bluuebunny/crossref_metadata_2025 huggingface dataset:
Elephants in the farm – changing temporal and seasonal patterns of human-elephant interactions in a forest-agriculture matrix in the Western Ghats, India
Authors: Anoop N. R. , Krishnan Siddhartha , Ganesh T.
Published: May 2023

Accelerating levels of human-elephant conflicts (HEC) have become a topic of major concern in conservation efforts of endangered Asian elephants (Elephas maximus) throughout their range. Wayanad plateau (WP) is a key summer habitat of Asian elephants in the Brahmagri-Nilgiri Eastern Ghats elephant landscape (Nilgiris), harbouring the largest breeding population in Asia. With the increase in human population density and consequent forest loss, HEC amplified in frequency and intensity in Wayanad. We assessed the drivers of HEC in a temporal and spatial context by integrating questionnaire surveys, compensation claims for crop loss, and individual identification of crop-raiding elephants. The ordinal regression analysis showed that season and proximity to the forest boundary were the major drivers of conflict. The pattern of conflict is spatially heterogeneous, and there is peak crop depredation during the jackfruit and mango season (MayS-September), followed by paddy season (September-December). The conflict has resulted in the removal of jackfruit and mango trees from farmlands and stopped cultivation of several crops that attract elephants. This has impacted rural food supply, economic well-being, local biodiversity, and human-elephant coexistence. We discuss effective and locally appropriate conflict mitigation and management strategies which can apply in human-dominated landscapes.
3D-bioprinting of patient-derived cardiac tissue models for studying congenital heart disease
Authors: Wolfe Jayne T. , He Wei , Kim Min-Su , Liang Huan-Ling , Shradhanjali Akankshya , Jurkiewicz Hilda , Freudinger Bonnie P. , Greene Andrew S. , LaDisa John F. , Tayebi Lobat , Mitchell Michael E. , Tomita-Mitchell Aoy , Tefft Brandon J.
Published: May 2023

Introduction

Congenital heart disease is the leading cause of death related to birth defects and affects 1 out of every 100 live births. Induced pluripotent stem cell technology has allowed for patient-derived cardiomyocytes to be studied in vitro. An approach to bioengineer these cells into a physiologically accurate cardiac tissue model is needed in order to study the disease and evaluate potential treatment strategies.

Methods

To accomplish this, we have developed a protocol to 3D-bioprint cardiac tissue constructs comprised of patient-derived cardiomyocytes within a hydrogel bioink based on laminin-521.

Results

Cardiomyocytes remained viable and demonstrated appropriate phenotype and function including spontaneous contraction. Contraction remained consistent during 30 days of culture based on displacement measurements. Furthermore, tissue constructs demonstrated progressive maturation based on sarcomere structure and gene expression analysis. Gene expression analysis also revealed enhanced maturation in 3D constructs compared to 2D cell culture.

Discussion

This combination of patient-derived cardiomyocytes and 3D-bioprinting represents a promising platform for studying congenital heart disease and evaluating individualized treatment strategies.
Low extracellular vesicle concentrations predict survival in patients with heart failure
Authors: Schöler David , Loosen Sven H. , Wirtz Theresa H. , Brozat Jonathan F. , dos Santos Ferreira Grani Lauredana A. , Luedde Tom , Heinrichs Lisa , Frank Derk , Koch Alexander , Roderburg Christoph , Spehlmann Martina E.
Published: May 2023

Background

Heart disease is of worldwide importance due to high morbidity and mortality. Extracellular vesicle (EV) concentration and size represent novel diagnostic and prognostic biomarkers, e.g. in patients with liver cancer, but data on their prognostic relevance in heart disease are lacking. Here, we investigated the role of EV concentration, size and zeta potential in patients with heart disease.

Methods

Vesicle size distribution, concentration and zeta potential were measured by nanoparticle tracking analysis (NTA) in 28 intensive care unit (ICU) and 20 standard care (SC) patients and 20 healthy controls.

Results

Patients with any disease had a lower zeta potential compared to the healthy controls. Vesicle size (X50) was significantly higher in ICU patients (245 nm) with heart disease as compared to those patients with heart disease receiving standard care (195 nm), or healthy controls (215 nm) (p = 0.001). Notably, EV concentration was lower in ICU patients with heart disease (4.68 × 1010 particles/ml) compared to SC patients with heart disease (7,62 × 1010 particles/ml) and healthy controls (1.50 × 1011 particles/ml) (p = 0.002). Extracellular vesicle concentration is prognostic for overall survival in patients with heart disease. Overall survival is significantly reduced when the vesicle concentration is below 5.55 × 1010 particles/ml. Median overall survival was only 140 days in patients with vesicle concentrations below 5.55 × 1010 particles/ml compared to 211 days in patients with vesicle concentrations above 5.55 × 1010 particles/ml (p = 0.032).

Concentration of EVs is a novel prognostic marker in ICU and SC patients with heart disease.
The implication of chromosomal abnormalities in the surgical outcomes of Chinese pediatric patients with congenital heart disease
Authors: Yu Xiafeng , Tao Yu , Liu Xu , Yu Feng , Jiang Chuan , Xiao Yingying , Zhang Haibo , He Yongrui , Ye Lincai , Wang Ying , Zhou Chunxia , Wang Jian , Jiang Zhengwen , Hong Haifa
Published: May 2023

Background

Copy number variations (CNVs) have been shown to be overrepresented in children with congenital heart disease (CHD). Genetic evaluation of CHD is currently underperformed in China. We sought to determine the occurrence of CNVs in CNV regions with disease-causing potential among a large cohort of Chinese pediatric CHD patients and investigate whether these CNVs could be the important critical modifiers of surgical intervention.

Methods

CNVs screenings were performed in 1,762 Chinese children who underwent at least one cardiac surgery. CNV status at over 200 CNV locus with disease-causing potential was analyzed with a high-throughput ligation-dependent probe amplification (HLPA) assay.

Results

We found 378 out of 1,762 samples (21.45%) to have at least one CNV and 2.38% of them were carrying multiple CNVs. The detection rates of ppCNVs (pathogenic and likely pathogenic CNVs) were 9.19% (162/1,762), significantly higher than that of the healthy Han Chinese individuals from The Database of Genomic Variants archive (9.19% vs. 3.63%; P = 0.0012). CHD cases with ppCNVs had a significantly higher proportion of complex surgeries compared to CHD patients with no ppCNVs (62.35% vs. 37.63%, P < 0.001). Duration of cardiopulmonary bypass and aortic cross clamp procedures were significantly longer in CHD cases with ppCNVs (all P < 0.05), while no group differences were identified for complications of surgery and one-month mortality after surgery. The detection rate of ppCNVs in the atrioventricular septal defect (AVSD) subgroup was significantly higher than that in other subgroups (23.10% vs. 9.70%, P = 0.002).

Conclusions

CNV burden is an important contributor to Chinese children with CHD. Our study demonstrated the robustness and diagnostic efficiency of HLPA method in the genetic screening of CNVs in CHD patients.
Quantity and location of aortic valve calcification predicts paravalvular leakage after transcatheter aortic valve replacement: a systematic review and meta-analysis
Authors: Shi Jiale , Li Wei , Zhang Tangshan , Han Chengwen , Wang Zhengjun , Pei Xinhao , Li Xuetao , Zhao Zidong , Wang Pengbo , Han Jingying , Chen Shiqiao
Published: May 2023

Introduction

Transcatheter aortic valve replacement (TAVR) is the first-line treatment for patients with moderate-to-high surgical risk of severe aortic stenosis. Paravalvular leakage (PVL) is a serious complication of TAVR, and aortic valve calcification contributes to the occurrence of PVL. This study aimed to investigate the effect of location and quantity of calcification in the aortic valve complex (AVC) and left ventricular outflow tract (LVOT) on PVL after TAVR.

Method

We performed a systematic review and meta-analysis to evaluate the effect of quantity and location of aortic valve calcification on PVL after TAVR using observational studies from PubMed and EMBASE databases from inception to February 16, 2022.

Results

Twenty-four observational studies with 6,846 patients were included in the analysis. A high quantity of calcium was observed in 29.6% of the patients; they showed a higher risk of significant PVL. There was heterogeneity between studies (I2 = 15%). In the subgroup analysis, PVL after TAVR was associated with the quantity of aortic valve calcification, especially those located in the LVOT, valve leaflets, and the device landing zone. A high quantity of calcium was associated with PVL, regardless of expandable types or MDCT thresholds used. However, for valves with sealing skirt, the amount of calcium has no significant effect on the incidence of PVL.

Conclusion

Our study elucidated the effect of aortic valve calcification on PVL and showed that the quantity and location of aortic valve calcification can help predict PVL. Furthermore, our results provide a reference for the selection of MDCT thresholds before TAVR. We also showed that balloon-expandable valves may not be effective in patients with high calcification, and valves with sealing skirts instead of those without sealing skirts should be applied more to prevent PVL from happening.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=354630, identifier: CRD42022354630.
Identifying analogues for data-limited volcanoes using hierarchical clustering and expert knowledge: a case study of Melimoyu (Chile)
Authors: Burgos Vanesa , Jenkins Susanna F. , Bono Troncoso Laura , Perales Moya Constanza Valeria , Bebbington Mark , Newhall Chris , Amigo Alvaro , Prada Alonso Jesús , Taisne Benoit
Published: May 2023

Determining the eruption frequency-Magnitude (f-M) relationship for data-limited volcanoes is challenging since it requires a comprehensive eruption record of the past eruptive activity. This is the case for Melimoyu, a long-dormant and data-limited volcano in the Southern Volcanic Zone (SVZ) in Chile with only two confirmed Holocene eruptions (VEI 5). To supplement the eruption records, we identified analogue volcanoes for Melimoyu (i.e., volcanoes that behave similarly and are identified through shared characteristics) using a quantitative and objective approach. Firstly, we compiled a global database containing 181 variables describing the eruptive history, tectonic setting, rock composition, and morphology of 1,428 volcanoes. This database was filtered primarily based on data availability into an input dataset comprising 37 numerical variables for 438 subduction zone volcanoes. Then, we applied Agglomerative Nesting, a bottom-up hierarchical clustering algorithm on three datasets derived from the input dataset: 1) raw data, 2) output from a Principal Component Analysis, and 3) weighted data tuned to minimise the dispersion in the absolute probability per VEI. Lastly, we identified the best set of analogues by analysing the dispersion in the absolute probability per VEI and applying a set of criteria deemed important by the local geological service, SERNAGEOMIN, and VB. Our analysis shows that the raw data generate a low dispersion and the highest number of analogues (n = 20). More than half of these analogues are in the SVZ, suggesting that the tectonic setting plays a key role in the clustering analysis. The eruption f-M relationship modelled from the analogue’s eruption data shows that if Melimoyu has an eruption, there is a 49% probability (50th percentile) of it being VEI≥4. Meanwhile, the annual absolute probability of a VEI≤1, VEI 2, VEI 3, VEI 4, and VEI≥5 eruption at Melimoyu is 4.82 × 10−4, 1.2 × 10−3, 1.45 × 10−4, 9.77 × 10−4, and 8.3 × 10−4 (50th percentile), respectively. Our work shows the importance of using numerical variables to capture the variability across volcanoes and combining quantitative approaches with expert knowledge to assess the suitability of potential analogues. Additionally, this approach allows identifying groups of analogues and can be easily applied to other cases using numerical variables from the global database. Future work will use the analogues to populate an event tree and define eruption source parameters for modelling volcanic hazards at Melimoyu.
Computational simulation of the ore-forming processes associated with the Sanshandao-Haiyu gold belt, Jiaodong Peninsula, eastern China: implications for the duration of ore formation
Authors: Shan Wenfa , Mao Xiancheng , Liu Zhankun , Deng Hao , Tang Lei , Wang Dutao , Pan Yong , Liu Yao
Published: May 2023

The Sanshandao-Haiyu gold belt, Jiaodong Peninsula, Eastern China accounts for more than 1,400 t gold resources, which is always recognized as a coupled result of structural deformation, pore-fluid flow, and hydrothermal alteration-mineralization processes. However, the ore-forming processes associated with this gold belt has not been fully understood by the coupled perspective. In this paper, we use computational modeling to study the spatial distribution of dilation (positive volumetric strain) and the mineralization rate, which can predict the mineralization patterns from a chemical perspective, so as to solve the fully coupled problem during ore-forming processes. The model was loaded on the FLAC3D platform to test four scenarios: 1) Syn-compression in the NW-SE direction; 2) syn-compression in the WNW-ESE direction; 3) syn-compression in the NNW-SSE direction, and 4) syn-extension in the NW-SE direction. The simulation results show that only the syn-compressional scenario can produce wide dilation zones with a distribution pattern similar to the known orebodies. The higher dilation zones with the volumetric strain (>0.1%) and the highest pore-fluid flux are closely associated with the fault geometry, particularly for the gentle segments near the steep-flat transition areas. Besides, the dilation zones also occur with very high absolute values of pore-fluid pressure gradient and temperature gradient, indicating significantly perturbed physical-chemical conditions. The receiver operating characteristic (ROC) curves of the mineralization rate show that the area under the curve (AUC = 0.862) of the NW-SE syn-compression model is the highest among these four scenarios, indicating a major paleo compression stress direction of NW-SE during ore-forming period. Furthermore, based on the mineralization rate, we estimated that the mineralization duration of the Sanshandao-Haiyu gold belt would be less than 100,000 years. These simulation results can not only enhance our understanding of the ore-forming processes in the Sanshandao-Haiyu gold belt and Jiaodong Peninsula but also demonstrate that these can be used directly or indirectly for deep mineral exploration.
Association of size for gestational age and dehydroepiandrosterone sulfate with cardiometabolic risk in central precocious puberty girls
Authors: Zhang Guijiao , Yu Huan , Yu Shengxu , Luo Xiaoping , Liang Yan , Hou Ling , Wu Wei
Published: May 2023

Objective

The aim of this study was to assess whether size for gestational age and dehydroepiandrosterone sulfate (DHEAS) are associated with cardiometabolic risk in central precocious puberty (CPP) girls.

Methods

The retrospective study included 443 patients with newly diagnosed CPP. Subjects were categorized by birth weight for gestational age (appropriate [AGA], small [SGA], and large [LGA] for gestational age) and serum DHEAS concentration (high [≥75th percentile] and normal [<75th percentile] DHEAS). Cardiometabolic parameters were examined. Composite cardiometabolic risk (CMR) score was calculated based on BMI, blood pressure, glucose, insulin, triglyceride, and HDL cholesterol. Non-obesity CMR score was computed, omitting the value from BMI. Logistic regression models, general linear models, and partial correlation analyses were used to evaluate associations. Propensity score matching was performed for sensitivity analyses.

Results

Overall, 309 patients (69.8%) were born AGA, 80 (18.1%) were born SGA, and 54 (12.2%) were born LGA. Compared with AGA counterparts, CPP girls born SGA were more prone to have elevated HbA1c (adjusted OR = 4.54; 95% CI, 1.43–14.42) and low HDL cholesterol (adjusted OR = 2.33; 95% CI, 1.18–4.61). In contrast, being born LGA was not associated with increased risk for any glucose or lipid derangements. Despite the fact that elevated CMR score was more common among individuals born LGA than AGA (adjusted OR = 1.84; 95% CI, 1.07–4.35), no significant difference was found on non-obesity CMR score (adjusted OR = 0.75; 95% CI, 0.30–1.88). When controlling for age, birth weight SDS, and current BMI-SDS, individuals with high DHEAS exhibited higher HDL cholesterol and apolipoprotein A-1 concentrations and lower triglyceride level and non-obesity CMR score. Furthermore, DHEAS correlated positively with HDL cholesterol and apolipoprotein A-1 and negatively with triglyceride, prominently in girls born SGA, after adjustments for the three abovementioned confounders. Sensitivity analyses corroborated the findings.

Conclusion

Among CPP girls, those born SGA were more likely to possess cardiometabolic risk factors compared to their AGA peers. The difference we observed in cardiometabolic risk between individuals born LGA and AGA was driven by BMI. High DHEAS was associated with favorable lipid profile in CPP girls, even in subjects born SGA.
Physical activity in infancy and early childhood: a narrative review of interventions for prevention of obesity and associated health outcomes
Authors: Eichner-Seitz Natalie , Pate Russell R. , Paul Ian M.
Published: May 2023

In the context of the childhood obesity epidemic, this narrative review aims to explore opportunities to promote physical activity (PA) between birth and age 5 years as well as the health outcomes associated with PA in early childhood. Although early childhood is an ideal time to promote healthy habits, guidelines for PA have often ignored early childhood given the limited evidence for children <5 years old. Herein we discuss and highlight infant, toddler and preschool age interventions to promote PA and prevent obesity both in the short and long-term. We describe novel and modified interventions to promote improved early childhood health outcomes, encompassing cardiorespiratory, muscle, and bone strengthening components necessary for short-term motor development and long-term health. We call for new research aimed at developing and testing innovative early childhood interventions that may be performed in home or childcare settings, monitored by parents or caregivers.
Efficacy of combination therapy with GABA, a DPP-4i and a PPI as an adjunct to insulin therapy in patients with type 1 diabetes
Authors: Rabinovitch Alexander , Koshelev Daniil , Lagunas-Rangel Francisco Alejandro , Kosheleva Liudmila , Gavra Tali , Schiöth Helgi B. , Levit Shmuel
Published: May 2023

Introduction

The purpose of this retrospective clinic chart review study was to determine the potential of a combination therapy (CT) consisting of γ-aminobutyric acid (GABA), a dipeptidyl peptidase-4 inhibitor (DPP-4i), and a proton pump inhibitor (PPI) to improve glycemic control as an adjunct to insulin therapy in patients with type 1 diabetes (T1D).

Research design and methods

Nineteen patients with T1D on insulin therapy were treated with additional CT in oral form. Fasting blood glucose (FBG), HbA1c, insulin dose-adjusted HbA1c (IDA-A1c), daily insulin dose, insulin/weight ratio (IWR), and fasting plasma C-peptide were measured after 26-42 weeks of treatments.

Results

FBG, HbA1c, IDA-A1c, insulin dose and IWR were all significantly decreased while plasma C-peptide was significantly increased by the CT. Treatment outcomes were further analyzed by separation of the 19 patients into two groups. One group started on the CT within 12 months of insulin treatment (early therapy, 10 patients) and another group started on this therapy only after 12 months of insulin treatment (late therapy, 9 patients). FBG, IDA-A1c, insulin dose, and IWR decreased significantly in both the early and late CT groups, however to a better extent in the early therapy group. Moreover, plasma C-peptide increased significantly only in the early therapy group, and 7 of the 10 patients in this group were able to discontinue insulin treatment while maintaining good glycemic control to study end compared with none of the 9 patients in the late therapy group.

Conclusion

These results support the concept that the combination of GABA, a DPP-4i and a PPI as an adjunct to insulin therapy improves glycemic control in patients with T1D, and that the insulin dose required for glycemic control can be reduced or even eliminated in some patients receiving this novel therapy.
An MMC based HVDC system with optimized AC fault ride-through capability and enhanced circulating current suppression control
Authors: Badar Jahangeer , Akhtar Faheem , Kumar Dileep , Munir Hafiz Mudassir , Ali Khawaja Haider , Alsaif Faisal , Alsulamy Sager
Published: May 2023

Modular multilevel converter (MMC) is a proven technology for HVDC applications due to its salient features such as modularity and excellent power quality. To ensure best possible grid support, recent grid codes require incorporating fault ride-through (FRT) strategies so that HVDC converter stations remain connected and maintain reliable operation under various symmetrical and asymmetrical AC faults. In this paper, a communication-free enhanced fault ride-through technique without the need of DC chopper has been proposed. The proposed FRT strategy ensures quick post fault recovery operation and can effectively manage DC link and capacitor voltages within safe limits. Along with proposed FRT strategy, in order to avoid high circulating current (CC) inside an MMC, this paper has proposed an optimal circulating current control approach based on proportional resonant and PI controllers in an abc reference frame. The suggested technique lowers the ripple in capacitor voltages while reducing the magnitude of the CC. Under both balanced and unbalanced ac grid conditions, the ripple in the dc link voltage is also reduced without the use of dual synchronous reference frame or any additional controllers. Simulation results confirm the effectiveness of the proposed FRT and CC suppression techniques for a 580-kV, 850-MW MMC-based HVDC system.
Elevated road segment (ERS) passage design may provide enhanced connectivity for amphibians, reptiles, and small mammals
Authors: Brehme Cheryl S. , Barnes Stephanie , Ewing Brittany , Gould Philip , Vaughan Cassie , Hobbs Michael , Tornaci Charles , Holm Sarah , Sheldon Hanna , Fiutak Jon , Fisher Robert N.
Published: May 2023

Introduction

Designs for safe and effective road crossing structures for small animals are typically under-road microtunnels and culverts which have varying levels of effectiveness reported in the scientific literature. Many species, particularly migratory amphibians, may have limited ability to find and use passages if they are too far apart, resulting in substantial barrier effects.

Methods

We designed a novel open elevated passage (elevated road segment: ERS), similar to a low terrestrial bridge, that could theoretically be built to any length based upon species needs and movement characteristics. A 30 m length prototype ERS was installed along a forest road with a history of amphibian road mortality in Sierra National Forest, Fresno County, CA, USA. From 2018 to 2021, we monitored small animal activity under the ERS in relation to surrounding roadside and forest habitats using active infrared cameras.

Results

We documented a total of 8,815 unique use events, using species specific independence criteria, across 22 species of amphibians (3), reptiles (4), and small mammals (15). Poisson regression modeling of taxonomic group activity under the ERS, roadside and forest, showed that amphibian activity was highest in the forest habitat, no differences were observed for reptiles, and small mammal activity was highest under the ERS. However, mean activity estimates under the ERS were equal to or greater than the open roadside habitat for all 22 species, suggesting that adding cover objects, such as downed logs and vegetation may further enhance passage use.

Discussion

Overall, results showed that the design of the ERS crossing has potential to provide high connectivity for a wide range of amphibian, reptile, and small mammal species while reducing road mortality. ERS systems can also be used in areas with challenging terrain and other hydrological and environmental constraints. Incorporating current road ecology science, we provide supplemental ERS concept designs for secondary roads, primary roads and highways to help increase the options available for road mitigation planning for small animals.
Mapping spatial and temporal distribution information of plantations in Guangxi from 2000 to 2020
Authors: Zhou Quan , Wang Li , Tang Feng , Zhao Siyan , Huang Ni , Zheng Kaiyuan
Published: May 2023

Plantations are formed entirely by artificial planting which are different from natural forests. The rapid expansion of plantation forestry has brought about a series of ecological and environmental problems. Timely and accurate information on the distribution of plantation resources and continuous monitoring of the dynamic changes in plantations are of great significance. However, plantations have similar spectral and texture characteristics with natural forests. In addition, cloud and rain greatly affected the image quality of large area mapping. Here, we tested the possibility of applying Continuous Change Detection and Classification to distinguish plantations from natural forests and described the spatiotemporal dynamic changes of plantations. We adopted the Continuous Change Detection and Classification algorithm and used all available Landsat images from 2000 to 2020 to map annual plantation forest distribution in Guangxi Zhuang Autonomous Region, China and analyzed their spatial and temporal dynamic changes. The overall accuracy of the plantation extraction is 88.77%. Plantations in Guangxi increased significantly in the past 20 years, from 2.37 × 106 ha to 5.11 × 106 ha. Guangxi is expanding new plantation land every year, with the largest expansion area in 2009 of about 2.58 × 105 ha. Over the past 20 years, plantations in Guangxi have clearly shown a tendency to expand from the southeast to the northwest, transformed from natural forests and farmland. 30% of plantations have experienced at least one logging-and-replanting rotation event. Logging rotation events more intensively occur in areas with dense plantation forests. Our study proves that using fitting coefficients from Continuous Change Detection and Classification algorithm is effective to extract plantations and mitigating the adverse effects of clouds and rain on optical images in a large scale, which provides a fast and effective method for long-time and large-area plantation identification and spatiotemporal distribution information extraction, and strong data support and decision reference for plantation investigation, monitoring and management.
Self-monitoring of blood glucose levels among pregnant individuals with gestational diabetes: a systematic review and meta-analysis
Authors: Yeh Ping Teresa , Kennedy Caitlin Elizabeth , Rhee Dong Keun , Zera Chloe , Tunçalp Özge , Lucido Briana , Gomez Ponce de Leon Rodolfo , Narasimhan Manjulaa
Published: May 2023

Introduction

The World Health Organization (WHO) recommends treatment and management of gestational diabetes (GD) through lifestyle changes, including diet and exercise, and self-monitoring blood glucose (SMBG) to inform timely treatment decisions. To expand the evidence base of WHO's guideline on self-care interventions, we conducted a systematic review of SMBG among pregnant individuals with GD.

Setting

Following PRISMA guidelines, we searched PubMed, CINAHL, LILACS, and EMBASE for publications through November 2020 comparing SMBG with clinic-based monitoring during antenatal care (ANC) globally.

Primary and secondary outcome measures

We extracted data using standardized forms and summarized maternal and newborn findings using random effects meta-analysis in GRADE evidence tables. We also reviewed studies on values, preferences, and costs of SMBG.

Results

We identified 6 studies examining SMBG compared to routine ANC care, 5 studies on values and preferences, and 1 study on costs. Nearly all were conducted in Europe and North America. Moderate-certainty evidence from 3 randomized controlled trials (RCTs) showed that SMBG as part of a package of interventions for GD treatment was associated with lower rates of preeclampsia, lower mean birthweight, fewer infants born large for gestational age, fewer infants with macrosomia, and lower rates of shoulder dystocia. There was no difference between groups in self-efficacy, preterm birth, C-section, mental health, stillbirth, or respiratory distress. No studies measured placenta previa, long-term complications, device-related issues, or social harms. Most end-users supported SMBG, motivated by health benefits, convenience, ease of use, and increased confidence. Health workers acknowledged SMBG's convenience but were wary of technical problems. One study found SMBG by pregnant individuals with insulin-dependent diabetes was associated with decreased costs for hospital admission and length of stay.

Conclusion

SMBG during pregnancy is feasible and acceptable, and when combined in a package of GD interventions, is generally associated with improved maternal and neonatal health outcomes. However, research from resource-limited settings is needed.

Systematic Review Registration

PROSPERO CRD42021233862.
Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma
Authors: Zhang Zhuochao , Wang Gaofei , Du Lei , Zhao Jie , Pan Lichao , Zhang Gong , Wang Fei , Liu Rong
Published: May 2023

Patients with advanced intrahepatic cholangiocarcinoma (iCCA) often have a poor prognosis. Recent advancements in targeted molecular therapy and immunotherapy have been made. Herein, we report a case of advanced iCCA treated with a combination of pemigatinib (a selective FGFR inhibitor), chemotherapy, and an immune checkpoint inhibitor. A 34-year-old female was diagnosed with advanced iCCA with multiple liver masses and metastases in the peritoneum and lymph nodes. Next-generation sequencing (NGS) identified the genetic mutations. An FGFR2-BICC1 gene fusion was found in this patient. The patient was treated with pemigatinib in combination with pembrolizumab plus systemic gemcitabine and oxaliplatin. After 9 cycles of the combination therapy, the patient achieved a partial response, complete metabolic response, and normalization of tumor markers. Sequentially, the patient received pemigatinib and pembrolizumab for 3 months. Due to the elevated tumor biomarker, she is currently receiving chemotherapy, pemigatinib, and pembrolizumab treatment again. She regained an excellent physical status after 16 months of treatment. To the best of our knowledge, this was the first reported case of advanced iCCA successfully treated with a combination of pemigatinib, chemotherapy, and ICIs as a first-line regimen. This treatment combination may be effective and safe in the advanced iCCA.
Case report: Bullous pemphigoid in HIV-1-positive patients: interplay or coincidence? A case series and review of the literature
Authors: Foerster Yannick , Sollfrank Lukas , Rechtien Laura , Harrer Thomas , Berking Carola , Sticherling Michael
Published: May 2023

Bullous pemphigoid (BP) is an autoimmune inflammatory skin disease, mostly affecting the elderly population. Therefore, patients often have multiple comorbidities, but there is inconsistent data regarding the relationship between HIV-1 infection and BP, which has been rarely reported in combination. Herein, we describe three patients who presented with BP and concomitant HIV-1 infection that was well controlled with modern combined antiretroviral therapy. All patients received topical and oral corticosteroids. Depending on the individual severity, further add-on therapeutics, such as azathioprine, dapsone, doxycycline and the interleukin 4/13 antibody dupilumab, were added to the therapy regimen. All patients recovered from pruritic skin lesions and blistering. The cases are further discussed in the context of the current study landscape. In conclusion, HIV-1 infection shifts the cytokine profile from T-helper type 1 (TH1) towards T-helper type 2 (TH2), resulting in the excessive secretion of distinct cytokines, such as interleukin 4 (IL-4) and interleukin 10 (IL-10). With IL-4 being a main driver in the pathogenesis of BP, HIV-1-positive patients may benefit greatly from targeting IL-4 with monoclonal antibodies.
Distinct vertical behavior of key Arctic copepods following the midnight sun period in the East Siberian continental margin region, Arctic Ocean
Authors: Son Wuju , Kim Jee-Hoon , Yang Eun Jin , La Hyoung Sul
Published: May 2023

Diel vertical migration (DVM) of zooplankton plays a vital role in biological carbon pump and food web interactions. However, there is considerable debate about the DVM of zooplankton in response to environmental changes in the Arctic Ocean. We investigated DVM behavior in the key Arctic copepods Calanus glacialis, Calanus hyperboreus, and Metridia longa following the midnight sun period in the East Siberian continental margin region. The two Calanus species showed non-DVM behaviors, whereas M. longa showed a typical DVM pattern consistent with the solar radiation cycle. Additionally, these species showed different vertical distributions. Calanus glacialis was distributed at depths above 20 m in the warm fresh water, where the highest density gradient was observed. Calanus hyperboreus was distributed at depths between 30 and 55 m in the cold salty water, where a high contribution of micro phytoplankton and the subsurface chlorophyll maximum (SCM) layer were observed. M. longa was found across a broader range of temperature and salinity than both Calanus species, and it was distributed in the upper water column, where the SCM layer was observed at night and at depths between 100 and 135 m in the daytime. These results imply that M. longa can be well adapted to the changing Arctic Ocean environment, where sea ice loss and ocean warming are ongoing, whereas C. hyperboreus can be the most vulnerable to these changes. These findings provide important information for understanding variations in the vertical distributions of key copepod species in the rapidly changing Arctic marine environment.
Novel morphological and molecular data for Nasitrema spp. (Digenea: Brachycladiidae) in the East Asian finless porpoise (Neophocaena asiaeorientalis sunameri)
Authors: Kim Sunmin , Youn Heejeong , Lee Kyunglee , Lee Hyunjoo , Kim Min Ju , Kang Yeseul , Choe Seongjun , Georgieva Simona
Published: May 2023

The East Asian finless porpoise, Neophocaena asiaeorientalis sunameri, ranks among the most endangered species with rapidly decreasing population in the Northwest Pacific. Trematode parasites of the genus Nasitrema that inhabit the air sinuses, inner ear, and the central nervous system of cetaceans frequently cause equilibrium dysfunction, disorientation, interference with echolocation, incoordination, and nervous system degeneration. Due to their specific location and associated pathologies, they have been recognized as one of the causes of cetacean strandings. Stranding data provides crucial information on the species’ biology, population health, and on the status of entire marine ecosystem. However, published data on parasite-induced standings that include information on the causative parasite pathogens are scarce. As part of a wider survey on the causes of East Asian finless porpoise strandings along the west coast of Korea, herein, we provide novel morphological and molecular data on two sympatric species of Nasitrema, namely, Nasitrema spathulatum and Nasitrema sunameri based on newly collected specimens from a stranded alive East Asian finless porpoise at the West coast of Korea. Our study adds a new distribution record for important parasite pathogens in cetaceans and provides the first molecular data for the parasite species recovered, which enabled us to re-evaluate the species relationships within the family Brachycladiidae, a group of important parasite pathogens of marine mammals.
Improved clinical outcomes in response to a 12-week blended digital and community-based long-COVID-19 rehabilitation programme
Authors: Smith Jemma L. , Deighton Kevin , Innes Aidan Q. , Holl Marc , Mould Laura , Liao Zhining , Doherty Patrick , Whyte Greg , King James A. , Deniszczyc Davina , Kelly Benjamin M.
Published: May 2023

Introduction

Two million people in the UK are experiencing long COVID (LC), which necessitates effective and scalable interventions to manage this condition. This study provides the first results from a scalable rehabilitation programme for participants presenting with LC.

Methods

601 adult participants with symptoms of LC completed the Nuffield Health COVID-19 Rehabilitation Programme between February 2021 and March 2022 and provided written informed consent for the inclusion of outcomes data in external publications. The 12-week programme included three exercise sessions per week consisting of aerobic and strength-based exercises, and stability and mobility activities. The first 6 weeks of the programme were conducted remotely, whereas the second 6 weeks incorporated face-to-face rehabilitation sessions in a community setting. A weekly telephone call with a rehabilitation specialist was also provided to support queries and advise on exercise selection, symptom management and emotional wellbeing.

Results

The 12-week rehabilitation programme significantly improved Dyspnea-12 (D-12), Duke Activity Status Index (DASI), World Health Orginaisation-5 (WHO-5) and EQ-5D-5L utility scores (all p < 0.001), with the 95% confidence intervals (CI) for the improvement in each of these outcomes exceeding the minimum clinically important difference (MCID) for each measure (mean change [CI]: D-12: −3.4 [−3.9, −2.9]; DASI: 9.2 [8.2, 10.1]; WHO-5: 20.3 [18.6, 22.0]; EQ-5D-5L utility: 0.11 [0.10, 0.13]). Significant improvements exceeding the MCID were also observed for sit-to-stand test results (4.1 [3.5, 4.6]). On completion of the rehabilitation programme, participants also reported significantly fewer GP consultations (p < 0.001), sick days (p = 0.003) and outpatient visits (p = 0.007) during the previous 3 months compared with baseline.

Discussion

The blended and community design of this rehabilitation model makes it scalable and meets the urgent need for an effective intervention to support patients experiencing LC. This rehabilitation model is well placed to support the NHS (and other healthcare systems worldwide) in its aim of controlling the impacts of COVID-19 and delivering on its long-term plan.

Clinical trial registration

https://www.isrctn.com/ISRCTN14707226, identifier 14707226.
Lyme disease and the pursuit of a clinical cure
Authors: Adkison Heather , Embers Monica E.
Published: May 2023

Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most common vector-borne illness in the United States. Many aspects of the disease are still topics of controversy within the scientific and medical communities. One particular point of debate is the etiology behind antibiotic treatment failure of a significant portion (10–30%) of Lyme disease patients. The condition in which patients with Lyme disease continue to experience a variety of symptoms months to years after the recommended antibiotic treatment is most recently referred to in the literature as post treatment Lyme disease syndrome (PTLDS) or just simply post treatment Lyme disease (PTLD). The most commonly proposed mechanisms behind treatment failure include host autoimmune responses, long-term sequelae from the initial Borrelia infection, and persistence of the spirochete. The aims of this review will focus on the in vitro, in vivo, and clinical evidence that either validates or challenges these mechanisms, particularly with regard to the role of the immune response in disease and resolution of the infection. Next generation treatments and research into identifying biomarkers to predict treatment responses and outcomes for Lyme disease patients are also discussed. It is essential that definitions and guidelines for Lyme disease evolve with the research to translate diagnostic and therapeutic advances to patient care.
Competition between two Usutu virus isolates in cell culture and in the common house mosquito Culex pipiens
Authors: van Bree Joyce W. M. , Linthout Charlotte , van Dijk Teije , Abbo Sandra R. , Fros Jelke J. , Koenraadt Constantianus J. M. , Pijlman Gorben P. , Wang Haidong
Published: May 2023

Usutu virus (USUV) is a mosquito-borne flavivirus of African origin. Over the past decades, USUV has spread through Europe causing mass die-offs among multiple bird species. The natural transmission cycle of USUV involves Culex spp. mosquitoes as vectors and birds as amplifying hosts. Next to birds and mosquitoes, USUV has also been isolated from multiple mammalian species, including humans, which are considered dead-end hosts. USUV isolates are phylogenetically classified into an African and European branch, subdivided into eight genetic lineages (Africa 1, 2, and 3 and Europe 1, 2, 3, 4, and 5 lineages). Currently, multiple African and European lineages are co-circulating in Europe. Despite increased knowledge of the epidemiology and pathogenicity of the different lineages, the effects of co-infection and transmission efficacy of the co-circulating USUV strains remain unclear. In this study, we report a comparative study between two USUV isolates as follows: a Dutch isolate (USUV-NL, Africa lineage 3) and an Italian isolate (USUV-IT, Europe lineage 2). Upon co-infection, USUV-NL was consistently outcompeted by USUV-IT in mosquito, mammalian, and avian cell lines. In mosquito cells, the fitness advantage of USUV-IT was most prominently observed in comparison to the mammalian or avian cell lines. When Culex pipiens mosquitoes were orally infected with the different isolates, no overall differences in vector competence for USUV-IT and USUV-NL were observed. However, during the in vivo co-infection assay, it was observed that USUV-NL infectivity and transmission were negatively affected by USUV-IT but not vice versa.
Effects of tomato inoculation with the entomopathogenic fungus Metarhizium brunneum on spider mite resistance and the rhizosphere microbial community
Authors: Rasool Shumaila , Markou Andreas , Hannula S. Emilia , Biere Arjen
Published: May 2023

Entomopathogenic fungi have been well exploited as biocontrol agents that can kill insects through direct contact. However, recent research has shown that they can also play an important role as plant endophytes, stimulating plant growth, and indirectly suppressing pest populations. In this study, we examined the indirect, plant-mediated, effects of a strain of entomopathogenic fungus, Metarhizium brunneum on plant growth and population growth of two-spotted spider mites (Tetranychus urticae) in tomato, using different inoculation methods (seed treatment, soil drenching and a combination of both). Furthermore, we investigated changes in tomato leaf metabolites (sugars and phenolics), and rhizosphere microbial communities in response to M. brunneum inoculation and spider mite feeding. A significant reduction in spider mite population growth was observed in response to M. brunneum inoculation. The reduction was strongest when the inoculum was supplied both as seed treatment and soil drench. This combination treatment also yielded the highest shoot and root biomass in both spider mite-infested and non-infested plants, while spider mite infestation increased shoot but reduced root biomass. Fungal treatments did not consistently affect leaf chlorogenic acid and rutin concentrations, but M. brunneum inoculation via a combination of seed treatment and soil drenching reinforced chlorogenic acid (CGA) induction in response to spider mites and under these conditions the strongest spider mite resistance was observed. However, it is unclear whether the M. brunneum-induced increase in CGA contributed to the observed spider mite resistance, as no general association between CGA levels and spider mite resistance was observed. Spider mite infestation resulted in up to two-fold increase in leaf sucrose concentrations and a three to five-fold increase in glucose and fructose concentrations, but these concentrations were not affected by fungal inoculation. Metarhizium, especially when applied as soil drench, impacted the fungal community composition but not the bacterial community composition which was only affected by the presence of spider mites. Our results suggest that in addition to directly killing spider mites, M. brunneum can indirectly suppress spider mite populations on tomato, although the underlying mechanism has not yet been resolved, and can also affect the composition of the soil microbial community.
Antifungal mechanisms of the antagonistic bacterium Bacillus mojavensis UTF-33 and its potential as a new biopesticide
Authors: Zhang Yifan , Yang Yanmei , Zhang Luyi , Zhang Jia , Zhou Zhanmei , Yang Jinchang , Hu Yu , Gao Xiaoling , Chen Rongjun , Huang Zhengjian , Xu Zhengjun , Li Lihua
Published: May 2023

Biological control has gradually become the dominant means of controlling fungal disease over recent years. In this study, an endophytic strain of UTF-33 was isolated from acid mold (Rumex acetosa L.) leaves. Based on 16S rDNA gene sequence comparison, and biochemical and physiological characteristics, this strain was formally identified as Bacillus mojavensis. Bacillus mojavensis UTF-33 was sensitive to most of the antibiotics tested except neomycin. Moreover, the filtrate fermentation solution of Bacillus mojavensis UTF-33 had a significant inhibitory effect on the growth of rice blast and was used in field evaluation tests, which reduced the infestation of rice blast effectively. Rice treated with filtrate fermentation broth exhibited multiple defense mechanisms in response, including the enhanced expression of disease process-related genes and transcription factor genes, and significantly upregulated the gene expression of titin, salicylic acid pathway-related genes, and H2O2 accumulation, in plants; this may directly or indirectly act as an antagonist to pathogenic infestation. Further analysis revealed that the n-butanol crude extract of Bacillus mojavensis UTF-33 could retard or even inhibit conidial germination and prevent the formation of adherent cells both in vitro and in vivo. In addition, the amplification of functional genes for biocontrol using specific primers showed that Bacillus mojavensis UTF-33 expresses genes that can direct the synthesis of bioA, bmyB, fenB, ituD, srfAA and other substances; this information can help us to determine the extraction direction and purification method for inhibitory substances at a later stage. In conclusion, this is the first study to identify Bacillus mojavensis as a potential agent for the control of rice diseases; this strain, and its bioactive substances, have the potential to be developed as biopesticides.