bluuebunny/crossref_metadata_2025 huggingface dataset:
DNA fragility at topologically associated domain boundaries is promoted by alternative DNA secondary structure and topoisomerase II activity
Authors: Raimer Young Heather M , Hou Pei-Chi , Bartosik Anna R , Atkin Naomi D , Wang Lixin , Wang Zhenjia , Ratan Aakrosh , Zang Chongzhi , Wang Yuh-Hwa
Published: March 2024

CCCTC-binding factor (CTCF) binding sites are hotspots of genome instability. Although many factors have been associated with CTCF binding site fragility, no study has integrated all fragility-related factors to understand the mechanism(s) of how they work together. Using an unbiased, genome-wide approach, we found that DNA double-strand breaks (DSBs) are enriched at strong, but not weak, CTCF binding sites in five human cell types. Energetically favorable alternative DNA secondary structures underlie strong CTCF binding sites. These structures coincided with the location of topoisomerase II (TOP2) cleavage complex, suggesting that DNA secondary structure acts as a recognition sequence for TOP2 binding and cleavage at CTCF binding sites. Furthermore, CTCF knockdown significantly increased DSBs at strong CTCF binding sites and at CTCF sites that are located at topologically associated domain (TAD) boundaries. TAD boundary-associated CTCF sites that lost CTCF upon knockdown displayed increased DSBs when compared to the gained sites, and those lost sites are overrepresented with G-quadruplexes, suggesting that the structures act as boundary insulators in the absence of CTCF, and contribute to increased DSBs. These results model how alternative DNA secondary structures facilitate recruitment of TOP2 to CTCF binding sites, providing mechanistic insight into DNA fragility at CTCF binding sites.
Optical and soft X-ray light-curve analysis during the 2022 eruption of U Scorpii: Structural changes in the accretion disk
Authors: Muraoka Katsuki , Kojiguchi Naoto , Ito Junpei , Nogami Daisaku , Kato Taichi , Tampo Yusuke , Taguchi Kenta , Isogai Keisuke , Arranz Teofilo , Blackwell John , Blane David , Brincat Stephen M , Coates Graeme , Cooney Walter , Dvorak Shawn , Galdies Charles , Glomski Daniel , Hambsch Franz-Josef , Harris Barbara , Hodge John , Hernández-Verdejo Jose L , Iozzi Marco , Itoh Hiroshi , Kiyota Seiichiro , Lee Darrell , Larsson Magnus , Lahtinen Tapio , Myers Gordon , Monard Berto , Morales Aimar Mario , Moriyama Masayuki , Mizutani Masanori , Nagai Kazuo , AlQaissieh Thabet , Gabuya Aldrin B , Odeh Mohammad , Perello Carlos , Pearce Andrew , Miguel Perales Juan , Quiles David , Romanov Filipp D , Lane David J , Richmond Michael , Ruocco Nello , Sano Yasuo , Spearman Mark , Schmidt Richard , Vanmunster Tonny , Dubovsky Pavol A , Wagner Richard , Wollenhaupt Guido , Lorenz Joachim , Lehmann Gerhard , Salewski Andrea , Williamson Guy
Published: March 2024

We present our optical photometric observations of the 2022 eruption of the recurrent nova U Scorpii (U Sco) using 49152 data points over 70 d following the optical peak. We have also analyzed its soft X-ray (0.3–1 keV) light curve by the Neil Gehrels Swift Observatory. During the 2022 eruption, the optical plateau stage started 13.8–15.0 d and ended 23.8–25.0 d after the optical peak. The soft X-ray stage started 14.6–15.3 d and ended 38.7–39.5 d after the optical peak. Both stages started later and had shorter durations, and the soft X-ray light curve peaked earlier and was less luminous compared to those during the U Sco 2010 eruption. These points suggest that there were differences in the envelope mass between the different cycles of the nova eruption. Furthermore, we have analyzed the optical eclipses during the 2022 eruption. The primary eclipse was first observed 10.4–11.6 d after the optical peak, earlier than the beginning of the optical plateau stage. This sequence of events can be explained by the receding ejecta photosphere associated with the expanding nova ejecta. We have determined the ingress and egress phases of the primary eclipses and estimated the outer radius of the optical light source centered at the white dwarf (WD). During the optical plateau stage, the source radius remained ∼1.2 times larger than the Roche volume radius of the primary WD, being close to the L1 point. When the optical plateau stage ended, the source radius drastically shrank to the tidal truncation radius within a few orbital periods. This previously unresolved phenomenon can be interpreted as a structural change in U Sco where the temporarily expanded accretion disk due to the nova wind returned to a steady state.
A dominant negative mutation of GhMYB25-like alters cotton fiber initiation, reducing lint and fuzz
Authors: Zhao Guannan , Le Yu , Sun Mengling , Xu Jiawen , Qin Yuan , Men She , Ye Zhengxiu , Tan Haozhe , Hu Haiyan , You Jiaqi , Li Jianying , Jin Shuangxia , Wang Maojun , Zhang Xianlong , Lin Zhongxu , Tu Lili
Published: March 2024

Cotton (Gossypium hirsutum) fibers, vital natural textile materials, are single-cell trichomes that differentiate from the ovule epidermis. These fibers are categorized as lint (longer fibers useful for spinning) or fuzz (shorter, less useful fibers). Currently, developing cotton varieties with high lint yield but without fuzz remains challenging due to our limited knowledge of the molecular mechanisms underlying fiber initiation. This study presents the identification and characterization of a naturally occurring dominant negative mutation GhMYB25-like_AthapT, which results in a reduced lint and fuzzless phenotype. The GhMYB25-like_AthapT protein exerts its dominant negative effect by suppressing the activity of GhMYB25-like during lint and fuzz initiation. Intriguingly, the negative effect of GhMYB25-like_AthapT could be alleviated by high expression levels of GhMYB25-like. We also uncovered the role of GhMYB25-like in regulating the expression of key genes such as GhPDF2 (PROTODERMAL FACTOR 2), CYCD3; 1 (CYCLIN D3; 1), and PLD (Phospholipase D), establishing its significance as a pivotal transcription factor in fiber initiation. We identified other genes within this regulatory network, expanding our understanding of the determinants of fiber cell fate. These findings offer valuable insights for cotton breeding and contribute to our fundamental understanding of fiber development.
Cryogenic electron microscopy and tomography reveal imperfect icosahedral symmetry in alphaviruses
Authors: Chmielewski David , Su Guan-Chin , Kaelber Jason T , Pintilie Grigore D , Chen Muyuan , Jin Jing , Auguste Albert J , Chiu Wah
Published: March 2024

Alphaviruses are spherical, enveloped RNA viruses with two-layered icosahedral architecture. The structures of many alphaviruses have been studied using cryogenic electron microscopy (cryo-EM) reconstructions, which impose icosahedral symmetry on the viral particles. Using cryogenic electron tomography (cryo-ET), we revealed a polarized symmetry defect in the icosahedral lattice of Chikungunya virus (CHIKV) in situ, similar to the late budding particles, suggesting the inherent imperfect symmetry originates from the final pinch-off of assembled virions. We further demonstrated this imperfect symmetry is also present in in vitro purified CHIKV and Mayaro virus, another arthritogenic alphavirus. We employed a subparticle-based single-particle analysis protocol to circumvent the icosahedral imperfection and boosted the resolution of the structure of the CHIKV to ∼3 Å resolution, which revealed detailed molecular interactions between glycoprotein E1–E2 heterodimers in the transmembrane region and multiple lipid-like pocket factors located in a highly conserved hydrophobic pocket. This complementary use of in situ cryo-ET and single-particle cryo-EM approaches provides a more precise structural description of near-icosahedral viruses and valuable insights to guide the development of structure-based antiviral therapies against alphaviruses.
Blood Flow Restriction and Veterans With Multiple Sclerosis and Advanced Disability: Protocol for a Randomized Controlled Trial
Authors: Mañago Mark M , Will Robert , Strahler Talia , Van Valkenburgh Lauren , Harris-Love Michael O , Forster Jeri E , Cameron Michelle , Christiansen Cory L
Published: March 2024

Objective

The purpose of this study will be to determine the efficacy of low intensity lower extremity resistance training with and without blood flow restriction (BFR) on quadriceps muscle strength and thickness in veterans with advanced multiple sclerosis (MS).

Methods

This will be an assessor-blinded, 2-group (1 to 1 allocation) randomized controlled trial targeting an enrollment of 58 participants with advanced MS as defined by Patient-Determined Disease Steps scale levels 4 to 7. Both groups will complete 10 weeks of twice weekly low-load resistance training (20%–30% of 1-repetition max) targeting knee and hip extension, knee flexion, and ankle plantarflexion. The intervention group will perform all training using BFR, with limb occlusion pressures between 60% and 80% of maximal limb occlusion pressure. Primary outcomes will be quadriceps muscle strength and thickness. Secondary outcomes will include knee flexion and ankle plantarflexion strength, functional mobility, physical activity, and patient-reported measures. All outcomes will be assessed at baseline before the intervention, immediately after the intervention, and at a 2-month follow-up assessment. The change between groups postintervention and after the 2-month follow-up will be reported for all outcomes. All analyses will assume a 2-sided test of hypothesis (α = .05).

Impact

There is very little evidence for the efficacy of exercise interventions in people with MS who have advanced mobility disability. Resistance training with BFR may be an important approach for people with advanced MS who may not tolerate more conventional, moderate-to-high intensity resistance training. The results of this study will inform clinicians regarding exercise decisions for people with advanced MS and future investigations on the role of BFR in people with MS.
Working memory load impairs tacit coordination but not inter-brain EEG synchronization
Authors: Newman Lionel A , Cao Ming , Täuber Susanne , van Vugt Marieke
Published: March 2024

Coordinating actions with others is thought to require Theory of Mind (ToM): the ability to take perspective by attributing underlying intentions and beliefs to observed behavior. However, researchers have yet to establish a causal role for specific cognitive processes in coordinated action. Since working memory load impairs ToM in single-participant paradigms, we tested whether load manipulation affects two-person coordination. We used EEG to measure P3, an assessment of working memory encoding, as well as inter-brain synchronization (IBS), which is thought to capture mutual adjustment of behavior and mental states during coordinated action. In a computerized coordination task, dyads were presented with novel abstract images and tried selecting the same image, with selections shown at the end of each trial. High working memory load was implemented by a concurrent n-back task. Compared with a low-load control condition, high load significantly diminished coordination performance and P3 amplitude. A significant relationship between P3 and performance was found. Load did not affect IBS, nor did IBS affect performance. These findings suggest a causal role for working memory in two-person coordination, adding to a growing body of evidence challenging earlier claims that social alignment is domain-specific and does not require executive control in adults.
The pill you don’t have to take that is still effective: neural correlates of imaginary placebo intake for regulating disgust
Authors: Schienle Anne , Kogler Wolfgang , Seibel Arved , Wabnegger Albert
Published: March 2024

A commonly established protocol for the administration of open-label placebos (OLPs)—placebos honestly prescribed—emphasizes the necessity of ingesting the pill for the placebo effect to manifest. The current functional magnetic resonance imaging study used a novel approach to OLP administration: the imaginary intake of an OLP pill for regulating disgust. A total of 99 females were randomly allocated to one of three groups that either swallowed a placebo pill (OLP Pill), imagined the intake of a placebo pill (Imaginary Pill) or passively viewed (PV) repulsive and neutral images. The imaginary pill reduced reported disgust more effectively than the OLP pill and was also perceived as a more plausible method to reduce emotional distress. Relative to the OLP pill, the imaginary pill lowered neural activity in a region of interest involved in disgust processing: the pallidum. No significant differences in brain activation were found when comparing the OLP pill with PV. These findings highlight that imagining the intake of an OLP emerged as a superior method for regulating feelings of disgust compared to the actual ingestion of a placebo pill. The study’s innovative approach sheds new light on the potential of placebo interventions in emotion regulation.
How much does immigration contribute to national poverty rates? A decomposition analysis for 17 European welfare states
Authors: de Smalen David , Van Bavel Jan , Van Lancker Wim
Published: March 2024

Over the past decades, many European welfare states failed to reduce poverty. We examine two coinciding trends: the inability to lower poverty rates, and the growth of immigrant populations. Immigrants have become the main contributor to population growth in Europe and have higher poverty risks than natives. This contribution quantifies to what extent national poverty rates were driven by population change. We present a Kitagawa–Blinder–Oaxaca decomposition of national poverty rates in 17 western European countries between 2005 and 2019 using EU-SILC data. The effect of shifting EU and non-EU immigrant populations on poverty rates is heterogeneous: while poverty in some countries increased substantially due to compositional changes, for the majority the effect was small or negligible, including in countries with above-average growth of foreign-born populations. Overall, in two-thirds of country–years changes in the population composition were not the main driver of national poverty rates.
Structural Disadvantages to the Kin Network from Intergenerational Racial Health Inequities
Authors: Sohn Heeju
Published: March 2024

This article utilizes the Panel Study of Income Dynamics to demonstrate how disadvantages in healthy life expectancies accumulated across generations create disparate kin structures among African American families in the United States. The analysis quantifies the overlap in parents’ healthy years with their adult children’s healthy life expectancies and examines how much the overlap coincides with the adult children’s childrearing years. Non-Hispanic Black adults experienced parental illness and death sooner than non-Hispanic White adults, and their parents’ poor health coincided longer with their own health declines. Non-Hispanic White adults, on the other hand, enjoyed more years in good health with two healthy parents. The intergenerational accumulation of unequal healthy life expectancies directly translated into unequal kin structures for the subsequent third generation. Race inequities in the intergenerational kin structure and health were greater among women than among men, and non-Hispanic Black women spent the most years raising children in poor health with unhealthy or deceased parents. Disparities in the intergenerational tempos of fertility, mortality, and morbidity are building profound structural racial inequities within a fundamental social institution—the family.
Bilingual Law in Wales (and England): The Implications of Law Being Made in Two Languages
Authors: Hughes Dylan Mortimer
Published: March 2024

This article concerns bilingual legislation and focusses on the legal status of the Welsh language in Welsh legislation, an issue complicated by the confusing context of the single jurisdiction for England and Wales. It refers to analysis of the position undertaken by the Law Commission of England and Wales (which included comparative analysis of the position in Canada, in particular), and to recent consideration by the Court of Appeal (E&W) of the implications of the England and Welsh languages having equal status for all purposes. This has significant effects on practitioners and the courts, in both Wales and England.
Subjective or Objective Legislative Intention: An Australian/German Perspective
Authors: Meyer Stephan
Published: March 2024

‘Legislative intention’ as the aim of statutory interpretation has attracted increased attention in the Australian High Court, reinvigorating scholarly attention on the elusive concept. A subjective approach regards it as having an empirical reality. The competing objective view denies any conceptual connection to empirical circumstances and demotes it to a metaphor for the proper application of rules of statutory interpretation. This antagonism prevails in civil law jurisdictions as well. In Germany specifically, it goes back to the 1830s. The article juxtaposes the two local debates so as to mutually provide an additional perspective on the subject matter that can inspire future cross-system discourse. It highlights how similar arguments from both theoretical camps have formed in the two countries over time. And it not only documents striking similarities in how Australia’s and Germany’s highest courts declared commitment to an objective approach but it also reveals contrary curial trends that have most recently emerged.
Genome-Wide Association Study for Identification of Marker-Trait Associations Conferring Resistance to Scald from Globally Collected Barley Germplasm
Authors: Ijaz Usman , Zhao Chenchen , Shahbala Sergey , Zhou Meixue
Published: March 2024

Scald is one of the major economically important foliar diseases in barley, causing up to 40% yield loss in susceptible varieties. The identification of quantitative trait loci and elite alleles that confer resistance to scald is imperative in reducing the threats to barley production. In this study, genome-wide association studies were conducted using a panel of 697 barley genotypes to identify quantitative trait loci for scald resistance. Field experiments were conducted over three consecutive years. Among different models used for genome-wide association studies analysis, FarmCPU was shown to be the best-suited model. Nineteen significant marker-trait associations related to scald resistance were identified across six different chromosomes. Eleven of these marker-trait associations correspond to previously reported scald resistance genes Rrs1, Rrs4, and Rrs2, respectively. Eight novel marker-trait associations were identified in this study, with the candidate genes encoding a diverse class of proteins, including region leucine-rich repeats, AP2/ERF transcription factor, homeodomain-leucine zipper, and protein kinase family proteins. The combination of identified superior alleles significantly reduces disease severity scores. The results will be valuable for marker-assisted breeding for developing scald-resistant varieties.
Beet Soil-Borne Virus Is a Helper Virus for the Novel Beta vulgaris Satellite Virus 1A
Authors: Weiland John J. , Wyatt Nathan , Camelo Viviana , Spanner Rebecca E. , Hladky Laura Jenkins , Ramachandran Vanitharani , Secor Gary A. , Martin Frank N. , Wintermantel William M. , Bolton Melvin D.
Published: March 2024

Sugar beet ( Beta vulgaris) is grown in temperate regions around the world as a source of sucrose used for natural sweetening. Sugar beet is susceptible to a number of viral diseases, but identification of the causal agent(s) under field conditions is often difficult due to mixtures of viruses that may be responsible for disease symptoms. In this study, the application of RNAseq to RNA extracted from diseased sugar beet roots obtained from the field and from greenhouse-reared plants grown in soil infested with the virus disease rhizomania (causal agent beet necrotic yellow vein virus; BNYVV) yielded genome-length sequences from BNYVV, as well as beet soil-borne virus (BSBV). The nucleotide identities of the derived consensus sequence of BSBV RNAs ranged from 99.4 to 96.7% (RNA1), 99.3 to 95.3% (RNA2), and 98.3 to 95.9% (RNA3) compared with published BSBV sequences. Based on the BSBV genome consensus sequence, clones of the genomic RNAs 1, 2, and 3 were obtained to produce RNA copies of the genome through in vitro transcription. Capped RNA produced from the clones was infectious when inoculated into leaves of Chenopodium quinoa and B. vulgaris, and extracts from transcript-infected C. quinoa leaves could infect sugar beet seedling roots through a vortex inoculation method. Subsequent exposure of these infected sugar beet seedling roots to aviruliferous Polymyxa betae, the protist vector of both BNYVV and BSBV, confirmed that BSBV derived from the infectious clones could be transmitted by the vector. Co-inoculation of BSBV synthetic transcripts with transcripts of a cloned putative satellite virus designated Beta vulgaris satellite virus 1A (BvSat1A) resulted in the production of lesions on leaves of C. quinoa similar to those produced by inoculation with BSBV alone. Nevertheless, accumulation of genomic RNA and the encoded protein of the satellite virus in co-inoculated leaves was readily detected on Northern and Western blots, respectively, whereas no accumulation of satellite virus products occurred when satellite virus RNA was inoculated alone. The predicted sequence of the detected protein encoded by BvSat1A bears hallmarks of coat proteins of other satellite viruses, and virions of a size consistent with a satellite virus were observed in samples testing positive for the virus. The results demonstrate that BSBV is a helper virus for the novel satellite virus BvSat1A.
Contemporary Management and Outcomes of Veterans Hospitalized With Alcohol Withdrawal: A Multicenter Retrospective Cohort Study
Authors: Ronan Matthew V. , Gordon Kirsha S. , Skanderson Melissa , Krug Michael , Godwin Patrick , Heppe Daniel , Hoegh Matthew , Boggan Joel C. , Gutierrez Jeydith , Kaboli Peter , Pescetto Micah , Guidry Michelle , Caldwell Peter , Mitchell Christine , Ehlers Erik , Allaudeen Nazima , Cyr Jessica , Smeraglio Andrea , Yarbrough Peter , Rose Richard , Jagannath Anand , Vargas Jaclyn , Cornia Paul B. , Shah Meghna , Tuck Matthew , Arundel Cherinne , Laudate James , Elzweig Joel , Rodwin Benjamin , Akwe Joyce , Trubitt Meredith , Gunderson Craig G.
Published: March 2024

Objectives

Few studies describe contemporary alcohol withdrawal management in hospitalized settings or review current practices considering the guidelines by the American Society of Addiction Medicine (ASAM).

Methods

We conducted a retrospective cohort study of patients hospitalized with alcohol withdrawal on medical or surgical wards in 19 Veteran Health Administration (VHA) hospitals between October 1, 2018, and September 30, 2019. Demographic and comorbidity data were obtained from the Veteran Health Administration Corporate Data Warehouse. Inpatient management and hospital outcomes were obtained by chart review. Factors associated with treatment duration and complicated withdrawal were examined.

Results

Of the 594 patients included in this study, 51% were managed with symptom-triggered therapy alone, 26% with fixed dose plus symptom-triggered therapy, 10% with front loading regimens plus symptom-triggered therapy, and 3% with fixed dose alone. The most common medication given was lorazepam (87%) followed by chlordiazepoxide (33%), diazepam (14%), and phenobarbital (6%). Symptom-triggered therapy alone (relative risk [RR], 0.68; 95% confidence interval [CI], 0.57–0.80) and front loading with symptom-triggered therapy (RR, 0.75; 95% CI, 0.62–0.92) were associated with reduced treatment duration. Lorazepam (RR, 1.20; 95% CI, 1.02–1.41) and phenobarbital (RR, 1.28; 95% CI, 1.06–1.54) were associated with increased treatment duration. Lorazepam (adjusted odds ratio, 4.30; 95% CI, 1.05–17.63) and phenobarbital (adjusted odds ratio, 6.51; 95% CI, 2.08–20.40) were also associated with complicated withdrawal.

Conclusions

Overall, our results support guidelines by the ASAM to manage patients with long-acting benzodiazepines using symptom-triggered therapy. Health care systems that are using shorter acting benzodiazepines and fixed-dose regimens should consider updating alcohol withdrawal management pathways to follow ASAM recommendations.
Exploring the Relationship Between Age at Nap Cessation and Social-Emotional Functioning in Children
Authors: Loeffler Anna , Rankin Peter , Smith Simon S. , Thorpe Karen , Staton Sally
Published: March 2024

Objective:

The objective of this study was to examine variations in age at nap cessation and identify whether there is an association with social-emotional functioning (SEF) as measured by internalizing/externalizing behavior, child temperament, and social skills in a sample of early childhood education and care–attending children.

Methods:

The sample comprised 1117 children from the Australian Effectiveness Early Educational Experiences for Children longitudinal early childhood study. We used children's age at nap cessation as retrospectively recalled by caregivers in 2011 or 2013 when children were between ages 2 and 7 years. Each child's SEF was reported by a caregiver using the Strengths and Difficulties Questionnaire, the Short Temperament Scale for Children, and the Social Skills Inventory Scale. Associations between children's age of nap cessation and SEF were tested using linear regressions.

Results:

The children's age at nap cessation ranged from 6 months to 6 years. For each additional year of napping, children's total, conduct, externalizing, and peer behavior problems decreased by 0.39 (95% confidence interval [CI], −0.70 to −0.09), 0.11 (95% CI, −0.21 to −0.01), 0.11 (95% CI, −0.51 to −0.06), and 0.11 (95% CI, −0.20 to −0.02) units on the Strengths and Difficulties Questionnaire scale, respectively. No further significant associations were found.

Conclusion:

This is the first study reporting the age range of nap cessation and its associations with social-emotional functioning. Our findings demonstrate earlier cessation ages in Australian children attending Early Childhood Education and Care programs than previously reported and a small association with externalizing and peer problems.
A Systematic Review on Treatment Outcomes of Striae
Authors: Zhu Catherine Keying , Mija Lorena Alexandra , Koulmi Kaouthar , Barankin Benjamin , Mukovozov Ilya
Published: March 2024

BACKGROUND

Striae are fine lines on the body that occur following rapid skin stretching (i.e., following pregnancy, puberty, weight change). The aim of this systematic review was to assess the current literature on treatment outcomes associated with striae.

OBJECTIVE

(1) To assess the efficacy and safety of different treatment options reported for striae and (2) to determine the most efficient treatment options for each subtype of striae.

METHODS

A systematic search was performed on MEDLINE, Embase, and PubMed with no publication date or language restrictions. All articles with original data and treatment outcomes were included.

RESULTS

One hundred fifty-one studies on the treatment of striae met inclusion criteria (83% female, mean age at diagnosis = 30.2), and 4,806 treatment outcomes of striae were described. Energy-based devices were the most reported modality (56%; n = 2,699/4,806), followed by topicals (19%; n = 919/4,806) and combinations (12%; n = 567/4,806). The highest rates of complete response were injection-based devices for striae distensae (7%; n = 12/172), CO2 lasers for striae alba (4%; n = 12/341), and platelet-rich plasma injections for striae rubra (31%; n = 4/13).

CONCLUSION

Treatment options for striae are varied, likely indicating a lack of effective treatments due to the diversity in striae subtypes. Improved outcomes in striae management may be achieved with additional research on factors that predict treatment response.
Spatiotemporal light exposure modeling for environmental circadian misalignment and solar jetlag
Authors: VoPham Trang , Ton Mimi , Weaver Matthew D.
Published: March 2024

Background:

Light exposure is the most powerful resetting signal for circadian rhythms. The objective of this study was to develop and validate a high-resolution geospatial light exposure model that measures environmental circadian misalignment (or solar jetlag) as the mismatch between the social clock and sun clock, which occurs from geographic variation in light exposure leading to delayed circadian phase from relatively less morning light exposure and greater evening light exposure with increasing westward position within a time zone.

Methods:

The light exposure model (30 m2 spatial resolution) incorporated geospatial data across the United States on time zones, elevation (using Google Earth Engine), sunrise time, and sunset time to estimate solar jetlag scores (higher values indicate higher environmental circadian misalignment). The validation study compared the light exposure model in 2022, which was linked with geocoded residential addresses of n = 20 participants in Boston, MA (eastern time zone position) and Seattle, WA (western time zone position) using a geographic information system, with illuminance values captured from wearable LYS light sensors and with sun times from the Solar Calculator.

Results:

Western versus eastern positions within a time zone were associated with higher solar jetlag scores from the light exposure model (P < 0.01) and relatively larger differences in sunset time measured using light sensors (social clock) and the Solar Calculator (sun clock) (P = 0.04).

Conclusion:

We developed and validated a geospatial light exposure model, enabling high spatiotemporal resolution and comprehensive characterization of geographic variation in light exposure potentially impacting circadian phase in epidemiologic studies.
Comparing the diagnostic adequacy of 25-Gauge fork-tip versus franseen versus reverse-bevel-type needles in EUS–guided tissue acquisition: A prospective randomized study with a retrospective control
Authors: Haig Adam , John Andrew St , Vaska Kasturi , Banh Xuan , Huelsen Alexander
Published: March 2024

Background and Objectives

EUS–guided fine-needle biopsy (FNB) is an established technique for the acquisition of tissue to diagnose lesions of the gastrointestinal tract and surrounding organs. Recently, newer-generation FNB needles have been introduced, including a second-generation reverse-bevel and the third-generation fork-tip and Franseen needles. We aimed to determine if there was any difference between these needles in terms of cytopathological diagnostic yield, sample cellularity, or sample bloodiness.

Methods

One hundred twenty-seven consecutive patients undergoing EUS–guided FNB of any solid lesion were randomized to use either a Franseen or fork-tip needle in a 1:1 ratio and were compared with 60 consecutive historical cases performed with reverse-bevel needles. Patient and procedure characteristics were recorded. Cases were reviewed by a blinded cytopathologist and graded based on cellularity and bloodiness. Overall diagnostic yield was calculated for each study arm.

Results

One hundred seventy-six cases were eligible for analysis, including 109 pancreatic masses, 24 lymphoid lesions, 17 subepithelial lesions, and 26 other lesions. The final diagnosis was malignancy in 127 cases (72%). EUS–guided FNB was diagnostic in 141 cases (80%) overall and in 89% of cases where malignancy was the final diagnosis. There was no difference in diagnostic yield, sample cellularity, or sample bloodiness between the different needle types. There was no difference in adverse events between groups.

Conclusions

EUS–guided FNB performed using 25-gauge Franseen, fork-tip, and reverse-bevel needles resulted in similar diagnostic yield, sample cellularity, and sample bloodiness. Our results may not be extrapolated to larger-caliber needles of the same design.
First-In-Man Trial of β3-Adrenoceptor Agonist Treatment in Chronic Heart Failure: Impact on Diastolic Function
Authors: Bahrami Hashmat Sayed Zohori , Hasselbalch Rasmus Bo , Søholm Helle , Thomsen Jakob Hartvig , Sørgaard Mathias , Kofoed Klaus Fuglsang , Valeur Nana , Boesgaard Søren , Fry Natasha Alexandria Sarah , Møller Jacob Eifer , Raja Anna Axelsson , Køber Lars , Iversen Kasper , Rasmussen Helge , Bundgaard Henning
Published: March 2024

Diastolic dysfunction (DD) in heart failure is associated with increased myocardial cytosolic calcium and calcium-efflux through the sodium–calcium exchanger depends on the sodium gradient. Beta-3-adrenoceptor (β3-AR) agonists lower cytosolic sodium and have reversed organ congestion. Accordingly, β3-AR agonists might improve diastolic function, which we aimed to assess. In a first-in-man, randomized, double-blinded trial, we assigned 70 patients with HF with reduced ejection fraction, New York Heart Association II-III, and left ventricular ejection fraction <40% to receive the β3-AR agonist mirabegron (300 mg/day) or placebo for 6 months, in addition to recommended heart failure therapy. We performed echocardiography and cardiac computed tomography and measured N-terminal probrain natriuretic peptide at baseline and follow-up. DD was graded per multiple renowned algorithms. Baseline and follow-up data were available in 57 patients (59 ± 11 years, 88% male, 49% ischemic heart disease). No clinically significant changes in diastolic measurements were found within or between the groups by echocardiography (E/e′ placebo: 13 ± 7 to 13 ± 5, P = 0.21 vs. mirabegron: 12 ± 6 to 13 ± 8, P = 0.74, between-group follow-up difference 0.2 [95% CI, −3 to 4], P = 0.89) or cardiac computed tomography (left atrial volume index: between-group follow-up difference 9 mL/m2 [95% CI, −3 to 19], P = 0.15). DD gradings did not change within or between the groups following 2 algorithms (P = 0.72, P = 0.75). N-terminal probrain natriuretic peptide remained unchanged in both the groups (P = 0.74, P = 0.64). In patients with HF with reduced ejection fraction, no changes were identified in diastolic measurements, gradings or biomarker after β3-AR stimulation compared with placebo. The findings add to the previous literature questioning the role of impaired Na+-Ca2+–mediated calcium export as a major culprit in DD. NCT01876433.
A Practical Guide to Understanding and Treating Peripheral Artery Disease
Authors: Chilbert Maya R. , Woodruff Ashley E. , Rogers Kelly C.
Published: March 2024

Peripheral arterial disease (PAD) is the third leading cause of atherosclerotic morbidity after coronary heart disease and stroke yet is widely underdiagnosed and undertreated. Treatment of risk factors such as diabetes and cigarette smoking can benefit patients with PAD. Patients should have adequate blood pressure and lipid control to decrease clinical manifestations and symptoms of PAD. Use of antithrombotic medications should be individualized to the patient depending on the presence of symptoms, revascularization, and comorbidities. All patient care providers, including physicians, pharmacists, nurse practitioners, and physician assistants, should incorporate PAD screening in their at-risk patients to improve access for appropriate earlier diagnosis, initiation of guideline directed therapy, and risk factor modification to reduce both major adverse CV and limb outcomes. The purpose of this narrative review is to provide an overview of PAD and summarize clinical trial evidence and guideline recommendations for screening and treatment to increase awareness among health care providers to ultimately have a positive impact on patient care.
Clinical Trials That Have Changed Clinical Practice and Care of Pregnant People With HIV
Authors: Fisher Stephanie A. , Madden Nigel , Espinal Mariana , Garcia Patricia M. , Jao Jennifer K. , Yee Lynn M.
Published: March 2024

Over the last 4 decades, significant advances in the care of HIV during pregnancy have successfully reduced, and nearly eliminated, the risk of perinatal HIV transmission. The baseline risk of transmission without intervention (25% to 30%) is now <1% to 2% in the United States with contemporary antepartum, intrapartum, and postnatal interventions. In this review, we discuss 3 landmark clinical trials that substantially altered obstetric practice for pregnant individuals with HIV and contributed to this extraordinary achievement: 1) the Pediatric AIDS Clinical Trials Group 076 Trial determined that antepartum and intrapartum administration of antiretroviral drug zidovudine to the pregnant individual, and postnatally to the newborn, could reduce the risk of perinatal transmission by approximately two-thirds; 2) the European Mode of Delivery Collaboration Trial demonstrated performance of a prelabor cesarean birth before rupture of membranes among pregnant people with viremia reduced the risk of perinatal transmission compared with vaginal birth; and 3) the International Maternal Pediatric Adolescent AIDS Clinical Trials Network 2010 Trial identified that dolutegravir-containing, compared with efavirenz-containing, antiretroviral regimens during pregnancy achieved a significantly higher rate of viral suppression at delivery with shorter time to viral suppression, with fewer adverse pregnancy outcomes. Collectively, these trials not only advanced obstetric practice but also advanced scientific understanding of the timing, mechanisms, and determinants of perinatal HIV transmission. For each trial, we will describe key aspects of the study protocol and outcomes, insights gleaned about the dynamics of perinatal transmission, how each study changed clinical practice, and relevant updates to current practice since the trial’s publication.
Associations Among Social Jet Lag, Sleep-Related Characteristics, and Burnout of Nurses in Tertiary Hospitals
Authors: Shen Yingjie , Zhao Mingli , Wei Ning , Zhao Wenya , Han Mengdan , Dai Shuangshuang , Wang Xue , Li Li , Zhang Xiaojing
Published: March 2024

To investigate the status of social jet lag (SJL) through sociodemographic factors among clinical nurses and examine the correlation with burnout. There has been relatively little research on the possible factors resulting in SJL among nurses in China and its role in burnout. A multicenter cross-sectional study recruited 596 nurses from 7 Chinese hospitals. Online questionnaires were delivered to assess sociodemographics, shift work, SJL, chronotypes, and the burnout of nurses. Nurses had severe levels of SJL. The number of children, forms of employment, specialty area, length of professional service, and chronotypes were the main predictors of SJL. Moreover, SJL affected burnout (emotional exhaustion and deindividuation), and reducing the nurses' SJL could relieve their burnout. Additional evidence-based interventions indicate that reducing the SJL is essential as the nurses are suffering severe job burnout.
Localized Myositis and Transient Encephalopathy as Presenting Symptoms in Murine Typhus
Authors: Mehta Malvi , Marek Rachel , Arthur Ciji , Starke Jeffrey , Dutta Ankhi
Published: March 2024

Murine typhus in the pediatric population has increased substantially in recent years. The most common clinical presentation of murine typhus includes fever, rash, headaches and myalgias. Murine typhus presenting with predominant myositis and/or encephalopathy is rare. It is important to recognize unusual clinical manifestations of murine typhus in children for early diagnosis and treatment.
The predictive value of systemic immune-inflammation index for long-term cardiovascular mortality in non-ST segment elevation myocardial infarction
Authors: Yaşan Mustafa , Özel Ramime , Yildiz Abdulkadir , Savaş Göktuğ , Korkmaz Ahmet
Published: March 2024

Background

Increased levels of inflammatory markers have been found in association with the severity of coronary atherosclerosis. Systemic immuneinflammation index (SII), which is calculated by multiplying neutrophil and platelet counts and then dividing the result by the lymphocyte count, can also be used as a prognostic indicator in different cardiovascular diseases. In this study, we investigated SII levels and long-term mortality of patients with non-ST segment elevation myocardial infarction (NSTEMI).

Methods

This is an observational, single-center study. Two hundred-eight patients who underwent coronary angiography for NSTEMI were included in the study. Patients were divided into 3 tertiles based on SII levels. We researched the relationship between level level and 1, 3 and 5 years mortality (NSTEMI).

Results

One-year mortality of the patients was significantly higher among patients in the upper SII tertile when compared with the lower and middle SII tertile groups [11 (15.9%) vs. 2 (2.9%) and 6 (8.7%); P = 0.008, P = 0.195, respectively). Three-year mortality of the patients was significantly higher among patients in the upper SII tertile when compared with the lower and middle SII tertile groups [21 (30.4%) vs. 5 (7.1%) and 12 (17.4%); P < 0.001, P = 0.072, respectively). Five-year mortality of the patients was significantly higher among patients in the upper SII tertile when compared with the lower and middle SII tertile groups [26 (37.7%) vs. 8 (11.4%) and 15 (21.7%); P < 0.001, P = 0.040, respectively).

Conclusion

Our study showed that NSTEMI patients with higher SII had worse long-term mortality.
Intravascular ultrasound-guided percutaneous coronary intervention for patients with unprotected left main coronary artery lesions
Authors: Bendary Ahmed , Elsaed Ahmed , Tabl Mohamed Abdelshafy , Ahmed ElRabat Khaled , Zarif Bassem
Published: March 2024

Background

In percutaneous coronary intervention (PCI) procedures for patients with unprotected left main coronary artery (ULMCA) lesions, intravascular ultrasonography (IVUS) guidance has shown potential for enhancing clinical outcomes. However, studies confirming its superiority to conventional angiographic-guided PCI remain few. This study aimed to assess if IVUS-guided PCI for patients with unprotected LMCA stenosis improves clinical outcomes compared to angiographic-guided PCI.

Methods

This randomized clinical study enrolled 181 patients with ULMCA lesions scheduled for drug-eluting stent implantation. Patients were split into 90 in the IVUS-guided group and 91 in the conventional group. Procedural characteristics, clinical outcomes, and the incidence of major adverse cardiovascular event (MACE) were evaluated for all patients. The risk reduction associated with IVUS-guided PCI was evaluated using a multivariate Cox regression analysis.

Results

Patients who underwent IVUS demonstrated significantly higher pre-dilatation before stenting (88.9% vs. 72.5%, P = 0.005), post-dilatation balloon diameter (4.46 ± 0.48 vs. 4.21 ± 0.49, P < 0.001), stent diameter (3.9 ± 0.4 vs. 3.7 ± 0.3, P = 0.002), and pressure for post dilatation (18 ± 3 vs. 16 ± 2, P = 0.001). Regarding 12-month outcomes, patients who underwent IVUS demonstrated significantly lower MACE (3.3% vs. 18.7%, P < 0.001) than those who underwent the conventional method. Multivariate Cox regression analysis revealed that IVUS was related to 84.4% risk reduction of 1-year MACE (HR = 0.156, 95% CI = 0.044–0.556, P = 0.004).

Conclusion

Compared to angiographic-guided PCI, IVUS-guided PCI resulted in improved clinical results and a markedly reduced risk of MACE in patients with ULMCA lesions.
Prognostic factors for tracheostomy early decannulation in acquired brain injury patients
Authors: Lee Jong Hwa , Kim Sang Beom , Lee Kyeong Woo , Kim Soo Hwan
Published: March 2024

After severe brain injuries, a tracheostomy tube is usually inserted for respiratory support. This study aimed to clarify the prognostic factors for tracheostomy early decannulation in patients with acquired brain injuries. We retrospectively reviewed the medical records of inpatients with acquired brain injuries who underwent successful tracheostomy decannulation between March 2021 and June 2022. Fifty-six patients were included; median age was 68 (59–72) years; 28 (50%) were men; 28 (50%) underwent tracheostomy due to stroke. The median time to decannulation was 47 days. The patients were divided into the early and the late decannulation groups based on the median time, and compared. In univariate analysis, the early decannulation group had a higher BMI, peak cough flow, and acquired brain injuries due to trauma, and a lower penetration-aspiration scale score, duration of antibiotic use, and duration of oxygen use. Multivariate Cox regression analysis revealed that a higher initial peak cough flow [hazard ratio (HR) 1.142; 95% confidence interval (CI) 0.912–0.954; P < 0.001] and lower duration of oxygen use (HR 0.930; 95% CI 0.502–0.864; P = 0.016) were independent factors for early tracheostomy decannulation, with each unit increase in peak cough flow corresponding to a 14.2% increase and each additional day of duration of oxygen use corresponding to a 7.0% decrease in the likelihood of early decannulation. In conclusion, key prognostic factors for early tracheostomy decannulation were identified as the initial cough strength and duration of oxygen use. These results could play important role in decannulation plans for patients with tracheostomy tube.
Comparison of Nausea and Vomiting Incidence After Laparoscopic Cholecystectomy With Pretreatment With Haloperidol and Ondansetron: A Randomization Clinical Trial Study
Authors: Karami Ali , Ramadani Elisa , Banifatemi Mahsa , Asmarian Naeimehossadat , Fattahi Saravi Zeinabsadat
Published: March 2024

Objective:

Nausea and vomiting after surgery are the most common complications. Therefore, we performed this study to compare the effect of ondansetron and haloperidol on nausea and vomiting after laparoscopic cholecystectomy.

Patients and Methods:

In this randomized clinical trial, 60 patients candidates for elective laparoscopic cholecystectomy were allocated to haloperidol (0.05 mg/kg, n = 30) and ondansetron (0.15 mg/kg, n = 30) groups. An Ocular Analog Scale was used to assess postoperative nausea and vomiting. Every 15 minutes in the recovery room, heart rate and blood pressure were measured up to 6 hours after surgery. In addition, patient satisfaction was assessed postoperatively.

Results:

Haloperidol and ondansetron have the same effect on postoperative nausea and vomiting in the recovery room and ward. It was found that the trend of Visual Analog Scale variable changes in the recovery room was similar in the haloperidol and ondansetron group (P = 0.58); it was also true for the ward (P = 0.79). Comparing the length of stay in a recovery room in the 2 groups was not statistically significant (P = 0.19). In addition, the 2 groups did not differ in satisfaction postoperatively (P = 0.82).

Conclusion:

Haloperidol and ondansetron had an equal effect on reducing nausea and vomiting in the recovery room and ward after laparoscopic cholecystectomy. Patient satisfaction and length of stay in the recovery room did not differ between groups.