bluuebunny/crossref_metadata_2025 huggingface dataset:
Mitochondrial function and coronary flow reserve improvement after autologous myoblast patch transplantation for ischaemic cardiomyopathy: a case report
Authors: Ito Yoshito , Kawamura Takuji , Chimura Misato , Miyagawa Shigeru
Published: September 2023

Background

Autologous myoblast patch (AMP) transplantation has resulted in good clinical outcomes for end-stage ischaemic cardiomyopathy, but the mechanisms behind them are unclear. Herein, we report the relationship between mitochondrial function and coronary flow reserve (CFR) before and after AMP transplantation.

Case summary

The patient was a 73-year-old man who underwent coronary artery bypass grafting (CABG). At that time, the left ventricular ejection fraction (LVEF) was 53%, but it declined to 25% after 6 years. He was diagnosed with ischaemic cardiomyopathy (ICM). Coronary flow reserve in NH3-positron emission tomography (NH3-PET) was impaired to 1.69. In Tc-99m MIBI scintigraphy, the washout rate (WR) was 17%, suggestive of impaired mitochondrial function. He was not a candidate for heart transplantation, and we performed AMP transplantation 6 years after CABG. One year after AMP transplantation, LVEF, CFR, and Tc-99m MIBI WR improved to 36%, 2.07, and 7%, respectively. The Tc-99m MIBI WR improved especially in the anterolateral region, and the CFR increased in almost all segments.

Discussion

In this case, AMP transplantation for ICM improved cardiac function, CFR, and mitochondrial function. The mitochondrial transfer from the transplanted myoblasts to the damaged myocardium may have contributed to the mitochondrial function improvement. This probably induced myocardial energy metabolism recovery and decreased oxygen demand. AMP transplantation also has the potential to improve microvascular dysfunction, due to angiogenesis induction. These effects can lead to improved prognoses of ICM after AMP transplantation, highlighting its potential to cure refractory heart failure.
Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment
Authors: Seekircher Lisa , Tschiderer Lena , Lind Lars , Safarova Maya S , Kavousi Maryam , Ikram M Arfan , Lonn Eva , Yusuf Salim , Grobbee Diederick E , Kastelein John J P , Visseren Frank L J , Walters Matthew , Dawson Jesse , Higgins Peter , Agewall Stefan , Catapano Alberico , de Groot Eric , Espeland Mark A , Klingenschmid Gerhard , Magliano Dianna , Olsen Michael H , Preiss David , Sander Dirk , Skilton Michael , Zozulińska-Ziółkiewicz Dorota A , Grooteman Muriel P C , Blankestijn Peter J , Kitagawa Kazuo , Okazaki Shuhei , Manzi Maria V , Mancusi Costantino , Izzo Raffaele , Desvarieux Moise , Rundek Tatjana , Gerstein Hertzel C , Bots Michiel L , Sweeting Michael J , Lorenz Matthias W , Willeit Peter
Published: September 2023

Aims

Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values.

Methods and results

We analysed individual records of 41 941 participants from 16 prospective studies in the Proof-ATHERO consortium {mean age 61 years [standard deviation (SD) = 11]; 53% female; 16% prior CVD}. Mean baseline values of near and far wall CCA-IMT were 0.83 (SD = 0.28) and 0.82 (SD = 0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: −0.40 to 0.43), and were moderately correlated [r = 0.44; 95% confidence interval (CI): 0.39–0.49). Over a median follow-up of 9.3 years, we recorded 10 423 CVD events. We pooled study-specific hazard ratios for CVD using random-effects meta-analysis. Near and far wall CCA-IMT values were approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14–1.22; I² = 30.7%) and 1.20 (1.18–1.23; I² = 5.3%) when adjusted for age, sex, and prior CVD and 1.09 (1.07–1.12; I² = 8.4%) and 1.14 (1.12–1.16; I²=1.3%) upon multivariable adjustment (all P < 0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only [+0.0046 vs. +0.0023 for near (P < 0.001), +0.0037 for far wall (P = 0.006)].

Conclusions

The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls.
Prognosis prediction in cardiac amyloidosis by cardiac magnetic resonance imaging: a systematic review with meta-analysis
Authors: Boretto Paolo , Patel Neal Hitesh , Patel Keval , Rana Mannat , Saglietto Andrea , Soni Manas , Ahmad Mahmood , Sin Ying Ho Jamie , De Filippo Ovidio , Providencia Rui Andre , Hyett Bray Jonathan James , D’Ascenzo Fabrizio
Published: September 2023

Cardiac involvement is the foremost determinant of the clinical progression of amyloidosis. The diagnostic role of cardiac magnetic resonance (CMR) imaging in cardiac amyloidosis has been established, but the prognostic role of various right and left CMR tissue characterization and functional parameters, including global longitudinal strain (GLS), late gadolinium enhancement (LGE), and parametric mapping, is yet to be delineated. We searched EMBASE, PubMed, and MEDLINE for studies analysing the prognostic use of CMR imaging in patients with light chain amyloidosis or transthyretin amyloidosis cardiac amyloidosis. The primary endpoint was all-cause mortality. A random effects model was used to calculate a pooled odds ratio using inverse-variance weighting. Nineteen studies with 2199 patients [66% males, median age 59.7 years, interquartile range (IQR) 58–67] were included. Median follow-up was 24 months (IQR 20–32), during which 40.8% of patients died. Both tissue characterization left heart parameters such as elevated extracellular volume [hazard ratio (HR) 3.95, 95% confidence interval (CI) 3.01–5.17], extension of left ventricular (LV) LGE (HR 2.69, 95% CI 2.07–3.49) elevated native T1 (HR 2.19, 95% CI 1.12–4.28), and functional parameters such as reduced LV GLS (HR 1.91, 95% CI 1.52–2.41) and reduced LV ejection fraction (EF; HR 1.20, 95% CI 1.17–1.23) were associated with increased all-cause mortality. Unlike the presence of right ventricular (RV) LGE (HR 3.40, 95% CI 0.51–22.54), parameters such as RV GLS (HR 2.08, 95% CI 1.6–2.69), RVEF (HR 1.13, 95% CI 1.05–1.22), and tricuspid annular systolic excursion (TAPSE) (HR 1.11, 95% CI 1.02–1.21) were also associated with mortality. In this large meta-analysis of patients with cardiac amyloidosis, CMR parameters assessing RV and LV function and tissue characterization were associated with an increased risk of mortality.
Catholic Intellectuals and Transnational Anti-Communism: Pax Romana from the Spanish Civil War to the post-1945 World Order
Authors: Richards Michael
Published: September 2023

This article analyses the conditions and ideas motivating cross-border connectivity among young Roman Catholic intellectuals during the trans-war era of the 1930s and 1940s. It examines Pax Romana, the Swiss-based international association of Catholic students and graduates, as it navigated between fascism and resistance in the aftermath of the Spanish Civil War and during the global conflict of 1939–45. The organisation was headed successively by two young activists from Spain, Joaquín Ruiz-Giménez, a legal scholar from Madrid who fought for Franco, and Ramon Sugranyes de Franch, a Catalan literary specialist who went into exile in 1936. Comparison of their parallel careers forms the central narrative cord of the article, illuminating the complex relationship of national to global Catholic fractures between conservative nation-statists and political and social pluralists. The Pax Romana congress held in Spain in 1946 was pivotal in accounting for the transnational legacy of that country’s civil war. The wartime ‘humanist’ critique of Franco’s ‘crusade’ made by key Catholic public thinkers was both disseminated and challenged and its relevance to Europe’s future assessed. Ruiz-Giménez, as its president, used the organisation from Spain to legitimate the country’s regime, aided by sympathetic foreign nation-statists. Sugranyes, in contrast, gravitated in the early 1940s to Fribourg in Switzerland, Pax Romana’s headquarters—via Geneva, Paris and southern France—encountering and allying with progressive Catholic exiles from Italy and Spain and French anti-fascist resisters. Although taking different routes, both men ultimately transcended their nationally rooted religious and political assumptions through dialogue across boundaries.
Birth weight influences cardiac structure, function, and disease risk: evidence of a causal association
Authors: Ardissino Maddalena , Morley Alec P , Slob Eric A W , Schuermans Art , Rayes Bilal , Raisi-Estabragh Zahra , de Marvao Antonio , Burgess Stephen , Rogne Tormod , Honigberg Michael C , Ng Fu Siong
Published: September 2023

Background and Aims

Low birth weight is a common pregnancy complication, which has been associated with higher risk of cardiometabolic disease in later life. Prior Mendelian randomization (MR) studies exploring this question do not distinguish the mechanistic contributions of variants that directly influence birth weight through the foetal genome (direct foetal effects), vs. variants influencing birth weight indirectly by causing an adverse intrauterine environment (indirect maternal effects). In this study, MR was used to assess whether birth weight, independent of intrauterine influences, is associated with cardiovascular disease risk and measures of adverse cardiac structure and function.

Methods

Uncorrelated (r2 < .001), genome-wide significant (P < 5 × 10−8) single nucleotide polymorphisms were extracted from genome-wide association studies summary statistics for birth weight overall, and after isolating direct foetal effects only. Inverse-variance weighted MR was utilized for analyses on outcomes of atrial fibrillation, coronary artery disease, heart failure, ischaemic stroke, and 16 measures of cardiac structure and function. Multiple comparisons were accounted for by Benjamini–Hochberg correction.

Results

Lower genetically-predicted birth weight, isolating direct foetal effects only, was associated with an increased risk of coronary artery disease (odds ratio 1.21, 95% confidence interval 1.06–1.37; P = .031), smaller chamber volumes, and lower stroke volume, but higher contractility.

Conclusions

The results of this study support a causal role of low birth weight in cardiovascular disease, even after accounting for the influence of the intrauterine environment. This suggests that individuals with a low birth weight may benefit from early targeted cardiovascular disease prevention strategies, independent of whether this was linked to an adverse intrauterine environment during gestation.
A novel polygenic risk score improves prognostic prediction of heart failure with preserved ejection fraction in the Chinese Han population
Authors: Han Yi , Lu Jiapeng , Chen Bowang , Li Xi , Dai Hao , Zhang Lihua , Yan Xiaofang , Liu Jiamin , Zhang Haibo , Fu Xin , Yu Qin , Ren Jie , Cui Hanbin , Gao Yan , Li Jing
Published: September 2023

Aims

Mortality risk assessment in patients with heart failure (HF) with preserved ejection fraction (HFpEF) presents a major challenge. We sought to construct a polygenic risk score (PRS) to accurately predict the mortality risk of HFpEF.

Methods and results

We first carried out a microarray analysis of 50 HFpEF patients who died and 50 matched controls who survived during 1-year follow-up for candidate gene selection. The HF-PRS was developed using the independent common (MAF > 0.05) genetic variants that showed significant associations with 1-year all-cause death (P < 0.05) in 1442 HFpEF patients. Internal cross-validation and subgroup analyses were performed to evaluate the discrimination ability of the HF-PRS. In 209 genes identified by microarray analysis, 69 independent variants (r < 0.1) were selected to develop the HF-PRS model. This model yielded the best discrimination capability for 1-year all-cause mortality with an area under the curve (AUC) of 0.852 (95% CI 0.827–0.877), which outperformed the clinical risk score consisting of 10 significant traditional risk factors for 1-year all-cause mortality (AUC 0.696, 95% CI 0.658–0.734, P = 4 × 10−11), with net reclassification improvement (NRI) of 0.741 (95% CI 0.605–0.877; P < 0.001) and integrated discrimination improvement (IDI) of 0.181 (95% CI 0.145–0.218; P < 0.001). Individuals in the medium and the highest tertile of the HF-PRS had nearly a five-fold (HR = 5.3, 95% CI 2.4–11.9; P = 5.6 × 10−5) and 30-fold (HR = 29.8, 95% CI 14.0–63.5; P = 1.4 × 10−18) increased risk of mortality compared to those in the lowest tertile, respectively. The discrimination ability of the HF-PRS was excellent in cross validation and throughout the subgroups regardless of comorbidities, gender, and patients with or without a history of heart failure.

Conclusion

The HF-PRS comprising 69 genetic variants provided an improvement of prognostic power over the contemporary risk scores and NT-proBNP in HFpEF patients.
A systematic review and cluster analysis approach of 103 studies of high-intensity interval training on cardiorespiratory fitness
Authors: Cadenas-Sanchez Cristina , Fernández-Rodríguez Rubén , Martínez-Vizcaíno Vicente , de los Reyes González Nicolás , Lavie Carl J , Galán-Mercant Alejandro , Jiménez-Pavón David
Published: September 2023

Aims

This study aims to systematically review the systematic reviews and meta-analyses examining the effect of high-intensity interval training (HIIT) protocols on improving cardiorespiratory fitness (CRF) and to characterize the main patterns of HIIT modalities using clustering statistical procedures to examine their potential differences on improving CRF. Finally, we aimed to develop a comprehensive guideline for reporting HIIT protocols.

Methods and results

A systematic review was conducted on PubMed and Web of Science from their inception to 31 October 2022 for systematic reviews and meta-analysis aimed at assessing the effect of HIIT on CRF in the entire study population. The Assessment of Multiple Systematic Reviews 2 tool was used to evaluate the risk of bias of each review. Additionally, a principal component analysis testing the data adequacy for the factor solution through the Kaiser–Meyer–Olkin procedure test was conducted. Once the number of factors was identified, in order to identify data patterns according to the main characteristics of the HIIT protocols, a two-step cluster analysis was conducted. Nineteen systematic reviews and/or meta-analyses comprising 103 studies were included. Clustering of systematic reviews and meta-analyses identified three HIIT modalities (‘HIIT-normal mixed’, ‘HIIT-long running’, and ‘HIIT-short cycling’) underlying the interventions across the included studies. Similar effectiveness in increasing CRF among the three HIIT modalities was observed. Subgroup analyses showed no significant differences in CRF by sex, weight status, study design, and baseline physical activity level (P > 0.05), but differences were observed by age group, and exercise intensity indicator was used in the HIIT programmes (P < 0.05).

Conclusion

All three HIIT modalities produced significant improvements of CRF, although some modalities showed greater changes for some specific age groups or intensity indicators.
Stellate ganglion ablation by conventional radiofrequency in patients with electrical storm
Authors: Rao B Hygriv , Lokre Avinash , Patnala Nagalaxmi , Padmanabhan T N C
Published: September 2023

Aims

We report a series of patients with Electrical Storm (ES) who underwent bilateral stellate ganglion ablation by using conventional radio frequency (RFA).

Methods and results

The procedure was done with fluoroscopic guidance using the COSMAN™ 1A RF Generator and a 22G RF needle (5 cm length and 5 mm active tip). Six patients, four male and two female (mean age 55 ± 7 years and mean LVEF—42 ± 21%) with ES underwent the procedure under fluoroscopic guidance. All patients experienced recurrent ICD shocks or required multiple external defibrillation shocks. There were no procedural complications. All patients survived free of ES at discharge. At a mean follow—up of 22 ± 8months, all were alive free of ES but two patients received appropriate shocks for VT and one patient had VT terminated by ATP.

Conclusion

This small series of cases is a proof of concept that neuromodulation by conventional RFA targeting bilateral stellate ganglia appears safe, feasible, and effective in treating selected unstable patients with ES.
A paradox of bacterial persistence and antibiotic resistance: chloramphenicol acetyl transferase as a double barrel shot gun
Authors: Alves da Silva Ana , Silva Inês Jesus , Arraiano Cecília Maria
Published: September 2023

The problematic microbial resistance to antibiotics has led to an increasing interest in bacterial persistence and its impact on infection. Nonetheless, these two mechanisms are often assessed in independent studies, and there is a lack of knowledge about their relation or possible interactions, both at cellular and population levels. This work shows evidence that the insertion of the resistance gene Chloramphenicol Acetyl Transferase (cat) together with its cognate antibiotic chloramphenicol (CAM), is capable to modulate Salmonella Typhimurium persistence to several antibiotics and decrease its survival. This effect is independent of the antibiotics’ mechanisms of action or the locus of cat. RelA [p(ppGpp) syntetase] has been shown to be involved in persistence. It was recently proposed that RelA [(p)ppGpp synthetase], binds to uncharged tRNAs, forming RelA.tRNA complexes. These complexes bind to vacant A-sites in the ribosome, and this mechanism is essential for the activation of RelA. In this study, we propose that the antibiotic chloramphenicol blocks the A-site of the ribosome, hindering the binding of RelA.tRNA complexes to the ribosome thus preventing the activation of RelA and (p)ppGpp synthesis, with a consequent decrease in the level of persistence of the population. Our discovery that the concomitant use of chloramphenicol and other antibiotics in chloramphenicol resistant bacteria can decrease the persister levels can be the basis of novel therapeutics aiming to decrease the persisters and recalcitrant infections.
High-throughput screening of the Saccharomyces cerevisiae genome for 2-amino-3-methylimidazo [4,5-f] quinoline resistance identifies colon cancer-associated genes
Authors: Dolan Michael , St. John Nick , Zaidi Faizan , Doyle Francis , Fasullo Michael
Published: September 2023

Heterocyclic aromatic amines (HAAs) are potent carcinogenic agents found in charred meats and cigarette smoke. However, few eukaryotic resistance genes have been identified. We used Saccharomyces cerevisiae (budding yeast) to identify genes that confer resistance to 2-amino-3-methylimidazo[4,5-f] quinoline (IQ). CYP1A2 and NAT2 activate IQ to become a mutagenic nitrenium compound. Deletion libraries expressing human CYP1A2 and NAT2 or no human genes were exposed to either 400 or 800 µM IQ for 5 or 10 generations. DNA barcodes were sequenced using the Illumina HiSeq 2500 platform and statistical significance was determined for exactly matched barcodes. We identified 424 ORFs, including 337 genes of known function, in duplicate screens of the “humanized” collection for IQ resistance; resistance was further validated for a select group of 51 genes by growth curves, competitive growth, or trypan blue assays. Screens of the library not expressing human genes identified 143 ORFs conferring resistance to IQ per se. Ribosomal protein and protein modification genes were identified as IQ resistance genes in both the original and “humanized” libraries, while nitrogen metabolism, DNA repair, and growth control genes were also prominent in the “humanized” library. Protein complexes identified included the casein kinase 2 (CK2) and histone chaperone (HIR) complex. Among DNA Repair and checkpoint genes, we identified those that function in postreplication repair (RAD18, UBC13, REV7), base excision repair (NTG1), and checkpoint signaling (CHK1, PSY2). These studies underscore the role of ribosomal protein genes in conferring IQ resistance, and illuminate DNA repair pathways for conferring resistance to activated IQ.
Avoidable Care Transitions: A Consensus-Based Definition Using a Delphi Technique
Authors: Makhmutov Rustem , Meyer Gabriele , Ellen Moriah E , Fleischer Steffen
Published: September 2023

Background and Objectives

Older adults are at increased risk of frequent transitions between care settings, even though some care transitions are avoidable. The term “avoidable care transitions” is not clearly defined in the research literature. This study aimed to find a consensus-based definition for “avoidable care transitions.”

Research Design and Methods

This study was conducted as part of the TRANS-SENIOR research network. A 4-round Delphi survey was based on a literature review that identified existing definitions of “avoidable care transitions.” Articles in MEDLINE via PubMed and CINAHL were searched. In total 95 references were included, and 106 definitions were identified. Definitions were coded to find themes, resulting in 3 themes with 2 codes for each.

Results

In total, 99 experts from 9 countries were invited, and the response rates in Delphi Rounds 1, 2, 3, and 4 were 37.5%, 19.1%, 33.3%, and 23.3%, respectively. Upon reaching the predefined minimum of 90% agreement, the following definition was declared as final: “Avoidable care transitions (a) are without significant patient-relevant benefits or with a risk of harm outweighing patient-relevant benefits and/or (b) are when a comparable health outcome could be achieved in lower resource settings using the resources available in that place/health care system, and/or (c) violate a patient’s/informal caregiver’s preference or an agreed care plan.”

Discussion and Implications

Consensus on a definition for “avoidable care transitions” was reached by a multidisciplinary and international panel of experts comprising researchers and providers. The resulting definition consists of 3 distinct dimensions relating to the balance of benefit and harm to a patient, resource consumption, and a patient’s or informal caregiver’s preferences. The new definition might enhance the common understanding of avoidable care transitions and is now ready for application in research and quality and safety management in health care.
Real-World Navigation With Application: Characteristics of Gaze Behavior and Associated Factors in Older Adults
Authors: Shimokihara Suguru , Maruta Michio , Han Gwanghee , Ikeda Yuriko , Kamasaki Taishiro , Hidaka Yuma , Akasaki Yoshihiko , Tabira Takayuki
Published: September 2023

Background and Objectives

Advancing age might impair real-world navigation ability. The use of mobile devices by older adults has grown rapidly in recent years. Navigation applications (apps) in mobile devices may facilitate the freedom of outings for older adults. Our aim is to investigate age-related differences in real-world app-based navigation walking in terms of accuracy, efficiency, and gaze behavior; and to explore clinical factors associated with navigation walking in older adults.

Research Design and Methods

A total of 20 community-dwelling older adults and 16 young adults completed a route navigation task using a navigation app while recording their gaze behavior. Outcomes were compared in both groups and a general linear regression was used to explore clinical factors associated with app-based navigation walk in older adults.

Results

Compared with young participants, older participants had more stops and root errors and less fixation time, smaller amplitude of saccades. Additionally, older adults were more likely to glance at their smartphones while app-based navigation walking. Furthermore, gait speed and the following assessment scores were significantly associated with navigation walking in older adults: Mini-Mental State Examination, Life-Space Assessment, and the short version of the Mobile Device Proficiency Questionnaire.

Discussion and Implications

For app-based navigation walks, differences in accuracy and gaze behavior were found to exist with age. Additionally, efficient real-world navigation walks in older adults require the extent of life space and proficiency with mobile devices, along with walking speed and cognitive function. It is possible that age-related functional decline, such as the visual field and shifting attention between mobile devices and the real world, may have influenced the results. The study also suggests the need to understand the level of proficiency with mobile devices so that older adults can continue to go out freely. These findings give the basis for providing older adults with appropriate navigation assistance.
3. Gender, race, and diversity in the legal profession
Authors: Herring Jonathan
Published: September 2023

This chapter examines the issue of diversity in the legal profession. It first explains the meaning of diversity and the reasons why it should be promoted. Debates around diversity have focused particularly on gender and race, although increasingly there is emphasis on achieving diversity in relation to socio-economic background, disability, and sexuality too. It reviews the current status of the profession in terms of diversity. It considers diversity rules as set out in in the Equality Act 2010, the Solicitors Regulation Authority (SRA) Handbook, and the Bar Standards Board (BSB) Handbook. Barriers to diversity and steps to promote diversity are also discussed.
11. Alternative dispute resolution
Authors: Herring Jonathan
Published: September 2023

This chapter examines the ethical issues raised by alternative dispute resolution (ADR). It first looks at the process of negotiation, which is the way in which lawyers resolve most disputes. It then considers other forms of ADR, including mediation and, briefly, arbitration. The chapter highlights the advantages and disadvantages of these processes. There are particular concerns where one party is in a stronger bargaining position, for example in a family case which has involved domestic abuse. There is also much debate over the role a mediator should play, andin particular over whether a mediator should take a neutral role or persuade the parties to reach what they regard as a fair settlement. It also considers what attracts clients to use these forms of dispute resolution.
13. Business ethics
Authors: Herring Jonathan
Published: September 2023

This chapter examines the issue of business ethics. It first explains why business ethics matter. It then considers the notion of notion of corporate responsibility, and sets out policies and practices to ensure that businesses have an ethical dimension to their decision-making. The chapter explores the role of businesses in promoting worldwide social goods. It also considers the role of the lawyer in helping businesses to behave in an ethical way. This can be a particular challenge for in-house lawyers who may find a tension between their role as an employee of a firm and as a voice to ensure good practice.
Habitat and distribution of the red decorator crab, Schizophrys aspera, a cryptic crown-of-thorns seastar predator
Authors: Wolfe Kennedy , Desbiens Amelia A , Pietsch Emma , Mumby Peter J
Published: September 2023

Cryptic species and their interactions are challenging to describe owing to the difficulties in observing and sampling their populations. Such methodological hurdles are critical to resolve, especially when important interactions involving poorly described species are detected. The red decorator crab, Schizophrys aspera, is a newfound predator of the corallivorous Pacific crown-of-thorns seastar (CoTS; Acanthaster sp.). We discuss the Indo-Pacific distribution and taxonomy of S. aspera and provide characterization of its cryptic population at sites around Heron Island, Great Barrier Reef, that differ in CoTS densities. Most S. aspera (>95%) were found under coral rubble pieces atop existing rubble, associated with large pieces and chasmic interstices. The three smallest individuals (carapace width: 5–11 mm) were found under rubble overlying sand. Mean density of S. aspera was 0.8 ± 0.2 ind. 100 m−2, which varied among sites. Areas with lower records of CoTS had higher densities of S. aspera (p = 0.002; R2 = 0.25), which justifies evaluation of the distribution and impact of this species in context of CoTS outbreaks. We present a method to survey cryptic decapods on coral reefs, along with microhabitat characteristics to help predict S. aspera on reefs prone to CoTS outbreaks and its capacity to act as a natural top-down control mechanism.
Oncologic outcomes of segmentectomy versus lobectomy for clinical T1c radiological pure-solid non-small-cell lung cancer
Authors: Hattori Aritoshi , Takamochi Kazuya , Matsunaga Takeshi , Fukui Mariko , Suzuki Kenji
Published: September 2023

OBJECTIVES

We aimed to compare the outcomes of segmentectomy with those of lobectomy in T1c (>2–3 cm) radiological pure-solid non-small-cell lung cancer detected on thin-section computed tomography.

METHODS

This retrospective review compared the survival outcomes, causes of death and recurrence patterns between the segmentectomy and lobectomy in patients with c-T1cN0M0 radiological pure-solid non-small-cell lung cancer. Multivariable analysis was performed to control for confounders of survival. The overall survival (OS) and recurrence-free survival were analysed using the Kaplan–Meier method. Differences in cumulative incidence of recurrence between groups were assessed using the methods of Gray.

RESULTS

Of the 426 patients, lobectomy was performed in 381 patients and segmentectomy in 45 patients. Nodal metastasis was noted in 104 (24.4%) patients. Multivariable analysis revealed that lobectomy was an independent prognosticator of better OS (hazard ratio 0.596, 95% confidence interval 0.366–0.969; P = 0.037). Lobectomy arm showed favourable 5-year OS and recurrence-free survival (OS: 72.9% vs 59.7%, log-rank test P = 0.007; recurrence-free survival: 64.4% vs 48.7%, P = 0.034) (median follow-up: 53 months). Approximately 14% of the patients in the lobectomy group and 27% in the segmentectomy group died of lung cancer. Furthermore, 5-year cumulative incidence of loco-regional recurrence rate was significantly higher in the segmentectomy group (35.5% vs 15.8%, P < 0.001).

CONCLUSIONS

In T1c radiological pure-solid non-small-cell lung cancer, segmentectomy was significantly associated with worse survival and insufficient loco-regional cancer control. Lobectomy remains the standard surgical treatment; meanwhile, segmentectomy should be applied with great caution.
Existence of a Percolation Threshold on Finite Transitive Graphs
Authors: Easo Philip
Published: September 2023

Let $(G_{n})$ be a sequence of finite connected vertex-transitive graphs with volume tending to infinity. We say that a sequence of parameters $(p_{n})$ is a percolation threshold if for every $\varepsilon> 0$, the proportion $\left \lVert K_{1}\right \rVert $ of vertices contained in the largest cluster under bond percolation ${\mathbb {P}}_{p}^{G}$ satisfies both $$ \begin{align*} \begin{split}{} \lim_{n \to \infty} {\mathbb{P}}_{(1+\varepsilon)p_{n}}^{G_{n}} \left( \left\lVert K_{1}\right\rVert \geq \alpha \right) &= 1 \qquad \textrm{for some}\ \alpha> 0, \textrm{and}\\ \lim_{n \to \infty} {\mathbb{P}}_{(1-\varepsilon)p_{n}}^{G_{n}} \left( \left\lVert K_{1}\right\rVert \geq \alpha \right) &= 0 \qquad \textrm{for all}\ \alpha > 0. \end{split} \end{align*}$$We prove that $(G_{n})$ has a percolation threshold if and only if $(G_{n})$ does not contain a particular infinite collection of pathological subsequences of dense graphs. Our argument uses an adaptation of Vanneuville’s new proof of the sharpness of the phase transition for infinite graphs via couplings [27] together with our recent work with Hutchcroft on the uniqueness of the giant cluster [15].
Reconsideration of Maternal Serological Testing for Predicting Congenital CMV Infection
Authors: Huang Yue , Tang Jiabao , Yu Huan , Song Qiaoqiao , Hao Mengling , Wang Han , Liu Junxian , Dong Yue , Liang Mufeng , Zhuang Sijie , Li Caihong , Wang Jiangding , Liang Caihong , Su Yingying , Li Tingdong , Wu Ting , Ge Shengxiang , Zhang Jun , Xia Ningshao
Published: September 2023

Background

The value of the widely applied maternal cytomegalovirus (CMV) serological testing approach in predicting intrauterine transmission in highly seroprevalent regions remains unknown.

Methods

A nested case-control study was conducted based on a maternal-child cohort study. Newborns with congenital CMV (cCMV) infection were included, and each of them was matched to 3 newborns without cCMV infection. Retrospective samples were tested for immunoglobulin G (IgG) avidity and immunoglobulin M (IgM) antibodies in maternal serum and CMV DNA in maternal blood and urine to analyze their associations with cCMV infection.

Results

Forty-eight newborns with cCMV infection and 144 matched newborns without infection were included in the study. Maternal IgM antibodies and IgG avidity during pregnancy were not statistically associated with intrauterine transmission. The presence of CMV DNAemia indicated a higher risk of cCMV infection, with odds ratio values of 5.7, 6.5, and 13.0 in early, middle, and late pregnancy, respectively. However, the difference in CMV shedding rates in transmitters and nontransmitters was not significant in urine.

Conclusions

The value of current maternal CMV serological testing in regions with high seropositivity rates is very limited and should be reconsidered. The detection of DNAemia would be helpful in assessing the risk of intrauterine transmission.
Underreporting and Misclassification of Respiratory Syncytial Virus–Coded Hospitalization Among Adults in Denmark Between 2015–2016 and 2017–2018
Authors: Egeskov-Cavling Amanda Marie , Johannesen Caroline Klint , Lindegaard Birgitte , Fischer Thea Kølsen ,   PROMISE Investigators, Nair Harish , Campbell Harry , Nohynek Hanna , Teirlinck Anne , Bont Louis , Openshaw Peter , Pollard Andrew , Beutels Philipe , Kumar Veena , Htar Tin Tin , Vernhes Charlotte , Kramer Rolf , Dos Santos Gael , Aerssens Jeroen , Manchin Nuria
Published: September 2023

Background

Low awareness and lack of routine testing for respiratory syncytial virus (RSV) infections among adults has led to underreporting in hospital records. This study aimed to assess the underreporting and misclassification of RSV infections among adults hospitalized with an respiratory tract infection (RTI)-coded hospitalization.

Methods

This study is an observational cohort study of RSV-associated hospitalizations among Danish adults (≥18 years old) conducted, between 2015 to 2018. Data were extracted from the Danish National Patient Registry (DNPR) and the Danish Microbiology Database. We identified RSV-positive hospitalizations by linking RTI-coded hospitalizations with a positive RSV test.

Results

Using hospital admission registries, we identified 440 RSV-coded hospitalizations, of whom 420 (95%) had a positive RSV test registered. By linking patients with RTI-coded hospital admissions to RSV test result, we found 570 additional episodes of RSV-positive hospitalizations without an RSV-coded diagnosis.

Conclusions

Our study of national register data showed that RSV is underreported among Danish adults. The study showed that the reliability of hospitalization data to estimate the burden of RSV among adults is questionable and are sensitive to changes in practice over time, even with complete nationwide healthcare data. Healthcare data can be useful to observe seasonality but to estimate the disease burden, prospective surveillance is recommended.
The Paradox of Peace: The Impact of Normalization with Israel on the Arab World
Authors: El Kurd Dana
Published: September 2023

How can peace initiatives facilitate authoritarian practices? Peace initiatives that do not address the root causes of conflict, and maintain structural violence, can facilitate authoritarian practices through both material and discursive mechanisms. I use the recent steps towards normalization and, in some instances, peace agreements between Israel and a number of Arab states to make this argument. I examine this dynamic across Gulf Cooperation Council states with varying authoritarian practices and ties to Israel. This paper contributes to our understanding of the impacts of illiberal peace and how it functions, transnationally and at varying levels within and outside state authority.
Analyzing the African Continental Free Trade Area (the AfCFTA) from an Informality Perspective: A Beautiful House in the Wrong Neighborhood
Authors: Kwasi Tieku Thomas , Yakohene Afua Boatemaa
Published: September 2023

The article critically explores the African Continental Free Trade Area (AfCFTA) from an informality perspective. The informality perspective sees unofficial rules, norms, practices, processes, actors, and decision-making structures as driving forces of the social world. They are ontologically prior to and building blocks of their formal counterparts. From this viewpoint, the failure to design the AfCFTA from the informal economy baseline makes it an unfit trade agreement for the African continent. Those who drafted the agreement, its supplementary protocols and annexes, and the decision-makers who signed as well as ratified them neglected the informal trading actors and unregistered enterprises in Africa. Rather than building the agreement around unregistered small-to-medium-scale enterprises, operated mostly by women and the youth, the AfCFTA and its legal instruments envisioned a utopian African trade market without them. The drafters and decision-makers of the AfCFTA seem to operate on the basic principle of no formalization and no gain from the free trade agreement. The result is a serious mismatch. The formally oriented AfCFTA is supposed to govern the largely informal African trading ecosystems. The failure to mainstream the informal economy in the AfCFTA makes the African free trade agreement look like, to use a house metaphor, a beautifully constructed house located in the wrong neighborhood. The article substantiates this claim and shows its implications for the Pan-African integration project and the study of international relations.
Ricardo as Spinoza: Secularization, Semitism, and Political Economy
Authors: Brody Samuel Hayim
Published: September 2023

Although the story that the great political economist David Ricardo (1772–1823) learned at the same school as Spinoza is most likely a romantic fiction, it suggests an intriguing parallel that reaches far beyond mere biographical coincidence. Like Spinoza, Ricardo was seen by both admirers and detractors as contributing in a “Jewish” way to forging a new, secular sphere of modern life. Because he left the Jewish community and did not frame his intellectual work as deriving from Judaism, such arguments necessarily appealed to racialization, making Ricardo Jewish in spite of himself. Considering Ricardo as a Spinoza figure offers us a deeper perspective on the role of racialized Jewishness in narratives of modern social science and thereby also in the theory of secularization.
Surveillance of ticks on a tropical island with introduced ungulates
Authors: Ku Ting-Hsiang , Liao Hsiao-Mei , Nelson Suppaluck , Cimo Erica , Jiang Le , Kuo Chi-Chien
Published: September 2023

The abundance of hard ticks can be determined by abiotic factors and the presence of suitable hosts. Since deer represent important hosts for many tick species, it is imperative to investigate whether deer introduction will increase the number of ticks, which can transmit a wide variety of pathogens. The sika deer (Cervus nippon) was introduced to Green Island, Taiwan, to supply velvet antlers, a traditional Chinese medicine. However, they were later released into the wild after a steep decline in antler prices. We conducted surveys for questing ticks, ticks on rodents and shrews, and the fecal pellet groups of ungulates (deer and goats) in 31 transects within 3 habitat types (forest, grassland, and roadside) on Green Island every 2 months in 2019. A total of 5,321 questing ticks were collected. All collected ticks were Haemaphysalis mageshimaensis Saito and Hoogstraal, a species first identified on an island with an abundance of sika deer. Additionally, 48 ticks collected from 126 trapped rodents and shrews were almost invariably Ixodes granulatus (except for 1 larval Haemaphysalis sp.). We did not find a positive correlation between the number of questing ticks and the number of fecal pellet groups, suggesting that factors other than ungulate abundance affect tick abundance. Nevertheless, large populations of questing ticks along some roadsides suggest a high risk of tick-borne diseases to tourists on this tropical island.
Toxicity profiles of antibody-drug conjugates for anticancer treatment: a systematic review and meta-analysis
Authors: Suzuki Yukio , Zhou Susu , Ota Yukihide , Harrington Matthew , Miyagi Etsuko , Takagi Hisato , Kuno Toshiki , Wright Jason D
Published: September 2023

Background

Antibody-drug conjugates are attractive targeted agents in anticancer treatment because of their unique mechanism of action and reduced toxicity. Little is known about the spectrum of adverse events associated with antibody-drug conjugates, despite tens of clinical trials.

Methods

A systematic review of randomized controlled trials evaluating antibody-drug conjugate efficacy in anticancer treatment was conducted. PubMed, EMBASE, and ClinicalTrial.gov were searched for relevant studies. Meta-analyses assessed the odds ratios (ORs) of 12 treatment-related symptoms and toxicities in patients treated with antibody-drug conjugates compared with those receiving other anticancer agents without antibody-drug conjugates. All-grade and high-grade (grade ≥3) toxicities were examined.

Results

Twenty studies involving 10 075 patients were included. Compared with control groups, antibody-drug conjugates were associated with a higher risk of all-grade fatigue (OR = 1.25, 95% confidence interval [CI] = 1.08 to 1.45), anorexia (OR = 1.36, 95% CI = 1.09 to 1.69), nausea (OR = 1.46, 95% CI = 1.09 to 1.97), and sensory neuropathy (OR = 2.18, 95% CI = 1.27 to 3.76) as treatment-related symptoms. Patients treated with antibody-drug conjugates had a statistically significantly lower risk of all-grade febrile neutropenia (OR = 0.46, 95% CI = 0.22 to 0.96). Conversely, they had a higher risk of thrombocytopenia (OR = 2.07, 95% CI = 1.00 to 4.31), increased alanine aminotransferase (OR = 2.51, 95% CI = 1.84 to 3.40), and increased aspartate aminotransferase (OR = 2.83, 95% CI = 2.04 to 3.93). Subgroup analysis showed a similar toxicity profile when comparing the solid tumors with hematologic malignancy groups and the antibody-drug conjugate vs antibody-drug conjugate plus chemotherapy groups, except for some neurologic and hematologic adverse events.

Conclusions

This comprehensive profile of adverse events associated with antibody-drug conjugate–based treatment shows an increase in various types of all-grade treatment-related symptoms and adverse events, although no increase in high-grade adverse events was seen.
Clinical Outcomes of Acutely Ill Children According to Cycle Threshold Values of Respiratory Viruses Detected by Multiplex PCR Testing
Authors: Mattila Suvi , Honkila Minna , Paalanne Niko , Mäki-Koivisto Vesa , Halt Kimmo , Jartti Tuomas , Ruuskanen Olli , Waris Matti , Pokka Tytti , Tapiainen Terhi
Published: September 2023

In this cohort study of 800 children attending a pediatric emergency department at Oulu University Hospital, Finland with fever or respiratory symptoms, the cycle threshold values of point-of-care multiplex polymerase chain reaction testing for respiratory viruses were not associated with hospitalization, respiratory support, or need for intensive care.
Proteomic Analysis Reveals Novel Plasma Biomarkers for Neurological Complications in Patients With Congenital Cytomegalovirus Infection
Authors: Yamaguchi Makoto , Suzuki Takako , Kidokoro Hiroyuki , Iwata Ken-ichi , Fukuda Yuto , Haruta Kazunori , Torii Yuka , Ito Yoshinori , Kawada Jun-ichi
Published: September 2023

Background

Congenital cytomegalovirus (cCMV) infection is a leading cause of nonhereditary neurological complications. When considering antiviral treatment, it is important to differentiate between symptomatic and asymptomatic patients. This study aimed to identify candidate plasma biomarkers for neurological complications of cCMV infection using proteomic analysis.

Methods

This study retrospectively enrolled five patients with symptomatic cCMV infection, four with asymptomatic cCMV infection with isolated sensorineural hearing loss (SNHL), and five with asymptomatic cCMV infection. The plasma samples were collected during neonatal period. The peptides were analyzed using liquid chromatography–mass spectrometry. The concentrations of differentially expressed proteins were validated using an enzyme-linked immunosorbent assay.

Results

A total of 456 proteins were identified and quantified. The levels of 80 proteins were significantly different between patients with and without cCMV-related symptoms including isolated SNHL. The levels of 31 proteins were significantly different between patients with and without neuroimaging abnormalities. The plasma concentrations of Fms-related receptor tyrosine kinase 4 in patients with cCMV-related symptoms were significantly higher than those in patients with asymptomatic cCMV infection. Moreover, plasma peptidylprolyl isomerase A levels were significantly higher in patients with neuroimaging abnormalities than in those without.

Conclusions

Proteomic analysis of patients with cCMV infection showed that Fms-related receptor tyrosine kinase 4 and peptidylprolyl isomerase A could be novel diagnostic biomarkers for neurological complications of cCMV infection.
Rare case of pediatric trauma with hepatic injury managed using gel-foam embolization: a case report
Authors: Rana Asama , O’Toole James , Hooda Zamaan , Veltri John , Kiselak Elizabeth , Rebein Benjamin
Published: September 2023

Nonoperative management for hepatic injuries requires observation and supportive care in the case of hemodynamically stable patients. If there is active bleeding on presentation, hepatic artery embolization is an option to achieve hemostasis in the acute setting. Although interventional radiology procedures are well documented in adults, there is limited literature regarding these procedures in the pediatric population. In this report, we present a case of a pediatric patient who sustained blunt abdominal trauma, resulting in a grade IV liver injury. Treatment involved fluoroscopically guided right hepatic segmental arterial gel-foam embolization.
Operative challenges in a gigantic ganglioneuroma of the posterior mediastinum with mediastinal compression
Authors: Amir Muhammad Abid , Isahak Mohamed Izzad , Adnan Isqandar , Dimon Mohd Zamrin
Published: September 2023

Symptomatic giant ganglioneuromas with mediastinal compression are rare, complicating its management with significant morbidity and mortality risks. A meticulous multidisciplinary preoperative planning is pivotal in ensuring success. We describe a case of a 30-year-old man with a giant posterior mediastinal mass with compression and displacement of the mediastinal structures. Biopsy confirmed a ganglioneuroma and patient underwent excision. Surgery was challenging in view of the size and adherence to the local structures. Haemodynamic instabilities were encountered necessitating a pre-emptive femoral-femoral cannulation for CPB. A piece-meal debulking of the tumour was performed, complicated with massive haemorrhage requiring autologous blood transfusion using an intraoperative blood salvage device. The patient recovered and was discharged home well at Day 8. A thorough pre-operative planning involving a multidisciplinary approach, an understanding of the surgical anatomy as well as anticipating impending complications is of paramount importance  in the management of this particular case.