bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac tamponade-mediated generalized coronary vasospasm presenting as an inferior ST-segment elevation myocardial infarction: a case report
Authors: Saxon Cara , Freeman Scott , Burke Joseph
Published: April 2023

Background

Coronary vasospasm is a rare cause of ST-segment elevation myocardial infarction (STEMI) and can be precipitated by numerous inciting factors including endogenous catecholamines. Differentiating coronary vasospasm from an acute atherothrombotic event is diagnostically challenging and requires a careful clinical history combined with electrocardiographic and angiographic abnormalities to make the diagnosis and guide therapy.

Case Summary

We report a case of cardiogenic shock secondary to cardiac tamponade leading to an endogenous catecholamine surge resulting in profound arterial vasospasm and STEMI. The patient presented with chest pain and inferior ST segment elevations prompting emergent coronary angiography, demonstrating subtotal occlusion of the right coronary artery, severe proximal left anterior descending coronary artery stenosis, and diffusely stenosed aortoiliac vessels. Emergent transthoracic echocardiogram revealed a large pericardial effusion and hemodynamics consistent with cardiac tamponade. Pericardiocentesis resulted in dramatic hemodynamic improvement with immediate normalization of ST segments. Repeat coronary angiography performed one day later showed no angiographically significant coronary or peripheral arterial stenosis.

Discussion

This is the first reported case of simultaneous coronary and peripheral arterial vasospasm presenting as inferior STEMI caused by endogenous catecholamines from cardiac tamponade. Several clues suggest coronary vasospasm including the discordant electrocardiography (ECG) and coronary angiographic findings as well as diffusely stenosed aortoiliac vessels. Diffuse vasospasm was confirmed when repeat angiography performed after pericardiocentesis demonstrated angiographic resolution of coronary and peripheral arterial stenosis. Though rare, circulating endogenous catecholamines resulting in diffuse coronary vasospasm may present as STEMI and should be considered based on the clinical history, ECG findings, and coronary angiography.
Hybrid surgical epicardial cryoablation for ventricular tachycardia in the electrophysiology laboratory: a case report
Authors: Jathanna Nikesh , Shanmuganathan Selvaraj , Staniforth Andrew , Jamil-Copley Shahnaz
Published: April 2023

Background

Scar-related ventricular tachycardia (VT) is a challenging medical condition, with catheter ablation providing a valuable treatment option. Whilst most VTs can be ablated endocardially, epicardial ablation is often required in patients with non-ischaemic cardiomyopathy. The percutaneous subxiphoid technique has become instrumental for epicardial access. However, it is not feasible in up to 28% of cases for multiple reasons.

Case summary

A 47-year-old patient was managed at our centre for VT storm and recurrent implantable cardioverter defibrillator shocks for monomorphic VT despite maximum drug therapy. No scar was noted during endocardial mapping, with confirmation of the localized epicardial scar on cardiac magnetic resonance imaging (CMR). Following failed percutaneous epicardial access, a successful hybrid surgical epicardial VT cryoablation via median sternotomy was performed in the electrophysiology (EP) laboratory utilizing data from CMR, prior endocardial ablation, and conventional EP mapping. The patient has remained arrhythmia-free for 30 months post-ablation without antiarrhythmic therapy.

Discussion

This case describes a practical multidisciplinary approach to managing a challenging clinical problem. Whilst the described technique is not entirely novel, this is the first case report that describes the practicalities and demonstrates the safety and feasibility of hybrid epicardial cryoablation via median sternotomy performed in the cardiac EP laboratory for the sole treatment of VT.
Urban Sprawl and Social Capital: Evidence from Indonesian Cities
Authors: Civelli Andrea , Gaduh Arya , Rothenberg Alexander D , Wang Yao
Published: April 2023

We use detailed data from Indonesian cities to study how variation in density within urban areas affects social capital. For identification, we instrument density with soil characteristics, and control for community averages of observed characteristics. Under plausible assumptions, these controls address sorting on observables and unobservables. We find that lower density increases trust in neighbours and community participation. We also find that lower density is associated with reduced interethnic tolerance, but this relationship is explained by sorting. Heterogeneity analysis suggests that crime in dense areas undermines community trust and participation, intensifying the negative impact of density.
MR guided cardiac ablation: how to build an interventional magnetic resonance suite and what's the role of the imaging
Authors: Fusco Armando , De Ruvo Ermenegildo , Stefanini Matteo , Borrelli Alessio , Ferrazza Alessandro , De Luca Lucia , Simonetti Giovanni , Calò Leonardo
Published: April 2023

Magnetic resonance (MR) represents a new interesting imaging approach for guiding electrophysiology (EP)-based ablation procedures of atrial flutter and typical atrial fibrillation. This new approach permits to reach good results if compared with conventional EP ablation. Tissue characterization by MR permits to detect cardiac anatomy and pathological substrate like myocardial scars well visualized with late gadolinium enhancement (LGE) sequences. Intra-procedural imaging is useful to real-time follow the catheter during the ablation procedure and at the same time to visualize cardiac anatomy in addition to understanding if the ablation is correctly performed using oedema sequences. Performing cardiac ablations inside an MR room permits to reduce radiation exposure and occupational illnesses.
Stage-specific therapy for hypertrophic cardiomyopathy
Authors: Argirò Alessia , Zampieri Mattia , Marchi Alberto , Cappelli Francesco , Del Franco Annamaria , Mazzoni Carlotta , Cecchi Franco , Olivotto Iacopo
Published: April 2023

Hypertrophic cardiomyopathy (HCM) is the most common inherited myocardial disease and is defined by otherwise unexplained left ventricular hypertrophy. The main complications include heart failure and arrhythmias such as atrial fibrillation and ventricular arrhythmias. Current treatment rests on septal reduction therapies, prevention of sudden cardiac death through implantable cardioverter defibrillator, and use of drugs such as beta-blockers, calcium antagonists, or amiodarone. In the last years, new pharmacological agents specifically targeting the pathophysiology of the disease have been developed with encouraging results in terms of functional capacity and symptoms improvement from clinical trials. In this review, we summarize the possible treatment approaches for each phase of the natural history of the disease: pre-phenotype expression, classic phenotype, adverse remodelling, and overt dysfunction.
Cardiac resynchronization therapy: present and future
Authors: Schiavone Marco , Arosio Roberto , Valenza Simone , Ruggiero Diego , Mitacchione Gianfranco , Lombardi Leonida , Viecca Maurizio , Forleo Giovanni Battista
Published: April 2023

Cardiac resynchronization therapy (CRT) via biventricular pacing (BVP) is a well-established therapy for patients with heart failure with reduced ejection fraction and left bundle branch block, who remain symptomatic despite optimal medical therapy. Despite the long-standing clinical evidence, as well as the familiarity of cardiac electrophysiologists with the implantation technique, CRT via BVP cannot be achieved or may result ineffective in up to one-third of the patients. Therefore, new alternative techniques, such as conduction system pacing and left ventricular pacing, are emerging as potential alternatives to this technique, not only in case of BVP failure, but also as a stand-alone first choice due to several potential advantages over traditional CRT. Specifically, due to its procedural characteristics, left bundle branch area pacing appears to be the most convincing technique, showing comparable efficacy outcomes when compared with traditional CRT, not increasing short-term device-related complications, as well as improving procedural times. However, transvenous leads remain a major limitation of all these pacing modalities. To overcome this limit, a leadless left ventricular endocardial pacing has been developed as an additional tool to achieve a left endocardial activation, although being still associated with non-negligible pitfalls, limiting its current use in clinical practice. This article focuses on the current state and latest progresses in cardiac resynchronization therapy.
Cardiac magnetic resonance-guided cardiac ablation: a case series of an early experience
Authors: De Zan Giulia , Calò Leonardo , Borrelli Alessio , Guglielmo Marco , De Ruvo Ermenegildo , Rier Sophie , van Driel Vincent , Ramanna Hemanth , Patti Giuseppe , Rebecchi Marco , Fusco Armando , Stefanini Matteo , Simonetti Giovanni , van der Bilt Ivo
Published: April 2023

Radiofrequency (RF) catheter ablation has become a widely used therapeutic approach. However, long-term results in terms of arrhythmia recurrence are still suboptimal. Cardiac magnetic resonance (CMR) could offer a valuable tool to overcome this limitation, with the possibility of targeting the arrhythmic substrate and evaluating the location, depth, and possible gaps of RF lesions. Moreover, real-time CMR-guided procedures offer a radiation-free approach with an evaluation of anatomical structures, substrates, RF lesions, and possible complications during a single procedure. The first steps in the field have been made with cavotricuspid isthmus ablation, showing similar procedural duration and success rate to standard fluoroscopy-guided procedures, while allowing visualization of anatomic structures and RF lesions. These promising results open the path for further studies in the context of more complex arrhythmias, like atrial fibrillation and ventricular tachycardias. Of note, setting up an interventional CMR (iCMR) centre requires safety and technical standards, mostly related to the need for CMR-compatible equipment and medical staff’s educational training. For the cardiac imagers, it is fundamental to provide correct CMR sequences for catheter tracking and guide RF delivery. At the same time, the electrophysiologist needs a rapid interpretation of CMR images during the procedures. The aim of this paper is first to review the logistic and technical aspects of setting up an iCMR suite. Then, we will describe the experience in iCMR-guided flutter ablations of two European centres, Policlinico Casilino in Rome, Italy, and Haga Teaching Hospital in The Hague, the Netherlands.
The association of intensive blood pressure treatment and non-fatal cardiovascular or serious adverse events in older adults with mortality: mediation analysis in SPRINT
Authors: Krishnaswami Ashok , Rich Michael W , Kwak Min Ji , Goyal Parag , Forman Daniel E , Damluji Abdulla A , Solomon Matthew , Rana Jamal S , Kado Deborah M , Odden Michelle C
Published: April 2023

Aims

Randomized clinical trials of hypertension treatment intensity evaluate the effects on incident major adverse cardiovascular events (MACEs) and serious adverse events (SAEs). Occurrences after a non-fatal index event have not been rigorously evaluated. The aim of this study was to evaluate the association of intensive (<120 mmHg) to standard (<140 mmHg) blood pressure (BP) treatment with mortality mediated through a non-fatal MACE or non-fatal SAE in 9361 participants in the Systolic Blood Pressure Intervention Trial.

Methods and results

Logistic regression and causal mediation modelling to obtain direct and mediated effects of intensive BP treatment. Primary outcome was all-cause mortality (ACM). Secondary outcomes were cardiovascular (CVM) and non-CV mortality (non-CVM). The direct effect of intensive treatment was a lowering of ACM [odds ratio (OR) 0.75, 95% confidence interval (CI): 0.60–0.94]. The MACE-mediated effect substantially attenuated (OR 0.96, 95% CI: 0.92–0.99) ACM, while the SAE-mediated effect was associated with increased (OR 1.03, 95% CI: 1.01–1.05) ACM. Similar patterns were noted for intensive BP treatment on CVM and non-CVM. We also noted that SAE incidence was 3.9-fold higher than MACE incidence (13.7 vs. 3.5%), and there were a total of 365 (3.9%) ACM cases, with non-CVM being 2.6-fold higher than CVM [2.81% (263/9361) vs. 1.09% (102/9361)]. The SAE to MACE and non-CVM to CVM preponderance was found across all age groups, with the ≥80-year age group having the highest differences.

Conclusion

The current analytic techniques demonstrated that intensive BP treatment was associated with an attenuated mortality benefit when it was MACE-mediated and possibly harmful when it was SAE-mediated. Current cardiovascular trial reporting of treatment effects does not allow expansion of the lens to focus on important occurrences after the index event.
Using photovoice to explore Bolivian children’s experiences of COVID-19
Authors: Gallego Gisselle , Cardona Beatriz , Scholz Brett
Published: April 2023

Our capacity to facilitate the empowerment of children is dependent on our ability to understand their values and experiences. This study aimed to explore Bolivian children’s experiences of COVID-19. This study used a participatory action research method, photovoice, which involved focus groups, individual interviews and the use of cameras by participants to capture their reality and express their ideas through photographs. Ten participants aged 12–15 years were recruited from a school in the municipality of Mecapaca in Bolivia. Thematic analysis was used to identify and report response patterns. Four themes were developed through analysis: (i) sadness and fear of getting sick, (ii) the challenges of online learning, (iii) the tension between traditional knowledge and modern medicine, and (iv) the role of nature and culture in supporting well-being—natural and cultural capital. The narratives and choice of images by the children illustrate some issues and experiences. These findings also highlighted the importance of considering and exploring how children’s experiences and interactions with their habitat, nature and their physical environment impacts on their health and well-being.
YouTube as a Source of Information for Food, Diet-Related Items, and Advisory Comments for the Management of Inflammatory Bowel Disease
Authors: Gkikas Konstantinos , Wan Mhairi , Svolos Vaios , Nichols Ben , Hansen Richard , Russell Richard K , Gerasimidis Konstantinos
Published: April 2023

Background

Patients with inflammatory bowel disease (IBD) often use the Internet to seek information beyond that received from healthcare professionals. This study assessed the perceptions of YouTube presenters on the role of diet in the management of IBD.

Methods

Videos discussing dietary aspects (food, diet-related items, and advisory comments [FODRIACs]) in the management of IBD were included. The perceptions of presenters toward each FODRIAC were labeled as positive, negative, or neutral/intermediate, and FODRIACs were classified according to their underlying role in the management of IBD (eg, symptom management, gut inflammation). Subgroup analysis was performed by type of video presenter (patients vs healthcare professionals), type of IBD (Crohn’s disease vs ulcerative colitis), and reporting of scientific evidence supporting presenters’ perceptions.

Results

We identified 122 FODRIACs within 160 videos. Patient videos received a higher number of likes (median 85 [interquartile range, 35-156]) than healthcare professional videos (median 44 [interquartile range, 16-1440]) (P = .01). Scientific evidence was cited in 2 (3%) of 76 patient videos compared with 25 (35%) of 71 healthcare professional videos (P < .001). Positive perceptions were expressed about avocadoes, salmon, bananas, white bread, and rice, whereas negative perceptions were reported for processed, high-fat and high-sugar foods and carbonated drinks. Fewer negative perceptions were expressed in videos supported by scientific evidence than in videos that lacked evidence (scientific: 4 positive, 0 negative vs nonscientific: 7 positive, 20 negative; P = .01).

Conclusions

We have identified FODRIACs proposed as beneficial or detrimental in the management of IBD. The effect this information has on dietary practice as patients with IBD self-manage their condition needs further exploration.
The freshwater Brachyura (Decapoda: Potamidae, Gecarcinucidae, Sesarmidae) of the Anambas and Natuna Islands, Kepulauan Riau Province, Indonesia
Authors: Ng Peter K L , Wowor Daisy , Yeo Darren C J
Published: April 2023

We report on the freshwater crabs of the families Potamidae, Gecarcinucidae, and Sesarmidae in the archipelago of Anambas and Natuna Islands in Indonesia. Five genera (one new) and eight species (four new) are now recorded from the islands. For the Potamidae, a new genus and a new species, Natunamon indonesicumn. sp., is described from Natuna; the taxon has diagnostic characters intermediate between IsolapotamonBott, 1968 and IbanumNg, 1995 from Borneo. A new species of Isolapotamon, I. remotumn. sp., is also described from Anambas; this is the first record of the genus outside Borneo and Mindanao, Philippines. For the Gecarcinucidae, the rare Balssiathelphusa natunaensisBott, 1970 is collected for the first time since its description, although the type was collected over 120 years ago; the species is redescribed in detail and the composition of the genus discussed. The widely distributed gecarcinucid, Parathelphusa maculataDe Man, 1879 is also recorded from Anambas and Natuna. Four species of Sesarmidae are reported: Geosesarma insulare Ng, 1986 (from Anambas), G. teschi Ng, 1986 (from Natuna), G. anambasn. sp. (from Anambas) and G. hashimin. sp. (from Natuna). Geosesarma hashimin. sp. is an arboreal species with a suite of atypical characters that suggest its present classification in Geosesarma needs to be reassessed.
Late dumping syndrome preceded by Coxsackievirus B4 infection and cholecystectomy
Authors: Weiss Joshua , Fewel Connor , Akinrinade Oyediran , Harrington Jane
Published: April 2023

A 44-year-old female patient presented with weight loss, diarrhea and intermittent episodes of left upper quadrant (LUQ) pain lasting for 3 years, accompanied by acute episodes of focal LUQ pain, dizziness, tachycardia, borborygmi and bloating, occurring approximately 60 min after meals. The patient developed chronic acalculous cholecystitis and transient exocrine pancreatic insufficiency after infection with Coxsackievirus B4 (CVB4), which resolved following laparoscopic cholecystectomy 2 years before the current presentation. Although imaging and functional investigation studies were unremarkable, a gastric transit study revealed rapid clearance of radiolabeled food, and the patient’s symptomatology and gastrointestinal studies supported the diagnosis of late dumping syndrome. The patient’s symptoms significantly improved with adherence to recommended dietary changes, including an increase in protein intake, abstinence from simple carbohydrates and avoidance of simultaneous consumption of beverages with food, following consultation with a dietitian.
An unusual case of small bowel obstruction because of body packing
Authors: Boucher Alexandra L , Shah Nikunj , Brynien Daniel H , Bregg Jason M , Yokota Shinichiro
Published: April 2023

Body packing is the internal concealment of illicit drugs for the purpose of transportation and evasion of law enforcement. It is associated with medical complications such as acute toxicity from ingested drug, bowel obstruction or perforation. It is rare to require surgical intervention with a small amount of ingested drug packet. Here, we present the case of a young adult male who presented with abdominal pain for 3 days. The patient admitted ingesting a condom filled with suboxone several years ago and denied recent ingestion. The patient was found to have small bowel obstruction with ingested foreign body being a transition point on CT scan, requiring exploratory laparotomy and small bowel resection.
Structural, nonclinical, and clinical features of ozoralizumab: A novel tumour necrosis factor inhibitor
Authors: Takeuchi Tsutomu
Published: April 2023

Tumour necrosis factor (TNF) inhibitors are currently the most widely used biological agents to treat rheumatoid arthritis. Ozoralizumab (OZR), a novel TNF inhibitor, is an antibody using variable heavy-chain domains of heavy-chain antibody (VHHs) and became the first VHH drug approved for the treatment of rheumatoid arthritis in September 2022. VHHs isolated from camelid heavy-chain antibodies can bind antigens with a single molecule. OZR is a trivalent VHH that consists of two anti-human TNFα VHHs and one anti–human serum albumin (anti-HSA) VHH. This review summarizes OZR’s unique structural characteristics and nonclinical and clinical data. The clinical data outline the pharmacokinetics, efficacy, relationship between efficacy and pharmacokinetics, and safety of OZR, focusing on a Phase II/III confirmatory study (OHZORA trial).
Quantitative elemental imaging in eukaryotic algae
Authors: Schmollinger Stefan , Chen Si , Merchant Sabeeha S
Published: April 2023

All organisms, fundamentally, are made from the same raw material, namely the elements of the periodic table. Biochemical diversity is achieved by how these elements are utilized, for what purpose, and in which physical location. Determining elemental distributions, especially those of trace elements that facilitate metabolism as cofactors in the active centers of essential enzymes, can determine the state of metabolism, the nutritional status, or the developmental stage of an organism. Photosynthetic eukaryotes, especially algae, are excellent subjects for quantitative analysis of elemental distribution. These microbes utilize unique metabolic pathways that require various trace nutrients at their core to enable their operation. Photosynthetic microbes also have important environmental roles as primary producers in habitats with limited nutrient supplies or toxin contaminations. Accordingly, photosynthetic eukaryotes are of great interest for biotechnological exploitation, carbon sequestration, and bioremediation, with many of the applications involving various trace elements and consequently affecting their quota and intracellular distribution. A number of diverse applications were developed for elemental imaging, allowing subcellular resolution, with X-ray fluorescence microscopy (XFM, XRF) being at the forefront, enabling quantitative descriptions of intact cells in a non-destructive method. This Tutorial Review summarizes the workflow of a quantitative, single-cell elemental distribution analysis of a eukaryotic alga using XFM.
Take Care
Authors: Lett Stephen
Published: April 2023

In this rejoinder, I elaborate on the uncomfortable and foundational call of “Making a Home of the Society for Music Theory, Inc.”: the necessity of abolition as at once the destruction of our colonial/capitalist worlding and the building of a life-affirming world otherwise. Bringing to the fore a couple of backgrounds to my writing—early career transience and building community with unhoused residents of Norman, Oklahoma—I clarify that my call is not for inclusion (and enclosure) within this colonial/capitalist worlding, but our collective liberation from it. Ultimately, I hope this response might inspire readers to build life-affirming, abolitionist worlds wherever they find themselves.
e-RNA: a collection of web-servers for the prediction and visualisation of RNA secondary structure and their functional features
Authors: Tsybulskyi Volodymyr , Semenchenko Egor , Meyer Irmtraud M
Published: April 2023

e-RNA is a collection of web-servers for the prediction and visualisation of RNA secondary structures and their functional features, including in particular RNA–RNA interactions. In this updated version, we have added novel tools for RNA secondary structure prediction and have significantly updated the visualisation functionality. The new method CoBold can identify transient RNA structure features and their potential functional effects on a known RNA structure during co-transcriptional structure formation. New tool ShapeSorter can predict evolutionarily conserved RNA secondary structure features while simultaneously taking experimental SHAPE probing evidence into account. The web-server R-Chie which visualises RNA secondary structure information in terms of arc diagrams, can now be used to also visualise and intuitively compare RNA–RNA, RNA–DNA and DNA–DNA interactions alongside multiple sequence alignments and quantitative information. The prediction generated by any method in e-RNA can be readily visualised on the web-server. For completed tasks, users can download their results and readily visualise them later on with R-Chie without having to re-run the predictions. e-RNA can be found at http://www.e-rna.org.
A Phase II Open-Label Trial of Binimetinib and Hydroxychloroquine in Patients With Advanced KRAS-Mutant Non-Small Cell Lung Cancer
Authors: Aggarwal Charu , Maity Alisha P , Bauml Joshua M , Long Qi , Aleman Tomas , Ciunci Christine , D’Avella Christopher , Volpe Melissa , Anderson Evan , Jones Lisa McCormick , Sun Lova , Singh Aditi P , Marmarelis Melina E , Cohen Roger B , Langer Corey J , Amaravadi Ravi
Published: April 2023

Background

In RAS-mutant tumors, combined MEK and autophagy inhibition using chloroquine demonstrated synthetic lethality in preclinical studies. This phase II trial evaluated the safety and activity of the MEK inhibitor binimetinib combined with hydroxychloroquine (HCQ) in patients with advanced KRAS-mutant non-small cell lung cancer (NSCLC).

Methods

Eligibility criteria included KRAS-mutant NSCLC, progression after first-line therapy, ECOG PS 0-1, and adequate end-organ function. Binimetinib 45 mg was administered orally (p.o.) bid with HCQ 400 mg p.o. bid. The primary endpoint was objective response rate (ORR). A Simon’s 2-stage phase II clinical trial design was used, with an α error of 5% and a power β of 80%, anticipating an ORR of 30% to proceed to the 2-stage expansion.

Results

Between April 2021 and January 2022, 9 patients were enrolled to stage I: median age 64 years, 44.4% females, 78% smokers. The best response was stable disease in one patient (11.1%). The median progression free survival (PFS) was 1.9 months, and median overall survival (OS) was 5.3 months. Overall, 5 patients (55.6%) developed a grade 3 adverse event (AE). The most common grade 3 toxicity was rash (33%). Pre-specified criteria for stopping the trial early due to lack of efficacy were met.

Conclusion

The combination of B + HCQ in second- or later-line treatment of patients with advanced KRAS-mutant NSCLC did not show significant antitumor activity. (ClinicalTrials.gov Identifier: NCT04735068).
An unexpected hydratase synthesizes the green light-absorbing pigment fucoxanthin
Authors: Cao Tianjun , Bai Yu , Buschbeck Paul , Tan Qiaozhu , Cantrell Michael B , Chen Yinjuan , Jiang Yanyou , Liu Run-Zhou , Ries Nana K , Shi Xiaohuo , Sun Yan , Ware Maxwell A , Yang Fenghua , Zhang Huan , Han Jichang , Zhang Lihan , Huang Jing , Lohr Martin , Peers Graham , Li Xiaobo
Published: April 2023

The ketocarotenoid fucoxanthin and its derivatives can absorb blue–green light enriched in marine environments. Fucoxanthin is widely adopted by phytoplankton species as a main light-harvesting pigment, in contrast to land plants that primarily employ chlorophylls. Despite its supreme abundance in the oceans, the last steps of fucoxanthin biosynthesis have remained elusive. Here, we identified the carotenoid isomerase-like protein CRTISO5 as the diatom fucoxanthin synthase that is related to the carotenoid cis–trans isomerase CRTISO from land plants but harbors unexpected enzymatic activity. A crtiso5 knockout mutant in the model diatom Phaeodactylum tricornutum completely lacked fucoxanthin and accumulated the acetylenic carotenoid phaneroxanthin. Recombinant CRTISO5 converted phaneroxanthin into fucoxanthin in vitro by hydrating its carbon–carbon triple bond, instead of functioning as an isomerase. Molecular docking and mutational analyses revealed residues essential for this activity. Furthermore, a photophysiological characterization of the crtiso5 mutant revealed a major structural and functional role of fucoxanthin in photosynthetic pigment–protein complexes of diatoms. As CRTISO5 hydrates an internal alkyne physiologically, the enzyme has unique potential for biocatalytic applications. The discovery of CRTISO5 illustrates how neofunctionalization leads to major diversification events in evolution of photosynthetic mechanisms and the prominent brown coloration of most marine photosynthetic eukaryotes.
Julius Caesar and the Revenge Plot from Oxford to Shakespeare’s Globe
Authors: Vozar Thomas Matthew
Published: April 2023

Several attempts have been made to demonstrate that Shakespeare knew and drew from the anonymous university drama Caesars Reuenge in writing Julius Caesar. This article revisits the question of influence, making the case that Reuenge not only influenced certain particulars of Shakespeare’s play but also helped to shape its general structure and suggested some of its major themes. Following the introduction, the first part situates Reuenge, performed by the students of Trinity College, Oxford, within its academic context, and examines the crucial matter of dating, arguing that it precedes Shakespeare’s Caesar tragedy. The second part treats the minor and major parallels between the two plays and demonstrates the ways in which Shakespeare’s academic predecessor seems to haunt the familiar plot of Julius Caesar. A brief conclusion considers what this might indicate about Shakespeare’s relationship with the universities, a subject of increasing scholarly attention.
“The Tables Are Turning”: The Evangelical Defense of Anti-LGBTQ+ Religious Liberty
Authors: McDowell Amy , Ward Pace T
Published: April 2023

This article extends research on how dominant groups use the rhetoric of marginality to defend and reinforce their control of the public sphere. We conducted interviews with evangelical churchgoers in Mississippi to understand the evangelical support for religious accommodations that privilege conservative Christian beliefs about sex, gender, and marriage. We found that rather than cite scripture about homosexuality or Godly marriage, churchgoers instead told stories about Christian maltreatment and censorship to defend the idea that LGBTQ+ individuals should stay in the closet or find alternatives to the people and places that will refuse service to them. Our findings shed critical light on how evangelical churchgoers accommodate Christian nationalism—or the ideological movement to put Christians back in charge of America—in a context where conservative Christians already enjoy unmatched social and political advantages.
Moral Disengagement in Social Work
Authors: Reamer Frederic G
Published: April 2023

In recent years, social workers have paid increased attention to ethical issues. The profession’s literature has burgeoned on topics such as ethical dilemmas in social work practice, ethical decision making, boundary issues and dual relationships, ethics-related risk management, and moral injury. This noteworthy trend builds on social work’s rich and long-standing commitment to the development of core values and ethical standards evident throughout its history. Unlike allied human service and behavioral health professions, social work’s ethics-related literature has not focused on the critically important issue of moral disengagement. Moral disengagement is typically defined as the process whereby individuals convince themselves that ethical standards do not apply to them. In social work, moral disengagement can lead to ethics violations and practitioner liability, particularly when social workers believe that they are not beholden to widely embraced ethical standards in the profession. The purpose of this article is to explore the nature of moral disengagement in social work, identify possible causes and consequences, and present meaningful strategies designed to prevent and respond to moral disengagement in the profession.
Similar patterns of leaf temperatures and thermal acclimation to warming in temperate and tropical tree canopies
Authors: Crous K Y , Cheesman A W , Middleby K , Rogers E I E , Wujeska-Klause A , Bouet A Y M , Ellsworth D S , Liddell M J , Cernusak L A , Barton C V M
Published: April 2023

As the global climate warms, a key question is how increased leaf temperatures will affect tree physiology and the coupling between leaf and air temperatures in forests. To explore the impact of increasing temperatures on plant performance in open air, we warmed leaves in the canopy of two mature evergreen forests, a temperate Eucalyptus woodland and a tropical rainforest. The leaf heaters consistently maintained leaves at a target of 4 °C above ambient leaf temperatures. Ambient leaf temperatures (Tleaf) were mostly coupled to air temperatures (Tair), but at times, leaves could be 8–10 °C warmer than ambient air temperatures, especially in full sun. At both sites, Tleaf was warmer at higher air temperatures (Tair > 25 °C), but was cooler at lower Tair, contrary to the ‘leaf homeothermy hypothesis’. Warmed leaves showed significantly lower stomatal conductance (−0.05 mol m−2 s−1 or −43% across species) and net photosynthesis (−3.91 μmol m−2 s−1 or −39%), with similar rates in leaf respiration rates at a common temperature (no acclimation). Increased canopy leaf temperatures due to future warming could reduce carbon assimilation via reduced photosynthesis in these forests, potentially weakening the land carbon sink in tropical and temperate forests.
Effects of different phosphorus levels on tiller bud development in hydroponic Phyllostachys edulis seedlings
Authors: Lin Chenjun , Hang Tingting , Jiang Chenhao , Yang Ping , Zhou Mingbing
Published: April 2023

An appropriate amount of phosphate fertilizer can improve the germination rate of bamboo buds and increase the bamboo shoot output. However, the underlying biological mechanisms of phosphate fertilizer in bamboo shoot development have not been systematically reported. Herein, the effects of low (LP, 1 μM), normal (NP, 50 μM) and high (HP, 1000 μM) phosphorus (P) on the growth and development of moso bamboo (Phyllostachys edulis) tiller buds were first investigated. Phenotypically, the seedling biomass, average number of tiller buds and bud height growth rate under the LP and HP treatments were significantly lower than those under the NP treatment. Next, the microstructure difference of tiller buds in the late development stage (S4) at three P levels was analyzed. The number of internode cells and vascular bundles were significantly lower in the LP treatments than in the NP treatments. The relative expression levels of eight P transport genes, eight hormone-related genes and four bud development genes at the tiller bud developmental stage (S2–S4) and the tiller bud re-tillering stage were analyzed with real-time polymerase chain reaction. The results showed that the expression trends for most P transport genes, hormone-related genes and bud development genes from S2 to S4 were diversified at different P levels, and the expression levels were also different at different P levels. In the tiller bud re-tillering stage, the expression levels of seven P transport genes and six hormone-related genes showed a downward trend with increasing P level. REV expression level decreased under LP and HP conditions. TB1 expression level increased under HP condition. Therefore, we conclude that P deficiency inhibits tiller bud development and re-tillering, and that P depends on the expression of REV and TB1 genes and auxin, cytokinin and strigolactones synthesis and transporter genes to mediate tiller bud development and re-tillering.
Biologicals in IgE-mediated food allergy
Authors: Mutarelli Antonio , Giavina-Bianchi Bruna , Arasi Stefania , Cafarotti Arianna , Fiocchi Alessandro
Published: April 2023

Purpose of review

A better understanding of the most recent scientific literature in the use of biological therapy in the treatment of patients with IgE-mediated food allergy.

Recent findings

A systematic review and meta-analysis demonstrated safety and effectiveness of omalizumab in the treatment of food allergy. The findings support the potential use of omalizumab as a monotherapy or as an adjunct to oral immunotherapy in IgE-mediated cow's milk allergy. The potential use of other biologics in the management of food allergy is subject of speculation.

Different biological therapies are under evaluation for food allergic patients. The advance in literature will guide for a personalized treatment in the near future. However, additional research is needed to better understand the best candidate for each treatment, the optimal dose and timing.
Food-labeling issues for severe food-allergic consumers
Authors: Dinardo Giulio , Fierro Vincenzo , del Giudice Michele Miraglia , Urbani Sara , Fiocchi Alessandro
Published: April 2023

Purpose of review

Food label represent the primary and only source of information before consuming a food product. Deputy government agencies on five continents require allergenic ingredients to be declared when used in prepackaged foods to assist patients in identifying allergenic foods and to help them to choose wisely. Unfortunately, the mandatory allergen list and legislation regarding food labels and reference doses is not uniform and varies by country. This may add difficulties to food-allergic patients, especially those with severe food allergy.

Recent findings

A new definition of food allergy severity (the DEFASE grid, developed by the World Allergy Organization), aims to assist clinicians in the identification of the at-risk patients. The FASTER ACT and Natasha's Laws has made important improvements such as the entry of sesame as a major allergen in the United States, and increased evidence of allergens on the food label within prepackaged for direct sale (PPDS) in the UK. The recent introduction of Vital 3.0 brought important new features such as an updated reference doses for many foods.

Currently, there are still considerable differences regarding food labels in different countries. Growing public and scientific attention to the problem promises to increase the food safety for allergens. Among the next improvements, we expect a reconsideration of the food reference doses, a harmonization of the food oral challenge process, and the promulgation of regulatory rules for the precautionary labeling.
The development of the DEFASE project
Authors: Arasi Stefania , Fiocchi Alessandro
Published: April 2023

Purpose of review

To familiarize the reader with the milestones of the DEFASE (Definition of Food Allergy Severity) project. This World Allergy Organization (WAO) initiative has recently developed the first international consensus-based classification system of severity associated with IgE-mediated food allergy as a whole disease incorporating multidisciplinary perspectives from different stakeholders involved.

Recent findings

After a systematic review of current evidence on the definition of severity of food allergy, an e-Delphi methodology has been applied to obtain the consensus/agreement through repeated rounds of survey. This comprehensive scoring system has been developed to be used in research settings in its current version with the scope of stratifying the severity of a clinical situation of food allergy.

Notwithstanding the limitations due to the complexity of the matter, the recent developed DEFASE definition will be relevant for establishing the levels of diagnostic, management and therapeutic commitment for the disease in the various geographical contexts. Future research should focus on internal and external validation of the scoring system, tailoring of these models to different food allergenic sources, populations, and settings.
Clinical outcomes of efficacy in food allergen immunotherapy trials
Authors: Bartha Irene , Rodríguez Del Río Pablo
Published: April 2023

Purpose of review

With food allergy affecting millions of children worldwide, the consolidation of food allergen immunotherapy represents an encouraging therapeutic option, that might expand in the next few years to reach greater number of candidates. This review aims at providing a critical overview of the efficacy outcomes employed in food allergen immunotherapy trials (AIT).

Recent findings

Understanding efficacy endpoints rely on identifying what and how these are being measured. Desensitization, as the efficacy of the therapy to increase the patient's reactivity threshold to the food during therapy, and Sustained Unresponsiveness, withholding such efficacy even if the therapy is withdrawn, are nowadays considered the main parameters of efficacy evaluation. Quality of life is a promising variable to capture food AIT impact from the patient's perspective.

There is a relevant degree of heterogeneity across studies in outcomes definitions and also in oral food challenges design, the tool that is more spread to assess results, hampering study comparison.

Interpreting the results of a clinical trial, and comparing data from different studies is an important task, both for the researcher and the clinician, that should be done after a careful analysis of the outcomes and the evaluation tools used.
Relationship between eliciting doses and the severity of allergic reactions to food
Authors: Yanagida Noriyuki , Sato Sakura , Ebisawa Motohiro
Published: April 2023

Purpose of review

Food allergies with low thresholds are associated with frequent accidental allergic reactions. Severe reactions attributable to accidental ingestion often result in a poor quality of life. Nevertheless, no evidence of a relationship between a low threshold dose and the severity of symptoms exists. Therefore, we evaluated recent data regarding the threshold of food allergies based on the oral food challenge (OFC). We also proposed a stepwise OFC method to identify threshold and consumable doses.

Recent findings

A higher specific IgE level and a history of food-induced anaphylaxis were related to low threshold doses and severe reactions during the OFC. In addition, a low threshold dose was not directly correlated with severe reactions. Performing a stepwise OFC may help safely clarify consumable doses and prevent the complete avoidance of allergy-causing foods.

Severe food allergies with high specific IgE levels are associated with lower thresholds and more severe reactions. However, the threshold is not directly related to the severity of food-induced allergic symptoms. Identifying a well tolerated consumable dose using a stepwise OFC may help manage food allergies.
New molecules for atopic dermatitis treatment beyond biological therapy
Authors: Freitas Egídio , Torres Tiago
Published: April 2023

Purpose of review

This review aims to provide a summary of current knowledge on new topical and oral non-biological therapies recently approved for Atopic Dermatitis (AD) treatment.

Recent findings

The immense research carried out in the last decade has focused on understanding the molecular basis underlying AD and has allowed the development of new targeted drugs. Despite several biologic therapies are approved or in development, other non-biologic targeted therapies (small molecules) have emerged, such as the Janus kinase (JAK) inhibitors baricitinib, upadacitinib and abrocitinib, expanding the range of therapeutic options. Based on recent available data from head-to-head comparisons and meta-analysis studies, JAK inhibitors showed a faster onset of action and slightly higher efficacy at 16 weeks compared with biologic agents. Concerning topical treatment, presently, corticosteroids and calcineurin inhibitors are the main therapeutic options, but are not recommended for long-term management due to potential safety issues. Currently, two topical JAK inhibitors (ruxolitinib and delgocitinib) and one phosphodiesterase 4 (PDE4) inhibitor (difamilast) are approved and have shown good efficacy results and a favorable safety profile.

These new drugs (systemic and topical) are needed to increase the success of AD treatment, particularly for patients who do not or no longer respond to treatment.
Effectiveness of an Oral Gastrografin Regimen for Complete Distal Intestinal Obstruction Syndrome
Authors: Giddings Hugh L. , McNeill Jared , Rahman Bayzidur , Meagher Alan P. , Gett Rohan , Lord Reginald V.
Published: April 2023

Objectives:

To assess the effectiveness of oral Gastrografin treatment and outcomes in adult patients with complete distal intestinal obstruction syndrome (cDIOS).

Background:

DIOS is an important gastrointestinal complication of cystic fibrosis (CF). Conservative treatment options for cDIOS are largely empirical, and the optimal management remains unclear. Surgery should be reserved for patients who have failed nonoperative treatment or have immediate indications for surgery.

Methods:

A retrospective single-institution cohort study was undertaken of adults with CF who had undergone lung transplantation and were admitted with an episode of cDIOS between 2004 and 2020. The outcomes of treatment in a high-volume CF transplant center with routine oral Gastrografin-based therapy were assessed.

Results:

Forty-seven episodes of cDIOS were recorded in 29 (23.3%) of 124 patients who had undergone lung transplantation for CF, and mean age at cDIOS was 30.3 years (SD ±11.2). Mean follow-up post cDIOS was 75.6 months (SD ±45.5). Twelve patients had >1 cDIOS episode. One episode occurred during recovery after transplantation, and 5 patients were readmitted within 30 days posttransplant with cDIOS. A history of previous abdominal surgery was associated with the development of cDIOS (P < 0.001). Oral Gastrografin therapy was used in 95.7% of the episodes, at varying doses. Three patients (7.0%) were resistant to oral Gastrografin treatment, requiring laparotomy. There were no deaths due to DIOS.

Conclusions:

Oral Gastrografin is effective and safe for the treatment of cDIOS, with low treatment failure rates. It should be considered as a first-line treatment option for patients with CF presenting with complete distal intestinal obstruction.