bluuebunny/crossref_metadata_2025 huggingface dataset:
Floral morph variation mediated by clonal growth and pollinator functional groups of Limonium otolepis in a heterostylous fragmented population
Authors: Ren Dengfu , Jiao Fangfang , Zhang Aiqin , Zhao Jing , Zhang Jing
Published: March 2024

Abstract. Heterostyly, a genetic style polymorphism, is linked to symmetric pollen transfer, vital for its maintenance. Clonal growth typically impacts sexual reproduction by influencing pollen transfer. However, the floral morph variation remains poorly understood under the combined effects of pollinators and clonal growth in heterostyly characterized by negative frequency-dependent selection and disassortative mating. We estimated morph ratios, ramets per genet and heterostylous syndrome and quantified legitimate pollen transfer via clonal growth, pollinators and reciprocal herkogamy between floral morphs in Limonium otolepis, a fragmented population composed of five subpopulations in the desert environment of northwestern China, with small flower and large floral morph variation. All subpopulations but one exhibited pollen-stigma morphology dimorphism. The compatibility between mating types with different pollen-stigma morphologies remained consistent regardless of reciprocal herkogamy. Biased ratios and ramets per genet of the two mating types with distinct pollen-stigma morphologies caused asymmetric pollen flow and varying fruit sets in all subpopulations. Short-tongued insects were the primary pollinators due to small flower sizes. However, pollen-feeding Syrphidae sp. triggered asymmetry in pollen flow between high and low sex organs, with short-styled morphs having lower stigma pollen depositions and greater variation. Clonal growth amplified this variation by reducing intermorph pollen transfer. All in all, pollinators and clonal growth jointly drive floral morph variation. H-morphs with the same stigma-anther position and self-incompatibility, which mitigate the disadvantages of sunken low sex organs with differing from the classical homostyly, might arise from long- and short-styled morphs through a ‘relaxed selection’. This study is the first to uncover the occurrence of the H-morph and its associated influencing factors in a distylous plant featuring clonal growth, small flowers and a fragmented population.
Space for everyone
Authors: Offer Lucinda , Kanani Sheila
Published: March 2024

Something special happens when people encounter astronomy and geophysics in unusual settings, and the RAS plans to embrace that to diversify its outreach
Clinical and gonadal transcriptome analysis of 38,XX disorder of sex development pigs
Authors: Wu Jinhua , Tan Shuwen , Zhou Yi , Zhao Haiquan , Yu Hui , Zhong Bingzhou , Yu Congying , Wang Haoming , Yang Yin , Li Hua , Li Yugu
Published: March 2024

Pigs serve as a robust animal model for the study of human diseases, notably in the context of disorders of sex development (DSD). This study aims to investigate the phenotypic characteristics and molecular mechanisms underlying the reproductive and developmental abnormalities of 38,XX ovotestis-DSD (OT-DSD) and 38,XX testis-DSD (T-DSD) in pigs. Clinical and transcriptome sequencing analyses were performed on DSD and normal female pigs. Cytogenetic and SRY analyses confirmed that OT/T-DSD pigs exhibited a 38,XX karyotype and lacked the SRY gene. The DSD pigs had higher levels of follicle-stimulating hormone, luteinizing hormone, and progesterone, but lower testosterone levels when compared with normal male pigs. The reproductive organs of OT/T-DSD pigs exhibit abnormal development, displaying both male and female characteristics, with an absence of germ cells in the seminiferous tubules. Sex determination and development-related differentially expressed genes shared between DSD pigs were identified in the gonads, including WT1, DKK1, CTNNB1, WTN9B, SHOC, PTPN11, NRG1, and NXK3–1. DKK1 is proposed as a candidate gene for investigating the regulatory mechanisms underlying gonadal phenotypic differences between OT-DSD and T-DSD pigs. Consequently, our findings provide insights into the molecular pathogenesis of DSD pigs and present an animal model for studying into DSD in humans.
Case weighted power priors for hybrid control analyses with time-to-event data
Authors: Kwiatkowski Evan , Zhu Jiawen , Li Xiao , Pang Herbert , Lieberman Grazyna , Psioda Matthew A
Published: March 2024

We develop a method for hybrid analyses that uses external controls to augment internal control arms in randomized controlled trials (RCTs) where the degree of borrowing is determined based on similarity between RCT and external control patients to account for systematic differences (e.g., unmeasured confounders). The method represents a novel extension of the power prior where discounting weights are computed separately for each external control based on compatibility with the randomized control data. The discounting weights are determined using the predictive distribution for the external controls derived via the posterior distribution for time-to-event parameters estimated from the RCT. This method is applied using a proportional hazards regression model with piecewise constant baseline hazard. A simulation study and a real-data example are presented based on a completed trial in non-small cell lung cancer. It is shown that the case weighted power prior provides robust inference under various forms of incompatibility between the external controls and RCT population.
Putting Outcomes into Practice: The Implementation of a Framework of Outcome Measures within a Child and Family Service
Authors: Flynn Susan , Lakkshme Sundaresan Sowmia , Caffrey Louise
Published: March 2024

Of utmost concern for effective child protection and child and family services is evidence-based practice. There is an onus of accountability on providers of therapeutic services to establish the merit and cost efficiency of their work. Developing standardised evidence-based outcome measures for children and families, towards which the service provider can strive, is assuredly required as a yardstick against which progress can be measured and modified. Yet, outcome measures will only work in conducive organisational conditions. Specifically, to operationalise a suite of outcome measures into a complex organisation, from administrative policy to grassroots practice, requires understanding of barriers and facilitators of implementation. Through funded research, we investigate these factors within the implementation of a new outcomes framework in a European child and family service. Following a literature review exercise, qualitative research findings from two focus groups targeted, respectively, at the managerial and front line practitioner level, illuminate complex conditions and underlying mechanisms, as well as attitudinal, resource and knowledge factors upon which implementation is predicated. We conclude with recommendations around establishing sustainable conditions and arrangements in organisations, to ensure outcome measures act as effective instruments, rather than costly and dispensable paper exercises.
A phylogenomic reconstruction of the Endangered Malagasy tree genusCapurodendron(Sapotaceae) with nine new species and an identification key
Authors: Boluda Carlos G , Naciri Yamama , Gautier Laurent
Published: March 2024

Capurodendron is the second largest endemic genus of vascular plants in Madagascar. It comprises mainly trees that are frequently logged for their valued wood. This, together with deforestation, led to 76% of the known species being Endangered or Critically Endangered. However, a confident species identification is often not possible with the current available literature and many morphotypes do not fit any described taxa, which has impeded the implementation of conservation measures. We performed a phylogenomic revision studying c. 900 collections morphologically, and sequencing 638 nuclear genetic markers of 180 representative specimens up to 90 years old, including all the described species and some undescribed morphotypes. Our results show that Capurodendron may contain up to 21 undescribed species in addition to the 35 already known. Nine of these are confirmed as valid species supported by genetic, morphological, and ecological data, and we describe them here (Capurodendron ainae, C. ambanizanense, C. antilahimenae, C. christeae, C. nataliae, C. ratovosonii, C. razakamalalae, C. sommerae, and C. vulcanicola). For the remaining 12 candidate new species, three are genetically analysed but require more sampling, and nine are only supported by morphological and ecological data so far, and therefore require genetic analyses to confirm their validity. For practical purposes and to assist with conservation assessments we provide an identification key, based mainly on vegetative characters, that also include the undescribed species.
Pollination of thermogenic inflorescence of Pandanus odorifer by a specialist Amystrops sap beetle that reproduces on the male inflorescence
Authors: Miyamoto Toru , Mochizuki Ko , Kawakita Atsushi
Published: March 2024

Pandanus is a morphologically unique plant group of the Paleotropical flora, with approximately 450 known species occupying diverse habitats. Because the male inflorescences of this genus are pendent and nectarless, they are commonly assumed to be wind-pollinated; however, their floral scent coupled with the observation that female inflorescences mature while still covered by bracts suggest the possibility of an alternative pollination mechanism. We studied the pollination system of Pandanus odorifer in subtropical Japan. A peroxidase assay was conducted to determine the timing of stigma receptivity, which showed that the stigmas were sensitive to peroxidase while the female inflorescences were covered by bracts. We found numerous pollen-bearing adult beetles of the genus Amystrops on both male and female inflorescences. Nitidulid larvae were also found on male inflorescences, and the larvae became adults of the same Amystrops species as found on the inflorescences by feeding only on Pandanus pollen. Last, floral temperature was monitored to test for floral thermogenesis. Both male and female inflorescences were thermogenic at night when insect visitation occurred. This study provides the first examples of insect pollination and floral thermogenesis in Pandanaceae. Most known Amystrops species are associated with Pandanus inflorescences, suggesting a widespread, specialized Pandanus–Amystrops association.
Cortical remyelination in multiple sclerosis: a target for disease monitoring and intervention
Authors: Mainero Caterina , Miscioscia Alessandro , Treaba Constantina A
Published: March 2024

This scientific commentary refers to ‘Time is myelin: early cortical myelin repair prevents atrophy and clinical progression in multiple sclerosis’ by Lazzarotto et al. (https://doi.org/10.1093/brain/awae024).
Inflation regimes and hyperinflation: a Post-Keynesian/structuralist typology
Authors: Bastian Eduardo F , Charles Sébastien , Marie Jonathan
Published: March 2024

The article proposes a typology of inflation regimes based on the Post-Keynesian and structuralist literature. We identify three separate regimes: the low, moderate and high inflation regimes. Hyperinflation is also defined and described. Each regime presents different characteristics. We identify the key role played by the distributive conflict between workers and capitalists in all the regimes, the role played by the indexation of wages on domestic prices in the moderate and high inflation regimes and the specific roles played by the widespread indexation on a short-term basis in the high inflation regime. Hyperinflation is explained by self-fulfilling prophecies about exchange rate variations and by the rejection of the domestic currency.
Case report: the ‘vanished’ left pulmonary artery
Authors: Chan Jiahui Charmaine , Kotecha Monika Kantilal , Choo Jonathan Tze Liang , Fortier Marielle V , Sundararaghavan Sreekanthan
Published: March 2024

Background

We report a case of isolated ductal origin of pulmonary artery (DOPA) diagnosed in an asymptomatic newborn. The primary aim of this case is to highlight the need to investigate for DOPA in patients diagnosed with an ‘absent branch pulmonary artery’.

Case summary

Our patient was an asymptomatic newborn infant, with normal intracardiac anatomy. He was initially diagnosed post-natally with ‘absent left pulmonary artery’ (LPA), though the LPA was seen in antenatal scans. He underwent angiography and was re-diagnosed with bilateral arterial ducts, with ductal origin of the LPA from the left arterial duct. The LPA was salvaged by first stenting the left arterial duct on Day 11 of life, with subsequent surgery to connect the LPA to the main pulmonary artery at 4.5 months old. The patient had an uneventful recovery after the surgery.

Discussion

Ductal origin of pulmonary artery is a rare vascular anomaly characterized by continuity of the left or right pulmonary artery (PA) with the distal end of the arterial duct, and discontinuity with the main PA. It is commonly misdiagnosed as pulmonary artery agenesis when the patent arterial duct constricts, with cessation of blood flow into the affected pulmonary artery. A high index of suspicion is necessary for diagnosis of DOPA. Once diagnosed, this lesion is clearly amenable to intervention, with benefits from unifocalization, to prevent late onset pulmonary hypertension or cardiac failure.
Impact of multimorbidity patterns on outcomes and treatment in patients with coronary artery disease
Authors: Zheng Wen , Huang Xin , Wang Xiao , Suo Min , Yan Yan , Gong Wei , Ai Hui , Que Bin , Nie Shaoping
Published: March 2024

Aims

With an aging population and better survival rates, coronary artery disease (CAD) with multimorbidity has become more prevalent, complicating treatment and impacting life quality and longevity. This study identifies multimorbidity patterns in CAD patients and their effect on clinical outcomes, emphasizing treatment strategies.

Methods and results

The study analysed data from the DCEM registry (173 459 patients) and BleeMACS cohort (15 401 patients) to categorize CAD patients into three multimorbidity patterns. The focus was on how these patterns influence outcomes, especially concerning the efficacy and safety of dual antiplatelet therapy (DAPT). The study identified three distinct multimorbidity patterns: Class 1 encompassed cardiovascular–kidney–metabolic comorbidities indicating the highest risk; Class 2 included hypertension–dyslipidaemia comorbidities, reflecting intermediate risk; and Class 3 involved non-specific comorbidities, indicating the lowest risk. Class 1 patients demonstrated a six-fold increase in in-hospital mortality and a four-fold increase in severe in-hospital complications compared with Class 3. Over a 1-year period, Class 1 was associated with the highest risk, displaying a significant increase in all-cause mortality [adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.52–2.31, P < 0.001] and a notable risk for major bleeding (adjusted HR 1.74, 95% CI 1.36–2.24, P < 0.001) compared with Class 3. The use of DAPT, particularly aspirin combined with clopidogrel, significantly reduced the 1-year all-cause mortality in Class 1 patients (adjusted HR 0.60, 95% CI 0.37–0.98, P = 0.04) without increasing in major bleeding.

Conclusion

Coronary artery disease patients with a cardiovascular–kidney–metabolic profile face the highest mortality risk. Targeted DAPT, especially aspirin and clopidogrel, effectively lowers mortality without significantly raising bleeding risks.

Registration

DCEM registry (NCT05797402) and BleeMACS registry (NCT02466854).
Current frailty knowledge, awareness, and practices among physicians following the 2022 European consensus document on Frailty in Cardiology
Authors: Wong Jie Jun , Wang Laureen Yi-Ting , Hasegawa Koji , Ho Kay Woon , Huang Zijuan , Teo Louis L Y , Tan Jack Wei Chieh , Kasahara Kazuyuki , Tan Ru-San , Ge Junbo , Koh Angela S
Published: March 2024

Aims

Aging-related cardiovascular disease and frailty burdens are anticipated to rise with global aging. In response to directions from major cardiovascular societies, we investigated frailty knowledge, awareness, and practices among cardiologists as key stakeholders in this emerging paradigm a year after the European Frailty in Cardiology consensus document was published.

Methods and results

We launched a prospective multinational web-based survey via social networks to broad cardiology communities representing multiple World Health Organization regions, including Western Pacific and Southeast Asia regions. Overall, 578 respondents [38.2% female; ages 35–49 years (55.2%) and 50–64 years (34.4%)] across subspecialties, including interventionists (43.3%), general cardiologists (30.6%), and heart failure specialists (HFSs) (10.9%), were surveyed. Nearly half had read the consensus document (38.9%). Non-interventionists had better perceived knowledge of frailty assessment instruments (fully or vaguely aware, 57.2% vs. 45%, adj. P = 0.0002), exercise programmes (well aware, 12.9% vs. 6.0%, adj. P = 0.001), and engaged more in multidisciplinary team care (frequently or occasionally, 52.6% vs. 41%, adj. P = 0.002) than interventionists. Heart failure specialists more often addressed pre-procedural frailty (frequently or occasionally, 43.5% vs. 28.2%, P = 0.004) and polypharmacy (frequently or occasionally, 85.5% vs. 71%, adj. P = 0.014) and had consistently better composite knowledge (39.3% vs. 21.6%, adj. P = 0.001) and practice responses (21% vs. 11.1%, adj. P = 0.018) than non-HFSs. Respondents with better knowledge responses also had better frailty practices (40.3% vs. 3.6%, adj. P < 0.001).

Conclusion

Distinct response differences suggest that future strategies strengthening frailty principles should address practices peculiar to subspecialties, such as pre-procedural frailty strategies for interventionists and rehabilitation interventions for HFSs.
Increased risk of diabetes mellitus and hyperlipidemia in patients with differentiated thyroid cancer
Authors: Ahn Hwa Young , Lee Jooyoung , Kang Jinmo , Lee Eun Kyung
Published: March 2024

Objective

This study aimed to assess the risk of cardiometabolic disease (CMD) in patients with differentiated thyroid cancer (DTC) using a population-based nationwide cohort in Korea.

Design

This was a population-based cohort study.

Methods

We selected 2649 patients with DTC and 7947 matched controls. The primary outcome was the composite of CMD including diabetes mellitus (DM), hypertension, hyperlipidemia, cerebrovascular disease, and ischemic heart disease. The secondary outcomes were each individual type of CMD, all-cause mortality, and CMD-specific mortality. The cause-specific hazard ratios (HRs) for each outcome were estimated based on cause-specific Cox proportional hazard regression models.

Results

Patients with DTC had an 11% higher risk of the primary composite outcome than controls (HR, 1.11; 95% confidence interval [CI], 1.04–1.19). The risks of DM (HR, 1.22; 95% CI, 1.08–1.38) and hyperlipidemia (HR, 1.36; 95% CI, 1.24–1.48) were higher in patients with DTC. In contrast, the risk of CMD-specific mortality was lower in those with DTC (HR, 0.24; 95% CI, 0.09–0.68). A nonlinear, U-shaped relationship was observed between the daily dose of levothyroxine and the risk of DM (P = .021), but the risk of hyperlipidemia was low with high doses of levothyroxine in patients with DTC (P = .003).

Conclusions

Patients with DTC had an increased risk of CMD, especially DM and hyperlipidemia, but a low risk of CMD mortality. Special attention to metabolic diseases is required in the long-term follow-up of patients with DTC.
A call for action to include psychosocial management into holistic, integrated care for patients with atrial fibrillation
Authors: Brandes Axel , Pedersen Susanne S , Hendriks Jeroen M
Published: March 2024

Contemporary management of atrial fibrillation (AF) has become increasingly complex. Therefore, strong efforts have been made during the past decade to develop models for structured, integrated care for patients with AF. These have also been incorporated in international guidelines for the management of patients with AF. However, implementation of integrated care approaches in daily clinical practice is scarce and far from optimal, and it may require a re-thinking of the structure of the healthcare system. The reasons for the poor implementation are many, from limited time and economic resources to deficits in postgraduate education of healthcare professionals, lack of involvement of patients in how integrated care should be designed, and fragmentation of the healthcare system. Moreover, patients’ psychological challenges, which not only impact patients’ adherence to treatment but, if untreated, increase their risk of morbidity, mortality, and poor quality of life, are not given sufficient attention. It is time to start a necessary discussion of what integrated care should be, what it should contain, and what is necessary to implement it in daily clinical practice.
Bacterial and fungal communities in sub-Arctic tundra heaths are shaped by contrasting snow accumulation and nutrient availability
Authors: Männistö Minna K , Ahonen Saija H K , Ganzert Lars , Tiirola Marja , Stark Sari , Häggblom Max M
Published: March 2024

Climate change is affecting winter snow conditions significantly in northern ecosystems but the effects of the changing conditions for soil microbial communities are not well-understood. We utilized naturally occurring differences in snow accumulation to understand how the wintertime subnivean conditions shape bacterial and fungal communities in dwarf shrub-dominated sub-Arctic Fennoscandian tundra sampled in mid-winter, early, and late growing season. Phospholipid fatty acid (PLFA) and quantitative PCR analyses indicated that fungal abundance was higher in windswept tundra heaths with low snow accumulation and lower nutrient availability. This was associated with clear differences in the microbial community structure throughout the season. Members of Clavaria spp. and Sebacinales were especially dominant in the windswept heaths. Bacterial biomass proxies were higher in the snow-accumulating tundra heaths in the late growing season but there were only minor differences in the biomass or community structure in winter. Bacterial communities were dominated by members of Alphaproteobacteria, Actinomycetota, and Acidobacteriota and were less affected by the snow conditions than the fungal communities. The results suggest that small-scale spatial patterns in snow accumulation leading to a mosaic of differing tundra heath vegetation shapes bacterial and fungal communities as well as soil carbon and nutrient availability.
Monitoring Progress Towards the Elimination of Hepatitis C as a Public Health Threat in Norway: A Modelling Study Among People Who Inject Drugs and Immigrants
Authors: Whittaker Robert , Midtbø Jørgen E , Kløvstad Hilde
Published: March 2024

Background

The global incidence target for the elimination of hepatitis C among people who inject drugs (PWID) is <2/100. In Norway, the hepatitis C epidemic is concentrated in PWID. Immigrants are the second most important risk group for chronic infection. We modelled the incidence of hepatitis C among active PWID, and the prevalence of chronic infection among active PWID, ex-PWID, and immigrants in Norway to 2022.

Methods

We built a stochastic compartmental model, which was informed using data from national data sources, literature, and expert opinion. We report median values with 95% credible intervals (CrI).

Results

The model estimated 30 (95% Crl, 13–52) new infections among active PWID in 2022, or 0.37/100 (95% Crl, 0.17–0.65), down from a peak of 726 (95% Crl, 506–1067) in 2000. Across all groups, the model estimated 3202 (95% Crl, 1273–6601) chronically infected persons in 2022. Results were robust in sensitivity analyses.

Conclusions

Norway provides an example of the feasibility of hepatitis C elimination in a setting with a concentrated epidemic, high coverage of harm reduction services, and no treatment restrictions. Continued momentum is needed to further reduce the transmission and burden of hepatitis C in Norway.
Immunogenicity and protective capacity of a CpG ODN adjuvanted alum adsorbed bivalent meningococcal outer membrane vesicle vaccine
Authors: Canavar Yildirim Tugce , Ozsurekci Yasemin , Yildirim Muzaffer , Evcili Irem , Yazar Volkan , Aykac Kubra , Guler Ulku , Salih Bekir , Gursel Mayda , Gursel Ihsan
Published: March 2024

Invasive meningococcal disease (IMD) is caused by Neisseria meningitidis, with the main serogroups responsible for the disease being A, B, C, W, X, and Y. To date, several vaccines targeting N. meningitidis have been developed albeit with a short-lived protection. Given that MenW and MenB are the most common causes of IMD in Europe, Turkey, and the Middle East, we aimed to develop an outer membrane vesicle (OMV) based bivalent vaccine as the heterologous antigen source. Herein, we compared the immunogenicity, and breadth of serum bactericidal activity (SBA) assay-based protective coverage of OMV vaccine to the X serotype with existing commercial meningococcal conjugate and polysaccharide (PS) vaccines in a murine model. BALB/c mice were immunized with preclinical batches of the W + B OMV vaccine, either adjuvanted with Alum, CpG ODN, or their combinations, and compared with a MenACYW conjugate vaccine (NimenrixTM, Pfizer), and a MenB OMV-based vaccine (Bexsero®, GSK), The immune responses were assessed through enzyme-linked immunosorbent assay (ELISA) and SBA assay. Antibody responses and SBA titers were significantly higher in the W + B OMV vaccine when adjuvanted with Alum or CpG ODN, as compared to the control groups. Moreover, the SBA titers were not only significantly higher than those achieved with available conjugated ACYW vaccines but also on par with the 4CMenB vaccines. In conclusion, the W + B OMV vaccine demonstrated the capacity to elicit robust antibody responses, surpassing or matching the levels induced by licensed meningococcal vaccines. Consequently, the W + B OMV vaccine could potentially serve as a viable alternative or supplement to existing meningococcal vaccines.
A cyclic dipeptide for salinity stress alleviation and the trophic flexibility of endophyte provide insights into saltmarsh plant–microbe interactions
Authors: Hung Shih-Hsun Walter , Yeh Pin-Hsien , Huang Tsai-Ching , Huang Shao-Yu , Wu I-Chen , Liu Chia-Ho , Lin Yu-Hsi , Chien Pei-Ru , Huang Fan-Chen , Ho Ying-Ning , Kuo Chih-Horng , Hwang Hau-Hsuan , Chiang En-Pei Isabel , Huang Chieh-Chen
Published: March 2024

In response to climate change, the nature of endophytes and their applications in sustainable agriculture have attracted the attention of academics and agro-industries. This work focused on the endophytic halophiles of the endangered Taiwanese salt marsh plant, Bolboschoenus planiculmis, and evaluated the functions of these isolates through in planta salinity stress alleviation assay using Arabidopsis. The endophytic strain Priestia megaterium BP01R2, which can promote plant growth and salinity tolerance, was further characterized through multi-omics approaches. The transcriptomics results suggested that BP01R2 could function by tuning hormone signal transduction, energy-producing metabolism, multiple stress responses, etc. In addition, the cyclodipeptide cyclo(L-Ala-Gly), which was identified by metabolomics analysis, was confirmed to contribute to the alleviation of salinity stress in stressed plants via exogenous supplementation. In this study, we used multi-omics approaches to investigate the genomics, metabolomics, and tropisms of endophytes, as well as the transcriptomics of plants in response to the endophyte. The results revealed the potential molecular mechanisms underlying the occurrence of biostimulant-based plant-endophyte symbioses with possible application in sustainable agriculture.
Scallop-bacteria symbiosis from the deep sea reveals strong genomic coupling in the absence of cellular integration
Authors: Lin Yi-Tao , Ip Jack Chi-Ho , He Xing , Gao Zhao-Ming , Perez Maeva , Xu Ting , Sun Jin , Qian Pei-Yuan , Qiu Jian-Wen
Published: March 2024

Previous studies have revealed tight metabolic complementarity between bivalves and their endosymbiotic chemosynthetic bacteria, but little is known about their interactions with ectosymbionts. Our analysis of the ectosymbiosis between a deep-sea scallop (Catillopecten margaritatus) and a gammaproteobacterium showed that bivalves could be highly interdependent with their ectosymbionts as well. Our microscopic observation revealed abundant sulfur-oxidizing bacteria (SOB) on the surfaces of the gill epithelial cells. Microbial 16S rRNA gene amplicon sequencing of the gill tissues showed the dominance of the SOB. An analysis of the SOB genome showed that it is substantially smaller than its free-living relatives and has lost cellular components required for free-living. Genomic and transcriptomic analyses showed that this ectosymbiont relies on rhodanese-like proteins and SOX multienzyme complex for energy generation, mainly on the Calvin–Benson–Bassham (CBB) cycle and peripherally on a phosphoenolpyruvate carboxylase for carbon assimilation. Besides, the symbiont encodes an incomplete tricarboxylic acid (TCA) cycle. Observation of the scallop’s digestive gland and its nitrogen metabolism pathways indicates it does not fully rely on the ectosymbiont for nutrition. Analysis of the host’s gene expression provided evidence that it could offer intermediates for the ectosymbiont to complete its TCA cycle and some amino acid synthesis pathways using exosomes, and its phagosomes, endosomes, and lysosomes might be involved in harvesting nutrients from the symbionts. Overall, our study prompts us to rethink the intimacy between the hosts and ectosymbionts in Bivalvia and the evolution of chemosymbiosis in general.
Screening for Primary Aldosteronism by Mass Spectrometry Versus Immunoassay Measurements of Aldosterone: A Prospective Within-Patient Study
Authors: Fuld Sybille , Constantinescu Georgiana , Pamporaki Christina , Peitzsch Mirko , Schulze Manuel , Yang Jun , Müller Lisa , Prejbisz Aleksander , Januszewicz Andrzej , Remde Hanna , Kürzinger Lydia , Dischinger Ulrich , Ernst Matthias , Gruber Sven , Reincke Martin , Beuschlein Felix , Lenders Jacques W M , Eisenhofer Graeme
Published: March 2024

Background

Measurements of aldosterone by mass spectrometry are more accurate and less prone to interferences than immunoassay measurements, and may produce a more accurate aldosterone:renin ratio (ARR) when screening for primary aldosteronism (PA).

Methods

Differences in diagnostic performance of the ARR using mass spectrometry vs immunoassay measurements of aldosterone were examined in 710 patients screened for PA. PA was confirmed in 153 patients and excluded in 451 others. Disease classifications were not achieved in 106 patients. Areas under receiver-operating characteristic curves (AUROC) and other measures were used to compare diagnostic performance.

Results

Mass spectrometry-based measurements yielded lower plasma aldosterone concentrations than immunoassay measurements. For the ARR based on immunoassay measurements of aldosterone, AUROCs were slightly lower (P = 0.018) than those using mass spectrometry measurements (0.895 vs 0.906). The cutoff for the ARR to reach a sensitivity of 95% was 30 and 21.5 pmol/mU by respective immunoassay and mass spectrometry-based measurements, which corresponded to specificities of 57% for both. With data restricted to patients with unilateral PA, diagnostic sensitivities of 94% with specificities >81% could be achieved at cutoffs of 68 and 52 pmol/mU for respective immunoassay and mass spectrometry measurements.

Conclusions

Mass spectrometry-based measurements of aldosterone for the ARR provide no clear diagnostic advantage over immunoassay-based measurements. Both approaches offer limited diagnostic accuracy for the ARR as a screening test. One solution is to employ the higher cutoffs to triage patients likely to have unilateral PA for further tests and possible adrenalectomy, while using the lower cutoffs to identify others for targeted medical therapy.

German Clinical Trials Register ID: DRKS00017084.
Preparing for the bedside—optimizing a postpartum depression risk prediction model for clinical implementation in a health system
Authors: Liu Yifan , Joly Rochelle , Reading Turchioe Meghan , Benda Natalie , Hermann Alison , Beecy Ashley , Pathak Jyotishman , Zhang Yiye
Published: March 2024

Objective

We developed and externally validated a machine-learning model to predict postpartum depression (PPD) using data from electronic health records (EHRs). Effort is under way to implement the PPD prediction model within the EHR system for clinical decision support. We describe the pre-implementation evaluation process that considered model performance, fairness, and clinical appropriateness.

Materials and Methods

We used EHR data from an academic medical center (AMC) and a clinical research network database from 2014 to 2020 to evaluate the predictive performance and net benefit of the PPD risk model. We used area under the curve and sensitivity as predictive performance and conducted a decision curve analysis. In assessing model fairness, we employed metrics such as disparate impact, equal opportunity, and predictive parity with the White race being the privileged value. The model was also reviewed by multidisciplinary experts for clinical appropriateness. Lastly, we debiased the model by comparing 5 different debiasing approaches of fairness through blindness and reweighing.

Results

We determined the classification threshold through a performance evaluation that prioritized sensitivity and decision curve analysis. The baseline PPD model exhibited some unfairness in the AMC data but had a fair performance in the clinical research network data. We revised the model by fairness through blindness, a debiasing approach that yielded the best overall performance and fairness, while considering clinical appropriateness suggested by the expert reviewers.

Discussion and Conclusion

The findings emphasize the need for a thorough evaluation of intervention-specific models, considering predictive performance, fairness, and appropriateness before clinical implementation.
Multimodal learning for temporal relation extraction in clinical texts
Authors: Knez Timotej , Žitnik Slavko
Published: March 2024

Objectives

This study focuses on refining temporal relation extraction within medical documents by introducing an innovative bimodal architecture. The overarching goal is to enhance our understanding of narrative processes in the medical domain, particularly through the analysis of extensive reports and notes concerning patient experiences.

Materials and Methods

Our approach involves the development of a bimodal architecture that seamlessly integrates information from both text documents and knowledge graphs. This integration serves to infuse common knowledge about events into the temporal relation extraction process. Rigorous testing was conducted on diverse clinical datasets, emulating real-world scenarios where the extraction of temporal relationships is paramount.

Results

The performance of our proposed bimodal architecture was thoroughly evaluated across multiple clinical datasets. Comparative analyses demonstrated its superiority over existing methods reliant solely on textual information for temporal relation extraction. Notably, the model showcased its effectiveness even in scenarios where not provided with additional information.

Discussion

The amalgamation of textual data and knowledge graph information in our bimodal architecture signifies a notable advancement in the field of temporal relation extraction. This approach addresses the critical need for a more profound understanding of narrative processes in medical contexts.

Conclusion

In conclusion, our study introduces a pioneering bimodal architecture that harnesses the synergy of text and knowledge graph data, exhibiting superior performance in temporal relation extraction from medical documents. This advancement holds significant promise for improving the comprehension of patients’ healthcare journeys and enhancing the overall effectiveness of extracting temporal relationships in complex medical narratives.
Perspectives on the role of industry in informatics research and authorship
Authors: Strasberg Howard R , Jackson Gretchen Purcell , Bakken Suzanne R , Boxwala Aziz , Richardson Joshua E , Morrow Jon D
Published: March 2024

Objectives

Advances in informatics research come from academic, nonprofit, and for-profit industry organizations, and from academic-industry partnerships. While scientific studies of commercial products may offer critical lessons for the field, manuscripts authored by industry scientists are sometimes categorically rejected. We review historical context, community perceptions, and guidelines on informatics authorship.

Process

We convened an expert panel at the American Medical Informatics Association 2022 Annual Symposium to explore the role of industry in informatics research and authorship with community input. The panel summarized session themes and prepared recommendations.

Conclusions

Authorship for informatics research, regardless of affiliation, should be determined by International Committee of Medical Journal Editors uniform requirements for authorship. All authors meeting criteria should be included, and categorical rejection based on author affiliation is unethical. Informatics research should be evaluated based on its scientific rigor; all sources of bias and conflicts of interest should be addressed through disclosure and, when possible, methodological mitigation.
Influence of low-level tannin supplementation on comparative growth performance of Holstein and Angus × Holstein cross calf-fed concentrate-based finishing diets for 328 d
Authors: Carvalho Pedro H V , Latack Brooke C , Ferraz Marcos V C , Nolasco Lester J R P , Meireles Willi R , Oliveira Heitor O M , Zinn Richard A
Published: March 2024

The objective of the current study was to evaluate the effects of tannin and monensin supplementation in feedlot diets and breed (Holstein vs. Angus × Holstein) on growth performance, energetic efficiency, and carcass characteristics. Eighty purebred Holstein calves (HOL; initial body weight (BW) = 130 ± 5 kg) and 80 Angus × Holstein calves (AXH; initial BW = 129 ± 6 kg) were blocked by initial BW and randomly assigned to 40 pens. Dietary treatments consisted of a steam-flaked corn-based diet supplemented with (1) no feed additive (CON); (2) 30 mg of monensin/kg of dry matter (DM; MON; Rumensin 90, Elanco, Greenfield, IN); (3) 1.5 g tannin)/kg of DM (TAN; ByPro, 70% condensed tannin, SilvaFeed, Indunor, S.A., Buenos Aires, Argentina); (4) M + T, the combination of MON plus TAN dietary treatments. Data were analyzed as a randomized complete block in a 2 × 4 factorial arrangement of treatments, using pens as experimental units. There were no interactions (P > 0.05) between feed additives and breed. Supplemental MON increased (P ≤ 0.04) initial 112-d BW and gain efficiency. However, there were no dietary treatment effects (P > 0.10) on overall growth performance. Monensin supplementation decreased (P = 0.04) minimum daily ruminal temperature compared with other dietary treatments during July, but TAN did not affect ruminal temperature. Holstein steers had greater (P = 0.04) overall DM intake compared with AXH, with no difference (P = 0.19) in overall ADG, leading to increased (P < 0.01) gain efficiency for AXH compared with HOL. Dietary net energy for maintenance and gain, based on growth performance, were greater (P ≤ 0.01) for AXH vs HOL. Compared with HOL, AXH steers had greater (P ≤ 0.01) carcass weight, dressing percentage, kidney, pelvic, and heart fat, 12th rib fat thickness, longissimus area, and preliminary yield grade. Holstein steers had lower (P ≤ 0.04) minimum average ruminal temperature during June compared with AXH, with no differences (P ≥ 0.14) between breeds during July or August. Results indicate that feed additives did not appreciably affect steer growth performance and carcass characteristics, but crossbred AXH steers had greater growth performance, efficiency of dietary energy utilization, and carcass quality measures compared with HOL. This study observed a reduction (4.7%) in maintenance energy expenditure in AXH compared with HOL, implying in maintenance energy coefficient of 0.086 vs 0.082 for HOL and AXH, respectively.
The European Securitization Market: Effects of an Uneven Regulatory Playing Field
Authors: Varouchakis Thomas Papadogiannis
Published: March 2024

This article critically assesses the European securitization industry’s claim of the existence of an uneven regulatory playing field for securitization structures vis-à-vis financial instruments deemed ‘neighbouring’ to securitization by the industry, like whole loan pools, corporate bonds, and covered bonds. According to market participants, the adverse regulatory treatment of securitization is negatively affecting the European securitization market, by pushing issuers and investors towards other financial instruments that are treated preferentially. Ultimately, this prevents the securitization market from escaping the subdued state in which it has been ever since the global financial crisis. To address this problem, market participants are advocating a fundamental recalibration of the existing regulatory framework. By examining the regulatory framework that applies to securitization structures, against the backdrop of regulation for whole loan pools, corporate bonds, and covered bonds, this article confirms that securitization structures are indeed treated adversely, as claimed by the industry. Nevertheless, a valid comparison can only be drawn between ‘true sale’ residential mortgage-backed securities (RMBS) structures and mortgage covered bonds, given the structural-economic similarities between the two financial instruments. In that regard, the adverse regulatory treatment of RMBS is found to be negatively impacting the European securitization market, by fuelling a ‘crowding out’ of RMBS by covered bonds.
Spinal versus general anesthesia for hip arthroscopy—a pandemic (COVID) and epidemic (opioid) driven study
Authors: Byrd J. W. Thomas , Jones Kay S , Dwyer Nicole , McManus Amy M , Byrd Ellen B , Freeman Wallace L
Published: March 2024

The purpose of this study is to compare general anesthesia (GA) to spinal anesthesia (SA) for hip arthroscopy, based on measurable perioperative parameters. The pandemic signaled a change from GA to SA, and thus a retrospective review was performed of the first 120 consecutive SA cases compared to the last 120 GA cases prior to the pandemic. Demographic data included age, sex, BMI, preop narcotic usage and procedure performed. The groups were compared for post-anesthesia care unit length of stay, entry and discharge visual analog scale (VAS) scores, morphine mg equivalent usage, need for regional blocks and untoward events. Additionally, the length of time from entry to the operating room until completion of induction anesthesia was compared. Demographically, the groups were virtually identical. SA used significantly less morphine mg equivalent (6.0 versus 8.1; P = 0.005), had more needing no narcotics (17 versus 7; P = 0.031), fewer requiring blocks (1 versus 14; P = 0.001) and lower entry VAS scores (5.2 versus 6.2; P = 0.003). Five early SA patients required catheterization for urinary retention, and this was avoided later in the study by having patient void on call to operating room and avoiding anticholinergic agents. Completion of induction anesthesia was 0.8 min longer for SA. Hip arthroscopy can be effectively performed with either GA or SA. SA results in statistically significant better post-anesthesia care unit pain control, reflected by lower entry VAS, less need for narcotics and fewer requiring regional blocks compared to GA. Urinary retention, a potential problem of SA, is minimized with routine precautions.
Why 50?: ‘industrial application’ limitation in the Indian copyright-design interface
Authors: Aggarwal Ambika , Sircar Anindya
Published: March 2024

The current IP overlap in Indian copyright and design laws maintains that fine art aesthetics remain a province of copyright law and are strictly disjointed from protection afforded to utilitarian objects under design law. In practical application, however, Section 15 of the Indian Copyright Act, 1957 serves as a point of partial cumulation. Section 15(2) creates a curious situation where the nature of the work could be determined not by its substantive subject-matter requirement but rather an arbitrary rule of more-than-50 articles of production. Section 15 remains an unrefined relic of the Imperial Copyright Act of 1914. The strong reactions against the repeal of Section 52 of the UK Copyright, Designs and Patents Act of 1988 along with varied applications of the 50-article rule in other common law jurisdictions can be useful for the Delhi High Court in considering the ongoing constitutional challenge against Section 15(2). Differences in judicial opinions in a rather small pool of precedents have created significant scepticism in interpreting the precise scope of this ‘industrial application’ limitation. Repealing Section 15(2), despite its controversial status, would move the Indian copyright-design interface from partial to full cumulation—a result that does not sit well with the present legislative structure. Resolution of the issue requires the court to display sound conceptual deftness.
Legal incentives for innovations in the emotional AI domain: a carrot and stick approach?
Authors: Ballardini Rosa Maria , van den Hoven van Genderen Rob , Nokelainen Tomi
Published: March 2024

Emotions strongly influence the human way of living and life experiences. In this context, Artificial Intelligence (AI) technologies are crucial to pushing developments further. Although emotional AI-driven innovations are welcome in our society, they might also have negative effects on the interdependence and autonomy of natural persons. Thus, they might be challenged by several legal provisions in the EU such as the General Data Protection Regulation (GDPR) and the draft AI Act. Yet these inventions require considerable investment, where legal incentives such as intellectual property rights (IPR) are crucial. Indeed, it is also important to secure certainty as to the legal and ethical acceptability of such innovations. This article looks at emotional AI to investigate the interlinkage between technological innovations, legal incentives and ethics, through the lenses of patent law and fundamental rights, in order to shed light over the challenges, limitations, but also opportunities for the protection, commercialization and exploitation of emotional AI-related inventions. Our research offers new scientific knowledge on the largely under-explored issue of legal incentives for emotional AI-related inventions in the European framework. It also provides companies and inventors with key points to consider in decision-making related to investments in and incentives for emotional AI-related innovations, also elaborating on suggestions for the European legislator and policymakers to better stimulate and promote emotional AI technology through regulation.