transferrin level between the case and control groups.

Results:

The serum transferrin levels were statistically significant between the control and case groups (P<0.001). The serum transferrin level of PI patients with stages 3 and 4 was significantly lower than that of patients with stages 1 and 2 (P<0.05). After adjusting for covariates, serum transferrin remained negatively associated with PI occurrence (B=−0.045, adjusted OR=0.956, P<0.001) and stage (B=−2.266, adjusted OR=0.104, P<0.001).

Conclusions:

The serum transferrin level was decreased with the progression of PI. This study suggests that serum transferrin can serve as positive evidence for treating PI patients.
The Test and Protect Program: A Data-Driven, Community-Engaged Approach to COVID-19 Testing Site Localization
Authors: Beck Andrew F. , Mattingly Tiffany , Brokamp Cole , Sahay Rashmi , Manning Erika R. , Taylor Stuart , Kuhnell Pierce , Kegley Brian , Trabue Kiana , Margolis Peter A. , Kahn Robert S. , Hartley David M.
Published: September 2024

As the COVID-19 pandemic progressed, reliable, accessible, and equitable community-based testing strategies were sought that did not flood already overburdened hospitals and emergency departments. In Hamilton County, Ohio, home to ~800 000 people across urban, suburban, and rural areas, we sought to develop and optimize an accessible, equitable county-wide COVID-19 testing program. Using Coronavirus Aid, Relief, and Economic Security Act funding, multidisciplinary, multiorganization partners created the test and protect program to deliver safe, reliable testing in neighborhoods and organizations needing it most. Our approach involved: (1) use of geospatial analytics to identify testing locations positioned to optimize access; (2) community engagement to ensure sites were in trusted places; and (3) tracking of data over time to facilitate ongoing improvement. Between August 2020 and December 2021, more than 65 000 tests were completed for nearly 46 000 individuals at community-based testing sites. These methods could have application beyond COVID-19 and our region.
Index-Linked Assisted HIV Self-Testing for Children 2–14 Years: Results of a Pilot Evaluation in Ethiopia
Authors: Gutema Yoseph , Lulseged Sileshi , Getachew Mirtie , Getahun Meklit , Melaku Zenebe , Tilahun Michael , Shimelis Mesfin , Temesgen Chanie , Asres Tsegaye , Dereje Adinew , Assefa Alemu , Tewoldebirhan Esayas , Teferi Wondimu , Mekonnen Alemayehu , Fayorsey Ruby , Zerbe Allison , Gunn Jayleen , Medley Amy , Gross Jessica , Hrapcak Susan , Abrams Elaine J.
Published: September 2024

Background:

Case identification remains a challenge to reaching the United Nations 95-95-95 targets for children with HIV. Although the World Health Organization approved oral mucosal HIV self-testing (HIVST) for children older than 2 years in 2019, there is little information on HIVST for pediatric case identification in Ethiopia.

Setting:

Nine health facilities across Ethiopia.

Methods:

We implemented a pilot program from November 2021 to April 2022 to assess acceptability and feasibility of using HIVST to screen children 2–14 years of adult index clients, (ie, parents/caregivers living with HIV and on antiretroviral therapy). HIV-positive adults who had children with unknown HIV status were given HIVST kits (OraQuick) to screen their children at home. Parents/caregivers were asked to report results telephonically and bring children screening positive to the health facility for confirmatory HIV testing. We defined HIVST acceptability as ≥50% of parents/caregivers accepting testing and ≥50% reporting results within 7 days of receiving a test kit. Feasibility was defined as ≥60% of children with a reactive HIVST receiving confirmatory testing and <5 serious social harms reported per 1000 kits distributed.

Results:

Overall, 1496 of 1651 (91%) parents/caregivers accepted HIVST kits to test their children at home and 1204 (71%) reported results within 7 days. Of 17 children (1%) with reactive results, 13 (76%) received confirmatory testing; of which 7 (54%) were confirmed to be HIV positive. One serious social harm was reported.

Conclusions:

Providing adult parents/caregivers with HIVST kits to screen their children at home is an acceptable and feasible strategy to reach untested children and improve pediatric case finding in a low prevalence setting.
Posterior Cranial Vault Distractor Osteogenesis for the Treatment of Chiari Malformation Type 1: A Systematic Review of the Literature
Authors: Cobb William , Pan Rachel , Zhu Jianbin , Swanson Marco , Baumgartner James , Lopez Joseph
Published: September 2024

Background:

Although posterior cranial vault distraction osteogenesis (PVDO) is utilized routinely now for the treatment of craniosynostosis, its use as a treatment option for Chiari type 1 malformation (CM1) is limited to case reports and small retrospective case series.

Methods:

The authors conducted a systematic review of the published literature for PVDO as a treatment for CM1. The primary outcomes were reported complications, symptom improvement, and reoperation rates in patients that had PVDO surgery for CM1. The authors further investigated differences between patients with CM1 with an associated genetic syndrome and craniosynostosis.

Results:

In total, 42 patients with an average age of 41.1 months were used in our analysis. A total of 38.1% of the patients had a diagnosed syndrome, 78.6% of patients had associated craniosynostosis, and 26/42 (61.9%) total patients-reported symptom improvement. Of 26 patients that reported symptom improvement, 20 (76.9%) had associated syndromes and 6 (23.1%) did not (P=0.011). In addition, of these 26 symptom improved patients, 17 (65.4%) were associated with craniosynostosis while 9 (36.4%) did not have craniosynostosis (P=0.008)

Conclusions:

Posterior cranial vault distraction osteogenesis seems to be a promising new surgical intervention for treatment of CM1. Most patients saw symptom improvement after treatment (61.9%). There was a clinically and statistically significant difference in symptom improvement for patients with syndromic CM1 when compared with nonsyndromic CM1 patients.