bluuebunny/crossref_metadata_2025 huggingface dataset:
Chaetoglobosin A Contributes to the Antagonistic Action ofChaetomium globosumStrain 61239 Toward the Apple Valsa Canker PathogenCytospora mali
Authors: Liang Xiaofei , Lin Yuyi , Yu Wei , Yang Menghan , Meng Xiangchen , Yang Wenrui , Guo Yunzhong , Zhang Rong , Sun Guangyu
Published: April 2023

Apple Valsa canker (AVC) weakens apple trees and significantly reduces apple production in China and other East Asian countries. Thus far, very few AVC-targeting biocontrol resources have been described. Here, we present a thorough description of a fungal isolate ( Chaetomium globosum, 61239) that has strong antagonistic action toward the AVC causal agent Cytospora mali. Potato dextrose broth culture filtrate of strain 61239 completely suppressed the mycelial growth of C. mali on potato dextrose agar, and strongly constrained the development of AVC lesions in in vitro infection assays. ultra-performance liquid chromatography (UPLC) and HPLC-MS/MS investigations supported the conclusion that strain 61239 produces chaetoglobosin A, an antimicrobial metabolite that inhibits C. mali. Using genome sequencing, we discovered a gene cluster in strain 61239 that may be responsible for chaetoglobosin A production. Two of the cluster's genes— cheA, a PKS-NRPS hybrid enzyme, and cheB, an enoyl reductase—were individually silenced, which significantly decreased chaetoglobosin A accumulation as well as the strain's antagonistic activity against C. mali. Together, the findings of our investigation illustrate the potential use of Chaetomium globosum for the management of AVC disease and emphasize the significant contribution of chaetoglobosin A to the antagonistic action of strain 61239.
Genome Sequence Resource of Pseudofabraea citricarpa: A Fungus Causing Citrus Target Spot
Authors: Chen Li , Liu Saifei , Ren Jiequn , Li Li , Sun Haijun , Zhang Xin , Qiao Xinghua , Yang Yuheng
Published: April 2023

Citrus target spot disease caused by Pseudofabraea citricarpa poses a major threat to citrus production worldwide. Here, we report a high-quality genome assembly and annotation of a strain isolated from Chongqing, China. We have provided valuable insights into the evolution and pathogenicity of this fungus. The genome of P. citricarpa spans 44,005,176 bp with a G+C content of 44.71%, and its coding genes have been extensively annotated in various databases, such as GO and KEGG. Notably, we have predicted important proteins, such as secreted proteins, transmembrane proteins, and carbohydrate-active enzymes. Our findings serve as a key resource for understanding the global spread of this pathogen, enabling better control measures to be implemented. In conclusion, this study enriches our understanding of P. citricarpa and provides a foundation for future research in the field.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Genome Assembly Resource and Annotation of Bursaphelenchus xylophilus TS-1, the Causal Agent of Pine Wilt Disease
Authors: Li Jie , Xiong Xiong , Ma Shencheng , Yu Chengming , Li Chuanrong , Li Yongxia , Liu Huixiang
Published: April 2023

Pine wilt disease is a major biological disaster caused by Bursaphelenchus xylophilus. This study establishes a high-quality and well-annotated genome sequence of B. xylophilus strain TS-1 from Mountain Tai in Shandong province, China. The 75-Mbp assembly containing six chromosomes was established. These genome data represent a valuable new resource for future studies on B. xylophilus and the management of pine wilt disease.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
The Long Shadow: A Historical Perspective on Racism in Medical Education
Authors: Anderson Nientara , Nguyen Mytien , Marcotte Kayla , Ramos Marco , Gruppen Larry D. , Boatright Dowin
Published: April 2023

To dismantle racism in U.S. medical education, people must understand how the history of Christian Europe, Enlightenment-era racial science, colonization, slavery, and racism shaped modern American medicine. Beginning with the coalescence of Christian European identity and empire, the authors trace European racial reasoning through the racial science of the Enlightenment into the White supremacist and anti-Black ideology behind Europe’s global system of racialized colonization and enslavement. The authors then follow this racist ideology as it becomes an organizing principle of Euro-American medicine and examine how it manifests in medical education in the United States today. Within this historical context, the authors expose the histories of violence underlying contemporary terms such as implicit bias and microaggressions. Through this history, they also gain a deeper appreciation of why racism is so prevalent in medical education and how it affects admissions, assessments, faculty and trainee diversity, retention, racial climate, and the physical environment. The authors then recommend 6 historically informed steps for confronting racism in medical education: (1) incorporate the history of racism into medical education and unmask institutional histories of racism, (2) create centralized reporting mechanisms and implement systematic reviews of bias in educational and clinical activities, (3) adopt mastery-based assessment in medical education, (4) embrace holistic review and expand its possibilities in admissions, (5) increase faculty diversity by using holistic review principles in hiring and promotions, and (6) leverage accreditation to combat bias in medical education. These strategies will help academic medicine begin to acknowledge the harms propagated throughout the history of racism in medicine and start taking meaningful steps to address them. Although the authors have focused on racism in this paper, they recognize there are many forms of bias that impact medical education and intersect with racism, each with its particular history, that deserve their own telling and redress.
Monitoring the Resolution of Acute Exacerbation of Airway Bronchoconstriction in an Asthma Attack Using Capnogram Waveforms
Authors: Shikama Mio , Yamamoto Miyuki , Osawa Itsuki , Sato Takuya , Hirayama Ichiro , Hayase Naoki , Matsubara Takehiro , Doi Kent
Published: April 2023

BACKGROUND:

Patients with acute bronchospasm can show a distinct slope of the capnogram (“shark fin”) as a result of asynchronous alveolar excretion. Although the slope of the upward alveolar plateau (phase III) in the capnogram waveforms of non-intubated patients is known to help monitor the therapeutic response to acute bronchospasm, little is known about the significance of its slope among intubated patients. Therefore, we quantified the phase III slope of an intubated patient with acute asthma to investigate whether capnogram waveforms could be useful for identifying the response to antibronchospasm treatment in real time.

CASE SUMMARY:

The patient was a 53-year-old man who had a history of asthma. He presented to the emergency department with the primary complaint of respiratory distress. He was diagnosed with severe asthma attack and required invasive mechanical ventilation for 10 days, during which we quantified the phase III slope of the capnogram. The phase III slope decreased during treatment, with a significant reduction from the third to the fourth day; however, a significant decrease in end-tidal carbon dioxide (EtCO
2) was observed from the fifth to the sixth day. We found that the slope values decreased earlier than EtCO
2 reduction, although the absolute EtCO
2 values eventually decreased in response to antibronchospasm treatment.

CONCLUSION:

There were several reports that evaluated the phase III slope in non-intubated patients with asthma, but this is the first report measuring the phase III slope in an intubated patient over several days. Capnogram waveforms may serve as useful real-time indicators to monitor acute bronchospasm among mechanically ventilated patients.
Impact of Radial Arterial Location on Catheter Lifetime in ICU Surgical Intensive Care
Authors: Marie Damien , Dahyot-Fizelier Claire , Barrau Stéphanie , Boisson Matthieu , Frasca Denis , Jamet Angeline , Chauvet Stéphane , Ferrand Nathan , Pichot Amélie , Mimoz Olivier , Kerforne Thomas
Published: April 2023

OBJECTIVES:

The use of arterial catheters is frequent in intensive care for hemodynamic monitoring of patients and for blood sampling, but they are often removed because of dysfunction. The primary objective is to compare the prevalence of radial arterial catheter dysfunction according to location in relation to the radiocarpal joint in intensive care patients.

DESIGN:

Prospective randomized, controlled, single-center study.

SETTING:

The surgical ICU of the university hospital of Poitiers in France.

PATIENTS:

From January 2016 to April 2017, all patients over 18 years old admitted to the surgical ICU and requiring an arterial catheter were included.

INTERVENTIONS:

Randomization into two groups: catheter placed near the wrist (within 4 cm of the radiocarpal joint) and catheter placed away the wrist. The primary endpoint was the prevalence of dysfunction. We also compared the prevalence of infection and colonization.

MEASUREMENTS AND MAIN RESULTS:

One hundred seven catheters were analyzed (14 failed placements with no difference between the two groups, and 16 catheters excluded for missing data), with 58 catheters in near the wrist group and 49 in away the wrist group. We did not find any significant difference in the number of catheter dysfunctions between the two groups (p = 0.56). The prevalence density of catheter dysfunction was 30.5 of 1,000 catheter days for near the wrist group versus 26.7 of 1,000 catheter days for away the wrist group. However, we observed a significant difference in terms of catheter-related infection in favor of away the wrist group (p = 0.04). In addition, distal positioning of the catheter was judged easier by the physicians.

CONCLUSIONS:

The distal or proximal position of the arterial catheter in the radial position has no influence on the occurrence of dysfunction. However, there may be an association with the prevalence of infections.
The Efficacy and Safety of Cryoballoon Versus Radiofrequency Ablation for the Treatment of Atrial Fibrillation: A Meta-Analysis of 15 International Randomized Trials
Authors: Huang Chuan , Wang Jie , He Chaojie , Yang Kun , Zhao Hanru , Chen Jianfei , Su Li
Published: April 2023

The purpose of this study was to evaluate the efficacy and safety of cryoballoon versus radiofrequency ablation for the treatment of atrial fibrillation (AF) by systematically reviewing randomized controlled trials (RCTs). Databases of Pubmed, Web of science, Embase, and Cochrane Library were searched for published studies up to June 31, 2022. Only RCTs comparing the efficacy and safety of cryoballoon vs radiofrequency ablation for the treatment of AF were enrolled in meta-analysis. Fifteen RCTs characterizing 2709 patients were finally included. Meta-analysis found that cryoballoon ablation was associated with a similar proportion of patients free from AF [risk ratio (RR): 1.02; 95% confidence interval (CI): 0.93 to 1.12, P = 0.65]. Acute pulmonary vein isolation rate [RR: 1.0; 95% CI: 0.98 to 1.01, P = 0.64] and fluoroscopy time (weighted mean difference: −0.03; 95% CI: −4.35 to 4.28; P = 0.99) were not statistically significant difference. The procedure time was shorter in the cryoballoon ablation (CBA) group (weighted mean difference : −18.76; 95% CI: −27.27 to −10.25; P < 0.0001). Transient phrenic nerve palsy was uniquely observed in the CBA group (RR = 6.66; 95% CI: 2.82 to 15.7, P < 0.0001) and resolved in all during the follow-up period, total complication was similar in both groups (RR = 1.24; 95% CI: 0.86 to 1.79, P = 0.24). Although the procedure time was shorter in CBA group, the efficacy and safety were similar in each group. Compared with radiofrequency ablation for the treatment of AF, patients receiving cryoballoon ablation have similar outcomes. CBA is associated with a shorter duration of procedure.
The Role of SGLT2 Inhibitors in Cardiovascular Management
Authors: Wang Andy , Mahmood Uzair , Dey Subo , Fishkin Tzvi , Frishman William H. , Aronow Wilbert S.
Published: April 2023

Cardiovascular disease is a major cause of morbidity and mortality worldwide in patients with type 2 diabetes. Type 2 diabetes confers an elevated risk of developing heart failure and atherosclerotic cardiovascular disease. Until recently, there have been limited options to prevent and reduce the cardiovascular complications of type 2 diabetes. However, recent therapeutic advances have led to the adoption of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in cardiovascular management. Though SGLT2i were originally used for antihyperglycemic treatment, a series of landmark trials found that SGLT2i may confer cardio-protective effects in patients with heart failure and atherosclerotic cardiovascular disease, particularly a reduction in cardiovascular mortality and hospitalizations for heart failure. The cardiovascular benefits of SGLT2i were similarly demonstrated in patients with and without type 2 diabetes. Though previous trials found SGLT2i to be cardio-protective in heart failure with reduced ejection fraction, recent trials demonstrated that SGLT2i may also provide cardiovascular benefits in heart failure with mildly reduced and preserved ejection fraction. These advances have led SGLT2i to become an instrumental component of cardiovascular therapy.
Duration of Breastfeeding and Supportive Paternal Caregiving in Early Childhood and the Potential Mediating Function of Maternal Caregiving
Authors: Feldman Julia S. , Natale Brianna N. , Shaw Daniel S. , Nordahl Kristin Berg , Janson Harald , Nærde Ane
Published: April 2023

Objective:

Supportive paternal caregiving is influenced by contextual factors, including maternal caregiving behaviors. Although longer periods of breastfeeding have been found to be associated with higher levels of maternal supportive parenting, it remains unknown whether the benefits of breastfeeding also extend to fathers' supportive caregiving. This study tested the indirect relation between the duration of breastfeeding and paternal supportive parenting through maternal supportive parenting.

Methods:

Participating families (N = 623) were from the Behavior Outlook Norwegian Developmental Study, a population-based longitudinal study in Southeast Norway. Path analysis was used to test associations between the duration of breastfeeding in the first year (parent report) and paternal supportive parenting (observed, 36 months), as potentially mediated by maternal supportive parenting (observed, 24 months).

Results:

After controlling for sociodemographic and birth factors, a longer duration of breastfeeding was indirectly associated with higher levels of observed paternal supportive parenting through maternal supportive parenting.

Conclusion:

The current findings suggest that the longer breastfeeding duration during the first year of life (i.e., infancy) might have important implications for both maternal and paternal supportive parenting in toddlerhood.
Internal Limiting Membrane Peeling in Patients Undergoing Vitrectomy for Tractional Retinal Detachment Secondary to Diabetic Retionpathy
Authors: Rush Ryan B. , Gomez Pedro Luis , Rush Sloan W. , Bastar Pedro Gomez
Published: April 2023

Purpose:

To assess the merits of internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV) in subjects with a tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy (PDR).

Methods:

One hundred and ninety one PDR subjects undergoing PPV for the principal indication of TRD were enrolled into this randomized controlled trial. Study subjects were intraoperatively randomized into one of the following treatment groups: Cohort A patients underwent ILM peeling, while Cohort B patients did not undergo ILM peeling. The main outcome was postsurgical epiretinal membrane (ERM) development at 6 months. The secondary outcome was attainment of ≥ 20/50 visual acuity (Snellen) at 6 months.

Results:

One hundred and thirty nine subjects underwent randomization and completed the study’s 6-month trial period. Cohort A had 3.1% (2/64) of subjects develop an ERM postoperatively, while Group B had 26.7% (20/75) of subjects develop an ERM postoperatively at 6 months (p<0.001). Attainment of ≥ 20/50 visual acuity (Snellen) at 6 months was found in 21.9% (14/64) of subjects in Cohort A and 9.3% (7/75) of subjects in Cohort B (p=0.039).

Conclusions:

PDR patients undergoing PPV for TRD have a lower frequency of postsurgical ERM formation and a greater likelihood of attaining ≥ 20/50 Snellen visual acuity at 6 months when ILM peeling is conducted. Specialists may consider peeling of the ILM during PPV an important surgical maneuver in this patient population.
Optical coherence tomography angiography in neuro-ophthalmology
Authors: Douglas Vivian Paraskevi , Douglas Konstantinos A.A. , Torun Nurhan
Published: April 2023

Purpose of review

Optical coherence tomography angiography (OCTA) is a novel, noninvasive imaging technique, which provides depth resolved visualization of microvasculature of the retina and choroid. Although OCTA has been widely used for the evaluation of a number of retinal diseases, its use in the field of neuro-ophthalmology has been less studied. In this review, we provide an update on the utility of OCTA in neuro-ophthalmic conditions.

Recent findings

Peripapillary and macular microvasculature analyses have indicated that OCTA can be a promising tool for early detection of a number of neuro-ophthalmic diseases, differential diagnosis, and monitoring of disease progression. Recent studies have demonstrated that structural and functional impairment can develop at early stages in some conditions such as in multiple sclerosis and Alzheimer's disease even in the absence of overt clinical symptoms. Furthermore, this dye-less technique can be a valuable adjunct tool in the detection of complications commonly seen in some congenital entities such optic disc drusen.

Since its introduction, OCTA has emerged as an important imaging approach shedding light on unrevealed pathophysiological mechanisms of several ocular diseases. The use of OCTA as a biomarker in the field of neuro-ophthalmology has recently gained considerable attention with studies supporting its role in clinical setting while larger studies are warranted for correlating these findings with traditional diagnostic procedures and clinical features and outcomes.
Unplanned Extubation During Pediatric Cardiac Intensive Care: U.S. Multicenter Registry Study of Prevalence and Outcomes*
Authors: Perry Tanya , Klugman Darren , Schumacher Kurt , Banerjee Mousumi , Zhang Wenying , Bertrandt Rebecca , Wolovits Joshua S. , Murphy Lee D. , Misfeldt Andrew M. , Alten Jeffrey , Cooper David S.
Published: April 2023

Objectives:

The epidemiology of unplanned extubations (UEs) and associated adverse outcomes in pediatric cardiac ICUs (CICU).

Design:

Registry data (August 2014 to October 2020).

Setting:

Forty-five Pediatric Cardiac Critical Care Consortium hospitals.

Patients:

Patients receiving mechanical ventilation (MV) via endotracheal tube (ETT).

Interventions:

None.

Measurements and Main Results:

Fifty-six thousand five hundred eight MV courses occurred in 36,696 patients, with a crude UE rate of 2.8%. In cardiac surgical patients, UE was associated with longer duration of MV, but we failed to find such association in medical patients. In both cohorts, UE was associated with younger age, being underweight, and airway anomaly. In multivariable logistic regression, airway anomaly was associated with UE in all patients. Younger age, higher Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery score category, longer duration of MV, and initial oral rather than nasal ETT are associated with UE in the surgical group, but we failed to find such associations in the medical group. UE was associated with a higher reintubation rate compared with elective extubation (26.8 vs 4.8%; odds ratio [OR], 7.35; 95% CI, 6.44–8.39; p < 0.0001) within 1 day of event. After excluding patients having redirection of care, UE was associated with at least three-fold greater odds for each of ventilator-associated pneumonia (VAP), cardiac arrest, and use of mechanical circulatory support (MCS). However, we failed to identify an association between UE and greater odds of mortality (1.2 vs 0.8%; OR, 1.48; 95% CI, 0.86–2.54; p = 0.15), but uncertainty remains.

Conclusions:

UE in CICU patients is associated with greater odds of cardiac arrest, VAP, and MCS. Cardiac medical and surgical patients in the CICU appear to have different explanatory factors associated with UE, and perhaps these may be modifiable and tested in future collaborative population research.
Team Approach to Delayed Pediatric Vestibular Diagnosis: A Case Study
Authors: Reaves Tyler , Bliss Rebecca , Chole Dana , Bridges Jeff
Published: April 2023

Background and Purpose:

This report highlights the challenges of diagnosing pediatric vestibular neuritis following dental treatment and addressing fear avoidance behaviors.

Case Description:

An 11-year-old boy came to physical therapy with vestibular dysfunction following dental treatment that was unable to be diagnosed by emergency department staff. The participant received multispecialty treatment for 6 weeks.

Measurements:

Computerized Dynamic Posturography, Limits of Stability, Dizziness Handicap Inventory, Functional Gait Assessment, Dynamic Visual Acuity, and Modified Clinical Test of Sensory Interaction on Balance.

Outcomes:

Most notable improvements were seen in Limits of Stability and Computerized Dynamic Posturography. The participant made a full return to school and sport.

Conclusions:

The difficulty of pediatric vestibular neuritis diagnosis led to fear avoidance behaviors that were addressed by a collaborative specialty approach.

What This Adds to Evidence:

This is the first documented case of pediatric vestibular neuritis as a complication of a dental procedure with intervention focused on fear avoidance behaviors.
Dissemination of Remote Patient Monitoring: An Academic-Community Primary Care Partnership in South Carolina
Authors: Kirkland Elizabeth Barnhardt , Dericke Dawn , Bays Chloe Cooper , Wallinger Caroline , McElligott James , Slaughter Sabra , Moran William P.
Published: April 2023

Context:

Remote patient monitoring (RPM) for diabetes and hypertension may reduce barriers to patient care, leading to improved disease control and decreased morbidity and mortality.

Program:

We describe the implementation of a community-academic partnership to improve diabetes and hypertension control for underserved populations using RPM.

Implementation:

In 2014, our academic medical center (AMC) began working with community health centers (CHCs) to implement a centrally monitored RPM program for patients with diabetes. AMC nurses recruited, trained, and supported community partners through regular communication. Community sites were responsible for enrollment, follow-up visits, and all treatment adjustments.

Evaluation:

More than 1350 patients have been enrolled across 19 counties and 16 predominantly rural CHCs. The majority of patients reported low annual household income and African American or Hispanic background. It took about 6 to 9 months of planning at each CHC prior to first enrolled patient. More than 30% of patients utilizing the newer device continued to transmit glucose readings regularly at week 52 of enrollment. Hemoglobin A1c data reporting was completed for more than 90% of patients at 6 and 12 months postenrollment.

Discussion:

Partnering of our AMC with CHCs enabled dissemination of an effective, inexpensive tool that engaged underserved populations in rural South Carolina and improved chronic disease management. We supported implementation of clinically effective diabetes RPM programs at several CHCs, reaching a large number of historically underserved and underresourced rural CHC patients with diabetes. We summarize key steps to achieving a successful, collaborative RPM program through AMC-CHC partnerships.
Susceptibility to 3BNC117 and 10-1074 in ART suppressed chronically infected persons
Authors: Tebas Pablo , Lynn Kenn , Azzoni Livio , Cocchella Giorgio , Papasavvas Emmanouil , Fair Matthew , Karanam Brijesh , Sharma Paridhima , Reeves Jacqueline D. , Petropoulos Christos J. , Lalley-Chareczko Linden , Kostman Jay R. , Short Willian , Mounzer Karam , Montaner Luis J.
Published: April 2023

Objective:

The aim of this study was to assess the susceptibility of HIV to two HIV monoclonal antibodies (bnAbs), 3BNC117 and 10-1074, in individuals with chronically suppressed HIV infection.

Design:

The susceptibility of bnAbs was determined using the PhenoSense mAb Assay, which is a cell-based infectivity assay designed to assess the susceptibility of luciferase-reporter pseudovirions. This assay is the only CLIA/CAP compliant screening test specifically developed for evaluating bnAb susceptibility in people with HIV infection.

Method:

The susceptibility of luciferase-reporter pseudovirions, derived from HIV-1 envelope proteins obtained from PBMCs of 61 ART-suppressed individuals, to 3BNC117 and 10-1074 bnAbs was assessed using the PhenoSense mAb assay. Susceptibility was defined as an IC90 of <2.0 μg/ml and 1.5 μg/ml for 3BNC117 and 10-1074, respectively.

Results:

About half of the individuals who were chronically infected and virologically suppressed were found to harbor virus with reduced susceptibility to one or both of the tested bnAbs.

Conclusions:

The reduced combined susceptibility of 3BNC117 and 10-1074 highlights a potential limitation of using only two bnAbs for PREP or treatment. Further studies are needed to define and validate the clinical correlates of bnAb susceptibility.
New Contrast Media for K-Edge Imaging With Photon-Counting Detector CT
Authors: Jost Gregor , McDermott Michael , Gutjahr Ralf , Nowak Tristan , Schmidt Bernhard , Pietsch Hubertus
Published: April 2023

The recent technological developments in photon-counting detector computed tomography (PCD-CT) and the introduction of the first commercially available clinical PCD-CT unit open up new exciting opportunities for contrast media research. With PCD-CT, the efficacy of available iodine-based contrast media improves, allowing for a reduction of iodine dosage or, on the other hand, an improvement of image quality in low contrast indications. Virtual monoenergetic image reconstructions are routinely available and enable the virtual monoenergetic image energy to be adapted to the diagnostic task.

A key property of PCD-CT is the ability of spectral separation in combination with improved material decomposition. Thus, the discrimination of contrast media from intrinsic or pathological tissues and the discrimination of 2 or more contrasting elements that characterize different tissues are attractive fields for contrast media research. For these approaches, K-edge imaging in combination with high atomic number elements such as the lanthanides, tungsten, tantalum, or bismuth plays a central role.

The purpose of this article is to present an overview of innovative contrast media concepts that use high atomic number elements. The emphasis is on improving contrast enhancement for cardiovascular plaque imaging, stent visualization, and exploring new approaches using 2 contrasting elements. Along with the published research, new experimental findings with a contrast medium that incorporates tungsten are included.

Both the literature review and the new experimental data demonstrate the great potential and feasibility for new contrast media to significantly increase diagnostic performance and to enable new clinical fields and indications in combination with PCD-CT.
Primary Unilateral Cleft Lip Rhinoplasty Technique: The Melbourne Technique
Authors: Wilkes Courtney , Burge Jonathan , Chong David K.
Published: April 2023

Addressing the primary nasal deformity associated with congenital cleft lip is a complex problem that ranges in severity. There are both esthetic and functional ramifications that develop over time. This paper serves to describe the novel Melbourne technique in addressing the primary cleft nasal deformity through repositioning the septal cartilage to the facial midline, reconstructing the nasal floor, and an upper lateral suture to suspend and overcorrect the lower lateral cartilage by modifying the McComb technique. The definitive aim is long-term symmetry in the correction of the cleft lip nasal deformity and these techniques have demonstrated improved nasal symmetry in our unilateral cleft patients.
The Effect of Adding Curcumin to Sertraline in the Treatment of Severe Major Depressive Disorder: A Randomized, Double-Blind Clinical Trial
Authors: Talaei Ali , Noori Reza , Rezaei Ardani Amir , Mohammadpour Amir Hooshang , Azimipoor Zohre , Afzaljavan Fahimeh
Published: April 2023

Objectives

Major depressive disorder (MDD) is a chronic and debilitating disease influenced by inflammatory processes in the brain. Some evidence has represented the adding curcumin as a complementary regime to the standard medication in treating depressive symptoms. However, limited clinical trials have been conducted on the antidepressants effects of curcumin in MDD patients. Therefore, this study aimed to investigate the effectiveness of curcumin in the treatment of MDD.

Methods

In a randomized, double-blind clinical trial, 45 severe MDD patients referred to the psychiatric clinic of Ibn-e-Sina Hospital, Mashhad, Iran, during 2016 were selected. Patients were randomly divided into 2 groups who received sertraline plus curcumin or placebo at a dose of 40 mg/d for 8 weeks. The patients were evaluated using Beck Anxiety and Depression Surveys at the beginning of the study, fourth, and eighth weeks by a psychiatry resident. The data analyzed aiding SPSS software.

Results

While depression and anxiety significantly decreased during the 8 weeks of the study, there was no significant difference between the 2 groups (P > 0.05). However, the anxiety score was lower in the intervention group. Moreover, no severe adverse events were observed in all patients.

Conclusions

Adding 40 mg/d of SinaCurcumin to sertraline as a routine medical regimen did not improve the depression and anxiety levels in severe MDD patients. However, the anxiety score was lower in the intervention group than in the placebo receiver, which suggests curcumin may have a more effect on anxiety.
Peter M. Maitlis. 15 January 1933—18 May 2022
Authors: Crabtree FRS Robert H.
Published: April 2023

Starting life with a dramatic escape from Nazi Germany, Peter Maitlis rose to make important contributions to a variety of areas of organometallic chemistry, many of which have had a continuing influence in both academic and industrial practice. Perhaps his most significant work was his early discovery of pentamethylcyclopentadienyl complexes of rhodium and iridium, compounds that have been eagerly taken up elsewhere for a very wide variety of purposes. His mechanistic work related to the Fischer–Tropsch and Cativa processes had important industrial implications.
Morphology and niche evolution influence hummingbird speciation rates
Authors: Barreto Elisa , Lim Marisa C. W. , Rojas Danny , Dávalos Liliana M. , Wüest Rafael O. , Machac Antonin , Graham Catherine H.
Published: April 2023

How traits affect speciation is a long-standing question in evolution. We investigate whether speciation rates are affected by the traits themselves or by the rates of their evolution, in hummingbirds, a clade with great variation in speciation rates, morphology and ecological niches. Further, we test two opposing hypotheses, postulating that speciation rates are promoted by trait conservatism or, alternatively, by trait divergence. To address these questions, we analyse morphological (body mass and bill length) and niche traits (temperature and precipitation position and breadth, and mid-elevation), using a variety of methods to estimate speciation rates and correlate them with traits and their evolutionary rates. When it comes to the traits, we find faster speciation in smaller hummingbirds with shorter bills, living at higher elevations and experiencing greater temperature ranges. As for the trait evolutionary rates, we find that speciation increases with rates of divergence in the niche traits, but not in the morphological traits. Together, these results reveal the interplay of mechanisms through which different traits and their evolutionary rates (conservatism or divergence) influence the origination of hummingbird diversity.
Early-life sibling conflict in Canada jays has lifetime fitness consequences
Authors: Fuirst Matthew , Strickland Dan , Freeman Nikole E. , Sutton Alex O. , Ryan Norris D.
Published: April 2023

While delaying natal dispersal can provide short-term benefits for juveniles, lifetime fitness consequences are rarely assessed. Furthermore, competition for limited positions on a natal territory could impose an indirect fitness cost on the winner if the outcome has negative effects on its siblings. We use radio-tracking and 58 years of nesting data in Ontario, Canada to examine the lifetime fitness consequences of sibling expulsion in the Canada jay (Perisoreus canadensis). Six weeks after fledging, intra-brood dominance struggles result in one ‘dominant juvenile’ (DJ) remaining on the natal territory after expelling its subordinate siblings, the 'ejectees' (EJs). Despite an older age-at-first-reproduction, DJs produced more recruits over their lifetime and had higher first-year survival than EJs, leading to substantially higher direct fitness. Even though DJs incurred an indirect fitness cost by expelling their siblings and there was no evidence that their presence on the natal territory increased their parents' reproductive output the following year, they still had substantially higher inclusive fitness than EJs. Our results demonstrate how early-life sibling conflict can have lifetime consequences and that such fitness differences in Canada jays are driven by the enhanced first-year survival of DJs pursuant to the early-summer expulsion of their sibling competitors.
Origin of adaptations to open environments and social behaviour in sabretoothed cats from the northeastern border of the Tibetan Plateau
Authors: Jiangzuo Qigao , Werdelin Lars , Sanisidro Oscar , Yang Rong , Fu Jiao , Li Shijie , Wang Shiqi , Deng Tao
Published: April 2023

The iconic sabretooth
Homotherium
is thought to have hunted cooperatively, but the origin of this behaviour and correlated morphological adaptations are largely unexplored. Here we report the most primitive species of
Amphimachairodus
(
Amphimachairodus hezhengensis
sp. nov.), a member of Machairodontini basal to
Homotherium
, from the Linxia Basin, northeastern border of the Tibetan Plateau (9.8–8.7 Ma). The long snout, laterally oriented and posteriorly located orbit of
Amphimachairodus
suggest a better ability to observe the surrounding environment, rather than targeting single prey, pointing to an adaptation to the open environment or social behaviour. A pathological forepaw of
Amphimachairodus
provides direct evidence of partner care. Our analyses of trait evolutionary rates support that traits correlated with killing behaviour and open environment adaptation evolved prior to other traits, suggesting that changes in hunting behaviour may be the major evolutionary driver in the early evolution of the lineage.
A. hezhengensis
represents one of the most important transitions in the evolution of Machairodontini, leading to adaptation in open environments and contributing to their further dispersal and radiation worldwide. This rapid morphological change is likely to be correlated with increasingly arid environments caused by the rise of the Tibetan Plateau, and competition from abundant large carnivores in this area.
A major flood caused by a typhoon did not affect the population genetic structure of a river mayfly metapopulation
Authors: Suzuki Tomoya , Yano Koki , Okamoto Seiya , Ueki Gaku , Fukakusa Ayako , Ikeda Maki , Inoue Gaku , Tagashira Haruno , Yoshida Takumi , Tojo Koji
Published: April 2023

Floods affect the population structure of organisms that inhabit streams. In recent decades, the scale of floods has become larger due to climate change. Under these circumstances, on 12 October 2019, the largest typhoon in the history of observation in Japan struck the Japanese Archipelago. This typhoon caused heavy rainfall in various places, and the Chikuma–Shinano River System (Japan's largest) suffered great damage. Eight years before the large-scale disturbance in the river system, the population structure of the mayfly
Isonychia japonica
was studied in detail using quantitative sampling (population numbers and biomass) and by sequencing the mtDNA cytochrome c oxidase subunit I. To understand the impact of the flood on the population and genetic structures, we repeated the same research approximately 1 year after the flood. Direct comparison of sites before and after the flood revealed no significant changes between pre- and post-flood population genetic structure. This indicates high
in situ
resistance and/or resilience recovery of the populations to the disturbance. We hypothesize that this high resistance/resilience to flood disturbance is a result of strong selection for such traits in the rivers of the Japanese Archipelago, which are short, steep, flow rapidly and violently, and are strongly affected by floods.
Ongoing over-exploitation and delayed responses to environmental change highlight the urgency for action to promote vertebrate recoveries by 2030
Authors: Cornford Richard , Spooner Fiona , McRae Louise , Purvis Andy , Freeman Robin
Published: April 2023

To safeguard nature, we must understand the drivers of biodiversity loss. Time-delayed biodiversity responses to environmental changes (ecological lags) are often absent from models of biodiversity change, despite their well-documented existence. We quantify how lagged responses to climate and land-use change have influenced mammal and bird populations around the world, while incorporating effects of direct exploitation and conservation interventions. Ecological lag duration varies between drivers, vertebrate classes and body size groupings—e.g. lags linked to climate-change impacts are 13 years for small birds, rising to 40 years for larger species. Past warming and land conversion generally combine to predict population declines; however, such conditions are associated with population increases for small mammals. Positive effects of management (
>
+4% annually for large mammals) and protected areas (
>
+6% annually for large birds) on population trends contrast with the negative impact of exploitation (
<
−7% annually for birds), highlighting the need to promote sustainable use. Model projections suggest a future with winners (e.g. large birds) and losers (e.g. medium-sized birds), with current/recent environmental change substantially influencing abundance trends to 2050. Without urgent action, including effective conservation interventions and promoting sustainable use, ambitious targets to stop declines by 2030 may already be slipping out of reach.
Dim light at night affects the locomotor activity of nocturnal African pygmy mice (Mus minutoides) in an intensity-dependent manner
Authors: Viljoen A. , Oosthuizen M. K.
Published: April 2023

Rodents are integral components of ecosystems as they provide several important ecosystem services. Despite their importance as prey, pollinators and seed distributors, African rodents are largely understudied. The effect of anthropogenic changes such as artificial light at night extends past urban areas to peri-urban and rural habitats, and can have profound effects on entire ecosystems. We investigated the effect of dim light at night (dLAN) on the locomotor activity rhythms of the African pygmy mouse (Mus minutoides). Pygmy mice showed a dramatic, intensity-dependent reduction in their locomotor activity when subjected to dLAN, which was accompanied by a delay in the activity onset. We also considered masking responses with a dark pulse (DP) during the day and a light pulse at night. All animals became inactive in response to a light pulse during the night, whereas approximately half of the animals showed activity during a DP in the day. Our results suggest that the African pygmy mouse is highly sensitive to light and that their activity is strongly masked by light. In their natural environment, vegetation could shield pygmy mice against high light levels; however, other anthropogenic disturbances can alter the behaviour of these animals and could affect their survival.
Are all underimmunized measles clusters equally critical?
Authors: Moon Sifat Afroj , Marathe Achla , Vullikanti Anil
Published: April 2023

Disruptions in routine immunizations due to the COVID-19 pandemic have been a cause of significant concern for health organizations worldwide. This research develops a system science approach to examine the potential risk of geographical clustering of underimmunized individuals for an infectious disease like measles. We use an activity-based population network model and school immunization records to identify underimmunized clusters of zip codes in the Commonwealth of Virginia. Although Virginia has high vaccine coverage at the state level for measles, finer-scale investigation at the zip code level finds three statistically significant underimmunized clusters. To estimate the criticality of these clusters, a stochastic agent-based network epidemic model is used. Results show that different clusters can cause vastly different outbreaks in the region, depending on their size, location, and network characteristics. This research aims to understand why some underimmunized geographical clusters do not cause a large outbreak while others do. A detailed network analysis shows that it is not the average degree of the cluster or the percentage of underimmunized individuals in the cluster but the average eigenvector centrality of the cluster that is important in determining its potential risk.
Core warming of coronavirus disease 2019 (COVID-19) patients undergoing mechanical ventilation - a pilot study
Authors: Bonfanti Nathaniel P , Mohr Nicholas M , Willms David C , Bedimo Roger J , Gundert Emily , Goff Kristina L , Kulstad Erik B , Drewry Anne M
Published: April 2023

Fever is a recognized protective factor in patients with sepsis, and growing data suggest beneficial effects on outcomes in sepsis with elevated temperature, with a recent pilot randomized controlled trial showing lower mortality by warming afebrile sepsis patients in the intensive care unit. The objective of this prospective single-site randomized controlled trial was to determine if core warming improves respiratory physiology of mechanically ventilated patients with COVID-19, allowing earlier weaning from ventilation, and greater overall survival. A total of 19 patients with mean age of 60.5 (±12.5) years, 37% female, mean weight 95.1 (±18.6) kg, and mean BMI 34.5 (±5.9) kg/m2 with COVID-19 requiring mechanical ventilation were enrolled from September 2020 through February 2022. Patients were randomized 1:1 to standard-of-care or to receive core warming for 72 hours via an esophageal heat exchanger commonly utilized in critical care and surgical patients. The maximum target temperature was 39.8 °C. A total of 10 patients received usual care and 9 patients received esophageal core warming. After 72 hours of warming, PaO2/FiO2 ratios were 197 (±32) and 134 (±13.4), Cycle Thresholds were 30.8 (±6.4) and 31.4 (±3.2), ICU mortality was 40% and 44%, 30-day mortality was 30% and 22%, and mean 30-day ventilator-free days were 11.9 (±12.6) and 6.8 (±10.2) for standard-of-care and warmed patients, respectively (p=NS). This pilot study suggests that core warming of patients with COVID-19 undergoing mechanical ventilation is feasible and appears safe. Optimizing time to achieve febrile-range temperature may require a multimodal temperature management strategy to further evaluate effects on outcome.
An Integrated Genomic and Transcriptomic Analysis Reveals Distinct Molecular Features Associated with Mild-to-moderate Atopic Dermatitis
Authors: Hu Tu , Todberg Tanja , Skov Lone , Litman Thomas , Hoof Ilka , Rosa Joel Correa da
Published: April 2023

Atopic dermatitis (AD) is a common skin disorder, characterized by impaired skin barrier function and cutaneous inflammation. The pathophysiology of AD is incompletely understood, and has considerable genetic contributions. To obtain a detailed molecular understanding of AD, we integrated the genomic, skin transcriptomic, and clinical measurements from 30 AD and 30 healthy control (HC) subjects. We found that the AD group had mild-to-moderate disease severity and only showed slightly increased genetic risk compared with HC. When comparing within the AD group, we found that the lesional skin of patients with increased genetic risk was characterized by a possible “self-protection” mechanism, including elevation of the anti-inflammatory cytokine IL-34, activation of fibroblasts, wound healing, and the complement system. We hypothesize that this mechanism may contribute to halting further progression of AD.
Diagnostic accuracy of a point-of-care urine tenofovir assay, and associations with HIV viraemia and drug resistance among people receiving dolutegravir and efavirenz-based antiretroviral therapy
Authors: Dorward Jienchi , Lessells Richard , Govender Katya , Moodley Pravikrishnen , Samsunder Natasha , Sookrajh Yukteshwar , Turner Phil , Butler Christopher C , Hayward Gail , Gandhi Monica , Drain Paul K. , Garrett Nigel
Published: April 2023

Introduction

Novel point-of-care assays which measure urine tenofovir (TFV) concentrations may have a role in improving adherence monitoring for people living with HIV (PLHIV) receiving antiretroviral therapy (ART). However, further studies of their diagnostic accuracy, and whether results are associated with viraemia and drug resistance, are needed to guide their use, particularly in the context of the global dolutegravir rollout.

Methods

We conducted a cross-sectional evaluation among PLHIV receiving first-line ART containing tenofovir disoproxil fumarate (TDF). We calculated the diagnostic accuracy of the Abbott point-of-care assay to detect urine TFV measured by liquid chromatography and mass spectrometry. We evaluated the association between point-of-care urine TFV results and self-reported adherence, viraemia ≥1000 copies/mL, and HIV drug resistance, among people receiving either efavirenz or dolutegravir-based ART.

Results

Among 124 participants, 55% were women, median age was 39 (IQR 34-45) years. 74 (59.7%) were receiving efavirenz, and 50 (40.3%) dolutegravir. Sensitivity and specificity to detect urine TFV ≥1500ng/mL were 96.1% (95%CI 90.0-98.8) and 95.2% (75.3-100.0) respectively. Urine TFV results were associated with short (p<0.001) and medium term (p=0.036) self-reported adherence. Overall, 44/124 (35.5%) had viraemia, which was associated with undetectable TFV in those receiving efavirenz (OR 6.01, 1.27-39.0, p=0.014) and dolutegravir (OR 25.7, 4.20-294.8, p<0.001). However, in those with viraemia while receiving efavirenz, 8/27 (29.6%) had undetectable urine TFV, compared to 11/17 (64.7%) of those receiving dolutegravir. Drug resistance was detected in 23/27 (85.2%) of those receiving efavirenz and only 1/16 (6.3%) of those receiving dolutegravir. There was no association between urine TFV results and drug resistance.

Conclusions

Among PLHIV receiving ART, a rapid urine TFV assay can be used to accurately monitor urine TFV levels. Undetectable point-of-care urine TFV results were associated with viraemia, particularly among people receiving dolutegravir.

Trial registration

Pan-African Clinical Trials Registry: PACTR202001785886049.