bluuebunny/crossref_metadata_2025 huggingface dataset:
A188 INFORMING IMMUNOCOMPROMISED POPULATIONS: AN EFFECTIVE AND EFFICIENT COVID-19 KNOWLEDGE TRANSLATION STRATEGY
Authors: Windsor J W , Coward S , Lee K , Specic A , Ghandeharian S , Benchimol E I , Kaplan G G
Published: March 2023

Background

Throughout the COVID-19 pandemic, one of the major challenges was conveying expert health information, which was evolving rapidly, to confer population-level advice; this was especially relevant to at risk groups, such as those who are immunocompromised due to conditions like inflammatory bowel disease (IBD) or medications to manage disease.

Purpose

To provide sufficient information to those with IBD (>0.75% of the Canadian population or roughly 300,000 individuals) and their carers to allow self assessment of personal risks related to COVID-19.

Method

On March 17, 2020, Crohn’s and Colitis Canada (CCC) convened the COVID-19 & IBD Taskforce comprised of adult and pediatric gastroenterologists, IBD nurses, infectious disease experts, scientists, public health officials, communication and government relations experts, and patient advisors. The taskforce met weekly (later monthly) to synthesize rapidly evolving information on COVID-19 and personal risk assessment. Expert reviews of population-level recommendations were tailored to the IBD community and communicated through website FAQs and infographics; a public-oriented burden report with foci on additional special populations (e.g., pregnant people, pediatrics, seniors), IBD medications, and mental health and access to care during the pandemic; and through a moderated, online webinar series. The 1- to 2-hour webinar recordings were then curated into 3- to 5-minute video clips to answer specific questions and uploaded to CCC’s YouTube page. YouTube and website metrics show the continued efficacy of this strategy.

Result(s)

More than 24,778 households registered for the first 23 webinars, with more than one third registering for more than one webinar. As of April 1, 2021 (just after the 23rd webinar), there have been 54,136 views of the archived full (1- to 2-hour) webinars and a further 78,862 views of individual webinar segments (3- to 5-minute curated clips), for a total of 126,187 views. Additionally, traffic to the CCC website increased exponentially with 484,755 unique views to the COVID-19 web pages, viewed for up to 28.29 minutes. Since April 2021, after an additional seven webinars, these numbers have continued to swell to 33,243 (registrants), 81,370 (webinar views), 92,862 (segment views), and 810,156 (unique website views); this is demonstrative of the continued impact of the electronic knowledge translation strategy.

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Conclusion(s)

While many within the IBD community were secluded during the early portions of the pandemic due to lockdown restrictions and public health advice not tailored to immunocompromised individuals, advice tailored to this community and presented through electronic methods proved to be an effective and efficient knowledge translation strategy.

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CCC

Disclosure of Interest

None Declared
A201 EFFECT OF MIRIKIZUMAB ON BOWEL URGENCY CLINICALLY MEANINGFUL IMPROVEMENT AND REMISSION: RESULTS FROM THE PHASE 3 LUCENT INDUCTION AND MAINTENANCE STUDIES
Authors: Travis S , Hibi T , Hisamatsu T , Fisher D , Shan M , Gibble T H , Rubin D , Jones J
Published: March 2023

Background

Bowel urgency (BU) was assessed in mirikizumab (miri) Phase 3 LUCENT studies in moderately-to-severely active UC using the validated Urgency Numeric Rating Scale (UNRS). UNRS measures BU severity in the past 24 hours from 0 (no urgency) to 10 (worst possible urgency). Psychometric evaluation of the UNRS showed Clinically Meaningful Improvement (CMI) is >3 point change; Remission is a score of 0 or 1.

Purpose

This analysis evaluated the proportions of patients in LUCENT studies achieving BU CMI and BU remission.

Method

The modified intent-to-treat (mITT) population (patients receiving ≥1 dose of miri or placebo (PBO); N= 1281) was randomized at induction study baseline in a 3:1 ratio to IV doses of 300mg miri or PBO every 4 weeks (Q4W) during induction (W0, 4, and 8). Patients achieving Clinical Response, measured by Modified Mayo Score (MMS), to miri during induction were re-randomized at W0 of the maintenance study in a 2:1 ratio to subcutaneous (SC) 200mg miri or PBO Q4W through W40 (52 weeks of treatment). Patients recorded their UNRS score daily in an e-diary. Mean weekly UNRS scores were calculated from diary data if ≥4 days of data were available. Rates of BU CMI and BU remission in the miri v PBO groups were compared at W12 (induction) in the mITT population with a baseline UNRS score ≥3, and W52 (maintenance) among miri clinical responders at W12 with a baseline UNRS score ≥3. Cochran-Mantel-Haenszel tests with non-responder imputation for missing values were used for all treatment comparisons.

Result(s)

Patient population: mean age 43 years, 60% male, disease duration 7 years; 63.0% left-sided colitis; 36.3% pancolitis; 46.7% moderate disease (MMS 4-6); 53.2% severe disease (MMS 7-9). Significantly higher proportions of miri versus PBO patients achieved BU CMI (48.7% v 32.2%) and BU remission (22.1% v 12.3%) at W12 (both p<0.001; Table) in the induction study. Similarly, at W40 of maintenance, significantly greater proportion of miri patients achieved BU CMI (65.2% v 41.9%) and BU remission (42.9% v 25.0%) compared to PBO among miri induction responders (both p<0.001; Table).

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Conclusion(s)

Miri had a highly significant and clinically meaningful benefit on reducing bowel urgency, one of the most disruptive UC symptoms. The Urgency Numeric Rating Scale usefully quantified the baseline level and change in bowel urgency after treatment across a spectrum of severity.

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Other

Please indicate your source of funding;

Eli Lilly and Company

Disclosure of Interest

None Declared
A285 CHANGE IN ALT DURING MODIFIED OPTIFAST WEIGHT LOSS PROGRAM IN INDIVIDUALS AT RISK FOR NON-ALCOHOLIC FATTY LIVER DISEASE
Authors: Meddings Maybury L , Kelly E , Dent R , Bielawska B
Published: March 2023

Background

Obesity is linked to various health complications, including diabetes, metabolic syndrome, cardiovascular disease, and non-alcoholic fatty liver disease (NAFLD). NAFLD is the most frequent cause of abnormally high alanine aminotransferase (ALT) levels. ALT is released at higher levels during hepatocellular injury and represents a simple, low cost and non-invasive method of assessing liver damage. There are conflicting data on ALT response to weight loss between men and women, with some evidence of transient increase in ALT levels in women.

Purpose

The aim of this study was to assess the impact of a dietary weight loss intervention with Optifast on ALT in patients with obesity who have baseline elevated ALT levels.

Method

This was a retrospective cohort study of Ontario adults who participated in a 26 week weight loss program, including 6 or 12 weeks of low-calorie liquid diet meal replacement with Optifast 900® (Nestlé, Canada), between 1992 and 2015. We included patients with elevated baseline ALT levels, defined by > 40 U/L, who had at least one follow-up ALT between week 15 and 26. We excluded patients with nonadherence to dietary intervention, established liver disease or using hepatotoxic drugs, excessive alcohol intake (>11U/wk for females and >14U/wk for males), and insufficient data to calculate FIB-4. The primary outcome was change in ALT levels, measured by normalization (post-intervention ALT < 40 U/L), percentage decrease and absolute decrease. Multiple linear regressions were obtained for the relationship between ALT changes and age, sex, body mass index (BMI) and FIB-4. All analyses were conducted in SPSS. P value of ≤0.05 was considered statistically significant.

Result(s)

444 patients met study criteria. Mean age was 47.1 years +/- 10.9, 49 % of patients were female, and mean BMI was 43.5 kg/m2 +/- 7.9. All patients lost weight, with mean weight loss 27.3 kg +/- 11.5 and a mean 20.7% decrease from baseline weight. Mean ALT at baseline was 58.9 U/L +/- 25.4 and mean ALT post intervention was 32.3 U/L +/- 28.1 (p <0.01). 85.1% of patients had normalization of ALT. Mean % decrease in ALT was 41.9% and mean absolute decrease in ALT was 26.6 U/L +/- 25.4. Younger age and higher baseline FIB-4 were significantly associated with a larger decrease in ALT levels, while sex and initial BMI were not significantly associated with changes in ALT.

Conclusion(s)

In patients with obesity and baseline elevated ALT, dietary weight loss intervention with Optifast leads to ALT normalization in most patients, regardless of sex. Younger age at baseline and higher baseline FIB-4 are significantly associated with greater decrease in ALT.

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None

Disclosure of Interest

None Declared
How Sensory Language Shapes Influencer’s Impact
Authors: Cascio Rizzo Giovanni Luca , Berger Jonah , De Angelis Matteo , Pozharliev Rumen
Published: March 2023

Influencer marketing has become big business. But while influencers have the potential to spread marketing messages and drive purchase, some posts get lots of engagement and boost sales, while others do not. What makes some posts more impactful? This work examines how sensory language (e.g., words like “crumble” and “juicy” that engage the senses) shapes consumer responses to influencer-sponsored content. A multimethod investigation, combining controlled experiments with automated text, image, and video analysis of thousands of sponsored social media posts, demonstrates that sensory language increases engagement and willingness to buy the sponsored product. Furthermore, the studies illustrate that these effects are driven by perceived authenticity. Sensory language leads consumers to infer that influencers actually use the product they are endorsing, which increases perceived authenticity, and thus engagement and purchase. These findings shed light on how language shapes responses to influencer-sponsored content, deepen understanding of the drivers of authenticity, and suggest how to develop more impactful social media campaigns.
Population growth of Tetranychus truncatus (Acari: Tetranychidae) on different drought-tolerant potato cultivars
Authors: Zhang Ke-Xin , Ma Yue , Li Chun-Chun , Quandahor Peter , Haq Inzamam Ul , Zhang Qiangyan , Kong Li-Li , Tao Yan , Liu Chang-Zhong
Published: March 2023

Tetranychus truncatus Ehara (Acari: Tetranychidae) has become one of the major phytophagous pests in China in recent years, and is found on a wide range of host plants. However, little information is available on the population performance of this arthropod pest on potatoes. In this study, we explored the population growth of T. truncatus on two drought-tolerant potato (Solanum tuberosum L.) cultivars under laboratory conditions using the age-stage, two-sex life table. Tetranychus truncatus completed its entire life history on both potato cultivars tested, Holland 15 and Longshu 10. There was no significant difference between two potato cultivars in developmental duration. Tetranychus truncatus had shorter adult longevity (20.61 days), adult female longevity (20.41 days), and total female longevity (33.66 days) on Longshu 10 than Holland 15 (21.16 days, 21.19 days, and 34.38 days, respectively). However, it exhibited a higher preadult survival rate, higher fecundity (F = 88.32 eggs per female), and relatively higher population parameters when reared on Longshu 10 than on Holland 15 (F = 75.70 eggs per female). Growth projection also showed that the population size of T. truncatus on Longshu 10 (expand 750-fold) was larger than that on Holland 15 (expand 273-fold) after 60 days. Our results demonstrate that the drought-sensitive potato variety, Holland 15, is relatively resistant to T. truncatus compared with the drought-tolerant variety, Longshu 10, and suggest that T. truncatus exhibited a trade-off between longevity and reproduction on both potato cultivars. Our findings provide information on population prediction, which may aid the management of this pest mite species of potatoes.
Potential risk to pollinators from neonicotinoid applications to host trees for management of spotted lanternfly,Lycorma delicatula(Hemiptera: Fulgoridae)
Authors: Elmquist Jonathan , Biddinger David , Phan Ngoc T , Moural Timothy W , Zhu Fang , Hoover Kelli
Published: March 2023

Neonicotinoid insecticides are used to manage spotted lanternfly (Lycorma delicatula (White); hereafter SLF), a recently introduced pest in the United States. Neonicotinoids can harm nontargets, such as pollinators potentially exposed via floral resources of treated plants. We quantified neonicotinoid residues in whole flowers of two SLF host plant species, red maple (Acer rubrum L. [Sapindales: Sapindaceae]) and tree-of-heaven (Ailanthus altissima (Mill.) [Sapindales: Simaroubaceae]), treated with post-bloom imidacloprid or dinotefuran applications that differed in timing and method of application. In red maple flowers, dinotefuran residues from fall applications were significantly higher than summer applications, while imidacloprid residues from fall applications were significantly lower than summer applications. Residues did not differ between application methods or sites. In tree-of-heaven flowers, dinotefuran residues were only detected in one of 28 samples at a very low concentration. To assess acute mortality risk to bees from oral exposure to residues in these flowers, we calculated risk quotients (RQ) using mean and 95% prediction interval residue concentrations from treatments in this study and lethal concentrations obtained from acute oral bioassays for Apis mellifera (L. (Hymenoptera: Apidae)) and Osmia cornifrons (Radoszkowski (Hymenoptera: Megachilidae)), then compared these RQs to a level of concern. For A. mellifera, only one treatment group, applied at 2X maximum label rate, had an RQ that exceeded this level. However, several RQs for O. cornifrons exceeded the level of concern, suggesting potential acute risk to solitary bees. Further studies are recommended for more comprehensive risk assessments to nontargets from neonicotinoid use for SLF management.
Clio in the Operating Theatre: Historical Research, Emotional Health, and Surgical Training in Contemporary Britain
Authors: Arnold-Forster Agnes
Published: March 2023

Drawing on my experience working as a postdoctoral research and engagement fellow on the Wellcome Trust-funded project, Surgery & Emotion, this article reflects on this innovative model of historical research and professional engagement, explores the challenges posed by crossing disciplinary boundaries, and interrogates the practical and theoretical utility of bringing historical research into the operating theatre. How do surgeons specifically engage with the history of their profession? What can the history of emotions offer to the training of medical students and surgeons? What obstacles interfere in this type of cross-disciplinary engagement? What peculiar opportunities and challenges do the United Kingdom higher education system and National Health Service pose to the teaching of medical history in clinical settings?

Bringing Clio into the operating theatre provides surgeons with an alternative narrative to that which they have come to expect about the emotions they ought to feel and express in their work. It allows them to explore the high feelings of their professional lives at a remove and offers an array of possible solutions to the current emotional health crisis in British medicine. History allows surgeons to imagine an alternative world: one where the pervasive and persistent models of emotional detachment – damaging to both patient experience and professional wellbeing – dissolve.
Endoscopic iliopsoas lengthening for treatment of recalcitrant iliopsoas tendinitis after total hip arthroplasty
Authors: Bonano John C , Pierre Kinsley , Jamero Christopher , Segovia Nicole A , Huddleston James I , Safran Marc R
Published: March 2023

Iliopsoas (IP) tendinitis from impingement upon the acetabular component after total hip arthroplasty (THA) has been treated with open and endoscopic IP tenotomy or acetabular component revision. This study describes the results of a consecutive series of patients treated with endoscopic IP tenotomy as a less invasive alternative. Twenty-eight patients with IP impingement after THA underwent endoscopic IP lengthening from 2012 to 2021 at a single-center academic institution. The follow-up of 24 of these patients was achieved with a mean follow-up of 7.6 months (range 1–28). Outcomes included the modified Harris Hip Score (mHHS), visual analog pain scale (VAS), satisfaction, component positioning and complications. Seventy-one percent of patients were satisfied or very satisfied after their operation. The median mHHS preoperatively was 57 (Interquartile range [IQR] 43–60) and postoperatively was 75 (IQR 66–92, P < 0.001). Clinically meaningful improvements in mHHS were seen in patients with VAS pain scores <5, cup prominence >8 mm, body mass index >30, and less than 2 years from their index THA. Two patients developed a deep infection 7 and 10 months postoperatively (neither related to the release), and one patient underwent open psoas release for persistent impingement. Endoscopic IP tenotomy is a safe and effective treatment for impingement after THA. Patients with cup prominence >8 mm, body mass index >30 and less than 2 years since their index THA may have more clinically meaningful improvements in pain and function.
A Climate Change Carve-Out for Investment Treaties
Authors: Paine Joshua , Sheargold Elizabeth
Published: March 2023

This article responds to the growing risk of Investor–State Dispute Settlement (ISDS) claims arising from states’ measures to mitigate climate change, such as fossil fuel phase-outs. It proposes a carve-out that would cover measures that are adopted in good faith and have a reasonable causal nexus with reducing and stabilizing greenhouse gas emissions (e.g. measures ‘related to’ this aim). Depending on states’ preferences, the carve-out could be designed as a treaty-wide exclusion from international investment agreements (IIAs) or as a carve-out that only removes such measures from ISDS procedures. Importantly, we propose a process to govern the application of the carve-out that prevents this issue being determined by ISDS tribunals. We argue that questions concerning the carve-out’s application to specific investor claims should initially be subject to joint determination by the treaty parties’ environmental authorities. Where these authorities cannot agree, we propose that this issue should be referred to a State–State tribunal that includes members with climate-related expertise. This article advances the specific debate about a climate carve-out for IIAs and wider debates about strategies for protecting regulatory space under IIAs through its detailed examination of carve-outs, drawing on examples from a range of subject areas.
hCINAP alleviates senescence by regulating MDM2 via p14ARF and the HDAC1/CoREST complex
Authors: Huang Xinping , Zhao Yan , Wei Min , Zhuge Ruipeng , Zheng Xiaofeng
Published: March 2023

Cellular senescence is a major process affected by multiple signals and coordinated by a complex signal response network. Identification of novel regulators of cellular senescence and elucidation of their molecular mechanisms will aid in the discovery of new treatment strategies for aging-related diseases. In the present study, we identified human coilin-interacting nuclear ATPase protein (hCINAP) as a negative regulator of aging. Depletion of cCINAP significantly shortened the lifespan of Caenorhabditis elegans and accelerated primary cell aging. Moreover, mCINAP deletion markedly promoted organismal aging and stimulated senescence-associated secretory phenotype in the skeletal muscle and liver from mouse models of radiation-induced senescence. Mechanistically, hCINAP functions through regulating MDM2 status by distinct mechanisms. On the one hand, hCINAP decreases p53 stability by attenuating the interaction between p14ARF and MDM2; on the other hand, hCINAP promotes MDM2 transcription via inhibiting the deacetylation of H3K9ac in the MDM2 promoter by hindering the HDAC1/CoREST complex integrity. Collectively, our data demonstrate that hCINAP is a negative regulator of aging and provide insight into the molecular mechanisms underlying the aging process.
On the potential in film for ethics education: in defence of educational ethicism
Authors: MacAllister James
Published: March 2023

In this paper the potential in film for ethics education is considered, and the theory of educational ethicism is defended. Some key features of ethicism are firstly outlined. Bery’s Gaut’s argument about how artworks may teach ethics in an aesthetically meritorious way is also discussed. Two objections (from Matthew Kieran and Andrea Sauchelli) to Gaut’s position are then considered. It is argued that Gaut’s ethicism is not well placed to overcome these objections. However, I draw upon Paul Hirst to explain why a refined species of ethicism (educational ethicism) can surmount these objections. Educational ethicism holds that artworks with ethical themes be regarded as starting points for conversations about ethics rather than conveyers of definite ethical teachings that only a normatively specified audience can grasp. Three ways that film can possess potential for ethics education are also documented: through the moral growth of the audience, by helping them to deepen understanding of an aspect of ethical experience, and in developing theoretical understanding.
Plant community traits and functions mediate the biomass trade-off of alpine grasslands along precipitation gradients on the Tibetan Plateau
Authors: Sun Le , Sun Jian , Wu Jun-Xi , Du Zi-Yin , Chen You-Jun , Wang Yi , Liu Miao , Li Wen-Cheng , Liang Er-Yuan
Published: March 2023

A better understanding the mechanisms driving plant biomass allocation in different ecosystems is an important theoretical basis for illustrating the adaptive strategies of plants. To date, the effects of habitat conditions on plant biomass allocation have been widely studied. However, it is less known how plant community traits and functions (PCTF) affect biomass allocation, particularly in alpine grassland ecosystems. In this study, community-weighted means (CWM) were calculated at the community level using five leaf functional traits, and the relationships between PCTF and biomass trade-offs were explored using correlation analysis, variation partitioning analysis and structural equation modeling. We found that the trade-off values were greater than zero in both alpine meadow (AM) and alpine steppe (AS) across the Tibetan Plateau, with different values of 0.203 and 0.088 for AM and AS, respectively. Moreover, the critical factors determining biomass allocation in AS were species richness (SR; scored at 0.69) and leaf dry matter content of CWM (CWMLDMC, scored at 0.42), while in AM, the key factors were leaf dry matter content (CWMLDMC, scored at 0.48) and leaf carbon content of CWM (CWMLC, scored at −0.45). In particular, both CWMLDMC and SR in AS, as well as CWMLDMC and CWMLC in AM were primarily regulated by precipitation. In summary, precipitation tends to drive biomass allocation in alpine grasslands through its effects on PCTF, hence highlighting the importance of PCTF in regulating plant biomass allocation strategies along precipitation gradients.
Urine and Saliva Viral Load in Children with Congenital Cytomegalovirus Infection
Authors: Kabani Nazia , Pinninti Swetha , Boppana Suresh , Fowler Karen , Ross Shannon
Published: March 2023

Viral load in infant saliva and urine was assessed to predict sensorineural hearing loss (SNHL) in children with congenital cytomegalovirus infection. Viral load was higher in symptomatic infants. Viral load in asymptomatic children with and without SNHL did not differ. Congenital cytomegalovirus infection viral load in urine and saliva does not predict hearing loss.
Synthalin: a lost lesson for glucagon suppression in diabetes therapeutics
Authors: Thomas Keith G , Klempel Natalie J , Flatt Peter R , Bailey Clifford J , Moffett R Charlotte
Published: March 2023

Objectives

Within mammalian pancreatic islets, there are two major endocrine cell types, beta-cells which secrete insulin and alpha-cells which secrete glucagon. Whereas, insulin acts to lower circulating glucose, glucagon counters this by increasing circulating glucose via the mobilisation of glycogen. Synthalin A (Syn A) was the subject of much research in the 1920s and 1930s as a potential pancreatic alpha-cell toxin to block glucagon secretion. However, with the discovery of insulin and its lifesaving use in patients with diabetes, research on Syn-A was discontinued.

Key findings

This short review looks back on early studies performed with Syn A in animals and humans with diabetes. These are relevant today because both type 1 and type 2 diabetes are now recognised as states of not only insulin deficiency but also glucagon excess.

Lessons learned from this largely forgotten portfolio of work and therapeutic strategy aimed at limiting the number or function of islet alpha-cells might be worthy of reconsideration.
APETx2 regulates intestinal motility and visceral sensitivity in post-infectious irritable bowel syndrome mice through 5-HT signalling pathway
Authors: Yuan Liping , Xiao Hongyun , Li Huan , Yan Bo
Published: March 2023

Objectives

To investigate whether APETx2, a potent and selective inhibitor of ASIC3, regulates intestinal motility and visceral sensitivity in post-infectious irritable bowel syndrome (PI-IBS) mice through the 5-HT signalling pathway.

Methods

The PI-IBS model was established by Trichinella spiralis infection of NIH mice. APETx2(120 µg/kg) was administrated to PI-IBS mice by intraperitoneal injection once a day, lasting for 7 days. The gastrointestinal function of mice was assessed by the time of the first dark stool and the number of pellets defecated within 2 h. The visceral sensitivity was tested via abdominal withdrawal reflex. The protein levels of 5-HT and CRF in colon tissues were detected by immunohistochemistry. The changes in serum 5-HT and colon CRF contents were detected by ELISA. The mRNA levels of colon 5-HT4R and CRF were detected by RT-qPCR. The protein levels of colon 5-HT4R and dorsal root ganglion (DRG) ASIC3 were detected by Western blotting.

Key findings

The results indicated that APETx2 could markedly improve gastrointestinal function and visceral sensitivity in mice. Moreover, APETx2 could reduce the expression level of ASIC3 protein in the DRG of PI-IBS mice. APETx2 could increase the expression levels of 5-HT in serum and colon, CRF and 5-HT4R in the colon, and 5-HT4R in brain tissue in PI-IBS mice.

Conclusions

APETx2 can improve visceral sensitivity and intestinal motility in PI-IBS through 5-HT signalling pathway.
Post-infectious irritable bowel syndrome following a diagnosis of traveller’s diarrhoea: a comprehensive characterization of clinical and laboratory parameters
Authors: España-Cueto Sergio , Oliveira-Souto Inés , Salvador Fernando , Goterris Lidia , Treviño Begoña , Sánchez-Montalvá Adrián , Serre-Delcor Núria , Sulleiro Elena , Rodríguez Virginia , Aznar Maria Luisa , Bosch-Nicolau Pau , Espinosa-Pereiro Juan , Pou Diana , Molina Israel
Published: March 2023

Background

Prolonged or recurrent gastrointestinal symptoms may persist after acute traveller’s diarrhoea (TD), even after adequate treatment of the primary cause. This study aims to describe the epidemiological, clinical and microbiological characteristics of patients with post-infectious irritable bowel syndrome (PI-IBS) after returning from tropical or subtropical areas.

Methods

We conducted a retrospective study of patients presenting between 2009 and 2018 at the International Health referral centre in Barcelona with persistent gastrointestinal symptoms following a diagnosis of TD. PI-IBS was defined as the presence of persistent or recurrent gastrointestinal manifestations for at least 6 months after the diagnosis of TD, a negative stool culture for bacterial pathogens and a negative ova and parasite exam after targeted treatment. Epidemiological, clinical and microbiological variables were collected.

Results

We identified 669 travellers with a diagnosis of TD. Sixty-eight (10.2%) of these travellers, mean age 33 years and 36 (52.9%) women, developed PI-IBS. The most frequently visited geographical areas were Latin America (29.4%) and the Middle East (17.6%), with a median trip duration of 30 days (IQR 14–96). A microbiological diagnosis of TD was made in 32 of these 68 (47%) patients, 24 (75%) of whom had a parasitic infection, Giardia duodenalis being the most commonly detected parasite (n = 20, 83.3%). The symptoms persisted for a mean of 15 months after diagnosis and treatment of TD. The multivariate analysis revealed that parasitic infections were independent risk factors for PI-IBS (OR 3.0, 95%CI 1.2–7.8). Pre-travel counselling reduced the risk of PI-IBS (OR 0.4, 95%CI 0.2–0.9).

Conclusions

In our cohort, almost 10% of patients with travellers’ diarrhoea developed persistent symptoms compatible with PI-IBS. Parasitic infections, mainly giardiasis, seem to be associated with PI-IBS.
Decarbonizing the GCC: sustainability and life after oil and in GCC countries
Authors: Truby Jon
Published: March 2023

Energy transition and decarbonization in the Gulf Cooperation Council (GCC) is crucial to achieving Sustainable Development Goal (SDG) 7 and global climate objectives. This article first highlights the serious impact of the imminent and longer-term threats to the Gulf region caused by rising temperatures and climate change risks. As a shared problem, the article analyses how countries in the GCC are individually and collectively responding to the rising threat, by exploring the recent revised 2020 Nationally Determined Contributions delivered in advance of Conference of the Parties 26, as well as climate and energy targets. On this basis, the article evaluates the legal strategies to decarbonize energy and switch to cleaner economies. The article also highlights how clean energy transitions can help deliver environmental and economic dividends, and achieve a sustainable economy envisioned in SDG7.
Nutrient availability regulates Deschampsia antarctica photosynthetic and stress tolerance performance in Antarctica
Authors: Gago Jorge , Nadal Miquel , Clemente-Moreno María José , Figueroa Carlos María , Medeiros David Barbosa , Cubo-Ribas Neus , Cavieres Lohengrin Alexis , Gulías Javier , Fernie Alisdair Robert , Flexas Jaume , Bravo León Aloys
Published: March 2023

Deschampsia antarctica is one of the only two native vascular plants in Antarctica, mostly located in the ice-free areas of the Peninsula’s coast and adjacent islands. This region is characterized by a short growing season, frequent extreme climatic events, and soils with reduced nutrient availability. However, it is unknown whether its photosynthetic and stress tolerance mechanisms are affected by the availability of nutrients to deal with this particular environment. We studied the photosynthetic, primary metabolic, and stress tolerance performance of D. antarctica plants growing on three close sites (<500 m) with contrasting soil nutrient conditions. Plants from all sites showed similar photosynthetic rates, but mesophyll conductance and photobiochemistry were more limiting (~25%) in plants growing on low-nutrient availability soils. Additionally, these plants showed higher stress levels and larger investments in photoprotection and carbon pools, most probably driven by the need to stabilize proteins and membranes, and remodel cell walls. In contrast, when nutrients were readily available, plants shifted their carbon investment towards amino acids related to osmoprotection, growth, antioxidants, and polyamines, leading to vigorous plants without appreciable levels of stress. Taken together, these findings demonstrate that D. antarctica displays differential physiological performances to cope with adverse conditions depending on resource availability, allowing it to maximize stress tolerance without jeopardizing photosynthetic capacity.
Telehealth in the Military Health System: Impact, Obstacles, and Opportunities
Authors: Madsen Cathaleen , Poropatich Ronald , Koehlmoos Tracey Pérez
Published: March 2023

Background

The U.S. Military Health System (MHS) pioneered the use of telehealth in deployed environments in the early 1990s. However, its use in non-deployed environments historically lagged behind that of the Veterans Health Administration (VHA) and comparable large civilian health systems, due to administrative, policy, and other obstacles that slowed or blocked its expansion in the MHS. A report was prepared in December 2016, which summarized past and then-present telehealth initiatives in the MHS; described the obstacles, opportunities, and policy environment; and provided three possible courses of action for expansion of telehealth in deployed and non-deployed settings.

Methods

Gray literature, peer-reviewed literature, presentations, and direct input were aggregated under the guidance of subject matter experts.

Results

Past and then-current efforts demonstrated significant telehealth capability in use and in development for the MHS, mainly in deployed or operational settings. Policy from 2011 to 2017 demonstrated an environment favorable for MHS expansion, while the review of comparable civilian and veterans’ healthcare systems showed significant benefits including increased access and lower cost from use of telehealth in non-deployed settings. The 2017 National Defense Authorization Act charged the Secretary of Defense with promoting telehealth usage for the Department of Defense, including provisions for removing obstacles and reporting progress within 3 years. The MHS has the ability to reduce burdensome interstate licensing and privileging requirements, but still requires an increased level of cybersecurity, compared to civilian systems.

Discussion

The benefits of telehealth fit with the MHS Quadruple Aim of improving cost, quality, access, and readiness. Readiness is particularly served by the use of “physician extenders,” which allows nurses, physician assistants, medics, and corpsmen to provide hands-on care under remote oversight and to practice at the top of their licenses. Based on this review, three courses of action were recommended: to focus largely on developing telehealth in deployed environments; to maintain focus in deployed environments and increase telehealth development in non-deployed environments to keep pace with the VHA and private sector; or to use lessons learned from military and civilian telehealth initiatives to leapfrog the private sector.

Conclusion

This review serves as a snapshot in time of the steps leading to telehealth expansion before 2017, which helped to set the stage for later use of telehealth in behavioral health initiatives and as a response to coronavirus disease 2019. The lessons learned are ongoing and further research is expected to inform additional development of telehealth capability for the MHS.
Graduate Medical Education in the Military Health System: Strategic Analysis and Options
Authors: Degutis Linda C , Kellermann Arthur L , Jackson Kevin , Middleton Allen , Harris Racine S
Published: March 2023

Introduction

At the request of then-Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, Defense Health Horizons (DHH) examined options for shaping Graduate Medical Education (GME) in the Military Health System (MHS) in order to achieve the goals of a medically ready force and a ready medical force.

Materials and Methods

The DHH interviewed service GME directors, key designated institutional officials, and subject-matter experts on GME in the military and civilian health care systems.

Results

This report proposes numerous short- and long-term courses of action in three areas:

1. Balancing the allocation of GME resources to suit the needs of active duty and garrisoned troops. We recommend developing a clear, tri-service mission and vision for GME in the MHS and expanding collaborations with outside institutions in order to prepare an optimal mix of physicians and ensure that trainees meet requirements for clinical experience.

2. Improving the recruitment and tracking of GME students, as well as the management of accessions. We recommend several measures to improve the quality of incoming students, to track the performance of students and medical schools, and to foster a tri-service approach to accessions.

3. Aligning MHS with the tenets of the Clinical Learning Environment Review to advance a culture of safety and to help the MHS become a high reliability organization (HRO). We recommend several actions to strengthen patient care and residency training and to develop a systematic approach to MHS management and leadership.

Conclusion

Graduate Medical Education (GME) is vital to produce the future physician workforce and medical leadership of the MHS. It also provides the MHS with clinically skilled manpower. Graduate Medical Education (GME) research sows the seeds for future discoveries to improve combat casualty care and other priority objectives of the MHS. Although readiness is the MHS’s top mission, GME is also vital to meeting the other three components of the quadruple aim (better health, better care, and lower costs). Properly managed and adequately resourced GME can accelerate the transformation of the MHS into an HRO. Based on our analysis, DHH believes that there are numerous opportunities for MHS leadership to strengthen GME so it is more integrated, jointly coordinated, efficient, and productive. All physicians emerging from military GME should understand and embrace team-based practice, patient safety, and a systems-oriented focus. This will ensure that those we prepare to be the military physicians of the future are prepared to meet the needs of the line, to protect the health and safety of deployed warfighters, and to provide expert and compassionate care to garrisoned service members, families, and military retirees.
Chemical models of adenine precursors cyanamide and carbodiimide in the interstellar medium
Authors: Zhang Xia , Quan Donghui , Li Runxia , Esimbek Jarken , Chen Long-Fei , Zhao Guoming , Zhou Yan
Published: March 2023

Cyanamide (NH2CN) and its isomer, carbodiimide (HNCNH), may form adenine in the interstellar medium (ISM) via a series of reactions. Therefore, they are considered key prebiotic molecules in the study of the origin of life. We used the three-phase NAUTILUS chemical code, which includes the gas, the dust surface, and the icy mantle, to investigate the formation and destruction of cyanamide and carbodiimide. We added over 200 new chemical reactions of the two isomers and related species and established a relatively complete network. We applied cold core, hot corino/core, and shock models to simulate the different physical environments, and found that the two isomers are mainly produced by the free radical reactions on grain surfaces. Our simulated results suggest that cyanamide and carbodiimide molecules come from surface chemistry at early evolutionary stages. Then they are released back to the gas phase, either by thermal process (in hot cores, hot corinos) or by shock-induced desorption (in shock regions). We speculate that it is an inefficient route to form a tautomer of adenine by starting from molecules cyanoacetylene (C3NH), cyanamide, and carbodiimide in ISM.
A solar metallicity galaxy at z > 7? Possible detection of the [N ii] 122 μm and [O iii] 52 μm lines
Authors: Killi Meghana , Watson Darach , Fujimoto Seiji , Akins Hollis , Knudsen Kirsten , Richard Johan , Harikane Yuichi , Rigopoulou Dimitra , Rizzo Francesca , Ginolfi Michele , Popping Gergö , Kokorev Vasily
Published: March 2023

We present the first detection of the [N ii] 122 $\mu$m and [O iii] 52 $\mu$m lines for a reionization-epoch galaxy. Based on these lines and previous [C ii] 158 $\mu$m and [O iii] 88 $\mu$m measurements, using two different radiative transfer models of the interstellar medium, we estimate an upper limit on electron density of ≲500 cm−3 and an approximate gas-phase metallicity of Z/Z⊙ ∼ 1.1 ± 0.2 for A1689-zD1, a gravitationally lensed dusty galaxy at z = 7.133. Other measurements or indicators of metallicity so far in galaxy interstellar media at z ≳ 6 are typically an order of magnitude lower than this. The unusually high metallicity makes A1689-zD1 inconsistent with the fundamental metallicity relation, although there is likely significant dust obscuration of the stellar mass, which may partly resolve the inconsistency. Given a solar metallicity, the dust-to-metals ratio is a factor of several lower than expected, hinting that galaxies beyond z ∼ 7 may have lower dust formation efficiency. Finally, the inferred nitrogen enrichment compared to oxygen, on which the metallicity measurement depends, indicates that star formation in the system is older than about 250 Myr, pushing the beginnings of this galaxy to z > 10.
The influence of physiological and lifestyle factors on essential mineral element isotopic compositions in the human body: implications for the design of isotope metallomics research
Authors: Sullivan Kaj V , Moore Rebekah E T , Vanhaecke Frank
Published: March 2023

In the last 20 years, the application of high-precision isotopic analysis of essential mineral elements (Mg, K, Ca, Fe, Cu, and Zn) to biomedicine (sometimes referred to as isotope metallomics) has revealed that their stable isotopic compositions are altered by the metal dysregulation that is fundamental to the pathogenesis of many cancers and other diseases. Despite many published works showing the diagnostic and prognostic potential of this approach, a number of factors that may influence the stable isotopic composition of these essential mineral elements in healthy individuals remain unstudied. In this perspective article, we summarize the available evidence from trophic level studies, animal models, and ancient and modern humans, relating to physiological and lifestyle factors that appear likely (there is evidence indicating their influence) or unlikely (there is evidence indicating their lack of influence) to require controlling for when investigating variations in essential mineral element isotopic compositions in human subjects. We also discuss factors that require additional data to properly assess. There is evidence that sex, menopausal status, age, diet, vitamin and metal supplementation, genetic variation, and obesity influence the isotopic composition of at least one essential mineral element in the human body. The task of investigating potential influences on essential mineral element isotopic compositions in the human body is sizeable, but presents an exciting research opportunity, with each incremental advance helping to improve the quality of research output in the context of isotope metallomics.
Bisulfite probing reveals DNA structural intricacies
Authors: Bagshaw Andrew T M , Gemmell Neil J
Published: March 2023

In recent decades, study of DNA structure has largely been focused on the interrelationships between nucleotides at the level of nearest neighbours. A little-utilized approach to probing structure on a larger scale is non-denaturing bisulfite modification of genomic DNA in conjunction with high-throughput sequencing. This technique revealed a marked gradient in reactivity increasing towards the 5′ end of poly-dC:dG mononucleotide repeats as short as two base pairs, suggesting that access of the anion may be greater at these points due to positive-roll bending not predicted by existing models. Consistent with this, the 5′ ends of these repeats are strikingly enriched at positions relative to the nucleosome dyad that bend towards the major groove, while their 3′ ends tend to sit outside these areas. Mutation rates are also higher at the 5′ ends of poly-dC:dG when CpG dinucleotides are excluded. These findings shed light on the mechanisms underlying bending/flexibility of the DNA double helix as well as the sequences that facilitate DNA packaging.
The MksG nuclease is the executing part of the bacterial plasmid defense system MksBEFG
Authors: Weiß Manuela , Giacomelli Giacomo , Assaya Mathilde Ben , Grundt Finja , Haouz Ahmed , Peng Feng , Petrella Stéphanie , Wehenkel Anne Marie , Bramkamp Marc
Published: March 2023

Cells are continuously facing the risk of taking up foreign DNA that can compromise genomic integrity. Therefore, bacteria are in a constant arms race with mobile genetic elements such as phages, transposons and plasmids. They have developed several active strategies against invading DNA molecules that can be seen as a bacterial ‘innate immune system’. Here, we investigated the molecular arrangement of the Corynebacterium glutamicum MksBEFG complex, which is homologous to the MukBEF condensin system. We show here that MksG is a nuclease that degrades plasmid DNA. The crystal structure of MksG revealed a dimeric assembly through its C-terminal domain that is homologous to the TOPRIM domain of the topoisomerase II family of enzymes and contains the corresponding ion binding site essential for DNA cleavage in topoisomerases. The MksBEF subunits exhibit an ATPase cycle in vitro and we reason that this reaction cycle, in combination with the nuclease activity provided by MksG, allows for processive degradation of invading plasmids. Super-resolution localization microscopy revealed that the Mks system is spatially regulated via the polar scaffold protein DivIVA. Introduction of plasmids results in an increase in DNA bound MksG, indicating an activation of the system in vivo.
LncRNA HOTAIRM1 functions in DNA double-strand break repair via its association with DNA repair and mRNA surveillance factors
Authors: Chuang Tzu-Wei , Su Chun-Hao , Wu Pei-Yu , Chang Yao-Ming , Tarn Woan-Yuh
Published: March 2023

The eukaryotic exon junction complex component Y14 participates in double-strand break (DSB) repair via its RNA-dependent interaction with the non-homologous end-joining (NHEJ) complex. Using immunoprecipitation-RNA-seq, we identified a set of Y14-associated long non-coding RNAs (lncRNAs). The lncRNA HOTAIRM1 serves as a strong candidate that mediates the interaction between Y14 and the NHEJ complex. HOTAIRM1 localized to near ultraviolet laser-induced DNA damage sites. Depletion of HOTAIRM1 delayed the recruitment of DNA damage response and repair factors to DNA lesions and compromised the efficiency of NHEJ-mediated DSB repair. Identification of the HOTAIRM1 interactome revealed a large set of RNA processing factors including mRNA surveillance factors. The surveillance factors Upf1 and SMG6 localized to DNA damage sites in a HOTAIRM1-dependent manner. Depletion of Upf1 or SMG6 increased the level of DSB-induced non-coding transcripts at damaged sites, indicating a pivotal role for Upf1/SMG6-mediated RNA degradation in DNA repair. We conclude that HOTAIRM1 serves as an assembly scaffold for both DNA repair and mRNA surveillance factors that act in concert to repair DSBs.