bluuebunny/crossref_metadata_2025 huggingface dataset:
Structure optimization of pulsed electric field processor and its sterilization effect
Authors: Tian Ye , Fan Wenshuo , Lu Weijian , Zhang Guanjun , Chang Zhengshi
Published: October 2023

Pulsed electric field (PEF) technology is a highly promising non-thermal processing technique, which holds great potential for sterilizing liquid food. The effectiveness of this treatment depends on two crucial factors: pulse parameters and the structure of the processor. In this study, we focus on optimizing the shape of insulators within the PEF processor to improve the sterilization effect. This research provides a reliable technical reference for designing industrial equipment. The numerical simulation of multi-physics fields was employed to analyze the temperature, electric field, and fluid field distributions for different insulators. Ultimately, the geometric structure of the insulator was optimized by embedding a 0.7-mm arc. Sterilization experiments were then conducted on Escherichia coli and Staphylococcus aureus suspensions with conductivities similar to those of real grapefruit juice. The sterilization effect of the processor with the optimized structure and the maximum applied voltage was examined at the same driving frequency. The results indicate that compared to the original structure, there is an increase in withstanding voltage by 5–10 kV while maintaining significantly improved bactericidal effects at the same applied voltage. Furthermore, we preliminarily discussed the sterilization mechanism by combining electroporation theory with the electroporation threshold of S. aureus.
A Reappraisal of the Effects of L-type Ca2+ Channel Blockers on Store-Operated Ca2+ Entry and Heart Failure
Authors: Bird Gary S , D’Agostin Diane , Alsanosi Safaa , Lip Stefanie , Padmanabhan Sandosh , Parekh Anant B
Published: October 2023

Dihydropyridines such as amlodipine are widely used as antihypertensive agents, being prescribed to ∼70 million Americans and >0.4 billion adults worldwide. Dihydropyridines block voltage-gated Ca2+ channels in resistance vessels, leading to vasodilation and a reduction in blood pressure. Various meta-analyses show that dihydropyridines are relatively safe and effective in reducing hypertension. The use of dihydropyridines has recently been called into question as these drugs appear to activate store-operated Ca2+ entry in fura-2-loaded nonexcitable cells, trigger vascular remodeling, and increase heart failure, leading to the questioning of their clinical use. Given that hypertension is the dominant “silent killer” across the globe affecting ∼1.13 billion people, removal of Ca2+ channel blockers as antihypertensive agents has major health implications. Here, we show that amlodipine has marked intrinsic fluorescence, which further increases considerably inside cells over an identical excitation spectrum as fura-2, confounding the ability to measure cytosolic Ca2+. Using longer wavelength Ca2+ indicators, we find that concentrations of Ca2+ channel blockers that match therapeutic levels in serum of patients do not activate store-operated Ca2+ entry. Antihypertensive Ca2+ channel blockers at pharmacological concentrations either have no effect on store-operated channels, activate them indirectly through store depletion or inhibit the channels. Importantly, a meta-analysis of published clinical trials and a prospective real-world analysis of patients prescribed single antihypertensive agents for 6 mo and followed up 1 yr later both show that dihydropyridines are not associated with increased heart failure or other cardiovascular disorders. Removal of dihydropyridines for treatment of hypertension cannot therefore be recommended.
Endoscopic ultrasound-guided injection of carbon nanoparticles suspension to label rectal cancer before neoadjuvant chemoradiotherapy: a retrospective cohort study
Authors: Lin Nan , Wang Yuanzhao , Yu Changwei , Wu Weihang , Fang Yongchao , Yang Jin , Liu Wangwu , Wang Rong , Jiang Yanyan , Wang Yu
Published: October 2023

Background

Localization of the primary tumor and ensuring safe distal surgical margins (DSMs) following neoadjuvant chemoradiotherapy (nCRT) are challenging in locally advanced rectal cancers (LARCs). This study investigated the effectiveness of carbon nanoparticles suspension (CNS) for labeling the primary tumor and allowing precise tumor resection after nCRT.

Methods

Clinicopathological data of LARC patients who underwent nCRT followed by laparoscopic radical anal preservation surgery at our center between January 2018 and February 2023 were prospectively collected. The patients were divided into the CNS tattooed (CNS) and non-tattooed (control) groups. In the CNS group, CNS was injected in four quadrants on the anal side 1 cm away from the lower tumor margin. DSMs were determined through intraoperative distal rectal examination in the control group and observation of CNS tattoos in the CNS group. DSM lengths and positive DSM rates were compared between the two groups to analyse the feasibility and effectiveness of CNS for labeling LARCs before nCRT.

Results

There was no statistically significant difference in the basic demographic data, effectiveness of nCRT, or post-operative recovery rates between the two groups (all P > 0.05). In the CNS group, CNS tattoos were observed on the outside of the rectal wall, with an overall efficiency of 87.1% (27/31). The CNS group had fewer positive DSMs and safer DSM lengths (2.73 ± 0.88 vs 2.12 ± 1.15 cm, P = 0.012) than the control group (P < 0.05).

Conclusions

Endoscopic ultrasound-guided injection of CNS tattoos before nCRT could effectively label the LARCs, ensuring safe DSMs during anus-preserving surgeries (Chictr.org.cn No.: ChiCTR2300068991).
The role of theory in researching and understanding human communication
Authors: Levine Timothy R , Markowitz David M
Published: October 2023

Communication is a theory-driven discipline, but does it always need to be? This article raises questions related to the role of theory in communication science, with the goal of providing a thoughtful discussion about what theory is, why theory is (or is not) important, the role of exploration in theory development, what constitutes a theoretical contribution, and the current state of theory in the field. We describe communication researchers’ interest with theory by assessing the number of articles in the past decade of research that mention theory (nearly 80% of papers have attended to theory in some way). This article concludes with a forward-looking view of how scholars might think about theory in their work, why exploratory research should be valued more and not considered as conflicting with theory, and how conceptual clarity related to theoretical interests and contributions are imperative for human communication research.
Real-time multi-month forecasting of skipjack tuna (Katsuwonus pelamis) habitat in the western and central Pacific Ocean for improved fishing efficiency and fisheries management
Authors: Wu X H , Chang Y , Liao T Y , Ding M M , Ke C C
Published: October 2023

Marine fish experience shifts in their distribution due to changes in the physical and biological environments. These shifts pose challenges for fishery businesses and management in international fisheries organizations. In the western and central Pacific Ocean, changes in the spatial distribution of skipjack tuna (Katsuwonus pelamis) due to climate variability often influence fishing activities and economic benefits. This study provides an operational forecast to enhance the decision-making process for fishery managers and fishermen by informing them about fish distributions in the coming months. Monthly forecasts of skipjack tuna habitat are generated utilizing a species distribution model (boosted regression trees) in combination with real-time environmental forecasts. An alternative method (dynamic time warping) is proposed to improve monthly chlorophyll forecasts, which are crucial for enhancing skipjack tuna habitat forecasting. To assess the prediction skills of the model, a retrospective analysis was conducted, forecasting skipjack tuna distribution over 9-month periods and comparing the forecasts with observed occurrences. The results demonstrate that 67.9% of the observed skipjack tuna catches occurred within the forecasted habitats, indicating that the forecast model skillfully predicted skipjack tuna movements 9 months in advance. These monthly updated forecasts can serve as a potential tool for resource managers in developing effective management strategies and fishers in planning fishing operations sustainably and responsibly.
What Is Needed to Move Toward Single-Step Diagnosis of Current HCV Infection?
Authors: Feld Jordan J
Published: October 2023

Despite remarkable therapeutic advances, hepatitis C virus (HCV) infection continues to be a major global problem. While the development of highly effective direct-acting antivirals has ensured that almost all those who are treated achieve viral cure, progress toward HCV elimination globally has stalled due to challenges upstream of treatment in the cascade of care, namely diagnosis and linkage to care. The major challenge continues to be the relative complexity of HCV diagnosis with the current requirement for a confirmatory HCV RNA test after an initial antibody-positive result. In this review, challenges with the current paradigm are highlighted with a focus on new technologies, as well as simple strategies using existing tools, which may simplify diagnosis and improve linkage to care and treatment. To achieve HCV elimination, improvements in the HCV diagnostics field to allow for a simple single-step diagnosis are required.
Insights into molecular mechanism of plasticizer biodegradation in Dietzia kunjamensis IITR165 and Brucella intermedia IITR166 isolated from a solid waste dumpsite
Authors: Singh Saurabh , Thakur Ravindra Singh , Manickam Natesan
Published: October 2023

Aims

Isolation of phthalate esters (PAEs) degrading bacteria from a solid waste dumpsite could degrade many plasticizers efficiently and to investigate their degrading kinetics, pathways, and genes.

Methods and results

Based on their 16S rRNA gene sequence the strains were identified as Dietzia kunjamensis IITR165 and Brucella intermedia IITR166, which showed a first-order degradation kinetic model under lab conditions. The quantification of phthalates and their intermediate metabolites identification were done by using ultra-high-performance liquid chromatography (UHPLC) and gas chromatography-tandem mass-spectrometry (GC-MS/MS), respectively. Both the bacteria utilized >99% dibutyl phthalate at a high concentration of 100-400 mg L−1 within 192 h as monitored by UHPLC. GC-MS/MS revealed the presence of metabolites dimethyl phthalate (DMP), phthalic acid (PA), and benzoic acid (BA) during DBP degradation by IITR165 while monobutyl phthalate (MBP) and PA were identified in IITR166. Phthalate esters degrading gene cluster in IITR165 comprised two novel genes coding for carboxylesterase (dkca1) and mono-alkyl phthalate hydrolase (maph), having only 37.47% and 47.74% homology, respectively, with reported phthalate degradation genes, along with the terephthalate dioxygenase system (tphA1, A2, A3, and B). However, IITR166 harbored different gene clusters comprising di-alkyl phthalate hydrolase (dph_bi), and phthalate dioxygenase (ophA, B, and C) genes.

Conclusions

Two novel bacterial strains, Dietzia kunjamensis IITR165 and Brucella intermedia IITR166, were isolated and found to efficiently degrade DBP at high concentrations. The degradation followed first-order kinetics, and both strains exhibited a removal efficiency of over 99%. Metabolite analysis revealed that both bacteria utilized de-methylation, de-esterification, and decarboxylation steps during degradation.
Disparities in outcomes and access to therapy options in hepatocellular carcinoma
Authors: Beltrán Ponce Sara , Gokun Yevgeniya , Douglass Francisca , Dawson Laura , Miller Eric , Thomas Charles R , Pitter Kenneth , Conteh Lanla , Diaz Dayssy A
Published: October 2023

Background

Hepatocellular carcinoma (HCC) disproportionately impacts racial and ethnic minorities and patients with lower socioeconomic status. These social determinants of health (SDH) lead to disparities in access to care and outcomes. We aim to understand the relationship between SDH and survival and locoregional treatment options in HCC.

Methods

Using the National Cancer Database, we evaluated survival and access locoregional treatments including non-transplant surgery, liver transplant (LT), and liver-directed radiation therapy (LDRT) in patients with HCC diagnosed between 2004 and 2017. Variables including clinical stage, age, sex, race, income, rurality, year of diagnosis, facility type (FT), Charlson-Deyo score (CD), and insurance were evaluated. Cox proportional hazards multivariable regression and dominance analyses were used for analyses.

Results

In total, 140 340 patients were included. Worse survival was seen with advanced stage, older age, Black race, rurality, public insurance, treatment at a nonacademic center, and lower income. The top predictors for survival included stage, age, and income. Completion of non-transplant surgery was best predicted by stage, FT, and insurance type, whereas LT was predicted by age, year of diagnosis, and CD score. LDRT utilization was most associated with year of diagnosis, FT, and CD score.

Conclusion

For patients with HCC, survival was predicted primarily by stage, age, and income. The primary sociodemographic factors associated with access to surgical treatments, in addition to FT, were insurance and income, highlighting the financial burdens of health care. Work is needed to address disparities in access to care, including improved insurance access, addressing financial inequities and financial toxicities of treatments, and equalizing care opportunities in community centers.
Iatrogenic tracheal laceration due to rigid bronchoscopy treated by endoscopic stent placement: a case report
Authors: Motono Nozomu , Mizoguchi Takaki , Ishikawa Mashahito , Iwai Shun , Iijima Yoshihito , Uramoto Hidetaka
Published: October 2023

Although rigid bronchoscopy may lead to tracheal injury, the incidence is unknown. A 59-year-old woman diagnosed with clinical stage IV esophageal cancer was scheduled to undergo placement of a silicon Y-stent by rigid bronchoscopy to address tracheal stenosis. When the tumor was cored out by rigid bronchoscopy, perforation of the lower trachea occurred, and a silicon Y-stent was inserted to cover the tracheal fistula. Chest X-ray revealed right pneumothorax, and chest drainage was performed. When spontaneous ventilation was confirmed, the patient was weaned from the ventilator in the operating room. Chest computed tomography immediately after surgery showed an air space on the right side of the stent. The space gradually disappeared over time, and no air leakage was observed. The chest drain was removed on postoperative Day 12. Conservative treatment using a silicon Y-stent for iatrogenic tracheal injury due to rigid bronchoscopy is safe.
UV-continuum β slopes of individual z ∼ 2–6 clumps and their evolution
Authors: Bolamperti A , Zanella A , Meštrić U , Vanzella E , Castellano M , Bergamini P , Calura F , Grillo C , Meneghetti M , Mercurio A , Rosati P , Devereaux T , Iani E , Vernet J
Published: October 2023

We study the ultraviolet (UV) continuum β slope of a sample of 166 clumps, individual star-forming regions observed in high-redshift galaxies. They are hosted by 67 galaxies with redshift between 2 and 6.2, strongly lensed by the Hubble Frontier Fields cluster of galaxies MACS J0416.1 − 2403. The β slope is sensitive to a variety of physical properties, such as the metallicity, the age of the stellar population, the dust attenuation throughout the galaxy, the stellar initial mass function (IMF), and the star formation history (SFH). The aim of this study is to compare the β-values of individual clumps with those measured on the entire galaxy, to investigate possible physical differences between these regions and their hosts. We found a median value of β ∼ −2.4, lower than that of integrated galaxies. This result confirms that clumps are sites of intense star formation, populated by young, massive stars, whose spectrum strongly emits in the UV. This is also consistent with the assumption that the dust extinction at the location of the clumps is lower than the average extinction of the galaxy, or that clumps have a different IMF or SFH. We made use of the correlations, discovered for high-redshift galaxies, of the β-value with those of redshift and UV magnitude, MUV, finding that clumps follow the same relations, extended to much fainter magnitudes (MUV < −13). We also find evidence of eight clumps with extremely blue (β ≲ −2.7) slopes, which could be the signpost of low-metallicity stars and constrain the emissivity of ionizing photons at high redshift.
Effect of temperature on measurement of fundamental constants using white dwarfs in Gaia-EDR3 survey
Authors: Uniyal Akhil , Kalita Surajit , Chakrabarti Sayan
Published: October 2023

Fundamental constants are crucial for comprehending physical mechanisms, but their measurements contain uncertainties due to experimental limitations. We investigate the impact of system temperature on these uncertainties using nearby white dwarfs observed in the Gaia Early Data Release 3 (EDR3) survey. Using the structures of these white dwarfs, we show that the variation in system temperature can affect the accuracy of measurements for fundamental parameters such as the fine-structure constant and the proton-to-electron mass ratio. This exploration emphasizes the importance of considering the energy of a system while putting bounds on the values of fundamental constants.
A conserved isoleucine in the binding pocket of RIG-I controls immune tolerance to mitochondrial RNA
Authors: de Regt Ann Kristin , Anand Kanchan , Ciupka Katrin , Bender Felix , Gatterdam Karl , Putschli Bastian , Fusshöller David , Hilbig Daniel , Kirchhoff Alexander , Hunkler Charlotte , Wolter Steven , Grünewald Agathe , Wallerath Christina , Schuberth-Wagner Christine , Ludwig Janos , Paeschke Katrin , Bartok Eva , Hagelueken Gregor , Hartmann Gunther , Zillinger Thomas , Geyer Matthias , Schlee Martin
Published: October 2023

RIG-I is a cytosolic receptor of viral RNA essential for the immune response to numerous RNA viruses. Accordingly, RIG-I must sensitively detect viral RNA yet tolerate abundant self-RNA species. The basic binding cleft and an aromatic amino acid of the RIG-I C-terminal domain(CTD) mediate high-affinity recognition of 5′triphosphorylated and 5′base-paired RNA(dsRNA). Here, we found that, while 5′unmodified hydroxyl(OH)-dsRNA demonstrated residual activation potential, 5′-monophosphate(5′p)-termini, present on most cellular RNAs, prevented RIG-I activation. Determination of CTD/dsRNA co-crystal structures and mutant activation studies revealed that the evolutionarily conserved I875 within the CTD sterically inhibits 5′p-dsRNA binding. RIG-I(I875A) was activated by both synthetic 5′p-dsRNA and endogenous long dsRNA within the polyA-rich fraction of total cellular RNA. RIG-I(I875A) specifically interacted with long, polyA-bearing, mitochondrial(mt) RNA, and depletion of mtRNA from total RNA abolished its activation. Altogether, our study demonstrates that avoidance of 5′p-RNA recognition is crucial to prevent mtRNA-triggered RIG-I-mediated autoinflammation.
MRI phenotypes of glioblastomas early after treatment are suggestive of overall patient survival
Authors: Schmitz-Abecassis Bárbara , Dirven Linda , Jiang Janey , Keller Jasmin A , Croese Robert J I , van Dorth Daniëlle , Ghaznawi Rashid , Kant Ilse M J , Taphoorn Martin J B , van Osch Matthias J P , Koekkoek Johan A F , de Bresser Jeroen
Published: October 2023

Background

Distinguishing true tumor progression (TP) from treatment-induced abnormalities (eg, pseudo-progression (PP) after radiotherapy) on conventional MRI scans remains challenging in patients with a glioblastoma. We aimed to establish brain MRI phenotypes of glioblastomas early after treatment by combined analysis of structural and perfusion tumor characteristics and assessed the relation with recurrence rate and overall survival time.

Methods

Structural and perfusion MR images of 67 patients at 3 months post-radiotherapy were visually scored by a neuroradiologist. In total 23 parameters were predefined and used for hierarchical clustering analysis. Progression status was assessed based on the clinical course of each patient 9 months after radiotherapy (or latest available). Multivariable Cox regression models were used to determine the association between the phenotypes, recurrence rate, and overall survival.

Results

We established 4 subgroups with significantly different tumor MRI characteristics, representing distinct MRI phenotypes of glioblastomas: TP and PP rates did not differ significantly between subgroups. Regression analysis showed that patients in subgroup 1 (characterized by having mostly small and ellipsoid nodular enhancing lesions with some hyper-perfusion) had a significant association with increased mortality at 9 months (HR: 2.6 (CI: 1.1–6.3); P = .03) with a median survival time of 13 months (compared to 22 months of subgroup 2).

Conclusions

Our study suggests that distinct MRI phenotypes of glioblastomas at 3 months post-radiotherapy can be indicative of overall survival, but does not aid in differentiating TP from PP. The early prognostic information our method provides might in the future be informative for prognostication of glioblastoma patients.
RNA structure and multiple weak interactions balance the interplay between RNA binding and phase separation of SARS-CoV-2 nucleocapsid
Authors: Estelle Aidan B , Forsythe Heather M , Yu Zhen , Hughes Kaitlyn , Lasher Brittany , Allen Patrick , Reardon Patrick N , Hendrix David A , Barbar Elisar J
Published: October 2023

The nucleocapsid (N) protein of SARS-CoV-2 binds viral RNA, condensing it inside the virion, and phase separating with RNA to form liquid–liquid condensates. There is little consensus on what differentiates sequence-independent N–RNA interactions in the virion or in liquid droplets from those with specific genomic RNA (gRNA) motifs necessary for viral function inside infected cells. To identify the RNA structures and the N domains responsible for specific interactions and phase separation, we use the first 1,000 nt of viral RNA and short RNA segments designed as models for single-stranded and paired RNA. Binding affinities estimated from fluorescence anisotropy of these RNAs to the two-folded domains of N (the NTD and CTD) and comparison to full-length N demonstrate that the NTD binds preferentially to single-stranded RNA, and while it is the primary RNA-binding site, it is not essential to phase separation. Nuclear magnetic resonance spectroscopy identifies two RNA-binding sites on the NTD: a previously characterized site and an additional although weaker RNA-binding face that becomes prominent when binding to the primary site is weak, such as with dsRNA or a binding-impaired mutant. Phase separation assays of nucleocapsid domains with double-stranded and single-stranded RNA structures support a model where multiple weak interactions, such as with the CTD or the NTD's secondary face promote phase separation, while strong, specific interactions do not. These studies indicate that both strong and multivalent weak N–RNA interactions underlie the multifunctional abilities of N.
Association of healthy sleep patterns with risk of mortality and life expectancy at age of 30 years: a population-based cohort study
Authors: Li H , Qian F , Han L , Feng W , Zheng D , Guo X , Zhang H
Published: October 2023

Background

The importance of sleep on cardiovascular health has been increasingly acknowledged. However, the effect of combined sleep behaviors on life expectancy remains understudied.

Aim

To investigate the association between sleep patterns with total and cause-specific mortality and life expectancy, using a nationally representative sample of US adults.

Design

Population-based cohort study.

Methods

This cohort study included 172 321 adults aged 18 years or older in the National Health Interview Survey (2013–18) with linkage to the National Death Index records up to 31 December 2019. The life expectancy at the age of 30 years by the number of low-risk sleep scores was estimated using a flexible parametric survival model.

Results

During a median follow-up of 4.3 years, of the 172 321 adults (50.9% women; mean [SE] age, 46.98 [0.10] years), 8681 individuals died. The adjusted hazard ratios (95% confidence intervals [CI]) of participants with five vs. 0–1 low-risk sleep factors for all-cause, cardiovascular, and cancer mortality were 0.70 (0.63–0.77), 0.79 (0.67–0.93) and 0.81 (0.66–0.98), respectively. Nearly 8% (population attributable fraction 7.9%, 95% CI: 5.5–10.4) of mortality in this cohort could be attributed to suboptimal sleep patterns. When compared to those with 0–1 low-risk sleep factors, life expectancy at the age of 30 years for individuals with all five low-risk sleep factors was 4.7 (95% CI: 2.7–6.7) years greater for men and 2.4 (95% CI: 0.4–4.4) years greater for women.

Conclusions

Our findings suggest that greater adherence to a low-risk sleep pattern may lead to significant gains in life expectancy among US adults.
Gender Bias in Promotions: Evidence from Financial Institutions
Authors: Huang Ruidi , Mayer Erik J , Miller Darius P
Published: October 2023

We test for gender bias in promotions at financial institutions using two central predictions of Becker’s (1957, 1993) model: firms with bias will (1) raise the promotion bar for marginally promoted female workers, and (2) incur costs from forgoing efficient employment practices. We find support for both of these predictions using a new nationwide panel of mortgage loan officers and their managers encompassing approximately 72,000 workers from over 1,000 shadow banks from 2014 to 2019. Overall, our findings provide evidence that gender bias is an important factor in gender gaps at financial institutions.
Pathways of Peer Influence on Major Choice
Authors: Rubineau Brian , Noh Shinwon , Neblo Michael A , Lazer David M J
Published: October 2023

Peers influence students’ academic decisions and outcomes. For example, several studies with strong claims to causality demonstrate that peers affect the choice of and persistence in majors. One remaining issue, however, has stymied efforts to translate this evidence into actionable interventions: the literature has not grappled adequately with the fact that in natural settings, students typically select most of their peers. The bulk of causal evidence for peer influence comes from exogenously assigned peers (e.g., roommates) because peer effects are easier to identify in such cases. However, students do not form their most important ties for the convenience of scientific inference. In order to link theory and practice, we need to understand which peers are influential. We employ longitudinal, multiplex network data on students’ choices of and persistence in their majors from 1260 students across 14 universities to identify likely causal pathways of peer influence via self-selected peers. We introduce time-reversed analysis as a novel tool for addressing some selection concerns in network influence studies. We find that peers with whom a student reports merely spending time, rather than—e.g., close friends, study partners, esteemed peers—consistently and potently influence their college major choice.
Decrypting the feared genus Hiatella (Bivalvia): South American species
Authors: Zelaya Diego G , Güller Marina
Published: October 2023

Hiatella is among the most poorly understood bivalve genera. Most of the species remain known only from shell morphology, which has proved to be extremely variable in the group. Few studies have addressed their anatomy and biology, and no studies have combined morphological, anatomical and biological characters with molecular characters. This has led to the hiatellids all around the world being regarded as a single, widely distributed species. This contribution represents a step towards a better understanding of hiatellids worldwide by providing the first integrative study of the species occurring in southern South America. Three entities are recognized: Hiatella meridionalis, Hiatella barnea and Hiatella umbonata sp. nov. To understand their intraspecific variability, all the species are carefully described and figured, based on large series of specimens. Saxicava chilensis, Saxicava mollis, Saxicava lebruni and Saxicava subantarctica are considered synonyms of H. meridionalis; a lectotype for S. subantarctica is designated; and S. antarctica and S. frigida are regarded as nomina dubia. This study suggests that worldwide living hiatellids might have originated from South American species and that reduction/loss of hinge teeth during ontogeny and life on hard substrates or on/inside other invertebrates would represent derived traits within the genus Hiatella.
A cryptic radiation of Caribbean sea slugs revealed by integrative analysis: Cyerce ‘antillensis’ (Sacoglossa: Caliphyllidae) is six distinct species
Authors: Moreno Karina , Rico Diane M , Middlebrooks Michael , Medrano Sabrina , Valdés Ángel A , Krug Patrick J
Published: October 2023

Integrative studies have revealed cryptic radiations in several Caribbean lineages of heterobranch sea slugs, raising questions about the evolutionary mechanisms that promote speciation within the tropical Western Atlantic. Cyerce Bergh, 1871 is a genus comprising 12 named species in the family Caliphyllidae that lack the photosynthetic ability of other sacoglossans but are noted for vibrant colours on the large cerata (dorsal leaf-like appendages) that characterize many species. Two species are widely reported from the Caribbean: Cyerce cristallina (Trinchese, 1881) and Cyerce antillensis Engel, 1927. Here, we present an integrative assessment of diversity in Caribbean Cyerce. Four methods of molecular species delimitation supported seven species in samples from the Caribbean and adjacent subtropical Western Atlantic. Six delimited species formed a monophyletic lineage in phylogenetic analyses but were > 9% divergent at the barcoding COI locus and could be differentiated using ecological, reproductive and/or morphological traits. We redescribe C. antillensis, a senior synonym for the poorly known Cyerce habanensis Ortea & Templado, 1988, and describe five new species. Evolutionary shifts in algal host use, penial armature and larval life history might have acted synergistically to promote the rapid divergence of endemic species with restricted distributions in this radiation, substantially increasing global diversity of the genus.
Resolvin D1 improves airway inflammation and exercise capacity in cystic fibrosis lung disease
Authors: Ferri Giulia , Serano Matteo , Isopi Elisa , Mucci Matteo , Mattoscio Domenico , Pecce Romina , Protasi Feliciano , Mall Marcus A. , Romano Mario , Recchiuti Antonio
Published: October 2023

Mucus plugging and non‐resolving inflammation are inherent features of cystic fibrosis (CF) that may lead to progressive lung disease and exercise intolerance, which are the main causes of morbidity and mortality for people with CF. Therefore, understanding the influence of mucus on basic mechanisms underlying the inflammatory response and identifying strategies to resolve mucus‐driven airway inflammation and consequent morbidity in CF are of wide interest. Here, we investigated the effects of the proresolving lipid mediator resolvin (Rv) D1 on mucus‐related inflammation as a proof‐of‐concept to alleviate the burden of lung disease and restore exercise intolerance in CF. We tested the effects of RvD1 on inflammatory responses of human organotypic airways and leukocytes to CF mucus and of humanized mice expressing the epithelial Na + channel (βENaC‐Tg) having CF‐like mucus obstruction, lung disease, and physical exercise intolerance. RvD1 reduced pathogenic phenotypes of CF‐airway supernatant (ASN)‐stimulated human neutrophils, including loss of L‐selectin shedding and CD16. RNASeq analysis identified select transcripts and pathways regulated by RvD1 in ASN‐stimulated CF bronchial epithelial cells that are involved in sugar metabolism, NF‐κB activation and inflammation, and response to stress. In in vivo inflammation using βENaC TG mice, RvD1 reduced total leukocytes, PMN, and interstitial Siglec‐MΦ when given at 6–8 weeks of age, and in older mice at 10–12 weeks of age, along with the decrease of pro‐inflammatory chemokines and increase of anti‐inflammatory IL‐10. Furthermore, RvD1 treatment promoted the resolution of pulmonary exacerbation caused by Pseudomonas aeruginosa infection and significantly enhanced physical activity and energy expenditure associated with mucus obstruction, which was impaired in βENaC‐Tg mice compared with wild‐type. These results demonstrate that RvD1 can rectify features of CF and offer proof‐of‐concept for its therapeutic application in this and other muco‐obstructive lung diseases.
Nail Plate Combination Fixation Versus Lateral Locked Plating for Distal Femur Fractures: A Multicenter Experience
Authors: Shi Brendan Y. , Brodke Dane J. , O'Hara Nathan , Devana Sai , Hernandez Adolfo , Burke Cynthia , Gupta Jayesh , McKibben Natasha , O'Toole Robert , Morellato John , Gillon Hunter , Walters Murphy , Barber Colby , Perdue Paul , Dekeyser Graham , Steffenson Lillia , Marchand Lucas , Shymon Stephen , Fairres Marshall James , Black Loren , Working Zachary , Roddy Erika , El Naga Ashraf , Hogue Matthew , Gulbrandsen Trevor , Atassi Omar , Mitchell Thomas , Lee Christopher
Published: October 2023

Objectives:

To (1) report on clinical, radiographic, and functional outcomes after nail-plate fixation (NPF) of distal femur fractures and (2) compare outcomes after NPF with a propensity matched cohort of fractures treated with single precontoured lateral locking plates.

Design:

Multicenter retrospective cohort study.

Setting:

Ten Level 1 trauma centers.

Patients/Participants:

Patients with OTA/AO 33A or 33C fractures.

Intervention:

Fixation with (1) retrograde intramedullary nail combined with lateral locking plate (n = 33) or (2) single precontoured lateral locking plate alone (n = 867).

Main Outcome Measurements:

The main outcomes of interest were all-cause unplanned reoperation and presence of varus collapse at final follow-up.

Results:

One nail-plate patient underwent unplanned reoperation excluding infection and 2 underwent reoperation for infection at an average of 57 weeks after surgery. No nail-plate patients required unplanned reoperation to promote union and none exhibited varus collapse. More than 90% were ambulatory with no or minimal pain at final follow-up. In comparison, 7 of the 30 matched lateral locked plating patients underwent all-cause unplanned reoperation excluding infection (23% vs. 3%, P = 0.023), and an additional 3 lateral locked plating patients were found to have varus collapse on final radiographs (10% vs. 0%, P = 0.069).

Conclusions:

Despite a high proportion of high-energy, open, and comminuted fractures, no NPF patients underwent unplanned reoperation to promote union or demonstrated varus collapse. Propensity score matched analysis revealed significantly lower rates of nonunion for NPF compared with lateral locked plating alone. Larger studies are needed to identify which distal femur fracture patients would most benefit from NPF.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Open Fixation After Preperitoneal Pelvic Packing Is Associated With a High Surgical Site Infection Rate
Authors: Kim Ye Joon , Scott Bryan L. , Pieracci Fredric M. , Moore Ernest E. , Mauffrey Cyril , Parry Joshua A.
Published: October 2023

Objectives:

To evaluate the incidence of pelvic space surgical site infection (SSI) after preperitoneal pelvic packing (PPP) for persistent hemodynamic instability.

Design:

Retrospective comparative study.

Setting:

Urban Level 1 trauma center.

Patients/Participants:

83 patients who received PPP and 55 patients who had open reduction and internal fixation (ORIF) of the anterior pelvic ring without PPP.

Intervention:

Operative fixation.

Main Outcome Measurements:

Pelvic space SSI.

Results:

The SSI rate in the PPP group was 31.3% (26/83) compared with 10.9% (6/55) in the control group (proportional difference 20.4%, confidence interval (CI) 6.4–32.5, P = 0.007). Patients in the PPP group (n = 43) were 1:1 propensity score matched with patients in the control group to account for differences in Injury Severity Score and American Society of Anesthesiologists score. In this matched cohort, the rate of pelvic space SSI remained higher in the PPP group compared with that in the control group (30.2% vs. 9.3%; proportional difference 20.9%, CI, 3.7–36.3; P = 0.02). On multivariate analysis of the PPP group, anterior ORIF (odds ratio 6.56, CI, 2.00–21.47, P = 0.002) was found to be independently associated with SSI.

Conclusions:

PPP is an independent risk factor of space SSI. The likelihood of SSI after PPP is increased with anterior ORIF. The morbidity of SSI after PPP must be weighed against the risk of exsanguination.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Molecular mechanisms of HCG18 in the sorafenib resistance of hepatocellular carcinoma
Authors: Li Heping , Hu Jie , Qiu Lijie , Wu Yijiang , Zhong Baiyin , Ye Rong , Xie Binhui
Published: October 2023

Sorafenib has been approved for advance hepatocellular carcinoma (HCC), however, drug resistance often occurred. Therefore, it is of great significance to clarify the underlying mechanisms of sorafenib resistance and to find out the effective strategies to overcome sorafenib resistance. The expression of HCG18 was detected by qPCR, MTT, colony formation, flow cytometry and TUNEL assay were used to explore the function of HCG18 on sorafenib resistance in HCC. RNA pull-down, RNA immunoprecipitation, immunofluorescence labeling, luciferase reporter assay, western blot and qPCR were used to investigate the mechanism of HCG18 regulating sorafenib resistance in HCC. Our results showed that HCG18 was significantly increased in HCC, which resulted in shorter 5-year survival for patients with HCC. Sorafenib can induce the expression of HCG18, suggesting HCG18 might be involved in sorafenib resistance in HCC. Further analysis showed that knockdown of HCG18 can reduce viability and increase apoptosis of HCC cells. Mechanistically, HCG18 can bind to USP15, further regulated the protein stability of p65, TAB2 and TAB3, and nuclear location of p65, which finally modulated the NF-κB signaling. Our findings showed that HCG18 played an important role in sorafenib resistance in HCC. And knockdown of HCG18 can promote the sensitivity of HCC cells to sorafenib, inferring that targeting HCG18 might be an effective strategy to overcome sorafenib resistance in HCC.
Virtual Reality Simulation in Nursing and Midwifery Education
Authors: Saab Mohamad M. , McCarthy Megan , O'Mahony Billy , Cooke Eoghan , Hegarty Josephine , Murphy David , Walshe Nuala , Noonan Brendan
Published: October 2023

Virtual reality simulation offers students the opportunity to acquire clinical and psychomotor skills in a safe and interactive environment. This study describes the usability of virtual reality simulation among undergraduate nursing and midwifery students. Participants were recruited using convenience and snowball sampling and engaged in a 20-minute virtual reality simulation scenario of their choice. They then completed a 21-item survey comprising a sociodemographic questionnaire, the System Usability Scale, a satisfaction questionnaire, and open-ended questions. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using deductive content analysis. Forty-three students participated in this study. The mean (SD) System Usability Scale score was 75.87 (13.7), indicating that virtual reality simulation was acceptable. Almost all participants were either “extremely satisfied” or “somewhat satisfied” with virtual reality simulation, which was perceived as informative and enjoyable, fostering safe and self-directed learning without causing patient harm. Participants recommended using virtual reality simulation to practice clinical skills, prepare for clinical placements, and learn about rare clinical situations. Virtual reality simulation needs to be underpinned by a strong pedagogy and aligned with learning outcomes. Educators and students should be trained in virtual reality simulation prior to its integration into the curriculum.
Identification and Management of a Central Type 2 Big Bubble in Deep Anterior Lamellar Keratoplasty
Authors: Wileman Justin M. , Price Marianne O. , Price Francis W.
Published: October 2023

Purpose:

The purpose of this study was to document a case of central type 2 bubble formation during deep anterior lamellar keratoplasty and discuss its intraoperative management.

Methods:

A rare case of central type 2 bubble formation with no peripheral extension beyond the trephination mark was documented with operative video and concurrent intraoperative optical coherence tomography imaging.

Results:

The type 2 bubble was decompressed with a needle intraoperatively, and deep anterior lamellar keratoplasty was successfully performed without perforation of Descemet membrane.

Conclusions:

Identifying formation of a type 2 bubble during deep anterior lamellar keratoplasty is crucial in avoiding perforation of Descemet membrane. This case shows that the behavior of type 2 bubbles can be different than what has been widely reported. It is hoped that this will aid the surgeon in identifying a type 2 bubble and in properly managing it intraoperatively.
Lenticule Intrastromal Keratoplasty for the Correction of Iatrogenic High Hyperopia
Authors: Lin Feng , Han Xiaosong , Liu Shengtao , Wei Ruoyan , Zhou Xingtao , Li Meiyan
Published: October 2023

Purpose:

The aim of this study was to evaluate the safety, efficacy, and predictability of lenticule intrastromal keratoplasty (LIKE) for the correction of iatrogenic high hyperopia.

Methods:

Three patients (4 eyes) were referred to our department because of overcorrection of myopia induced by femtosecond laser-assisted in situ keratomileusis. All eyes exhibited hyperopia (between +4.00 and +8.00 D) and thin corneas ranging from 307 to 378 μm. Because of the regression of the use of laser ablation to correct high hyperopia and thin corneas, we initially adopted LIKE to correct iatrogenic high hyperopia in all 4 eyes. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, corneal topography, and anterior segment optical coherence tomography findings were recorded during each follow-up evaluation.

Results:

No postoperative complications, such as interface haze and opacification, were observed in the 4 eyes during each follow-up evaluation, with an average follow-up of 9.50 months. All eyes had significantly improved UDVA postoperatively. A total of 3 eyes achieved an UDVA of 20/25 or better while the other 1 eye had an UDVA of 20/40 postoperatively. In addition, 2 of the 4 eyes had a postoperative UDVA equal to or better than preoperative CDVA. No eyes lost any CDVA lines. All 4 eyes were within ±0.50 D of the spherical power (intended target of 0). The central corneal thickness and curvature of the anterior corneal surface in all 4 eyes increased postoperatively. Anterior segment optical coherence tomography revealed that the lenticule was transparent, with no wrinkles or offsets, during each follow-up evaluation.

Conclusions:

LIKE for the correction of iatrogenic hyperopia has good efficacy and safety. Although an extremely thin cornea after overcorrection may not be suitable for hyperopic laser enhancement, LIKE is a good choice because of its good predictability and ability to restore the normal corneal structure.
Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children From Wild-type to Population Immunity: A Prospective Multicenter Cohort Study With Real-time Reporting
Authors: Tulling Adam J. , Lugthart Gertjan , Mooij Miriam G. , Brackel Caroline L. H. , Terheggen-Lagro Suzanne W. J. , Oostenbrink Rianne , Buysse Corinne M. P. , Hashimoto Simone , Armbrust Wineke , Bannier Michiel A. G. E. , Bekhof Jolita , van Gameren-Oosterom Helma B. , Hendriks Han , van Houten Marlies A. , van der Linden Jan W. , Lebon Ankie , van Onzenoort-Bokken Lonneke , Tramper-Stranders Gerdien A. , van Veen Mirjam , von Asmuth Erik G. J. , Buddingh Emilie P. ,   on behalf of the COPP-study group
Published: October 2023

Background:

SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data.

Methods:

This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity.

Results:

We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies.

Conclusions:

Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.
Educational initiatives and achievements of the International Association for the Study of Pain
Authors: Nicholas Michael K. , Cardosa Mary , Turner Judith
Published: October 2023

This article summarizes the many initiatives and achievements of the International Association for the Study of Pain (IASP) in pain education worldwide since 1973. These range from major events such as the World Congress on Pain that attracts thousands of attendees to the more intimate and focused Pain Schools and Pain Camps. The article describes how education has been a key focus of IASP since its inception and how IASP has responded to its members' desire for access to the latest knowledge about pain and evidence-based pain treatments. The unique contribution of IASP to the study of pain is reflected in its consistent focus on a biopsychosocial approach to pain, the promotion of interactions between basic scientists and clinicians, as well as multidisciplinary and interdisciplinary collaborations. Details of these rich offerings can be found on the IASP web site, and this article provides a guide for those seeking to access them.