bluuebunny/crossref_metadata_2025 huggingface dataset:
The minimal important change for measures of balance and postural control in older adults: a systematic review
Authors: Low Daniel C , Walsh Gregory S
Published: December 2022

The minimal important change and analogous terms (MIC) can provide a measure of change in health outcome variables that is associated with a level of importance for participant/patient. This review explores the availability of the MIC for different balance measures used with older adults in research and clinical settings. PubMed, ProQuest and Web of Science search engines were used and based on the inclusion and exclusion criteria, 11 studies were deemed suitable for data extraction and analysis. The results demonstrated that MIC is available for the following balance-associated tests: Berg Balance Scale, Timed Up and Go, Short Physical Performance Battery, BESTest and the Tinetti test. A range of MIC values were shown, reflective of different older adult health conditions, calculation methods and anchors used. It was also evident that the responsiveness of the test was not always available or appropriately determined, questioning the validity of the MIC value published. Greater research is needed to establish MIC for balance measurements for use with older adults with different health conditions, preferably using objective measures such as falls. The calculation of such statistics will improve the evaluation of intervention effectiveness.
Targeted reduction of airborne viral transmission risk in long-term residential aged care
Authors: Brass Amanda , Shoubridge Andrew P , Larby Nicolas , Elms Levi , Sims Sarah K , Flynn Erin , Miller Caroline , Crotty Maria , Papanicolas Lito E , Wesselingh Steve L , Morawska Lidia , Bell Scott C , Taylor Steven L , Rogers Geraint B
Published: December 2022

COVID-19 has demonstrated the devastating consequences of the rapid spread of an airborne virus in residential aged care. We report the use of CO2-based ventilation assessment to empirically identify potential ‘super-spreader’ zones within an aged care facility, and determine the efficacy of rapidly implemented, inexpensive, risk reduction measures.
Lanthanum masquerading as foreign body ingestion in a critically ill patient with end-stage renal disease
Authors: Rappaport Stephen H , Vineyard Tedd , Hack Madelaine , Shah Tanya , Dooley Joseph W
Published: December 2022

Purpose

Medication use may affect imaging results. In this case study, we report a case of lanthanum ingestion resulting in imaging consistent with ingested metallic foreign bodies.

Hyperphosphatemia affects most patients with end-stage renal disease (ESRD) and is associated with morbidity and mortality. Lanthanum carbonate reduces daily phosphate absorption and is indicated as a non–calcium-based phosphate binder in patients with ESRD. A 58-year-old man with a medical history of stage 5 chronic kidney disease was admitted to the intensive care unit (ICU) for hyperkalemia and acute respiratory failure after a missed dialysis session. He required vasopressors, intubation, and continuous renal replacement therapy. Admission imaging demonstrated several ingested metallic foreign bodies within the colon. There was consideration of colorectal surgery and gastroenterology consultation. On the initial medication reconciliation, no medications that would have the radiographic appearance of ingested metallic foreign bodies were identified. On further review of prescription data available through the electronic medical record, it was noted that the patient had recently filled a prescription for lanthanum despite its apparent discontinuation on a previous admission. After interviewing the patient’s wife, it was confirmed that the patient had continued taking lanthanum and that he was swallowing it whole and not chewing it. No consultations or interventions were performed, and the metallic foreign bodies were no longer present on further imaging after a period of 35 days.

Conclusion

Escalation of care was avoided in this patient due to the performance of diligent medication reconciliation and recognition of the impact of lanthanum ingestion on imaging.
Severe Acute Respiratory Syndrome Coronavirus 2 Infection History and Antibody Response to 3 Coronavirus Disease 2019 Messenger RNA Vaccine Doses
Authors: Herring Meghan K , Romine James K , Wesley Meredith G , Ellingson Katherine D , Yoon Sarang K , Caban-Martinez Alberto J , Meece Jennifer , Gaglani Manjusha , Grant Lauren , Olsho Lauren E W , Tyner Harmony L , Naleway Allison L , Khan Sana M , Phillips Andrew L , Solle Natasha Schaefer , Rose Spencer , Mak Josephine , Fuller Sammantha B , Hunt Angela , Kuntz Jennifer L , Beitel Shawn , Yoo Young M , Zheng Pearl Q , Arani Gayatri , Lamberte Julie Mayo , Edwards Taylor , Thompson Mark G , Sprissler Ryan , Thornburg Natalie J , Lowe Ashley A , Pilishvili Tamara , Uhrlaub Jennifer L , Lutrick Karen , Burgess Jefferey L , Fowlkes Ashley L
Published: December 2022

Background

Data on antibody kinetics are limited among individuals previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). From a cohort of healthcare personnel and other frontline workers in 6 US states, we assessed antibody waning after messenger RNA (mRNA) dose 2 and response to dose 3 according to SARS-CoV-2 infection history.

Methods

Participants submitted sera every 3 months, after SARS-CoV-2 infection, and after each mRNA vaccine dose. Sera were tested for antibodies and reported as area under the serial dilution curve (AUC). Changes in AUC values over time were compared using a linear mixed model.

Results

Analysis included 388 participants who received dose 3 by November 2021. There were 3 comparison groups: vaccine only with no known prior SARS-CoV-2 infection (n = 224); infection prior to dose 1 (n = 123); and infection after dose 2 and before dose 3 (n = 41). The interval from dose 2 and dose 3 was approximately 8 months. After dose 3, antibody levels rose 2.5-fold (95% confidence interval [CI] = 2.2–3.0) in group 2 and 2.9-fold (95% CI = 2.6–3.3) in group 1. Those infected within 90 days before dose 3 (and median 233 days [interquartile range, 213–246] after dose 2) did not increase significantly after dose 3.

Conclusions

A third dose of mRNA vaccine typically elicited a robust humoral immune response among those with primary vaccination regardless of SARS-CoV-2 infection >3 months prior to boosting. Those with infection <3 months prior to boosting did not have a significant increase in antibody concentrations in response to a booster.
Review: Unravelling the Role of DNA Sensing in Alum Adjuvant Activity
Authors: Gatt Zara , Gunes Utku , Raponi Arianna , da Rosa Larissa Camargo , Brewer James M
Published: December 2022

Public interest in vaccines is at an all-time high following the SARS-CoV-2 global pandemic. Currently, over 6 billion doses of various vaccines are administered globally each year. Most of these vaccines contain Aluminium-based adjuvants (alum), which have been known and used for almost 100 years to enhance vaccine immunogenicity. However, despite the historical use and importance of alum, we still do not have a complete understanding of how alum works to drive vaccine immunogenicity. In this article, we critically review studies investigating the mechanisms of action of alum adjuvants, highlighting some of the misconceptions and controversies within the area. Although we have emerged with a clearer understanding of how this ubiquitous adjuvant works, we have also highlighted some of the outstanding questions in the field. While these may seem mainly of academic interest, developing a more complete understanding of these mechanisms has the potential to rationally modify and improve the immune response generated by alum-adjuvanted vaccines.
Predictive value of late gadolinium enhancement cardiovascular magnetic resonance in patients with persistent atrial fibrillation: dual-centre validation of a standardized method
Authors: Althoff Till F , Eichenlaub Martin , Padilla-Cueto David , Lehrmann Heiko , Garre Paz , Schoechlin Simon , Ferro Elisenda , Invers Eric , Ruile Philipp , Hein Manuel , Schlett Christopher , Figueras i Ventura Rosa M , Prat-Gonzalez Susanna , Mueller-Edenborn Bjoern , Bohnen Marius , Porta-Sanchez Andreu , Tolosana Jose Maria , Guasch Eduard , Roca-Luque Ivo , Arbelo Elena , Neumann Franz-Josef , Westermann Dirk , Sitges Marta , Brugada Josep , Arentz Thomas , Mont Lluís , Jadidi Amir
Published: December 2022

Aims

With recurrence rates up to 50% after pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF), predictive tools to improve patient selection are needed. Patient selection based on left atrial late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been proposed previously (UTAH-classification). However, this approach has not been widely established, in part owed to the lack of standardization of the LGE quantification method. We have recently established a standardized LGE-CMR method enabling reproducible LGE-quantification. Here, the ability of this method to predict outcome after PVI was evaluated.

Methods and results

This dual-centre study (n = 219) consists of a prospective derivation cohort (n = 37, all persistent AF) and an external validation cohort (n = 182; 66 persistent, 116 paroxysmal AF). All patients received an LGE-CMR prior to first-time PVI-only ablation. LGE was quantified based on the signal-intensity-ratio relative to the blood pool, applying a uniform LGE-defining threshold of >1.2.  In patients with persistent AF in the derivation cohort, left atrial LGE-extent above a cut-off value of 12% was found to best predict relevant low-voltage substrate (≥2 cm two with <0.5 mV during sinus rhythm) and arrhythmia-free survival 12 months post-PVI. When applied to the external validation cohort, this cut-off value was also predictive of arrhythmia-free survival for both, the total cohort and the subgroup with persistent AF (LGE < 12%: 80% and 76%; LGE > 12%: 55% and 44%; P = 0.007 and P = 0.029, respectively).

Conclusion

This dual-centre study established and validated a standardized, reproducible LGE-CMR method discriminating PVI responders from non-responders, which may improve choice of therapeutic approach or ablation strategy for patients with persistent AF.
Incompatibility and Interchangeability in Molecular Evolution
Authors: Sloan Daniel B , Warren Jessica M , Williams Alissa M , Kuster Shady A , Forsythe Evan S
Published: December 2022

There is remarkable variation in the rate at which genetic incompatibilities in molecular interactions accumulate. In some cases, minor changes—even single-nucleotide substitutions—create major incompatibilities when hybridization forces new variants to function in a novel genetic background from an isolated population. In other cases, genes or even entire functional pathways can be horizontally transferred between anciently divergent evolutionary lineages that span the tree of life with little evidence of incompatibilities. In this review, we explore whether there are general principles that can explain why certain genes are prone to incompatibilities while others maintain interchangeability. We summarize evidence pointing to four genetic features that may contribute to greater resistance to functional replacement: (1) function in multisubunit enzyme complexes and protein–protein interactions, (2) sensitivity to changes in gene dosage, (3) rapid rate of sequence evolution, and (4) overall importance to cell viability, which creates sensitivity to small perturbations in molecular function. We discuss the relative levels of support for these different hypotheses and lay out future directions that may help explain the striking contrasts in patterns of incompatibility and interchangeability throughout the history of molecular evolution.
Investigation of Causal Effects of Protein Biomarkers on Cardiovascular Disease in Persons With HIV
Authors: Reilly Cavan S , Borges Álvaro H , Baker Jason V , Safo Sandra E , Sharma Shweta , Polizzotto Mark N , Pankow James S , Hu Xiaojun , Sherman Brad T , Babiker Abdel G , Lundgren Jens D , Lane H Clifford
Published: December 2022

Background

There is an incompletely understood increased risk for cardiovascular disease (CVD) among people with HIV (PWH). We investigated if a collection of biomarkers were associated with CVD among PWH. Mendelian randomization (MR) was used to identify potentially causal associations.

Methods

Data from follow-up in 4 large trials among PWH were used to identify 131 incident CVD cases and they were matched to 259 participants without incident CVD (controls). Tests of associations between 460 baseline protein levels and case status were conducted.

Results

Univariate analysis found CLEC6A, HGF, IL-6, IL-10RB, and IGFBP7 as being associated with case status and a multivariate model identified 3 of these: CLEC6A (odds ratio [OR] = 1.48, P = .037), HGF (OR = 1.83, P = .012), and IL-6 (OR = 1.45, P = .016). MR methods identified 5 significantly associated proteins: AXL, CHI3L1, GAS6, IL-6RA, and SCGB3A2.

Conclusions

These results implicate inflammatory and fibrotic processes as contributing to CVD. While some of these biomarkers are well established in the general population and in PWH (IL-6 and its receptor), some are novel to PWH (HGF, AXL, and GAS6) and some are novel overall (CLEC6A). Further investigation into the uniqueness of these biomarkers in PWH and the role of these biomarkers as targets among PWH is warranted.
Pod Save IR: Podcasts as Effective Assignments in the International Relations Classroom
Authors: Krain Matthew
Published: December 2022

This paper discusses the development of a podcast assignment as an alternative to a literature review paper in the international studies classroom. A podcast assignment still enables students to read, evaluate, and synthesize research in a given field, but also allows them to meet other important educational objectives such as application of research to a real-world problem or setting, teamwork, problem-solving, feeling a part of an intellectual community, communication and digital media skills, engagement with the field and the material, and ability to communicate academic research to an interested nonexpert audience. The paper situates podcasts within the scholarship of active teaching and learning, and describes the rationale for the development of the assignment in a course on international political economy, in part to deal with issues arising from the COVID-19 disruption. It describes how the assignment was run and was evaluated, and provides the assignment task description and scoring rubric, as well as supporting materials and resources. Finally, the paper uses student postexperience surveys to gather indirect assessment data on the podcast assignment's effectiveness in achieving a range of educational objectives.
What Are UN General Assembly Resolutions for? Four Views on Parliamentary Diplomacy
Authors: Mesquita Rafael , Pires Antonio
Published: December 2022

The United Nations General Assembly (UNGA) has passed over eighteen thousand resolutions since its foundation. It is a very heterogeneous collection, containing at once landmark documents, such as the Universal Declaration of Human Rights, and scores of less important and even controversial pieces. Hence, scholarship for the past 75 years has been divided on the actual relevance of UNGA resolutions and on member states’ motivations in engaging with their drafting. We propose a novel theoretical typology to organize prevailing views on the role of UNGA resolutions. Relying on the dimensions of effect and consensus, that is, whether or not resolutions are deemed to have a real-world impact and to what extent they represent world opinion, we sort the literature into four ideal types: resolutions can be regarded as the fruit of deliberation, dispute, diversion, or drama. We discuss the rationale of each view and indicate proposals within the UNGA that exemplify these perspectives. Our typology contributes to scholarship by both tidying previous debates and highlighting unnoticed commonalities between the UNGA and topics from the political representation literature.
Artificial Intelligence for Breast US
Authors: Villa-Camacho Juan C , Baikpour Masoud , Chou Shinn-Huey S
Published: December 2022

US is a widely available, commonly used, and indispensable imaging modality for breast evaluation. It is often the primary imaging modality for the detection and diagnosis of breast cancer in low-resource settings. In addition, it is frequently employed as a supplemental screening tool via either whole breast handheld US or automated breast US among women with dense breasts. In recent years, a variety of artificial intelligence systems have been developed to assist radiologists with the detection and diagnosis of breast lesions on US. This article reviews the background and evidence supporting the use of artificial intelligence tools for breast US, describes implementation strategies and impact on clinical workflow, and discusses potential emerging roles and future directions.
In vivogenotoxicity of high-intensity intermediate frequency magnetic fields in somatic cells and germ cells
Authors: Ohtani Shin , Ushiyama Akira , Wada Keiji , Suzuki Yukihisa , Hattori Kenji
Published: December 2022

Intermediate frequency magnetic fields (IF-MFs) at ~85 kHz are one of the components of wireless power transfer (WPT) systems. However, the available data needed for the assessment of the safety of organisms from IF-MF exposure are scarce. Thus, there is an imminent need to accumulate evidence-based assessment data. In particular, if humans are exposed to IF-MF due to an accident or trouble, they are at increased risk of being exposed to high-intensity IF-MF within a short period. The already existing exposure system was improved to a system that could intermittently expose animals at 3 s intervals. This system allows the exposure of a mouse to high-intensity IF-MF (frequency: 82.3 kHz; induced electric field: 87 V/m, which was 3.8 times the basic restriction level for occupational exposure in the ICNIRP guideline), while regulating the heat generated by the coil. In vivo genotoxicity after IF-MF exposure was assessed using micronucleus (MN) test, Pig-a assay, and gpt assay. The results of MN test and Pig-a assay in hematopoietic cells revealed that neither the reticulocytes nor the mature erythrocytes exhibited significant increases in the IF-MF-exposed group compared with that in the sham-exposed group. In germ cells, MN test and gpt assay outcomes showed that IF-MF exposure did not cause any genetic or chromosomal abnormality. Based on these data, there was no genotoxic effect of our set IF-MF exposure on somatic and germ cells. These findings can contribute to the widespread use of WPT systems as effective data of IF-MF safety assessment.
Unexpected post-operative haemorrhage: Could it be splenosis?
Authors: Boerkamp Andrea , Das Ashwin , De Robles Marie Shella
Published: December 2022

Ectopic splenic tissue can be classified as accessory spleen, polysplenia or a phenomenon termed as splenosis. Once believed a rare occurrence, the incidence of splenosis is now thought to be significantly higher. Generally, splenosis is asymptomatic and discovered incidentally during operation, imaging or at autopsy. The case presented herein describes an incidental finding of an intraabdominal splenosis, which was subsequently biopsied to investigate for peritoneal metastatic disease. The biopsied tissue subsequently caused significant post-operative haemorrhage. Past medical history and specific pre-operative imaging modalities for patients presenting with asymptomatic peritoneal or intra-abdominal nodules are discussed. Splenosis is highlighted as a common condition to consider prior to invasive investigations.
Reference genes for quantitative Arabidopsis single molecule RNA fluorescencein situhybridization
Authors: Duncan Susan , Johansson Hans E , Ding Yiliang
Published: December 2022

Subcellular mRNA quantities and spatial distributions are fundamental for driving gene regulatory programmes. Single molecule RNA fluorescence in situ hybridization (smFISH) uses fluorescent probes to label individual mRNA molecules, thereby facilitating both localization and quantitative studies. Validated reference mRNAs function as positive controls and are required for calibration. Here we present selection criteria for the first set of Arabidopsis smFISH reference genes. Following sequence and transcript data assessments, four mRNA probe sets were selected for imaging. Transcript counts per cell, correlations with cell size, and corrected fluorescence intensities were all calculated for comparison. In addition to validating reference probe sets, we present sample preparation steps that can retain green fluorescent protein fluorescence, thereby providing a method for simultaneous RNA and protein detection. In summary, our reference gene analyses, modified protocol, and simplified quantification method together provide a firm foundation for future quantitative single molecule RNA studies in Arabidopsis root apical meristem cells.
SICRET: Supernova Ia Cosmology with truncated marginal neural Ratio EsTimation
Authors: Karchev Konstantin , Trotta Roberto , Weniger Christoph
Published: December 2022

Type Ia supernovae (SNe Ia), standardizable candles that allow tracing the expansion history of the Universe, are instrumental in constraining cosmological parameters, particularly dark energy. State-of-the-art likelihood-based analyses scale poorly to future large data sets, are limited to simplified probabilistic descriptions, and must explicitly sample a high-dimensional latent posterior to infer the few parameters of interest, which makes them inefficient. Marginal likelihood-free inference, on the other hand, is based on forward simulations of data, and thus can fully account for complicated redshift uncertainties, contamination from non-SN Ia sources, selection effects, and a realistic instrumental model. All latent parameters, including instrumental and survey-related ones, per object and population-level properties, are implicitly marginalized, while the cosmological parameters of interest are inferred directly. As a proof of concept, we apply truncated marginal neural ratio estimation (TMNRE), a form of marginal likelihood-free inference, to bahamas, a Bayesian hierarchical model for salt parameters. We verify that TMNRE produces unbiased and precise posteriors for cosmological parameters from up to 100 000 SNe Ia. With minimal additional effort, we train a network to infer simultaneously the ${\sim}100\, 000$ latent parameters of the supernovae (e.g. absolute brightnesses). In addition, we describe and apply a procedure that utilizes local amortization of the inference to convert the approximate Bayesian posteriors into frequentist confidence regions with exact coverage. Finally, we discuss the planned improvements to the model that are enabled by using a likelihood-free inference framework, like selection effects and non-Ia contamination.
The Intersections of Race, Burnout, and Self-Care in Social Justice and Music Therapy
Authors: Kunimura Ami
Published: December 2022

Burnout, race, self-care, and social justice are multidimensional and dynamic topics that have multiple intersections and implications for music therapists. Exploring the relationship between race and burnout is necessary because centuries of racism have created health and occupational inequities for people of color and because retaining a diverse workforce is essential for quality client care. This is especially important for music therapy, where professionals of color are underrepresented in a field that serves a diverse clientele with music, a culturally centered art form. This article will first explore current research on race and 2 types of burnout. Occupational burnout is a current public health issue and activist burnout is a major barrier to sustaining social movements. These 2 types of burnout may overlap and may be symptoms of larger systemic and social issues. Although self-care is needed to navigate both occupational burnout and activist burnout, self-care is not just a means of burnout prevention and stress management. In the context of race and social justice, self-care takes on deeper meanings and purposes that can be further supported by the principles of moral courage and moral resilience to cultivate progress, strength, equity, and inclusion in the music therapy profession. Self-care can symbolize freedom and compassion, and new perspectives will be offered on acknowledging self-care as an ethical responsibility and honoring self-care as an inherent human right.
Calc-Alkaline Plutons in a Proto-Tethyan Intra-Oceanic Arc (Qilian Orogen, NW China): Implications for the Construction of Arc Crust
Authors: Wang Chao , Song Shuguang , Zhao Guochun , Allen Mark B , Su Li , Gao Tianyu , Wen Tao , Feng Di
Published: December 2022

Intra-oceanic arcs are one of the major building blocks of continents, and the rarely exposed calc-alkaline plutons in intra-oceanic arcs are a critical component of arc crust. These calc-alkaline plutons provide juvenile crustal materials to the continental crust, and thus their petrogenesis has important implications for the formation and evolution of continental crust. Here, we present the results of an integrated study, involving field investigation, petrology, geochronology and geochemistry, on calc-alkaline intermediate–felsic plutons and their mafic magmatic enclaves (MMEs) within a Proto-Tethyan intra-oceanic arc in the Lajishan terrane of the Qilian Orogen, northern Tibetan Plateau. These calc-alkaline intermediate–felsic plutons range from gabbroic diorites, through diorites, to granodiorites. In situ zircon U–Pb dating demonstrates that these plutons were emplaced in the Early Paleozoic (474–460 Ma), slightly older than previously identified 460–440 Ma intra-oceanic arc volcanics (boninites, ankaramites, high-Mg basaltic andesites, high-Al andesites, sanukites) in the Lajishan terrane. The geochemistry of these plutons indicates that they were differentiation products of subduction-metasomatized arc mantle-derived melts, and isotope modeling constrains that their mantle source was metasomatized by less than 10% addition of slab-derived fluids/melts. Their parental melts experienced polybaric medium- to high-pressure fractional crystallization to generate the compositional variation of these plutons. There are two types of MMEs according to their different geochemistry (high- and low-MgO MMEs) and both of them are early crystallized melts derived from the heterogeneous subduction-metasomatized arc mantle wedge, captured by evolving magmas. Alkaline high-MgO MMEs represent near-primitive alkaline melts derived from melting of pyroxenite with phlogopite-enriched veins in the heterogeneous arc mantle wedge, while low-MgO MMEs stand for relatively evolved calc-alkaline melts formed during differentiation of the melts parental to their host. The upper crustal construction of this Proto-Tethyan intra-oceanic arc was achieved through earlier emplacement of 474–460 Ma calc-alkaline plutons followed by slightly later eruption of arc volcanics at 460–440 Ma above these plutons. As approximated by the composition of these calc-alkaline plutons and arc volcanics, the upper crustal composition of this Proto-Tethyan intra-oceanic arc is still juvenile and primitive. This juvenile intra-oceanic crust was accreted to continental blocks through arc–continent collision at 440–420 Ma, in response to closure of the Proto-Tethys Ocean. The accreted intra-oceanic crust represents addition of juvenile crustal materials to existing continents and has remained primitive and intact, which could be balanced by other more evolved crustal components to form a mature bulk continental crust.
Differences of nitrogen metabolism in date palm (Phoenix dactylifera) seedlings subjected to water deprivation and salt exposure
Authors: Du Baoguo , Winkler Jana Barbro , Ache Peter , White Philip J , Dannenmann Michael , Alfarraj Saleh , Albasher Gadah , Schnitzler Joerg-Peter , Hedrich Rainer , Rennenberg Heinz
Published: December 2022

Drought and salt exposure are among the most prevalent and severe abiotic stressors causing serious agricultural yield losses, alone and in combination. Little is known about differences and similarities in the effects of these two stress factors on plant metabolic regulation, particularly on nitrogen metabolism. Here, we studied the effects of water deprivation and salt exposure on water relations and nitrogen metabolites in leaves and roots of date palm seedlings. Both, water deprivation and salt exposure had no significant effects on plant water content or stable carbon (C) and nitrogen (N) isotope signatures. Significant effects of water deprivation on total C and N concentrations were only observed in roots, i.e., decreased total C and increased total N concentrations. Whereas salt exposure initially decreased total C and increased total N concentrations significantly in roots, foliar total C concentration was increased upon prolonged exposure. Initially C/N ratios declined in roots of plants from both treatments and upon prolonged salt exposure also in the leaves. Neither treatment affected soluble protein and structural N concentrations in leaves or roots, but resulted in the accumulation of most amino acids, except for glutamate and tryptophan, which remained stable, and serine, which decreased, in roots. Accumulation of the most abundant amino acids, lysine and proline, was observed in roots under both treatments, but in leaves only upon salt exposure. This finding indicates a similar role of these amino acids as compatible solutes in the roots in response to salt und drought, but not in the leaves. Upon prolonged treatment, amino acid concentrations returned to levels found in unstressed plants in leaves of water deprived, but not salt exposed, plants. The present results show both water deprivation and salt exposure strongly impact N metabolism of date palm seedlings, but in a different manner in leaves and roots.
Zearalenone regulates microRNA156 to affect the root development ofTetrastigma hemsleyanum
Authors: Li Jiangshan , Huang Xiaoping , Zeng Zhanghui , Chen Zhehao , Huang Jinxin , He Chenjing , Xiang Taihe
Published: December 2022

Zearalenone (ZEN) is a secondary metabolite from Fusarium species. It is also present in plants and regulates the photochemical reaction in Photosystem II, the stress response and root growth. To investigate the mechanism by which ZEN regulates Tetrastigma hemsleyanum root growth, differentially expressed microRNAs (miRNAs) were identified and verified by high-throughput sequencing and Agrobacterium rhizogenes-mediated transformation of the roots of T. hemsleyanum seedlings treated with and without ZEN. The predicted functions of microRNA156b (miR156b) and microRNA156f (miR156f) were confirmed in transgenic hairy roots. (i) A total of 70 miRNAs showed significantly different expression levels under ZEN treatment, including seven highly conserved miRNAs. (ii) The number of lateral roots and total root length of the transgenic hairy roots overexpressing miR156b and miR156f was significantly higher than the wild-type hairy roots, and thus the overexpression of miR156b and miR156f in T. hemsleyanum promoted lateral root development. (iii) Bioinformatics analysis predicted that the target genes of miR156b and miR156f were SPL9/10. As compared with the wild-type hairy roots, the expression of SPL9 was significantly lower in the hairy roots overexpressing miR156b, and the expression of SPL10 was significantly lower in the hairy roots overexpressing miR156f. Therefore, SPL9 could be the target gene of miR156b, and SPL10 could be the target gene of miR156f. This study shows that ZEN could increase the expression of miR156b and miR156f in T. hemsleyanum roots, which negatively regulated the expression of their putative target genes SPL9 and SPL10, consequently promoting the growth and development of the lateral roots.
Physiological and transcriptome analyses of the effects of excessive water deficit on malic acid accumulation in apple
Authors: Wang Ping , Lu Shixiong , Cao Xuejing , Ma Zonghuan , Chen Baihong , Mao Juan
Published: December 2022

Acidity is a determinant of the organoleptic quality of apple, whereas its regulatory mechanism under water stress remains obscure. Fruit from apple ‘Yanfu 3’ of Fuji trees grown under normal water irrigation (CK), excessive water deficit treatment (DRT) and excessive water irrigation treatment (WAT) were sampled at 85, 100, 115, 130, 145, 160 and 175 days after full bloom designated stages S1, S2, S3, S4, S5, S6 and S7, respectively. DRT treatment reduced the individual fruit weight and fruit moisture content, and increased fruit firmness. The malate content of DRT treatment was higher than that of CK and WAT from stages S1 to S7. RNA sequencing (RNA-seq) analysis of the transcriptome at stages S4, S6 and S7 indicated that malate anabolism was associated with cysteine and methionine, auxin signaling, glyoxylate and dicarboxylate and pyruvate metabolism. Overexpression of MdPEPC4 increased the malate content in apple calli induced by 4% PEG. Our study provides novel insights into the effects of water stress on the molecular mechanism underlying apple fruit acidity.
An update on inflammation in antiphospholipid syndrome
Authors: Ambati Amala , Zuo Yu , Knight Jason S.
Published: December 2022

Purpose of review

Antiphospholipid syndrome (APS) is an acquired thrombo-inflammatory disease associated with diverse clinical manifestations in the setting of persistently circulating antiphospholipid antibodies (aPL). This review summarizes recent developments in our understanding of the pathogenesis of APS and its various clinical manifestations with a focus on the activation of endothelial cells, complement, and neutrophils.

Recent findings

Elucidating the pathophysiology that leads to the diverse array of clinical manifestations of APS is an area of active exploration. Here, we highlight recent studies that have explored various impacts of endothelial activation and injury in APS, including the promotion of circulating endothelial cells and extracellular vesicles; the association between complement activity and different APS phenotypes, including pregnancy loss; and the relationship between neutrophil extracellular traps (NETs) and high-risk aPL profiles in thrombotic APS. We also call attention to recent work that proposes approaches to mitigating these pathologic changes as potential treatment strategies for APS. Lastly, we highlight promising future directions in APS research, such as multiomics approaches to molecularly stratifying APS patients.

The identification of novel aspects of pathogenesis and more nuanced approaches to phenotyping patients will hopefully pave the way for developing safer and more effective patient-specific therapeutic strategies for APS.
Projected burden of stroke in China through 2050
Authors: Yao Minghong , Ren Yan , Jia Yulong , Xu Jiayue , Wang Yuning , Zou Kang , Sun Xin
Published: December 2022

Background:

Stroke is the leading cause of death in China, and predicting the stroke burden could provide essential information guiding the setting of medium- and long-term health policies and priorities. The study aimed to project trends associated with stroke burden in China through 2050, not only in terms of incidence and mortality but also for prevalence and disability-adjusted life years (DALYs).

Methods:

Data on stroke rates in incidence, prevalence, deaths, and DALYs in China between 1990 and 2019 were obtained from a recent Global Burden of Disease study. Demographic-specific trends in rates over time were estimated using three models: the loglinear model, the Lee-Carter model, and a functional time series model. The mean absolute percentage error and the root mean squared error were used for model selection. Projections up to 2050 were estimated using the best fitting model. United Nations population data were used to project the absolute numbers through 2050.

Results:

From 2019 to 2050, the crude rates for all measures of the stroke burden are projected to increase continuously among both men and women. We project that compared with those in 2019, the incidence, prevalence, deaths, and DALYs because of stroke in China in 2050 will increase by 55.58%, 119.16%, 72.15%, and 20.04%, respectively; the corresponding increases in number were 2.19, 34.27, 1.58, and 9.21 million. The age-standardized rate is projected to substantially decline for incidence (8.94%), death (40.37%), and DALYs (43.47%), but the age-standardized prevalence rate is predicted to increase by 10.82%. By 2050, the burden of stroke among the population aged ≥65 years will increase significantly: by 104.70% for incidence, by 218.48% for prevalence, by 100.00% for death, and by 58.93% for DALYs.

Conclusions:

With the aging population in China increasing over the next three decades, the burden of stroke will be markedly increased. Continuous efforts are needed to improve stroke health care and secondary prevention, especially for older adults.
Regular use of vitamin D supplement is associated with fewer melanoma cases compared to non-use: a cross-sectional study in 498 adult subjects at risk of skin cancers
Authors: Kanasuo Emilia , Siiskonen Hanna , Haimakainen Salla , Komulainen Jenni , Harvima Ilkka T.
Published: December 2022

There are conflicting results on the role of vitamin D system in cutaneous carcinogenesis. Therefore, it was investigated whether the use of oral vitamin D supplements associates with photoaging, actinic keratoses, pigment cell nevi, and skin cancers. In this cross-sectional study, 498 adults (aged 21–79 years, 253 males, 245 females, 96 with immunosuppression) subjects at risk of any type of skin cancer were examined, and possible confounding factors were evaluated. The subjects were divided into three groups based on their self-reported use of oral vitamin D supplements: non-use, occasional use, or regular use. The serum level of 25-hydroxyvitamin-D3 was analyzed in 260 subjects. In 402 immunocompetent subjects, vitamin D use did not associate with photoaging, actinic keratoses, nevi, basal, and squamous cell carcinoma. In contrast, there were lower percentages of subjects with a history of past or present melanoma (32/177, 18.1% versus 32/99, 32.3%, P = 0.021) or any type of skin cancer (110/177, 62.1% versus 74/99, 74.7%, P = 0.027) among regular users compared to non-users. In the logistic regression analysis, the odds ratio for melanoma was 0.447 (P = 0.016, 95% confidence interval, 0.231–0.862) among regular users. Furthermore, the investigator-estimated risk class of skin cancers was significantly lower among regular users. Serum 25-hydroxyvitamin-D3 did not show marked associations with skin-related parameters. The results on 96 immunosuppressed subjects were somewhat similar, although the number of subjects was low. In conclusion, regular use of vitamin D associates with fewer melanoma cases, when compared to non-use, but the causality between them is obscure.
Factors Affecting Incidence of Ventilator-Associated Pneumonia With Multidrug-Resistant Microbes in Intensive Care Unit
Authors: Sami Ramin , Mousavi Fatemeh Al-Sadat , Mahjobipoor Hossein , Soltaninejad Forogh , Naderi Zohre
Published: December 2022

Ventilator-associated pneumonia (VAP) with multidrug-resistant (MDR) microbes is one of the leading causes of hospital mortality. In this study, the risk factors of pneumonia with MDR microbes are investigated. This work was a retrospective study conducted at 2 academic centers and 3 intensive care units (ICUs). All patients who were clinically suspected VAP and had a positive microbial culture have been included in this study from late March 2018 to mid-June 2019. Patients were divided into 2 groups: MDR and non-MDR. Clinical and paraclinical (CBC, microbial culture, CXR) findings of these patients were recorded and reviewed. Then, using the multivariate analysis, the factors affecting the incidence of VAP with MDR microbes were investigated. Out of the 1854 patients admitted to the ICU, 110 of them have been diagnosed with VAP using X-ray and microbiological findings, and MDR microbes were separated in the culture of 85 patients. The mean age range of the patients was 60 ± 20 years and 75% of them were male. In univariate analysis, the factors affecting the incidence of MDR VAP were as follows: length of stay in the ICU, length of stay in other wards, history of admission in ward before ICU, duration of mechanical ventilation, and diabetes. In multivariate analysis, diabetes (odds ratio, 2.66; 95% confidence interval, 0.9–7.8; P = 0.002), history of admission in ward before ICU (odds ratio, 10.25; 95% confidence interval, 3.17–33.1), and a combination of the 3 factors related to the length of exposuring health care environment which named FAC, were independent risk factors of infection with MDR microbes. Hence, the FAC variable includes the length of stay in ICU, duration of mechanical ventilation, and length of stay in other wards.
Antimicrobial Susceptibility Profile of Aerococcus urinae: Recommendations for Empirical Therapy
Authors: Saad Anas , Hailes Jennifer , Jacobs Michael R. , Navas Maria E.
Published: December 2022

Background

We studied the susceptibility profile of Aerococcus urinae recovered from urinary clinical samples with the aim of providing guidance in the choice of empiric antimicrobial treatment for urinary tract infection (UTI).

Methods

We studied stored isolates collected from UTIs of adult male and female VA patients of varying race/ethnicities from January 2019 to January 2021. Susceptibility of antimicrobials in the GPALLF3 Sensititre tray was determined. Minimum Inhibitory Concentration were interpreted based on breakpoints for Aerococcus species as outlined in the CLSI M45 standard and Streptococcus species viridans group or Enterococcus species, as outlined in the CLSI M100 standard.

Results

A total of 64 unique A. urinae isolates were recovered from the stored isolates. All isolates were susceptible to ampicillin, penicillin, linezolid, nitrofurantoin, and vancomycin, while 92.1% were susceptible to tetracycline, 63.6% to levofloxacin, and 44.5% to ciprofloxacin.

Conclusions

Our findings lead us to suggest the use of ampicillin, tetracycline, and nitrofurantoin for the empirical treatment of lower UTI caused by A. urinae.
A Case of Multifocal Pneumonia and Bacteremia Due to Streptococcus pneumoniae Complicated by Purulent Pericarditis in an Immunocompetent Patient
Authors: Cabanilla M. Gabriela , Jones Erika , Thompson Cecilia M. , Domman Daryl , Lacy Mark D.
Published: December 2022

Purulent pericarditis is rare in the antibiotic era. However, if not diagnosed quickly, it may be fatal. We describe a rare case of purulent pericarditis due to Streptococcus pneumoniae serotype 4 that originated from multifocal pneumonia complicated by bacteremia in an immunocompetent host.
A Case of Cryptococcal Meningitis Complicated by Postinfectious Inflammatory Response Syndrome in an Apparently Immunocompetent Patient
Authors: Miller Dwayvania , Osella Julieta , D’Acunto Victoria , Alper David P. , Gomez Ivette Saveedra , Feinstein Addi
Published: December 2022

Cryptococcal meningitis (CM) is a fungal infection most commonly seen in immunocompromised patients and rarely affecting immunocompetent patients. Cryptococcal meningitis can present with varying complications, such as disseminated disease and neurological complications that include intracranial hypertension, cerebral infarcts, and vision loss. Delayed diagnosis of CM contributes to the disease's mortality in the immunocompetent patient. We would like to present the case of a 27-year-old apparently immunocompetent woman admitted for CM with initial improvement and then neurological decline concerning for cryptococcal–postinfectious inflammatory response syndrome.
Alexithymia and Coping With Stress in Patients With Multiple Sclerosis: A Comparative Study
Authors: Taskin Yilmaz Feride , Sabanciogullari Selma , Sevimligul Gulgun
Published: December 2022

BACKGROUND:Multiple sclerosis (MS), which is frequently seen in young adults, affects mental health because of disease symptoms and cognitive disorders. This study was conducted to evaluate the presence of alexithymia and problem- or emotion-focused coping strategies with stress in MS patients, determine the relationship between these variables, and compare the results of MS patients with those of healthy individuals.METHODS:This descriptive, cross-sectional, and comparative study was carried out with the participation of 120 MS patients presenting to a neurology clinic and outpatient clinic of a university hospital and 120 healthy individuals. Data were collected using a personal information form, the Toronto Alexithymia Scale, and the Ways of Coping Scale.RESULTS:The 40.8% rate of alexithymia in the MS patients was higher than that in the healthy individuals (21.7%). Compared with healthy individuals, MS patients use emotion-focused coping methods, such as a lack of self-confidence approach and a submissive approach, more frequently (P< .05). A significant negative correlation was found between the alexithymia and problem-focused coping strategies of MS patients (P< .01).CONCLUSION:Alexithymia is more common in MS patients than in healthy individuals. Alexithymia negatively affects the methods patients use to cope with stress. In the treatment and care of MS patients, nurses should plan interventions for the ability of these patients to recognize and express their emotions and develop positive coping methods.
Study on the Cutoff Value of Backward Walking Speed to Distinguish the Mobility Deficits of Stroke Patients
Authors: Peng Jing , Teng Xiaoqiong , Lin Jing , Guo Junyi
Published: December 2022

BACKGROUND: Backward walking speed is an objective index to evaluate motor ability, but it is not clear whether it can screen stroke patients with mobility disorders. This study aims to test the diagnostic efficacy of backward maximum walking speed (BMWS) and backward comfortable walking speed (BCWS) on mobility defects in stroke patients and obtain the cutoff values of them.METHODS: We conducted a cross-sectional study of poststroke patients who were hospitalized from July 2021 to January 2022. 98 poststroke patients were selected for 6 functional tests and divided into the high–mobility function group and low–mobility function group byK-means cluster analysis. According to the test results of BMWS and BCWS, the receiver operating characteristic curve was drawn to determine the cutoff values and compare the diagnostic efficiency of the 2 indexes.RESULTS: The BMWS of stroke patients was 0.54 (0.29) m/s, and the BCWS was 0.37 (0.19) m/s. Receiver operating characteristic results showed that the cutoff value of BMWS for the diagnosis of mobility impairment in stroke patients was 0.3 m/s, the area under the curve was 0.95 (95% confidence interval, 0.89–0.98), the specificity was 0.86, and the sensitivity was 0.93. The cutoff value of BCWS was 0.27 m/s, the area under the curve was 0.91 (95% confidence interval, 0.84–0.96), the specificity was 0.91, and the sensitivity was 0.8. There was no significant difference between the 2 indexes in the diagnosis of mobility defects in stroke patients (P> .05).CONCLUSIONS: Backward walking speed is a useful indicator for discriminating stroke patients with mobility deficits. Considering the risks associated with backward walking, BCWS can be used in clinical assessments to guide nurses in the development and implementation of rehabilitation programs.