bluuebunny/crossref_metadata_2025 huggingface dataset:
Osteomyelitis of the Jaw Bones and Its Mimics: Resolving the Diagnostic Enigma
Authors: Justine Deepak , Bhalla Ashu Seith , Manchanda Smita , Bhutia Ongkila , Roychoudhury Ajoy
Published: December 2024

Jaw osteomyelitis is a severe inflammatory condition affecting the maxilla or mandible, posing diagnostic and therapeutic challenges. An early and accurate diagnosis is crucial to initiating appropriate treatment and preventing potential complications. Radiological imaging plays a pivotal role in diagnosing and evaluating jaw osteomyelitis, providing valuable insights into the extent of the disease and aiding clinicians in making informed decisions. One of the most important aspects of imaging is to differentiate them from the noninfectious mimics, which can closely mimic their imaging appearance. This article aims to present a comprehensive overview of imaging in jaw osteomyelitis, focusing on the critical clinical and imaging markers that distinguish it from its noninfectious imitators.
T2 Mapping of Articular Cartilage of the Adult Knee Joint: Changes in the Relaxation Time and Thickness of Knee Cartilage with Age among Normal Adult Patients in 3 Tesla MRI
Authors: Debnath Manna , Patel Viral
Published: December 2024

Background Degenerative joint disease, such as osteoarthritis, is characterized by the breakdown of cartilage in the joints, resulting in a decreased range of motion and stiffness. The T2 mapping approach is a very useful tool for detecting early osteoarthritis. The main goal of the study was to assess the variations in the relaxation time and articular cartilage thickness of knee cartilage across different age groups among healthy adults using the T2 mapping technique in 3 Tesla magnetic resonance imaging.

Methods A total of 42 measurements were taken from each individual's knee cartilage and were confirmed to have no cartilage damage. The relaxation time was calculated from T2 maps using 21 circular regions of interest and the articular cartilage thickness was measured using 21 linear measurements from a self-created fusion image. The thickness was measured in the same regions where the relaxation time was measured. Overall, 2,142 measurements (1,071 circular regions of interest from T2 maps and 1,071 linear measurements from fusion images) were taken from 51 participants.

Results The majority of the variables of T2 relaxation time show a positive linear correlation with age groups. As age increases, cartilage relaxation time increases, which may be connected to an increase in cartilage degeneration. However, half of the variables associated with knee cartilage thickness show a negative linear correlation with age group. As age increases, the thickness of the cartilage starts to decrease. T2 relaxation times of the middle lateral tibial condyle, middle superior patella, and central inferior patella differ significantly between healthy males and females (p < 0.05). The cartilage thickness of the posterior lateral tibial condyle, middle medial patella, central superior patella, central middle patella, and lateral middle patella varied significantly between healthy males and females (p < 0.05).

Conclusion Using an additional T2 articular cartilage mapping sequence to a routine sequence in the knee joint can reveal age-related changes in relaxation time and cartilage thickness in knee cartilage. The T2 mapping technique also can help detect early changes in osteoarthritis, track progression, and plan treatment.
Tracking of Financial Burden: A Longitudinal Study of Out-of-Pocket Expenditure (OOPE) among Rural Households with Hypertension (HTN)
Authors: Poojary Santhosh N. , Siddappa Nanjesh Kumar , Jacob Ankeeta Menona , Shetty Sukanya , Kamath Neetha
Published: December 2024

Objectives The study aimed to determine the monthly expenditure pattern and out-of-pocket expenditure (OOPE) associated with managing hypertension in households with patients with hypertension in a rural community in Karnataka, India.

Materials and Methods A longitudinal study was conducted over a period 6 months in a rural community under a rural primary health center in Karnataka. One hundred and one households were included in the study with at least one member diagnosed with hypertension. Household income and other sociodemographic variables were also recorded to assess the economic impact relative to household resources. Monthly spending on nonhealth essentials and hypertension-related OOPEs revealed significant financial strain on households.

Statistical Analysis Descriptive statistics were used to summarize the study of population's demographic characteristics, monthly expenditure in nonhealth essentials, and OOPE. Inferential statistics of Friedman and chi-square tests (Fischer's exact) were used to determine factors associated with OOPE.

Results The population's median age was 59.1 ± 12 years, with a median of 5 (3–10) years since diagnosis with hypertension. Micro to macro vascular complications related to hypertension were present in 17 (22.66%), and 13 (24.52%) were admitted to the hospital in the past 1 year/for 6 months’ follow-up. Seventy-two (71.30%) had a monthly OOPE on health (INR) of ≥ 500. Higher socioeconomic status and visits to private health facilities for hypertension treatment were associated with higher OOPE.

Conclusion Monthly expenditure among households with patients with hypertension in the rural community shows no significant variation for nonhealth essential items. Higher OOPE was associated with households having higher socioeconomic status and visits to private health facilities for treatment of hypertension.
A New Case of Kilquist's Syndrome with a Novel Variant in SLC12A2 and a Brief Review of the Literature
Authors: Yalçın Hatice Yelda , Güzin Yiğithan , Cinleti Tayfun , Özyılmaz Berk , Uzan Gamze , Köse Melis , Baydan Figen
Published: December 2024

Background Kilquist's syndrome is a recently described rare disease characterized by hearing loss, secretory dysfunction, gastrointestinal system abnormalities, and neurological anomalies including hypotonia and global developmental delay. It is caused by mutations in the solute carrier family 12 member 2 (SLC12A2) gene, which encodes the Na-K-2Cl cotransporter isoform 1 (NKCC1).

Objective The aim of this study was to contribute to understanding the genotype–phenotype correlations of SLC12A2 variants.

Material and Methods We evaluated a Turkish patient with a novel variant in SLC12A2 and reviewed all previously reported cases with Kilquist's syndrome. Whole exome sequencing and Sanger sequencing were used as molecular genetic testing methods.

Results Whole exome sequencing revealed a nonsense homozygous NM_001046.3: c.2534G > A (pW845*) variant in the SLC12A2 gene. Sanger sequencing confirmed the variant. The patient was homozygous for this variant; the parents were heterozygous.

Conclusion This is the first Turkish patient with a novel variant in SLC12A2 reported in the literature. With this report, we have contributed to expanding the clinical and mutation spectrum of SLC12A2.
Multi-electron states in small dielectric particles
Authors: Artem’ev A. A. , Khrapak A. G. , Yakubov I. T.
Published: December 2024

The physical properties of multi-electron bubbles in liquid helium and small condensed dielectric particles are studied theoretically. It is shown that the strong electrostatic repulsion between electrons gives rise to the formation of a two-dimensional Wigner crystal. The correlation between electrons on the surface of a particle is taken into account. The conditions of Rayleigh stability of a bubble are discussed. The maximum equilibrium charge of dielectric particles is determined.
The attenuation of sound and the phonon spectrum in 3He–4He solutions
Authors: Adamenko I. N. , Rudavskiĭ É. Ya. , Tsyganok V. I. , Chagovets V. K.
Published: December 2024

An analysis is carried out of the dispersion of the phonon spectrum in solutions with 3He concentrations 0.15, 0.5 and 1% at the saturation vapor pressure and at elevated pressures, on the basis of measurements made of the attenuation of first sound in 3He–4He solutions and the kinetic theory developed for a phonon-impurity system. It was established that the dispersion of the phonon spectrum in the solutions is the same as in pure 4He. This conclusion is also supported by an analysis of other experimental results on the attenuation of second sound, on thermal conductivity, on the velocity of first sound and on the propagation of pulses.
Magneto-bending vibrations and the stability of antiferromagnetic plates in an external magnetic field
Authors: Bar’yakhtar V. G. , Loktev V. M.
Published: December 2024

A rotationally invariant theory is developed for the magneto-bending vibrations of thin plane-parallel plates and for layered crystals with antiferromagnetic order. It is shown that an account of the rotational invariance leads to interaction of the spin and bending waves and to the formation of magneto-bending spectra. In an external magnetic field, depending on its direction relative to the plane of a free plate and the antiferromagnetism vector, it is possible either to change the original quadratic bending dispersion curve into a linear one or to cause the appearance of a macroscopic period for the bending, with a wavelength which is determined by the field magnitude.
Magnetization oscillations in a magnetic field in the two-dimensional Kondo problem
Authors: Karnaukhov I. N.
Published: December 2024

A two-dimensional s–d model with allowance for quantization of electron energy in a magnetic field is considered. It is found that the magnetization caused by localized magnetic moments undergo oscillations in a magnetic field.
(NH3)2(CH2)3MnCI4 a quasi-two-dimensional four-sublattice antiferromagnet with a significant noncollinearity of the magnetic structure
Authors: Bar’yakhtar V. G. , Zvyagin A. I. , Kobets M. I. , Krivoruchko V. N. , Stepanov A. A. , Yablonskii D. A.
Published: December 2024

We report experimental and theoretical studies of the antiferromagnetic resonance in the compound (NH3)2(CH2)3MnCl4 which enable us to determine uniquely the magnitude of the effective fields of the exchange and relativistic interactions and to establish the magnetic structure of the material. It is shown that the structure of (NH3)2(CH2)3MnCl4 is significantly noncollinear.
Transverse waves in 3He–A
Authors: Kekutiya Sh. E. , Sanikidze D. G. , Chkhaidze N. D.
Published: December 2024

Viscous waves in 3He–A are investigated in the absence of a magnetic field. It is shown that the hydrodynamic equations have two solutions that correspond to the shear wave of the normal component of the superfluid and to the orbital viscous wave. These waves have a circular polarization while such waves in ordinary liquids and in 4He are linearly polarized. The wave-induced viscous forces acting at the surface of parallel planes are calculated for the case when one of the planes oscillates tangentially.
Nonequilibrium phonons in conducting point contacts
Authors: Itskovich I. F. , Shekhter R. I.
Published: December 2024

The effect of reabsorption of nonequilibrium phonons on the nonlinear electrical conductivity of metallic and semiconducting point contacts is studied theoretically. It is shown that in the presence of sufficiently strong elastic scattering of phonons, the contribution of reabsorption processes to the point-contact spectrum is comparable to the contribution of spontaneous phonon generation, and gives rise to the appearance of a background and an asymmetry in the PC spectra relative to the polarity of the voltage. This asymmetry is linked to the drag of the electron flow by nonequilibrium phonons and is determined by the elastic scattering length for scattering of phonons by defects. It is shown that it is in principle possible to reconstruct the energy dependence of the phonon elastic scattering time from the form of the asymmetric part of the PC spectrum.
H. Kamerlingh Onnes, the founder of low-temperature physics and the creator of the first school of low-temperature physics
Authors: Khramov Yu. A.
Published: December 2024

A short history is given of the development of concepts relating to low temperatures, starting from the middle of the 18th century and going up to 1908, when Kamerlingh Onnes liquefied helium. The significance is shown of results obtained by van Marum, Cagniard de la Tour, Faraday, Andrews, van der Waals, Cailletet, Pictet, Wroblevski, Olszevskii, and Dewar. The scientific and organizational abilities of Kamerlingh Onnes are discussed in detail; these led to a new avenue opening up at the beginning of the 20th century, low-temperature physics, and also to the establishment, between the end of the 19th and the ‘20’s of the 20th century, of the first large scientific school in this field. The period up to 1908 is treated as the prehistory of low-temperature physics. The personal composition of the Kamerlingh Onnes school is described and the scientific results obtained by the school and their significance for the subsequent development of physics are discussed. The qualities of Kamerlingh Onnes both as a man and as a scientific leader of a team are described, and his role in founding a highly effective scientific institute, the Leiden Cryogenic Laboratory, is shown and its significance for the international cooperation of scientists is recorded.
Dynamic nonequilibrium distributions and nonlinear electromagnetic absorption in superconducting films at low temperatures
Authors: Bezuglyĭ E. V. , Azovskiĭ A. Yu.
Published: December 2024

The dynamic nonequilibrium distributions of electronic excitations in superconducting films, arising owing to the oscillations of the density of states and of the boundary of the energy spectrum of the superconductor in an alternating electromagnetic field, are studied. At low temperatures T≪ Δ, comparable to the amplitude of the oscillations of the boundary of the spectrum, the distrubution and density of quasiparticles differ substantially from the nonequilibrium values. The amplitude and temperature dependences of the nonlinear relaxational electromagnetic absorption, determined by nonadiabatic oscillations of the density of the superfluid component of the current and transfer of kinetic energy from the condensate to the excitations, are found.
Quantum phenomena in superconducting tunnel structures
Authors: Golub A. A.
Published: December 2024

The quantum corrections to the Josephson phase difference of a contact in a metastable current-carrying state are calculated in the limit of zero temperature. It is shown that the perturbation theory with respect to the Josephson interaction is applicable in the case of high viscosity. The magnitude of the quantum fluctuations determines the criterion for the validity of the resistive model.
Equilibrium phase diagram of the O2–Ar system
Authors: Prokhvatilov A. I. , Baryl’nik A. S.
Published: December 2024

We report an x-ray structural study of the solid solutions O2 + Ar. We construct the equilibrium solubility diagram. We have established the important influence of small argon concentrations on the temperature of the phase transitions in oxygen. It is shown that the presence in argon of an insignificant amount (∼ 1%) of oxygen molecules leads to a change in the symmetry of its lattice. Four metastable phases have been studied and we have studied various of the their properties.
Magnetic properties of orthoferrites with substitutions in the rare earth sublattice
Authors: Ges’ A. P. , Derkachenko V. N. , Solovykh T. K. , Fedotova V. V.
Published: December 2024

We have studied the influence of partial substitution of Sm3+ ions by Gd3+, Tb3+, Dy3+, Er3+, and Tm3+ ions on the behavior of the spontaneous magnetic moment in the temperature range 4.2–400° K. In all the crystals studied phase transitions of the type GxFz-GxFz were observed, including even orthoferrites containg Dy3+ ions. In crystals containing Tb3+ ions a hyperbolic curve σa(T) was observed at low temperatures, which is evidence for a positive sign of the effective field at the Tb3+ ions. Partial substitution of the Sm3+ ions by Er3+ and Tm3+ ions leads to the presence of compensation points at 20, 16, and 13.2° K, respectively, and introduction of Tm3+ ions into the orthoferrite composition displaces Tc to higher temperatures than would be expected. All these results suggest a rather complex nature for the R–Fe interaction in orthoferrites with various substituents in the rare earth sublattice.
γ-oxygen, a quasi-one-dimensional magnetic material
Authors: Brodynaskii A. P. , Freiman Yu. A.
Published: December 2024

On the basis of an analysis of the structural features, magnetic susceptibility, and magnetic heat capacity of a γ-O2 crystal we conclude that γ-O2 is a quasi-one-dimensional magnetic material, i.e., during the β–γ transition the magnetic subsystem of the crystal is transformed from quasi-two-dimensional into quasi-one-dimensional. The possibility of low-dimensional magnetic phases of various dimensions occurring in solid oxygen is associated with the distinctive features of the orientational subsystem of the crystal. We express some ideas about the retention of the γ-phase structure as a short-range order in liquid oxygen.
Rebuilding the clinical and operational acute care pharmacist productivity model: Leveraging electronic health record data and analytics at an academic medical center
Authors: Forshay Charlotte , Mellett John , Truong Chan , Kennerly-Shah Julie , Jordan Trisha A , Hafford Amanda
Published: December 2024

Purpose

Acute care pharmacy practice continues to evolve, and useful pharmacist productivity models should reflect contemporary practice. The purpose of this project was to rebuild an acute care pharmacist productivity model to accurately capture and categorize the variable workload of acute care generalists and specialists using electronic health record (EHR) data reports and analytic capabilities.

The acute care pharmacist productivity model was rebuilt with 5 variable workload drivers, including order verification, medication preparation verification (product check), clinical scoring, pharmacist-documented progress notes, and pharmacy intensity score–weighted patient admissions and patient days. Reports from the EHR database were used to capture all workload drivers. For each variable workload driver, more granular categories included in the reports were assigned time standards based on the work’s complexity. Work output data, represented as units of service, were mapped by the user’s job title (ie, generalist or specialist) and by the inpatient department.

Conclusion

The rebuilt pharmacist productivity model leverages EHR data and standard documentation of patient care activities to capture workload and reflect clinical practice. The EHR-generated reports enabled construction of a comprehensive and sustainable productivity model for acute care pharmacists without the need for additional manual documentation for productivity purposes.
De-biasing the bias: methods for improving disparity assessments with noisy group measurements
Authors: Wastvedt Solvejg , Snoke Joshua , Agniel Denis , Lai Julie , Elliott Marc N , Martino Steven C
Published: December 2024

Health care decisions are increasingly informed by clinical decision support algorithms, but these algorithms may perpetuate or increase racial and ethnic disparities in access to and quality of health care. Further complicating the problem, clinical data often have missing or poor quality racial and ethnic information, which can lead to misleading assessments of algorithmic bias. We present novel statistical methods that allow for the use of probabilities of racial/ethnic group membership in assessments of algorithm performance and quantify the statistical bias that results from error in these imputed group probabilities. We propose a sensitivity analysis approach to estimating the statistical bias that allows practitioners to assess disparities in algorithm performance under a range of assumed levels of group probability error. We also prove theoretical bounds on the statistical bias for a set of commonly used fairness metrics and describe real-world scenarios where our theoretical results are likely to apply. We present a case study using imputed race and ethnicity from the modified Bayesian Improved First and Surname Geocoding algorithm for estimation of disparities in a clinical decision support algorithm used to inform osteoporosis treatment. Our novel methods allow policymakers to understand the range of potential disparities under a given algorithm even when race and ethnicity information is missing and to make informed decisions regarding the implementation of machine learning for clinical decision support.
The benefits and harms of oral iron supplementation in non-anaemic pregnant women: a systematic review and meta-analysis
Authors: Watt Archie , Eaton Holden , Eastwick-Jones Kate , Thomas Elizabeth T , Plüddemann Annette
Published: December 2024

Background

Iron deficiency during pregnancy poses a significant risk to both maternal and foetal health. Current international guidelines provide discrepant advice on antenatal iron supplementation for non-anaemic women.

Objective

We aimed to quantify the benefits and harms of routine antenatal supplementation in non-anaemic women.

Methods

The Cochrane Library, MEDLINE, Embase, and clinical trial registries were searched for randomized controlled trials and observational studies comparing oral iron supplementation with placebo or no supplement in non-anaemic pregnant women. Risk of bias was assessed for each study and the results were synthesized via meta-analysis.

Results

Twenty-three eligible studies were identified with 4492 non-anaemic pregnant women. Supplemented groups had higher haemoglobin [mean difference = 6.95 g/l, 95% confidence interval (CI): 4.81–9.09, P < .001, moderate certainty, I2 = 91%] and ferritin (mean difference = 12.22 ng/ml, 95% CI: 6.92–17.52, P < .001, moderate certainty, I2 = 87%) and were at lower risk of anaemia (relative risk = 0.50, 95% CI: 0.34–0.74, P < .001, high certainty, I2 = 42%, number needed to treat (NNT) = 10). There was no difference in birth weight, preterm birth, and rate of caesarean section. Reporting on harms was inconsistent and there was insufficient evidence to determine an association between iron supplements and any negative outcome.

Discussion

Prophylactic iron supplementation likely results in a large reduction in maternal anaemia during pregnancy. Future research should qualify the impact of this benefit on women’s quality of life and determine which subpopulations benefit most. Evidence surrounding the harms of iron supplementation in the non-anaemic population is poor quality and inconsistent. Randomized controlled trials quantifying the risk of gastrointestinal (GI) disturbance and iron overload are essential to inform iron supplement use and reduce unwarranted variations in international guidelines.
Can Policy Succeed through Inactivity? A Case Study of UK Foreign Policy after the Gulf War
Authors: Kettle Louise
Published: December 2024

Can policy succeed through inactivity? Why does some inactivity lead to policy success, whilst others lead to policy failure? Whilst traditional approaches to policy success and failure have focused upon the impact of active policy interventions, this article draws together literature on policy failure and inactivity to develop hypotheses and a new conceptual framework to engage with the problem of inactivity in foreign policy. These are then applied to the case study of UK foreign policy in the Middle East after the 1990–1991 Gulf War. During this time the British government established four key policies; two would succeed, whilst two would fail. Using the new framework, extensive archival research, and documents received under the Freedom of Information Act, conditions for policy success and failure are revealed. As a result, this article argues that inactivity can be highly consequential and deserves much greater attention within foreign policy scholarship.
A virulent milRNA of Fusarium oxysporum f. sp. cubense impairs plant resistance by targeting banana AP2 transcription factor coding gene MaPTI6L
Authors: Zhong Jiaqi , Situ Junjian , He Chengcheng , He Jiahui , Kong Guanghui , Li Huaping , Jiang Zide , Li Minhui
Published: December 2024

Fungi produce microRNA-like RNAs (milRNAs) with functional importance in various biological processes. Our previous research identified a new milRNA Foc-milR87 from Fusarium oxysporum f. sp. cubense, which contributes to fungal virulence by targeting the pathogen glycosyl hydrolase encoding gene. However, the potential roles of fungal milRNAs in interactions with hosts are not well understood. This study demonstrated that Foc-milR87 specifically suppressed the expression of MaPTI6L, a pathogenesis-related gene that encodes a transcriptional activator in the banana (Musa acuminata Cavendish group cv. ‘Baxi Jiao’) genome, by targeting the 3'untranslated region (UTR) of MaPTI6L. Transient overexpression of MaPTI6L activated plant defense responses that depend on its nuclear localization, yet co-expression with Foc-milR87 attenuated these responses. MaPTI6L enhanced plant resistance by promoting transcription of the salicylic acid (SA) signaling pathway marker gene MaEDS1. Sequence analysis of the MaPTI6L gene in 19 banana varieties, particularly those resistant to Fusarium wilt, uncovered single nucleotide polymorphisms (SNPs) at Foc-milR87 target sites. Experimental validation showed that these SNPs significantly reduce the microRNA's ability to suppress target gene expression. Our findings reveal that Foc-milR87 plays an important role in impairing plant resistance by targeting MaPTI6L mRNA and reducing MaEDS1 transcription during the early infection stage, suggesting the 3'UTR of MaPTI6L as a promising target for genome editing in generation of disease-resistant banana cultivars.
Development of an efficient and heritable virus-induced genome editing system in Solanum lycopersicum
Authors: Lee HuiJun , Baik Ji Eun , Kim Kyung-Nam
Published: December 2024

The CRISPR-Cas9 system can be used to introduce site-specific mutations into the genome of tomato (Solanum lycopersicum) plants. However, the direct application of this revolutionary technology to desirable tomato cultivars has been hindered by the challenges of generating transgenic plants. To address this issue, we developed an efficient and heritable genome editing system using tobacco rattle virus (TRV) for an elite tomato cultivar (the paternal line of Saladette). Notably, this virus-induced genome editing (VIGE) system enables the rapid production of various mutant seeds without the need for additional plant transformation and tissue culture, once a Cas9-expressing tomato line is established. This VIGE system consists of transgenic tomato plants that express Cas9 under the control of the tomato ubiquitin 10 (SlUbi10) gene promoter and a mobile guide RNA scaffold (gRNA:SlmFT) generated using the sequence of the tomato Flowering Locus T (SlFT) gene. We determined its editing efficiency by targeting the tomato phytoene desaturase (SlPDS) gene, which causes photobleaching symptoms when disrupted. Most transgenic seedlings infected with the TRV vectors carrying the SlPDS-targeting sgRNA developed chimeric albino leaves associated with a high frequency of indel mutations in the SlPDS gene. Remarkably, fruits from these plants yielded homozygous SlPDS knockout seeds at rates ranging from 15% to 100%. These results demonstrate the exceptional effectiveness of our VIGE system in rapidly generating heritable genome edits in tomato.
Does methylene blue improve outcomes in patients with post-cardiac surgery vasoplegic syndrome?
Authors: Zhu Michael Z L , Scullion Jackson , Stroebel Andrie , He Cheng
Published: December 2024

OBJECTIVES

A best evidence topic was written according to a structured protocol described in ICVTS. The question addressed was ‘In patients with vasoplegic syndrome following cardiac surgery with cardiopulmonary bypass, does adjunctive methylene blue improve outcomes including reduced mortality, morbidity and vasopressor requirements?’

METHODS

Ovid Medline was searched using a reported search algorithm. Articles that represented the best evidence to answer the clinical question were selected, tabulated and discussed.

RESULTS

Seven articles were selected: 4 randomized controlled trials and 3 observational studies. Studies were single centre with sample sizes ranging from 30 to 120 patients. Two studies reported a significant reduction in mortality among patients who received adjunctive methylene blue for post-cardiopulmonary bypass (CPB) vasoplegic syndrome compared with placebo or standard therapy. Four studies reported improved haemodynamic stability and reduced vasopressor requirements following methylene blue. No studies reported methylene blue-related adverse events or worse outcomes compared to controls or standard therapy. There was significant heterogeneity among the included studies in terms of the timing and dosage of methylene blue therapy as well as the definition of vasoplegic syndrome.

CONCLUSIONS

The summation of the best available evidence, which was limited to small clinical trials and observational studies, suggests that the adjunctive administration of methylene blue for refractory post-CPB vasoplegic syndrome is safe and may provide benefits in terms of improved haemodynamic stability, reduction in vasopressor requirements and reduced mortality. Questions surrounding the optimal timing of methylene blue administration, as prophylactic, adjunctive, or rescue therapy for vasoplegic syndrome, require further investigation.
The Design of Autocratic Trade Agreements: Economic Integration and Political Survival
Authors: Postnikov Evgeny , Gamso Jonas
Published: December 2024

Abstracts

The number of preferential trade agreements signed among non-democratic states (autocratic PTAs) has grown significantly over the last decades. Trade policy scholarship remains silent on the institutional design of these autocratic economic arrangements. In this paper, we explore the core institutional characteristic of autocratic PTAs—their depth. It has been shown that many North–South and, increasingly, South–South PTAs tend to be deep, yet the depth of PTAs comprised of autocratic members remains puzzling, as government elites are faced with competing pressures for economic integration and political survival. We argue that autocratic PTAs tend to have considerable depth when it comes to the coverage of certain trade-plus issues, such as investment and trade-in services, due to the desire of government elites to attract trade and investment and enhance the ruling regime's legitimacy and political survival. However, dispute settlement provisions that could breach domestic political autonomy are carefully eschewed. We also expect to see higher levels of agreement flexibility in deep autocratic PTAs, reflecting autocrats’ dual interests in economic openness and political control. We test these expectations using data from the Design of Trade Agreements Database and we carry out interviews with trade officials to clarify the mechanisms at work.
SmartChart Suite: a Fast Healthcare Interoperability Resources-based framework for longitudinal syphilis surveillance using structured and unstructured data
Authors: Stevens Andrew , Karki Saugat , Shivers Elizabeth , Pérez Alejandro , Choi Myung , Berro Andre , Riley Michael , Yang Jane , Tassev Plamen , Jackson David Alexander , Kim Inho , Duke Jon D
Published: December 2024

Objective

The resurgence of syphilis in the United States presents a significant public health challenge. Much of the information needed for syphilis surveillance resides in electronic health records (EHRs). In this manuscript, we describe a surveillance platform for automating the extraction of EHR data, known as SmartChart Suite, and the results from a pilot.

Materials and Methods

The SmartChart Suite framework has been developed in compliance with the HHS Health IT Alignment Policy. The platform’s major functionalities are (1) data retrieval; (2) logical evaluation; (3) standardized data storage; and (4) results display. The SmartChart Suite was deployed in September 2023 at the Grady Health System in Atlanta, Georgia. We established a cohort of likely syphilis patients, randomly selected 50 medical records for manual and automated chart review, and analyzed the results.

Results

The SmartChart Suite was successfully deployed and integrated with the Epic EHR system at Grady. The overall performance results were precision of 97.6%, recall of 100.0%, and F-Score of 98.8%

Discussion

Automated abstraction of EHR data has significant potential to improve public health surveillance and case investigation processes while reducing the resource burden on health departments and reporters. The SmartChart Suite comprises a flexible open-source solution for registry development and maintenance across a wide spectrum of conditions and use cases.

Conclusion

SmartChart Suite demonstrates the potential of automated chart abstraction to support disease surveillance. HHS-compliant open-source tools such as SmartChart Suite can support more efficient human review by providing accurate and relevant data for critical public health activities.
Using Minimally Invasive Tissue Sampling and Determination of Cause of Death to Establish Etiologies of Community Respiratory Deaths Among Zambian Infants and Children
Authors: Wheelock Alyse , Chasaya Mwelwa , Namuziya Natasha , Jumbe Marsden Emilia , Kapasa Monica , Mumba Chibamba , Mulenga Bwalya , Nkole Lisa , Pieciak Rachel , Mudenda Victor , Chikoti Chilufya , Ngoma Benard , Chimoga Charles , Chirwa Sarah , Pemba Lilian , Nzara Diana , Lungu James , Forman Leah , MacLeod William , Moyo Crispin , Wa Somwe Somwe , Gill Christopher
Published: December 2024

In low-to-middle-income countries, acute lower respiratory infection (ALRI) remains the leading infectious cause of death among infants and children under 5 years old. Case-control studies based on upper respiratory sampling have informed current understandings of ALRI etiologies; in contrast, minimally invasive tissue sampling (MITS) offers a method of directly interrogating lower respiratory tract pathogens to establish etiologic distributions. This study performed in the postmortem setting used MITS and a Determination of Cause of Death (DeCoDe) panel to elucidate the causes of fatal pneumonia in the community in Lusaka, Zambia. For deceased infants and children under age 5 years whose next-of-kin provided consent, a verbal autopsy was obtained and 6 lung tissue biopsies from each case were sent for histopathology and multiplex polymerase chain reaction testing. Subsequently, a multi-disciplinary DeCoDe panel met to review each case, determine if the child died of respiratory causes, construct a causal chain of diagnoses directly leading to the death, and determine if the death was preventable (i.e., if an identifiable intervention would have averted the death). Among 106 deaths, 49 were adjudicated as respiratory deaths, with etiologic causes including Klebsiella pneumoniae (13), Streptococcus pneumoniae (5), and Pneumocystis jirovecii (4), among others. Of note, for 21 respiratory deaths, a causative pathogen could not be identified despite clinical and histopathologic evidence of ALRI. A large majority of all deaths were considered preventable (90/106 or 85%). This study demonstrates the impact of certain respiratory pathogens through direct in situ tissue sampling with supportive pathologic data and presents a useful method of studying the etiologic distribution of fatal ALRIs in settings where many deaths occur in the community.
The Victorian Royal Family and the Body of Princess Elizabeth Stuart: Historical Culture and Heritage, Collection and Display
Authors: Betts Sarah
Published: December 2024

This essay explores the afterlife of Princess Elizabeth Stuart, daughter of the seventeenth-century civil war King, Charles I, and how her untimely death reverberated in Victorian culture. Drawing on a wide range of sources, from newspaper and diaries to details of memorials and history genre paintings, it argues that the interest of the Royal Family, and Queen Victoria in particular, in memorializing this tragic story should not be siloed off as is often the case with royal histories, but instead be read as part of a wider cultural movement around the romantic past which the Royal Family both passively consumed, and were actively involved in shaping. Investigating this participation and the influence of Victoria and her family in marking and representing the life of Elizabeth Stuart offers fresh perspective on currents of historicism, visual culture, and traditions around mourning and commemoration in Victorian culture and society.
Single-cell RNA sequencing reveals the intercellular crosstalk and the regulatory landscape of stromal cells during the whole life of the mouse ovary
Authors: Jiang Wan , Sun Wenya , Peng Yue , Xu Hao , Fan Haonan , Jin Xin , Xiao Yue , Wang Yuxiang , Yang Pin , Shu Wenjie , Li Jing
Published: December 2024

The heterogeneity of ovarian mesenchymal/stromal cells has just been revealed in both mice and humans. However, it remains unclear about the cellular development trace and the intercellular communication network in the whole life of the ovary. In the study, we integrated ours and published single-cell RNA sequencing data from E11.5 (embryonic day 11.5) until M12 (12-month-old) ovaries to show the dynamics of somatic cells along the developmental timeline. The intercellular crosstalk among somatic cell types was depicted with collagen signaling pathway as the most outgoing signals from stromal cells. We identified mesenchymal progenitor cells (CD24+) as the origin of stromal cells. Although their numbers decreased significantly in adults, the cells served as the major signal sender until ovarian senescence. Moreover, the ovarian injury could activate these stem cells and induce stroma remodeling in the aged ovary. Thus, mesenchymal progenitor cells may represent a new strategy to delay ovarian aging in the future.
Cell cycle progression of under-replicated cells
Authors: Huang Min , Yang Chang , Nie Litong , Zhang Huimin , Zhu Dandan , Wang Chao , Park Jeong-Min , Srivastava Mrinal , Mosa Elina , Li Siting , Tang Mengfan , Feng Xu , Keast Sarah J , Stossi Fabio , Chen Junjie
Published: December 2024

Cell cycle checkpoints are the regulatory mechanisms that secure the strict order of cellular events for cell division that ensure genome integrity. It has been proposed that mitosis initiation depends on the completion of DNA replication, which must be tightly controlled to guarantee genome duplication. Contrary to these conventional hypotheses, we showed here that cells were able to enter mitosis without completion of DNA replication. Although DNA replication was not completed in cells upon depletion of MCM2, CDC45 or GINS4, these under-replicated cells progressed into mitosis, which led to cell death. These unexpected results challenge current model and suggest the absence of a cell cycle checkpoint that monitors the completion of DNA replication.
Transcriptomic analysis of EGFR co-expression and activation in glioblastoma reveals associations with its ligands
Authors: Ghisai Santoesha A , Barin Nastaran , van Hijfte Levi , Verhagen Kim , de Wit Maurice , van den Bent Martin J , Hoogstrate Youri , French Pim J
Published: December 2024

Background

Approximately half of the isocitrate dehydrogenase (IDH)-wildtype glioblastomas (GBMs) exhibit EGFR amplification. Additionally, genomic changes that occur in the extracellular domain of EGFR can lead to ligand-hypersensitivity (R108K/A289V/G598V) or ligand-independence (EGFRvIII). Unlike in lung adenocarcinoma (LUAD), clinical trials with epidermal growth factor receptor (EGFR) inhibitors showed no survival benefit for GBM and it remains unclear why. We aimed to elucidate differences in molecular mechanisms of EGFR activation and regulation between GBM and LUAD.

Methods

We used RNA-sequencing (RNA-seq) data to find EGFR co-regulated genes and pathways in GBM and compare EGFR signaling patterns between GBM and LUAD. Cellular origins of expression signals were determined by analyzing single-cell RNA-seq data.

Results

We identified 2 ligands (BTC/EREG) among the significant EGFR predictor genes (TCGA-GBM: n = 169, Intellance-2: n = 166). Their expression was inversely correlated with EGFR amplification and incidence of ligand-sensitive mutations. Ligands were expressed by nonmalignant cells and differed in their primary source of expression (BTC: neurons, EREG: myeloid). High expression of MDM2 and CDK4 was less common in EGFR-amplified GBMs with ligand-sensitive mutations compared with those without these mutations. Our analyses revealed distinct transcriptional profiles between GBM and LUAD when comparing tumors carrying activating mutations.

Conclusions

BTC and EREG are negatively associated with EGFR expression in GBM. These findings emphasize the role of ligands in regulating EGFR, where EGFR activation seems to be modulated by the highly varying levels of EGFR amplification, the sensitivity of the receptor toward ligands, and ligand expression levels. Ligand expression levels and EGFR mutations could refine patient stratification for EGFR-targeted therapies in GBM.
Academic engagement in Brazilian university laboratories
Authors: Dantas Leticia Ayumi Kubo , Dias Alexandre
Published: December 2024

In this study, we add new evidence to the literature by investigating how individual and organizational attributes relate to the intensity of academic engagement (AE) in university research laboratories. AE relies on the adoption of mechanisms of interaction between academia and the business sector, facilitating knowledge exchange and collaboration for mutual benefits. The individual attributes of laboratory coordinators corresponded to gender, academic rank, and nonacademic experience. Organizational attributes were proxied by the scale of laboratory research resources, their competence to establish links with industry, and perceived institutional support. From a sample of 240 Brazilian university laboratories, we defined a typology to discriminate laboratories in terms of the intensity with which they practice multiple AE activities. We then investigated differences in the mean vectors of variables representing individual and organizational attributes across laboratories with distinct levels of AE. The results indicated that at the individual level, only the gender of the lab heads showed an association with the intensity of AE. Compared to laboratories with minimal involvement in AE activities, the intensely engaged ones showed higher means for the number of permanent researchers, staff size, and capital stock. Among the highly engaged laboratories, we found a predominance of those with competence to prospect and attract industrial partners and those who received sufficient support from the departments to facilitate collaboration with industry. Idiosyncrasies related to the Brazilian context are discussed in light of new insights typical of a developing country.
Improved methodology for tracing a pulse of 13C-labelled tree photosynthate carbon to ectomycorrhizal roots, other soil biota and soil processes in the field
Authors: Högberg Peter , Klatt Christian , Franklin Oskar , Henriksson Nils , Lim Hyungwoo , Inselsbacher Erich , Hurry Vaughan , Näsholm Torgny , Högberg Mona N
Published: December 2024

Isotopic pulse-labelling of photosynthate allows tracing of carbon (C) from tree canopies to below-ground biota and calculations of its turnover in roots and recipient soil microorganisms. A high concentration of label is desirable but is difficult to achieve in field studies of intact ecosystem patches with trees. Moreover, root systems of trees overlap considerably in most forests, which requires a large labelled area to minimize the impact of C allocated below-ground by un-labelled trees. We describe a method which combines a high level of labelling at ambient concentrations of CO2, [CO2], with undisturbed root systems and a model to account for root C and root-derived C from un-labelled trees. We raised 5-m-tall chambers, each covering 50 m2 of ground (volume 250 m3) in a young boreal Pinus sylvestris L. forest with up to 5 m tall trees. Rather than a conventional single release of 13CO2, we used five consecutive releases, each followed by a draw-down period, thus avoiding high [CO2]. Hence, we elevated successively the 13CO2 from 1.1 to 23 atom% after the first release to 61 atom% after the fifth, while maintaining [CO2] below 500 p.p.m. during 4–4.5 h of labelling. The average abundance of 13CO2 was as high as 42 atom%. We used the central 10 m2 of the 50 m2 area for sampling of roots and other soil biota. We modelled the dilution of labelled C across the plots by un-labelled C from roots of trees outside the area. In the central 10 m2 area, ~85% of roots and root-associated biota received C from labelled trees. In summary, we elevated the labelling of roots and associated soil biota four-fold compared with previous studies and described the commonly overlooked impact of roots from un-labelled trees outside the labelled area.
Missed Opportunity for Initial Diagnosis in Children With Complex Appendicitis
Authors: Srinivas Shruthi , Svetanoff Wendy Jo , Kalsotra Sidhant , Rachwal Brenna , Akbar Taha , Griffin Kristine L. , Su Madeline , Kenney Brian , Van Arendonk Kyle , Besner Gail E.
Published: December 2024

Objectives

Delayed diagnosis of acute appendicitis in children may result in complex appendicitis with appendiceal perforation. Delayed diagnosis can result from missed opportunity for initial diagnosis (MOID) despite medical attention. Studies report MOID of less than 5% in pediatric emergency departments (EDs), but we hypothesized that many MOID occurs outside tertiary care facilities. Our goals were to determine the MOID rate in all presenting facilities in children with complex appendicitis and to identify associated risk factors.

Methods

Children (age ≤18) undergoing appendectomy for complex appendicitis between 2018 and 2022 at a single free-standing academic children's hospital were reviewed. Missed opportunity for initial diagnosis was defined as evaluation for related symptoms without a diagnosis of appendicitis within 7 days prior to appendectomy. Logistic regression and UpSet plots were used to identify associated risk factors.

Results

Of 856 children, 140 (16.4%) had MOID. Most MOID originated from nontertiary facilities [urgent care (38.6%), local EDs (26.4%), primary care (25.0%)] compared to our pediatric ED (11.4%). Compared to single-encounter diagnosis, MOID was associated with younger age (adjusted odds ratio per year [aOR] 0.93, 95% confidence interval [CI]: 0.88–0.97) and non-English/Spanish primary language (aOR 2.61, 95% CI: 1.18–5.76). Uninsured patients had lower MOID (aOR 0.22, 95% CI: 0.05–0.96). Missed opportunity for initial diagnosis was associated with more complications (33.6% vs 19.1%, P < 0.0001), prolonged length of stay (6 vs 4 days, P < 0.0001), and increased readmission (11.4% vs 6.6%, P = 0.044).

Conclusions

Missed opportunity for initial diagnosis of complex appendicitis occurs in nontertiary care facilities, is more common in younger children and non-English/Spanish speakers, and is associated with worse outcomes, highlighting the need for interpreters and algorithmic evaluation in nontertiary care facilities.