bluuebunny/crossref_metadata_2025 huggingface dataset:
LncRNA expression analysis by comparative transcriptomics among closely related poplars and their regulatory roles in response to salt stress
Authors: Li Guiting , Chen Qingyuan , Bai Qiuxian , Feng Yannan , Mao Kaili , Yang Mengran , He Ling , Liu Meijun , Liu Jianquan , Wan Dongshi
Published: April 2023

Long noncoding ribonucleic acids (lncRNAs) play crucial roles in regulating key biological processes; however, our knowledge of lncRNAs’ roles in plant adaptive evolution is still limited. Here, we determined the divergence of conserved lncRNAs in closely related poplar species that were either tolerant or sensitive to salt stress by comparative transcriptome analysis. Among the 34,363 identified lncRNAs, ~3% were shared among poplar species with conserved sequences but diversified in their function, copy number, originating genomic region and expression patterns. Further cluster analysis revealed that the conserved lncRNAs showed more similar expression patterns within salt-tolerant poplars (Populus euphratica and P. pruinosa) than between salt-tolerant and salt-sensitive poplars. Among these lncRNAs, the antisense lncRNA lncERF024 was induced by salt and the differentiated expression between salt-sensitive and salt-tolerant poplars. The overexpression of lncERF024 in P. alba var. pyramidalis enhanced poplar tolerance to salt stress. Furthermore, RNA pull-down and RNA-seq analysis showed that numerous candidate genes or proteins associated with stress response and photosynthesis might be involved in salt resistance in PeulncERF024-OE poplars. Altogether, our study provided a novel insight into how the diversification of lncRNA expression contributes to plant adaptation traits and showed that lncERF024 may be involved in the regulation of both gene expression and protein function conferring salt tolerance in Populus.
Femoral lengthening using limb reconstruction system augmented with only one antegrade flexible nail in children: early results
Authors: Danisman Murat , Bakircioglu Sancar , Tuncay Ozan , Yilmaz Guney
Published: April 2023

Several techniques have been described for decreasing the duration of external fixator use, augmenting stability, and minimizing complications. The purpose of the present study was to evaluate the clinical results and complications of femoral lengthening procedures using the Limb Reconstruction System (LRS) in combination with a single antegrade flexible intramedullary nail (FIN). Femoral lengthening with LRS and FIN was applied to 14 patients (aged 6–16 years) between 2017 and 2021. The etiology was a congenital femoral deficiency in 12 patients and post-traumatic growth arrest in two. A single nail was inserted antegradely through the trochanteric apophysis in each patient. Radiographs and medical records of the patients were assessed retrospectively. The mean lengthening achieved was 4.8 ± 1.0 cm. The mean duration of external fixation was 181 days (range 139–248 days) and the mean healing index was 39.6 ± 12.1 days/cm. The mean values of mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, mechanical lateral proximal femoral angle, and mechanical lateral distal femoral angle were within the normal range at the last follow-up. Seven of the 14 cases had a regenerate deformity that caused a displacement of more than 2 mm in the mechanical axis deviation, none of them was greater than 10 mm and considered clinically insignificant. Fracture was seen in two limbs with regenerate deformity. This study suggests that LRS in combination with only one FIN may be an effective alternative for femoral lengthening, with acceptable complication rates.
Treatment of proximal tibial buckle fractures: removable knee immobilizer versus long leg cast
Authors: Rohrback Mitchell , Wagner Kurt J. , Abdelaziz Abed , Kaufman Brian E. , Souder Christopher D. , Ellington Matthew D.
Published: April 2023

The purpose of this study was to compare outcomes and management of patients with buckle fractures of the proximal tibia treated with either a knee immobilizer or a long leg cast (LLC). A retrospective review was performed of pediatric patients with a buckle fracture of the proximal tibia over a 5-year period. Two cohorts were included, those treated with a LLC versus a removable knee immobilizer. Data collected included immobilization type, fracture laterality, length of immobilization, number of clinic visits, fracture displacement, and complications. Differences in complications and management between the cohorts were evaluated. In total, 224 patients met inclusion criteria (58% female, mean age 3.1 years ± 1.7 years). Of these patients, 187 patients (83.5%) were treated with a LLC. No patients in either group were found to have interval fracture displacement during treatment. Seven patients (3.1%) demonstrated skin complications, all in the LLC cohort. Mean length of immobilization was shorter for those treated in a knee immobilizer at 25.9 days versus 27.9 days for the LLC cohort (P = 0.024). Total number of clinic visits was also less at 2.2 (SD ± 0.4 days) for the knee immobilizer and 2.6 (SD ± 0.7 days) for the LLC (P = 0.001) cohorts. Pediatric patients with proximal tibial buckle fractures can be safely managed with a knee immobilizer. This treatment method is associated with a shorter duration of immobilization and fewer clinic visits without incidence of fracture displacement. In addition, knee immobilizers can lessen skin issues associated with cast immobilization and cast-related office visits. This is a Level III evidence, retrospective comparative study.
Effect of Angiotensin Receptor Blocker Dose in Myocardial Infarction With Preserved Left Ventricular Systolic Function
Authors: Kim Hee-Yeol , Mok Jisu , Kim Jae-Young , Jeon Doosoo , Her Sung-Ho , Park Mahn Won , Kim Dong-Bin , Park Chul-Su , Lee Jong-Min , Chang Kiyuk , Jung Wook Sung , Ahn Yongkeun
Published: April 2023

There have been few studies of angiotensin receptor blocker (ARB) dose in myocardial infarction (MI) with preserved left ventricular (LV) systolic function. We evaluated the association of ARB dose with clinical outcomes after MI with preserved LV systolic function. We used MI multicenter registry. Six months after discharge, the ARB dose was indexed to the target ARB doses used in randomized clinical trials and grouped as >0%–25% (n = 2333), >25% of the target dose (n = 1204), and no ARB (n = 1263). The primary outcome was the composite of cardiac death or MI. Univariate analysis showed that mortality of those with any ARB dose was lower than those without ARB therapy. After multivariable adjustment, patients receiving >25% of target dose had a similar risk of cardiac death or MI compared with those receiving ≤25% or no ARB [hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.83–1.33; HR 0.94, 95% CI 0.82–1.08, respectively]. Propensity score analysis also demonstrated that patients with >25% dose had no difference in primary endpoint compared with those ≤25% dose or the no ARB group (HR 1.03, 95% CI 0.79–1.33; HR 0.86, 95% CI 0.64–1.14, respectively). The present study demonstrates that patients treated with >25% of target ARB dose do not have better clinical outcomes than those treated with ≤25% of target ARB dose or those with no ARB dose in MI patients with preserved LV systolic function.
Is Plastic Surgery Training Equitable? An Analysis of Health Equity across US Plastic Surgery Residency Programs
Authors: Cevallos Priscila , Amakiri Uchechukwu O. , Johnstone Thomas , Kim Trudy Sea-Eun , Maheta Bhagvat , Nazerali Rahim , Sheckter Clifford
Published: April 2023

Background:

Achieving health equity includes training surgeons in environments exemplifying access, treatment, and outcomes across the racial, ethnic, and socioeconomic spectrum. Increased attention on health equity has generated metrics comparing hospitals. To establish the quality of health equity in plastic and reconstructive surgery (PRS) residency training, we determined the mean equity score (MES) across training hospitals of US PRS residencies.

Methods:

The 2021 Lown Institute Hospital Index database was merged with affiliated training hospitals of US integrated PRS residency programs. The Lown equity category is composed of three domains (community benefit, inclusivity, pay equity) generating a health equity grade. MES (standard deviation) was calculated and reported for residency programs (higher MES represented greater health equity). Linear regression modeled the effects of a program’s number of training hospitals, safety net hospitals, and geographical region on MES.

Results:

The MES was 2.64 (0.62). An estimated 5.9% of programs had an MES between 1–2. In total, 56.5% of programs had an MES between 2 and 3, and 37.7% had an MES of 3 or more. The southern region was associated with a higher MES compared with the reference group (Northeast) (P = 0.03). The number of safety net hospitals per program was associated with higher MES (P = 0.02).

Conclusions:

Two out of three programs train residents in facilities failing to demonstrate high equity healthcare. Programs should promote health equity by diversifying care delivery through affiliated hospitals. This will aid in the creation of a PRS workforce trained to provide care for a socioeconomically, racially, and ethnically diverse population.
Expanding Indications of the Medial Femoral Condyle Free Flap: Systematic Review in Head and Neck Reconstruction
Authors: Patel Niki K. , Tipps John A. , Bartlett Scott P. , Kovach Stephen J. , Levin L. Scott , Mendenhall Shaun D.
Published: April 2023

Background:

The medial femoral condyle free flap serves as an attractive reconstructive option for small- to intermediate-sized bony defects. It is commonly applied in the extremities with limited reports in the head and neck.

Methods:

A systematic review of the literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results:

Seventeen articles met inclusion criteria, yielding 166 cases for analysis, with a majority of the cohort from a single study (n = 107; 64.4%). However, all included studies represented novel reconstructive sites and surgical indications. Flap components were described in 157 cases; periosteum was used only in four cases (2.5%), whereas all others are composed of cortical bone combined with periosteum, cancellous bone, and/or cartilage (97.5%). Additionally, a skin island was used in 43 cases (25.9%). Flap measurements were reported in 51 cases, averaging 4.5 ± 2.7 cm in length. Seven cases listed skin island dimensions, averaging 20.2 ± 12.8 cm2. The descending genicular artery was the primary pedicle employed (n = 162; 97.6%), while the superior medial genicular was used in the descending genicular artery’s absence (n = 4; 2.4%). Descending genicular artery pedicle length from 15 reporting cases averaged 6.4 ± 1.2 cm. Successful reconstructions totaled 160 cases (96.4%). Recipient complications were seen in 16 cases (9.6%) with six constituting flap failures (3.6%). Donor site complications were minimal (n = 6; 3.6%); however, this included one major complication of femoral shaft fracture.

Conclusion:

The medial femoral condyle free flap is an effective reconstructive option for the head and neck due to its versatile nature, low complication profile at both recipient and donor site, ease of harvest, and two-team approach.
HIV and hypertension epidemiology
Authors: De Anda-Duran Ileana , Kimbrough Alexander D. , Bazzano Lydia A.
Published: April 2023

Purpose of review

The aim of this study was to provide an overview of the burden, pathogenesis, and recent recommendations for treating hypertension among people living with HIV (PLWH). This review is relevant because of the increase in the prevalence of HIV as a chronic disease and the intersection of the increasing prevalence of hypertension.

Recent findings

The contribution of HIV to the pathogenesis of hypertension is complex and still incompletely understood. Evidence suggests that chronic inflammation from HIV, antiretroviral treatment (ART), and comorbidities such as renal disease and insulin resistance contribute to developing hypertension in PLWH. Treatment is not distinct from guidelines for HIV-noninfected people. Nonpharmacological guidelines such as decreasing blood pressure by promoting a healthy lifestyle emphasizing exercise, weight loss, and smoking cessation are still recommended in the literature. The pharmacological management of hypertension in PLWH is similar, but special attention must be given to specific drugs with potential interaction with ART regimens. Further research is needed to investigate the pathways and effects of hypertension on HIV.

There are different pathways to the pathogenesis of hypertension in PLWH. Clinicians should take it into consideration to provide more precise management of hypertension in PLWH. Further research into the subject is still required.
Hypertension severity, apparent treatment resistant hypertension and hyperuricemia in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study
Authors: Tanner Rikki M. , Chaudary Ninad , Colantonio Lisandro D. , Merriman Tony R. , Reynolds Richard J. , Bridges S. Louis , Cushman Mary , Saag Kenneth , Limdi Nita , Muntner Paul , Howard George , Irvin M. Ryan
Published: April 2023

Background:

Prior studies have identified an association between hypertension and hyperuricemia; however, there has been limited research on the association between hypertension severity and hyperuricemia.

Method:

We studied 997 Black and white adults with serum urate data from the reasons for geographic and racial differences in stroke (REGARDS) study. Hypertension was defined as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or self-reported use of antihypertensive medication. Apparent treatment-resistant hypertension (aTRH) was defined as a SBP ≥ 140 mmHg or DBP ≥ 90 mmHg with concurrent use of three classes of antihypertensive medications, or taking four or more classes of antihypertensive medication regardless of BP level. Controlled BP was defined as SBP <140 mmHg and DBP <90 mmHg.

Results:

Overall 5.9% of participants had aTRH and 36.6% had hyperuricemia, defined as serum urate >7.0 mg/dl for men and >6.0 mg/dl for women. After full multivariable adjustment, the odds ratio (OR) for hyperuricemia associated with hypertension was 1.60 [95% confidence interval (95% CI): 1.06–2.40]. Compared to participants not taking antihypertensive medication, the ORs for hyperuricemia for participants taking one, two and three classes of antihypertensive medication without aTRH were 1.98 (95% CI: 1.23–3.20), 2.08 (95% CI: 1.25–3.43), 4.31 (95% CI: 2.07–8.97), respectively, and 3.96 (95% CI: 1.75–8.96) for aTRH. Compared to participants without hypertension, the odds ratios for hyperuricemia were 1.67 (95% CI: 1.08–2.58) and 1.46 (95% CI: 0.88–2.44) among those with hypertension with and without controlled BP, respectively. Diuretic use was associated with a higher odds of hyperuricemia.

Conclusion:

This study suggests that individuals taking more classes of antihypertensive medication may benefit from monitoring for hyperuricemia.
Chronic pain among U.S. sexual minority adults who identify as gay, lesbian, bisexual, or “something else”
Authors: Zajacova Anna , Grol-Prokopczyk Hanna , Liu Hui , Reczek Rin , Nahin Richard L.
Published: April 2023

This study assesses chronic pain prevalence among sexual minority U.S. adults who self-identify as gay/lesbian, bisexual, or “something else,” and examines the role of select covariates in the observed patterns. Analyses are based on 2013 to 2018 waves of the National Health Interview Survey, a leading cross-sectional survey representative of the U.S. population. General chronic pain and chronic pain in 3+ sites among adults aged 18 to 64 years (N = 134,266 and 95,675, respectively) are analyzed using robust Poisson regression and nonlinear decomposition; covariates include demographic, socioeconomic, healthcare, and psychological distress measures. We find large disparities for both pain outcomes. Americans who self-identify as bisexual or “something else” have the highest general chronic pain prevalence (23.7% and 27.0%, respectively), compared with 21.7% among gay/lesbian and 17.2% straight adults. For pain in 3+ sites, disparities are even larger: Age-adjusted prevalence is over twice as high among adults who self-identify as bisexual or “something else” and 50% higher among gay/lesbian, compared with straight adults. Psychological distress is the most salient correlate of the disparities, whereas socioeconomic status and healthcare variables explain only a modest proportion. Findings thus indicate that even in an era of meaningful social and political advances, sexual minority American adults have significantly more chronic pain than their straight counterparts. We call for data collection efforts to include information on perceived discrimination, prejudice, and stigma as potential key upstream factors that drive pain disparities among members of these minoritized groups.
COVID-19 Infections and Predictors of Sickness Related Absences Among Healthcare Workers
Authors: Sakr Carine J. , Fakih Lina , Melhem Nada M. , Fakhreddine Mohammad , Musharrafieh Umayya , Banna Hanin , Doudakian Rita , Zahreddine Nada Kara , Tannous Joseph , Kanj Souha S. , Slade Martin , Redlich Carrie A. , Rahme Diana
Published: April 2023

Background

Little has been published on predictors of prolonged sick leaves during the COVID-19 pandemic. This study aims to determine the rate of COVID-19 infections among healthcare workers (HCWs) and to identify the predictors of longer sick leave days.

Methods

We identified predictors of longer sick leave using linear regression analysis in a cross-sectional study design.

Results

Thirty-three percent of the total workforce contracted COVID-19. On average, HCWs took 12.5 sick leave days after COVID-19 infection. The regression analysis revealed that older employees, nurses, and those who caught COVID-19 earlier in the pandemic were more likely to take longer sick leave.

Conclusions

Age, job position, and month of infection predicted sick leave duration among HCWs in our sample. Results imply that transmission was most likely community-based. Public health interventions should consider these factors when planning for future pandemics.
Maternal and Paternal Household Pesticide Exposure During Pregnancy and Risk of Childhood Acute Lymphoblastic Leukemia
Authors: Ruth Alexandra L. , Rehman Umer , Stewart Patricia , Moore Lee E. , Yucel Recai , Taylor Wilson Robin
Published: April 2023

Objective

The aim of this study was to investigate whether risk estimates for childhood acute lymphoblastic leukemia change when restricting model comparison groups to “nonpesticide exposure” (NPE10) households.

Methods

Cases (n = 1810) 15 years or younger were identified through Children's Cancer Group institutions between 1989 and 1993 and age-/sex-matched to controls (n = 1951). Household pesticide use during pregnancy/month prior was collected via telephone. NPE10 comparison group reporting no parental exposure to 10 pesticide classes was identified.

Results

Adjusted odds ratios increased from 15% to 49% when limiting the comparison to NPE10. Maternal termite insecticide exposure was associated with greatest risk (adjusted odds ratio, 4.21; 95% confidence interval, 2.00–8.88). There was minimal evidence of interaction by child sex or occupational pesticide exposure, and no monotonic dose-response pattern with frequency of use (times per year).

Conclusions

Elevated risks are consistent with published pooled-/meta-analyses and DNA damage. The consistency and magnitude of these associations warrant product labeling, exposure reduction interventions, or both.
An early pop-up mpox vaccine clinic
Authors: Hicks Rodney W. , Blackwell Christopher
Published: April 2023

Mpox, formerly known as monkeypox, emerged as a viral zoonotic disease in 2022. The World Health Organization (WHO) declared a global pandemic in July 2022. Through the U.S. Food and Drug Administration's emergency use authorization, JYNNEOS became the dominant vaccine for prevention of mpox. California leads the nation in the number of U.S. cases, and the outbreak created opportunities for a nurse practitioner–led pop-up vaccination clinic in Los Angeles County. Interprofessional teamwork with pharmacists and public health officials increased the number of individuals vaccinated. By November, the WHO released operational planning guidelines. Nurse practitioners can use these guidelines in anticipation of the next pandemic.
Artificial Deep Neural Network for Sensorless Pump Flow and Hemodynamics Estimation During Continuous-Flow Mechanical Circulatory Support
Authors: Kuroda Taiyo , Kuban Barry D. , Miyamoto Takuma , Miyagi Chihiro , Polakowski Anthony R. , Flick Christine R. , Karimov Jamshid H. , Fukamachi Kiyotaka
Published: April 2023

The objective of this study was to compare the estimates of pump flow and systemic vascular resistance (SVR) derived from a mathematical regression model to those from an artificial deep neural network (ADNN). Hemodynamic and pump-related data were generated using both the Cleveland Clinic continuous-flow total artificial heart (CFTAH) and pediatric CFTAH on a mock circulatory loop. An ADNN was trained with generated data, and a mathematical regression model was also generated using the same data. Finally, the absolute error for the actual measured data and each set of estimated data were compared. A strong correlation was observed between the measured flow and the estimated flow using either method (mathematical, R = 0.97, p < 0.01; ADNN, R = 0.99, p < 0.01). The absolute error was smaller in the ADNN estimation (mathematical, 0.3 L/min; ADNN 0.12 L/min; p < 0.01). Furthermore, strong correlation was observed between measured and estimated SVR (mathematical, R = 0.97, p < 0.01; ADNN, R = 0.99, p < 0.01). The absolute error for ADNN estimation was also smaller than that of the mathematical estimation (mathematical, 463 dynes·sec·cm−5; ADNN, 123 dynes·sec·cm−5, p < 0.01). Therefore, in this study, ADNN estimation was more accurate than mathematical regression estimation.

http://links.lww.com/ASAIO/A991
Prognosis of Venoarterial Extracorporeal Membrane Oxygenation in Mixed, Cardiogenic and Septic Shock
Authors: Kim Ah-Ram , Hyun Junho , Lee Sang Eun , Hong Jung Ae , Kang Pil-Je , Jung Sung-Ho , Kim Min-Seok
Published: April 2023

Mixed cardiogenic-septic shock (MS), defined as the combination of cardiogenic (CS) and septic (SS) shock, is often encountered in cardiac intensive care units. Herein, the authors compared the impact of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in MS, CS, and SS. Of 1,023 patients who received VA-ECMO from January 2012 to February 2020 at a single center, 211 with pulmonary embolism, hypovolemic shock, aortic dissection, and unknown causes of shock were excluded. The remaining 812 patients were grouped based on the cause of shock at VA-ECMO application: i) MS (n = 246, 30.3%), ii) CS (n = 466, 57.4%), iii) SS (n = 100, 12.3%). The MS group was younger and had lower left ventricular ejection fraction than the CS or SS group did. The 30 day and 1 year mortalities were the highest in SS (30 day mortality: 50.4% vs. 43.3% vs. 69.0%, p < 0.001 for MS versus CS versus SS, respectively; 1 year mortality: 67.5% vs. 53.2% vs. 81.0%, p < 0.001 for MS versus CS versus SS, respectively). Posthoc analysis showed that the 30 day mortality of MS was not different from CS, while the 1 year mortality of MS was worse than CS but better than SS. Venoarterial extracorporeal membrane oxygenation application for MS may help improve survival and should therefore be considered if indicated.
Nutritional and medical approaches to intestinal failure
Authors: Salazar Jonathan A. , Carey Alexandra N. , Duggan Christopher P.
Published: April 2023

Purpose of review

Advances in the field of intestinal failure continue to reduce mortality rates of this complex syndrome. Over the last 20 months (January 2021– October 2022), several important papers were published that relate to the nutritional and medical management of intestinal failure and rehabilitation.

Recent findings

New reports on the epidemiology of intestinal failure have shown that short bowel syndrome (SBS) remains the most common cause of intestinal failure worldwide in both adults and children. Advances in the provision of parenteral nutrition (PN), the advent of Glucagon-like peptide-2 (GLP-2) analogs, and the development of interdisciplinary centers have allowed for safer and longer courses of parenteral support. Unfortunately, rates of enteral anatomy continue to lag behind these advancements, requiring greater focus on quality of life, neurodevelopmental outcomes, and management of sequalae of long-term PN such as Intestinal Failure Associated Liver Disease (IFALD), small bowel bacterial overgrowth (SBBO), and Metabolic Bone Disease (MBD).

There have been significant advances in the nutritional and medical approaches in intestinal failure, including advances in PN, use of GLP-2 analogs, and key developments in the medical management of this condition. As children with intestinal failure increasingly survive to adulthood, new challenges exist with respect to the management of a changing population of patients with SBS. Interdisciplinary centers remain standard of care for this complex patient population.
Linoleic acid, an omega-6 fatty acid that reduces risk for cardiometabolic diseases: premise, promise and practical implications
Authors: Belury Martha Ann
Published: April 2023

Purpose of review

As heart disease and type 2 diabetes mellitus (T2DM) cases continue to rise, identifying lifestyle modifications to prevent cardiometabolic disease (CMD) is urgently needed. Clinical evidence consistently shows that higher dietary or biomarker levels of linoleic acid (LA; 18:2n6) reduce metabolic syndrome (Mets) and reduce the risk for CMD. Yet, dietary recommendations to include LA as part of a lifestyle plan with the goal of preventing CMD remain elusive.

Recent findings

Clinical interventions consistently show that dietary the addition of LA to the diet improves body composition, dyslipidemia, and insulin sensitivity while reducing systemic inflammation and fatty liver. These effects of LA position dietary LA-rich oils as a potential dietary strategy to aid in preventing CMD. Peroxisome proliferator-activated receptors (PPARs) are nuclear hormone receptors that are cellular targets for many polyunsaturated fatty acids and oxylipin metabolites. PPAR activation can regulate dyslipidemia, insulin sensitivity, adipose biology, and inflammation, potentially explaining the plethora of effects of dietary LA on aspects of CMD.

Unraveling the cellular mechanism(s) of LA to impact PPAR activity may reset a false dogma that LA, as a member of the omega-6 fatty acid family, promotes inflammation in humans. In fact, LA appears to reduce inflammation and reduce risk for CMD.
Growing experience of surgical gut rehabilitation: essential role in the management of gut failure in adult patients
Authors: Fujiki Masato , Osman Mohammed , Abu-Elmagd Kareem
Published: April 2023

Purpose of review

With the inherent therapeutic limitations of gut transplantation, the concept of surgical gut rehabilitation was introduced to restore nutritional autonomy in pediatric patients. With favorable outcomes in these young patients, there has been increasing interest in the applicability of gut rehabilitative surgery to a growing population of adults with gut failure due to various etiologies. We aim to review the current status of surgical gut rehabilitation for adult gut failure patients in the era of multidisciplinary gut rehabilitation and transplantation.

Recent findings

Indications for surgical gut rehabilitation have been gradually expanding, with gut failure after bariatric surgery recently added. Serial transverse enteroplasty (STEP) has been used with favorable outcomes in adult patients, including those with intrinsic intestinal disease. Autologous gut reconstruction (AGR) is the most frequently used surgical rehabilitative method; its outcome is further improved with conjunctive use of bowel lengthening and enterocyte growth factor as a part of comprehensive gut rehabilitation.

Accumulated experiences have validated the efficacy of gut rehabilitation for survival, nutritional autonomy, and quality of life in adults with gut failure of various etiology. Further progress is expected with growing experience around the world.
The Spectrum of Digestive Tract Histopathologic Findings in the Setting of Severe Acute Respiratory Syndrome Coronavirus-2 Infection: What Pathologists Need to Know
Authors: AL-Zaidi Rana Shaker
Published: April 2023

Although the novel severe acute respiratory syndrome coronavirus-2 is known primarily to affect the respiratory system, current evidence supports its capability to infect and induce gastrointestinal tract injury. Data describing the histopathologic alterations of the digestive system in patients infected with severe acute respiratory syndrome coronavirus-2 are becoming more detailed, as the number of studies is increasing and the quality of our insight into the infection and the histopathologic findings is improving. This review highlights the range of pathologic findings that could be observed in gastrointestinal specimens from patients infected with coronavirus disease 2019 and the potential underlying pathogenetic mechanisms of this disease.
Plasma Interleukin-6 (IL-6), Angiopoietin-2, and C-Reactive Protein Levels Predict Subsequent Type 1 Myocardial Infarction in Persons With Treated HIV Infection
Authors: Graham Susan M. , Nance Robin M. , Chen Junmei , Wurfel Mark M. , Hunt Peter W. , Heckbert Susan R. , Budoff Matthew J. , Moore Richard D. , Jacobson Jeffrey M. , Martin Jeffrey N. , Crane Heidi M. , López José A. , Liles W. Conrad
Published: April 2023

Background:

HIV infection leads to endothelial activation, promoting platelet adhesion, and accelerating atherosclerosis. Our goal was to determine whether biomarkers of endothelial activation and hemostasis/thrombosis were elevated in people with treated HIV (PWH) before myocardial infarction (MI).

Methods:

In a case–control study nested within the CFAR Network of Integrated Clinical Systems (CNICS) cohort, we compared 69 adjudicated cases with type 1 MI with 138 controls matched for antiretroviral therapy regimen. We measured angiopoietin-1, angiopoietin-2 (ANG-2), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13), von Willebrand factor, C-reactive protein (CRP), interleukin-6 (IL-6), plasminogen activation inhibitor-1, P-selectin, serum amyloid-A, soluble CD14, and apolipoprotein A1 in stored plasma. Conditional logistic regression identified associations with subsequent MI, with and without adjustment for Atherosclerotic Cardiovascular Disease (ASCVD) and Veterans Aging Cohort Study (VACS) scores.

Results:

Higher IL-6 was associated with MI after adjustment for ASCVD score (adjusted odds ratio [AOR] 1.51, 95% confidence interval [95% CI]: 1.05 to 2.17 per standard-deviation-scaled log2 increment). In a separate model adjusting for VACS score, higher ANG-2 (AOR 1.49, 95% CI: 1.04 to 2.14), higher CRP (AOR 1.45, 95% CI: 1.06 to 2.00), and higher IL-6 (AOR 1.68, 95% CI: 1.17 to 2.41) were associated with MI. In a sensitivity analysis excluding PWH with viral load ≥400 copies/mL, higher IL-6 remained associated with MI after adjustment for ASCVD score and after adjustment for VACS score.

Conclusions:

Among PWH, higher levels of plasma IL-6, CRP, and ANG-2 predict subsequent type 1 MI, independent of conventional risk scores. IL-6 had the most consistent associations with type 1 MI, regardless of viral load suppression.
Synchronous Squamous Cell Carcinoma of Rectum and Anal Canal Detected by FDG PET/CT—A Rare Entity
Authors: Jabbar Shabana Abdul , Selvakumar B. , Soni Subhash Chandra , Taywade Sameer , Elhence Poonam
Published: April 2023

Squamous cell carcinoma is the most common malignancy of the anal canal, and FDG PET/CT is recommended in its nodal staging, radiotherapy planning, and response assessment. We share an interesting case of dual primary malignancy of the anal canal and rectum, which was detected by 18F-FDG PET/CT and confirmed on histopathology as synchronous squamous cell carcinoma.
Exploring the EVolution in PrognOstic CapabiLity of MUltisequence Cardiac MagneTIc ResOnance in PatieNts Affected by Takotsubo Cardiomyopathy Based on Machine Learning Analysis
Authors: Cau Riccardo , Muscogiuri Giuseppe , Pisu Francesco , Gatti Marco , Velthuis Birgitta , Loewe Christian , Cademartiri Filippo , Pontone Gianluca , Montisci Roberta , Guglielmo Marco , Sironi Sandro , Esposito Antonio , Francone Marco , Dacher Nicholas , Peebles Charles , Bastarrika Gorka , Salgado Rodrigo , Saba Luca
Published: April 2023

Purpose:

Takotsubo cardiomyopathy (TTC) is a transient but severe acute myocardial dysfunction with a wide range of outcomes from favorable to life-threatening. The current risk stratification scores of TTC patients do not include cardiac magnetic resonance (CMR) parameters. To date, it is still unknown whether and how clinical, trans-thoracic echocardiography (TTE), and CMR data can be integrated to improve risk stratification.

Methods:

EVOLUTION (Exploring the eVolution in prognOstic capabiLity of mUlti-sequence cardiac magneTIc resOnance in patieNts affected by Takotsubo cardiomyopathy) is a multicenter, international registry of TTC patients who will undergo a clinical, TTE, and CMR evaluation. Clinical data including demographics, risk factors, comorbidities, laboratory values, ECG, and results from TTE and CMR analysis will be collected, and each patient will be followed-up for in-hospital and long-term outcomes. Clinical outcome measures during hospitalization will include cardiovascular death, pulmonary edema, arrhythmias, stroke, or transient ischemic attack.

Clinical long-term outcome measures will include cardiovascular death, pulmonary edema, heart failure, arrhythmias, sudden cardiac death, and major adverse cardiac and cerebrovascular events defined as a composite endpoint of death from any cause, myocardial infarction, recurrence of TTC, transient ischemic attack, and stroke. We will develop a comprehensive clinical and imaging score that predicts TTC outcomes and test the value of machine learning models, incorporating clinical and imaging parameters to predict prognosis.

Conclusions:

The main goal of the study is to develop a comprehensive clinical and imaging score, that includes TTE and CMR data, in a large cohort of TTC patients for risk stratification and outcome prediction as a basis for possible changes in patient management.
Molecular characterization and comparative genomic analysis of Acinetobacter baumannii isolated from the community and the hospital: an epidemiological study in Segamat, Malaysia
Authors: Muzahid Nazmul Hasan , Hussain Md Hamed , Huët Marie Andrea Laetitia , Dwiyanto Jacky , Su Tin Tin , Reidpath Daniel , Mustapha Faizah , Ayub Qasim , Tan Hock Siew , Rahman Sadequr
Published: April 2023

Acinetobacter baumannii

is a common cause of multidrug-resistant (MDR) nosocomial infections around the world. However, little is known about the persistence and dynamics of

A. baumannii

in a healthy community. This study investigated the role of the community as a prospective reservoir for

A. baumannii

and explored possible links between hospital and community isolates. A total of 12 independent

A. baumannii

strains were isolated from human faecal samples from the community in Segamat, Malaysia, in 2018 and 2019. Another 15 were obtained in 2020 from patients at the co-located tertiary public hospital. The antimicrobial resistance profile and biofilm formation ability were analysed, and the relatedness of community and hospital isolates was determined using whole-genome sequencing (WGS). Antibiotic profile analysis revealed that 12 out of 15 hospital isolates were MDR, but none of the community isolates were MDR. However, phylogenetic analysis based on single-nucleotide polymorphisms (SNPs) and a pangenome analysis of core genes showed clustering between four community and two hospital strains. Such clustering of strains from two different settings based on their genomes suggests that these strains could persist in both. WGS revealed 41 potential resistance genes on average in the hospital strains, but fewer (n=32) were detected in the community strains. In contrast, 68 virulence genes were commonly seen in strains from both sources. This study highlights the possible transmission threat to public health posed by virulent

A. baumannii

present in the gut of asymptomatic individuals in the community.
High-dose Polyphenol-rich Nutrition Improves Lipid and Inflammation Profiles and Triggers Apoptotic Signaling in Healthy Elderly People (the ErdBEHR Study)
Authors: Hartmann Alexander , Secci Riccardo , Mensch Juliane , Jäger Kathrin , Steinhagen-Thiessen Elisabeth , Barrantes Israel , Palmer Daniel , Kowald Axel , Schwarz Rico , Hinz Burkhard , Weber Daniela , Grune Tilman , Hübbe Patricia , Rimbach Gerald , Rudolf Henrik , Walter Michael , Fuellen Georg
Published: April 2023

Nutritional interventions in healthy individuals may be particularly informative if high, but not excessive, amounts of specific healthy foods are taken to maximize effects without sacrificing safety. We hypothesized that high amounts of polyphenols taken on single days may eliminate senescent blood cells. We conducted a ten-week parallel-group controlled randomized open trial with an escalation of consumption, up to ∼4kg fresh strawberries weekly, plus 200g dried strawberries and 240g capers in olive oil on three single “seno-intervention” days, in 168 healthy elderly people aged 50-80 years. Two primary endpoints, LDL cholesterol and high sensitive CRP, were prespecified. We found a significant decline in LDL cholesterol, and in CRP by ∼50% in all groups with seno-intervention days (limited to participants with increased baseline values). LDL levels were reduced by 0.0174 mmol/L for any single 500g-increment in the weekly fresh strawberry intake of the average participant. Gene expression analyses of whole blood suggested improvement of mitochondrial and immunological function, suppression of inflammation (in high-intervention groups), and positive regulation of apoptotic signaling (in the highest-intervention group). Overall, a medium-term nutritional intervention improved lipid and inflammation status, and provided specific hints for apoptotic/senolytic effects.

Key findings

High-dose polyphenol-rich nutrition improves LDL and CRP levels in healthy elderly

At highest dose, gene expression data highlight “positive regulation of apoptotic signaling”

A clear dose-response pattern based on an escalating intervention design
Active learning impairments in substance use disorders when resolving the explore-exploit dilemma: A replication and extension of previous computational modeling results
Authors: Taylor Samuel , Lavalley Claire A. , Hakimi Navid , Stewart Jennifer L. , Ironside Maria , Zheng Haixia , White Evan , Guinjoan Salvador , Paulus Martin P. , Smith Ryan
Published: April 2023

Background

Substance use disorders (SUDs) represent a major public health risk. Yet, our understanding of the mechanisms that maintain these disorders remains incomplete. In a recent computational modeling study, we found initial evidence that SUDs are associated with slower learning rates from negative outcomes and less value-sensitive choice (low “action precision”), which could help explain continued substance use despite harmful consequences.

Methods

Here we aimed to replicate and extend these results in a pre-registered study with a new sample of 168 individuals with SUDs and 99 healthy comparisons (HCs). We performed the same computational modeling and group comparisons as in our prior report (doi: 10.1016/j.drugalcdep.2020.108208) to confirm previously observed effects. After completing all pre-registered replication analyses, we then combined the previous and current datasets (N = 468) to assess whether differences were transdiagnostic or driven by specific disorders.

Results

Replicating prior results, SUDs showed slower learning rates for negative outcomes in both Bayesian and frequentist analyses (η2=.02). Previously observed differences in action precision were not confirmed. Logistic regressions including all computational parameters as predictors in the combined datasets could differentiate several specific disorders from HCs, but could not differentiate most disorders from each other.

Conclusions

These results provide robust evidence that individuals with SUDs have more difficulty adjusting behavior in the face of negative outcomes than HCs. They also suggest this effect is common across several different SUDs. Future research should examine its neural basis and whether learning rates could represent a new treatment target or moderator of treatment outcome.
Validation of Flavivirus Infectious Clones Carrying Fluorescent Markers for Antiviral Drug Screening and Replication Studies
Authors: Cherkashchenko Liubov , Gros Nathalie , Trausch Alice , Neyret Aymeric , Hénaut Mathilde , Dubois Gregor , Villeneuve Matthieu , Chable-Bessia Christine , Lyonnais Sébastien , Merits Andres , Muriaux Delphine
Published: April 2023

Flaviviruses have emerged as major arthropod-transmitted pathogens and represent an increasing public health problem worldwide. High-throughput screening can be facilitated by the use of viruses that express easily detectable marker proteins. Developing molecular tools such as reporter-carrying versions of flaviviruses for studying viral replication and screening of antiviral compounds therefore represents a top priority. However, the engineering of flaviviruses carrying either fluorescent or luminescent reporters remains challenging due to the genetic instability caused by marker insertion; therefore, new approaches to overcome these limitations are needed. Here, we describe reverse genetic methods which includes design and validation of infectious clones of Zika, Kunjin and Dengue viruses harboring different reporter genes for infection, rescue, imaging and morphology using super-resolution microscopy. It was observed that for different flaviviruses constructs with identical design displayed strikingly different genetic stability while corresponding virions resembled wild-type virus particles in shape and size. A successful strategy was assessed to increase stability of rescued reporter virus and permit antiviral drug screening based on quantitative automated fluorescence microscopy and replication studies.
Formulation development and comparability studies with an aluminum-salt adjuvanted SARS-CoV-2 Spike ferritin nanoparticle vaccine antigen produced from two different cell lines
Authors: Kumru Ozan S. , Sanyal Mrinmoy , Friedland Natalia , Hickey John , Joshi Richa , Weidenbacher Payton , Do Jonathan , Cheng Ya-Chen , Kim Peter S. , Joshi Sangeeta B. , Volkin David B.
Published: April 2023

The development of safe and effective second-generation COVID-19 vaccines to improve affordability and storage stability requirements remains a high priority to expand global coverage. In this report, we describe formulation development and comparability studies with a self-assembled SARS-CoV-2 spike ferritin nanoparticle vaccine antigen (called DCFHP), when produced in two different cell lines and formulated with an aluminum-salt adjuvant (Alhydrogel, AH). Varying levels of phosphate buffer altered the extent and strength of antigen-adjuvant interactions, and these formulations were evaluated for their (1)in vivoperformance in mice and (2)in vitrostability profiles. Unadjuvanted DCFHP produced minimal immune responses while AH-adjuvanted formulations elicited greatly enhanced pseudovirus neutralization titers independent of ∼100%, ∼40% or ∼10% of the DCFHP antigen adsorbed to AH. These formulations differed, however, in theirin vitrostability properties as determined by biophysical studies and a competitive ELISA for measuring ACE2 receptor binding of AH-bound antigen. Interestingly, after one month of 4°C storage, small increases in antigenicity with concomitant decreases in the ability to desorb the antigen from the AH were observed. Finally, we performed a comparability assessment of DCFHP antigen produced in Expi293 and CHO cells, which displayed expected differences in their N-linked oligosaccharide profiles. Despite consisting of different DCFHP glycoforms, these two preparations were highly similar in their key quality attributes including molecular size, structural integrity, conformational stability, binding to ACE2 receptor and mouse immunogenicity profiles. Taken together, these studies support future preclinical and clinical development of an AH-adjuvanted DCFHP vaccine candidate produced in CHO cells.
Male behavior in a swallowtail butterfly (Battus philenor) ensures directional iridescent sexual signal is visible to females during courtship
Authors: Rutowski Ronald L. , Lessios Nicolas , Seymoure Brett , Pegram Kim , Raymundo Andrew
Published: April 2023

Iridescent colors in animals may vary with the arrangement of the observer and the light source relative to the animal. When these highly directional colors are used as signals, there may be transmission problems for senders in that the perception of the signal by intended receivers can be greatly affected by the spatial arrangement of the sender, receiver, and sources of contributing light. One potential solution to this problem is for senders to behave in a manner that arranges the positions of sender, light source, and receiver to enhance signal perception by the receiver. We tested this idea by describing the structure of courtship behavior of males of the Pipevine Swallowtail (Battus philenor) butterfly and analyzing its consequences for the female detection of the male’s iridescent sexual signal which is used in mate choice by females. During courtship, males perform a swoop maneuver that brings their dorsal hindwing from below to directly in front of the female. Several swoops in rapid succession occur in aerial courtships that lead to copulation. We measured under solar radiation the radiance of the male’s dorsal hindwing as seen by the female during a swoop. Regardless of how the male’s swoop path is oriented relative to the sun, there will be a brief, bright, and saturated flash of blue visible to the female. Our results support the conclusion that male swoops enhance the visibility of the male’s iridescent color signal to the female during courtship.