bluuebunny/crossref_metadata_2025 huggingface dataset:
Demography of the Transatlantic Slave Trade
Authors: Felipe-Gonzalez Jorge
Published: September 2024

By the time the transatlantic slave trade ended in 1866, around 12.5 million enslaved Africans had been forcibly embarked from hundreds of coastal slave-trading regions stretching from Senegal to Mozambique to populate most regions in the Americas from Newfoundland to Patagonia. For over three centuries, these displaced people were vital for the western hemisphere’s European conquest, settlement, and economic growth. Every major European nation and some of its colonies, such as Cuba, Brazil, and the United States, outfitted slaving expeditions. Based on the Trans-Atlantic Slave Trade Database (Voyages) and the most recent scholarship, this article addresses a selection of demographic topics which have remained at the core of the historiographical debates on the transatlantic slave trade, such as the number of enslaved Africans carried to the Americas, the mortality rate during the middle passage, African regions of provenance and destination, national carriers in the transportation of Africans, shipboard rebellions, and the gender and age of the captives. These demographic parameters, such as embarkation and disembarkation regions, mortality rate, the nationality of the carriers, or shipboard revolts, were interdependent and experienced significant temporal and regional changes.
The UFW, Cesar Chavez, and Struggles for Farmworker Justice
Authors: Garcia Matt
Published: September 2024

In September 1962, the National Farm Workers Association held its first convention in Fresno, California, initiating a multiracial movement that would result in the creation of United Farm Workers (UFW) and the first contracts for farmworkers in the state of California. Led by Cesar Chavez, the union contributed several innovations to the art of social protest, including the most successful consumer boycott in the history of the United States. Chavez welcomed contributions from numerous ethnic and racial groups, men and women, young and old. During the 1970s, Chavez struggled to effectively transform his movement into a functioning labor union and maintain the momentum created by the boycott as the state of California became the first to give farmworkers the right to protected union activity and representational elections under the California Agricultural Labor Relations Act. Although Chavez and the UFW ultimately failed to establish a permanent, national union, many labor organizers acquired valuable experience within the UFW, and many applied the lessons they learned to movements for farmworker justice elsewhere. The strategies devised by the UFW continue to be used in farmworker struggles all over the nation in the early 21st century, including among organizers too young to have known Chavez or to participate in the UFW.
Grocery Stores and Supermarkets
Authors: Upright Craig
Published: September 2024

The modern grocery store is an institution that could not have existed in earlier time periods. Its creation required the development of reliable distribution systems, preservation technologies, and cultural changes related to the purchase and consumption of food products. The constellation of contemporary grocery store operations is incredibly varied: while dominated by large multinational organizations that often seek vertical integration, grocery stores in the Global North also rely on many types of smaller actors more intimately tied to the communities they serve. The distribution of grocery store outlets often reflects the systems of stratification that exist in all communities across the globe.
Islamic Bioethics: Birth Control
Authors: El Bernoussi Zaynab , Dupret Baudouin
Published: September 2024

The practice of birth control encompasses several techniques that can be either preventive or corrective. In the premodern Islamic tradition, the ʿazl or withdrawal was the most common method of birth control that often required the woman’s approval. Given the lack of precise condemnation of contraception in the Qurʾān, recent fatwas have allowed contraception and abortion in cases of malformation of the fetus or—(according to some scholars) in extremely exceptional situations—economic incapacity of the parents to raise the child. In the modern states of the Muslim world, the ambitions for economic development have oftentimes been associated with population control. In modern Muslim societies birth rates are influenced not only by modern attitudes and new interpretations of contraception, but also by global dynamics such as an integrated world economy, migration, and statism. The different stances of premodern and modern jurists in Islam regarding questions of birth control also reveal pluralism in these societies.
Morphological and Syntactic Variation and Change in European French
Authors: Smith John Charles
Published: September 2024

With the introduction of free compulsory elementary education by laws passed in 1881 and 1882, French children were exposed to the standard language as a matter of course. By the end of the First World War, therefore, a majority of the population was, for the first time, competent in French, as well as, or instead of, a regional or local dialect. However, this national language has always exhibited variation, including in its morphology and syntax, and this variation has often been a driving force behind change. Loci of variation include competing morphological exponents (‘overabundance’), morphomic (autonomously morphological) structure, the expression of number and gender, use of tenses and moods, agreement, negation, interrogation, and dislocation of elements to the beginning or end of the sentence. Geography and social class may still have some effect on variation in French, although it is often argued that their influence has largely been leveled, with style and register becoming more significant factors.
The Movement for Black Lives
Authors: Harden Troy D. , Pulley Aislinn
Published: September 2024

The phrase “Black Lives Matter” has become an identifiable phrase across the globe. Accelerated by social media in an online platform and social action, it is marked by a mass of not only Black folks, but a multiracial collective that has also manifested in direct action protests against police violence toward Black people. Initially a hashtag, #BlackLivesMatter, the phrase emerged into one of the most significant social movements in modern times. The Black Lives Matter Movement, along with the term Movement for Black Lives (M4BL), has centered on the historically ignored killings of Black men, women, and youth at the hands of state-sanctioned violence in public discourse, and offers an inclusive approach to organizing for social change.
Reparations
Authors: Jones V. Nikki , McElderry Cathy G.
Published: September 2024

Reparations are a form of redress for harms or wrongdoings committed against individuals and their descendants in the interest of justice and individual and collective healing and restoration. Reparations entail material and non-material restitution. A framework for effective and equitable reparations includes comprehensive, targeted, and backward- and forward-looking measures that are corrective, restorative, and evidence-based. Various arguments in opposition and support of reparations exist. In the United States, most of the arguments against relate to liability, practicality, and lack of public support. Those who oppose reparations argue that current citizens are not financially liable for past injustices, reparations are unattainable due to statute of limitations (i.e., enslaved people are no longer living), and reparations remain politically divisive. In contrast, reparationists assert that taxpayers are responsible for the acts committed by the government. The U.S. government has a history of making reparations for harm, which is indicative of the practicality of this framework. Public division does not negate government accountability in the interest of justice. Advancing reparations aligns with the mission of social work to enhance human well-being and achieve the goals of justice, human rights, and dismantling systemic and structural inequities.
Analysis of sex-biased gene expression in a Eurasian admixed population
Authors: Cheng Shuangshuang , Ning Zhilin , Huang Ke , Yuan Yuan , Tan Xinjiang , Pan Yuwen , Zhang Rui , Tian Lei , Lu Yan , Wang Xiaoji , Lu Dongsheng , Yang Yajun , Guan Yaqun , Mamatyusupu Dolikun , Xu Shuhua
Published: September 2024

Sex-biased gene expression differs across human populations; however, the underlying genetic basis and molecular mechanisms remain largely unknown. Here, we explore the influence of ancestry on sex differences in the human transcriptome and its genetic effects on a Eurasian admixed population: Uyghurs living in Xinjiang (XJU), by analyzing whole-genome sequencing data and transcriptome data of 90 XJU and 40 unrelated Han Chinese individuals. We identified 302 sex-biased expressed genes and 174 sex-biased cis-expression quantitative loci (sb-cis-eQTLs) in XJU, which were enriched in innate immune-related functions, indicating sex differences in immunity. Notably, approximately one-quarter of the sb-cis-eQTLs showed a strong correlation with ancestry composition; i.e. populations of similar ancestry tended to show similar patterns of sex-biased gene expression. Our analysis further suggested that genetic admixture induced a moderate degree of sex-biased gene expression. Interestingly, analysis of chromosome interactions revealed that the X chromosome acted on autosomal immunity-associated genes, partially explaining the sex-biased phenotypic differences. Our work extends the knowledge of sex-biased gene expression from the perspective of genetic admixture and bridges the gap in the exploration of sex-biased phenotypes shaped by autosome and X-chromosome interactions. Notably, we demonstrated that sex chromosomes cannot fully explain sex differentiation in immune-related phenotypes.
GeneRaMeN enables integration, comparison, and meta-analysis of multiple ranked gene lists to identify consensus, unique, and correlated genes
Authors: Yousefi Meisam , See Wayne Ren , Aw-Yong Kam Leng , Lee Wai Suet , Yong Cythia Lingli , Fanusi Felic , Smith Gavin J D , Ooi Eng Eong , Li Shang , Ghosh Sujoy , Ooi Yaw Shin
Published: September 2024

High-throughput experiments often produce ranked gene outputs, with forward genetic screening being a notable example. While there are various tools for analyzing individual datasets, those that perform comparative and meta-analytical examination of such ranked gene lists remain scarce. Here, we introduce Gene Rank Meta Analyzer (GeneRaMeN), an R Shiny tool utilizing rank statistics to facilitate the identification of consensus, unique, and correlated genes across multiple hit lists. We focused on two key topics to showcase GeneRaMeN: virus host factors and cancer dependencies. Using GeneRaMeN ‘Rank Aggregation’, we integrated 24 published and new flavivirus genetic screening datasets, including dengue, Japanese encephalitis, and Zika viruses. This meta-analysis yielded a consensus list of flavivirus host factors, elucidating the significant influence of cell line selection on screening outcomes. Similar analysis on 13 SARS-CoV-2 CRISPR screening datasets highlighted the pivotal role of meta-analysis in revealing redundant biological pathways exploited by the virus to enter human cells. Such redundancy was further underscored using GeneRaMeN’s ‘Rank Correlation’, where a strong negative correlation was observed for host factors implicated in one entry pathway versus the alternate route. Utilizing GeneRaMeN’s ‘Rank Uniqueness’, we analyzed human coronaviruses 229E, OC43, and SARS-CoV-2 datasets, identifying host factors uniquely associated with a defined subset of the screening datasets. Similar analyses were performed on over 1000 Cancer Dependency Map (DepMap) datasets spanning 19 human cancer types to reveal unique cancer vulnerabilities for each organ/tissue. GeneRaMeN, an efficient tool to integrate and maximize the usability of genetic screening datasets, is freely accessible via https://ysolab.shinyapps.io/GeneRaMeN.
Prolonged Time to Diagnosis of Crohn’s Disease in Patients With Perianal Fistulas Negatively Affects Long-Term Outcomes
Authors: Munster Liesbeth Jozefien , Pronk Aagje Johanna Martina , Mundt Marco William , Hompes Roel , Bemelman Willem Adrianus , van der Bilt Jarmila Dagmara Wendelien , Buskens Christianne Johanna
Published: September 2024

Background and Aim

This study aims to evaluate the effect of time to Crohn’s disease (CD) diagnosis on perianal fistula (PAF) outcomes in patients with a fistula as the first manifesting sign.

Methods

In this multicenter, retrospective study, CD patients with a PAF preceding CD diagnosis between November 2015 and June 2022 were included. The primary outcome parameter was the time to CD diagnosis and its correlation with long-term outcomes.

Results

In total, 126 patients with a PAF prior to CD diagnosis were identified. The median time to CD diagnosis was 15.0 months (IQR 3.8-47.3). A total of 49 patients (38.9%) had a clinically closed fistula of which 21 patients (42.9%) achieved radiological healing. Twenty-five patients (19.8%) underwent defunctioning, of which 9 patients (36.0%) needed proctectomy. Median time to CD diagnosis was shortest in patients with radiological healing (4.0 months, IQR 2.0-16.5) or clinical closure without radiological healing (11.0 months, IQR 3.0-47.8). In patients without fistula closure (n = 51), the median time to CD diagnosis was significantly longer compared to patients with fistula closure, 18.0 months vs 8.0 months (p = 0.031). In patients who needed defunctioning, the median time to diagnosis was more than twice as long compared to patients without defunctioning, 30.0 months vs 12.0 months (p = 0.054).

Conclusion

A prolonged time to CD diagnosis in patients with a PAF as a manifesting sign is associated with worse long-term outcomes. Patients in whom radiological healing could be achieved had the shortest time to CD diagnosis, emphasizing the relevance of increased clinical awareness of underlying CD in fistula patients.
Right ventricular free wall strain predicts transthyretin amyloidosis prognosis as well as biomarker-based staging systems
Authors: Istratoaie Sabina , Bourg Corentin , Lee K Charlotte , Marut Benjamin , Antonelli Jerome , L’official Guillaume , Wazzan Adrien Al , Donal Erwan
Published: September 2024

Aims

The diagnosis of transthyretin amyloidosis (ATTR) significantly impacts the management and prognosis of patients initially presenting with heart failure (HF). Despite recent advancements in treatment, prognosticating ATTR remains challenging. In this study, we aim to assess echocardiographic parameters associated with mid-term prognosis in patients with wild-type ATTR using a biomarker staging system as a reference point.

Methods and results

We studied 182 consecutive patients with wild-type ATTR (91% male and median age 82 years) who were referred to our centre between 2016 and 2022. Using N-terminal pro-B-type natriuretic peptide and estimated glomerular filtration rate cut-offs, we classified patients into the following three stages: Stage I (101 patients, 55.5%), Stage II (53 patients, 29.0%), and Stage III disease (28 patients, 15.5%). We then compared traditional echocardiographic indices and markers of subclinical ventricular dysfunction [left ventricular (LV) global longitudinal strain, right ventricular (RV) free wall strain, and left atrial (LA) strain] among groups. Over a fixed follow-up period of 18 months, which included treatment with tafamidis 61 mg daily, 48 patients (26.4%) experienced the composite outcome of death or HF hospitalization. When compared with Stage I ATTR, the hazard ratio (HR) for death or hospitalization was 1.55 [95% confidence interval (CI) 0.62–3.86] for Stage II ATTR and 4.53 (95% CI 1.66–12.4, P = 0.0116) for Stage III ATTR. Among echocardiographic parameters, reduced RV free wall strrain (FWS) was independently associated with all-cause mortality or HF hospitalization after adjustment for the staging system (HR 2.03, 95% CI 1.07–3.85, P < 0.05).

Conclusion

RV FWS should be routinely assessed for all patients with ATTR. It is an independent predictor of poor prognosis and provides additional value beyond biomarker staging systems.
Organic farming systems improve soil quality and shape microbial communities across a cotton-based crop rotation in an Indian Vertisol
Authors: Lori Martina , Kundel Dominika , Mäder Paul , Singh Akanksha , Patel Dharmendra , Sisodia Bhupendra Singh , Riar Amritbir , Krause Hans-Martin
Published: September 2024

The adverse effects of intensified cropland practices on soil quality and biodiversity become especially evident in India, where nearly 60% of land is dedicated to cultivation and almost 30% of soil is already degraded. Intensive agricultural practice significantly contributes to soil degradation, highlighting the crucial need for effective countermeasures to support sustainable development goals. A long-term experiment, established in the semi-arid Nimar Valley (India) in 2007, monitors the effect of organic and conventional management on the plant-soil system in a Vertisol. The focus of our study was to assess how organic and conventional farming systems affect biological and chemical soil quality indicators. Additionally, we followed the community structure of the soil microbiome throughout the vegetation phase under soya or cotton cultivation in the year 2019. We found that organic farming enhanced soil organic carbon and nitrogen content, increased microbial abundance and activity, and fostered distinct microbial communities associated with traits in nutrient mineralization. In contrast, conventional farming enhanced the abundance of bacteria involved in ammonium oxidation suggesting high nitrification and subsequent nitrogen losses with regular mineral fertilization. Our findings underscore the value of adopting organic farming approaches in semi-arid subtropical regions to rectify soil quality and minimize nitrogen losses.
An explanation for the sister repulsion phenomenon in Patterson's f-statistics
Authors: Atağ Gözde , Waldman Shamam , Carmi Shai , Somel Mehmet
Published: September 2024

Patterson's f-statistics are among the most heavily utilized tools for analyzing genome-wide allele frequency data for demographic inference. Beyond studying admixture, f3- and f4-statistics are also used for clustering populations to identify groups with similar histories. However, previous studies have noted an unexpected behavior of f-statistics: multiple populations from a certain region systematically show higher genetic affinity to a more distant population than to their neighbors, a pattern that is mismatched with alternative measures of genetic similarity. We call this counter-intuitive pattern “sister repulsion”. We first present a novel instance of sister repulsion, where genomes from Bronze Age East Anatolian sites show higher affinity toward Bronze Age Greece rather than each other. This is observed both using f3- and f4-statistics, contrasts with archaeological/historical expectation, and also contradicts genetic affinity patterns captured using principal components analysis or multidimensional scaling on genetic distances. We then propose a simple demographic model to explain this pattern, where sister populations receive gene flow from a genetically distant source. We calculate f3- and f4-statistics using simulated genetic data with varying population genetic parameters, confirming that low-level gene flow from an external source into populations from 1 region can create sister repulsion in f-statistics. Unidirectional gene flow between the studied regions (without an external source) can likewise create repulsion. Meanwhile, similar to our empirical observations, multidimensional scaling analyses of genetic distances still cluster sister populations together. Overall, our results highlight the impact of low-level admixture events when inferring demographic history using f-statistics.
Tracheobronchoplasty for severe tracheobronchomalacia: a case-series of patients with acute and chronic critical comorbidities
Authors: Herron Robert , Dhamija Ankit , Shumar Jenna , Kakuturu Jahnavi , Hayanga J W Awori , Lamb Jason , Toker Alper
Published: September 2024

OBJECTIVES

There are little data within the literature regarding tracheobronchoplasty in the setting of the acute and chronically ill, morbidly obese or ventilator-dependent patients with tracheobronchomalacia. Short- and long-term outcomes are studied.

METHODS

The series represents 12 tracheobronchomalacia patients with American Society of Anesthesiologists (ASA) physical status scores of 3–5. Candidacy was based on bronchoscopic findings during spontaneous respirations with >90% collapse of the trachea and both mainstem bronchi. We used dynamic computed tomography scan as an adjunct in those not mechanically ventilated. Our operative approach was a complete portal robotic approach for those outpatients (wheelchair dependent) and right thoracotomy for those who were already mechanically ventilated with 100% fraction of inspired oxygen with high pressure. Extracorporeal support was used in 2 patients.

RESULTS

Patients who underwent robotic repair were discharged without complications. Two patients who were critically ill and required extracorporeal support for their surgeries were separated from extracorporeal membrane oxygenation on postoperative day 2. Three patients died at the follow-up. In 1 patient, the prolene mesh migrated into trachea and caused obstruction of the trachea and required removal with endobronchial techniques.

CONCLUSIONS

The repair of tracheobronchomalacia in patients with multiple comorbidities and with severe life-threatening problems in or outside the intensive care unit may have improvement due to the ability to wean from positive pressure ventilation. Surgical technique and the utilization of mesh support in tracheobronchoplasty operations may need to be debated due to duration of the surgery in patients with severe comorbidities.
Digital identity: an approach to its nature, concept, and functionalities
Authors: Robles-Carrillo Margarita
Published: September 2024

Digital identity is a basic component of the knowledge economy and society. It is the key for accessing the digital world and for carrying out commercial, economic, or any kind of transactions and communications. Far from being a merely digital version of the physical identity, digital identity is a singular and complex construct which poses three main dilemmas that provide the framework for its analysis. The first arises from the context in which it is located, the digital ecosystem, that changes its scope and nature. The second, conceptual, is a consequence of the lack of agreement about its definition but also of the different legal framework derived from it. A third dilemma, functional, is due to the fact that digital identity can fulfil different, even contradictory, functionalities. An analysis of these dilemmas can contribute to a better understanding of this category leading to a proposal for its definition and legal framework.
A coupled steady thermo-electromagnetic problem in axisymmetric geometries. Mathematical and numerical analysis
Authors: Gómez Dolores , López-Rodríguez Bibiana , Salgado Pilar , Venegas Pablo
Published: September 2024

This paper focuses on the analysis of a steady thermo-electromagnetic problem related to the modeling of induction heating processes. Taking advantage of the cylindrical symmetry, the original three-dimensional problem can be reduced to a two-dimensional one on a meridional section, provided that the current density has only the azimuthal component. A variational formulation is presented in appropriately weighted Sobolev spaces, and the existence of a solution is established by employing a fixed-point argument. Furthermore, uniqueness and additional regularity results are proved under reasonable assumptions on the physical coefficients. A finite element approximation combined with a fixed-point iteration scheme is proposed for the numerical solution of the problem. A priori error estimates are obtained to quantify the accuracy of the approximation. Finally, numerical results are reported to validate the theoretical estimates and assess the performance of the method in a physical application.
Character Sheaves on Reductive Lie Algebras in Positive Characteristic
Authors: Zhou Tong
Published: September 2024

We prove a microlocal characterisation of character sheaves on a reductive Lie algebra over an algebraically closed field of sufficiently large positive characteristic: a perverse irreducible $G$-equivariant sheaf is a character sheaf if and only if it has nilpotent singular support and is quasi-admissible. We also present geometric proofs, in positive characteristic, of the equivalence between being admissible and being a character sheaf, and various characterisations of cuspidal sheaves, following the work of Mirković.
Evaluation of rifle cartridge and shot placement for euthanizing feral swine (Sus scrofa) in traps
Authors: Lavelle Michael J , Snow Nathan P , Brown Vienna R , Bodenchuk Michael J , Cook Seth M , VerCauteren Kurt C
Published: September 2024

Feral swine are a highly destructive invasive species around the globe. Wildlife managers commonly trap and euthanize feral swine with firearms to reduce their adverse impacts. The utility of euthanizing domestic swine with firearms has been considered when emergency situations arise such as in the event of a foreign animal disease outbreak in domestic swine. Similarly, the rapid depopulation of domestic swine facilities became necessary when the COVID-19 pandemic disrupted pork production in 2020. Evaluation of the effects of caliber, cartridge, size of feral swine, and shot placement on effectiveness and safety of the method is needed. We collected data from feral swine euthanized in traps on how those variables influenced the effectiveness in time to death and number of shots required and safety risks based on the occurrence of bullet pass-through (i.e., bullet exiting the pig). We tested 3 cartridges of 2 calibers (0.22 long rifle, 0.22 Winchester magnum rimfire, and 0.308 Winchester) delivered from a rifle with 3 shot placements targeting the brain. From 570 euthanization events, we calculated an average time to death of 100.06 (SD = 29.24) s, with larger feral swine taking slightly longer. Most feral swine (73%) were euthanized with a single shot but averaged 1.28 (SD = 0.48) shots overall. Safety risks from pass-through shots were more common when using the 0.308 Winchester cartridge, and when rear and side shot placements were used. Overall, we recommend a 0.22 long rifle cartridge and frontal shot placement as an effective and safe option for euthanizing feral swine in traps, and likely for domestic swine of similar size and shot distances.
Colour polymorphism is prevalent on islands but shows no association with range size in web-building spiders
Authors: Salgado-Roa Fabian C , Stuart-Fox Devi , White Thomas E , Medina Iliana
Published: September 2024

One of the most evident sources of phenotypic diversity within a population is colouration, as exemplified by colour polymorphism. This is relevant to a greater extent in animals with visually biased sensory systems. There is substantial evidence suggesting that different colour morphs can access a broader range of habitats or niches, leading to larger geographic range sizes. However, this hypothesis has been tested in few lineages, comprising species where colour is likely to be involved in sexual selection. Furthermore, some available evidence considers geographical variation as polymorphism, thus limiting our comprehension of how sympatric colour polymorphism can influence a species’ geographic range. Through an extensive systematic literature review and a comparative analysis, we examined the relationship between colour polymorphism and range size or niche breadth in web-building spiders. We identified 140 colour polymorphic spider species, belonging mainly to the families Araneidae and Theridiidae. We found no evidence that colour polymorphic species differ significantly from non-polymorphic species in terms of range size and niche breadth, after accounting for phylogenetic relationships and other covariates. However, we did observe that colour polymorphic species were more likely to be found on islands compared to non-polymorphic species. Overall, our results indicate that the association between colour polymorphism and geographic range size may not exist among web-building spiders, or be as pronounced as in other lineages. This suggests that the strength of the association between colour polymorphism and ecological success might depend on the ecological role that colouration plays in each clade.
A case of rare obstructive jaundice induced by concealed displacement of T-tube
Authors: Yangjun Gu , Qingqing Fang , Zhitao Chen , Qiyong Li
Published: September 2024

We present the case of a 32-year-old woman who was ultimately diagnosed with obstructive jaundice. She exhibited persist jaundice, liver dysfunction with normal drainage of T-tube (400–500 ml per day), and normal stools. Prior to her admission to our department, she had undergone a cholecystectomy and T-tube placement following common bile duct exploration for cholelithiasis. Although her serum bilirubin levels initially decreased post-surgery, it rose sharply after T-tube cholangiography. The diagnosis remained unclear until we performed endoscopic retrograde cholangiopancreatography (ERCP), which revealed that the obstructive jaundice was induced by improper T-tube placement. There were few such presentations reported before, and it’s particularly unusual to encounter jaundice following T-tube placement. Moreover, diagnosing and treating this condition can be challenging when T-tube drainage appears normal. Thus, our case report provides a unique contribution to the literature on obstructive jaundice.
Successful management of severe scalp avulsion injury: a case report and review of surgical interventions
Authors: Paudel Sujan , Luitel Prajjwol , Thapaliya Ishwor , Thapa Anup , Sharma Samit
Published: September 2024

Scalp avulsion injuries caused by machinery present substantial challenges necessitating urgent medical intervention. A 30-year-old female suffered near-complete scalp avulsion from entanglement in agricultural machinery and underwent surgical repair with a latissimus dorsi free flap and split-thickness skin graft. Free flap techniques offer reliable wound closure but may lead to cosmetic concerns. Safety measures in high-risk environments are crucial to prevent such incidents.
Nodal melanosis in malignant melanoma: a rare case from the Middle East with comprehensive surgical and histopathological findings
Authors: Suliman Alsadig , Mohamed Osman Reem , SeedAhmed Lina
Published: September 2024

Malignant melanoma, a highly aggressive skin cancer, accounts for 75% of skin cancer-related deaths. This case report details a 59-year-old Sudanese male with a malignant melanoma of the left foot, presenting with nodal melanosis, a rare condition involving benign pigmented deposits in the lymph nodes. The patient underwent below-knee amputation and inguinal lymph node dissection. Significant black discoloration was observed in the lymph nodes, indicating nodal melanosis. Histopathological examination of excised lymph nodes confirmed the presence of both malignant melanoma and benign melanosis. Despite surgical intervention, the patient eventually developed distant metastases, including lung nodules and a liver lesion. This case underscores the importance of recognizing nodal melanosis in metastatic malignant melanoma and highlights the challenges of managing advanced cases in resource-limited settings. Surgical management remains critical, particularly wide resection and lymph node dissection, even as systemic therapies advance.
A phase II study of FOLFOX combined with nab-paclitaxel in the treatment of metastatic or advanced unresectable gastric, gastroesophageal junction adenocarcinoma: a Big Ten Cancer Research Consortium trial
Authors: Dreyer Marie S , Mulcahy Mary , Kocherginsky Masha , Chen Yolande , Hochster Howard S , Kasi Pashtoon M , Kircher Sheetal , Lou Emil , Ma Yangruijue , Uboha Nataliya V , Benson Al B
Published: September 2024

Background

Doublet platinum or taxane-based therapies are the current standard backbone of treatment for advanced gastric/gastroesophageal junction (GEJ) adenocarcinoma. Previously used anthracycline-based triplet regimens are no longer used routinely due to toxicity and lack of superior efficacy. We hypothesized that the addition of nab-paclitaxel to FOLFOX (FOLFOX-A) would induce higher efficacy and better tolerability.

Patients and Methods

Eligible patients with chemotherapy-naïve advanced unresectable HER2-negative gastric or GEJ adenocarcinoma were enrolled in this phase II single-arm trial of FOLFOX (oxaliplatin 85 mg/m2, leucovorin 400 mg/m2, 5-FU 2400 mg/m2 over 46-48 hours) + nab-paclitaxel (150 mg/m2) every 14 days of a 28-day cycle. Evaluable disease according to RECIST v1.1 for solid tumors was required. The primary endpoint was the objective response rate. Simon’s optimal 2-stage design was used to test 5% versus 20% response rate with 90% power and 10% one-sided type I error rate.

Results

The study enrolled 39 patients. Median age was 63 (range 20-80) years, 30 (77%) were male, 34 (94%) were White, and 21 (57%) had gastric tumors. The median number of cycles completed was 4.5 (range: 0-36), and 25 patients required dose reductions or discontinuation of at least one component due to toxicity. Of the 38 patients evaluable for response, 15 (42.9%) had complete/partial response (CR/PR) as the best response, and 13 (37.1%) had stable disease. progression-free survival (PFS) and OS data were available for 38 patients, with a median follow-up duration of 27 months (range: 18.2-51.9 months for censored patients). Median PFS was 6.6 months (95% CI: 5.6-12.9), with 31.0% (95% CI: 18.4%-52.4%) 12-month PFS rate. The median OS was 10.5 months (95% CI: 8.8-20.7), 12-month OS rate was 44.7% (95% CI: 31.4%-63.7%). Treatment-related grade 3-4 toxicities included peripheral sensory neuropathy and anemia (18.4% each), neutropenia (15.8%), and diarrhea and lymphopenia (7.9% each).

Conclusions

FOLFOX-A has a significant response rate, expected toxicities, and should be considered for future investigation in combination with immunotherapy given the recent approvals.
Supercharged Phosphotriesterase for improved Paraoxon activity
Authors: Kronenberg Jacob , Britton Dustin , Halvorsen Leif , Chu Stanley , Kulapurathazhe Maria Jinu , Chen Jason , Lakshmi Ashwitha , Renfrew P Douglas , Bonneau Richard , Montclare Jin Kim
Published: September 2024

Phosphotriesterases (PTEs) represent a class of enzymes capable of efficient neutralization of organophosphates (OPs), a dangerous class of neurotoxic chemicals. PTEs suffer from low catalytic activity, particularly at higher temperatures, due to low thermostability and low solubility. Supercharging, a protein engineering approach via selective mutation of surface residues to charged residues, has been successfully employed to generate proteins with increased solubility and thermostability by promoting charge–charge repulsion between proteins. We set out to overcome the challenges in improving PTE activity against OPs by employing a computational protein supercharging algorithm in Rosetta. Here, we discover two supercharged PTE variants, one negatively supercharged (with −14 net charge) and one positively supercharged (with +12 net charge) and characterize them for their thermodynamic stability and catalytic activity. We find that positively supercharged PTE possesses slight but significant losses in thermostability, which correlates to losses in catalytic efficiency at all temperatures, whereas negatively supercharged PTE possesses increased catalytic activity across 25°C–55°C while offering similar thermostability characteristic to the parent PTE. The impact of supercharging on catalytic efficiency will inform the design of shelf-stable PTE and criteria for enzyme engineering.
Suture Pull-Through Technique for EndoArt Insertion in a Complex Case Scenario
Authors: Vishwakarma Pratima , Wiedemann Johanna , Kobayashi Akira , Hayashi Takahiko , Schlereth Simona , Cursiefen Claus , Bachmann Björn
Published: September 2024

Purpose:

The purpose of this study was to describe a novel suture pull-through technique of EndoArt implant insertion.

Method:

EndoArt insertion was performed using a novel suture pull-through technique after several failed Descemet membrane endothelial keratoplasty surgeries for a 59-year-old woman who had undergone multiple surgeries after open globe injury and had artificial iris implant with scleral-fixated intraocular lens.

Result:

With this technique, EndoArt insertion into the anterior chamber was possible without implant dislocation. Postoperatively, anterior segment optical coherence tomography was recorded and peripheral detachment of the implant was noted. Rebubbling was required thrice with augmentation of the anchoring sutures. At 45 days of follow-up, EndoArt was principally attached.

Conclusions:

A novel suture pull-through technique of EndoArt implant insertion can be used for ensuring higher safety in complex cases like aphakia, aniridia, and vitrectomized eyes to prevent implant dislocation into the vitreous cavity.
TREM2 macrophages mediate the beneficial effects of bariatric surgery against MASH
Authors: Fredrickson Gavin , Florczak Kira , Barrow Fanta , Mahmud Shamsed , Dietsche Katrina , Wang Haiguang , Parthiban Preethy , Hakeem Andrew , Almutlaq Rawan , Adeyi Oyedele , Herman Adam , Bartolomucci Alessandro , Staley Christopher , Dong Xiao , Jahansouz Cyrus , Williams Jesse W. , Mashek Douglas G. , Ikramuddin Sayeed , Revelo Xavier S.
Published: September 2024

Background and Aims:

For patients with obesity and metabolic syndrome, bariatric procedures such as vertical sleeve gastrectomy (VSG) have a clear benefit in ameliorating metabolic dysfunction-associated steatohepatitis (MASH). While the effects of bariatric surgeries have been mainly attributed to nutrient restriction and malabsorption, whether immuno-modulatory mechanisms are involved remains unclear.

Approach and Result:

Using murine models, we report that VSG ameliorates MASH progression in a weight loss-independent manner. Single-cell RNA sequencing revealed that hepatic lipid-associated macrophages (LAMs) expressing the triggering receptor expressed on myeloid cells 2 (TREM2) repress inflammation and increase their lysosomal activity in response to VSG. Remarkably, TREM2 deficiency in mice ablates the reparative effects of VSG, suggesting that TREM2 is required for MASH resolution. Mechanistically, TREM2 prevents the inflammatory activation of macrophages and is required for their efferocytic function.

Conclusions:

Overall, our findings indicate that bariatric surgery improves MASH through a reparative process driven by TREM2+ macrophages, providing insights into the mechanisms of disease reversal that may result in new therapies and improved surgical interventions.
Seizure Risk Associated With the Use of Transcranial Magnetic Stimulation for Coma Recovery in Individuals With Disordered Consciousness After Severe Traumatic Brain Injury
Authors: Ripley David , Krese Kelly , Rosenow Joshua M. , Patil Vijaya , Schuele Stephan , Pacheco Marilyn S. , Roth Eliot , Kletzel Sandra , Livengood Sherri , Aaronson Alexandra , Herrold Amy , Blabas Brett , Bhaumik Runa , Guernon Ann , Burress Kestner Catherine , Walsh Elyse , Bhaumik Dulal , Bender Pape Theresa L.
Published: September 2024

Objective:

Repetitive Transcranial Magnetic Stimulation (rTMS) is emerging as a promising treatment for persons with disorder of consciousness (DoC) following traumatic brain injury (TBI). Clinically, however, there are concerns about rTMS exacerbating baseline seizure risk. To advance understanding of risks, this article reports evidence of DoC-TBI rTMS-related seizure risk.

Setting:

Acute and sub-acute hospitals.

Participants:

Persons in states of DoC 6.5 months to 15 years after TBI (n = 20) who received active rTMS (n = 17) or placebo rTMS (n = 3). After completing placebo procedures, placebo participants completed active rTMS procedures. These 3 participants are included in the active group.

Design:

Meta-analysis of data from 3 clinical trials; 2 within-subject, 1 double blind randomized placebo-controlled. Each trial used the same rTMS protocol, provided at least 30 rTMS sessions, and delivered rTMS to the dorsolateral prefrontal cortex.

Main Measures:

During each study’s rTMS treatment phase, seizure occurrences were compared between active and placebo groups using logistic regression. After stratifying active group by presence/absence of seizure occurrences, sub-groups were compared using contingency chi-square tests of independence and relative risk (RR) ratios.

Results:

Two unique participants experienced seizures (1 active, 1 placebo). Post seizure, both participants returned to baseline neurobehavioral function. Both participants received antiepileptics during remaining rTMS sessions, which were completed without further seizures. rTMS-related seizure incidence rate is 59 per 1000 persons. Logistic regression revealed no difference in seizure occurrence by treatment condition (active vs placebo) or when examined with seizure risk factors (P > .1). Presence of ventriculoperitoneal shunt elevated seizure risk (RR = 2.0).

Conclusion:

Collectively, findings indicate a low-likelihood that the specified rTMS protocol exacerbates baseline seizure rates in persons with DoC after TBI. In presence of VP shunts, however, rTMS likely elevates baseline seizure risk and mitigation of this increased risk with pharmacological seizure prophylaxis should be considered.
Beyond T-Trials, T4DM and TRAVERSE: the next large testosterone randomized controlled trial
Authors: Yeap Bu B. , Tran Cammie , Douglass Catherine M. , McNeil John J.
Published: September 2024

Purpose of review

Lower testosterone concentrations have been associated with poorer health outcomes in ageing men, but proving causality and demonstrating potential for therapeutic benefit requires randomized clinical trials (RCTs). This review discusses recent observational findings and results of major testosterone RCTs, to explore the need for another, larger trial.

Recent findings

Evidence of Leydig cell impairment emerges in men above the age of 70 years. Lower testosterone is associated with diabetes risk, and also risk of incident dementia. An individual participant data meta-analysis found that below thresholds of testosterone of 7.4 nmol/L and 5.3 nmol/l respectively, risks of all-cause mortality and cardiovascular deaths in men increased. Testosterone for the Prevention of Type 2 Diabetes Mellitus (T4DM), a multicentre RCT, showed that testosterone treatment prevented or reverted type 2 diabetes in men at high risk. Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE), a cardiovascular safety trial, demonstrated cardiovascular and prostate safety of testosterone treatment in men with or at risk of cardiovascular disease. T4DM confirmed findings from the Testosterone Trials (T-Trials) that testosterone improved sexual function, and bone microarchitecture and density. However, in TRAVERSE, testosterone-treated men had a higher risk of clinical bone fractures, but not major osteoporotic fractures.

Men with disorders of the hypothalamic–pituitary–testicular (HPT) axis causing androgen deficiency warrant consideration for testosterone therapy. In men with an intact HPT axis, testosterone treatment is a pharmacological intervention which requires justification from high quality RCT data. Currently, there is insufficient evidence to justify wider use of testosterone for prevention of cardiometabolic disease. However, there is scope for another large testosterone RCT to investigate whether testosterone treatment might, in older men, extend disability-free survival.
Investigating the prevalence burden of peptic ulcer disease in older adults aged 70+ from 1990 to 2019: an analysis of Global Disease Burden Studies
Authors: Zhuo Mingxing , Fang Meiling , Yin Ying , Wang Jin , Wei Zhaoxia , Lu Jiaming , Jia Yegui
Published: September 2024

Background

Peptic ulcer disease (PUD) affects individuals aged ≥70 years globally, exerting a significant impact on their health and well-being. Understanding its epidemiological evolution and associated factors is crucial for guiding interventions and improving management.

Methods

This study utilized Global Burden of Disease Study data to examine the prevalence and temporal changes of PUD in individuals aged 70 years and older between 1990 and 2019. The analysis included assessing estimated annual percentage changes (EAPCs) to investigate temporal trends and regional variations.

Results

Over the past 30 years, the number of individuals aged 70 years and above suffering from PUD globally has increased from 1 065 730 cases in 1990 to 1 608 463 cases in 2019. Despite an increasing number of cases, the prevalence of PUD among the elderly has exhibited a steady decline, with an EAPC of −1.47 (95% confidence interval: −1.57 to −1.37) over this timeframe. In 2019, the prevalence rates of PUD among individuals aged 70–74, 75–79, 80–84, and 85 years and older were 313.36, 365.77, 388.45, and 352.51 per 100 000 population, respectively. South Asia, high-income North America, and Central Sub-Saharan Africa were the regions with the highest prevalence rates of PUD in 2019, with rates of 624.90, 575.48, and 474.80 per 100 000 population, respectively. At the national level, Ireland, Australia, Brazil, Brunei Darussalam, and Bangladesh have effectively managed the burden of PUD among the elderly, achieving the greatest reduction. Additionally, regions with higher levels of socioeconomic development tended to have relatively lower burdens of PUD among the elderly, and prevalence rates varied across different regions and age groups.

Conclusion

Our study highlights the enduring burden of PUD among the global elderly population, emphasizing the significance of tailored interventions to address this pressing issue. This research underscores the critical need for targeted public health strategies aimed at improving outcomes specifically for older adults affected by PUD.