bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of machine learning models for predicting HER2-zero and HER2-low breast cancers
Authors: Huang Xu , Wu Lei , Liu Yu , Xu Zeyan , Liu Chunling , Liu Zaiyi , Liang Changhong
Published: July 2024

Objectives

To develop and validate machine learning models for human epidermal growth factor receptor 2 (HER2)-zero and HER2-low using MRI features pre–neoadjuvant therapy (NAT).

Methods

Five hundred and sixteen breast cancer patients post-NAT surgery were randomly divided into training (n = 362) and internal validation sets (n = 154) for model building and evaluation. MRI features (tumour diameter, enhancement type, background parenchymal enhancement, enhancement pattern, percentage of enhancement, signal enhancement ratio, breast oedema, and apparent diffusion coefficient) were reviewed. Logistic regression (LR), support vector machine (SVM), k-nearest neighbour (KNN), and extreme gradient boosting (XGBoost) models utilized MRI characteristics for HER2 status assessment in training and validation datasets. The best-performing model generated a HER2 score, which was subsequently correlated with pathological complete response (pCR) and disease-free survival (DFS).

Results

The XGBoost model outperformed LR, SVM, and KNN, achieving an area under the receiver operating characteristic curve (AUC) of 0.783 (95% CI, 0.733-0.833) and 0.787 (95% CI, 0.709-0.865) in the validation dataset. Its HER2 score for predicting pCR had an AUC of 0.708 in the training datasets and 0.695 in the validation dataset. Additionally, the low HER2 score was significantly associated with shorter DFS in the validation dataset (hazard ratio: 2.748, 95% CI, 1.016-7.432, P = .037).

Conclusions

The XGBoost model could help distinguish HER2-zero and HER2-low breast cancers and has the potential to predict pCR and prognosis in breast cancer patients undergoing NAT.

Advances in knowledge

HER2-low–expressing breast cancer can benefit from the HER2-targeted therapy. Prediction of HER2-low expression is crucial for appropriate management. MRI features offer a solution to this clinical issue.
Desmoid fibromatosis: interventional radiology (sometimes) to the rescue for an atypical disease
Authors: Garnon Julien , Cazzato Roberto Luigi , Autrusseau Pierre-Alexis , Koch Guillaume , Weiss Julia , Gantzer Justine , Kurtz Jean-Emmanuel , Gangi Afshin
Published: July 2024

Desmoid fibromatosis (DF) is a rare locally aggressive soft tissue tumour that is characterized as benign as it cannot metastasize. It was managed until recently like sarcomas, that is, with radical surgical resection combined or not with radiotherapy. However, this approach was associated with a high rate of recurrence and significant morbidity. The management of this disease has progressively changed to a more conservative approach given the fact that DF may spontaneously stop to grow or even shrink in more than half of the cases. Should treatment be required, recent guidelines recommend choosing between systemic therapies, which include principally chemotherapy and tyrosine kinase inhibitors, and local treatments. And this is where the interventional radiologist may have an important role in treating the disease. Various ablation modalities have been reported in the literature to treat DF, notably high-intensity focused ultrasound and cryoablation. Results are promising and cryoablation is now mentioned in recent guidelines. The interventional radiologist should nevertheless apprehend the disease in its globality to understand the place of percutaneous treatments among the other therapeutic options. The goal of this review is therefore to present and discuss the role of interventional radiology in the management of DF.
Assembly/disassembly control of gold nanorods with uniform orientation on anionic polymer brush substrates
Authors: Yang Jingyan , Sekizawa Yu , Shi Xu , Ijiro Kuniharu , Mitomo Hideyuki
Published: July 2024

Sophisticated control of the spatial arrangement of gold nanorods provides significant advantages in the design of plasmonic systems. However, dynamic modulation of the gold nanorod spatial arrangements remains challenging. Here, we present a novel strategy for dynamic control of thermo-responsive gold nanorods with uniform alignment on a solid substrate using polymer brushes. In this system, cationic and thermo-responsive gold nanorods were immobilized into anionic polymer brushes via moderate electrostatic interactions, providing vertically aligned gold nanorod arrays. Upon heating, the gold nanorods were assembled while maintaining their vertical orientation within the polymer brushes. They returned to the original state upon cooling, indicating reversible assembly/disassembly. It is noticeable that this system exhibits rapid changes in nanostructure arrangement even when immobilized in the polymer brush substrate on a solid substrate rather than those dispersed in solution. Importantly, the gold nanorods showed good adhesion stability in polymer brushes without any significant detachment during washing and thermal cycling processes but performed assembly formation even at largely separated conditions, indicating the traveling of considerable distances similar to the lateral diffusion of membrane proteins in cell membranes. In addition to providing unprecedented control over gold nanorod spatial configurations, our approach introduces a versatile platform for developing advanced plasmonic devices.
Extensive asymptomatic violaceous plaques on the upper body of a middle-aged man
Authors: Brooks Sarah G , Lopez Lourdes M , Elgart George W , Yosipovitch Gil
Published: July 2024

We describe an extensive, asymptomatic presentation of a rare condition in a 59-year-old male patient presenting with nonpruritic, nonpainful, hyperpigmented plaques on the upper body. Multiple treatments had failed to resolve the lesions, but with an added JAK inhibitor the patient developed no new lesions. We hope this description contributes to our limited understanding of this rarely reported clinical entity.
Functional states of prelimbic and related circuits during the acquisition of a GO/noGO task in rats
Authors: Muñoz-Redondo Carmen , Parras Gloria G , Andreu-Sánchez Celia , Martín-Pascual Miguel Ángel , Delgado-García José M , Gruart Agnès
Published: July 2024

GO/noGO tasks enable assessing decision-making processes and the ability to suppress a specific action according to the context. Here, rats had to discriminate between 2 visual stimuli (GO or noGO) shown on an iPad screen. The execution (for GO) or nonexecution (for noGO) of the selected action (to touch or not the visual display) were reinforced with food. The main goal was to record and to analyze local field potentials collected from cortical and subcortical structures when the visual stimuli were shown on the touch screen and during the subsequent activities. Rats were implanted with recording electrodes in the prelimbic cortex, primary motor cortex, nucleus accumbens septi, basolateral amygdala, dorsolateral and dorsomedial striatum, hippocampal CA1, and mediodorsal thalamic nucleus. Spectral analyses of the collected data demonstrate that the prelimbic cortex was selectively involved in the cognitive and motivational processing of the learning task but not in the execution of reward-directed behaviors. In addition, the other recorded structures presented specific tendencies to be involved in these 2 types of brain activity in response to the presentation of GO or noGO stimuli. Spectral analyses, spectrograms, and coherence between the recorded brain areas indicate their specific involvement in GO vs. noGO tasks.
Comprehensive Review on the Use of Oral Cholera Vaccine (OCV) in Ethiopia: 2019 to 2023
Authors: Edosa Moti , Jeon Yeonji , Gedefaw Abel , Hailu Dejene , Mesfin Getachew Edlawit , Mogeni Ondari D , Jang Geun Hyeog , Mukasa David , Yeshitela Biruk , Getahun Tomas , Lynch Julia , Bouhenia Malika , Worku Demlie Yeshambel , Hussen Mukemil , Wossen Mesfin , Teferi Mekonnen , Park Se Eun
Published: July 2024

Background

Cholera outbreaks in Ethiopia necessitate frequent mass oral cholera vaccine (OCV) campaigns. Despite this, there is a notable absence of a comprehensive summary of these campaigns. Understanding national OCV vaccination history is essential to design appropriate and effective cholera control strategies. Here, we aimed to retrospectively review all OCV vaccination campaigns conducted across Ethiopia between 2019 and 2023.

Methods

The OCV request records from 2019 to October 2023 and vaccination campaign reports for the period from 2019 to December 2023 were retrospectively accessed from the Ethiopia Public Health Institute (EPHI) database. Descriptive analysis was conducted using the retrospective data collected.

Results

From 2019 to October 2023, Ethiopian government requested 32 044 576 OCV doses (31 899 576 doses to global stockpile; 145 000 doses to outside of stockpile). Around 66.3% of requested doses were approved; of which 90.4% were received. Fifteen OCV campaigns (12 reactive and 3 pre-emptive) were conducted, including five two-dose campaigns with varying dose intervals and single-dose campaigns partially in 2019 and entirely in 2021, 2022 and 2023. Overall vaccine administrative coverage was high; except for Tigray region (41.8% in the 1st round; 2nd round didn't occur). The vaccine administrative coverage records were documented, but no OCV coverage survey data was available.

Conclusions

This study represents the first comprehensive review of OCV campaigns in Ethiopia spanning the last five years. Its findings offer valuable insights into informing future cholera control strategies, underscoring the importance of monitoring and evaluation despite resource constraints. Addressing the limitations in coverage survey data availability is crucial for enhancing the efficacy of future campaigns.
Ethiopia National Cholera Elimination Plan 2022–2028: Experiences, Challenges, and the Way Forward
Authors: Hussen Mukemil , Worku Demlie Yeshambel , Edosa Moti , Kebede Mandefro , Wossen Mesfin , Mulugeta Chane Azeb , Abate Girma , Hailu Asfaw Wondosen , Hailu Dejene , Teferi Mekonnen , Jeon Yeonji , Gedefaw Abel , Park Se Eun
Published: July 2024

Cholera remains a significant public health concern in Ethiopia. More than 15.9 million Ethiopians, constituting 15% of the total population, live in areas with a history of recurrent cholera outbreaks. The last 9 years of national cholera surveillance data show the country has been experiencing cholera outbreaks every year. The current cholera outbreak, starting in August 2022, has affected the entire country, with 841 reported cases and a 3.13% case fatality rate (CFR) in 2022, and >30 000 cases with nearly a 1.4% CFR in 2023. In line with “Ending Cholera—A Global Roadmap to 2030,” the government of Ethiopia is committed to eliminate cholera in the country and has prepared its “National Cholera Elimination Plan (NCP): 2022–2028” with aims to achieve zero local transmission in cholera hotspot areas by 2028 and 90% fatality reduction from the recent (2020–2022) average of 1.8% CFR. The plan is multisectoral, has a clear coordination platform, contains all interventions with in-depth situational analysis, is concordant with existing plans and strategies, and is cascaded at the regional level and implemented with existing government and public structures. Nationwide, total 118 cholera hotspot woredas (districts) were identified, and a comprehensive situation analysis of the existing cholera outbreak response capacity was assessed. This multisectoral and multiyear NCP has forecasted around US$404 million budget estimates with >90% allocated to improving the country's water, sanitation, and hygiene (US$222 million; 55% of total NCP budget) and case management (US$149 million; 37%). The cholera vaccination strategy included in the NCP exhibited a 5-year oral cholera vaccine (OCV) introduction plan with 2 doses (30 604 889 doses) and single dose (3 031 266 doses) in selected cholera hotspot areas. However, its implementation is challenged due to a lack of financial support, inability to get the requested vaccine for targeted hotspot woredas (due to the current shortage of doses in the OCV global stockpile), recurrent cholera outbreaks, and high humanitarian needs in the country. It is recommended to have a sustainable financial mechanism to support implementation, follow the requested vaccine doses, and reorganize the planned coordination platform to foster the implementation.
Dissecting Water, Sanitation, and Hygiene (WaSH) to Assess Risk Factors for Cholera in Shashemene, Oromia Region, Ethiopia
Authors: Hailu Dejene , Jeon Yeonji , Gedefaw Abel , Kim Jong-Hoon , Mraidi Ramzi , Getahun Tomas , Mogeni Ondari D , Mesfin Getachew Edlawit , Jang Geun Hyeog , Mukasa David , Pak Gi Deok , Kim Deok Ryun , Ayele Abebe Samuyel , Yeshitela Biruk , Edosa Moti , Worku Demlie Yeshambel , Park Se Eun , Teferi Mekonnen
Published: July 2024

Background

Cholera outbreaks have afflicted Ethiopia, with nearly 100 000 cases and 1030 deaths reported from 2015 to 2023, emphasizing the critical need to understand water, sanitation, and hygiene (WaSH) risk factors.

Methods

We conducted a cross-sectional household (HH) survey among 870 HHs in Shashemene Town and Shashemene Woreda, alongside extracting retrospective cholera case data from the Ethiopian Public Health Institute database. Relationships between WaSH and sociodemographic/economic-levels of HHs were examined. WaSH status and cholera attack rates (ARs) were described at kebele-level using geospatial mapping, and their association was statistically analyzed.

Results

Access to basic drinking water, sanitation, and hygiene facilities was limited, with 67.5% (95% confidence interval, 64.4–70.6), 73.4% (70.3–76.3), and 30.3% (27.3–33.3) of HHs having access, respectively. Better WaSH practices were associated with urban residence (adjusted odds ratio, 1.7, [95% confidence interval, 1.1–2.7]), higher educational levels (2.7 [1.2–5.8]), and wealth (2.5 [1.6–4.0]). The association between cholera ARs and at least basic WaSH status was not statistically significant (multiple R2 = 0.13; P = .36), although localized effects were suggested for sanitation (Moran I = 0.22; P = .024).

Conclusions

Addressing gaps in WaSH access and hygiene practices is crucial for reducing cholera risk. Further analyses with meaningful covariates and increased sample sizes are necessary to understand the association between cholera AR and specific WaSH components.
Obesity Is Associated With Increased Pediatric Dengue Virus Infection and Disease: A 9-Year Cohort Study in Managua, Nicaragua
Authors: Mercado-Hernandez Reinaldo , Myers Rachel , Bustos Carillo Fausto Andres , Zambrana José Victor , López Brenda , Sanchez Nery , Gordon Aubree , Balmaseda Angel , Kuan Guillermina , Harris Eva
Published: July 2024

Background

Obesity is on the rise globally in adults and children, including in tropical areas where diseases such as dengue have a substantial burden, particularly in children. Obesity impacts risk of severe dengue disease; however, the impact on dengue virus (DENV) infection and dengue cases remains an open question.

Methods

We used 9 years of data from 5940 children in the Pediatric Dengue Cohort Study in Nicaragua to determine whether pediatric obesity is associated with increased susceptibility to DENV infection and symptomatic presentation. Analysis was performed using generalized estimating equations adjusted for age, sex, and preinfection DENV antibody titers.

Results

From 2011 to 2019, children contributed 26 273 person-years of observation, and we observed an increase in prevalence of overweight (from 12% to 17%) and obesity (from 7% to 13%). There were 1682 DENV infections and 476 dengue cases in the study population. Compared with participants with normal weight, participants with obesity had higher odds of DENV infection (adjusted odds ratio [aOR], 1.21; 95% confidence interval [CI]: 1.03–1.42) and higher odds of dengue in DENV-infected individuals (aOR, 1.59; 95% CI: 1.15–2.19). Children with obesity infected with DENV showed increased odds of presenting fever (aOR, 1.46; 95% CI: 1.05–2.02), headache (aOR, 1.51; 95% CI: 1.07–2.14), and rash (aOR, 2.26; 95% CI: 1.49–3.44) when compared with children with normal weight.

Conclusions

Our results indicate that obesity is associated with increased susceptibility to DENV infection and dengue cases in children, independent of age, sex, and preinfection DENV antibody titers.
Clip opening while locked after transcatheter edge-to-edge mitral valve repair with different onset times: a case series
Authors: Matsuzoe Hiroki , Mizutani Kazuki , Onishi Naoko Soejima , Yoshida Ayano , Kawamura Takayuki , Ueno Masafumi , Sakaguchi Genichi , Nakazawa Gaku
Published: July 2024

Background

Transcatheter edge-to-edge mitral valve repair is now available in many countries and has achieved favourable therapeutic outcomes. However, there have been no reported cases of clip opening while locked (COWL) during the acute phase using the MitraClip G4 system (Abbott, Abbott Park, IL, USA).

Case summary

We present two cases of COWL occurring at different phases: one immediately after clip release and the other 2 days post-procedure. In both cases, the initial treatment involved the use of the XTW system. Subsequently, an additional XT system was deployed for the deterioration of mitral regurgitation caused by COWL, without any complications.

Discussion

The MitraClip G4 system offers four size variations, providing a larger grasping area and increased flexibility for accessing complex lesions. Furthermore, the complication rate decreased with increasing operator experience and device generation. However, it has been reported that COWL can occur after the clip is deployed during TEER. Although the mechanism of COWL is unclear, the nature and mobility of the valve leaflets and the product specificity of the MitraClip may be involved.
Machine learning-based prediction of 1-year all-cause mortality in patients undergoing CRT implantation: validation of the SEMMELWEIS-CRT score in the European CRT Survey I dataset
Authors: Tokodi Márton , Kosztin Annamária , Kovács Attila , Gellér László , Schwertner Walter Richard , Veres Boglárka , Behon Anett , Lober Christiane , Bogale Nigussie , Linde Cecilia , Normand Camilla , Dickstein Kenneth , Merkely Béla
Published: July 2024

Aims

We aimed to externally validate the SEMMELWEIS-CRT score for predicting 1-year all-cause mortality in the European Cardiac Resynchronization Therapy (CRT) Survey I dataset—a large multi-centre cohort of patients undergoing CRT implantation.

Methods and results

The SEMMELWEIS-CRT score is a machine learning-based tool trained for predicting all-cause mortality in patients undergoing CRT implantation. This tool demonstrated impressive performance during internal validation but has not yet been validated externally. To this end, we applied it to the data of 1367 patients from the European CRT Survey I dataset. The SEMMELWEIS-CRT predicted 1-year mortality with an area under the receiver operating characteristic curve (AUC) of 0.729 (0.682–0.776), which concurred with the performance measured during internal validation [AUC: 0.768 (0.674–0.861), P = 0.466]. Moreover, the SEMMELWEIS-CRT score outperformed multiple conventional statistics-based risk scores, and we demonstrated that a higher predicted probability is not only associated with a higher risk of death [odds ratio (OR): 1.081 (1.061–1.101), P < 0.001] but also with an increased risk of hospitalizations for any cause [OR: 1.013 (1.002–1.025), P = 0.020] or for heart failure [OR: 1.033 (1.015–1.052), P < 0.001], a less than 5% improvement in left ventricular ejection fraction [OR: 1.033 (1.021–1.047), P < 0.001], and lack of improvement in New York Heart Association functional class compared with baseline [OR: 1.018 (1.006–1.029), P = 0.003].

Conclusion

In the European CRT Survey I dataset, the SEMMELWEIS-CRT score predicted 1-year all-cause mortality with good discriminatory power, which confirms the generalizability and demonstrates the potential clinical utility of this machine learning-based risk stratification tool.
Design and rationale of the Engage-HF study: the impact of a gamified engagement toolkit on participation and engagement in a heart failure registry
Authors: Shakoor Abdul , Mohansingh Chanu , El Osrouti Azzeddine , Borleffs Jan Willem C , van Houwelingen Gert K , van de Swaluw Julio E C , van Kimmenade Roland , den Besten Marjolein , Pisters Ron , van Ofwegen-Hanekamp Clara E E , Koudstaal Stefan , Handoko Louis M , Asselbergs Folkert W , van Veghel Dennis , van Wijk Sandra S , van der Boon Robert M A , Brugts Jasper J , Schaap Jeroen
Published: July 2024

Aims

Heart failure (HF) registries provide valuable insights into patient management and quality of care. However, healthcare professionals face challenges due to the administrative burden of participation in registries. This study aims to evaluate the impact of education through an engagement toolkit on HF nurse practitioners’ participation rate and data completeness in a national registry: the Netherlands Heart Registration-Heart Failure (NHR-HF) registry.

Methods and results

Engage-HF is an observational study (intervention at the HF nurse level) with a pretest–posttest design within the participating hospitals. Between December 2022 and April 2024, 28 HF nurse practitioners from 12 hospitals will participate in a 24-week educational programme using the Engage-HF engagement toolkit. The main interaction platform in this toolkit is a gamified smartphone-based educational application called BrightBirds. The complete toolkit includes this educational application with weekly challenges, interactive posters, pop-ups, and alert messages, and a follow-up call at Week 4. The primary endpoints are the NHR-HF participation rates and data completeness at 1 and 6 months after using the toolkit. Additionally, we will analyse the experience of participants with the toolkit concerning their HF registry and knowledge of ESC 2021 HF guidelines.

Conclusion

The Engage-HF study is the first to explore the impact of education through a gamified engagement toolkit to boost participation rates in a HF registry (NHR-HF) and test participant knowledge of the ESC 2021 HF guidelines. This innovative approach addresses challenges in the rollout of healthcare registries and the implementation of guidelines by providing a contemporary support base and a time-efficient method for education.
Influence of multiple risk factor control level on cardiovascular outcomes in hypertensive patients
Authors: Peng Xinyi , Zhuang Miaomiao , Song Qirui , Bai Jingjing , Cai Jun
Published: July 2024

Aims

The relationship between the level of baseline risk factor control and cardiovascular outcomes in hypertensive patients with blood pressure interventions is not well understood. It is also unclear whether the level of baseline risk factor control is persuasively associated with cardiovascular outcomes in hypertensive patients with a blood pressure lowering strategy.

Method and results

We performed an analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Participants without complete baseline risk factor data were excluded. The primary outcome was a composite of cardiovascular events and all-cause mortality. Cox proportional hazard models were used to calculate the hazard ratio (HR) and estimate the association between risk factor control levels (≥6, 5, 4, and ≤3) and cardiovascular outcomes. A total of 8337 participants were involved in the analysis, and the median follow-up period was 3.19 years. Each additional risk factor uncontrolled was associated with a 24% higher cardiovascular risk (HR 1.24, 95% CI 1.11–1.37). Compared with participants with optimal risk factor control, those with ≤3 factors control exhibited 95% higher cardiovascular risk (HR 1.95, 95% CI 1.37–2.77). The corresponding protective effects of multiple risk factor modification were not influenced by intensive or standard antihypertensive treatment (P for interaction = 0.71).

Conclusion

A stepwise association was observed between cardiovascular risk and the number of risk factor control in hypertensive patients. The more risk factors were modified, the less cardiovascular risk was observed, irrespective of different blood pressure lowering strategies. Comprehensive risk factor control strategies are warranted to reduce cardiovascular disease risk in hypertensive patients.
The Caenorhabditis elegans cuticle and precuticle: a model for studying dynamic apical extracellular matrices in vivo
Authors: Sundaram Meera V , Pujol Nathalie
Published: July 2024

Apical extracellular matrices (aECMs) coat the exposed surfaces of animal bodies to shape tissues, influence social interactions, and protect against pathogens and other environmental challenges. In the nematode Caenorhabditis elegans, collagenous cuticle and zona pellucida protein-rich precuticle aECMs alternately coat external epithelia across the molt cycle and play many important roles in the worm's development, behavior, and physiology. Both these types of aECMs contain many matrix proteins related to those in vertebrates, as well as some that are nematode-specific. Extensive differences observed among tissues and life stages demonstrate that aECMs are a major feature of epithelial cell identity. In addition to forming discrete layers, some cuticle components assemble into complex substructures such as ridges, furrows, and nanoscale pillars. The epidermis and cuticle are mechanically linked, allowing the epidermis to sense cuticle damage and induce protective innate immune and stress responses. The C. elegans model, with its optical transparency, facilitates the study of aECM cell biology and structure/function relationships and all the myriad ways by which aECM can influence an organism.
Deciphering the Biological Aging Impact on Alveolar Bone Loss: Insights From α-Klotho and Renal Function Dynamics
Authors: Wang Zifei , Xue Hao , Sun Yuqiang , Wang Qing , Sun Wansu , Zhang Hengguo
Published: July 2024

Alveolar bone loss is generally considered a chronological age-related disease. As biological aging process is not absolutely determined by increasing age, whether alveolar bone loss is associated with increasing chronological age or biological aging remains unclear. Accurately distinguishing whether alveolar bone loss is chronological age-related or biological aging-related is critical for selecting appropriate clinical treatments. This study aimed to identify the relationship between alveolar bone loss and body aging. In total, 3 635 participants from the National Health and Nutrition Examination Survey and 71 living kidney transplant recipients from Gene Expression Omnibus Datasets were enrolled. Multivariate regression analysis, smooth curve fittings, and generalized additive models were used to explore the association among alveolar bone loss, age, serum α-Klotho level, renal function markers, as well as between preoperative creatinine and renal cortex-related α-Klotho gene expression level. Meanwhile, a 2-sample Mendelian randomization (MR) study was conducted to assess the causal relationship between α-Klotho and periodontal disease (4 376 individuals vs 361 194 individuals). As a biological aging-related indicator, the α-Klotho level was negatively correlated with impaired renal function and alveolar bone loss. Correspondingly, accompanied by decreasing renal function, it was manifested with a downregulated expression level of α-Klotho in the renal cortex and aggravated alveolar bone loss. The MR analysis further identified the negative association between higher genetically predicted α-Klotho concentrations with alveolar bone loss susceptibility using the IVW (odds ratio [OR] = 0.999, p = .005). However, an inversely U-shaped association was observed between chronological age and alveolar bone loss, which is especially stable in men (the optimal cutoff values were both 62 years old). For men above 62 years old, increasing age is converted to protective factor and is accompanied by alleviated alveolar bone loss. Alveolar bone loss that is directly associated with decreased renal function and α-Klotho level was related to biological aging rather than chronological age. The renal–alveolar bone axis could provide a new sight of clinical therapy in alveolar bone loss.
Quality of life improvement from thoracoscopic atrial fibrillation ablation in women versus men: a prospective cohort study
Authors: Vos Lara M , Vos Rein , Nieuwkerk Pythia T , Vos Peter-Paul W K , Hofman Frederik N , Klautz Robert J M , Van Putte Bart P
Published: July 2024

OBJECTIVES

Thoracoscopic ablation has proven to be an effective and safe rhythm control strategy, especially for persistent atrial fibrillation. However, its impact on quality of life (QoL) and potential gender differences remains unclear.

METHODS

This prospective, single-centre observational study included consecutive patients with symptomatic atrial fibrillation undergoing thoracoscopic ablation. QoL was measured using the Short Form 36 (SF-36) and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaires and longitudinal trend analysis including linear mixed models was used to assess gender-specific differences.

RESULTS

A total of 191 patients were included; mean age 63.9 ± 8.6 years, 61 (31.9%) women and 148 (77.5%) with non-paroxysmal atrial fibrillation. Women were older, more symptomatic and reported lower baseline QoL. AFEQT summary scores substantially improved after three months (relative increase 51.5% from baseline; P < 0.001) and persisted up to 1-year (57.2%; P < 0.001). Women showed substantial QoL improvement, which was comparable to men at 1 year. Distinct gender-related trajectories for AFEQT were observed. Women showed more often clinically important decline over time, yet AF recurrence and age were predictive factors in both men and women. Patients with AF recurrence also experienced QoL improvements, albeit to a lesser extent than those in sinus rhythm (61.3% vs 26.9%, P < 0.001), with no differences between men and women.

CONCLUSIONS

Thoracoscopic ablation for atrial fibrillation results in substantial QoL improvement and was comparable for men and women. Understanding sex-specific and age-related trajectories is important to further enhance patient-centred atrial fibrillation care.
Thrombocytopenia in Severe Fever with Thrombocytopenia Syndrome Due to Platelets With Altered Function Undergoing Cell Death Pathways
Authors: Fang Yaohui , Shen Shu , Zhang Jingyuan , Xu Ling , Wang Tong , Fan Lei , Zhu Qiong , Xiao Jian , Wu Xiaoli , Jin Jiayin , Wu Qiaoli , Zhang Yanfang , Tang Shuang , Zheng Xin , Deng Fei
Published: July 2024

Background

Thrombocytopenia is the major clinical feature of severe fever with thrombocytopenia syndrome (SFTS), but the mechanism by which it occurs remains unclear.

Methods

RNA transcriptome analyses were performed on platelets purified from patients with SFTS and mice infected with SFTS virus (SFTSV). The functions of differentially expressed genes (DEGs) in the platelets were characterized. Enzyme-linked immunosorbent assay, flow cytometry, and quantitative reverse-transcription polymerase chain reaction were used to measure the levels of platelet activation, SFTSV infection in platelets, formation of neutrophil extracellular traps, transcription of DEGs, and the percentage of platelets undergoing cell death.

Results

Enhanced neutrophil activation and interferon signaling involved in the viral life cycle were common platelet responses in SFTS, which may consume increasing numbers of platelets. Other functional changes may be associated with different outcomes of SFTS. SFTSV infection led to platelet destruction by pyroptosis, apoptosis, necroptosis, and autophagy. Platelets in SFTSV-infected mice mainly play a role in adaptive immunity, and platelet death was not as severe as in humans.

Conclusions

The altered functions of platelets, including mediating leukocyte activation and undergoing cell death, contribute to thrombocytopenia in patients with SFTS. The different mechanisms of thrombocytopenia in mice suggest that platelet functions should be considered in experimental animal models.
Marine particle size-fractionation indicates organic matter is processed by differing microbial communities on depth-specific particles
Authors: Comstock Jacqueline , Henderson Lillian C , Close Hilary G , Liu Shuting , Vergin Kevin , Worden Alexandra Z , Wittmers Fabian , Halewood Elisa , Giovannoni Stephen , Carlson Craig A
Published: July 2024

Passive sinking flux of particulate organic matter in the ocean plays a central role in the biological carbon pump and carbon export to the ocean’s interior. Particle-associated microbes colonize particulate organic matter, producing “hotspots” of microbial activity. We evaluated variation in particle-associated microbial communities to 500 m depth across four different particle size fractions (0.2–1.2, 1.2–5, 5–20, >20 μm) collected using in situ pumps at the Bermuda Atlantic Time-series Study site. In situ pump collections capture both sinking and suspended particles, complementing previous studies using sediment or gel traps, which capture only sinking particles. Additionally, the diagenetic state of size-fractionated particles was examined using isotopic signatures alongside microbial analysis. Our findings emphasize that different particle sizes contain distinctive microbial communities, and each size category experiences a similar degree of change in communities over depth, contradicting previous findings. The robust patterns observed in this study suggest that particle residence times may be long relative to microbial succession rates, indicating that many of the particles collected in this study may be slow sinking or neutrally buoyant. Alternatively, rapid community succession on sinking particles could explain the change between depths. Complementary isotopic analysis of particles revealed significant differences in composition between particles of different sizes and depths, indicative of organic particle transformation by microbial hydrolysis and metazoan grazing. Our results couple observed patterns in microbial communities with the diagenetic state of associated organic matter and highlight unique successional patterns in varying particle sizes across depth.
Molecular epidemiology of carbapenemase encoding genes in A. baumannii-calcoaceticus complex infections in children: a systematic review
Authors: Chávez Rodríguez Mariana , Mascareñas De Los Santos Abiel Homero , Vaquera Aparicio Denisse Natalie , Aguayo Samaniego Rebeca , García Pérez Rodrigo , Siller-Rodríguez Daniel , Rosales-González Sara Paulina , Castillo-Morales Patricia Lizeth , Castillo Bejarano José Iván
Published: July 2024

Background

Acinetobacter baumannii-calcoaeticus complex is the leader pathogen for the World Health Organization’s list due to the escalating prevalence of multidrug-resistant strains. Insights into the molecular characterization of carbapenemase genes in A. baumannii-calcoaceticus complex infections among children are scarce. To address this gap, we conducted a systematic review to describe the molecular epidemiology of the carbapenemase genes in A. baumannii-calcoaceticus complex infections in the pediatric population.

Methods

Adhering to the PRISMA 2020 guidelines for reporting systematic reviews, we conducted a review of in chore bibliographic databases published in English and Spanish, between January 2020 and December 2022. All studies conducted in patients ≤6 years with molecular characterization of carbapenemase-encoding genes in A. baumannii-calcoaceticus infections were included.

Results

In total, 1129 cases were reviewed, with an overall carbapenem-resistance rate of 60.3%. A. baumannii-calcoaceticus was isolated from blood cultures in 66.6% of cases. Regionally, the Eastern Mediterranean exhibited the highest prevalence of carbapenem resistance (88.3%). Regarding the carbapenemase genes, blaKPC displayed an overall prevalence of 1.2%, while class B blaNDM had a prevalence of 10.9%. Class D blaOXA-23-like reported a prevalence of 64%, blaOXA-48 and blaOXA-40 had a prevalence of 33% and 18.1%, respectively. Notably, the Americas region showed a prevalence of blaOXA-23-like at 91.6%.

Conclusion

Our work highlights the high prevalence of carbapenem-resistant A. baumannii-calcoaceticus and class D carbapenemase genes in children. Of note the distribution of different carbapenemase genes reveals considerable variations across WHO regions. To enhance epidemiological understanding, further extensive studies in children are imperative.
Culturable yeast community associated with grape must and honey bees sampled from apiaries located in the vineyards
Authors: Siesto Gabriella , Pietrafesa Rocchina , Alberico Grazia , Tedesco Francesco , Cardinale Massimiliano , Romano Patrizia , Capece Angela
Published: July 2024

Aim

In this study, we investigated culturable yeast community, present in grape must sampled from vineyards with apiaries on the borders, and in honey bees collected in these apiaries.

Methods and results

To this aim, yeasts isolated from spontaneously fermented grapes randomly collected in two vineyards (P1 and P2) with apiaries on the borders (A1 and A2) were compared to those isolated from spontaneously fermented grapes collected from a vineyard without apiary (P4). At the same time, yeast community was analyzed on bees collected in each apiary placed in the vineyards, in comparison to yeasts isolated from an apiary (A3) located far from the vineyards. The analysis was performed for two consecutive years (2021 and 2022). The isolated yeasts were identified by restriction analysis of amplified ITS region, followed by sequencing of ITS fragment.

Our research showed that the presence of apiaries seems to increase yeast counts of grape must, in particular of Saccharomyces cerevisiae; furthermore, the permanence of apiaries in the vineyards allowed the recovering of these yeasts also from bees.

Conclusions

Our findings seem to corroborate the role of bees as vectors and reservoirs of oenologically relevant yeasts, such as a source of non-conventional yeasts with potential biotechnological applications.
Identification of mechanisms modulating chlorhexidine and octenidine susceptibility inProteus mirabilis
Authors: Pelling Harriet , Bennett Vicky , Bock Lucy J , Wand Matthew E , Denham Emma L , MacFarlane Wendy M , Sutton J Mark , Jones Brian V
Published: July 2024

Aims

We aimed to identify mechanisms underlying the tolerance of Proteus mirabilis—a common cause of catheter associated urinary tract infection—to the clinically used biocides chlorhexidine (CHD) and octenidine (OCT).

Methods and results

We adapted three clinical isolates to grow at concentrations of 512 µg ml−1 CHD and 128 µg ml−1 OCT. Genetic characterization and complementation studies revealed mutations inactivating the smvR repressor and increasing smvA efflux expression were associated with adaptation to both biocides. Mutations in mipA (encoding the MltA interacting protein) were less prevalent than smvR mutations and only identified in CHD adapted populations. Mutations in the rppA response regulator were exclusive to one adapted isolate and were linked with reduced polymyxin B susceptibility and a predicted gain of function after biocide adaptation. Biocide adaptation had no impact on crystalline biofilm formation.

Conclusions

SmvR inactivation is a key mechanism in both CHD and OCT tolerance. MipA inactivation alone confers moderate protection against CHD, and rppA showed no direct role in either CHD or OCT susceptibility.
Evaluation of the capacity and effective angle of thalamic damage for 2 commercially available captive bolt tool types on cadaver heads from sows >200 kg body weight
Authors: Anderson Karly N , Woiwode Ruth , Kirk Ashlynn A , Berger Jennifer , Reyes Arquimides A , Zhitnitskiy Perle E , Vogel Kurt D
Published: July 2024

This study evaluated the ability of 2 penetrating captive bolt (PCB) types (PISTOL, INLINE) to reach and disrupt the thalamus when applied in 2 placements (FRONTAL, BEHIND EAR) to chilled cadaver heads (N = 60) from sows >200 kg. Heads were randomly distributed across 6 treatments (n = 10): FRONTAL-INLINE, FRONTAL-PISTOL, FRONTAL-NO SHOT, BEHIND EAR-INLINE, BEHIND EAR-PISTOL, and BEHIND EAR-NO SHOT. The FRONTAL shot was placed 3.5 cm superior to the optic orbits at the midline; the BEHIND EAR shot was placed directly caudal to the pinna of the ear on the same plane as the eyes and targeting the middle of the opposite eye. For INLINE treatments, a Jarvis PAS—Type C 0.25R Super Heavy Duty PCB with a Long Bolt and 6.0 GR power loads was used. For PISTOL treatments, a Jarvis PAS—Type P 0.25R Pistol PCB with a Long Stunning Rod Nosepiece Assembly and 3.5 GR power loads was used. Heads were split along the bolt with a band saw. Tissue depth measurements are reported as Mean ± SE followed by 97.5% one-sided upper reference limit (URL). Total tissue thickness was less (P < 0.0001) at the FRONTAL (56.31 ± 1.76 mm; URL: 73.17 mm) than the BEHIND EAR placement (95.52 ± 3.30 mm; URL: 126.53 mm). Thalamic depth was less (P < 0.0001) at the FRONTAL (78.31 ± 1.32 mm; URL: 88.19 mm) than the BEHIND EAR placement (111.86 ± 3.22 mm; URL: 135.99 mm). The effective angle was greater (P < 0.0001) at the FRONTAL (4.72 ± 0.20°) than the BEHIND EAR placement (3.22 ± 0.17°). Potential for bolt-brain contact was not different (P = 1.0000) between FRONTAL-INLINE (10/10, 100% ± 0.01%), FRONTAL-PISTOL (10/10, 100% ± 0.01%), BEHIND EAR-INLINE (9/10, 90% ± 9.49%), and BEHIND EAR-PISTOL (10/10, 100% ± 0.01%); brain damage (P = 0.5577) between FRONTAL-INLINE (9/9, 100% ± 0.02%), FRONTAL-PISTOL (10/10, 100% ± 0.02%), BEHIND EAR-INLINE (4/10, 40% ± 15.49%), and BEHIND EAR-PISTOL (1/10, 10% ± 9.49%); potential for bolt-thalamus contact (P = 0.0683) for FRONTAL-INLINE (2/10, 20% ± 12.65%), FRONTAL-PISTOL (8/10, 80% ± 12.65%), BEHIND EAR-INLINE (7/9, 77.78% ± 13.86%), and BEHIND EAR-PISTOL (9/9, 100% ± 0.02%); or thalamic damage (P = 0.8041) for FRONTAL-INLINE (1/10, 10% ± 9.49%), FRONTAL-PISTOL (1/10, 10% ± 9.49%), BEHIND EAR-INLINE (2/8, 25% ± 15.31%), and BEHIND EAR-PISTOL (0/9, 0% ± 0.00%). The FRONTAL placement with an INLINE PCB may present the least risk of failure for the PCB euthanasia of mature sows >200 kg body weight due to less total tissue thickness and thalamic depth, greater effective angle, and prevalent brain damage.
In Search of the Prototype of Forced Marriage
Authors: Quackelbeen Ligeia
Published: July 2024

This article discusses the categorization of the phenomenon of bush wives as forced marriage under the residual category of other inhumane acts in the Ongwen case. It reveals how judges at the International Criminal Court have used an Aristotelian Approach to characterization which entailed them to examine, on the basis of a jurisprudentially established checklist, whether the bush wives phenomenon shares the properties of the crime category of other inhumane acts. By discussing the forced marriage practices through an ‘other inhumane acts’ categorization, this article reveals the limits and pitfalls of the Aristotelian Approach. The main problem is that the Aristotelian Approach fails to grasp that categorization does not merely work on the basis of a checklist logic but also is a culturally determined process in which cultural prototypes need to be examined. This article’s main proposition is to consider an alternative way of categorization drawing from the philosophy of language and social sciences and suggests judges adopt a Prototype Approach. This approach enables judges to move away from a generic way of labelling different fact patterns through a checklist of properties and take on a more tailor-made and culturally sensitive approach that involves categorization through the discussion of the similarity and distinctiveness of a certain fact pattern to a prototype. In this way, judges can diversify interpretation of the other inhumane acts category in light of local practices as it requires a fresh decision of the facts by engaging with cultural practices in a more sensitive way and examining whether this phenomenon entails prototypical marriage practices. In this way, prototype theory opens new pathways in terms of how we label cultural practices and how we use the residual category of other inhumane acts.
Diversity and relative abundance of immature mosquitoes (Diptera: Culicidae) in Hohenbergia catingae Ule bromeliads and larvitraps in the Nísia Floresta National Forest, northeast Brazil
Authors: da Silva José Hilário Tavares , Silva-Inacio Cássio Lázaro , Gama Renata Antonaci , Ximenes Maria de Fátima Freire de Melo
Published: July 2024

The Nísia Floresta National Forest, located in Rio Grande do Norte (RN), is an important remnant of the Atlantic Forest biome in Brazil. Bromeliad tanks in this forest offer suitable breeding sites for mosquito species that may act as viral vectors, thus posing an epidemiological concern. However, studies investigating the presence of immature Culicidae in natural breeding sites in RN have thus far been restricted to Caatinga vegetation. This study investigated mosquitoes and their natural breeding sites in bromeliads growing in the Nísia Floresta National Forest. From March 2013 to February 2014, monthly samples were collected from the tanks of five randomly selected bromeliads and larvitraps placed in each of the three forest management areas. Hohenbergia catingae Ule (Hohenbergia bromeliad) is an important shelter for immature mosquitoes. Culex (Microculex) was the predominant species, representing 86% of the immature mosquitoes collected. A rare occurrence of Aedes (Stegomyia) aegypti (Linnaeus, 1762) (generally associated with urban areas under high anthropogenic influence) was observed, highlighting the importance of investigating the presence of mosquitoes in different natural habitats. An analysis of species diversity revealed that species such as Culex imitator Theobald, 1903 and Culex davisi Kumm, 1933, have a strong association with bromeliads. In tire traps (larvitraps) Aedes (Stegomyia) albopictus Skuse, 1894 was predominant. Environmental changes, such as deforestation, removal of bromeliads, and climate change in the area, can influence the migration of species and adaptation to new habitats in a peridomiciliary environment around the forest, consequently the possibility of transmission of virus and other pathogens.
ERBB2 amplification in gastric cancer: a genomic insight into ethnic disparities
Authors: Mirza Muhammad Bilal , Choi Jungyoon , Marincola Smith Paula , Baechle Jordan J , Padmanabhan Chandrasekhar , Holowatyj Andreana N , Shah Shailja C , Guo Xingyi , Idrees Kamran
Published: July 2024

Overall, gastric adenocarcinoma (GC) incidence rates have declined in recent years, but racial and ethnic disparities persist. Individuals who identify as Hispanic/Spanish/Latino are diagnosed with GC at younger ages and have poorer outcomes than non-Hispanic individuals. However, our understanding of GC biology across racial/ethnic groups remains limited. We assessed tumor genomic patterns by race/ethnicity among 1019 patients with primary GC in the American Association for Cancer Research (AACR) Project GENIE Consortium. Hispanic individuals presented with significantly higher rates of ERBB2/HER2 amplification vs other racial/ethnic groups (Hispanic: 13.9% vs 9.8% non-Hispanic White, 8.1% non-Hispanic Asian, and 11.0% non-Hispanic Black; P < .001, FDR adjusted q < 0.001). Hispanic patients also had higher odds of an ERBB2 amplification vs non-Hispanic Whites in adjusted models (OR = 2.52, 95%CI = 1.20 to 5.33, P = .015). These findings underscore the important role of genomic factors in GC disparities. Ensuring equitable access to genomic profiling and targeted therapies, such as trastuzumab for HER2-overexpressing GC, is a promising avenue to mitigate GC disparities and improve outcomes.