bluuebunny/crossref_metadata_2025 huggingface dataset:
PGPointNovo: an efficient neural network-based tool for parallel de novo peptide sequencing
Authors: Xu Xiaofang , Yang Chunde , He Qiang , Shu Kunxian , Xinpu Yuan , Chen Zhiguang , Zhu Yunping , Chen Tao
Published: April 2023

De novo peptide sequencing for tandem mass spectrometry data is not only a key technology for novel peptide identification, but also a precedent task for many downstream tasks, such as vaccine and antibody studies. In recent years, neural network models for de novo peptide sequencing have manifested a remarkable ability to accommodate various data sources and outperformed conventional peptide identification tools. However, the excellent model is computationally expensive, taking up to 1 week to process about 400 000 spectrums. This article presents PGPointNovo, a novel neural network-based tool for parallel de novo peptide sequencing. PGPointNovo uses data parallelization technology to accelerate training and inference and optimizes the training obstacles caused by large batch sizes. The results of extensive experiments conducted on multiple datasets of different sizes demonstrate that compared with PointNovo the excellent neural network-based de novo peptide sequencing tool, PGPointNovo, accelerates de novo peptide sequencing by up to 7.35× without precision or recall compromises.

Availability and implementation

The source code and the parameter settings are available at https://github.com/shallFun4Learning/PGPointNovo.

Supplementary information

Supplementary data are available at Bioinformatics Advances online.
“Beyond BAME, WOC, and ‘political blackness’”: diasporic digital communing practices
Authors: Sobande Francesca , Basu Maitrayee
Published: April 2023

What forms of opacity and excess propel Black and South Asian digital diasporic feminist cultures of commoning and communing? This article explores digital expressions of retreat, refusal, remixing, and reclamation which are central to diasporic feminist practices. We analyze three illustrative digital practices via two vignettes: (1) Quote tweets and digital anonymity as expressions of subaltern excess; (2) diasporic meme culture as a callout praxis of refusal; and (3) digital opacity as feminist retreat and reclamation of time, interiority, and intimacy. Throughout our analysis we incorporate reflections on the contours of “diasporic feminist excess” and the parameters of public, private, and personal spaces. Overall, by extending the vocabularies of feminist commoning to include certain digital diasporic feminist practices, we conceptualize the fluid and fraught ways that contrapublic discourses move in, between, and beyond, digital publics.
Threading the needle: a case report of double-wiring technique and double intracoronary imaging guidance for a multifenestrated iatrogenic coronary artery dissection
Authors: Viegas José Miguel , Ferreira Vera , Pereira-da-Silva Tiago , Ferreira Rui Cruz
Published: April 2023

Background

Iatrogenic coronary artery dissection (ICAD) may represent a serious complication of percutaneous coronary intervention. Stenting the dissected segment is recommended in large dissections with compromised distal blood flow, although wiring the true lumen is often difficult.

Case summary

A 64-year-old woman with effort angina was submitted to invasive coronary angiography that revealed a severe stenosis in the distal right coronary artery. A large spiral ICAD occurred after pre-dilatation and guidewire position is lost. We report the treatment of this multifenestrated dissection using combined intracoronary imaging guidance with angiographic co-registered optical coherence tomography and real-time intravascular ultrasound, which were crucial to achieve a successful outcome.

Discussion

A double-wiring technique with double intracoronary imaging guidance enables a comprehensive depiction of the compromised artery and should be considered in selected cases to guide true lumen wiring and stent implantation.
Tomato LysM receptor kinase 4 mediates chitin-elicited fungal resistance in both leaves and fruit
Authors: Ai Yingfei , Li Qinghong , Li Chenying , Wang Ran , Sun Xun , Chen Songyu , Cai Xin-Zhong , Qi Xingjiang , Liang Yan
Published: April 2023

Fungal infection is a major cause of crop and fruit losses. Recognition of chitin, a component of fungal cell walls, endows plants with enhanced fungal resistance. Here, we found that mutation of tomato LysM receptor kinase 4 (SlLYK4) and chitin elicitor receptor kinase 1 (SlCERK1) impaired chitin-induced immune responses in tomato leaves. Compared with the wild type, sllyk4 and slcerk1 mutant leaves were more susceptible to Botrytis cinerea (gray mold). SlLYK4 extracellular domain showed strong binding affinity to chitin, and the binding of SlLYK4 induced SlLYK4-SlCERK1 association. Remarkably, qRT–PCR analysis indicated that SlLYK4 was highly expressed in tomato fruit, and β-GLUCURONIDASE (GUS) expression driven by the SlLYK4 promoter was observed in tomato fruit. Furthermore, SlLYK4 overexpression enhanced disease resistance not only in leaves but also in fruit. Our study suggests that chitin-mediated immunity plays a role in fruit, providing a possible way to reduce fungal infection-related fruit losses by enhancing the chitin-induced immune responses.
EuMAR: a roadmap towards a prospective, cycle-by-cycle registry of medically assisted reproduction in Europe
Authors: De Geyter Christian , Calhaz-Jorge Carlos , Goossens Veerle , Magli Cristina M , Smeenk Jesper , Vesela Kristina , Vermeulen Nathalie , Wyns Christine
Published: April 2023

More than 20 years ago, the survey of activities in medically assisted reproduction (MAR) was initiated in Europe and resulted in cross-sectional annual reports, as issued by the European IVF Monitoring (EIM) consortium of ESHRE. Over time, these reports mirror the continuous development of the technologies and contribute to increased transparency and surveillance of reproductive care. Meanwhile, progressive changes of existing treatment modalities and the introduction of new technologies resulted in the need of a cumulative approach in the assessment of treatment outcomes, which warrants a prospective cycle-by-cycle data registry on MAR activities, including fertility preservation. This change in the paradigm of data collection in Europe towards the construction of cumulative outcome results is expected to generate additional insights into cross-institutional but also cross-border movements of patients and reproductive material. This is essential to improve vigilance and surveillance. The European monitoring of Medically Assisted Reproduction (EuMAR) project, co-funded by the European Union, will establish a registry for the transnational collection of prospective cycle-by-cycle MAR and fertility preservation data on the basis of an individual reproductive care code (IRCC). The rationale for the project and the objectives are presented here.
Optimal control of energy storage system of high-permeability distributed photovoltaic low-voltage distribution network
Authors: Yang Yi , Yuan Yubo , Jiao Hao , Chen Jinming , Pang Xianglu , Zhuang Shuyi
Published: April 2023

Photovoltaic (PV) is one of the very promising renewable energy sources, but its output power is fluctuating. To maintain PV-energy storage system-load power balance in low-voltage distribution networks, we propose a new optimized sag control strategy, which is no longer indexed by the battery voltage but by the battery state of charge (SOC) because the battery SOC can better reflect the remaining battery capacity for better performance. In addition, to further optimize its performance, we try to use the ratio of intercell SOC for optimization. We analysed the deficiencies of sag control in detail, derived a control strategy with cell SOC as an indicator and finally analysed its performance in detail. To verify the performance of the proposed strategy, based on MATLAB, we designed the power variation of 2 lithium-ion battery packs to maintain the bus power stability under two cases of sudden rise as well as sudden fall of PV power and 3 lithium-ion battery packs to maintain during the bus power stabilization with one set of performance after failure, and the simulation results prove the feasibility of the proposed strategy.
Measuring health system responsiveness in a national community health worker primary care programme in rural Liberia
Authors: Mendin Savior Flomo , Krause Julie A , Gweh Andrew , Baysah Massaboi , Nyumah Joseph , Gaye Chris J , Max Zorh T- , Kraemer John D , Subah Marion , Hirschhorn Lisa R
Published: April 2023

As many low- and middle-income countries scale up community health worker (CHW) programmes to achieve universal health coverage, ensuring quality as well as access is critical. Health system responsiveness (HSR) is a core domain of quality patient-centred care but has not been widely measured in CHW-delivered care. We report results from a household survey measuring HSR and health systems’ quality of CHW-delivered care in two Liberian counties where the national CHW programme of Community Health Assistants (CHAs) for communities ≥5 km from a health centre has been implemented. We conducted a cross-sectional population-based household survey in 2019 in Rivercess (RC) and Grand Gedeh (GG) counties, using a two-stage cross-sectional cluster sampling approach. We included validated HSR questions on six responsiveness domains and patient-reported health system outcomes, such as satisfaction and trust in the CHA’s skills and abilities. The HSR questions were administered to women aged 18–49 years who reported seeking care from a CHA in the 3 months prior to the survey. A composite responsiveness score was calculated and divided into tertiles. Multivariable analysis using Poisson regression with log link and adjusting for respondent characteristics was used to determine the association between responsiveness and patient-reported health system outcomes. The proportion of individuals rating responsiveness as very good or excellent was similar across all domains within a district, with ratings being lower in RC (23–29%) than in GG (52–59%). High ratings in both counties were seen for high trust in the CHA’s skills and abilities (GG 84%, RC 75%) and high confidence in the CHA (GG 58%, RC 60%). Compared with women in the lowest responsiveness tertile (score ≤3), women in the highest tertile (score $ \ge $4.25) were significantly more likely to report high quality of CHA-delivered care (prevalence ratio, PR = 14.1), very good/excellent at meeting health needs (PR = 8.0), high confidence in the CHA to provide future care (PR = 2.4), and a high level of trust in CHA’s skills and abilities (PR = 1.4). Controlling for respondent characteristics, the composite responsiveness score was significantly associated with all patient-reported health system outcomes (P < 0.001). We found that HSR was associated with important patient-reported health system quality outcomes, including satisfaction, trust, and confidence in the CHA. Measuring patients’ experience and outcomes of care is important to complement more common measures of technical quality for CHW-delivered care to ensure that this domain of quality is central to the community health programme design and delivery.
Utility of indocyanine green in assessing blood perfusion in anomalous systemic arterial supply to the lung
Authors: Kumeda Hirotaka , Saito Gaku
Published: April 2023

The chosen treatment for anomalous systemic arterial supply to the basal segment of the lung (ABLL) is typically the division of the anomalous artery and resection of the abnormal area, dependent on the anomalous artery. Although only division or interventional embolization of the anomalous artery may be selected. However, leaving the area dependent on the anomalous artery can lead to complications, such as necrosis and pulmonary infarction. We report the case of a 39-year-old female with ABLL. Intraoperatively, the anomalous artery was first divided. Indocyanine green (ICG) was subsequently injected intravenously to evaluate blood perfusion within the abnormal lung area. Since the abnormal area was still poorly perfused after a few minutes, a left basal segmentectomy was performed because of the possibility of complications. Thus, evaluation of perfusion via ICG can be used in the decision to resect abnormal area.
The transplant ureter causing small bowel obstruction following intraperitoneal kidney transplantation: a case report
Authors: Selim Motaz A , Krepline Ashley , Eriksen Calvin , Murphy Patrick , Cooper Matthew
Published: April 2023

Internal bowel herniation under the ureter of an intraperitoneally transplanted kidney is a rare complication yet carries a high burden of morbidity and potential mortality if not recognized and managed appropriately. We describe a case where early intervention salvaged the bowel without ureteral injury. We also describe a technique to close the space beneath the ureter to prevent further episodes of internal herniation.
Symptoms of illness during travel and risk factors for non-adherence to malaria prophylaxis—a cross-sectional study in travellers from Germany
Authors: Reinsberg Friederike , Moehlmann Mary W , Krumkamp Ralf , Landsmann Lena , Heitkamp Christian , Jochum Johannes , Addo Marylyn , Ramharter Michael , Radt Christiane , Rothe Camilla , Vinnemeier Christof , Kreuels Benno
Published: April 2023

Background

Perceived adverse effects of antimalarial chemoprophylaxis can be difficult to distinguish from travel-related illness and are often cited as important reasons for non-adherence or refusal of antimalarial chemoprophylaxis. We aimed to investigate the occurrence of symptoms of illness in travellers with and without chemoprophylaxis in a cross-sectional study after travel and to identify risk factors for non-adherence to prophylaxis.

Methods

We enrolled 458 travellers to Africa and South America during their pre-travel medical consultation at the travel clinic of the University Medical Centre Hamburg-Eppendorf and conducted post-travel interviews on symptoms of illness and intake of malaria prophylaxis.

Results

Eleven percent (49/437) of the participants reported symptoms of illness during travel. In total, 36% (160/448) of the participants reported prescription of chemoprophylaxis, the vast majority of these travelled to Africa (98%) and received atovaquone/proguanil (93%). Frequency of symptoms did not differ significantly between participants without prophylaxis and those taking atovaquone/proguanil. Non-adherence to prophylaxis was frequent (20%), but only 3% (4/149) of the participants stopped the medication early because of perceived side effects. Risk factors associated with non-adherence to prophylaxis included age under 30 years, travel to West or Central Africa and travel duration greater than 14 days.

Conclusions

Symptoms of illness during travel occurred at similar frequencies irrespective of intake of chemoprophylaxis. Travellers should be informed about chemoprophylaxis in a balanced way, without raising fear of side effects, especially among groups at higher risk for incorrect use of prophylaxis.
Melting of Fe-bearing and Fe-free carbonated pelites under fluid-saturated conditions at 6 GPa
Authors: Chen Xueqian , Wang Meili , Inoue Toru , Liu Qiong , Zhang Lifei
Published: April 2023

Although the induced melting of pelitic sediments, i.e., the devolatilization of hydrous and carbonate minerals, has been widely studied at fluid-undersaturated conditions, the flush dissolution of carbonated pelite has not been fully understood. In addition, the role of iron in the melting of carbonated pelite has not received much attention. To address these issues, we conducted two sets of experiments for carbonated pelite with an iron-bearing (LH-gloss) and an iron-free (LHIF-gloss) starting bulk composition at 5.5 to 6 GPa, 800 to 1600 °C at fluid-saturated conditions. The phase assemblages for both experiments at 800 °C are composed of garnet + clinopyroxene + coesite + kyanite + phengite + aragonite + magnesite ± lawsonite ± rutile. Higher jadeite component and lower diopside–hedenbergite solid solution (Di–Hdss) in omphacitic clinopyroxene are observed in the LH-gloss experiments; also, garnet remains stable to higher temperatures (800–1400 °C) in the LH-gloss than in the LHIF-gloss (900–1200 °C). Carbonate- and phengite-out temperature boundaries are overlapping in the respective system, with the temperature boundary in the LH-gloss (800–900 °C) slightly lower than that in the LHIF-gloss experiments (900–1000 °C). The different stability fields of volatile-bearing minerals can be ascribed not only to variable bulk XH2O [molar ratio H2O/(H2O + CO2)], which in turn depends on bulk H2O, CO2 and K2O contents, but also to bulk FeO*(Total Fe as FeO) content. Both the characteristic “fish egg” texture and the strong increase in the amount of dissolved solids in the liquid phase over a narrow temperature interval at 6 GPa testify to the possible existence of supercritical fluid. The marked solvent power of supercritical fluid can explain the earlier disappearance of experimental products including phengite, aragonite and magnesite. For the produced liquid phase (supercritical fluid or melt), the K2O/Na2O weight ratio decreases, whereas that of the SiO2/CaO increases with increasing temperature, placing potassium-rich carbonatitic supercritical fluids in the low-temperature and sodium-rich (carbonated) silicate melts in the high-temperature sections of both systems. The produced ultrapotassic (supercritical) liquid, when liberated from the subducting slab, may evolve into a melt parental to carbonatites and possibly result in the formation of diamonds. While those (carbonated) silicate melts, especially the more oxidized and buoyant ones produced by the melting of ferrous iron-depleted carbonated pelite, are expected to intensely interact with the overlying peridotite during the upward migration, which could lead to the formation of the metasomatic garnet pyroxenite.
Developmental pyrethroid exposure causes a neurodevelopmental disorder phenotype in mice
Authors: Curtis Melissa A , Dhamsania Rohan K , Branco Rachel C , Guo Ji-Dong , Creeden Justin , Neifer Kari L , Black Carlie A , Winokur Emily J , Andari Elissar , Dias Brian G , Liu Robert C , Gourley Shannon L , Miller Gary W , Burkett James P
Published: April 2023

Neurodevelopmental disorders (NDDs) are a widespread and growing public health challenge, affecting as many as 17% of children in the United States. Recent epidemiological studies have implicated ambient exposure to pyrethroid pesticides during pregnancy in the risk for NDDs in the unborn child. Using a litter-based, independent discovery–replication cohort design, we exposed mouse dams orally during pregnancy and lactation to the Environmental Protection Agency's reference pyrethroid, deltamethrin, at 3 mg/kg, a concentration well below the benchmark dose used for regulatory guidance. The resulting offspring were tested using behavioral and molecular methods targeting behavioral phenotypes relevant to autism and NDD, as well as changes to the striatal dopamine system. Low-dose developmental exposure to the pyrethroid deltamethrin (DPE) decreased pup vocalizations, increased repetitive behaviors, and impaired both fear conditioning and operant conditioning. Compared with control mice, DPE mice had greater total striatal dopamine, dopamine metabolites, and stimulated dopamine release, but no difference in vesicular dopamine capacity or protein markers of dopamine vesicles. Dopamine transporter protein levels were increased in DPE mice, but not temporal dopamine reuptake. Striatal medium spiny neurons showed changes in electrophysiological properties consistent with a compensatory decrease in neuronal excitability. Combined with previous findings, these results implicate DPE as a direct cause of an NDD-relevant behavioral phenotype and striatal dopamine dysfunction in mice and implicate the cytosolic compartment as the location of excess striatal dopamine.
Live and carcass production traits for progeny of purebred sires in comparison with the clone of a USDA prime yield grade one carcass
Authors: Sperber Jessica L , Lust David G , Veneklasen Gregg O , Hawkins Dean E , McEvers Trent J , Lawrence Ty E
Published: April 2023

Cloning is a technology by which an animal’s tissue can be salvaged and replicated. Carcasses that grade USDA prime–yield grade 1 (P1) represent a rare and antagonistic outcome and are a goal for terminal sire selection in the United States. A terminal sire progeny test generated offspring for a crossbred bull (14% Zebu, 86% Angus; ALPHA), born in 2012 via somatic cell nuclear transfer (SCNT) from a carcass that graded P1. ALPHA progeny (steers and heifers) were compared against progeny of three purebred (Angus; Charolais; Simmental) reference sires. Live production traits included weaning weight, morbidity, mortality, and days on feed; carcass traits included abscessed liver frequency and lung lesion frequency, individual quality and yield grade (YG) parameters, and carcass value. Observed carcass traits for progeny from the Angus, Charolais, and Simmental sires were reflective of the carcass outcomes expected for each sire’s respective breed. Calves sired by the Angus were the earliest maturing indicated by the youngest chronological age at harvest (P ≤ 0.02) concomitant with the most backfat (P < 0.01), and the greatest marbling scores (P < 0.01). Calves sired by the Charolais had the heaviest carcass weight (P = 0.04), greatest cutability as assessed by USDA calculated YG (P < 0.01) and were the heaviest muscled based on “longissimus” muscle area (P < 0.01). ALPHA-sired calves were the most similar in carcass outcomes to calves sired by the Simmental, combining advantageous quality and yield parameters to produce an intermediate for carcass quality and yield. The economic value of moderate carcass outcomes is reflected in the carcass value per century weight, in which ALPHA-sired steers tended (P = 0.07) to be of the greatest value compared to other sire groups. ALPHA progeny performed comparably to high-performing reference sires for terminal sire production traits and the P1 genetics in which ALPHA was cloned have economical and biological value in modern U.S. beef production.
Intestinal transplantation: an update
Authors: Sharkey Lisa M. , Russell Neil K.
Published: April 2023

Purpose of review

The role of intestinal transplant has expanded in recent years and is no longer only considered for patients with no other options remaining. 5 year survival in high-volume centres is over 80% for certain graft types. The aim of this review is to update the audience on the current state of intestinal transplant, with a focus on recent medical and surgical advances.

Recent findings

There has been a greater understanding of the interplay and balance of host and graft immune responses, which may facilitate individualized immunosuppression. Some centres are now performing ‘no-stoma’ transplants, with preliminary data showing no adverse effects from this strategy and other surgical advances have lessened the physiological insult of the transplant operation. Earlier referrals are encouraged by transplant centres, such that vascular access or liver disease has not progressed too much to increase the technical and physiological challenge of the procedure.

Clinicians should consider intestinal transplant as a viable option for patients with intestinal failure, benign unresectable abdominal tumours or acute abdominal catastrophes.
The Liver in Hemophagocytic Lymphohistiocytosis: Not an Innocent Bystander
Authors: Diamond Tamir , Bennett Aaron D. , Behrens Edward M.
Published: April 2023

Hemophagocytic lymphohistiocytosis (HLH) is a rare multisystemic hyperinflammatory disease commonly associated with hepatic dysfunction. Liver injury is mediated by unchecked antigen presentation, hypercytokinemia, dysregulated cytotoxicity by natural killer and CD8 T cells, and disruption of intrinsic hepatic metabolic pathways. Over the past decade, there have been significant advances in diagnostics and expansion in therapeutic armamentarium for this disorder allowing for improved morbidity and mortality. This review discusses the clinical manifestations and pathogenesis of HLH hepatitis in both familial and secondary forms. It will review growing evidence that the intrinsic hepatic response to hypercytokinemia in HLH perpetuates disease progression and the novel therapeutic approaches for patients with HLH-hepatitis/liver failure.
Feeding Practices of Preterm Low Birthweight Infants Up to 6 Months: A Comparison Between Kangaroo and Conventional Care
Authors: Romão Rejane Sousa , Souza Rayany Cristina , Medeiros Eliziane Santos , Pires Priscilla Larissa Silva , Pereira Leandro Alves , Azevedo Vivian Mara Gonçalves de Oliveira , Rinaldi Ana Elisa Madalena
Published: April 2023

Objective:

The objective of this study is to compare feeding practices of low birthweight (LBW) infants, according to type of care received during and after hospital discharge: Kangaroo Care (KC) and Conventional Care (CC).

Methods:

Prospective cohort study was conducted at a university hospital (Brazil) between 2019 and 2021. The sample consisted of 65 LBW infants (weight ≤ 1800 g)—46 in KC and 19 in CC. KC includes breastfeeding (BF) guidance and support to parents at hospital and after discharge. Data collection was performed at hospital discharge, and at the 4th and 6th month of corrected gestational age (CGA). Consumption of 27 foods was analyzed in the last 2 periods of the follow-up and expressed in relative frequency. Three indicators were analyzed: exclusive breastfeeding (EBF), mixed BF, and introduction of liquid and solid foods.

Results:

Groups had similar health characteristics, except for the weight at hospital discharge and the Score for Neonatal Acute Physiology – Perinatal (SNAPPE II) score that were lower in KC group. We found higher frequency of EBF among KC at hospital discharge (CC = 5.3% vs KC = 47.8%; P = 0.001). The higher frequency of mixed BF was observed in KC at 4 months of CGA (CC = 5.6% vs KC = 35.0%; P = 0.023), and at 6 months of CGA (CC = 0.0% vs KC = 24.4%; P = 0.048). Consumption of solid foods (4th month of CGA = 25.9%, 6th month of CGA = 91.2%) and liquids (4th month of CGA = 77.6%, 6th month of CGA = 89.5%) were similar between groups.

Conclusions:

In KC, SNAPPE II scores were lower and frequency of EBF was higher at hospital discharge and frequency of mixed BF was higher over 6 months. Early supply of infant formula, liquid and solid foods were similar in both groups.
Reproducibility and Generalizability of the Web-Based Tool to Predict Lamina Propria Fibrosis in Eosinophilic Esophagitis
Authors: Hiremath Girish , Arva Nicoleta C. , Wechsler Joshua B.
Published: April 2023

We investigated reproducibility and generalizability of the recently developed web-based model to predict lamina propria fibrosis (LPF) in esophageal biopsies with inadequate lamina propria (LP) from patients with eosinophilic esophagitis (EoE) using an independent dataset (N = 183). For grade and stage scores of LPF, the area under the curve for predictive model was 0.77 (0.69–0.84) and 0.75 (0.67–0.82), and its accuracy was 78% and 72%, respectively. These model performance metrics were similar to that of the original model. A significant positive correlation was noted between the models’ predictive probability and the grade and stage of LPF assessed by a pathologist (grade: r
2 = 0.48, P < 0.001; and stage: r
2 = 0.39, P < 0.001). These results support the reproducibility and generalizability of the web-based model to predict the presence of LPF in esophageal biopsies with inadequate LP in EoE. Additional studies are warranted to refine the web-based predictive models to provide predictive probability for sub-scores of LPF severity.
Performance and acceptability of the Stressful Life Events Screening Questionnaire in a chronic pain population: a mixed-methods study
Authors: Linnemørken Lene Therese Bergerud , Stangeland Helle , Reme Silje Endresen , Stensland Synne Øien
Published: April 2023

Introduction:

Pain-related fear, anxiety, and avoidance may play key roles in the chronification of pain and related disability. For practitioners, knowledge about the source or drivers of these fears, including patients' exposure to potentially traumatic events (PTEs) and related posttraumatic stress symptoms, could be particularly helpful in guiding their treatment approach.

Objectives:

We aimed to investigate whether the use of a brief screening for PTEs could help inform chronic pain treatment.

Methods:

The performance and acceptability of the Stressful Life Events Screening Questionnaire (SLESQ) was assessed among 567 adult patients (59% women, mean age 48.1 years) meeting at a hospital outpatient pain clinic. The sensitivity, specificity, and 20 months temporal stability of the SLESQ, assessing exposure to 14 specific trauma types followed by a 15th item capturing exposure to “other events,” were assessed through digital administration and follow-up interviews with 55 participants. The qualitative responses of 158 participants reporting exposure to “other events” were reviewed and assessed based on fulfillment of the A Criterion for traumatic events in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The acceptability of the SLESQ was assessed in clinical interviews with 12 participants.

Results:

The SLESQ demonstrated acceptable sensitivity (70.0%), high specificity (94.9%), and moderate temporal stability (κ = 0.66, P < 0.001). Participants' qualitative elaborations of “other events” were largely (76.3%) consistent with Criterion A events. The screening was well accepted and welcomed.

Conclusion:

The results indicate that the use of a brief screening for potential trauma may be helpful to guide clinical practice in chronic pain settings.
Multidisciplinary Strategies With Real-Time Fluorescence Images and Negative Pressure Wound Therapy to Manage Organ/Space Surgical Site Infection in Transplanted Kidneys
Authors: Chen Chih-Heng , Lee Yi-Ching , Wu Yi-Chun , Lee Chi-Hung , Tsai Yuan-Jen , Liu Yung-Ching , Chen Yu-Han , Wang Fu-Yu , Chang Shun-Cheng
Published: April 2023

Background

Surgical site infection (SSI) after kidney transplantation can severely compromise graft function and prolong hospital stay. Organ/space SSI (osSSI) is a severe type of SSI associated with a significantly higher mortality rate.

Aims and Objectives

This study aims to provide new strategies of managing (osSSI) after kidney transplant and other high-risk wound infections.

Method

This is a single-center, retrospective study that analyzed the treatment outcomes of 4 patients who developed osSSI after kidney transplant at Shuang-Ho Hospital. The management strategy included real-time fluorescence imaging with MolecuLight, negative-pressure wound therapy (NPWT) with Si-Mesh, and incisional NPWT (iNPWT).

Result

The average length of hospital stay was 18 days (range, 12–23 days). During hospitalization, all patients obtained high-quality debridement under real-time fluorescence image confirmation. The average duration of NPWT was 11.8 days (range, 7–17 days) and iNPWT was 7 days. All transplanted kidneys were preserved with normal function after 6 months of follow-up.

Conclusions

Our strategies with real-time fluorescence imaging provide a novel and effective method that can be used in adjunct with the standard of care for managing osSSI after kidney transplantation. More studies are warranted to validate the efficacy of our approach.
Comparison of LeniScar Silicone Stick (AnsCare) With Traditional Silicone Gel (Dermatix Ultra) in Wound Scar Prevention and Removal
Authors: Ma Yu-Kun , Lin Shang-Hsi , Lin Yu-Hsien
Published: April 2023

Background

As we all know, the numbers of aesthetic surgery are increasing around the world. After the surgery, the scar would be a problematic issue for both the surgeons and the patients. Silicone has proven to be effective for keloids, hypertrophic scars, and prevention of scar formation in many literatures for a long time. In terms of scar prevention, silicone has been used in the form of silicone sheets in early times, which is later improved to be the form of silicone gel with the advantage of easier usage. Although silicone gel has improved greatly in the aspect of appearance and convenience of the silicone sheets, there are still some disadvantages of the gel form. Therefore, the LeniScar silicone stick (AnsCare) is invented.

Objective

This article aimed to compare the results of scar treatment and prevention of the AnsCare LeniScar Silicone Stick versus the traditional silicone gel (Dermatix Ultra).

Methods

This study was a prospective, nonblinded, randomized clinical study. There were a total of 68 patients from September 2018 to January 2020. Patients were divided into 2 groups with AnsCare (n = 43) and Dermatix (n = 25), who both were required to schedule regular outpatient clinic follow-up, and photographs were taken before use, 1, 2, and 3 months later after the usage for the record. The physician assessed the scar condition by the Vancouver Scar Scale (VSS). The scores of the VSS were further analyzed and compared.

Results

The overall P value of total score of VSS was 0.635, which indicates that there is no significant difference in using AnsCare LeniScar Silicone Stick versus Dermatix Ultra silicone gel in terms of scar prevention and treatment. Individual items of VSS such as pliability, height, vascularity, and pigmentation all show no significant statistical difference in the 2 treatment products, with P = 0.980, 0.778, 0.528, and 0.366, respectively.

Conclusion

Traditional Dermatix Ultra silicone gel has been effective in the treatment of scar formation. AnsCare LeniScar Silicone Stick is statistically not different from the Dermatix Ultra silicone gel when comparing the treatment results of scar prevention. Furthermore, the AnsCare LeniScar Silicone Stick has the advantages of being time-saving with no need to wait for it to dry and application of precise amount to precise location, preventing waste or overuse.
Discharge Opioid Over- and Underprescription to Patients after General Surgery: A Retrospective Cohort Study
Authors: Guan Lucy S , Langnas Erica , Bongiovanni Tasce , Campbell Liam J , Wick Elizabeth C , Guan Zhonghui
Published: April 2023

Background:

Although postoperative opioid overprescription has been well-studied, little is known about opioid underprescription. This study aims to determine the extent of improper discharge opioid prescription in patients undergoing general surgery procedures.

Study Design:

This retrospective cohort study investigated opioid-naïve adult patients who underwent inpatient general surgery at an academic medical center between June 2012 and December 2019. The primary outcome was the difference between individual patient’s inpatient daily oral morphine milligram equivalent (MME) 24 hours before discharge and patient’s prescribed daily MME at discharge. Data were analyzed using chi-square, Mann-Whitney, Wilcoxon and Kruskal-Wallis tests and multivariable logistic regression.

Results:

Among 5,531 patients, 58.1% had opioid overprescription and 22.4% had opioid underprescription. Median prescribed daily MME was 311% of median inpatient daily MME in over-prescribed patients and 56.3% of median inpatient daily MME in under-prescribed patients. About half (52.3%) of patients who consumed no opioids on the day before discharge were opioid over-prescribed, and 69.9% of patients who required inpatient daily opioid of > 100 MME were opioid under-prescribed. Opioid under-prescribed patients had an increased opioid refill rate 1-30 days after discharge, whereas opioid over-prescribed patients had an increased refill rate 31-60 days after discharge. From 2017 to 2019, the percentage of over-prescribed patients decreased by 35.8%, but the percentage of under-prescribed patients increased by 42.4%.

Conclusion:

Although avoiding postoperative opioid overprescription remains imperative, preventing postoperative opioid underprescription is also essential. We recommend using a patient-centered approach to match the daily dose of opioid prescription with each patient’s inpatient daily opioid consumption.
Refractory giardiasis in a child with steroid-resistant nephrotic syndrome
Authors: Kalita Jitu Mani , Sharma Kirtika , Mohammad Naila , Tak Vibhor , Mittal Aliza , Nag Vijaya Lakshmi
Published: April 2023

Giardiasis is an infection of the small intestine caused by the protozoan parasite Giardia intestinalis and one of the most common parasitic intestinal diseases in humans worldwide. It mainly manifests as a self-limited illness in the case of immunocompetent patients and usually does not require treatment. However, immunodeficiency is a risk factor for the onset of severe Giardia infection. In this report, a case of recurrent giardiasis refractory to nitroimidazole therapy is presented. A 7-year-old male patient with steroid-resistant nephrotic syndrome came to our hospital because of chronic diarrhoea. The patient was on long-term immunosuppressive therapy. Microscopic examination of stool showed a significant number of trophozoites and cysts of G. intestinalis. Treatment with metronidazole for longer duration than recommended has failed to clear the parasite in the present case.
The Impact of Midodrine On Guideline-Directed Medical Therapy in Patients Admitted with Systolic Heart Failure
Authors: Scoma Christopher B , Lee Dae Hyun , Money David , Eichelberger Gerry , Usmani Ahsan , Cohen Adam J , Fernandez Joel
Published: April 2023

Background

Midodrine is occasionally used off-label to treat hypotension associated with advanced heart failure. Its association with changes in prescription of guideline-directed medical therapy (GDMT) has not previously been evaluated.

Objectives

We sought to evaluate the clinical characteristics and GDMT prescriptions of heart failure patients who were prescribed midodrine.

Methods

We performed a retrospective cohort study identifying all patients admitted to our hospital in 2020 with decompensated systolic heart failure who were prescribed midodrine upon discharge. They were compared to decompensated systolic heart failure patients who were not prescribed midodrine. Baseline characteristics, GDMT adjustments, and clinical outcomes were collected.

Results

114 patients met inclusion criteria in the midodrine group and were compared to 358 patients in the control group. At baseline, the midodrine group had worse left ventricular function, more right ventricular dysfunction, and more severe heart failure symptoms. At 6-months, the midodrine group had more initiation or up-titration of beta blockers (24.6% vs.15.4%; p=0.035), renin-angiotensin-aldosterone system (RAAS) inhibitors (34.2% vs. 24.0%; p=0.043) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) (19.3% vs.10.6%; p=0.024) compared to the non-midodrine group, with a similar pattern for MRA (mineralocorticoid receptor antagonists) prescriptions (17.5% vs. 11.5%; p=0.126). Mortality was not statistically different between the two groups, but the midodrine group had more frequent re-hospitalization for heart failure (39.5% vs. 25.4%; p=0.006).

Conclusions

Midodrine is frequently prescribed to patients presenting with systolic heart failure; the patients given midodrine tended to have more advanced heart failure and worse 6-month clinical outcomes. However, the patients who were prescribed midodrine achieved better initiation and up-titration of GDMT at 6 months compared to those who were not prescribed midodrine. Future prospective clinical trials are warranted to confirm these findings and determine if this translates to improved clinical outcomes.
The role of hnRNP A3 on age-related increased expression of FIX in the Liver
Authors: Hamada Toshiyuki , Kushige Hiroko , Fukushima Shiori , Kurachi Sumiko
Published: April 2023

HnRNP A3 is a protein that binds the age-related increase element (AIE) of blood coagulation factor IX (FIX) and that plays critical roles in age-related gene expression, likely through an epigenetic mechanism as yet unidentified. In a previous study, we found that Ser359phosphorylated hnRNP A3 proteins do not bind to the AIE of FIX although both unphosphorylated and Ser359phosphorylated hnRNP proteins exist in the liver. In the present study, to explore the relationship between hnRNP A3 and FIX, we examined the age-related expression pattern of 14 single spots of hnRNP A3 detected by 2DE and subsequent MALDI-TOF/TOF/MS analyses in mouse liver. We found that the level of all four Ser359phosphorylated hnRNP A3 proteins increased with age (from 1-21 months), while the 10 unphosphorylated hnRNP A3 proteins showed various expression patterns with age. We then examined the functional role of hnRNP A3 in FIX expression using siRNA knockdown technology targeting the hnRNP A3 gene in aged mice (12-17 months old). Inhibition of hnRNP A3 expression induced an increase in the circulating FIX level in aged mice.

These results suggested that hnRNP A3 inhibits age-related FIX protein expression and that age-dependent modification of hnRNP A3, including its phosphorylation at Ser359, might be involved in the age-dependent increase in FIX expressionin vivo.
Socioeconomic Disparities for Healthcare Utilization of Senior Adult Falls in Southeast Wisconsin, 2020-2022
Authors: Tong Ling , Khani Masoud , Taylor Bradley , Osinski Kristen , Adams Jazzmyne A. , Friedland David R. , Luo Jake
Published: April 2023

Background

To examine the social determinant factors of the healthcare utilizations for senior patients with history of falls.

Methods

We analyzed effects of socioeconomic factors on the utilization rate of healthcare in a tertiary care center including 495,041 senior adults. We included Zip Code Tabulation Areas to measure socioeconomic factors on a community level. Cohort group comparison and multiple linear regression models evaluated the association between healthcare services utilization and age, sex, education, race, insurance type, distance, and income levels.

Results

Patients with a history of falls were older than those without a history of falls (79.4 ± 12.1 vs. 75.4 ± 11.6 years old), predominantly female (odds ratio [OR]: 1.26, 95% confidence interval [95% CI]: 1.24–1.28), white (OR: 1.35, 95% CI: 1.32–1.38). Patients with a fall history were predominantly retired (OR: 2.53, 95% CI: 2.49–2.58), publicly insured (OR: 2.88, 95% CI: 2.82–2.93), and more likely to require an interpreter during a hospital visit (OR: 2.40, 95% CI: 2.35–2.44). Using a geospatial analysis, healthcare utilization was higher in areas close to the care center. A regression model showed that a community’s median income, private insurance rate, and college education rate were positively associated with healthcare utilization.

Conclusions

Lower utilization of healthcare is associated with disadvantaged neighborhood social conditions, including under-insured status, residing far from a hospital, lower education, and lower income. We revealed the current inequities and disparities in the healthcare of senior adult fall patients in Southeast Wisconsin.

1)

What is the current understanding of this subject?

Current healthcare outcome studies focus on risk factors of falls. However, there is a lack of studies on patient socioeconomic effects to the healthcare utilization.

2)

What does this report add to the literature?

The study reveals the potential socioeconomic inequities and disparities in the healthcare adoption of the senior adult falls.

3)

What are the implications for public health practice?

With the growing percentage of senior adult populations, specific strategies are needed to address the disparities to the adoption in underserved senior populations.
Mycobacterium tuberculosis– Macrophage Interactome: Molecular Network Structure and Resilience against Antibiotics
Authors: Paulina Puente-Mancera , Antonio Valcárcel , Isabel Castillo-Rodal Antonia , Díaz José
Published: April 2023

Resistance to several antibiotics againstMycobacterium tuberculosisis a serious problem to be solved worldwide. In the present work, we made the statistical analysis of the gene regulatory network ofMycobacterium tuberculosisand of theMycobacterium tuberculosis-macrophage interactome to find the probable cause of this resistance. The results from this analysis show that both the gene regulatory network and the interactoma have a hierarchical free scale modular structure that assures a high degree of resilience of these networks against external perturbations. In particular, the interactome is a complex hybrid network that results from the formation of novel links between theMycobacterium tuberculosisand macrophage proteins and from the modification of the previously existing links between the native macrophage proteins, which give rise to novel negative and positive feedback loops that modify the dynamical behavior of the interactome and protect the mycobacterium against the attack with antibiotics by taking control of the macrophage immune response and apoptosis. The statistical analysis of the interactome shows that the highly connected mycobacterium proteins inhA, ahpC, kasA, katG and rpsL exert this control by creating new links with the host proteins FAS and NF-κB. These new hybrid circuits embedded in the hierarchical scale-free modular molecular structure of the interactome produce its high resistance to external perturbations like antibiotics. As consequence, the present work proposes the hypothesis thatMycobacterium tuberculosisantibiotic resistancein vivoduring chronic tuberculosis is only a particular case of a more complex problem that is the interactomeresilienceagainst antibiotics. Thus, new strategies of drug design are necessary to shatter the complex structure of theMycobacterium tuberculosis-macrophage interactome.
The delayed bloodstream clearance ofPlasmodium falciparumparasites after M5717 treatment is attributable to the inability to modify their red blood cell hosts
Authors: Schneider Molly Parkyn , Looker Oliver , Rebelo Maria , Khoury David K. , Dixon Matthew W.A. , Oeuvray Claude , Crabb Brendan S. , McCarthy James , Gilson Paul R.
Published: April 2023

M5717 is a promising antimalarial drug under development thatacts against multiple stages of the life cycle ofPlasmodiumparasites by inhibiting the translation elongation factor 2 (PfeEF2), thereby preventing protein synthesis. The parasite clearance profile after drug treatment in preclinical studies in mice, and clinical trials in humans showed a notable delayed clearance phenotype whereby parasite infected red blood cells (iRBCs) persisted in the bloodstream for a significant period before eventual clearance. In a normalP. falciparuminfection iRBCs sequester in the deep circulation by cytoadherence, allowing them to avoid surveillance and clearance in the spleen. In this work we show that M5717 treatment renders iRBCs invisible to normal splenic clearance mechanisms. We found that M5717 blocks parasite modification of their host red blood cells (RBCs) by preventing synthesis of new exported proteins, rather than by directly blocking the export of these proteins into the RBC compartment. Usingin vitromodels, we demonstrated that M5717 treated ring/trophozoite stage iRBCs became less rigid, and cytoadhered less well compared to untreated iRBCs. This indicates thatin vivopersistence of M5717 treated iRBCs in the blood stream is likely due to reduced cytoadherence and splenic clearance.