bluuebunny/crossref_metadata_2025 huggingface dataset:
Contested Legitimating Agents: The Regional “Battle” for Legitimacy in Venezuela
Authors: Wajner Daniel F
Published: February 2024

Practitioners, pundits, and scholars increasingly recognize the role that international organizations play in conflicts. Regional organizations (ROs), as brokers of collective security, welfare, and identity, have become particularly active agents during violent crises by granting legitimacy to certain protagonists and discrediting the legitimacy of others, thus affecting international policymaking. However, existing research generally assesses the legitimizing effects of ROs in either a static way, in which the stances of their member states do not change over time, or in an institutional vacuum, where ROs are not challenged by other ROs. This study aims to shed light on the impact of multiple ROs dynamically and simultaneously intervening in legitimation struggles. It focuses on the 2014–2020 regional “battle” over the legitimate authority of the Chavista–Madurista regime in Venezuela, examining how multiple Latin American ROs articulated their discourse seeking to influence the crisis’ outcomes. To this end, a multi-step process tracing based on four phases (opening, deliberation, judgment, and denouement) is applied. The findings reveal the lively competition between involved actors for the recognition of ROs as the relevant legitimating agents, and the limits faced in achieving collective action when polarization over such a regional legitimating role prevails. The study has novel implications for scholarly understanding of the role of legitimation dynamics in promoting international cooperation during periods of disruption.
An adult right inguinal hernia and cryptorchidism treated simultaneously with laparoscopic transabdominal preperitoneal repair and laparoscopic orchiectomy: a case report
Authors: Kimura Dai , Miyagawa Yusuke , Miyao Masafumi , Matumura Hideyasu , Koike Shoichiro
Published: February 2024

Pediatric health checkups have been mandatory for all citizens since 1966 based on the Maternal and Child Health Law in Japan, and cryptorchidism or undescended testis in adult males are rare. We report a case of an adult right inguinal hernia and cryptorchidism treated simultaneously with laparoscopic transabdominal preperitoneal repair and laparoscopic orchiectomy. A 35-year-old man came to our department with a chief complaint of bulging in the right inguinal region for several months. He was diagnosed with a right inguinal hernia and was scheduled for transabdominal preperitoneal repair. During intraoperative intraperitoneal observation, a white 30-mm mass was found in the hernia orifice. A diagnosis of right cryptorchidism was made, and transabdominal preperitoneal repair and laparoscopic orchiectomy were performed. Laparoscopic simultaneous surgery could be safely performed in an adult patient with a hernia complicated by a cryptorchidism. It can be recommended as a surgical option in such cases.
A rare manifestation of IgG4-related disease and secondary hypereosinophilic syndrome: A case report
Authors: Takeuchi Miyoshi , Shojima Masumi , Matsueda Shumei , Nagae Hiroshi , Kuroiwa Mika , Fujita Aya , Kawano Mitsuhiro , Inoue Dai , Komori Takahiro , Takeuchi Mai , Ooshima Koichi , Kuroki Yusuke , Katafuchi Ritsuko
Published: February 2024

We report a case of IgG4-related disease (IgG4-RD) with marked eosinophilia. A 79-year-old woman was admitted due to diarrhoea and weight loss. Cervical lymphadenopathy, bilateral submandibular glands swelling, anaemia (Hb8.5 g/dl), hypereosinophilia (9750/μl), elevated serum creatinine (1.57 mg/dl), pancreatic amylase (191 IU/l), and IgG4 (3380 mg/dl) were found. Diffusion-weighted image on magnetic resonance imaging showed high-intensity signals inside both the pancreas and the kidneys. The echogram of submandibular glands revealed cobblestone pattern. Kidney biopsy revealed acute tubulointerstitial nephritis. Biopsies of lip, gastrointestinal tract, and bone marrow showed infiltration of lymphoplasmacytic cells and IgG4-positive plasma cells (30–67/HPF). Gastrointestinal and bone marrow biopsies also showed eosinophilic infiltration. Adrenal insufficiency, rheumatic disease, tuberculosis, parasite infection, drug-induced eosinophilia, and eosinophilic leukaemia were all ruled out. We started treatment with 40 mg of prednisolone (PSL) and her general condition rapidly improved. The eosinophil count, serum IgG4, and serum creatinine decreased. We gradually tapered PSL and maintained 5 mg/day. During the 5 years of treatment, she had no recurrence of the symptom. According to the 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-RD, eosinophils >3000/μl is one of the exclusion criteria. If we comply with this criterion, the diagnosis of IgG4-RD should be avoided. However, our case fit the diagnostic criteria of type I autoimmune pancreatitis, IgG4-related sialadenitis, and global diagnosis of IgG4-RD. We finally diagnosed our case as IgG4-RD with secondary hypereosinophilic syndrome. This case suggests that IgG4-RD with eosinophils >3000/μl does exist in the real world.
Changes in muscle strength and risk of cardiovascular disease among middle-aged and older adults in China: Evidence from a prospective cohort study
Authors: Yang Ze , Wei Jiemin , Liu Hongbo , Zhang Honglu , Liu Ruifang , Tang Naijun , Yang Xueli
Published: February 2024

Background:

Evidence indicates that low muscle strength is associated with an increased cardiovascular diseases (CVDs) risk. However, the association between muscle strength changes based on repeated measurements and CVD incidence remains unclear.

Methods:

The study used data from the China Health and Retirement Longitudinal Study in 2011 (Wave 1), 2013 (Wave 2), 2015 (Wave 3), and 2018 (Wave 4). Low muscle strength was defined as handgrip strength <28 kg for men or <18 kg for women, or chair-rising time ≥12 s. Based on changes in muscle strength from Waves 1 to 2, participants were categorized into four groups of Normal–Normal, Low–Normal, Normal–Low, and Low–Low. CVD events, including heart disease and stroke, were recorded using a self-reported questionnaire during Waves 3 and 4 visits. Cox proportional hazards models were used to investigate the association between muscle strength changes and CVD incidence after multivariable adjustments. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated with the Normal–Normal group as the reference.

Results:

A total of 1164 CVD cases were identified among 6608 participants. Compared to participants with sustained normal muscle strength, the CVD risks increased progressively across groups of the Low–Normal (HR = 1.20, 95% CI: 1.01–1.43), the Normal–Low (HR = 1.35, 95% CI: 1.14–1.60), and the Low–Low (HR = 1.76, 95% CI: 1.49–2.07). Similar patterns were observed for the significant associations between muscle strength status and the incidence risks of heart disease and stroke. Subgroup analyses showed that the significant associations between CVD and muscle strength changes were consistent across age, sex, and body mass index (BMI) categories.

Conclusions:

The study found that muscle strength changes were associated with CVD risk. This suggests that continuous tracking of muscle status may be helpful in screening cardiovascular risk.
Validation of a screening panel for pediatric metabolic dysfunction–associated steatotic liver disease using metabolomics
Authors: Huneault Helaina E. , Gent Alasdair E. , Cohen Catherine C. , He Zhulin , Jarrell Zachery R. , Kamaleswaran Rishikesan , Vos Miriam B.
Published: February 2024

Background:

Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly known as NAFLD, is the most common liver disease in children. Liver biopsy remains the gold standard for diagnosis, although more efficient screening methods are needed. We previously developed a novel NAFLD screening panel in youth using machine learning applied to high-resolution metabolomics and clinical phenotype data. Our objective was to validate this panel in a separate cohort, which consisted of a combined cross-sectional sample of 161 children with stored frozen samples (75% male, 12.8±2.6 years of age, body mass index 31.0±7.0 kg/m2, 81% with MASLD, 58% Hispanic race/ethnicity).

Methods:

Clinical data were collected from all children, and high-resolution metabolomics was performed using their fasting serum samples. MASLD was assessed by MRI-proton density fat fraction or liver biopsy and cardiometabolic factors. Our previously developed panel included waist circumference, triglycerides, whole-body insulin sensitivity index, 3 amino acids, 2 phospholipids, dihydrothymine, and 2 unknowns. To improve feasibility, a simplified version without the unknowns was utilized in the present study. Since the panel was modified, the data were split into training (67%) and test (33%) sets to assess the validity of the panel.

Results:

Our present highest-performing modified model, with 4 clinical variables and 8 metabolomics features, achieved an AUROC of 0.92, 95% sensitivity, and 80% specificity for detecting MASLD in the test set.

Conclusions:

Therefore, this panel has promising potential for use as a screening tool for MASLD in youth.
Applying human-centered design to the construction of a cirrhosis management clinical decision support system
Authors: Ge Jin , Buenaventura Ana , Berrean Beth , Purvis Jory , Fontil Valy , Lai Jennifer C. , Pletcher Mark J.
Published: February 2024

Background:

Electronic health record (EHR)-based clinical decision support is a scalable way to help standardize clinical care. Clinical decision support systems have not been extensively investigated in cirrhosis management. Human-centered design (HCD) is an approach that engages with potential users in intervention development. In this study, we applied HCD to design the features and interface for a clinical decision support system for cirrhosis management, called CirrhosisRx.

Methods:

We conducted technical feasibility assessments to construct a visual blueprint that outlines the basic features of the interface. We then convened collaborative-design workshops with generalist and specialist clinicians. We elicited current workflows for cirrhosis management, assessed gaps in existing EHR systems, evaluated potential features, and refined the design prototype for CirrhosisRx. At the conclusion of each workshop, we analyzed recordings and transcripts.

Results:

Workshop feedback showed that the aggregation of relevant clinical data into 6 cirrhosis decompensation domains (defined as common inpatient clinical scenarios) was the most important feature. Automatic inference of clinical events from EHR data, such as gastrointestinal bleeding from hemoglobin changes, was not accepted due to accuracy concerns. Visualizations for risk stratification scores were deemed not necessary. Lastly, the HCD co-design workshops allowed us to identify the target user population (generalists).

Conclusions:

This is one of the first applications of HCD to design the features and interface for an electronic intervention for cirrhosis management. The HCD process altered features, modified the design interface, and likely improved CirrhosisRx’s overall usability. The finalized design for CirrhosisRx proceeded to development and production and will be tested for effectiveness in a pragmatic randomized controlled trial. This work provides a model for the creation of other EHR-based interventions in hepatology care.
Correlation between systolic blood pressure and mortality in heart failure patients with hypertension
Authors: Lang Xueyan , Peng Cheng , Zhang Yanxiu , Gao Rong , Zhao Bing , Li Yilan , Zhang Yao
Published: February 2024

Background:

The correlation between systolic blood pressure (SBP) and mortality in hypertensive patients with different phenotypes of heart failure (HF) has not been adequately studied, and optimal blood pressure control targets remain controversial. To explore the link between SBP and prognosis in all or three ejection fraction (EF) phenotypes of HF patients with hypertension.

Methods:

We analyzed 1279 HF patients complicated by hypertension in a retrospective cohort. The SBP <130 mmHg group included 383 patients, and the SBP ≥130 mmHg group included 896 patients. The major end point was all-cause mortality.

Results:

Of the 1279 study patients, with a median age of 66.0 ± 12.0 years, 45.3% were female. The proportions of the three subtypes of heart failure complicated with hypertension (HFrEF, HEmrEF, and HFpEF) were 26.8%, 29.3%, and 43.9%, respectively. During the 1-year follow-up, 223 patients experienced all-cause death, and 133 experienced cardiovascular death. Restricted cubic splines showed that the risk of all-cause and cardiovascular death increased gradually as the SBP level decreased in patients with HFrEF and HFmrEF. Furthermore, the multivariate Cox proportional hazards model revealed that SBP <130 mmHg was also associated with an increased risk of all-cause death [hazard ratio (HR) 2.53, 95% confidence interval (CI) 1.23–5.20, P = 0.011] and cardiovascular death (HR 1.91, 95% CI 1.01–3.63, P = 0.047) in HFrEF patients. A trend toward increased risk was observed among HFmrEF patients, but it was not statistically significant. This trend was not observed in HFpEF patients.

Conclusion:

In HFrEF patients, SBP <130 mmHg was associated with an increased risk of all-cause and cardiovascular mortality. A trend toward increased risk was observed among HFmrEF patients, but not among HFpEF patients.
Clinical Characteristics and Outcomes of Unvaccinated Kidney Transplant Recipients Infected with the SARS-CoV-2 Omicron Variant: A Case Series
Authors: Qu Yue , Zhuang Jing , Duan Yanya , Baibutihan Ahebaota , Maimaiti Zuolamu , Zhang Changrong , Niu Junqiao , Teng Wei , Ailimu Maierdang , Wei Xuemei , Qi Baowen , Li Jiuzhi , Du Shuang , Wang Dingding , Cao Ke , Wang Junyan , Lu Chen , Tian Xuefei , Jiang Hong
Published: February 2024

Background:

Due to their chronic immunocompromised status, kidney transplant (KT) recipients face escalated risks from coronavirus disease 2019 (COVID-19), which may be exacerbated by lower vaccination rates. However, there is a paucity of information regarding the clinical traits of unvaccinated KT recipients with COVID-19. We aimed to investigate the clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron infection in unvaccinated KT recipients.

Methods:

In this retrospective study, we analyzed the clinical outcomes of 36 unvaccinated KT recipients diagnosed with SARS-CoV-2 Omicron infection, as confirmed by reverse transcription polymerase chain reaction. Clinical characteristics, laboratory tests, treatment regimens, and outcomes were examined, and 2-month follow-up assessments were conducted.

Results:

KT recipients had a high incidence of severe infection, with 66.7% classified as having severe/critical illness. Factors associated with severe/critical illness included age; diabetes mellitus; lung infection computed tomography score; and elevated serum D-dimer, interleukin-6, C-reactive protein, procalcitonin, and ferritin levels. The patients in the severe/critical group also had significantly lower blood lymphocyte counts and serum albumin levels. Treatment strategies included discontinuation of antimetabolic drugs, reduction or discontinuation of calcineurin inhibitor drugs, antiviral therapy, and early patient-tailored nutritional support. Acute kidney injury was observed in 19.4% of patients. Four (11.1%) patients died during the observation period, with two (5.6%) succumbing hospitalization and two (5.6%) during the 2-month follow-up period due to infection. The remaining patients did not report any significant symptoms and are still undergoing follow-up.

Conclusion:

Early diagnosis, personalized treatment, and vigilant monitoring are all crucial aspects of the clinical management of unvaccinated KT recipients with COVID-19. These findings contribute to the understanding of the clinical characteristics and management of COVID-19 in patients undergoing KT.
How complicated can be a case with immune thrombocytopenic purpura?: postsplenectomy arterial thrombosis
Authors: Kaya Ahmet Deniz , Tekin Oguzhan , Colak Yasin , Serin Istemi
Published: February 2024

Arterial thrombus associated with the surgery can be seen in postsplenectomy cases, but there is no clear data in patients diagnosed with immune thrombocytopenic purpura (ITP). A 52-year-old female patient was admitted to the emergency department due to ecchymotic skin changes. Her initial platelet count was 6000/mm3; after two courses of high dose-dexamethasone, intravenous immunoglobulin and rituximab, splenectomy was planned for the patient whose platelet count was again <40 000/mm3. She presented to the emergency department with complaints of pain and pallor in the right arm in the second week of follow-up. There was a mural thrombus that caused approximately 50% stenosis in the lumen at the division site in the aortic arch, proximal of the right subclavian artery. The patient's clinic was found to be associated with the presence of an aberrant right subclavian artery and postoperative thrombocytosis/inflammation after elimination other prothrombotic conditions.
Impact of MAFLD criteria on postoperative recurrence of non-B, non-C HCC
Authors: Johira Yusuke , Nakahara Takashi , Yamaoka Kenji , Fujii Yasutoshi , Uchikawa Shinsuke , Fujino Hatsue , Ono Atsushi , Murakami Eisuke , Kawaoka Tomokazu , Miki Daiki , Tsuge Masataka , Oka Shiro
Published: February 2024

Background

This study aimed to clarify the population in whom the presence of metabolic dysfunction-associated fatty liver disease (MAFLD) especially contributes to recurrence after liver resection for non-B, non-C hepatocellular carcinoma (NBNC-HCC).

Methods

Of the 199 patients who underwent liver resection for NBNC-HCC, those who exceeded Milan criteria and with pathologically proven vascular invasion, intrahepatic metastasis, and positive resection margins were excluded, and the remaining 94 were eligible for this study. We explored factors contributing to postoperative recurrence in populations with and without advanced liver fibrosis.

Results

Independent factors contributing to postoperative recurrence in the study population were male sex (P = 0.023) and presence of type 2 diabetes (DM) (P = 0.006) and advanced liver fibrosis (P < 0.001). Factors in cases with advanced liver fibrosis (n = 43) were non-overweight (P = 0.02), type 2 DM (P = 0.006), and preoperative alpha-fetoprotein level of 8.2 ng/ml or higher (P = 0.021). In cases without advanced liver fibrosis (n = 51), only presence of all three MAFLD criteria was related to recurrence.

Conclusion

Liver fibrosis is a strong factor contributing to postoperative recurrence of NBNC-HCC, as previously reported. In patients with advanced liver fibrosis, presence of type 2 DM was the only factor associated with recurrence among MAFLD criteria. On the other hand, in patients without advanced liver fibrosis, the combination of all MAFLD criteria, rather than a specific criterion alone, contributed to recurrence. MAFLD criteria were found to have utility as predictors of postoperative recurrence in NBNC-HCC.
Prediction and evaluation of a nomogram model for recurrent acute pancreatitis
Authors: Chen Yuan , Huang Shu , Luo Bei , Jiang Jiao , Ren Wensen , Zou Kang , Zhong Xiaolin , Lü Muhan , Tang Xiaowei
Published: February 2024

Objective

The purpose of this study was to investigate the influencing factors for recurrent acute pancreatitis and construct the nomogram model to predict the risk of recurrent acute pancreatitis.

Methods

Patients diagnosed with acute pancreatitis in the Affiliated Hospital of Southwest Medical University were enrolled. We collected these patients’ basic information, laboratory data, imaging information. Using Logistic regression and least absolute shrinkage and selection operator regression to select risk factor for Cross-Validation Criterion. To create nomogram and validated by receiver operator characteristic curve, calibration curves and decision curve analysis.

Results

A total of 533 patients with acute pancreatitis were included, including 99 recurrent acute pancreatitis patients. The average age of recurrent acute pancreatitis patients was 49.69 years old, and 67.7% of them were male. At the same time, in all recurrent acute pancreatitis patients, hypertriglyceridemic pancreatitis is the most important reason (54.5%). Regression analysis and least absolute shrinkage and selection operator regression showed that smoking history, acute necrotic collection, triglyceride, and alcohol etiology for acute pancreatitis were identified and entered into the nomogram. The area under the receiver operator characteristic curve of the training set was 0.747. The calibration curve showed the consistency between the nomogram model and the actual probability.

Conclusion

In conclusion, some high-risk factors like smoking history, acute necrotic collection, triglyceride, and alcohol etiology for acute pancreatitis may predict recurrent pancreatitis and their incorporation into a nomogram has high accuracy in predicting recurrence.
Osteonecrosis in patients with inflammatory bowel disease: a systematic review and meta-analysis
Authors: Bhayana Himanshu , Sharma Tarun Kumar , Sharma Alka , Dhillon Mehtab S. , Jena Anuraag , Kumar Deepak , Sharma Vishal
Published: February 2024

Background

The relationship of inflammatory bowel disease (IBD) with osteonecrosis or avascular necrosis (AVN) is uncertain.

Methods

Systematic review to estimate the frequency of osteonecrosis in IBD was performed. Electronic databases were searched on 12 December 2022 to identify relevant studies. We planned to estimate the pooled prevalence of AVN in IBD, the risk in IBD when compared to the healthy population (without any chronic disease), and the impact of steroid use on osteonecrosis (IBD with and without steroid use). The risk of Bias was assessed with the Joanna Briggs Institute appraisal tool.

Results

Fifteen studies including 105 154 individuals were included. The pooled rate AVN was 10.39 per 1000 patients (95% confidence interval, 4.44–24.11, I2 = 97%). Subgroup analysis suggested that the prevalence was lower in larger studies (>1000 participants) at 3.10, 1.07; 8.98, I2 = 98% versus 21.03, 8.69; 50.01, I2 = 83%. The use of steroids did not seem to increase the risk of osteonecrosis in the included studies (pooled odds ratio: 1.88, 0.55–6.41, I2 = 39%). The systematic review was limited by the absence of comparison with the control population free of chronic disease.

Conclusion

IBD may be associated with a risk of osteonecrosis. Future studies should assess the risk in comparison to the healthy population and the impact of disease activity and IBD therapies on the risk.
Pediatric Plexiform Fibromyxoma: A Case Report
Authors: Bugeda Gómez Patricia , Costa-Roig Adrià , Montecino Romanini Carolina , Miró Rubio Ignacio , Guindos Rúa Santiago , Lara Cárdenas Diana C. , Germani Micaela , Roca Roca María , Romagosa Pérez Portabella Cleofe , Garrido Pontnou Marta , Hernández Losa Javier , Sanchís Solera Luis F.
Published: February 2024

The plexiform fibromyxoma is a rare mesenchymal tumor in adults that generally originates in the antrum of stomach, being its occurrence in pediatric patients exceptional. It was classified as a distinct entity by World Health Organization in 2010. No recurrences and metastases have been documented in many of the reported patients to date, being the surgical treatment curative. We report the case of a 3-month-old infant who presented to the emergency department with an episode of intestinal subocclusion requiring an emergent surgery. During the surgical intervention, a mass was identified in the jejunum, causing partial occlusion of its lumen. The surgical pathology report revealed an infiltrative tumor composed of spindle-shaped cells disposed in a stroma with a plexiform pattern alternating myxoid areas. These findings and the immunohistochemical characteristics of the neoplastic cells led to classify the tumor as a plexiform fibromyxoma. A description of the immunophenotype of this tumor is made and differential diagnosis with other gastrointestinal tumors is also discussed.
Trust-Building: Why Virtual Formats Threaten the Moral Ends of Surgical Informed Consent
Authors: Lee John H. , Neff Katherine E. , Vercler Christian J.
Published: February 2024

The COVID-19 pandemic forced a wide range of medical practices to virtual formats, including the preoperative informed consent practice. However, virtual informed consent persists despite the pandemic largely considered resolved. The continued use of virtual formats relies on a problematic “information-transfer” model of informed consent. We suggest that a “trust-building” model of consent as a better conceptualization of what is occurring during the consent process. Highlighting how virtual formats might fail to fulfill this fuller understanding of consent on both interpersonal and systemic levels, we offer up an ethical structure for physicians to navigate this novel virtual space.
Enhanced Donor Antigen Presentation by B Cells Predicts Acute Cellular Rejection and Late Outcomes After Transplantation
Authors: Ashokkumar Chethan , Ningappa Mylarappa , Raghu Vikram , Mazariegos George , Higgs Brandon W. , Morgan Paul , Remaley Lisa , Fazzolare Martin Tamara , Holzer Pamela , Trostle Kevin , Xu Qingyong , Zeevi Adriana , Squires James , Soltys Kyle , Horslen Simon , Khanna Ajai , Ganoza Armando , Sindhi Rakesh
Published: February 2024

Background.

Enhanced B-cell presentation of donor alloantigen relative to presentation of HLA-mismatched reference alloantigen is associated with acute cellular rejection (ACR), when expressed as a ratio called the antigen presenting index (API) in an exploratory cohort of liver and intestine transplant (LT and IT) recipients.

Methods.

To test clinical performance, we measured the API using the previously described 6-h assay in 84 LT and 54 IT recipients with median age 3.3 y (0.05–23.96). Recipients experiencing ACR within 60 d after testing were termed rejectors.

Results.

We first confirmed that B-cell uptake and presentation of alloantigen induced and thus reflected the alloresponse of T-helper cells, which were incubated without and with cytochalasin and primaquine to inhibit antigen uptake and presentation, respectively. Transplant recipients included 76 males and 62 females. Rejectors were tested at median 3.6 d before diagnosis. The API was higher among rejectors compared with nonrejectors (2.2 ± 0.2 versus 0.6 ± 0.04, P value = 1.7E-09). In logistic regression and receiver-operating-characteristic analysis, API ≥1.1 achieved sensitivity, specificity, and positive and negative predictive values for predicting ACR in 99 training set samples. Corresponding metrics ranged from 80% to 88% in 32 independent posttransplant samples, and 73% to 100% in 20 independent pretransplant samples. In time-to-event analysis, API ≥1.1 predicted higher incidence of late donor-specific anti-HLA antibodies after API measurements in LT recipients (P = 0.011) and graft loss in IT recipients (P = 0.008), compared with recipients with API <1.1, respectively.

Conclusions.

Enhanced donor antigen presentation by circulating B cells predicts rejection after liver or intestine transplantation as well as higher incidence of DSA and graft loss late after transplantation
Analysis of the lncRNA-miRNA-mRNA network to explore the regulation mechanism in human traumatic brain injury
Authors: Shao Xuefei , Zhang Maosong , Fang Jincheng , Ge Ruixiang , Su Yue , Liu Hongbing , Zhang Daojin , Wang Qifu
Published: February 2024

Traumatic brain injury (TBI) refers to brain dysfunction with or without traumatic structural injury induced by an external force. Nevertheless, the molecular mechanism of TBI remains undefined. Differentially expressed (DE) lncRNAs, DEmRNAs and DEmiRNAs were selected between human TBI tissues and the adjacent histologically normal tissue by high-throughput sequencing. Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis of overlapping DEmRNAs between predicted mRNAs of DEmiRNAs and DEmRNAs. The competitive endogenous RNA (ceRNA) network of lncRNA-miRNA-mRNA was established in light of the ceRNA theory. In the ceRNA network, the key lncRNAs were screened out. Then key lncRNAs related ceRNA subnetwork was constructed. After that, qRT-PCR was applied to validate the expression levels of hub genes. 114 DElncRNAs, 1807 DEmRNAs and 6 DEmiRNAs were DE in TBI. The TBI-related ceRNA network was built with 73 lncRNA nodes, 81 mRNA nodes and 6 miRNAs. According to topological analysis, two hub lncRNAs (ENST00000562897 and ENST00000640877) were selected to construct the ceRNA subnetwork. Subsequently, key lncRNA-miRNA-mRNA regulatory axes constructed by two lncRNAs including ENST00000562897 and ENST00000640877, two miRNAs including miR-6721-5p and miR-129-1-3p, two mRNAs including ketohexokinase (KHK) and cyclic nucleotide-gated channel beta1 (CNGB1), were identified. Furthermore, qRT-PCR results displayed that the expression of ENST00000562897, KHK and CNGB1 were significantly decreased in TBI, while the miR-6721-5p expression levels were markedly increased in TBI. The results of our study reveal a new insight into understanding the ceRNA regulation mechanism in TBI and select key lncRNA-miRNA-mRNA axes for prevention and treatment of TBI.
Nonoperative Management for Low-Grade Blunt Thoracic Aortic Injury
Authors: Golestani Simin , Dubose Joseph J , Efird Jessica , Teixeira Pedro G , Cardenas Tatiana C , Trust Marc D , Ali Sadia , Aydelotte Jayson , Bradford James , Brown Carlos VR
Published: February 2024

BACKGROUND:

Thoracic endovascular aortic repair (TEVAR) is the standard of care for the treatment of blunt thoracic aortic injury (BTAI) requiring intervention. Data suggest that low-grade BTAI (grade I [intimal tears] or grade II [intramural hematoma]) will resolve spontaneously if treated with nonoperative management (NOM) alone. There has been no comparison specifically between the use of NOM vs TEVAR for low-grade BTAI. We hypothesize that these low-grade injuries can be safely managed with NOM alone.

STUDY DESIGN:

Retrospective analysis of all patients with a low-grade BTAI in the Aortic Trauma Foundation Registry from 2016 to 2021 was performed. The study population was 1 primary outcome was mortality. Secondary outcomes included complications, ICU length of stay, and ventilator days.

RESULTS:

A total of 880 patients with BTAI were enrolled. Of the 269 patients with low-grade BTAI, 218 (81%) were treated with NOM alone (81% grade I, 19% grade II), whereas 51 (19%) underwent a TEVAR (20% grade I, 80% grade II). There was no difference in demographic or mechanism of injury in patients with low-grade BTAI who underwent NOM vs TEVAR. There was a difference in mortality between NOM alone and TEVAR (8% vs 18%, p = 0.009). Aortic-related mortality was 0.5% in the NOM group and 4% in the TEVAR group (p = 0.06). Hospital and ICU length of stay and ventilator days were not different between the 2 groups.

CONCLUSIONS:

NOM alone is safe and appropriate management for low-grade BTAI, with lower mortality and decreased rates of complication when compared with routine initial TEVAR.
Judicial hierarchy and discursive influence
Authors: Herron Felix , Carlson Keith , Rockmore Daniel N. , Livermore Michael A.
Published: February 2024

We apply a dynamic influence model to the opinions of the US federal courts to examine the role of the US Supreme Court in influencing the direction of legal discourse in the federal courts. We propose two mechanisms for how the Court affects innovation in legal language: a selection mechanism where the Court's influence primarily derives from its discretionary jurisdiction, and an authorship mechanism in which the Court's influence derives directly from its own innovations. To test these alternative hypotheses, we develop a novel influence measure based on a dynamic topic model that separates the Court's own language innovations from those of the lower courts. Applying this measure to the US federal courts, we find that the Supreme Court primarily exercises influence through the selection mechanism, with modest additional influence attributable to the authorship mechanism.

This article is part of the theme issue ‘A complexity science approach to law and governance’.
A network model of legal relations
Authors: Sichelman Ted , Smith Henry E.
Published: February 2024

From at least the early twentieth century, legal scholars have recognized that rights and other legal relations inhere between individual legal actors, forming a vast and complex social network. Yet, no legal scholar has used the mathematical machinery of network theory to formalize these relationships. Here, we propose the first such approach by modelling a rudimentary, static set of real property relations using network theory. Then, we apply our toy model to measure the level of modularity—essentially, the community structure—among aggregations of these real property relations and associated actors. In so doing, we show that even for a very basic set of relations and actors, law may employ modular structures to manage complexity. Property, torts, contracts, intellectual property, and other areas of the law arguably reduce information costs in similar, quantifiable ways by chopping up the world of interactions between parties into manageable modules that are semi-autonomous. We also posit that our network science approach to jurisprudential issues can be adapted to quantify many other important aspects of legal systems.

This article is part of the theme issue 'A complexity science approach to law and governance'.
Coalitions in international litigation: a network perspective
Authors: Mastrandrea R. , Antuofermo G. , Ovadek M. , Yeung T. Y.-C. , Dyevre A. , Caldarelli G.
Published: February 2024

We apply network science principles to analyse the coalitions formed by European Union nations and institutions during litigation proceedings at the European Court of Justice. By constructing Friends and Foes networks, we explore their characteristics and dynamics through the application of cluster detection, motif analysis and duplex analysis. Our findings demonstrate that the Friends and Foes networks exhibit disassortative behaviour, highlighting the inclination of nodes to connect with dissimilar nodes. Furthermore, there is a correlation among centrality measures, indicating that member states and institutions with a larger number of connections play a prominent role in bridging the network. An examination of the modularity of the networks reveals that coalitions tend to align along regional and institutional lines, rather than national government divisions. Additionally, an analysis of triadic binary motifs uncovers a greater level of reciprocity within the Foes network compared to the Friends network.

This article is part of the theme issue ‘A complexity science approach to law and governance’.
Words or code first? Is the legacy document or a code statement the better starting point for complexity-reducing legal automation?
Authors: Goodenough Oliver R. , Carlson Preston J.
Published: February 2024

Law is a critical tool that humans have created to assist them in managing complex social interactions. Computational Law holds the potential to significantly enhance our capacity to express and manage legal complexity, and a number of advantages can result from restating public and private legal rules in computable form. Capturing that potential depends in part on the approaches taken to automation. One set of choices involves whether to translate directly into code from existing natural language statements of laws, regulations and contracts or whether to step back, envision the basic structure underlying those statements and build a software approach that reflects that structure in a code-native manner. We argue that many advantages can flow from the second approach, and we present a specific use case of a simplified insurance policy as an example of this approach. Large language models may assist in this process, but are not yet a replacement for a code-native utility.

This article is part of the theme issue ‘A complexity science approach to law and governance’.
Polycladomyces zharkentensis sp. nov., a novel thermophilic cellulose- and starch-degrading member of the Bacillota from a geothermal aquifer in Kazakhstan
Authors: Mashzhan Akzhigit , Kistaubayeva Aida , Javier-López Rubén , Bissenova Ulzhan , Bissenbay Akerke , Birkeland Nils-Kåre
Published: February 2024

A thermophilic, aerobic and heterotrophic filamentous bacterium, designated strain ZKZ2T, was isolated from a pipeline producing hydrothermal water originating from a >2.3 km deep subsurface geothermal source in Zharkent, Almaty region, Kazakhstan. The isolate was Gram-stain-positive, non-motile, heat-resistant and capable of producing a variety of extracellular hydrolases. Growth occurred at temperatures between 55 and 75 °C, with an optimum around 70 °C, and at pH values between 5.5 and 9.0, with an optimum at pH 7.0–7.5 with the formation of aerial mycelia; endospores were produced along the aerial mycelium. The isolate was able to utilize the following substrates for growth: glycerol, l-arabinose, ribose, d-xylose, d-glucose, d-fructose, d-mannose, rhamnose, d-mannitol, methyl-d-glucopyranoside, aesculin, salicin, cellobiose, maltose, melibiose, sucrose, trehalose, melezitose, raffinose, starch, turanose and 5-keto-gluconate. Furthermore, it was able to hydrolyse carboxymethylcellulose, starch, skimmed milk, Tween 60 and Tween 80. The major cellular fatty acids were iso-C15 : 0, iso-C17 : 0, iso-C16 : 0 and C16 : 0. Our 16S rRNA gene sequence analysis placed ZKZ2T within the genus Polycladomyces, family Thermoactinomycetaceae, with the highest similarity to the type species Polycladomyces abyssicola JIR-001T (99.18 % sequence identity). Our draft genome sequence analysis revealed a genome size of 3.3 Mbp with a G+C value of 52.5 mol%. The orthologous average nucleotide identity value as compared to that of its closest relative, P. abyssicola JIR-001T, was 90.23 %, with an in silico DNA–DNA hybridization value of 40.7 %, indicating that ZKZ2T represents a separate genome species. Based on the phenotypic and genome sequence differences from the other two Polycladomyces species, we propose that strain ZKZ2T represents a novel species, for which we propose the name Polycladomyces zharkentensis sp. nov. The type strain is ZKZ2T (=CECT 30708T=KCTC 43421T).
Enhancing the Josephson diode effect with Majorana bound states
Authors: Cayao Jorge , Nagaosa Naoto , Tanaka Yukio
Published: February 2024

We consider phase-biased Josephson junctions with spin-orbit coupling under external magnetic fields and study the emergence of the Josephson diode effect in the presence of Majorana bound states. We show that junctions having middle regions with Zeeman fields along the spin-orbit axis develop a low-energy Andreev spectrum that is asymmetric with respect to the superconducting phase difference ϕ=π, which is strongly influenced by Majorana bound states in the topological phase. This asymmetric Andreev spectrum gives rise to anomalous current-phase curves and critical currents that are different for positive and negative supercurrents, thus signaling the emergence of the Josephson diode effect. While this effect exists even in the trivial phase, it gets enhanced in the topological phase due to the spatial nonlocality of Majorana bound states. Our paper thus establishes the utilization of topological superconductivity for enhancing the functionalities of Josephson diodes.

Published by the American Physical Society
2024
σ
exchange in the one-boson exchange model involving the ground state octet baryons
Authors: Wu Bing , Cao Xiong-Hui , Dong Xiang-Kun , Guo Feng-Kun
Published: February 2024

Based on the one-boson-exchange framework that the σ meson serves as an effective parametrization for the correlated scalar-isoscalar ππ interaction, we calculate the coupling constants of the σ to the 12+ ground state light baryon octet B by matching the amplitude of BB¯→ππ→B¯B to that of BB¯→σ→B¯B. The former is calculated using a dispersion relation, supplemented with chiral perturbation theory results for the BBππ couplings and the Muskhelishvili-Omnès representation for the ππ rescattering. Explicitly, the coupling constants are obtained as gNNσ=8.7−1.9+1.7, gΣΣσ=3.5−1.3+1.8, gΞΞσ=2.5−1.4+1.5, and gΛΛσ=6.8−1.7+1.5. These coupling constants can be used in the one-boson-exchange model calculations of the interaction of light baryons with other hadrons.

Published by the American Physical Society
2024
Toward an estimate of the amplitude
X(3872)→π0χc1(1P)
Authors: Achasov N. N. , Shestakov G. N.
Published: February 2024

The well-known model of the triangle diagrams with D*D¯D* and D¯*DD¯* mesons in the loops is compared with the modern data on the amplitude of the X(3872)→π0χc1(1P) decay. Considering the X(3872) object as a χc1(2P) charmonium state, we introduce a parameter ξ characterizing the scale of the isotopic symmetry violation in this decay and find a lower limit of ξ≃0.0916. The model incorporates the only fitted parameter associated with the form factor. We analyze in detail the influence of the form factor on the amplitude X(3872)→π0χc1(1P) and on the parameter ξ. As the suppression of the amplitude by the form factor increases, ξ increases. Because the X(3872) resonance is located practically at the threshold of the D0D¯*0 channel, the amplitude of X(3872)→π0χc1(1P) turns out to be proportional to md−mu. Using the estimating values for the coupling constants gXDD¯*, gχc1DD¯*, and gD*0D*0π0, we show that the model of the triangle loop diagrams is in reasonable agreement with the available data. Apart from the difference in the masses of neutral and charged charmed mesons, any additional exotic sources of isospin violation in X(3872)→π0χc1(1P) (such as a significant difference between the coupling constants gXD0D¯*0 and gXD+D*−) are not required to interpret the data. This indirectly confirms the isotopic neutrality of the X(3872), which is naturally realized for the cc¯ state χc1(2P).

Published by the American Physical Society
2024
Essay: Exploring the Physics of Basic Medical Research
Authors: Sandoghdar Vahid
Published: February 2024

The 20th century witnessed the emergence of many paradigm-shifting technologies from the physics community, which have revolutionized medical diagnostics and patient care. However, fundamental medical research has been mostly guided by methods from areas such as cell biology, biochemistry, and genetics, with fairly small contributions from physicists. In this Essay, I outline some key phenomena in the human body that are based on physical principles and yet govern our health over a vast range of length and time scales. I advocate that research in life sciences can greatly benefit from the methodology, know-how, and mindset of the physics community and that the pursuit of basic research in medicine is compatible with the mission of physics.

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Published by the American Physical Society2024
Characterization and optimized engineering of bosonic quantum interfaces under single-mode operational constraints
Authors: Fong Pak-Tik , Poon Sheung Chi , Lau Hoi-Kwan
Published: February 2024

Controlling the quantum interface between two bosonic modes is essential in countless implementations of quantum information processing. However, full controllability is rarely achieved in most platforms due to specific physical limitations. In this work, we completely characterize the linear two-mode interfaces under the most pessimistic restriction that only single-mode operation is available. When arbitrary Gaussian single-mode operations can be applied to both modes, we find that every interface can be characterized by an invariant transmission strength. Moreover, in the practical situation that squeezing is restricted in one of the modes, we discover two additional quantities, irreducible squeezing and irreducible shearing, that are invariant under the allowable controls. By using this characterization, we develop systematic strategies to engineer an arbitrary linear interface through cascading multiple fixed component interfaces. Without squeezing restriction, our protocol is optimal and requires at most three component interfaces. Under the squeezing constraint, our protocol can be extended to engineer also the additional invariants by using no more than two more rounds of cascade. We also propose the remote squeezing scheme to tackle the squeezing restriction through interfacing with an active auxiliary mode.

Published by the American Physical Society
2024
Extensibility governs the flow-induced alignment of polymers and rod-like colloids
Authors: Calabrese Vincenzo , Porto Santos Tatiana , Lopez Carlos G. , Lettinga Minne Paul , Haward Simon J. , Shen Amy Q.
Published: February 2024

Polymers and rod-like colloids (PaRC) adopt a favorable orientation under sufficiently strong flows. However, how the flow kinematics affect the alignment of such nanostructures according to their extensibility remains unclear. By analyzing the shear- and extension-induced alignment of chemically and structurally different PaRC, we show that extensibility is a key determinant of the structural response to the imposed kinematics. We propose a unified description of the effectiveness of extensional flow, compared to shearing flow, at aligning PaRC of different extensibility.

Published by the American Physical Society
2024
Role of Dilations in Reversing Physical Processes: Tabletop Reversibility and Generalized Thermal Operations
Authors: Aw Clive Cenxin , Zaw Lin Htoo , Balanzó-Juandó Maria , Scarani Valerio
Published: February 2024

Irreversibility, crucial in both thermodynamics and information theory, is naturally studied by comparing the evolution—the (forward) channel—with an associated reverse—the reverse channel. There are two natural ways to define this reverse channel. Using logical inference, the reverse channel is the Bayesian retrodiction (the Petz recovery map in the quantum formalism) of the original one. Alternatively, we know from physics that every irreversible process can be modeled as an open system: one can then define the corresponding closed system by adding a bath (“dilation”), trivially reverse the global reversible process, and finally remove the bath again. We prove that the two recipes are strictly identical, both in the classical and in the quantum formalism, once one accounts for correlations formed between system and the bath. Having established this, we define and study special classes of maps: (including ), for which no such system-bath correlations are formed for some states; and , when the reverse channel can be implemented with the same devices as the original one. We establish several general results connecting these classes, and a very detailed characterization when both the system and the bath are one qubit. In particular, we show that, when reverse channels are well defined, product preservation is a sufficient but not necessary condition for tabletop reversibility; and that the preservation of local energy spectra is a necessary and sufficient condition to generalized thermal operations.

Published by the American Physical Society
2024