bluuebunny/crossref_metadata_2025 huggingface dataset:
Proud Vermin
Authors: Lewis Colin J , Kling Jennifer
Published: October 2024

Contemporary arguments about private paramilitary organizations often focus on the threat of physical violence they pose to the state: if such organizations garner enough physical power, then they can overtake the state via violent coup. Inspired by the legalist scholar Han Feizi’s position, this chapter contends that such organizations also represent a sociopolitical, existential threat to the state. Specifically, their tendency for ideological expansion and subsequent gathering of political influence undermines state institutions, even without the use of overt physical force. Consequently, the sociopolitical enterprise of having a unified, stable state is incompatible with the existence of, and public political support for, private paramilitary organizations, regardless of their actual or potential physical power. This argument succeeds regardless of the moral status of such paramilitary groups. Such groups, when they match the essential components of the description Han Feizi provides, are practically and politically antithetical to the integrity of the state.
Histomorphologic spectrum of nodal marginal zone lymphoma as defined by its methylome
Authors: Spada Francesca , Rosenwald Andreas , Klapper Wolfram , Feller Alfred C , Fend Falko , Ott German , Fürstberger Axel , Barth Thomas F E , Möller Peter
Published: October 2024

Objectives

Primary nodal marginal B-cell lymphoma (NMZL) is rare and histologically very variable. Its large-cell presentation is difficult to distinguish from nodal diffuse large B-cell lymphoma (nDLBCL) due to the absence of specific markers for nodal marginal zone lymphomas in general.

Methods

Using a comprehensive cohort of NMZLs and a control cohort of nDLBCLs, we conducted a methylome analysis on subgroups of both.

Results

The methylomes were strikingly different between the cohorts but unexpectedly homogeneous within the NMZL cohort. This allowed us to describe the morphologic spectrum of NMZL in all its value ranges. The considerable overlap in growth pattern and cytology of NMZL with nDLBCL was explored morphometrically, leading to an operational tool for separating both by a simple measurement of cell size and nuclear size. This was integrated in a hierarchical approach, including a scoring system for the parameter growth pattern, follicular colonization, follicular dendritic network, IgD expression, and Ki-67 rate, and led to a proposal for a classifier that we present here.

Conclusions

This methylome-based study extends the morphological spectrum of NMZL towards large cell morphology and offers a conventional way to distinguish it from nDLBCL.
Multimodal Pilot Evaluation of a Hyaluronic Acid Infraorbital Filler Using Precise, Multipositional, 3-Dimensional Imaging Quantification, Patient-Reported Outcomes, and Anatomic Cadaveric Assessments
Authors: Honig Stephanie E , Toyoda Yoshiko , Ewing Jane N , Lemdani Mehdi S , Gala Zachary , Amro Chris , Wilson Alexander T , Broach Robyn B , Percec Ivona
Published: October 2024

Background

Despite the high demand of filler in the infraorbital area, there remains debate on injection practices, precise anatomical placement, and hyaluronic acid (HA) filler behavior.

Objectives

We aimed to contribute to the clinical and anatomic understanding of infraorbital HA injection through a prospective patient injection study in combination with a cadaveric analysis.

Methods

Patients were injected with Volbella XC (JUVÉDERM, Allergan Aesthetics, an AbbVie Company, Irvine, CA) into the tear trough region by a single experienced aesthetic plastic surgeon. Over a 90-day period, precise undereye volumetric measurements using 3-dimensional photogrammetry (VECTRA-M3, Canfield Scientific, Inc., Fairfield, NJ) and patient-reported outcomes (PROs; FACE-Q) were collected and analyzed relative to 2 pretreatment severity scales. Juvéderm Vycross (Allergan Aesthetics, an AbbVie Company, Irvine, CA) and Restylane NASHA (Galderma, Lausanne, Switzerland) products were injected into the infraorbital and malar region in 6 cephalus specimens and evaluated with regards to the anatomic injection location with and without common clinical physical manipulations.

Results

Eleven patients participated with a 100% retention rate. Infraorbital HA volume maintenance was 70% to 81% at 30 days and 50% to 70% at 90 days. Significant improvement was noted in the eyes, overall facial appearance, and cheekbones (P < .05) with FACE-Q outcomes, irrespective of pretreatment severity. In the cadaver examination, we observed differences in the anatomic locations occupied by Juvéderm and Restylane products as well as in behavior after physical manipulation between gel types.

Conclusions

Volbella XC effectively augments undereye volume to diminish infraorbital hollowing as measured over a 90-day period with significantly improved PROs. Enhanced knowledge of the behavior of Volbella XC and other HA fillers in this sensitive anatomic region will lead to improved patient outcomes.

Level of Evidence: 4 (Therapeutic)
Detecting expressed genes in cell populations at the single-cell level with scGeneXpress
Authors: Jung Sascha , Barlier Céline , Martinez Perez Aitor , del Sol Antonio
Published: October 2024

Determining whether genes are expressed or not remains a challenge in single-cell RNAseq experiments due to their different expression spectra, which are influenced by genetics, the microenvironment and gene length. Current approaches for addressing this issue fail to provide a comprehensive landscape of expressed genes, since they neglect the inherent differences in the expression ranges and distributions of genes. Here, we present scGeneXpress, a method for detecting expressed genes in cell populations of single-cell RNAseq samples based on gene-specific reference distributions. We demonstrate that scGeneXpress accurately detects expressed cell markers and identity genes in 34 human and mouse tissues and can be employed to improve differential expression analysis of single-cell RNAseq data.
Intra-rater agreement of lesion counts in hidradenitis suppurativa
Authors: Midgette Bria , Strunk Andrew , Garg Amit
Published: October 2024

The heterogeneous presentation of hidradenitis suppurativa (HS) lesions can result in variation in clinical trial outcome assessments when performed by the same rater as well as different raters. In the PIONEER I and II trials of patients with HS, there was substantial disagreement between repeated lesion counts by the same rater during a time period in which little true change is expected. Standardization of lesion classification and improved rater training are critical for advancing HS drug development.
Fixed rate vs fixed injection duration in single-pass contrast-enhanced abdominal multi-detector CT: effects on vascular enhancement
Authors: Camera Luigi , D’Ambrosio Vincenzo , Pinto Lorenzo , Paludi Adriana , Liuzzi Raffaele , De Cicco Rossella , Ponsiglione Andrea , Lagnese Maria Grazia , Maurea Simone , Brunetti Arturo
Published: October 2024

Objectives

To evaluate the effects on vascular enhancement of either a fixed rate (FR) or a fixed injection duration (FID) in single-pass (SP) contrast-enhanced abdominal multi-detector CT (CE-MDCT).

Methods

Ninety-nine (54 M; 45 F; aged 18-86 years) patients with nontraumatic acute abdomen underwent a SP CE-MDCT after i.v. injection of 1.7 cc/Kg of a nonionic iodinated contrast media (370 mgI/mL) performed with either a FR (2 cc/s; Group A) or a FID (55 s; Group B). In both groups, patients were further stratified according to total body weight (kg) as follows: 40-60 (L); 61-80 (M); 81-100 (H). Signal- (SNR) and contrast-to-noise ratios (CNR) were calculated for the liver and for both abdominal aorta (AA) and main portal vein (MPV). Statistical analysis was performed by Student t- or Chi-square test for continuous and categorical data, respectively, whereas post hoc analysis was performed by the Mann-Whitney test (P < .05).

Results

There were no significant differences in demographic and physical characteristics between Group A (n = 50; 53 ± 20 years; BMI = 23.4 ± 4.4) and Group B (n = 50; 51 ± 17 years; BMI 22.7 ± 4.2). Whereas overlapping findings were observed in the M sub-groups (n = 40), SNR and CNR were significantly higher (P < .01) in Group B for both AA and MPV in the high (H) weight sub-groups (n = 20) while not significant differences were observed in the low (L) weight sub-groups (n = 40) despite a significantly lower injection rate (1.6 ± 0.2 cc/s, P < .01) in Group B.

Conclusion

A FID results in an overall better vascular enhancement than a FR in SP CE-MDCT.

Advances in knowledge

Single-pass is an optimized contrast-enhanced abdominal CT protocol combining the benefits of vascular and visceral enhancement and characterized by a customized scan delay tailored around a monophasic contrast injection. In single-pass protocol, a fixed injection duration (55 s) results in an overall better vascular enhancement than a fixed rate (2 cc/s) and should be therefore regarded as the injection modality of choice.
The risk of candidiasis during treatment with bimekizumab for the management of plaque psoriasis: a 16-week multicentre real-world experience – IL PSO (Italian Landscape Psoriasis)
Authors: Megna Matteo
Published: October 2024

Anti-interleukin 17 use has been associated with a higher risk of candidiasis, as this cytokine is involved in maintaining mucosal barriers and orchestrating immune responses to fungal pathogens. We performed a real-life retrospective multicentre study aiming to assess the risk of candidiasis in patients undergoing treatment with bimekizumab at labelled dosage for psoriasis, for at least 16 weeks.
Not just another psoriasis…
Authors: Wong Vidette , Costley Matthew , McLoone Nabla
Published: October 2024

We present a memorable case of severe verrucous psoriasis in an immunocompetent 36-year-old White woman with a history of limited plaque psoriasis.
sB7-H4 is a diagnostic biomarker in epithelial ovarian cancer and correlates to platinum resistance
Authors: Zhou Ying , Tian Jingluan , Shen Yu , Liang Hansi , Chen Youguo , Wang Juan , Gu Yanzheng
Published: October 2024

Ovarian cancer (OC), with its high mortality rate among gynecological cancers, is often diagnosed late due to the lack of early diagnostic symptoms and biomarkers. The tumor immune microenvironment has become a focal point in cancer diagnostic and therapeutic research. Among these, B7-H4, a checkpoint protein, plays a crucial role in immune regulation and tumor suppression, contributing to immune evasion within the tumor microenvironment. This study aims to identify the concentration of soluble B7-H4(sB7-H4) in the plasma of patients with OC and to evaluate its clinical significance. Through a comprehensive analysis involving enzyme-linked immunosorbent assay, immunohistochemistry, and multicolor immunofluorescence, we quantified sB7-H4 levels in patient plasma and ascites, correlating these findings with tissue expression and clinical outcomes. Results indicated a strong association between high sB7-H4 levels and advanced disease, surgical outcomes, lymphatic metastasis, and platinum resistance. When compared with traditional biomarkers CA125 and HE4, sB7-H4, especially in conjunction with these markers, enhances the diagnostic accuracy for epithelial ovarian cancer (EOC), offering insights into disease progression and therapeutic efficacy. This comprehensive analysis suggests that sB7-H4 is a promising biomarker for EOC, providing valuable insights into diagnosis, stage differentiation, treatment effectiveness, and prognosis.
One-step synthesis of [15]paracyclophane and [16]paracyclophane via Pd-catalyzed C(sp2)–C(sp3) coupling and the cyclohexane-encapsulating crystal structure of [16]paracyclophane
Authors: Rakumitsu Kenta , Takahashi Daichi , Kusumoto Sotaro , Yokoyama Akihiro
Published: October 2024

Macrocycles consisting of methylene-bridged aromatic rings had been synthesized by aromatic electrophilic substitution reactions, thus limiting the substrates to electron-rich aromatic compounds. In this work, we developed a novel method for 1-step synthesis of [15]paracyclophane (PCP) and [16]PCP by the self-condensation of 4-bromobenzyl bromide via a Pd-catalyzed desulfinative coupling reaction between C(sp2) and C(sp3) carbon atoms. In the crystal structure, [16]PCP encapsulated cyclohexane and formed a 1D columnar structure
Copper hexacyanoferrate cathode as a selective adsorbent for ammonium ions in sodium-rich solutions
Authors: Shudo Yuta , Sugiyama Yutaka , Tomiyama Takeo , Parajuli Durga , Kawamoto Tohru , Tanaka Hisashi
Published: October 2024

Ammonium ion remediation has led to innovative methods, such as Faradaic redox reaction using Prussian blue. Our approach uses an adsorption reaction that is controlled by electric current instead of potential. By sweeping the potential through current control, selective adsorption of NH4+ was achieved in solutions with high concentrations of Na+ (ca. 1:50). The use of thick electrodes enabled ammonium levels to be reduced to environmentally acceptable levels in 3 steps, even from highly concentrated solutions of NH4+ (200 mmol/L).
Evaluation of patient satisfaction with an enhanced recovery protocol for esophageal resections: a concurrent quantitative and qualitative analysis
Authors: Moons Johnny , Declerck Hanne , Gijbels Eveline , Jans Marleen , Puttevils Eva , Lerut Toni , Nafteux Philippe , Van Achterberg Theo
Published: October 2024

Patient satisfaction during hospitalization for esophagectomy has been little studied. The aim of this study was to evaluate patients’ satisfaction with a newly introduced enhanced recovery protocol (ERP) for esophagectomy. At hospital discharge, patients were invited to complete a questionnaire. This pseudonymized questionnaire contained 5-point Likert scales regarding items on multidisciplinary care (n = 7), information/communication (n = 7), length of stay (n = 1), and specific adaptations of care in the ERP (n = 11). One open question asked for patient experiences and suggestions for improving the ERP. Between May 2017 and December 2021, 521 patients were included in the ERP after esophagectomy. Of them, 327 patients (63%) completed the questionnaire. Response rates were evenly distributed between genders and slightly higher in younger patients (<60 years; 68%) as compared to elderly patients (>70 years; 60%). Quantitative analysis revealed high satisfaction rates for multidisciplinary care (86.8%), information/communication (84.9%), and ERP adaptations (82.2%), and length of stay was considered optimal in 80%. There were no significant differences in satisfaction observed between gender nor age groups. For the qualitative analysis, there were 108 open answers, resulting in 268 statements. Sentiments expressed in these statements were evaluated as negative, positive, or unspecified. Negative sentiments were attributable to alimentation, organizational factors, and communication. Positive sentiments were attributed to interpersonal relations, multidisciplinary care, and ERP. Overall, patients are very satisfied with the ERP for esophagectomy during hospitalization. By incorporating qualitative data, the results of this quantitative analysis are expanded and elucidated, showing areas where improvements to our ERP are possible to increase patient satisfaction.
TikTok and Bilibili as health information sources on gastroesophageal reflux disease: an assessment of content and its quality
Authors: Liu Xuyan , Kong Qingzhou , Song Yihao , Ding Ruihao , Sun Longfei , Xu Leiqi , Li Yueyue , Zuo Xiuli , Li Yanqing
Published: October 2024

Gastroesophageal reflux disease (GERD) is a global chronic disease. Short video platforms make it easy for patients with GERD to obtain medical information. However, the quality of information from these videos remains uncertain. This study aimed to systematically assess videos related to GERD on TikTok and Bilibili. We conducted a search and gathered 241 Chinese videos related to GERD and recorded the essential information. Two independent evaluators assessed each video based on the completeness of six components of the GERD guidelines, and assessed the quality and reliability of the information in the videos using recognition tools. Finally, videos from different sources were compared. The uploaders of most videos were medical professionals (86.7%, n = 209). The content was mainly about symptoms and treatment. The quality of the videos information varied depending on the sources. Among videos posted on Bilibili, those posted by medical professionals had a lower content score for definition (P < 0.001). Videos produced by non-gastroenterologists had the highest mean modified DISCERN. (The DISCERN scoring tool was initially created for assessing written publications, but nowadays, it is frequently leveraged for appraising various health-related videos. Details can be found in the text) quality of the videos information was acceptable; however, the content varied significantly depending on the type of source used. Videos with broad content should be carefully screened to meet more needs.
Botulinum toxin injection of the lower esophageal sphincter to identify achalasia-variant esophagogastric junction outflow obstruction
Authors: Reddy Chanakyaram A , Ellison Ashton , Nguyen Anh D , Podgaetz Eitan , Souza Rhonda F , Konda Vani J A , Spechler Stuart J
Published: October 2024

Esophagogastric junction outflow obstruction (EGJOO) can be an achalasia variant caused by neuromuscular dysfunction of the lower esophageal sphincter (LES), or the manometric manifestation of mechanical processes that impair EGJ distensibility. Distinction among these conditions has important implications for treatment, but can be difficult. We hypothesized that response to botulinum toxin (BT) injection of the LES could be a diagnostic test for identifying achalasia-variant EGJOO likely to respond to LES muscle-directed invasive therapy. We reviewed our experience with symptomatic EGJOO patients who had BT injection of the LES. Data collected include demographics, esophageal body manometry findings, esophagram evidence of retention, and symptom response at 1–6 months after BT injection categorized as poor, partial, or good. Clinical response to any subsequent LES-directed invasive treatment (EsoFLIP dilation, pneumatic dilation, Heller myotomy, or POEM) also was recorded. Thirteen symptomatic EGJOO patients were included (mean age 55.9 ± 16.4 years; eight men, five women). Symptom response to BT injection was good in six (46%), partial in three (23%), and poor in three (23%); one was lost to follow-up. All five patients who received invasive treatment after partial or good response to BT had a partial or good response to invasive treatment. The one patient who had invasive treatment after a poor response to BT had a poor response to invasive treatment. These findings suggest that a good response to BT injection of the LES can identify an achalasia-variant form of EGJOO that will respond to LES muscle-directed invasive therapy.
Survival outcomes in EIF2AK4 mutation-associated pulmonary arterial hypertension: seeking clarity in contrast
Authors: Han Jennie , Kadani Zehra , Price Laura C , Kempny Aleksander , Rawal Bhavin , Wort Stephen J , McCabe Colm
Published: October 2024

Background

Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary arterial hypertension (PAH) characterized by widespread fibrous intimal proliferation of pre-septal pulmonary venules and a lower lung diffusion capacity for carbon monoxide when compared to classical PAH. Mutations in the eukaryotic translation initiation factor 2 alpha kinase 4 (EIF2AK4) gene have been linked to the development of PVOD, with the worst prognosis seen in homozygous mutation carriers.

Case summary

We describe two patients with homozygous EIF2AK4-associated PVOD, who despite typical clinical features at presentation have demonstrated a remarkable response to pulmonary vasodilator therapy and comparatively benign clinical courses. Intrapulmonary shunt (IPS) was evident on resting contrast transthoracic echocardiography (CTTE) in both patients undertaken 4 and 36 months following diagnosis. At 2 and 10 years of follow-up, respectively, both patients retain preserved right heart function and remain in the World Health Organization functional class II. This case series contrasts strikingly with prior reports of patients with classical PAH where IPS that develops in response to pulmonary vasodilator treatment has been associated with dramatic reduction in systemic oxygen saturations, necessitating withdrawal of therapy.

Discussion

In two patients with PVOD associated with homozygous EIF2AK4 mutations, IPS may act to offload the right ventricle with relative preservation of systemic exercise saturations and a more favourable prognosis. Greater use of CTTE in patients with PVOD as well as PAH with lower lung diffusion capacity may lend insight into the clinical and prognostic relevance of IPS in these patient subgroups with otherwise poor prognosis.
Colchicine prevents perioperative myocardial injury in cardiac surgery by inhibiting the formation of neutrophil extracellular traps: evidence from rat models
Authors: Pan Hao-Dong , Kong You-Ru , Xu Li , Liu Ming-Yue , Lv Zhi-Kang , Matniyaz Yusanjan , Zhang Hai-Tao , Tang Yu-Xian , Su Wen-Xin , Jiang Chen-Yu , Zhu Yi-Fan , Wang Dong-Jin , Jiao Xiao-Lu , Pan Tuo
Published: October 2024

OBJECTIVES

Colchicine, an anti-inflammatory agent, has been reported to improve myocardial infarction prognosis by inhibiting neutrophil extracellular traps (NETs) release. However, its role in cardiac surgery and the mechanisms behind NETs suppression remain unclear. This study aimed to explore colchicine’s cardioprotective effects against perioperative myocardial injury in cardiac surgery, focusing on NETs inhibition as a novel therapeutic strategy.

METHODS

Male Sprague-Dawley rats were pre-treated with colchicine (0.1 mg/kg/day) or CI-amidine (10 mg/kg/day) for 7 days before undergoing cardiopulmonary bypass and myocardial ischaemia/reperfusion injury. The model was created by subjecting the rats to cardiopulmonary bypass and myocardial ischaemia/reperfusion injury. Under 4.0% sevoflurane anaesthesia, cardiopulmonary bypass was initiated by cannulating the tail artery and right atrium, and perfusion was maintained for 4 h. Immunofluorescence detected NETs, and haematoxylin and eosin staining assessed inflammatory cell.

RESULTS

We found colchicine treatment significantly reduced perioperative myocardial injury in rats. Furthermore, we observed a notable elevation of NETs in the myocardial tissue of animal models. Moreover, suppressing peptidylarginine deiminase 4 was found to markedly diminish perioperative myocardial injury in rats. Additionally, colchicine can mitigate the release of NETs by inhibiting peptidylarginine deiminase 4.

CONCLUSIONS

NETs were significantly elevated during the perioperative period of cardiac surgery. Colchicine significantly mitigated myocardial injury in cardiac surgery by inhibiting NETs formation, with peptidylarginine deiminase 4 inhibition being one of its mechanisms.
A machine learning algorithm-based risk prediction score for in-hospital/30-day mortality after adult cardiac surgery
Authors: Sinha Shubhra , Dong Tim , Dimagli Arnaldo , Judge Andrew , Angelini Gianni D
Published: October 2024

OBJECTIVES

A study of the performance of in-hospital/30-day mortality risk prediction models using an alternative machine learning algorithm (XGBoost) in adults undergoing cardiac surgery.

METHODS

Retrospective analyses of prospectively routinely collected data on adult patients undergoing cardiac surgery in the UK from January 2012 to March 2019. Data were temporally split 70:30 into training and validation subsets. Independent mortality prediction models were created using sequential backward floating selection starting with 61 variables. Assessments of discrimination, calibration, and clinical utility of the resultant XGBoost model with 23 variables were then conducted.

RESULTS

A total of 224,318 adults underwent cardiac surgery during the study period with a 2.76% (N = 6,100) mortality. In the testing cohort, there was good discrimination (area under the receiver operator curve 0.846, F1 0.277) and calibration (especially in high-risk patients). Decision curve analysis showed XGBoost-23 had a net benefit till a threshold probability of 60%. The most important variables were the type of operation, age, creatinine clearance, urgency of the procedure and the New York Heart Association score.

CONCLUSIONS

Feature-selected XGBoost showed good discrimination, calibration and clinical benefit when predicting mortality post-cardiac surgery. Prospective external validation of a XGBoost-derived model performance is warranted.
Diagnosis and management of pituitary adenomas in children and adolescents
Authors: Maiter Dominique , Chanson Philippe , Constantinescu Stefan Matei , Linglart Agnès
Published: October 2024

Background

Pituitary adenomas (PAs)—also now called pituitary neuroendocrine tumours or Pit-NETS—are rare in children and adolescents and exceptional below the age of 10. Most evidence-based high-quality data are derived from larger studies in adult patients.

Aims

We will review recent knowledge on the epidemiology, clinical features, diagnosis, and treatment modalities of the different types of pituitary adenomas diagnosed in children and adolescents, emphasizing the many reasons why these cases should be discussed within pituitary-specific multidisciplinary teams with experts from both paediatric and adult practice.

Conclusions

Paediatric PA presents multiple peculiarities that may challenge their adequate management. They are overall proportionally larger and more aggressive than in adults, with potential mass effects including hypopituitarism. Hormonal hypersecretion is frequent, resulting in clinical syndromes affecting normal growth and pubertal development. Prolactinomas represent the most frequent subtype of PA found during childhood, followed by adrenocorticotropin (ACTH) and growth hormone (GH)–secreting adenomas, while clinically non-functioning adenomas are exceptionally diagnosed before the age of 16. The occurrence of a pituitary tumour in a young individual should also prompt genetic testing in each case, searching for either germline mutations in one of the known genes that may drive inherited/familial PA (such as the multiple endocrine neoplasia type 1 or MEN1 gene, or the aryl hydrocarbon receptor interacting protein or AIP gene), or for a mosaic activating mutation of GNAS as found in the McCune-Albright syndrome.
Abdominal aortic aneurysm repair in Sweden vs. Finland: benefits of population-wide screening
Authors: Laine Matti T , Mani Kevin , Gunnarsson Kim , Wanhainen Anders , Sund Reijo , Venermo Maarit
Published: October 2024

Background and Aims

In 2006, screening of 65-year-old men for abdominal aortic aneurysm (AAA) was started in Sweden. Decline in aneurysm-related mortality has been reported since, but aneurysm incidence has been diminishing globally. Neighbouring Finland with similar population structure and health care system has no AAA screening programme. The aim of this study was to compare incidence and results of AAA repair in Sweden and Finland to differentiate the effect of screening from other changes in the epidemiology and treatment of AAA.

Methods

All repairs for intact AAA (iAAA) or ruptured AAA (rAAA) from 1998 to 2017 were identified from national registers, and mortality data for these patients were collected.

Results

A total of 15 927 operations for iAAA were performed in Sweden and 6933 in Finland. In Sweden, the yearly operation volume increased after introduction of screening. Both countries showed a decrease in number of rAAA operations, but the decrease was more pronounced in Sweden. Sweden had a higher proportion of all AAA repairs because of rupture in the start of the study but by the end, the proportions were similar in both countries. Long-term survival improved for 65–79-old men in Sweden after start of screening.

Conclusions

This study reveals improvements in results of AAA repair in Sweden. A decrease in rAAA repair and increase in iAAA repair were evident after AAA screening was started in 2006 and resulted in better outcomes. These changes are likely the result of AAA screening as they cannot be seen in neighbouring Finland that is lacking an AAA screening programme.
Transcatheter non-acute retrieval of the tine-based leadless ventricular pacemaker
Authors: Funasako Moritoshi , Hála Pavel , Janotka Marek , Šorf Jan , Machová Lucie , Petrů Jan , Chovanec Milan , Škoda Jan , Šedivá Lucie , Šimon Jaroslav , Dujka Libor , Reddy Vivek Y , Neužil Petr
Published: October 2024

Aims

We report our single-centre experience of mid-term to long-term retrieval and reimplantation of a tine-based leadless pacemaker [Micra transcatheter pacing system (TPS)]. The TPS is a clinically effective alternative to transvenous single-chamber ventricular pacemakers. Whereas it is currently recommended to abandon the TPS at the end of device life, catheter-based retrieval may be favourable in specific scenarios.

Methods and results

We report on nine consecutive patients with the implanted TPS who subsequently underwent transcatheter retrieval attempts. The retrieval system consists of the original TPS delivery catheter and an off-the-shelf single-loop 7 mm snare. The procedure was guided by fluoroscopy and intracardiac echocardiography. After an implantation duration of 3.1 ± 2.8 years (range 0.4–9.0), the overall retrieval success rate was 88.9% (8 of 9 patients). The mean procedure time was 89 ± 16 min, and the fluoroscopy time was 18.0 ± 6.6 min. No procedure-related adverse device events occurred. In the one unsuccessful retrieval, intracardiac echocardiography revealed that the TPS was partially embedded in the ventricular tissue surrounding the leadless pacemaker body in the right ventricle. After retrieval, three patients were reimplanted with a new TPS device. All implantations were successful without complications.

Conclusion

A series of transvenous late retrievals of implanted TPS devices demonstrated safety and feasibility, followed by elective replacement with a new leadless pacing device or conventional transvenous pacing system. This provides a viable end-of-life management alternative to simple abandonment of this leadless pacemaker.
Early rapid local impedance drop is associated with acute lesion efficacy during pulmonary vein isolation
Authors: Perge Péter , Petrovic Nikola , Salló Zoltán , Piros Katalin , Nagy Vivien Klaudia , Ábrahám Pál , Osztheimer István , Merkely Béla , Gellér László , Szegedi Nándor
Published: October 2024

Aims

The predictive role of local impedance (LI) drop in lesion formation using a novel contact force sensing ablation catheter was recently described. The purpose of our current study was to assess the temporal characteristics of LI drop during ablation and its correlation with acute lesion efficacy.

Methods and results

Point-by-point pulmonary vein isolation was performed. The efficacy of applications was determined by pacing along the circular ablation line and assessing loss of capture. Local impedance, contact force, and catheter position data with high resolution were analysed and compared in successful and unsuccessful applications. Five hundred and fifty-nine successful and 84 unsuccessful applications were analysed. The successful applications showed higher baseline LI (P < 0.001) and larger LI drop during ablation (P < 0.001, for all). In case of unsuccessful applications, after a moderate but significant drop from baseline to the 2 s time point (153 vs. 145 Ω, P < 0.001), LI did not change further (P = 0.99). Contradictorily, in case of successful applications, the LI significantly decreased further (baseline–2 s–10 s: 161–150–141 Ω, P < 0.001 for all). The optimal cut-point for the LI drop indicating unsuccessful application was <9 Ω at the 4-s time point [AUC = 0.73 (0.67–0.76), P < 0.001]. Failing to reach this cut-point predicted unsuccessful applications [OR 3.82 (2.34–6.25); P < 0.001].

Conclusion

A rapid and enduring drop of the LI may predict effective lesion formation, while slightly changing or unchanged LI is associated with unsuccessful applications. A moderate LI drop during the first 4 s of radiofrequency application predicts ineffective radiofrequency delivery.
Unveiling the main drivers of tree decline in Zagros semi-arid forests
Authors: Shafeian Elham , Ewald Michael , Latifi Hooman , Fassnacht Fabian Ewald
Published: October 2024

Tree decline in arid and semi-arid forest ecosystems causes severe socioeconomic and ecological problems and thus needs to be thoroughly quantified and monitored across space and time. This study investigates tree and forest decline in Iran’s Zagros forests, considering environmental factors (e.g. topographic, soil, and climatic variables). We used field data from Chaharmahal-and-Bakhtiari (a study area covering 165 km2) and environmental data derived from freely available databases. Relationships between tree, forest decline, and environmental data were analyzed using generalized additive models. Our findings reveal that slope and the BioClim-16 variable (precipitation of the wettest quarter) significantly influence tree decline across various decline classes (P-values: slope = .009, BioClim-16 = .02). The best multivariate model for forest decline incorporated soil organic carbon and silt as predictive variables, with soil organic carbon emerging as the key factor (P-value = .04). Additionally, a spectral analysis of bare soil in declining and non-declining areas consistently demonstrated reduced reflectance values in declining regions across 10 Sentinel-2 bands, with VNIR-3, SWIR-2, red, green, and blue bands consistently showing significant differences as unveiled by the Wilcoxon test in all seasons except winter. These reduced reflectance values may indicate that forests stocked on soils with larger grain size (a higher fraction of sand) and/or higher organic carbon content may be more vulnerable to decline. This study contributes to our hitherto understanding of the main drivers of tree and forest decline in semi-arid forests, among others underscoring the potential utility of the spectral properties of bare soil in sparse semi-arid forests to predict the likelihood of tree decline.
Genotypic variation in winter wheat for fusarium foot rot and its biocontrol using Clonostachys rosea
Authors: Chaudhary Sidhant , Ricardo Rosa Margarida Nogueira , Dubey Mukesh , Jensen Dan Funck , Grenville-Briggs Laura , Karlsson Magnus
Published: October 2024

Biological control to manage plant diseases is an environmentally friendly alternative to using chemical pesticides. However, little is known about the role of genetic variation in plants affecting the efficacy of biological control agents (BCAs). The aim of this study was to explore the genetic variation in winter wheat for disease susceptibility to fusarium foot rot caused by Fusarium graminearum and variation in biocontrol efficacy of the fungal BCA Clonostachys rosea to control the disease. In total, 190 winter wheat genotypes were evaluated under controlled conditions in 2 treatments, i.e. (1) F. graminearum (Fg) and (2) F. graminearum infection on C. rosea–treated seeds (FgCr). Alongside disease severity, plant growth-related traits such as shoot length and root length were also measured. Comparison of genotypes between the 2 treatments enabled the dissection of genotypic variation for disease resistance and C. rosea efficacy. The study revealed significant variation among plant genotypes for fusarium foot rot susceptibility and other growth traits in treatment Fg. Moreover, significant variation in C. rosea efficacy was also observed in genotype contrasts between the 2 treatments for all traits. Using a 20K marker array, a genome-wide association study was also performed. We identified a total of 18 significant marker–trait associations for disease resistance and C. rosea efficacy for all the traits. Moreover, the markers associated with disease resistance and C. rosea efficacy were not co-localized, highlighting the independent inheritance of these traits, which can facilitate simultaneous selection for cultivar improvement.
Novel Sex-Specific Genes and Diverse Interspecific Expression in the Antennal Transcriptomes of Ithomiine Butterflies
Authors: Cicconardi Francesco , Morris Billy J , Martelossi Jacopo , Ray David A , Montgomery Stephen H
Published: October 2024

The olfactory sense is crucial for organisms, facilitating environmental recognition and interindividual communication. Ithomiini butterflies exemplify this importance not only because they rely strongly on olfactory cues for both inter- and intra-sexual behaviors, but also because they show convergent evolution of specialized structures within the antennal lobe, called macroglomerular complexes (MGCs). These structures, widely absent in butterflies, are present in moths where they enable heightened sensitivity to, and integration of, information from various types of pheromones. In this study, we investigate chemosensory evolution across six Ithomiini species and identify possible links between expression profiles and neuroanatomical. To enable this, we sequenced four new high-quality genome assemblies and six sex-specific antennal transcriptomes for three of these species with different MGC morphologies. With extensive genomic analyses, we found that the expression of antennal transcriptomes across species exhibit profound divergence, and identified highly expressed ORs, which we hypothesize may be associated to MGCs, as highly expressed ORs are absent in Methona, an Ithomiini lineage which also lacks MGCs. More broadly, we show how antennal sexual dimorphism is prevalent in both chemosensory genes and non-chemosensory genes, with possible relevance for behavior. As an example, we show how lipid-related genes exhibit consistent sexual dimorphism, potentially linked to lipid transport or host selection. In this study, we investigate the antennal chemosensory adaptations, suggesting a link between genetic diversity, ecological specialization, and sensory perception with the convergent evolution of MCGs. Insights into chemosensory gene evolution, expression patterns, and potential functional implications enhance our knowledge of sensory adaptations and sexual dimorphisms in butterflies, laying the foundation for future investigations into the genetic drivers of insect behavior, adaptation, and speciation.
Bioinformatics-aided function exploration of GH29 fucosidases from human gut Parabacteroides
Authors: Wu Haiyang , Li Qingxin , Wu Jin Chuan
Published: October 2024

Gut microbes produce α-l-fucosidases critical for utilizing human milk oligosaccharides, mucosal and dietary glycans. Although gut Parabacteroides have garnered attention for their impact on host health and disease, their CAZymes remain poorly studied. CAZome analysis of eleven gut Parabacteroides type strains revealed their capacity to degrade mucin O-glycans. Their abundance of GH29 fucosidases caught our attention, and we predicted the functional profiles of 46 GH29 fucosidases using in silico approaches. Our findings showed diverse linkages specificities and species-specific distributions, with over half of GH29 enzymes functioning as α1,3/4 fucosidases, essential for acting on Lewis antigen epitopes of mucin O-glycans. We further enzymatically validated 4 novel GH29 sequences from poorly characterized groups. PgoldGH29A (cluster37GH29BERT, GH29:75.1CUPP) does not act on tested natural substrates. PgoldGH29B (cluster1GH29BERT, GH29:84.1CUPP) functions as a strict α1,3/4 fucosidase. PgoldGH29C (cluster14GH29BERT, GH29:29.1CUPP) displays unprecedented substrate specificity for α1,2/3/4 disaccharides. PgoldGH29D (cluster4GH29BERT, GH29:6.2CUPP) acts on α1,2/3/4/6 linkages similar to enzymes from GH29:6.1CUPP but prefers disaccharides over trisaccharides. These results suggest that PgoldGH29B and PgoldGH29D can contribute to mucin O-glycan degradation via their α1,3/4 and α1,2 fucosidase activity, respectively, while the natural substrates of PgoldGH29A and PgoldGH29C may be irrelevant to host-glycans. These insights enhance our understanding of the ecological niches inhabited by gut Parabacteroides and may guide similar exploration in other intriguing gut microbial species.
Rethinking science diplomacy and global biosecurity: challenges, emerging practices and the way forward
Authors: Namdeo Suryesh Kumar , Zhang Joy Y
Published: October 2024

The changing organization and nature of biotechnology and bio-innovations have led to the global phenomenon of ‘science at large’. This has given rise to two key trends in global biosecurity governance: the growing role of science diplomacy in addressing biosecurity concerns and the rise of distributed agencies, particularly involving young practitioners from the global South, who are participating in a decentralization of western-dominated biosecurity discourse through Track II science diplomacy. These trends require updated and inclusive regulatory innovations that acknowledge biosecurity and related regulatory-ethical discussions as crucial elements of public diplomacy. There is a particular need to align these efforts with emerging forms of societal funding and to foster novel public–private partnerships in advanced bioscience research. They also call for promoting multitrack science diplomacy by bolstering institutional support for science diplomacy and biosecurity. This could be in the form of dedicated funding, or the establishment of sustained platforms to enable regular mutual learning and interactions between an international group of scientists and policy-makers. These efforts should be complemented by investment to normalize cross-disciplinary and cross-sectoral dialogues, which are essential for building communities among both established and new stakeholders. These dialogues can foster mutual learning, cultural harmonization and the development of joint initiatives to address shared biosecurity concerns. This policy paper advocates for the formal integration of science diplomacy training into university science curriculums, especially at the postgraduate level. This training will equip the next generation of scientists to align scientific visions and enhance biosecurity compliance in an increasingly connected yet ideologically diverse world.
Predictive role of cardiopulmonary bypass exposure indexed to body surface area on postoperative organ dysfunction: a retrospective cohort study
Authors: Falter Florian , Salter Ryan , Fernandes Jose , Burt Christiana , Drummond Kate , Ramalingam Ganesh , Nashef Samer
Published: October 2024

OBJECTIVES

Long cardiopulmonary bypass times are associated with adverse postoperative outcomes and increased healthcare resource use. It is likely that this effect is pronounced in smaller patients. Previous studies have been criticized for not taking into consideration that prolonged bypass times are often due to higher complexity. The purpose of this study was to investigate the relationship between bypass index (bypass time/body surface area) and adverse postoperative events.

METHODS

Single-centre, retrospective cohort study including 2413 patients undergoing cardiac surgery on cardiopulmonary bypass from June 2018 to April 2020. Length of hospital stay, as surrogate marker of postoperative morbidity, was selected as primary outcome. The strength of association between bypass index and the primary outcome was assessed with linear regression analysis. Secondary outcomes included new onset renal, pulmonary or cardiac rhythm dysfunction. The predictive value of bypass index was assessed with linear regression analysis; univariate and multiple regression were used to assess the strength of association between Bi and the secondary outcomes.

RESULTS

Bypass index was predictive for length of stay at univariate (Relative Risk (RR): 1.004, P < 0.001) and at multivariable (RR: 1.003, P < 0.001) analysis. The association between bypass index and new renal (mean difference: 14.1 min/m2, P < 0.001) and cardiac rhythm dysfunction (mean difference: 12.6 min/m2) was significant. This was not true of postoperative lung dysfunction (mean difference: −1.5 min/m2, P = 0.293).

CONCLUSIONS

Bypass index, calculated as total bypass time/patient body surface area, is predictive of postoperative morbidity and resource utilization after cardiac surgery on pump.
Faltering mortality improvements at young-middle ages in high-income English-speaking countries
Authors: Timonin Sergey , Leon David A , Banks Emily , Adair Tim , Canudas-Romo Vladimir
Published: October 2024

Background

Before the COVID-19 pandemic, stagnating life expectancy trends were reported in some high-income countries (HICs). Despite previous evidence from country-specific studies, there is a lack of comparative research that provides a broader perspective and challenges existing assumptions. This study aims to examine longevity trends and patterns in six English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom, United States) by combining period and cohort perspectives and to compare them with other HICs.

Methods

Using data from the Human Mortality and World Health Organization Mortality Databases, we estimated partial life expectancy, lifespan inequality and cohort survival differences for 1970–2021, as well as the contribution of causes of death to the gap in life expectancy between English-speaking countries and the average for other HICs in 2017–19.

Results

In the pre-pandemic period, the increase in life expectancy slowed in all English-speaking countries, except Ireland, mainly due to stagnating or rising mortality at young-middle ages. Relative to other HICs, those born in Anglophone countries since the 1970s experienced relative survival disadvantage, largely attributable to injuries (mainly suicides) and substance-related mortality (mainly poisonings). In contrast, older cohorts enjoyed advantages for females in Australia and Canada and for males in all English-speaking countries except the United States.

Conclusions

Although future gains in life expectancy in wealthy societies will increasingly depend on reducing mortality at older ages, adverse health trends at younger ages are a cause for concern. This emerging and avoidable threat to health equity in English-speaking countries should be the focus of further research and policy action.
Complex Structure That Admits Complete Nevanlinna–Pick Spaces of Hardy Type
Authors: Kojin Kenta
Published: October 2024

In this paper, we will characterize those sets, over which every irreducible complete Nevanlinna–Pick space enjoys that its multiplier and supremum norms coincide. Moreover, we will prove that, if there exists an irreducible complete Nevanlinna–Pick space of holomorphic functions on a reduced complex space $X$ whose multiplier algebra is isometrically equal to the algebra of bounded holomorphic functions (we will say that such a space is of Hardy type in this paper), then $X$ must be biholomorphic to the unit disk minus a zero analytic capacity set. This means that the Hardy space is characterized as a unique irreducible complete Nevanlinna–Pick space of Hardy type.