bluuebunny/crossref_metadata_2025 huggingface dataset:
Centrifuge-Simulated Spaceflight After Aortic Valve Replacement and Atrial Septal Defect Repair
Authors: Fernandez William L. , Blue Rebecca S. , Harrison Michael F. , Powers William , Shah Ronak , Auñón-Chancellor Serena
Published: January 2024

INTRODUCTION: Human access to space is expanding rapidly in the commercial environment, with various private companies offering commercial flights to spaceflight participants (SFPs). SFPs are more likely than career astronauts to have medical conditions novel to spaceflight and may not have undergone as rigorous a medical screening process as that used for career astronauts, representing new and unstudied risks in the spaceflight environment. We report participation of a subject with recent median sternotomy for aortic valve replacement and atrial septal defect closure in centrifuge-simulated dynamic phases of orbital and suborbital spaceflight.

CASE REPORT: A 40-yr-old man with a history of congenital bicuspid aortic valve and atrial septal defect with successful repair 8 mo prior participated in an ongoing human centrifuge research study. The subject had the opportunity to participate in up to five centrifuge runs in an 8-h period, with profiles simulating commercial spaceflight. Maximum exposures included +4.0 Gz, +4.5 Gx, 6.1 G resultant, and maximum onset rate < 0.5 Gz · s−1 and +1 Gx · s−1. Physiological data acquisition included hemodynamics, electrocardiogram, neurovestibular exams, and postrun questionnaires covering motion sickness, disorientation, and similar. The subject tolerated the physiological aspects of hypergravity well, noting progressive sternal pain with increasing +Gx, ultimately leading him to opt out of the final profile.

DISCUSSION: Postcardiothoracic surgery risks to SFPs are largely unknown, especially within 12 mo of a significant surgical procedure. This case provides an approach for risk stratification, preparticipation evaluation, and medical management of a postsurgical patient with significant cardiac history in spaceflight and analog environments.

Fernandez WL, Blue RS, Harrison MF, Powers W, Shah R, Auñón-Chancellor S. Centrifuge-simulated spaceflight after aortic valve replacement and atrial septal defect repair. Aerosp Med Hum Perform. 2024; 95(2):123–131.
Regime security and transnational thereat in post-Cold War Africa
Authors: Ito Hiroto
Published: January 2024

Structural adjustments since the 1980s, changes in the international system with the end of the Cold War, and the accompanying shifts in international norms have transformed the vulnerability of African states and altered the nature of conflicts and coups. In this context, what causes illegal and forced leader exits – coups and regime seizures by rebel groups, and why? We present a theory that emphasizes the connection between coups and conflicts and underscores the significance of transnational non-state actors, due to the vulnerabilities of African states. Specifically, the presence of foreign-mobilized rebels before the onset of an insurgency increases the likelihood of fatal consequences for regime leaders. The result suggests that threats to African leaders are not solely a product of domestic vulnerabilities but are also influenced by the vulnerabilities of neighboring countries and international hostilities.
Alcohol use and the pain system
Authors: Vigorito Michael , Chang Sulie L.
Published: January 2024

The World Health Organization’s epidemiological data from 2016 revealed that while 57% of the global population aged 15 years or older had abstained from drinking alcohol in the previous year, more than half of the population in the Americas, Europe, and Western Pacific consumed alcohol. The spectrum of alcohol use behavior is broad: low-risk use (sensible and in moderation), at-risk use (e.g., binge drinking), harmful use (misuse) and dependence (alcoholism; addiction; alcohol use disorder). The at-risk use and misuse of alcohol is associated with the transition to dependence, as well as many damaging health outcomes and preventable causes of premature death. Recent conceptualizations of alcohol dependence posit that the subjective experience of pain may be a significant contributing factor in the transition across the spectrum of alcohol use behavior. This narrative review summarizes the effects of alcohol at all levels of the pain system. The pain system includes nociceptors as sensory indicators of potentially dangerous stimuli and tissue damage (nociception), spinal circuits mediating defensive reflexes, and most importantly, the supraspinal circuits mediating nocifensive behaviors and the perception of pain. Although the functional importance of pain is to protect from injury and further or future damage, chronic pain may emerge despite the recovery from, and absence of, biological damage (i.e., in the absence of nociception). Like other biological perceptual systems, pain is a construction contingent on sensory information and a history of individual experiences (i.e., learning and memory). Neuroadaptations and brain plasticity underlying learning and memory and other basic physiological functions can also result in pathological conditions such as chronic pain and addiction. Moreover, the negative affective/emotional aspect of pain perception provides embodied and motivational components that may play a substantial role in the transition from alcohol use to dependence.
Enhanced hemocompatibility and rapid magnetic anastomosis of electrospun small-diameter artificial vascular grafts
Authors: Liu Peng , Liu Xin , Yang Lifei , Qian Yerong , Lu Qiang , Shi Aihua , Wei Shasha , Zhang Xufeng , Lv Yi , Xiang Junxi
Published: January 2024

Background: Small-diameter (<6 mm) artificial vascular grafts (AVGs) are urgently required in vessel reconstructive surgery but constrained by suboptimal hemocompatibility and the complexity of anastomotic procedures. This study introduces coaxial electrospinning and magnetic anastomosis techniques to improve graft performance.

Methods: Bilayer poly(lactide-co-caprolactone) (PLCL) grafts were fabricated by coaxial electrospinning to encapsulate heparin in the inner layer for anticoagulation. Magnetic rings were embedded at both ends of the nanofiber conduit to construct a magnetic anastomosis small-diameter AVG. Material properties were characterized by micromorphology, fourier transform infrared (FTIR) spectra, mechanical tests, in vitro heparin release and hemocompatibility. In vivo performance was evaluated in a rabbit model of inferior vena cava replacement.

Results: Coaxial electrospinning produced PLCL/heparin grafts with sustained heparin release, lower platelet adhesion, prolonged clotting times, higher Young’s modulus and tensile strength versus PLCL grafts. Magnetic anastomosis was significantly faster than suturing (3.65 ± 0.83 vs. 20.32 ± 3.45 min, p < 0.001) and with higher success rate (100% vs. 80%). Furthermore, magnetic AVG had higher short-term patency (2 days: 100% vs. 60%; 7 days: 40% vs. 0%) but similar long-term occlusion as sutured grafts.

Conclusion: Coaxial electrospinning improved hemocompatibility and magnetic anastomosis enhanced implantability of small-diameter AVG. Short-term patency was excellent, but further optimization of anticoagulation is needed for long-term patency. This combinatorial approach holds promise for vascular graft engineering.
Comparison of metagenomic next-generation sequencing and blood culture for diagnosis of bloodstream infections
Authors: Yu Juan , Zhang Li , Gao Deyu , Wang Jie , Li Yi , Sun Ning
Published: January 2024

Objectives

This study aimed to evaluate the clinical performance of plasma cell-free DNA (cfDNA) next-generation sequencing (NGS) for pathogen detection in patients with sepsis.

Methods

A total of 43 pairs of blood and plasma samples form 33 blood culture-positive patients were used as testing samples in metagenomic NGS (mNGS) and NGS of 16S ribosomal RNA gene amplicons (16S rRNA NGS). The results of routine tests, including microbial culture, complete blood count, and biochemical tests, were collected from electronic medical records.

Results

Using blood as an mNGS testing sample, the proportion of host DNA was 99.9%, with only three bacteria and no fungi detected. When using plasma in mNGS, the proportion of host DNA was approximately 97%, with 84 bacteria and two fungi detected. Notably, 16S rRNA NGS detected 15 and 16 bacteria in 43 pairs of blood and plasma samples, respectively. Blood culture detected 49 bacteria (23 gram-negative bacilli and 26 gram-positive cocci) and four fungi, with 14 bacteria considered contaminants by clinical microbiologists. For all blood cultures, plasma cfDNA mNGS detected 78.26% (19/23) gram-negative rods, 17% (2/12) gram-positive cocci, and no fungi. Compared to blood cultures, the sensitivity and specificity of plasma cfDNA mNGS for detecting bacteria and fungi were 62.07% and 57.14%, respectively.

Conclusion

Compared to blood, plasma is more suitable for the detection of bloodstream infections using mNGS and is less affected by host DNA. The positive detection rate of plasma cfDNA mNGS for bloodstream infections caused by gram-negative bacteria was higher than that caused by gram-positive cocci.
Circulating ketone bodies and mortality in heart failure: a community cohort study
Authors: Oyetoro Rebecca O. , Conners Katherine M. , Joo Jungnam , Turecamo Sarah , Sampson Maureen , Wolska Anna , Remaley Alan T. , Otvos James D. , Connelly Margery A. , Larson Nicholas B. , Bielinski Suzette J. , Hashemian Maryam , Shearer Joseph J. , Roger Véronique L.
Published: January 2024

Background

The relationship between ketone bodies (KB) and mortality in patients with heart failure (HF) syndrome has not been well established.

Objectives

The aim of this study is to assess the distribution of KB in HF, identify clinical correlates, and examine the associations between plasma KB and all-cause mortality in a population-based HF cohort.

Methods

The plasma KB levels were measured by nuclear magnetic resonance spectroscopy. Multivariable linear regression was used to examine associations between clinical correlates and KB levels. Proportional hazard regression was employed to examine associations between KB (represented as both continuous and categorical variables) and mortality, with adjustment for several clinical covariates.

Results

Among the 1,382 HF patients with KB measurements, the median (IQR) age was 78 (68, 84) and 52% were men. The median (IQR) KB was found to be 180 (134, 308) μM. Higher KB levels were associated with advanced HF (NYHA class III–IV) and higher NT-proBNP levels (both P < 0.001). The median follow-up was 13.9 years, and the 5-year mortality rate was 51.8% [95% confidence interval (CI): 49.1%–54.4%]. The risk of death increased when KB levels were higher (HRhigh vs. low group 1.23; 95% CI: 1.05–1.44), independently of a validated clinical risk score. The association between higher KB and mortality differed by ejection fraction (EF) and was noticeably stronger among patients with preserved EF.

Conclusions

Most patients with HF exhibited KB levels that were consistent with those found in healthy adults. Elevated levels of KB were observed in patients with advanced HF. Higher KB levels were found to be associated with an increased risk of death, particularly in patients with preserved EF.
Heart–brain interaction in cardiogenic dementia: pathophysiology and therapeutic potential
Authors: Liu Jiaxu , Xiao Guangxu , Liang Yujuan , He Shuang , Lyu Ming , Zhu Yan
Published: January 2024

Diagnosis and treatment of patients with cardiovascular and neurologic diseases primarily focus on the heart and brain, respectively. An increasing number of preclinical and clinical studies have confirmed a causal relationship between heart and brain diseases. Cardiogenic dementia is a cognitive impairment caused by heart dysfunction and has received increasing research attention. The prevention and treatment of cardiogenic dementia are essential to improve the quality of life, particularly in the elderly and aging population. This study describes the changes in cognitive function associated with coronary artery disease, myocardial infarction, heart failure, atrial fibrillation and heart valve disease. An updated understanding of the two known pathogenic mechanisms of cardiogenic dementia is presented and discussed. One is a cascade of events caused by cerebral hypoperfusion due to long-term reduction of cardiac output after heart disease, and the other is cognitive impairment regardless of the changes in cerebral blood flow after cardiac injury. Furthermore, potential medications for the prevention and treatment of cardiogenic dementia are reviewed, with particular attention to multicomponent herbal medicines.
Association of sleep characteristics with cardiovascular disease risk in adults over 40 years of age: a cross-sectional survey
Authors: Hou Xin-Zheng , Li Yu-Shan , Wu Qian , Lv Qian-Yu , Yang Ying-Tian , Li Lan-Lan , Ye Xue-Jiao , Yang Chen-Yan , Wang Man-Shi , Lv Yan-Fei , Cao Lin-Lin , Wang Shi-Han
Published: January 2024

Background

The relationship between sleep characteristics and cardiovascular disease (CVD) risk has yet to reach a consistent conclusion, and more research needs to be carried out. This study aimed to explore the relationship between snoring, daytime sleepiness, bedtime, sleep duration, and high-risk sleep patterns with CVD risk.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) 2015–2018 were collected and analyzed. Multivariable logistic regression was used to evaluate the relationship between snoring, daytime sleepiness, bedtime, sleep duration, high-risk sleep patterns, and CVD risk. Stratified analysis and interaction tests were carried out according to hypertension, diabetes and age.

Results

The final analysis contained 6,830 participants, including 1,001 with CVD. Multivariable logistic regression suggested that the relationship between snoring [OR = 7.37,95%CI = (6.06,8.96)], daytime sleepiness [OR = 11.21,95%CI = (9.60,13.08)], sleep duration shorter than 7 h [OR = 9.50,95%CI = (7.65,11.79)] or longer than 8 h [OR = 6.61,95%CI = (5.33,8.19)], bedtime after 0:00 [OR = 13.20,95%CI = (9.78,17.80)] compared to 22:00–22:59, high-risk sleep patterns [OR = 47.73,95%CI = (36.73,62.04)] and CVD risk were statistically significant. Hypertension and diabetes interacted with high-risk sleep patterns, but age did not.

Conclusions

Snoring, daytime sleepiness, excessive or short sleep duration, inappropriate bedtime, and high-risk sleep patterns composed of these factors are associated with the CVD risk. High-risk sleep patterns have a more significant impact on patients with hypertension and diabetes.
Unravelling seismogenesis and characterizing the unique features of two significant felt earthquakes (M > 4.0) of 2020 in the southwestern parts of the Delhi region
Authors: Prajapati Sanjay K. , Pandey Ajeet P. , Bhattacharjee Sudipto , Vashisth Shikha , Mishra O. P.
Published: January 2024

Two significant earthquakes (M4.6 and 4.2) occurred close to a NE–SW-trending lineament in the southwestern part of the Delhi NCR (National Capital Region) within a short time span of about 5 months in 2020. These events were located to the north of the Alwar district in Rajasthan and generated a significant ground shaking in and around Delhi. In the present study, we tried to understand a causal relationship between the events and a nearby source in the region, geologically demarcated as the lineament. We analyzed the broadband waveform data from 26 seismic stations that recorded the recent events of 03 July 2020 (M4.6) and 17 December 2020 (M4.2). Typically, the epicentral area has been devoid of significant earthquakes since the past six decades; however, a few minor events (M < 4.0) have been recorded till date. Analysis of the earthquake database for two decades (2000–2022) revealed low seismicity (nearly quiescent-like situation) in ∼100 sq km area around the epicentral zone, unlike considerable seismicity along faults/lineaments close to the Delhi region. The full-waveform inversion analyses of the events indicate normal faulting with a minor strike–slip components. The source parameters, viz., source radius, stress drop, and seismic moment, were estimated to be 6 km, 166 bars, and 8.28E+15 Nm, respectively, for the 03 July 2020 event and 4 km, 138 bars, and 2.29E+15 Nm, respectively, for the 17 December 2020 event. The causative source of these events is ascertained based on the stress inversion modeling that indicated a NW–SE tensile stress corroborating well with the NE–SW-trending lineament mapped in the study region. The static Coulomb stress modeling indicated that the event which occurred on 3 July 2020 had advanced the triggering process of the event in the northeast segment of the same source that occurred on 17 December 2020. We further emphasize that the aforementioned lineament probably activated due to the regional tectonics of the study area. The causative source of these events with strike 48°, dip 86°, and rake −60° is found to be in the conformity with the local tectonics and is well-supplemented by a high stress ratio (0.70 ± 0.05) and low friction coefficient (0.5).
A novel nomogram for predicting cardiometabolic diseases from modifiable risks in middle-aged adults-implication for health education
Authors: Chang Chia-Hao , Lin Ming-Shyan , Lin Yu-Chih , Huang Tung-Jung , Chen Mei-Yen
Published: January 2024

Background

Middle-aged adults often overlook critical modifiable risk factors that contribute to the emergence of cardiometabolic diseases (CMDs), including hypertension and diabetes. Many CMDs can be alleviated by addressing these modifiable risks. However, there has been insufficient research focused on rural adults with lower levels of health literacy in this regard. The aim of this study was to explore and develop an intuitive assessment tool for predicting cardiometabolic diseases (CMDs), which can be used for health education with adults of low health literacy.

Methods

This was a community-based, cross-sectional study. A structured questionnaire on health-promoting habits, smoking, sleep, and physiological biomarkers was obtained via community health screening in the coastal region of Yunlin County, Taiwan. Multivariate logistic regression was used to screen for significant variables in the nomogram construction. Analysis with nonlinear restricted cubic spline was performed.

Results

A total of 712 participants (60.9% females) aged 40–64 years, with middle school level or lower education, were included. The average age was 55.6 years (SD=7.3), and 220 individuals (31%) had CMDs. Multivariate logistic regression analysis revealed that age, lower scores of vegetables, fruit, water, and exercise (VFWE), smoking history, sleep deprivation, and being overweight were significantly associated with CMDs. The model incorporating these modifiable risk factors demonstrated good discriminatory ability, as indicated by an area under the receiver operating characteristic curve of 0.75 (0.73–0.76). A predictive nomogram was developed that presented modifiable risk factors in a simple graphical format to facilitate the prediction of CMDs.

Conclusions

This study highlights a high prevalence of CMDs among middle-aged adults, along with the disregard for important risk factors that could be modified. The developed nomogram could be a practical and effective tool for community health education to enhance health literacy and prevent the progression of CMDs.
The synergistic effect of diabetes mellitus and osteoporosis on the all-cause mortality: a cohort study of an American population
Authors: Li Weihua , Xie Siyu , Zhong Shengdong , Lan Liting
Published: January 2024

Background

The increasing incidence of diabetes mellitus (DM) and osteoporosis have different effects on prognosis. The two often co-occur, so we aimed to investigate whether DM and osteoporosis have an effect on all-cause death and whether DM and osteoporosis have a synergistic effect.

Methods

This study analyzed 18,658 subjects from five cycles of the National Health and Nutrition Examination Survey (NHANES). The primary endpoint was all-cause death. The subjects were divided into four groups based on the presence or absence of DM and osteoporosis. Survival curves and Cox regression analysis based on NHANES recommended weights were used to assess the risk of all-cause death between the diseased and non-diseased groups and to calculate additive interactions to assess whether there was a synergistic effect between diabetes and osteoporosis.

Results

The group with DM and osteoporosis had the lowest survival rate. After full adjustment for confounders, patients with DM alone had a 30% higher risk of all-cause death compared with those without DM and osteoporosis (HR: 1.30, 95%CI: 1.09-1.55). Patients with osteoporosis alone had a 67% higher risk of all-cause death (HR: 1.67, 95%CI:1.16-2.43) and patients with combined DM and osteoporosis had a 127% higher risk of all-cause death (HR:2.27, 95%CI: 1.57-3.27). There was an additive interaction between DM and osteoporosis [RERI (95%CI): 1.03(0.55-1.50)] and excess mortality risk of 38% [AP (95% CI) 0.38(0.30-0.46)].

Conclusions

There might be a synergistic effect of DM and osteoporosis on all-cause mortality, and patients with both conditions have a higher risk of death.
A control method for the single-phase three-leg unified power quality conditioner without a phase-locked loop
Authors: Feng Depin , Chen Tao , Zhang Liang , Meng Weiqi , He Jinwei
Published: January 2024

The single-phase three-leg unified power quality conditioner (UPQC) can achieve the functions of voltage compensation, reactive power compensation, and harmonic compensation. However, traditional control algorithms require a phase-locked loop to obtain the real-time phase angle of the grid voltage, which undoubtedly increases algorithm complexity. To simplify the phase-locked calculation, this paper proposes a control method without the phase-locked loop for the single-phase three-leg UPQC. In the proposed scheme, the instantaneous value of the grid voltage is employed to realize the grid integration control. Then, the load voltage reference is calculated in real time using a second-order generalized integrator. Moreover, a simple algorithm for reactive power and harmonic compensation is discussed, further simplifying the control algorithm. Finally, a small-scale experimental platform is built, and the effectiveness of the proposed method is verified by the experimental results.
Gene expression meta-analysis reveals aging and cellular senescence signatures in scleroderma-associated interstitial lung disease
Authors: Yang Monica M. , Lee Seoyeon , Neely Jessica , Hinchcliff Monique , Wolters Paul J. , Sirota Marina
Published: January 2024

Aging and cellular senescence are increasingly recognized as key contributors to pulmonary fibrosis. However, our understanding in the context of scleroderma-associated interstitial lung disease (SSc-ILD) is limited. To investigate, we leveraged previously established lung aging- and cell-specific senescence signatures to determine their presence and potential relevance to SSc-ILD. We performed a gene expression meta-analysis of lung tissues from 38 SSc-ILD and 18 healthy controls and found that markers (GDF15, COMP, and CDKN2A) and pathways (p53) of senescence were significantly increased in SSc-ILD. When probing the established aging and cellular senescence signatures, we found that epithelial and fibroblast senescence signatures had a 3.6- and 3.7-fold enrichment, respectively, in the lung tissue of SSc-ILD and that lung aging genes (CDKN2A, FRZB, PDE1A, and NAPI12) were increased in SSc-ILD. These signatures were also enriched in SSc skin and associated with degree of skin involvement (limited vs. diffuse cutaneous). To further support these findings, we examined telomere length (TL), a surrogate for aging, in the lung tissue and found that, independent of age, SSc-ILD had significantly shorter telomeres than controls in type II alveolar cells in the lung. TL in SSc-ILD was comparable to idiopathic pulmonary fibrosis, a disease of known aberrant aging. Taken together, this study provides novel insight into the possible mechanistic effects of accelerated aging and aberrant cellular senescence in SSc-ILD pathogenesis.
Toll-like receptor 2 (−196 to −174) del and TLR1 743 A > G gene polymorphism—a possible association with drug-resistant tuberculosis in the north Indian population
Authors: Varshney Deepika , Singh Shoor Vir , Mohanty Keshar Kunja , Kumar Santosh , Varshney Nitin , Sinha Ekata , Barik Sushanta Kumar
Published: January 2024

Objectives

The objective of this study is to analyze the association between TLR2 deletion (−196 to −174) and TLR1 743 A > G gene polymorphism with drug resistant tuberculosis (PTB, MDR-TB, and XDR-TB) in a population from Agra, Uttar Pradesh.

Methods

The present case–control study included 101 pulmonary TB patients, 104 multidrug-resistant TB patients, 48 extremely drug-resistant TB patients, and 130 healthy and unrelated controls residing in the same locality. The genotyping method for TLR2 deletion (−196 to −174) was carried out by allele-specific polymerase chain reaction (PCR), and TLR1 743 A > G gene polymorphism was performed by hybridization probe chemistry in Roche Real-Time PCR. Genotype and allele frequencies were analyzed by the chi-square test. Cytokine levels were measured by ELISA and compared using Mann–Whitney and Kruskal–Wallis tests.

Results

The frequency of heterozygous (Ins/del) genotypes for TLR2 (−196 to −174) polymorphism was predominant in XDR-TB patients (0.57), whereas heterozygous A/G genotype for TLR1 743 A > G single nucleotide polymorphism (SNP) was predominant in healthy controls (0.57) for TLR1 743 A > G gene polymorphism. The heterozygous genotype of TLR2 deletion polymorphism was found to be significantly higher in XDR-TB (p = 0.0001). TLR1 743 A > G SNP, AG genotypes were found to be significantly associated with healthy controls than PTB (p = 0.047). The level of serum cytokines (IL-6, TNF-α, and IFN-γ) was also found to be significantly different among TB patients and healthy controls.

Conclusion

The findings suggested that in the present population, the heterozygous (Ins/Del) genotype and deletion allele of TLR2 deletion (−196 to −174) polymorphism are associated with the risk for the development of drug-resistant TB. Furthermore, for TLR1 743 A > G gene polymorphism, A/G genotype, and G allele are found associated with healthy controls, suggesting the protective role against TB.
Unveil of the role of fungal taxa in iron(III) reduction in paddy soil
Authors: Li Ming-Jun , Ye Xiao-Xin , Da Yan-Mei , Sun Qing-Ye , Zhou Guo-Wei
Published: January 2024

Hitherto, research on iron(III)-reduction has mainly focused on bacteria rather than fungal communities. To acquire insight into fungi involved in iron(III) reduction, typical organic matters (containing cellulose, glucose, lactate, and acetate) and ferrihydrite were used as electron donors and acceptors, respectively, in the presence of antibiotics. After antibiotic addition, microbial iron(III) reduction was still detected at quite high rates. In comparison, rates of iron(III) reduction were significantly lower in cellulose-amended groups than those with glucose, lactate, and acetate under the antibiotic-added condition. Patterns of intermediate (e.g., acetate, pyruvate, glucose) turnover were markedly different between treatments with and without antibiotics during organic degradation. A total of 20 genera of potential respiratory and fermentative iron(III)-reducing fungi were discovered based on ITS sequencing and genome annotation. This study provided an insight into the diversity of iron(III)-reducing fungi, indicating the underestimated contribution of fungi to iron and the coupled carbon biogeochemical cycling in environments.
Graceful gait: virtual ballet classes improve mobility and reduce falls more than wellness classes for older women
Authors: Harrison Elinor C. , Haussler Allison M. , Tueth Lauren E. , Baudendistel Sidney T. , Earhart Gammon M.
Published: January 2024

Introduction

Dance is an effective and motivating form of exercise for older women, but few studies have quantified the benefits of virtual dance classes nor, specifically, ballet. This study tested the effectiveness of virtual ballet compared to virtual wellness classes, with the goal of reaching underserved populations. It is among the first to explore the effects of virtual classical ballet on functional gait mobility, balance, and quality of life measures in older women.

Methods

Older women were recruited in two waves and randomized to two groups: a ballet class modified for older adults and a wellness-based control class. Both groups received 12 weeks of online classes, meeting twice per week for 45-min sessions. Classes were taught by a local company that offers community-based ballet classes. The same instructor led both the ballet and the wellness classes. Pre- and post-intervention assessments include gait and balance testing using wearable inertial sensors and self-report outcomes including quality of life and mood questionnaires.

Results

Forty-four older women completed the study: Ballet group (n = 21, 67.81 ± 7.3 years); Wellness group (n = 23, 69.96 ± 6.7 years). Pre- to post-intervention, both groups increased velocity on the two-minute walk test (F1,42 = 25.36,p < 0.001) and improved their time on the Timed Up and Go (F1,42 = 4.744,p = 0.035). Both groups improved balance on the Mini-BESTest (F1,42 = 38.154,p < 0.001), increased their scores on the Activities-Specific Balance Confidence Scale (F1,42 = 10.688,p < 0.001), and increased quality of life via the Short Form Health Survey (F1,42 = 7.663,p = 0.008). The ballet group improved gait variability in the backward direction (F1,42 = 14.577,p < 0.001) and reduced fall rates more than the wellness group [χ2(1) = 5.096,p = 0.024].

Discussion

Both virtual ballet and wellness classes improve select measures of gait, balance, and quality of life. The benefits seen in both groups highlight the importance of considering social interaction as a key component when developing future interventions to target mobility in older women.
Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson’s disease: the VIRTREAD-PD randomized controlled trial protocol
Authors: Lombardi Gemma , Baccini Marco , Gualerzi Alice , Pancani Silvia , Campagnini Silvia , Doronzio Stefano , Longo Diego , Maselli Alessandro , Cherubini Giulio , Piazzini Michele , Ciapetti Tommaso , Polito Cristina , Pinna Samuele , De Santis Chiara , Bedoni Marzia , Macchi Claudio , Ramat Silvia , Cecchi Francesca
Published: January 2024

Background

Intensive treadmill training (TT) has been documented to improve gait parameters and functional independence in Parkinson’s Disease (PD), but the optimal intervention protocol and the criteria for tailoring the intervention to patients’ performances are lacking. TT may be integrated with augmented virtual reality (AVR), however, evidence of the effectiveness of this combined treatment is still limited. Moreover, prognostic biomarkers of rehabilitation, potentially useful to customize the treatment, are currently missing. The primary aim of this study is to compare the effects on gait performances of TT + AVR versus TT alone in II-III stage PD patients with gait disturbance. Secondary aims are to assess the effects on balance, gait parameters and other motor and non-motor symptoms, and patient’s satisfaction and adherence to the treatment. As an exploratory aim, the study attempts to identify biomarkers of neuroplasticity detecting changes in Neurofilament Light Chain concentration T0-T1 and to identify prognostic biomarkers associated to blood-derived Extracellular Vesicles.

Methods

Single-center, randomized controlled single-blind trial comparing TT + AVR vs. TT in II-III stage PD patients with gait disturbances. Assessment will be performed at baseline (T0), end of training (T1), 3 (T2) and 6 months (T3, phone interview) from T1. The primary outcome is difference in gait performance assessed with the Tinetti Performance-Oriented Mobility Assessment gait scale at T1. Secondary outcomes are differences in gait performance at T2, in balance and spatial–temporal gait parameters at T1 and T2, patients’ satisfaction and adherence. Changes in falls, functional mobility, functional autonomy, cognition, mood, and quality of life will be also assessed at different timepoints. The G*Power software was used to estimate a sample size of 20 subjects per group (power 0.95, α < 0.05), raised to 24 per group to compensate for potential drop-outs. Both interventions will be customized and progressive, based on the participant’s performance, according to a predefined protocol.

Conclusion

This study will provide data on the possible superiority of AVR-associated TT over conventional TT in improving gait and other motor and non-motor symptoms in persons with PD and gait disturbances. Results of the exploratory analysis could add information in the field of biomarker research in PD rehabilitation.
Auditory naming is impaired in posterior cortical atrophy and early-onset Alzheimer’s disease
Authors: Putcha Deepti , Eustace Ana , Carvalho Nicole , Wong Bonnie , Quimby Megan , Dickerson Bradford C.
Published: January 2024

Introduction

Visual naming ability reflects semantic memory retrieval and is a hallmark deficit of Alzheimer’s disease (AD). Naming impairment is most prominently observed in the late-onset amnestic and logopenic variant Primary Progressive Aphasia (lvPPA) syndromes. However, little is known about how other patients across the atypical AD syndromic spectrum perform on tests of auditory naming, particularly those with primary visuospatial deficits (Posterior Cortical Atrophy; PCA) and early onset (EOAD) syndromes. Auditory naming tests may be of particular relevance to more accurately measuring anomia in PCA syndrome and in others with visual perceptual deficits.

Methods

Forty-six patients with biomarker-confirmed AD (16 PCA, 12 lvPPA, 18 multi-domain EOAD), at the stage of mild cognitive impairment or mild dementia, were administered the Auditory Naming Test (ANT). Performance differences between groups were evaluated using one-way ANOVA and post-hoc t-tests. Correlation analyses were used to examine ANT performance in relation to measures of working memory and word retrieval to elucidate cognitive mechanisms underlying word retrieval deficits. Whole-cortex general linear models were generated to determine the relationship between ANT performance and cortical atrophy.

Results

Based on published cutoffs, out of a total possible score of 50 on the ANT, 56% of PCA patients (mean score = 45.3), 83% of EOAD patients (mean = 39.2), and 83% of lvPPA patients (mean = 29.8) were impaired. Total uncued ANT performance differed across groups, with lvPPA performing most poorly, followed by EOAD, and then PCA. ANT performance was still impaired in lvPPA and EOAD after cuing, while performance in PCA patients improved to the normal range with phonemic cues. ANT performance was also directly correlated with measures of verbal fluency and working memory, and was associated with cortical atrophy in a circumscribed semantic language network.

Discussion

Auditory confrontation naming is impaired across the syndromic spectrum of AD including in PCA and EOAD, and is likely related to auditory-verbal working memory and verbal fluency which represent the nexus of language and executive functions. The left-lateralized semantic language network was implicated in ANT performance. Auditory naming, in the absence of a visual perceptual demand, may be particularly sensitive to measuring naming deficits in PCA.
Resistant starches from dietary pulses improve neurocognitive health via gut-microbiome-brain axis in aged mice
Authors: Kadyan Saurabh , Park Gwoncheol , Hochuli Nathaniel , Miller Katelyn , Wang Bo , Nagpal Ravinder
Published: January 2024

Introduction

Cognitive decline is a common consequence of aging. Dietary patterns that lack fibers and are high in saturated fats worsen cognitive impairment by triggering pro-inflammatory pathways and metabolic dysfunctions. Emerging evidence highlights the neurocognitive benefits of fiber-rich diets and the crucial role of gut-microbiome-brain signaling. However, the mechanisms of this diet-microbiome-brain regulation remain largely unclear.

Methods

Accordingly, we herein investigated the unexplored neuroprotective mechanisms of dietary pulses-derived resistant starch (RS) in improving aging-associated neurocognitive function in an aged (60-weeks old) murine model carrying a human microbiome.

Results and discussion

Following 20-weeks dietary regimen which included a western-style diet without (control; CTL) or with 5% w/w fortification with RS from pinto beans (PTB), black-eyed-peas (BEP), lentils (LEN), chickpeas (CKP), or inulin fiber (INU), we find that RS, particularly from LEN, ameliorate the cognitive impairments induced by western diet. Mechanistically, RS-mediated improvements in neurocognitive assessments are attributed to positive remodeling of the gut microbiome-metabolome arrays, which include increased short-chain fatty acids and reduced branched-chain amino acids levels. This microbiome-metabolite-brain signaling cascade represses neuroinflammation, cellular senescence, and serum leptin/insulin levels, while enhancing lipid metabolism through improved hepatic function. Altogether, the data demonstrate the prebiotic effects of RS in improving neurocognitive function via modulating the gut-brain axis.
Zinner syndrome in pediatric patients: rare disease leading to challenging management
Authors: Adorisio Ottavio , Orazi Cinzia , Gregori Lorenzo Maria , De Peppo Francesco , Silveri Massimiliano
Published: January 2024

Introduction

Zinner syndrome (ZS) is the association of seminal vesicle cysts, ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. This condition is very rare in children and both diagnosis and treatment may be challenging. We reviewed the clinical presentation and treatment describing our experience with a series of three patients.

Methods

From January 2016 to January 2021, three patients (patients 1, 2, and 3) with symptomatic ZS, aged 2, 15, and 17 years, respectively, were diagnosed and treated. All three patients were symptomatic, manifesting pelvic pain and dysuria. The diagnosis was made by physical examination, ultrasonography, and abdominopelvic MRI. Patient 1 underwent open surgery, while for patients 2 and 3, laparoscopic excision was performed.

Results

The renal agenesis regarded the left side in patients 1 and 3, and the right side in patient 2. In all cases, the cystic complex was excised. The mean operating time was 4 h and the mean hospitalization time was 5 days (range 4–6 days). The mean follow-up period was 5 years (range 2–5 years). Patients 1 and 3 showed a complete resolution of the symptoms during postoperative follow-up. In patient 2, clinical symptoms relapsed because of the persistence of a 9 mm cyst requiring a redo laparoscopic excision.

Conclusions

Seminal vesicle cyst with ipsilateral renal agenesis, even if rare in pediatric age, should be suspected in young male patients presenting with pelvic cystic masses, pelvic pain, dysuria, and ipsilateral renal absence. Conservative management should be reversed to asymptomatic patients. Surgical treatment is mandatory in symptomatic cases and the preferred approach is minimally invasive surgery to magnify the operating field to spare anatomical structures, primarily the contralateral vas deferens. Radicality is crucial to avoid the persistence of symptoms and the need for reintervention.
Effect of augmented nutrient composition and fertigation system on biomass yield and cannabinoid content of medicinal cannabis (Cannabis sativa L.) cultivation
Authors: Velechovský Jiří , Malík Matěj , Šenkyřík Josef Baltazar , Tlustoš Pavel
Published: January 2024

Growing evidence underscores the role of nutrients and fertigation systems in soilless production, influencing medicinal cannabis biomass and secondary metabolite content. This study delves into the impact of enhanced nutrient regimes on the ‘ionome’ and its ramifications for biomass and cannabinoid production in medicinal cannabis, comparing two distinct fertigation systems: recirculation and drain-to-waste. Notably, we assess the optimal harvest time for maximizing profitability. In comparing the experimental variant with elevated levels of phosphorus (P), potassium (K), and iron (Fe) in the nutrient solution to the control variant, we observe distinct patterns in element composition across stems, leaves, and flowers, with significant differences between fertigation systems. Total nitrogen content was determined through the Kjeldahl method. Flame atomic absorption spectrometry (FAAS) and inductively coupled plasma optical emission spectrometry (ICP-OES) were employed for elemental analysis. Cannabinoid identification and quantification used high-performance liquid chromatography with a diode-array detector (HPLC/DAD). Followed statistical analyses included ANOVA and Tukey’s HSD test. Although the augmented nutrient regimen does not substantially increase plant biomass, interesting differences emerge between the two fertigation systems. The recirculation fertigation system proves more profitable during the recommended harvest period. Nonetheless, the altered nutrient regime does not yield statistically significant differences in final inflorescence harvest mass or cannabinoid concentrations in medicinal cannabis. The choice of fertigation system influences the quantity and quality of harvested inflorescence. To optimize the balance between the dry biomass yield of flowers and cannabinoid concentration, primarily total THC yield (sum of tetrahydrocannabinolic acid, Δ9-tetrahydrocannabinol, and Δ8-tetrahydrocannabinol), we propose the 11th week of cultivation as the suitable harvest time for the recirculation system. Importantly, the recirculation system consistently outperformed the drain-to-waste system, especially after the ninth week, resulting in significantly higher total THC yields. Enriched nutrition, when compared with control, increased THC yield up to 50.7%, with a remarkable 182% surge in the recirculation system when compared with the drain-to-waste system.
Molecular epidemiological characteristics of Mycobacterium leprae in highly endemic areas of China during the COVID-19 epidemic
Authors: Zhou Jiaojiao , Wu Ziwei , Tong Yi , Chokkakula Santosh , Shi Ying , Jiang Haiqin , Liu Jie , Wang De , Zhang Wenyue , Wang Chen , Zhao Tingfang , Yuan Kang , Li Tao , Ma Lu , Yang Qin , Wang Shizhen , Hong Feng , Wang Hongsheng , Li Jinlan
Published: January 2024

Objectives

The present study analyzed the impact of the COVID-19 pandemic on the prevalence and incidence of new leprosy cases, as well as the diversity, distribution, and temporal transmission of Mycobacterium leprae strains at the county level in leprae-endemic provinces in Southwest China.

Methods

A total of 219 new leprosy cases during two periods, 2018–2019 and 2020–2021, were compared. We genetically characterized 83 clinical isolates of M. leprae in Guizhou using variable number tandem repeats (VNTRs) and single nucleotide polymorphisms (SNPs). The obtained genetic profiles and cluster consequences of M. leprae were compared between the two periods.

Results

There was an 18.97% decrease in the number of counties and districts reporting cases. Considering the initial months (January–March) of virus emergence, the number of new cases in 2021 increased by 167% compared to 2020. The number of patients with a delay of >12 months before COVID-19 (63.56%) was significantly higher than that during COVID-19 (48.51%). Eighty-one clinical isolates (97.60%) were positive for all 17 VNTR types, whereas two (2.40%) clinical isolates were positive for 16 VNTR types. The (GTA)9, (TA)18, (TTC)21 and (TA)10 loci showed higher polymorphism than the other loci. The VNTR profile of these clinical isolates generated five clusters, among which the counties where the patients were located were adjacent or relatively close to each other. SNP typing revealed that all clinical isolates possessed the single SNP3K.

Conclusion

COVID-19 may have a negative/imbalanced impact on the prevention and control measures of leprosy, which could be a considerable fact for official health departments. Isolates formed clusters among counties in Guizhou, indicating that the transmission chain remained during the epidemic and was less influenced by COVID-19 preventative policies.
Human movement modifications induced by different levels of transparency of an active upper limb exoskeleton
Authors: Verdel Dorian , Farr Anais , Devienne Thibault , Vignais Nicolas , Berret Bastien , Bruneau Olivier
Published: January 2024

Active upper limb exoskeletons are a potentially powerful tool for neuromotor rehabilitation. This potential depends on several basic control modes, one of them being transparency. In this control mode, the exoskeleton must follow the human movement without altering it, which theoretically implies null interaction efforts. Reaching high, albeit imperfect, levels of transparency requires both an adequate control method and an in-depth evaluation of the impacts of the exoskeleton on human movement. The present paper introduces such an evaluation for three different “transparent” controllers either based on an identification of the dynamics of the exoskeleton, or on force feedback control or on their combination. Therefore, these controllers are likely to induce clearly different levels of transparency by design. The conducted investigations could allow to better understand how humans adapt to transparent controllers, which are necessarily imperfect. A group of fourteen participants were subjected to these three controllers while performing reaching movements in a parasagittal plane. The subsequent analyses were conducted in terms of interaction efforts, kinematics, electromyographic signals and ergonomic feedback questionnaires. Results showed that, when subjected to less performing transparent controllers, participants strategies tended to induce relatively high interaction efforts, with higher muscle activity, which resulted in a small sensitivity of kinematic metrics. In other words, very different residual interaction efforts do not necessarily induce very different movement kinematics. Such a behavior could be explained by a natural human tendency to expend effort to preserve their preferred kinematics, which should be taken into account in future transparent controllers evaluation.
Americans do not select their doctors based on race
Authors: Olinger Reilly , Matejka Benjamin , Chakravarty Rohan , Johnston Margaret , Ornelas Eliana , Draves Julia , Jain Nishi , Hentschel Jane , Owen William , Ma Yuchuan , Marx William , Freitag Joshua , Zhang Nicholas , Guage Cameron , Crabtree Charles
Published: January 2024

To what extent do Americans racially discriminate against doctors? While a large literature shows that racial biases pervade the American healthcare system, there has been no systematic examination of these biases in terms of who patients select for medical treatment. We examine this question in the context of the ongoing global COVID-19 pandemic, where a wealth of qualitative evidence suggests that discrimination against some historically marginalized communities, particularly Asians, has increased throughout the United States. Conducting a well-powered conjoint experiment with a national sample of 1,498 Americans, we find that respondents do not, on average, discriminate against Asian or doctors from other systematically minoritized groups. We also find no consistent evidence of treatment effect heterogeneity; Americans of all types appear not to care about the racial identity of their doctor, at least in our study. This finding has important implications for the potential limits of American prejudice.