bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of new paediatric VO2max reference equations to evaluate aerobic fitness in overweight or obese children with congenital heart disease
Authors: Amedro Pascal , Mura Thibault , Matecki Stefan , Guillaumont Sophie , Requirand Anne , Jeandel Claire , Kollen Laura , Gavotto Arthur
Published: June 2023

Aims

Overweight and obesity in children with congenital heart disease (CHD) represent an alarming cardiovascular risk. Promotion of physical activity and cardiac rehabilitation in this population requires assessing the level of aerobic fitness (VO2max) by a cardiopulmonary exercise test (CPET). Nevertheless, the interpretation of CPET in overweight/obese children with CHD remains challenging as VO2max is affected by both the cardiac condition and the body mass index (BMI). The new paediatric VO2max  Z-score reference equations, based on a logarithmic function of VO2max, height and BMI, were applied to overweight/obese children with a CHD and compared with overweight/obese children without any other chronic condition.

Methods and results

In this cross-sectional controlled study, 344 children with a BMI > 85th percentile underwent a CPET (54% boys; mean age 11.5 ± 3.1 years; 100 CHD; 244 controls). Using the VO2max  Z-score equations, aerobic fitness was significantly lower in obese/overweight CHD children than that in matched obese/overweight control children (−0.43 ± 1.27 vs. −0.01 ± 1.09; P = 0.02, respectively), and the proportion of children with impaired aerobic fitness was significantly more important in obese/overweight CHD children than in matched controls (17% vs.6%, P = 0.02, respectively). The paediatric VO2max  Z-score reference equations also identified specific complex CHD at risk of aerobic fitness impairment (univentricular heart and right outflow tract anomalies). Using Cooper’s weight- and height-based linear equations, similar matched-comparisons analyses found no significant group differences.

Conclusions

As opposed to the existing linear models, the new paediatric VO2max  Z-score equations can discriminate the aerobic fitness of obese/overweight children with CHD from that of obese/overweight children without any chronic disease.

Registration

ClinicalTrials.gov NCT04815577.
Proposal to transfer Bacillus dafuensis and Bacillus massiliigabonensis to the genus Cytobacillus as Cytobacillus dafuensis comb. nov., and Cytobacillus massiliigabonensis comb. nov., respectively
Authors: Liu Bing-Bing , Liu Guo-Hong , Dhulappa Awalagaway , Narsing Rao Manik Prabhu
Published: June 2023

In the present study, the taxonomic position of Bacillus dafuensis and Bacillus massiliigabonensis was evaluated using genome-based comparison. The 16S rRNA gene sequence obtained from the Bacillus dafuensis FJAT-25496T genome showed 99.7% similarity with the type strain of Cytobacillus citreus, while Bacillus massiliigabonensis Marseille-P2639T showed 98.7% similarity with the type species of Cytobacillus solani. The 16S rRNA gene sequence similarity of Bacillus dafuensis FJAT-25496T and Bacillus massiliigabonensis Marseille-P2639T with Cytobacillus members was above the threshold (94.5%) for genus delineation. In phylogenetic (based on 16S rRNA gene sequences) and phylogenomic (based on 71 bacterial single-copy genes) trees, Bacillus dafuensis and Bacillus massiliigabonensis clustered with Cytobacillus members. The 16S rRNA gene sequence, amino acid identity and percentage of conserved proteins analysis indicated Bacillus dafuensis FJAT-25496T and Bacillus massiliigabonensis Marseille-P2639T as a member of the genus Cytobacillus. The digital DNA–DNA hybridization and the average nucleotide identity values of Bacillus dafuensis FJAT-25496T and Bacillus massiliigabonensis Marseille-P2639T with Cytobacillus members was below the cut-off value (70/94%–95%) for species delineation. Based on the results we propose to transfer Bacillus dafuensis and Bacillus massiliigabonensis to the genus Cytobacillus as Cytobacillus dafuensis comb. nov., and Cytobacillus massiliigabonensis comb. nov., respectively.
Cell density dependent restriction of N2O reductase in denitrifyingPseudomonasspp., a potential driver of N2O emissions in natural systems
Authors: Kellermann Ricarda , Vick Silas Harry Watts , Lindtveit Kristine , Milligan Daniel Aleksanteri , Bergaust Linda Liberg
Published: June 2023

Denitrification is a major biological source and sink for the ozone-depleting greenhouse gas N2. Thus, the respiratory physiology of denitrifiers and the mechanisms determining their propensity for accumulation of N-oxides are of fundamental interest. Here, we report a pervasive positive correlation between cell density and N2O accumulation in Pseudomonas aeruginosa and P. fluorescens F113. We show that this was a result of quorum sensing by comparing the P. aeruginosa PAO1-UW wild type to a rhlI/lasI knockout mutant able to sense, but not synthesize the N-acyl-homoserine lactones (AHL) of the Rhl and Las circuits. Neither the transcription of nosZ (encoding N2O reductase, N2OR) nor the abundance of peptides of known relevance to denitrification could explain the restriction of N2O reduction in AHL-affected cultures. However, a protein shown to be involved in synthesis and repair of iron–sulphur (Fe–S) centers under NO stress, CyaY, was significantly downregulated in the AHL producing wild type. This hints to a possible route of N2OR-suppression via compromised Fe–S centers in the ancillary protein NosR. While the exact mechanism remains obscure, it appears that quorum sensing driven restriction of N2OR activity is common. Thus, given its ubiquity among prokaryotes, and the potential for cross-species and -strain effects, quorum sensing is plausibly a driver of N2O emissions in a range of systems.
Turnkey algorithmic approach for the evaluation of gastroesophageal reflux disease after bariatric surgery
Authors: Ghanem Omar M , Ghazi Rabih , Abdul Razzak Farah , Bazerbachi Fateh , Ravi Karthik , Khaitan Leena , Kothari Shanu N , Abu Dayyeh Barham K
Published: June 2023

Bariatric surgeries are often complicated by de-novo gastroesophageal reflux disease (GERD) or worsening of pre-existing GERD. The growing rates of obesity and bariatric surgeries worldwide are paralleled by an increase in the number of patients requiring post-surgical GERD evaluation. However, there is currently no standardized approach for the assessment of GERD in these patients. In this review, we delineate the relationship between GERD and the most common bariatric surgeries: sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), with a focus on pathophysiology, objective assessment, and underlying anatomical and motility disturbances. We suggest a stepwise algorithm to help diagnose GERD after SG and RYGB, determine the underlying cause, and guide the management and treatment.
Defining and Measuring Preclinical Mobility Limitation: An Expert Consensus Exercise Informed by a Scoping Review
Authors: Richardson Julie , Beauchamp Marla , Bean Jonathan , Brach Jennifer , Chaves Paulo H M , Guralnik Jack M , Jette Alan M , Leveille Suzanne G , Hoenig Helen , Manini Todd , Marottoli Richard , Porter Michelle M , Sinclair Susanne , Letts Lori , Kuspinar Ayse , Vrkljan Brenda , Morgan Ashley , Mirbaha Shaghayegh
Published: June 2023

Background

Early change in function in older adults has been termed preclinical disability (PCD). PCD has been understudied compared to other stages of disability because it is unlikely to receive comparative priority in clinical settings. It has major implications for prevention and population health as it may be the optimal time to intervene to prevent further decline. A standardized approach to research in PCD, including a common definition and measurement approaches, is needed to advance this work.

Methods

The process to establish how PCD should be defined and measured was undertaken in 2 stages: (1) a scoping review of the literature, which was used to inform (2) a web-enabled consensus meeting with content experts.

Results

The scoping review and the consensus meeting support the use of the term preclinical mobility limitation (PCML) and that it should be measured using both patient-reported and performance-based measures. It was agreed that the definition of PCML should include modification of frequency and/or method of task completion, without overt disability, and that requisite mobility tasks include walking (distance and speed), stairs, and transfers.

Conclusions

Currently, there are few standardized assessments that can identify PCML. PCML is the term that most clearly describes the stage where people experience a change in routine mobility tasks, without a perception of disability. Further evaluation into the reliability, validity, and responsiveness of outcome measures is needed to advance research on PCML.
Comparing cross-sectional and longitudinal approaches to tuberculosis patient cost surveys using Nepalese data
Authors: Bengey Daisy , Thapa Anchal , Dixit Kritika , Dhital Raghu , Rai Bhola , Paudel Puskar , Paudel Rajan , Majhi Govind , Aryal Tara Prasad , Sah Manoj Kumar , Pandit Ram Narayan , Mishra Gokul , Khanal Mukti Nath , Kibuchi Eliud , Caws Maxine , de Siqueira-Filha Noemia Teixeira
Published: June 2023

The World Health Organization has supported the development of national tuberculosis (TB) patient cost surveys to quantify the socio-economic impact of TB in high-burden countries. However, methodological differences in the study design (e.g. cross-sectional vs longitudinal) can generate different estimates making the design and impact evaluation of socio-economic protection strategies difficult. The objective of the study was to compare the socio-economic impacts of TB estimated by applying cross-sectional or longitudinal data collections in Nepal. We analysed the data from a longitudinal costing survey (patients interviewed at three time points) conducted between April 2018 and October 2019. We calculated both mean and median costs from patients interviewed during the intensive (cross-sectional 1) and continuation (cross-sectional 2) phases of treatment. We then compared costs, the prevalence of catastrophic costs and the socio-economic impact of TB generated by each approach. There were significant differences in the costs and social impacts calculated by each approach. The median total cost (intensive plus continuation phases) was significantly higher for the longitudinal compared with cross-sectional 2 (US$119.42 vs 91.63, P < 0.001). The prevalence of food insecurity, social exclusion and patients feeling poorer or much poorer were all significantly higher by applying a longitudinal approach. In conclusion, the longitudinal design captured important aspects of costs and socio-economic impacts, which were missed by applying a cross-sectional approach. If a cross-sectional approach is applied due to resource constraints, our data suggest that the start of the continuation phase is the optimal timing for a single interview. Further research to optimize methodologies to report patient-incurred expenditure during TB diagnosis and treatment is needed.
Have we overlooked the role of mifepristone for the medical management of tubal ectopic pregnancy?
Authors: Oltman Julia , Balachander Sanjana , Mol Ben W , Woolner Andrea M F
Published: June 2023

Ectopic pregnancy is a risk of both spontaneous and assisted reproduction pregnancies. The majority of ectopic pregnancies abnormally implant within a fallopian tube (extrauterine pregnancies). In haemodynamically stable women, medical or expectant treatment can be offered. Currently accepted medical treatment is using a drug called methotrexate. However, methotrexate has potential adverse effects, and a significant proportion of women will still require emergency surgery (up to 30%) to remove the ectopic pregnancy. Mifepristone (RU-486) has anti-progesterone effects and has a role in managing intrauterine pregnancy loss and termination of pregnancy. On reviewing the literature and given progesterone’s pivotal role in sustaining pregnancy, we propose that we may have overlooked the role of mifepristone in the medical management of tubal ectopic pregnancy in haemodynamically stable women.
Numerical analysis of a finite volume scheme for charge transport in perovskite solar cells
Authors: Abdel Dilara , Chainais-Hillairet Claire , Farrell Patricio , Herda Maxime
Published: June 2023

In this paper, we consider a drift-diffusion charge transport model for perovskite solar cells, where electrons and holes may diffuse linearly (Boltzmann approximation) or nonlinearly (e.g., due to Fermi–Dirac statistics). To incorporate volume exclusion effects, we rely on the Fermi–Dirac integral of order $-1$ when modeling moving anionic vacancies within the perovskite layer, which is sandwiched between electron and hole transport layers. After nondimensionalization, we first prove a continuous entropy-dissipation inequality for the model. Then, we formulate a corresponding two-point flux finite volume scheme on Voronoi meshes and show an analogous discrete entropy-dissipation inequality. This inequality helps us to show the existence of a discrete solution of the nonlinear discrete system with the help of a corollary of Brouwer’s fixed point theorem and the minimization of a convex functional. Finally, we verify our theoretically proven properties numerically, simulate a realistic device setup and show exponential decay in time with respect to the $L^2$ error as well as a physically and analytically meaningful relative entropy.
Metabolomic profiling and biological evaluations of Spongia irregularis-associated actinomycetes supported by multivariate statistical analysis
Authors: Abdelaleem Enas Reda , Samy Mamdouh Nabil , Rateb Mostafa E , Hendawy Omnia Magdy , Abdelmohsen Usama Ramadan , Yehia Desoukey Samar
Published: June 2023

Aim

Metabolomic analysis using LC–HRESIMS of 12 extracts of Spongia irregularis-associated actinomycetes for dereplication purposes in addition to evaluation of cytotoxic and antiviral activities of the extracts.

Methods and results

In this study, three actinomycetes belonging to the genera Micromonospora, Streptomyces, and Rhodococcus were recovered from the marine sponge Spongia irregularis. Applying the OSMAC approach, each strain was fermented on four different media, resulting in 12 extracts. All extracts were subjected to metabolomic analysis using LC–HRESIMS for dereplication purposes. Multivariate data statistical analysis was carried out for the differentiation between extracts. Additionally, the cytotoxic and anti-hepatitis C virus (anti-HCV) potentials of extracts were evaluated. Most of extracts showed strong to moderate cytotoxicity effects against HepG-2, CACO-2, and MCF-7 cell lines with a general IC50 range of 2.8–8.9 µg/ml. Moreover, the extracts of Micromonospora sp. UR44 using ISP2 and OLIGO media and Streptomyces sp. UR32 using ISP2 medium exhibited anti-HCV activity with IC50 of 4.5 ± 0.22, 3.8 ± 0.18, and 5.7 ± 0.15 µM, respectively.

Conclusion

Metabolomic analysis of 12 extracts of S. irregularis-associated actinomycetes led to the identification of a large number of secondary metabolites. Morever, investigation of cytotoxic and antiviral activities of the extracts revealed that only three extracts exhibited antiviral activity and seven extracts exhibited cytotoxic activity.
Suicide with oral midazolam: Postmortem toxicological investigations using Ostro® Plate and ultra-high performance liquid chromatography coupled to tandem mass spectrometry
Authors: Boudin Coralie , Eysseric-Guérin Hélène , Paysant François , Revet Melissa , Stanke-Labesque Françoise , Scolan Virginie , Willeman Théo
Published: June 2023

A middle-aged woman was found dead with multiple empty blisters of midazolam (MDZ) (DORMICUM®), equivalent to 450 mg, near her body. The autopsy revealed that the cause of death was secondary to an asphyxia syndrome. Standard toxicological procedures identified MDZ only in blood, urine and gastric content. A quantitative analytical method for MDZ and 1-hydroxymidazolam (1-OH-MDZ) was validated using protein precipitation, a phospholipid removal Ostro® plates and liquid chromatography coupled to tandem mass spectrometry. MDZ and 1-OH-MDZ were quantified in peripheral blood at 910 and 534 ng/mL, respectively, and superior to 2000 ng/mL in urine. Reported to the body weight, the dose, which was lethal, was estimated to be 6.7 mg/kg. The usual dose used in the intensive care unit is 0.03–0.3 mg/kg. MDZ intoxication outside of hospital is rare given the restricted availably of this drug in France. Nevertheless, MDZ under oral form remains available in several countries. Toxic MDZ blood concentrations are described after intravenous administration for anesthesia and are not suited for oral intoxication. Based on the autopsy findings, police investigation and toxicology results, the cause of death was determined to be a self-inflicted oral MDZ acute intoxication, which is the first to be documented to the best of our knowledge. This fatal intoxication provides analytical data that could support subsequent toxicological result interpretation in similar forensic cases.
Working Towards Holistic Scar Assessment and Improved Shared Decision Making in Global Burn Care
Authors: van de Warenburg Milly S , Munk Elleke F L , Davies Anna , McBride Craig A , Edgar Dale W , Vehmeijer-Heeman Mariëlle L A W , Young Amber E
Published: June 2023

Cutaneous burn scars impact various aspects of life. Scar treatment is mainly evaluated on scar characteristics. Consensus is needed on which other outcomes to capture, ensuring they are relevant to patients, clinicians, and researchers. The aim of this study was to identify, discuss and analyze outcomes related to cutaneous burn scarring, incorporating the voice of patients and views of healthcare professionals. For this, a Delphi process consisting of two survey rounds and a consensus meeting was initiated. Burn scar-related outcomes were identified from an existing comprehensive list of 100 outcomes by an international panel of patients, healthcare professionals and researchers. Fifty-nine outcomes were identified from the Delphi process as related to scarring (≥60% votes). Outcomes less impactful in relation to scar outcomes included psychosocial issues, sense of normality, understanding of treatment, costs and systemic issues. To represent a holistic assessment of outcomes related to cutaneous burn scarring, this Delphi process established a battery of outcomes currently included in scar quality assessment tools, and an expanded set of less frequently considered outcomes. Future work in this area must include the patient voice from developing countries. This is essential to identify globally applicable outcomes related to scarring.
A Regional Analysis of Potentially Preventable Injuries Sustained From Burning Garbage and Yard Waste
Authors: Hill David M , Rath Abigail J , Boam Tina , Fletchall Sandra , Sabbatini Sarah , Geib Teresa , Krebs Mamie , Funk David , Greer Catherine , Mincey Megan , Wayne Mary , Dadireddy Kalyan , Liu Xiangxia , Velamuri Sai R
Published: June 2023

Due to high prevalence in the south, understanding the injury pattern, healthcare burden, and cost of burn injuries associated with burning yard and trash debris are important for effective prevention. This 5-year retrospective, single-center study included patients sustaining an open flame burn injury due to burning brush or trash. Based on primary residence of the 136 patients, 56% had access to free municipal waste disposal, 25% could have had access with additional payment, and 18% did not have access. The median (Q1 and Q3) age and total body surface area (TBSA) burned was 50 (32, 66.5) years and 5% (2.5, 12), respectively, with 36% having some portion of full-thickness injury. One-third had some form of substance use. There were 151 total operations with a median of 1 (0, 1.5) per patient. There were 1,620 hospital days utilized (~6.6% of available bed-days per study period). Twenty-five percent were discharged with a paired functional status worse than pre-injury. Patients with some degree of pre-injury function limitations had a 3-fold higher length of stay (10 vs 3 days; P = .023). Patients with lower pre-injury functionality had almost four times higher mortality (23.7% vs 6.3%; P = .085). There were 9 (6.7%) deaths with an average (±SD) of 74.3 ± 13.1 years of age, median of 33% (31, 43) TBSA, and median full-thickness TBSA of 32% (21, 44). Total hospital charges exceeded $32.6 million with a median of $32,952.26 ($8,790.48, $103,113.95) per patient. Focusing future outreach efforts on education and resource availability may prevent future waste-burning injuries.
Solute segregation affected by transport properties during a bubble entrapment in upward solidification
Authors: Wei P S , Liao K C , Tseng T W , Chiou D , Wang S B , Tsai C E
Published: June 2023

The effects of transport properties on segregation of a dissolvable gas, for example, carbon dioxide in water in the presence of an entrapping bubble during upward unidirectional solidification is numerically investigated. Microporosity and inter-related solute segregation are two common defects detrimental to mechanical properties of components, especially to fatigue performance, strength, and ductility. In this work, transport processes between the bubble, liquid, and solid affected by mass, momentum, energy, and concentration equations are solved by finite element schemes provided from the commercial COMSOL code. The results find that solute concentration in solid and liquid surrounding the pore increases with decreasing Henry's law constant and gravitational acceleration, and increasing surface tension surrounding pressure and solid thermal conductivity. Solute gas concentration on the top free surface is insensitive to that in the pore rather than that in liquid and solid away from the pore. Apex cap becomes non-spherical affecting solidification rate and shape of the solidification front as ambient pressure at the top free surface and gravitational acceleration increase. Contact angle versus location of the solidification front predicted from this work and Abel's equation agrees well. Solute segregation encountered by pore formation is controllable.
A rare case: synchronous ipsilateral breast implant-associated anaplastic large cell lymphoma and invasive ductal carcinoma
Authors: Safari Aroosha , Hamza Saud , Paton David
Published: June 2023

A 78-year-old female with a history of cosmetic breast implants presented with unilateral breast enlargement and was subsequently diagnosed with stage IA breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) as well as stage IB ipsilateral synchronous invasive ductal carcinoma (IDC). Her assessment included bilateral breast ultrasounds,mammograms and MRIs with right-sided fine needle aspiration of peri-implant fluid, core biopsy of right breast mass and a whole-body positron emission tomography scan. She was surgically treated with bilateral capsulectomy, implant removal and mastectomy. No adjuvant treatment was required for the BIA-ALCL. The IDC required adjuvant chemotherapy, radiotherapy and endocrine therapy. This rare case highlights the paramount importance of thorough evaluation of suspected BIA-ALCL patients for synchronous breast pathologies. We conclude with a concise summary of the salient points on evaluation and management of BIA-ALCL for surgeons.
Association between sexual frequency and all-cause mortality in young and middle-aged patients with hypertension: a cohort study of patient data from the National Health and Nutrition Examination Survey 2005-2014
Authors: Luo Chuanjin , Xu Shuzhi , Bao Shiqin , Zhang Bo , Zhong Xiaofen , Huang Zhihua , Li Ping , Liang Jiahua
Published: June 2023

Background

Sexual activity appears to have protective effects on overall and cardiovascular health.

Aim

We hypothesized that decreased sexual frequency would be an early predictor of all-cause mortality in young and middle-aged patients (20 to 59 years old) with hypertension.

Methods

A total of 4565 patients with hypertension (55.6% men; mean [SD] age 40.60 [10.81] years) who had completed a sexual behavior questionnaire were enrolled from the National Health and Nutrition Examination Survey of 2005 to 2014. Cox proportional hazards models and Kaplan-Meier survival curves were used to evaluate the relationship between sexual frequency and all-cause mortality.

Outcomes

The outcome measure for this study is the relationship between sexual frequency and all-cause mortality in young and middle-aged patients with hypertension.

Results

During the 68-month median follow-up period, 109 (2.39%) patients died from any cause. After full adjustment for potential confounders, sexual frequency was an independent predictive factor for all-cause mortality in young and middle-aged patients with hypertension. A marital status difference was identified in the subgroup analysis: among patients with a sexual frequency of <12 times/year, only married patients had higher risks of all-cause mortality than the 12-51 times/year group (HR, 0.476, 95% CI, 0.235-0.963, P < .05) and > 51 (HR, 0.452, 95% CI, 0.213-0.961, P < .05) times/year groups. The association of sexual frequency and all-cause mortality was nonlinear.

Clinical Implications

Increased frequency of sexual activity may have protective effects on overall health and quality of life in patients with hypertension.

Strengths and Limitations

To our knowledge this is the first observational investigation performed to evaluate the correlation between sexual frequency and all-cause mortality in patients with hypertension. A limitation of the study is that the participants in our analysis were between the ages of 20 and 59 years, and this patient sample may not reflect possible outcomes for patients of other age groups.

Conclusion

The association between lower frequency of sexual intercourse and greater all-cause mortality was significant in young and middle-aged patients with hypertension in the United States.
Postbiotics as candidates in biofilm inhibition in food industries
Authors: Khani Nader , Abedi Soleimani Roya , Chadorshabi Sara , Moutab Bahareh Pouragha , Milani Payam Gonbari , Rad Aziz Homayouni
Published: June 2023

Food-borne pathogen-related biofilms in food processing environments pose significant risks to human health. To ensure human and environmental safety, natural substances with anti-microbial properties and generally recognized as safe (GRAS) status are the future disinfectants of the food industry. The use of postbiotics in food products is gaining attention due to their many benefits. Postbiotics are soluble substances produced by probiotics or released after their lysis, such as bacteriocins, biosurfactants (BSs), and exopolysaccharides (EPS). Postbiotics have drawn attention because of their clear chemical structure, safety dose parameters, long shelf life, and the content of various signaling molecules, which may have anti-biofilm and antibacterial activities. The main mechanisms of postbiotics to combat biofilm contain suppression of twitching motility, disturbing quorum sensing (QS), and reduction of virulence factors. However, there are obstacles to using these compounds in the food matrix because some factors (temperature and pH) can limit the anti-biofilm impact of postbiotics. Therefore, by using encapsulation or application of these compounds in packaging films, the effect of interfering factors can be eliminated. This review summarizes the concept and safety of postbiotics, focusing on their antibiofilm effect, as well as discussing the encapsulation of postbiotics and their application in packaging films.
Cytoplasmic DNA sensing boosts CD4+ T cell metabolism for inflammatory induction
Authors: Ye Jialin , Fu Jiemeng , Hou Hui , Wang Yan , Deng Wei , Hao Shumeng , Pei Yifei , Xu Jing , Zheng Mingyue , Xiao Yichuan
Published: June 2023

DNA accumulation is associated with the development of autoimmune inflammatory diseases. However, the pathological role and underlying mechanism of cytoplasmic DNA accumulation in CD4+ T cells have not been well established. Here, we show that Trex1 deficiency-induced endogenous DNA accumulation in CD4+ T cells greatly promoted their induction of autoimmune inflammation in a lupus-like mouse model. Mechanistically, the accumulated DNA in CD4+ T cells was sensed by the KU complex, then triggered the activation of DNA-PKcs and ZAK and further facilitated the activation of AKT, which exacerbated glycolysis, thereby promoting the inflammatory responses. Accordingly, blocking the DNA sensing pathway in CD4+ T cells by genetic knockout of Zak or using our newly developed ZAK inhibitor iZAK2 attenuated all pathogenic characteristics in a lupus-like inflammation mouse model induced with Trex1-deficient CD4+ T cells. Overall, our study demonstrated a causal link between DNA-sensing and metabolic reprogramming in CD4+ T cells for inflammatory induction and suggested inhibition of the DNA sensing pathway may be a potential therapy for the treatment of inflammatory diseases.
Lexical diversity as a lens into the classification of Slavic languages: A quantitative typology perspective
Authors: Zhou Chenliang , Liu Haitao
Published: June 2023

This study proposes a linguistic classification method based on quantitative typology, which leverages a large-scale multilingual parallel corpus to obtain valid language classification result by excluding the influence of covariates such as text genre and semantic content in cross-language comparison. To achieve this, we model the type–token relationships of each Slavic parallel text and calculate the lexical diversity to approximate the morphological complexity of the language. We perform automatic clustering of languages based on these lexical diversity metrics. Our findings show that (1) the lexical diversity metrics can well reflect that the language is located somewhere on the continuum of ‘analytism-synthetism’; (2) the automatic clustering based on these metrics effectively reflects the genealogical classification of Slavic languages; and (3) the geographical distribution of lexical diversity in the region where Slavic languages are spoken shows a monotonic increasing trend from southwest to northeast, which is consistent with the pattern found by previous authors on a global scale. The methodological approach taken in this study is data-driven, with the benefit of being independent of theoretical assumptions and easy for computer processing. This approach can offer a better insight into corpus-based typology and may shed light on the understanding of language as a human-driven complex adaptive system.
Interpersonal influences on decision-making capacity: a content analysis of court judgments
Authors: Ariyo Kevin , Kane Nuala B , Owen Gareth S , Ruck Keene Alex
Published: June 2023

For many purposes in England and Wales, the Court of Protection determines whether a person has or lacks capacity to make a decision, by applying the test within the Mental Capacity Act 2005. This test is regularly described as a cognitive test with cognitive processes discussed as internal characteristics. However, it is unclear how the courts have framed interpersonal influence as negatively impacting upon a person’s decision-making processes in a capacity assessment context. We reviewed published court judgments in England and Wales in which interpersonal problems were discussed as relevant to capacity. Through content analysis, we developed a typology that highlights five ways the courts considered influence to be problematic to capacity across these cases. Interpersonal influence problems were constructed as (i) P’s inability to preserve their free will or independence, (ii) restricting P’s perspective, (iii) valuing or dependence on a relationship, (iv) acting on a general suggestibility to influence, or (v) P denying facts about the relationship. These supposed mechanisms of interpersonal influence problems are poorly understood and clearly merit further consideration. Our typology and case discussion are a start towards more detailed practice guidelines, and raise questions as to whether mental capacity and influence should remain legally distinct.
Dark Energy Survey Year 3 results: magnification modelling and impact on cosmological constraints from galaxy clustering and galaxy–galaxy lensing
Authors: Elvin-Poole J , MacCrann N , Everett S , Prat J , Rykoff E S , De Vicente J , Yanny B , Herner K , Ferté A , Valentino E Di , Choi A , Burke D L , Sevilla-Noarbe I , Alarcon A , Alves O , Amon A , Andrade-Oliveira F , Baxter E , Bechtol K , Becker M R , Bernstein G M , Blazek J , Camacho H , Campos A , Rosell A Carnero , Kind M Carrasco , Cawthon R , Chang C , Chen R , Cordero J , Crocce M , Davis C , DeRose J , Diehl H T , Dodelson S , Doux C , Drlica-Wagner A , Eckert K , Eifler T F , Elsner F , Fang X , Fosalba P , Friedrich O , Gatti M , Giannini G , Gruen D , Gruendl R A , Harrison I , Hartley W G , Huang H , Huff E M , Huterer D , Krause E , Kuropatkin N , Leget P-F , Lemos P , Liddle A R , McCullough J , Muir J , Myles J , Navarro-Alsina A , Pandey S , Park Y , Porredon A , Raveri M , Rodriguez-Monroy M , Rollins R P , Roodman A , Rosenfeld R , Ross A J , Sánchez C , Sanchez J , Secco L F , Sheldon E , Shin T , Troxel M A , Tutusaus I , Varga T N , Weaverdyck N , Wechsler R H , Yin B , Zhang Y , Zuntz J , Aguena M , Avila S , Bacon D , Bertin E , Bocquet S , Brooks D , García-Bellido J , Honscheid K , Jarvis M , Li T S , Mena-Fernández J , To C , Wilkinson R D ,   DES Collaboration
Published: June 2023

We study the effect of magnification in the Dark Energy Survey Year 3 analysis of galaxy clustering and galaxy–galaxy lensing, using two different lens samples: a sample of luminous red galaxies, redMaGiC, and a sample with a redshift-dependent magnitude limit, MagLim. We account for the effect of magnification on both the flux and size selection of galaxies, accounting for systematic effects using the Balrog image simulations. We estimate the impact of magnification on the galaxy clustering and galaxy–galaxy lensing cosmology analysis, finding it to be a significant systematic for the MagLim sample. We show cosmological constraints from the galaxy clustering autocorrelation and galaxy–galaxy lensing signal with different magnifications priors, finding broad consistency in cosmological parameters in ΛCDM and wCDM. However, when magnification bias amplitude is allowed to be free, we find the two-point correlation functions prefer a different amplitude to the fiducial input derived from the image simulations. We validate the magnification analysis by comparing the cross-clustering between lens bins with the prediction from the baseline analysis, which uses only the autocorrelation of the lens bins, indicating that systematics other than magnification may be the cause of the discrepancy. We show that adding the cross-clustering between lens redshift bins to the fit significantly improves the constraints on lens magnification parameters and allows uninformative priors to be used on magnification coefficients, without any loss of constraining power or prior volume concerns.
Outflow densities and ionization mechanisms in the NLRs of the prototypical Seyfert galaxies NGC 1068 and NGC 4151
Authors: Holden Luke R , Tadhunter Clive N
Published: June 2023

Despite being thought to play an important role in galaxy evolution, the true impact of outflows driven by active galactic nuclei (AGNs) on their host galaxies is unclear. In part, this may be because electron densities of outflowing gas are often underestimated: recent studies that use alternative diagnostics have measured much higher densities than those from commonly used techniques and consequently find modest outflow masses and kinetic powers. Furthermore, outflow ionization mechanisms – which are often used to probe acceleration mechanisms – are also uncertain. To address these issues, we have analysed archival HST/STIS spectra of the inner regions (r < 160 pc) of the nearby prototypical Seyfert galaxies NGC 1068 and NGC 4151, which show evidence of warm-ionized outflows driven by the central AGN. We derive high electron densities (103.6 < ne < 104.8 cm−3) using the transauroral [O ii] and [S ii] emission line ratios for the first time with spatially resolved observations. Moreover, we find evidence that the gas along the radio axis in NGC 1068 has a significant AGN-photoionized matter-bounded component, and there is evidence for shock-ionization and/or radiation-bounded AGN-photoionization along the radio axis in NGC 4151. We also note that the outflow extents are similar to those of the radio structures, consistent with acceleration by jet-induced shocks. Taken together, our investigation demonstrates the diversity of physical and ionization conditions in the narrow-line regions of Seyfert galaxies, and hence reinforces the need for robust diagnostics of outflowing gas densities and ionization mechanisms.
Successful treatment of refractory enteritis and arthritis with combination of tumour necrosis factor and interleukin-6 inhibition in patients with ulcerative colitis
Authors: Ishigaki Sho , Kondo Yasushi , Ota Yuichiro , Chu Po-Sung , Hanaoka Hironari , Takeuchi Tsutomu , Kaneko Yuko
Published: June 2023

An 18 year-old man with autoimmune hepatitis-primary sclerosing cholangitis-overlap syndrome and ulcerative colitis was admitted due to relapsed enteritis and polyarthritis after cessation of infliximab. Colonoscopy and articular ultrasonography revealed large ulcers in the colon with crypt abscess in the specimens and active enthesitis and synovitis, respectively. His intestinitis was improved with golimumab but arthritis was persistent. Golimumab was switched to secukinumab, which was effective for arthritis. However, colitis was flared resulting in total colorectal resection. One month after colectomy, polyarthritis was relapsed. Tocilizumab ameliorated arthritis but enteritis emerged again, and switching tocilizumab to adalimumab improved enteritis but arthritis exacerbated. Finally, we restarted tocilizumab for arthritis with continued adalimumab for enteritis. The dual cytokine blocking strategy, tumour necrosis factor-α and interleukin-6 inhibition, subsided both of his refractory enteritis and arthritis and maintained remission for more than 3 years without any serious adverse event. Our case suggests that enteritis and arthritis in inflammatory bowel disease may be different in pathophysiology and raises the possible usefulness of simultaneous inhibition of two inflammatory cytokines in such cases.
Simultaneous hybrid closed-wedge supramalleolar osteotomy and ankle arthrodesis for post-traumatic varus ankle arthritis with periarticular deformity: A case report
Authors: Kobayashi Hayato , Shido Yoji
Published: June 2023

The treatment of end-stage ankle arthritis associated with extra-articular tibial deformity, especially for ankles deformed by previous traumatic injuries and/or surgical treatment, is extremely challenging but rewarding. Only one previous report describes simultaneous tibial deformity correction and ankle arthrodesis for tibial malalignment and ipsilateral ankle arthritis. Here, we describe a unique case of post-traumatic ankle osteoarthritis concomitant with extra-articular varus deformity in a 77-year-old female. We have combined medial opening-wedge supramalleolar osteotomy (SMO) and lateral closed-wedge SMO in this case, which we termed ‘hybrid’ closed-wedge SMO, to overcome the limitations of traditional closed-wedge SMO. The patient was successfully treated with simultaneous hybrid closed-wedge SMO and ankle arthrodesis using a single lateral locking plate. To our knowledge, this is the first report describing the successful introduction of a hybrid closed-wedge osteotomy procedure in the distal tibia. Three years after surgery, the patient could walk without assistance and swim normally. The patient experienced no discomfort or pain in the operated ankle and was satisfied with the results. Radiographs confirmed that the pre-existing ankle joint line was parallel to the ground and almost invisible. The hind foot alignment was slightly valgus. No progression of the subtalar joint arthritis was detected. The simultaneous hybrid closed-wedge SMO and ankle arthrodesis was technically difficult but effective. This technique preserves leg length and subtalar joint motion. Additionally, a single lateral incision minimises the risk of impaired blood supply. The one-stage surgical treatment reduces the recovery time, duration of hospitalisation, and surgical costs. Rigid locking fixation with careful postoperative weight-bearing is required for uneventful bone healing.
Primary angiitis of the central nervous system in a patient with transient episodes of headache and aphasia: A case report
Authors: Papantoniou Michail , Korfias Stefanos , Argyrakos Theodoros , Aggelidakis Panagiotis , Tavernarakis Antonios
Published: June 2023

Primary angiitis of the central nervous system (PACNS) refers to a rare form of vasculitis of unknown cause, with a challenging diagnostic work-up. We report the case of a 57-year-old patient who presented with transient episodes of headache and global aphasia. Cerebrospinal fluid (CSF) examination revealed lymphocytic pleocytosis with moderate elevated protein and normal glucose. CSF and serum tests for infections and autoimmune/paraneoplastic antibodies were negative, except CSF polymerase chain reaction testing that detected Epstein-Barr virus (EBV). Magnetic resonance imaging of the brain with intravenous gadolinium showed meningeal enhancement and pachymeningitis. Due to continuous relapsing episodes of aphasia, a leptomeningeal and brain tissue biopsy was performed and revealed lesions of granulomatous necrotising vasculitis of medium-sized leptomeningeal and intracranial vessels, as well as negative in situ hybridism for EBV. A diagnosis of primary granulomatous necrotising angiitis of the central nervous system was made, and the patient was treated with intravenous methylprednisolone and oral cyclophosphamide, showing excellent response to treatment. Diversity in clinical and laboratory features makes it difficult for PACNS to be distinguished by other systemic vasculitides. Laboratory tests and neuroimaging can provide guidance in evaluation of the patients and exclude other possible causes, but tissue biopsy remains the gold standard for a definite diagnosis.
Diagnostic and therapeutic potential of circular RNA in brain tumors
Authors: Katsushima Keisuke , Joshi Kandarp , Perera Ranjan J
Published: June 2023

Circular RNAs (circRNAs) are a class of RNA with a stable cyclic structure. They are expressed in various tissues and cells with conserved, specific characteristics. CircRNAs have been found to play critical roles in a wide range of cellular processes by regulating gene expression at the epigenetic, transcriptional, and posttranscriptional levels. There is an accumulation of evidence on newly discovered circRNAs, their molecular interactions, and their roles in the development and progression of human brain tumors, including cell proliferation, cell apoptosis, invasion, and chemoresistance. Here we summarize the current state of knowledge of the circRNAs that have been implicated in brain tumor pathogenesis, particularly in gliomas and medulloblastomas. In providing a comprehensive overview of circRNA studies, we highlight how different circRNAs have oncogenic or tumor-suppressive roles in brain tumors, making them attractive therapeutic targets and biomarkers for personalized therapy and precision diagnostics. This review article discusses circRNAs’ functional roles and the prospect of using them as diagnostic biomarkers and therapeutic targets in patients with brain tumors.
Intrinsic spin shielding effect in platinum–rare-earth alloy boosts oxygen reduction activity
Authors: Zhu Siyuan , Sun Mingzi , Mei Bingbao , Yang Liting , Chu Yuyi , Shi Zhaoping , Bai Jingsen , Wang Xian , Jiang Zheng , Liu Changpeng , Huang Bolong , Ge Junjie , Xing Wei
Published: June 2023

Oxygen reduction reactions (ORRs) involve a multistep proton-coupled electron process accompanied by the conversion of the apodictic spin configuration. Understanding the role of spin configurations of metals in the adsorption and desorption of oxygen intermediates during ORRs is critical for the design of efficient ORR catalysts. Herein, a platinum–rare-earth-metal-based alloy catalyst, Pt2Gd, is introduced to reveal the role of spin configurations in the catalytic activity of materials. The catalyst exhibits a unique intrinsic spin reconfiguration because of interactions between the Gd-4f and Pt-5d orbitals. The adsorption and desorption of the oxygen species are optimized by modifying the spin symmetry and electronic structures of the material for increased ORR efficiency. The Pt2Gd alloy exhibits a half-wave potential of 0.95 V and a superior mass activity of 1.5 A·mgPt−1 in a 0.1 M HClO4 electrolyte, as well as higher durability than conventional Pt/C catalysts. Theoretical calculations have proven that the spin shielding effect of Gd pairs increases the spin symmetry of Pt-5d orbitals and adsorption preferences toward spin-polarized intermediates to facilitate ORR. This work clarifies the impact of modulating the intrinsic spin state of Pt through the interaction with the local high spin 4f orbital electrons in rare-earth metals, with the aim of boosting the spin-related oxygen reduction reaction, thus fundamentally contributing to the understanding of new descriptors that control ORR activity.
Candidemia in Patients With Cardiovascular Implantable Electronic Devices: Uncertainty in Management Based on Current International Guidelines
Authors: Chesdachai Supavit , Baddour Larry M , Sohail M Rizwan , Palraj Bharath Raj , Madhavan Malini , Tabaja Hussam , Fida Madiha , Challener Douglas W , DeSimone Daniel C
Published: June 2023

Background

In contrast to bloodstream infection due to a variety of bacteria in patients with cardiovascular implantable electronic devices (CIED), there are limited data regarding candidemia and risk of CIED infection.

Methods

All patients with candidemia and a CIED at Mayo Clinic Rochester between 2012 and 2019 were reviewed. Cardiovascular implantable electronic device infection was defined by (1) clinical signs of pocket site infection or (2) echocardiographic evidence of lead vegetations.

Results

A total of 23 patients with candidemia had underlying CIED; 9 (39.1%) cases were community onset. None of the patients had pocket site infection. The duration between CIED placement and candidemia was prolonged (median 3.5 years; interquartile range, 2.0–6.5). Only 7 (30.4%) patients underwent transesophageal echocardiography and 2 of 7 (28.6%) had lead masses. Only the 2 patients with lead masses underwent CIED extraction, but device cultures were negative for Candida species. Two (33.3%) of 6 other patients who were managed as candidemia without device infection subsequently developed relapsing candidemia. Cardiovascular implantable electronic device removal was done in both patients and device cultures grew Candida species. Although 17.4% of patients were ultimately confirmed to have CIED infection, CIED infection status was undefined in 52.2%. Overall, 17 (73.9%) patients died within 90 days of diagnosis of candidemia.

Conclusions

Although current international guidelines recommend CIED removal in patients with candidemia, the optimal management strategy remains undefined. This is problematic because candidemia alone is associated with increased morbidity and mortality as seen in this cohort. Moreover, inappropriate device removal or retention can both result in increased patient morbidity and mortality.