bluuebunny/crossref_metadata_2025 huggingface dataset:
Telomere-to-telomere gap-free genome assembly of the endangered Yangtze finless porpoise and East Asian finless porpoise
Authors: Yin Denghua , Chen Chunhai , Lin Danqing , Hua Zhong , Ying Congping , Zhang Jialu , Zhao Chenxi , Liu Yan , Cao Zhichen , Zhang Han , Wang Chenhe , Liang Liping , Xu Pao , Jian Jianbo , Liu Kai
Published: September 2024

Background

The Yangtze finless porpoise (Neophocaena asiaeorientalis asiaeorientalis, YFP) and the East Asian finless porpoise (Neophocaena asiaeorientalis sunameri, EFP) are 2 subspecies of the narrow-ridged finless porpoise that live in freshwater and saltwater, respectively. The main objective of this study was to provide contiguous chromosome-level genome assemblies for YFP and EFP.

Results

Here, we generated and upgraded the genomes of YFP and EFP at the telomere-to-telomere level through the integration of PacBio HiFi long reads, ultra-long ONT reads, and Hi-C sequencing data with a total size of 2.48 Gb and 2.50 Gb, respectively. The scaffold N50 of 2 genomes was 125.12 Mb (YFP) and 128 Mb (EFP) with 1 contig for 1 chromosome. The telomere repeat and centromere position were clearly identified in both YFP and EFP genomes. In total, 5,480 newfound genes were detected in the YFP genome, including 56 genes located in the newly identified centromere regions. Additionally, synteny blocks, structural similarities, phylogenetic relationships, gene family expansion, and inference of selection were studied in connection with the genomes of other related mammals.

Conclusions

Our research findings provide evidence for the gradual adaptation of EFP in a marine environment and the potential sensitivity of YFP to genetic damage. Compared to the 34 cetacean genomes sourced from public databases, the 2 new assemblies demonstrate superior continuity with the longest contig N50 and scaffold N50 values, as well as the lowest number of contigs. The improvement of telomere-to-telomere gap-free reference genome resources supports conservation genetics and population management for finless porpoises.
Phylogeography of the ambrosia beetle Euwallacea interjectus (Coleoptera: Curculionidae: Scolytinae): an emerging poplar pest and its Fusarium mutualists from poplar plantations in China
Authors: Lai Shengchang , Jiang Nan , Wang Jianguo , Zhou Yang , Yu Xiaohang , Wu Yaping , Yang Jinhua , Dai LuLu , Hao Dejun
Published: September 2024

Native to Asia, Euwallacea interjectus (Blandford) (Coleoptera: Curculionidae: Scolytinae) is a destructive and invasive pest of live trees, and now it has been found in the United States and Argentina. In recent years, this pest appeared in high densities in poplar monocultures from Eastern China (Jiangsu and Shanghai) and Argentina and caused significant poplar mortality. However, the origin of the pests related to tree damage and the Fusarium mutualists from some poplar zones in China remained unclear. Here, we provided a broader phylogeographic analysis of E. interjectus based on the mitochondrial gene (cytochrome c oxidase I) to determine the global genetic structure of this species. Five mitochondrial lineages were found in the native area. Populations introduced to the United States were originated from 4 localities. The Argentine population was derived from Japan. The species was observed with strikingly high level of cytochrome c oxidase I intraspecific divergence that exceeded interspecific divergence, but the high intraspecific variation was correlated with geographical locations among the native populations. Two nuclear genes (arginine kinase and carbamoyl-phosphate synthetase 2–aspartate transcarbamylase–dihydroorotase) were more conservative, and intraspecific differences were lower than interspecific differences. The mitochondrial genetic variation was probably caused by evolution of lineages among geographically isolated populations. But it is immature to infer the existence of cryptic species based on cytochrome c oxidase I differences. All samples collected from poplar populations were indigenous and formed close relationship with a specimen from eastern and southern China. Surprisingly, pests from poplar populations in Jiangsu and Shanghai showed different haplotypes and mutualists. This suggested that the control strategies should consider the genetic and mutualistic diversity of beetles at different poplar localities.
Exploring the LET dependence of DNA DSB repair kinetics using the DR DNA database
Authors: Radstake Wilhelmina E , Parisi Alessio , Denbeigh Janet M , Beltran Chris J , Furutani Keith M
Published: September 2024

The repair of DNA double-strand breaks is a crucial yet delicate process which is affected by a multitude of factors. In this study, our goal is to analyse the influence of the linear energy transfer (LET) on the DNA repair kinetics. By utilizing the database of repair of DNA and aggregating the results of 84 experiments, we conduct various model fits to evaluate and compare different hypothesis regarding the effect of LET on the rejoining of DNA ends. Despite the considerable research efforts dedicated to this topic over the past decades, our findings underscore the complexity of the relationship between LET and DNA repair kinetics. This study leverages big data analysis to capture overall trends that single experimental studies might miss, providing a valuable model for understanding how radiation quality impacts DNA damage and subsequent biological effects. Our results highlight the gaps in our current understanding, emphasizing the pressing need for further investigation into this phenomenon.
Totally three-dimensional endoscopic mitral valve replacement in a patient with situs inversus totalis
Authors: Kanamori Taro , Yamanaka Shota , Onga Yohei , Maekawa Koki , Takahashi Shu
Published: September 2024

Situs inversus totalis (SIT) with dextrocardia is a rare congenital anomaly that poses a surgical challenge. This case report presents the first known case of a totally 3D endoscopic mitral valve replacement (MVR), which was performed in a 75-year-old woman with SIT and severe functional mitral regurgitation. Despite the anatomical complexity, the procedure was successfully completed using a simplified three-port system and a 3D endoscope by requiring careful preoperative planning and intraoperative adaptation to the mirrored anatomy of SIT. This case report demonstrates the feasibility and potential benefits of totally endoscopic MVR in patients withSIT.
Motor-evoked potentials as biomarkers for sexual arousal?
Authors: Ruhland Stefanie , Poeppl Timm B , Schoisswohl Stefan , Schwitzgebel Florian , Osnabrügge Mirja , Kanig Carolina , Langguth Berthold , Schecklmann Martin
Published: September 2024

Background

Motor cortex excitability may represent the neuronal endpoint of motivational processes and was shown to be modulated by both sexual arousal and deceptive behavior.

Aim

This is the first study to investigate the influence of lying and sex in heterosexual women and men based on motor-evoked potentials (MEPs) measured while viewing sexually arousing pictures.

Methods

Sixteen heterosexual couples were shown 360 trials consisting of pictures displaying both almost naked females and males and neutral control images. In a subsequent forced-choice question about wanting to see the respective pictures fully naked, they were instructed to either answer in agreement with or opposite to their sexual preference. Participants went through 2 blocks of answering truthfully and 2 blocks of lying, with these 4 blocks being shown in a randomized alternating order.

Outcomes

To measure cortical excitability, MEPs were used, evoked by single transcranial magnetic stimulation pulses between image presentation and response.

Results

In normalized MEPs, women and men showed higher amplitudes for preferred over non-preferred sexual stimuli, but only on a descriptive level. Planned contrasts showed higher non-normalized MEPs for lying in all picture categories. Direct comparisons to a preliminary study showed overall lower effect sizes.

Clinical Implications

Both sexes tend to show higher MEPs in response to their sexually preferred stimuli. MEPs are not stable markers for willful volitionally controlled deception although lying does increase cortical excitability. The present experimental design does not seem valid enough to serve as a diagnostic marker for sexual preference or paraphilia and malingering.

Strengths and Limitations

This is the first study investigating whether sexual motivational stimuli modulate MEPs in women, while also examining the influence of lying for both sexes. The sample was too small for some found effects to be significant. Also, the experimental setup may have been less suited for female participants in comparison to male ones.

Conclusion

The operationalization of sexual motivation via MEPs seems to highly depend on different experimental factors including the sex of the participants, induced motivation, and lying.
Tips: Leading From the Middle of an Organization
Authors: Mangalindan Kristin , McBee Elexis
Published: September 2024

The vast majority of medical officers and physicians are called upon to lead from the middle of the organization. To be effective, one must understand the different approaches needed to exert positive influence up, down, and across the chain of command while delineating the overlapping relationship between leadership and management.
Looming Large or Seeming Small? Attitudes Towards Losses in a Representative Sample
Authors: Chapman Jonathan , Snowberg Erik , Wang Stephanie W , Camerer Colin
Published: September 2024

We measure individual-level loss aversion using three incentivized, representative surveys of the U.S. population (combined N=3,000). We find that around 50% of the U.S. population is loss tolerant—they are willing to accept negative-expected-value gambles that contain a loss. This is counter to expert predictions and earlier findings—which mostly come from laboratory/student samples—that 70–90% of participants are loss averse. Consistent with the different findings in our study versus the prior literature, loss aversion is more prevalent in people with high cognitive ability. Further, our measure of gain–loss attitudes exhibits similar temporal stability and better predictive power outside our survey than measures of risk aversion. Loss-tolerant individuals are more likely to report recent gambling, investing a higher percentage of their assets in stocks, and experiencing financial shocks. These results support the general hypothesis that individuals value gains and losses differently, and that gain–loss attitudes are an important economic preference. However, the tendency in a large proportion of the population to emphasize gains over losses is an overlooked behavioural phenomenon.
Sleep restriction and age effects on distinct aspects of cognition in adolescents
Authors: Campbell Ian G , Kurinec Courtney A , Zhang Zoey Y , Cruz-Basilio Alejandro , Figueroa Jessica G , Bottom Vincent B , Whitney Paul , Hinson John M , Van Dongen Hans P A
Published: September 2024

Insufficient sleep negatively impacts scholastic performance in children and adolescents. Here we use a dose–response time in bed (TIB) restriction study to evaluate associations between sleep loss and multiple aspects of cognition. We evaluated changes in cognitive measures across ages 10 to 23 years and determined whether the effects of sleep loss changed across this age range. A younger cohort (n = 77, age range 9.9 to 16.2 years) was studied annually for 3 years. An older cohort study (n = 82, age range 15 to 22.8 years) was interrupted by the COVID pandemic with 25 participants completing multiple years. Annually participants completed each of three TIB conditions: four consecutive nights with 7, 8.5, or 10 hours in bed. A day of cognitive testing followed the fourth night. Restricting TIB to 7 hours was associated with impaired top–down attentional control and cognitive flexibility, but performance did not differ between 8.5 and 10 hours of TIB conditions. Psychomotor vigilance test performance decreased as TIB was restricted from 10 to 8.5 hours and decreased further with restriction to 7 hours. Sternberg test measures of working memory were not significantly affected by TIB restriction. The effects of sleep loss on these cognitive measures did not change significantly with age, but age-related improvement in many of the measures may compensate for some sleep loss effects. The findings here do not indicate an adolescent decrease in sleep need; however, the minimal duration of sleep needed for optimal performance appears to differ depending on the cognitive measure.
Serum alpha-synuclein in restless legs syndrome
Authors: Tahanis Aboud , Hashem Vera , Ondo William
Published: September 2024

Study Objectives

To determine any correlation between serum alpha-synuclein (α-syn) concentrations and restless legs syndrome (RLS), and to explore the impact of intravenous iron supplementation on serum α-syn levels.

Methods

We collected clinical data on 113 RLS patients in whom serum α-syn levels were quantified using an ELISA kit and compared to a group of 45 age-matched controls. A subset of nine RLS patients who received intravenous (IV) iron underwent pre- and post-treatment blood sampling to assess α-syn and ferritin response.

Results

A family history of RLS was reported by 62.8% of patients, and current dopaminergic augmentation was observed in 31.0%. Low serum ferritin levels below 75 μg/L were seen in 39.8%. Serum α-syn levels were found to be significantly decreased in RLS patients (mean: 7.7 ng/mL) compared to controls (mean: 10.7 ng/mL), p < .05. Stratification based on sex, age, and age of onset, did not reveal significant differences in α-syn levels. In nine RLS patients who received IV iron treatment, a linear correlation between fold change in α-syn and ferritin was observed (R: 0.7, p < .05). The temporal relation between serum α-syn and IV iron treatment showed a gradual decline of α-syn and ferritin by time correlation (p = .023, R: −.739).

Conclusion

In our study of 113 RLS participants, serum α-syn levels were decreased in RLS patients compared to healthy controls, and increased in the nine patients who received IV iron treatment in correlation with ferritin. This correlation could suggest a mechanism for reduced dopamine transmission in RLS.
Exploring the potential of selenium nanoparticles and fabricated selenium nanoparticles @vitamin C nanocomposite in mitigating nicotine-induced testicular toxicity in rats
Authors: Refaat Rana M M , Fouda Atef E , El-Shishtawy Mohamed A , Kumar Adarsh , El-Shafai Nagi M , Faruk Eman M , Nafea Ola E , Hindawy Rabab F
Published: September 2024

Background

The tobacco epidemic signifies a major public health threat. Nicotine (NIC), a major active constituent in tobacco, impedes male fertility and semen quality. This work is implemented to explore the potential of selenium nanoparticles (SeNPs) and the newly fabricated SeNPs @vitamin C (SeNPs@VITC) nanocomposite in mitigating testicular toxicity induced by NIC.

Materials and methods

The six groups of 48 adult Wistar rats were designed as follows: the control group injected intraperitoneally with normal saline, the SeNPs group treated orally with 2 mg/kg of SeNPs, the SeNPs@VITC nanocomposite group treated orally with 2 mg/kg of SeNPs@VITC nanocomposite, the NIC group injected intraperitoneally with 1.25 mL/kg of NIC, the NIC+ SeNPs group received SeNPs plus NIC, and the NIC+ SeNPs@VITC nanocomposite group received SeNPs@VITC nanocomposite plus NIC. Treatments were administered over a 28-day period.

Results

NIC treatment significantly caused poor sperm quality, decreased serum testosterone, increased follicle-stimulating hormone (FSH), luteinizing hormone (LH) concentrations, reduced hemoglobin levels, leukocytosis, disrupted testicular oxidant/antioxidant balance, and disorganized testicular structure. The construction of the novel SeNPs@VITC nanocomposite, compared to NIC plus SeNPs alone, demonstrated a more potent ameliorative effect on NIC-induced reproductive toxicity in adult rats. The SeNPs@VITC nanocomposite significantly increased sperm count, reduced the percentage of sperm head abnormalities, lowered both serum FSH and LH concentrations, and improved the hemoglobin response.

Conclusions

Both SeNPs and SeNPs@VITC nanocomposite alleviated the testicular toxicity induced by NIC, but the SeNPs@VITC nanocomposite exhibited superior efficacy. The SeNPs@VITC nanocomposite could be employed to advance enhanced therapeutic strategies for addressing male infertility.
Effect of Erector Spinae Plane Block on Postoperative Quality of Recovery in Patients Undergoing Transforaminal or Oblique Lumbar Interbody Fusion: A Randomized Controlled Trial
Authors: Jo Woo-Young , Shin Kyung Won , Lee Hyung-Chul , Park Hee-Pyoung , Kim Jun-Hoe , Lee Chang-Hyun , Kim Chi Heon , Chung Chun Kee , Oh Hyongmin
Published: September 2024

Background:

Erector spinae plane block (ESPB) can has been used for analgesia after lumbar spine surgery. However, its effect on postoperative quality of recovery (QoR) remains underexplored in patients undergoing transforaminal lumbar interbody fusion (TLIF) or oblique lumbar interbody fusion (OLIF). This study hypothesized that ESPB would improve postoperative QoR in this patient cohort.

Methods:

Patients undergoing TLIF or OLIF were randomized into ESPB (n=38) and control groups (n=38). In the ESPB group, 25 mL of 0.375% bupivacaine was injected into each erector spinae plane at the T12 level under ultrasound guidance before skin incision. Multimodal analgesia, including wound infiltration, was applied in both groups. The QoR-15 score was measured before surgery and 1 day (primary outcome) and 3 days after surgery. Postoperative pain at rest and during ambulation and postoperative ambulation were also evaluated for 3 days after surgery.

Results:

Perioperative QoR-15 scores were not significantly different between the ESPB and control groups including at 1 day after surgery (80±28 vs. 81±25, respectively; P=0.897). Patients in the ESPB group had a significantly lower mean (±SD) pain score during ambulation 1 hour after surgery (7±3 vs. 9±1, respectively; P=0.013) and significantly shorter median (interquartile range) time to the first ambulation after surgery (2.0 [1.0 to 5.5] h vs. 5.0 [1.8 to 10.0] h, respectively; P=0.038). There were no between-group differences in pain scores at other times or in the cumulative number of postoperative ambulations.

Conclusion:

ESPB, as performed in this study, did not improve the QoR after TLIF or OLIF with multimodal analgesia.
Free Vascularized Osseous Fibula Flap for Vertebral Body Defect in a Patient with Tuberculosis Spondylitis
Authors: Atmodiwirjo Parintosa , Ramadan Mohamad Rachadian , Lumbuun Ruth , Gunawan Kevin , Saekhu Mohamad , Nugroho Setyo Widi , Ralena Nadhira Anindita
Published: September 2024

In the context of tuberculous spondylitis, a rare form of extrapulmonary tuberculosis causing significant discomfort and neurological deficits, surgery becomes imperative to alleviate symptoms alongside antituberculosis treatment. However, the utilization of free vascularized fibula flaps for repairing vertebral deformities remains uncommon. This report presents the case of a 21-year-old man with limb weakness and sensory disturbances who was referred to our hospital, where contrast magnetic resonance imaging revealed a paravertebral abscess spanning several thoracic vertebrae. Collaborating with neurosurgeons, we performed decompression laminectomy, pedicle screw fixation, thoracic vertebrectomy, and restoration of the corporal defect using a free fibula flap. Utilizing a 2.5-cm fibula segment from the patient’s left leg without a skin paddle, the surgery demonstrated a pedicle length of 12 cm and a total ischemic time of 183 minutes. The fibula was press-fitted, with recipient vessels identified as 1-mm artery and vein from the intercostal artery perforator. Postsurgery, flap vitality was assessed using Doppler ultrasound, showing positive signals immediately and at 1-month follow-up, with the patient experiencing reduced pain and improved leg strength. Despite its rarity, free fibula flap reconstruction for spinal defects proves effective, safe, and beneficial, necessitating thorough preoperative planning and interdisciplinary collaboration for successful outcomes, marking this case as the first reported instance in Indonesia.
Dorsal Hand Reconstruction with Web Contracture Release Using Free Superficial Inferior Epigastric Artery Flap
Authors: Nomaguchi Matoku , Niimi Yosuke , Hasegawa Yuki , Matsumine Hajime , Sakurai Hiroyuki
Published: September 2024

We present a case in which reconstruction of the dorsum of the hand and finger web space was carried out concurrently with the insertion of a superficial inferior epigastric artery flap into the interdigital spaces. This approach was taken to prevent the potential development of subsequent web space contracture. The patient, a 57-year-old woman, presented with a necrotizing soft tissue infection on the dorsum of her left hand, resulting in a full-thickness skin defect extending from the metacarpophalangeal joint to the wrist, with exposure of the extensor tendons. The reconstructive surgery involved raising a superficial inferior epigastric artery flap and transplanting it onto the tissue defect, to cover not only the dorsal defect but also the interdigital spaces after releasing web space contracture. Consequently, the surgery successfully released scar contractures on the dorsum of the hand and provided adequate interdigital space formation without requiring additional procedures, except defatting. At the 7-month postoperative follow-up, the patient had a good outcome with shoulder and hand (Quick Disabilities of Arm, Shoulder and Hand) score of 28.9 points. Interdigital scar contractures often lead to decreased fine motor skills and functional impairment, affect aesthetics, and require a prolonged period for social reintegration. This surgical technique involves simultaneous one-stage closure of the dorsal defect with a flap and interdigital reconstruction to prevent future scar contractures and functional impairments, and is a valuable approach for shortening the treatment duration.
Experiences and Challenges Updating a Living Evidence-Based Review of Randomized Controlled Trials on Mental Health and Behavioral Disorders in Individuals With Moderate to Severe Traumatic Brain Injury
Authors: Teasell Robert , MacKenzie Heather M. , Flores-Sandoval Cecilia , McIntyre Amanda , Barua Ujjoyinee , Mehta Swati , Bayley Mark , Bateman Emma A.
Published: September 2024

Objective:

To describe experiences and challenges when updating a living evidence-based review database of randomized controlled trials (RCTs) on mental health and behavioral disorders in moderate to severe traumatic brain injury (MSTBI).

Method:

This commentary derives from our experience developing an extensive database of RCTs on MSTBI that has been conceptualized as a living evidence-based review. Our working group focused on mental health and behavior RCTs and reflected upon their experiences and challenges using the living systematic approach. We discuss challenges associated with metrics of study quality, injury etiology and severity, time post-injury, country of origin, and variability in outcome measures.

Results:

RCTs were conducted almost solely in high income countries, with smaller sample sizes, and most conducted in the chronic phase post-TBI. Issues related to lack of transparency, unclear and incomplete reporting of injury severity, etiology, and time post-injury remain a concern and can lead to challenges associated with interpretation of results, validity, and reliability of the data. There was significant heterogeneity regarding the use of outcome measures and constructs, underscoring the need for standardization.

Conclusion:

Lack of standardization and incomplete reporting of injury characteristics makes it difficult to compare data between RCTs of MSTBI, perform meta-analyses, and generate evidence-based clinical recommendations.
Identification of Retinal Amyloid-Beta in Ex Vivo Human Glaucoma Eyes Using a Novel Ocular Tracer
Authors: Pilotte Julie , Khoury Sami , Tafreshi Ali , Mandel Zachary T. , Sharma Svasti V. , Vanderklish Peter W. , Sarraf Stella T. , Sadun Alfredo A. , Weinreb Robert N. , Huang Alex S.
Published: September 2024

Purpose:

To characterize the presence of amyloid-beta (Aβ) in human glaucoma retina and to test the identification of retinal Aβ using a novel fluorescent Aβ-binding small molecule (AMDX-2011).

Methods:

Postmortem human eyes with (n=4) and without (n=4) glaucoma were acquired from an eye bank. Retinas were dissected, flat-mounted, and fixed. Using the flat mounts, immunofluorescence was performed against Aβ, AMDX-2011 staining was conducted, and images were acquired using fluorescence microscopy.

Results:

Fluorescence microscopy demonstrated the presence of an Aβ signal that colocalized with AMDX-2011 staining in the glaucoma retina. Colabeled puncta appeared in all quadrants of the retina, including the retina temporal to the optic nerve. The puncta were mainly located within the inner layers of the retina. Glaucoma retinas had more colabeled puncta than control retinas in all locations (P=0.002–0.02). Colabeled puncta were also larger in the superior quadrant of glaucoma compared with control retinas (P=0.02).

Conclusions:

Aβ was detected in human glaucomatous retina, and its distribution was mapped. AMDX-2011 identification of Aβ may lead to future diagnostic tests aimed at detecting Aβ in glaucoma patients.
Association between pre-arrest left ventricular ejection fraction and survival in nontraumatic out-of-hospital cardiac arrest
Authors: Ho Yi-Ju , Lien Chun-Ju , Tsai Ren-Jie , Fan Cheng-Yi , Chen Chi-Hsin , Huang Chien-Tai , Chen Ching-Yu , Chen Yun-Chang , Huang Chun-Hsiang , Chiang Wen-Chu , Huang Chien-Hua , Sung Chih-Wei , Huang Edward Pei-Chuan
Published: September 2024

Background and importance:

Out-of-hospital cardiac arrest (OHCA) poses major public health issues. Pre-arrest heart function is a prognostic factor, but the specific contribution of pre-arrest echocardiographic evaluation in predicting OHCA outcome remains limited.

Objective:

The primary objective was to investigate the association between left ventricular ejection fraction (LVEF) measured in echocardiography prior to OHCA and survival to hospital discharge.

Design, settings, and participants:

This multicenter retrospective cohort study analyzed data from the National Taiwan University Hospital and its affiliated hospitals. We included adult nontraumatic OHCA patients who were treated by the emergency medical services (EMS) and underwent echocardiography within 6 months prior to the OHCA event from January 2016 to December 2022. Data included demographics, preexisting diseases, resuscitation events, and echocardiographic reports.

Outcomes measure and analysis:

The primary outcome was the survival to hospital discharge after post-arrest care. Statistical analysis involved multivariable logistic regression to modify potential confounders, reported as adjusted odds ratio (aOR) and 95% confidence interval (CI), and evaluate the association between echocardiographic findings and survival to hospital discharge.

Main results:

This study analyzed 950 patients, with 33.6% surviving to discharge. A higher pre-arrest LVEF was independently associated with increased survival. Compared to patients with LVEF < 40%, those with LVEF between 40% and 60% had significantly higher odds of survival (aOR = 3.68, 95% CI = 2.14–6.35, P < 0.001), and those with LVEF > 60% had even greater odds of survival (aOR = 5.46, 95% CI = 3.09–9.66, P < 0.001). There was also an association between lower tricuspid regurgitation pressure gradient and survival (aOR = 0.98, 95% CI = 0.97–1.00, P = 0.015). Younger age, male gender, dyslipidemia, stroke, cancer, witnessed arrest, initial shockable rhythm, and shorter low-flow time are other significant predictors of survival.

Conclusion:

In adult, nontraumatic, EMS-treated OHCA patients, a higher LVEF 6 months prior to OHCA was associated with improved survival at hospital discharge.
International equity in access to home dialysis
Authors: Iyengar Arpana , Kalyesubula Robert , Darwish Rasha , Luyckx Valerie A.
Published: September 2024

Purpose of review

Discussion of inequalities and inequities in global distribution of and access to home dialysis.

Recent findings

The majority of patients receiving home dialysis receive peritoneal dialysis, but these are concentrated in few countries across the globe. Peritoneal dialysis as the most common form of home dialysis has many advantages in terms of individual freedoms, similar outcomes to haemodialysis, being less costly in some countries, and more scalable than in-centre haemodialysis. Despite this there are many inequities in access at the patient, clinician, health system and geopolitical levels. Poverty, discrimination and lack of support at home are important drivers of inequities at the patient level. At the clinician and health systems level lack of experience in home dialysis, lack of resources and lack of time drive patients towards in-centre dialysis. At the geopolitical level, high costs associated with procurement and distribution of peritoneal dialysis solutions exacerbate inequities in access.

The challenge of reducing global inequities in access to home dialysis in low- and middle-income countries are vast and would require training of the doctors, nurses, families, patients, leaders and community partners. Once this is achieved, dealing with costs and logistics of supplies is crucial to improve and sustain equitable access.
The comparison of efficacy of Escitalopram and Bupropion in treatment of depression symptoms in patients with heart failure: randomized clinical trial
Authors: Hamzehpour Romina , Hamidia Angela , Ramezani Azadeh , Abrootan Saeed , Shirafkan Hoda , Moallem Hirbod Hadizadeh , Tavakoli Negin , Ziaie Naghmeh
Published: September 2024

Objective:

This study aims to compare the effects of two medicines, Escitalopram and Bupropion, on HF patients who have depression symptoms.

Methods:

This double-blind randomized clinical trial study was conducted on HF patients with depression symptoms at the Heart Failure Clinics affiliated with Babol University of Medical Sciences. In this study, 80 participants were examined for depression based on the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS). They were randomly allocated into two groups of 40 participants treated with Bupropion 75 mg and Escitalopram 5 mg. Following the intervention, the individuals were assessed in terms of their depression score at 4, 8, and 12-week intervals. Finally, the data were analyzed using SPSS version 22.0.

Results:

In the examination of Beck and Hamilton scores in the two research groups during different follow-ups, a significant decrease was found over time (P<0.001 for both medicines). While the effectiveness of the two medicines was the same at different times (P>0.05 in all cases). Comparing the side effects between the two intervention groups, the orgasm disorder (P=0.018) and sexual dysfunction (P<0.001) were reported significantly more in the Escitalopram group than in the Bupropion group.

Conclusions:

The findings of this study showed that Escitalopram has the same efficacy as Bupropion in the treatment of depression symptoms in HF patients.
From Selfies to Surgery: Unveiling Trends and Ethical Considerations in Facial Feminization on Instagram
Authors: Hoffman Alexandra F. , Laspro Matteo , Chinta Sachin , Tran David L. , Rodriguez Eduardo D.
Published: September 2024

Facial feminization surgery (FFS) is a critical gender-affirming intervention utilized to alleviate gender dysphoria. This study investigates the role of Instagram in shaping public perceptions and disseminating information about FFS. The authors analyzed the most recent 500 Instagram posts using the hashtag "#facialfeminizationsurgery" through a nonbiased data scraping platform between June 1, 2023 and October 13, 2023. Posts were categorized, for example, by tone, author, hospital, practice location, and whether it was a patient or physician-reported outcome. Of the posts, 85% connoted a positive tone. Health care providers and organizations posted 65.4% of content. Geographic breakdown showed that of posts written in English, 55% of health care providers were from the United States. The top 3 most frequently cited locations outside of the United States were India (25.2%), England (19.1%), and South Korea (16.0%). Common themes among posts were perception of FFS and whether it be deemed cosmetic or reconstructive, ethical considerations, and insurance/funding. 36% of posts were advertisements, and 20% were educational, which emphasized the role of social media in disseminating information. This study emphasizes the dynamic nature of social media and its large impact on FFS with regard to disseminating accurate information, navigating the patient-physician relationship, and posting ethical content. The demographics of the users and posts show growing global interest in FFS, a largely positive tone from users, and a large presence of health care workers. Lastly, Instagram is an educational tool for FFS and spreads awareness of insurance and issues faced by patients through first-hand perspectives.
Advances in Reconstructive Robotic Microsurgery in the Extremity
Authors: Könneker Sören , Watson Jennifer Ashley , Weinzierl Andrea , von Reibnitz Donata , Besmens Inga , Kim Bong-Sung , Giovanoli Pietro , Lindenblatt Nicole
Published: September 2024

Robotic surgery has emerged as a promising technique for reconstructive procedures, offering potential advantages across various surgical fields. Following initial case reports on the use of the Symani Surgical System (Medical Microinstruments, S.p.A) for microsurgical anastomosis, the authors evaluated its full potential in extremity reconstruction. They conducted a retrospective analysis of patients with soft tissue defects of the upper and lower extremities treated between February 2022 and May 2024. Each patient underwent soft tissue reconstruction with free tissue transfer with microsurgical anastomosis performed using the Symani Surgical System. The study included 7 male patients and 1 female patient, aged between 19 and 71 years (mean age: 50.6 y). The most used recipient vessels were the anterior tibial artery and vein (37.5%). The preferred anastomotic technique was end-to-side in arterial anastomoses (6/8). All arterial anastomoses were performed using the Symani Surgical System. The mean anastomosis time was 33.2±5.8 minutes. One out of 8 patients required surgical revision outside of the anastomosis. The authors’ findings suggest that using the Symani Surgical System for microanastomosis in extremity reconstruction is a safe and effective approach, leading to satisfactory outcomes in different anatomic regions. The system allows for the successful execution of various anastomosis techniques, including end-to-end and end-to-side connections, using single interrupted or running sutures, which enhances its versatility in complex reconstructive procedures. The benefits of robotic assistance in terms of precision and ergonomics are promising for the future of reconstructive microsurgery.
Reclassification of Halomicroarcula saliterrae Straková et al. 2024 and Halomicroarcula onubensis Straková et al. 2024 into the genus Haloarcula, as Haloarcula saliterrae comb. nov. and Haloarcula onubensis comb. nov., respectively
Authors: Straková Dáša , Sánchez-Porro Cristina , de la Haba Rafael R. , Ventosa Antonio
Published: September 2024

The haloarchaeal genera Halomicroarcula and Haloarcula, belonging to the family Haloarculaceae, order Halobacteriales, class Halobacteria, within the phylum Methanobacteriota, have previously exhibited significant phylogenetic and taxonomic overlaps. This issue was recently resolved by merging the two genera into a single genus, Haloarcula. However, Halomicroarcula saliterrae and Halomicroarcula onubensis were described almost simultaneously with the proposal to unify the genera Haloarcula and Halomicroarcula. Their names were validly published under the International Code of Nomenclature of Prokaryotes (ICNP) according to Validation List no. 217, alongside six Haloarcula species and the transfer of the existing Halomicroarcula species into the genus Haloarcula. Therefore a phylogenetic, phylogenomic, and comparative genomic analysis was carried out to clarify the taxonomic status of these two haloarchaeal species, Halomicroarcula saliterrae and Halomicroarcula onubensis, with lower priority than the six new species of the genus Haloarcula. Phylogenetic studies of 16S rRNA and rpoB′ gene sequences, along with phylogenomic reconstructions using single-copy core-orthologous proteins, indicated that the two species clustered with the members of the genus Haloarcula. The overall genome relatedness indexes (OGRIs), comparative analyses of phenotypic features, and polar lipid profiles further supported their taxonomic reassignment as two separate species within the genus Haloarcula. Consequently, we propose the reclassification of Halomicroarcula saliterrae Straková et al. 2024 and Halomicroarcula onubensis Straková et al. 2024 into the genus Haloarcula, as Haloarcula saliterrae comb. nov. and Haloarcula onubensis comb. nov., respectively, in accordance with the ICNP.
Genome assembly ofFirmina major, an endangered savanna tree species endemic to China
Authors: Yang Jing , Zhang Rengang , Ma Yongpeng , Ma Yuqian , Sun Weibang
Published: September 2024

The tree speciesFirmiana majorwas once dominant in the savanna vegetation of the arid hot valleys of southwest China, but was considered extinct in the wild in 1998. After eight small populations were relocated by thorough investigations between 2018 and 2020, the species was subsequently recognized as a Plant Species of Extremely Small Populations (PSESP) in China in need of urgent rescue. Moreover, due to severe human disturbance, other species in the tropical woody genusFirmianaare also endangered, and the species in this genus have almost all been listed as second-class National Protected Wild Plants in China. In order to guide future research into the conservation of this group, we present here the high-quality genome assembly ofF. major. This is the first genome assembly in the genusFirmiana, and is 1.4 Gb in size. The assembly consists of 1.18 Gb repetitive sequences, 37,673 annotated genes and 31,965 coding genes.
Boosting forward connectivity between primary visual and body selective cortex reduces interference between sex and emotion judgements of bodies
Authors: Gandolfo Marco , D’Argenio Giulia , Downing Paul E. , Urgesi Cosimo
Published: September 2024

We effortlessly categorise other people along socially relevant categories such as sex, age, and emotion. A core question in social vision relates to whether we perceive these categories independently or in relation to each other. Here, we investigated categorisation of sex and emotion from the body, finding that participants generally fail to fully ignore task-irrelevant variations of sex while judging body emotional expressions. In contrast, sex categorisation was unaffected by variations in emotional expression. This asymmetric interaction between sex and emotion may arise because of bottom-up visual processing, due to partially shared visual features used for both judgments, or because of top-down, categorical associations between sex and emotion categories. To disentangle these possibilities, we used cortico-cortical paired associative stimulation (ccPAS) to modulate the connectivity between primary visual cortex and the extrastriate body area. We posited that boosting forward connectivity between these regions would increase efficiency of feature-based processing, while boosting feedback connectivity would enhance the separability of semantic categories related to sex and emotion. We found that boosting forward connectivity eliminated the interference of sex on emotion judgments, while that interference remained unaffected with modulation of feedback connectivity. These findings suggest that interactions between sex and emotion in body perception emerge during the perceptual analysis of the stimuli, and add to our understanding of person perception and social categorization.
Partial repair causes permanent defects in papillary structure and function after reversal of urinary obstruction
Authors: Vanichapol Thitinee , Gonzalez Alex , Delgado Rachel , Brewer Maya , Clouthier Kelly A. , Menshikh Anna , Snyder William E. , Rahman Teebro , Sander Veronika , Yang Haichun , Davidson Alan , de Caestecker Mark
Published: September 2024

Urinary obstruction causes injury to the renal papilla and leads to defects in the ability to concentrate urine which predisposes to progressive kidney injury. However, the regenerative capacity of the papilla after reversal of obstruction is poorly understood. To address this, we developed a mouse model of reversible urinary obstruction which is characterized by extensive papillary injury, followed by a robust regeneration response and complete histological recovery over a 3- month period. However, these mice have a pronounced defect in urinary concentrating capacity. We now show that this is due to permanent changes in the composition, organization, and transcriptional signatures of epithelial, endothelial, and interstitial cell lineages in the papilla. There are persistent inflammatory responses that are also seen in patients with renal stone disease but are associated with cell-specific adaptive responses to the increasingly hypoxic environment of the papilla after reversal of obstruction. Taken together, our analysis of a new model of reversible urinary obstruction reveals that partial repair leads to permanent changes in the structure and function of all of the major cellular compartments in the papilla that include both shared and distinct responses to different types of renal papillary injury in humans and mice.

Partial repair after reversal of urinary obstruction leads to permanent changes in structure and function of all major cellular compartments in the renal papilla
Utilizing AI-Generated Plain Language Summaries to Enhance Interdisciplinary Understanding of Ophthalmology Notes: A Randomized Trial
Authors: Tailor Prashant D. , D'Souza Haley S. , Castillejo Becerra Clara , Dahl Heidi M. , Patel Neil R. , Kaplan Tyler M. , Kohli Darrell , Bothun Erick D. , Mohney Brian G. , Tooley Andrea A. , Baratz Keith H. , Iezzi Raymond , Barkmeier Andrew J. , Bakri Sophie J. , Roddy Gavin W. , Hodge David , Sit Arthur J. , Starr Matthew R. , Chen John J.
Published: September 2024

Background Specialized terminology employed by ophthalmologists creates a comprehension barrier for non-ophthalmology providers, compromising interdisciplinary communication and patient care. Current solutions such as manual note simplification are impractical or inadequate. Large language models (LLMs) present a potential low-burden approach to translating ophthalmology documentation into accessible language. Methods This prospective, randomized trial evaluated the addition of LLM-generated plain language summaries (PLSs) to standard ophthalmology notes (SONs). Participants included non-ophthalmology providers and ophthalmologists. The study assessed: (1) non-ophthalmology providers' comprehension and satisfaction with either the SON (control) or SON+PLS (intervention), (2) ophthalmologists' evaluation of PLS accuracy, safety, and time burden, and (3) objective semantic and linguistic quality of PLSs. Results 85% of non-ophthalmology providers (n=362, 33% response rate) preferred the PLS to SON. Non-ophthalmology providers reported enhanced diagnostic understanding (p=0.012), increased note detail satisfaction (p<0.001), and improved explanation clarity (p<0.001) for notes containing a PLS. The addition of a PLS narrowed comprehension gaps between providers who were comfortable and uncomfortable with ophthalmology terminology at baseline (intergroup difference p<0.001 to p>0.05). PLS semantic analysis demonstrated high meaning preservation (BERTScore mean F1 score: 0.85) with greater readability (Flesch Reading Ease: 51.8 vs. 43.6, Flesch-Kincaid Grade Level: 10.7 vs. 11.9). Ophthalmologists (n=489, 84% response rate) reported high PLS accuracy (90% "a great deal") with minimal review time burden (94.9% ≤ 1 minute). PLS error rate on initial ophthalmologist review and editing was 26%, and 15% on independent ophthalmologist over-read of edited PLSs. 84.9% of identified errors were deemed low risk for patient harm and 0% had a risk of severe harm/death. Conclusions LLM-generated plain language summaries enhance accessibility and utility of ophthalmology notes for non-ophthalmology providers while maintaining high semantic fidelity and improving readability. PLS error rates underscore the need for careful implementation and ongoing safety monitoring in clinical practice.
Structure of small HBV surface antigen reveals mechanism of dimer formation
Authors: He Xiao , Kang Yunlu , Tao Weiyu , Xu Jiaxuan , Liu Xiaoyu , Chen Lei
Published: September 2024

Hepatitis B surface antigen (HBsAg), the only membrane protein on the HBV viral envelope, plays essential roles in HBV assembly, viral release, host cell attachment, and entry. Despite its functional and therapeutic importance, the detailed structure of HBsAg has remained enigmatic. Here, we present the core structure of HBsAg at 3.6 Å resolution, determined using recombinant small spherical subviral particles (SVPs). The structure reveals how two HBsAg monomers interact to form a dimer, which is the basic building block of SVPs.
Target-conditioned diffusion generates potent TNFR superfamily antagonists and agonists
Authors: Gloegl Matthias , Krishnakumar Aditya , Ragotte Robert , Goreshnik Inna , Coventry Brian , Bera Asim K , Kang Alex , Joyce Emily , Ahn Green , Huang Buwei , Yang Wei , Chen Wei , Sanchez Mariana Garcia , Koepnick Brian , Baker David
Published: September 2024

Despite progress in the design of protein binding proteins, the shape matching of binder to target has not yet reached that of highly evolved native protein-protein complexes, and previous design efforts have failed for hard targets such as the TNF receptor (TNFR1) that have relatively flat and polar surfaces. We reasoned that free diffusion starting from random noise could enable generation of extensive shape-matching binders to challenging targets, and tested this approach on TNFR1 and related super family members. The diffused TNFR1 binders have nanomolar affinities that increase to single-digit picomolar upon refinement by partial diffusion, and their specificities can be completely switched by partial diffusion in the context of other family members. The designs function as antagonists as monomers, and as superagonists when presented trivalently for OX40 and at higher valency for 4-1BB. The ability to design high -affinity and specific antagonists and agonists for a difficult but pharmacologically important class of proteins entirely in silico, without any large-scale screening or experimental optimization, presages a new era in which binders are made by computation rather than much more laborious and less controllable random screening approaches.