bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibacterial mode of action of garviecin LG34 against Gram-negative bacterium Salmonella typhimurium
Authors: Gao Yurong , Li Dapeng
Published: August 2024

Garviecin LG34 produced by Lactococcus garvieae LG34 exhibits wide-spectrum antibacterial activity against both Gram-positive and Gram-negative bacteria. This work aimed at clarifying the antibacterial mode of action of garviecin LG34 against Gram-negative bacterium Salmonella typhimurium. To determine the concentration for the bacteriocin antimicrobial mode experiments, the minimum inhibitory concentration of garviecin LG34 against S. typhimurium CICC21484 was determined as 0.25 mg/ml. Garviecin LG34 decreased the viable count of S. typhimurium CICC21484 and its antibacterial activity was the dose and time dependant. Garviecin LG34 led to the dissipation of transmembrane potential, the rise in the extracellular conductivity, UV-absorbing material at 260 nm, and LDH level of S. typhimurium CICC21484. Scanning electron micrographs results shown that garviecin LG34 cause dramatic deformation and fragmentation including the flagellum shedding, pores formation in surface, and even completely breakage of S. typhimurium cell. Moreover, garviecin LG34 decreased the intracellular ATP level. The results of this study demonstrated that garviecin LG34 can destroy cell structure, increase membrane permeability of S. typhimurium, thereby might be used as biopreservative for treating food borne and salmonellosis resulting from Gram-negative bacterium S. typhimurium.
Redefining the Successful Aging of Veterans: A Scoping Review
Authors: Burns Kate Hutton , Neves Barbara Barbosa , Warren Narelle
Published: August 2024

Background and Objectives

The aging experiences of military veterans provide critical insights into what successful aging is and means for later life contexts constrained by distinct health and social needs. Can veterans “successfully” age when they are exposed to so many stressors with serious health and social consequences for later life? Veterans can offer valuable lessons for developing comprehensive approaches to refining successful aging, ensuring inclusivity of different older populations. Building on Rowe and Kahn’s idea of successful aging, we utilize the complementary concept of “active aging” to explore if there are unique factors, characteristics, and interventions that support active aging in veterans, compared with nonveteran populations.

Research Design and Methods

A rapid review and evidence synthesis was conducted across 9 databases in medicine, psychology, anthropology, sociology, and public health to search for peer-reviewed articles and research reports.

Results

Findings suggest that programs linking health and social dimensions can support the active aging of veterans, namely interventions promoting active physical and cognitive lifestyle as well as social connectedness and engagement. Such programs and interventions help prevent and combat mental and physical health decline and increase quality of life and well-being.

Discussion and Implications

Findings have implications for veteran and nonveteran populations more broadly, as people can actively age even when they have unique health and social needs.
Starting conversations about mental health and wellbeing in Australian culturally and linguistically diverse communities
Authors: Morse Alyssa R , Smith Dianna G , Clifford Rosemary , Shrimpton Brad , Banfield Michelle
Published: August 2024

Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants’ mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful, cross-cultural connections, the importance of language, increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people’s confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV’s collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions.
Δ9-Tetrahydrocannabinol and 11-hydroxy-Δ9-tetrahydrocannabinol as markers of cannabis use in urinary drug testing
Authors: Vikingsson Svante , Winecker Ruth E , Cone Edward J , Kuntz David J , Hayes Eugene D , Flegel Ronald R , Davis Lisa S
Published: August 2024

With some exceptions, California Assembly Bill 2188 will preclude the use of ∆9-tetrahydrocannabinol-9-carboxylic acid (Δ9-THC-COOH) as a marker of cannabis use in urinary workplace drug testing. The bill allows for the use of psychoactive cannabis markers, which include Δ9-tetrahydrocannabinol (Δ9-THC) and the metabolite 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-Δ9-THC). Both analytes are present in urine mainly as conjugated metabolites and will require hydrolysis prior to analysis, but very little is known about expected concentrations in urine. The aim of this study was to report the concentrations from two large datasets comprising 1411 workplace drug-testing urine specimens that tested positive by immunoassay (50 ng/mL cutoff) and discuss strategies for using 11-OH-Δ9-THC and/or Δ9-THC to detect cannabis use. Median 11-OH-Δ9-THC and Δ9-THC concentrations were 28%–35% and 1.1%–1.6% of those of Δ9-THC-COOH, respectively, and correlations between the analytes were observed. To avoid the risk of positives from passive exposure, laboratories could use a cutoff with equivalent sensitivity to cannabis exposure. A 5 ng/mL cutoff for 11-OH-Δ9-THC showed 92% agreement with a 15 ng/mL cutoff for Δ9-THC-COOH, with only 0.9% of specimens being positive only for 11-OH-Δ9-THC. It was not possible to propose an estimated cutoff for Δ9-THC, due to the constraints of the limit of detection used in this study.
Mating frequency estimation and its importance for colony abundance analyses in eusocial pollinators: a case study of Bombus impatiens (Hymenoptera: Apidae)
Authors: Bird Sydney A , Pope Nathaniel S , McGrady Carley M , Fleischer Shelby J , López-Uribe Margarita M
Published: August 2024

The genus Bombus (bumble bees) includes approximately 265 species, many of which are in decline in North America and Europe. To estimate colony abundance of bumble bees in natural and agricultural habitats, sibship relationships are often reconstructed from genetic data with the assumption that colonies have 1 monandrous queen. However, some species such as the North American common eastern bumble bee (Bombus impatiens Cresson) can display low levels of polyandry, which may bias estimates of colony abundance based on monandrous sibship reconstructions. To accurately quantify rates of polyandry in wild and commercially mated queens of this species, we empirically estimated mating frequencies using a novel statistical model and genotypes from 730 bees. To genotype individuals, we used a highly polymorphic set of microsatellites on colonies established from 20 wild-caught gynes and 10 commercial colonies. We found multiple fathers in 3 of the wild colonies and 3 of the commercial colonies. This resulted in average effective mating frequencies of 1.075 ± 0.18 and 1.154 ± 0.25 for wild and commercial colonies, respectively. These findings agree with previous reports of low rates of polyandry for B. impatiens. Using a large empirical dataset, we demonstrate that assuming monandry for colony abundance estimation in species that violate this assumption results in an overestimation of the number of colonies. Our results emphasize the importance of studying mating frequencies in social species of conservation concern and economic importance for the accuracy of colony abundance estimation and for understanding their ecology and sociobiology.
Multiband polarimetric imaging of HD 34700 with SCExAO/CHARIS
Authors: Chen Minghan , Lawson Kellen , Brandt Timothy D , Lewis Briley L , Uyama Taichi , Millar-Blanchaer Max , Tazaki Ryo , Currie Thayne
Published: August 2024

We present Subaru/SCExAO + CHARIS broad-band (JHK) integral field spectroscopy of HD 34700 A in polarized light. CHARIS has the unique ability to obtain polarized integral field images at 22 wavelength channels in broad-band, as the incoming light is first split into different polarization states before passing though the lenslet array. We recover the transition disc around HD 34700 A in multiband polarized light in our data. We combine our polarized intensity data with previous total intensity data to examine the scattering profiles, scattering phase functions and polarized fraction of the disc at multiple wavelengths. We also carry out three-dimensional Monte Carlo radiative transfer simulations of the disc using mcfost, and make qualitative comparisons between our models and data to constrain dust grain properties. We find that in addition to micron-sized dust grains, a population of submicron grains is needed to match the surface brightness in polarized light and polarized fraction. This could indicate the existence of a population of small grains in the disc, or it could be caused by Mie theory simulations using additional small grains to compensate for submicron structures of real dust aggregates. We find models that match the polarized fraction of the data but the models do not apply strong constraints on the dust grain type or compositions. We find no models that can match all observed properties of the disc. More detailed modelling using realistic dust aggregates with irregular surfaces and complex structures is required to further constrain the dust properties.
Inequality Bands: Seventy-five years of measuring income inequality in Latin America
Authors: Alvaredo Facundo , Bourguignon François , Ferreira Francisco , Lustig Nora
Published: August 2024

Drawing on a comprehensive compilation of quantile shares and inequality measures for 34 countries, including over 5600 estimated Gini coefficients, we review the measurement of income inequality in Latin America and the Caribbean over the last seven decades. We find that there is quite a bit of uncertainty regarding inequality levels for the same country/year combinations. Differences in inequality levels estimated from household surveys alone are present but they derive from differences in the construction of the welfare indicator, the unit of analysis, or the treatment of the data. With harmonized household surveys, the discrepancies are quite small. The range, however, expands significantly when –to correct for undercoverage and underreporting especially at the top of the distribution– inequality estimates come from some combination of surveys and administrative tax data. The range increases even further when survey-based income aggregates are scaled to achieve consistency not only with tax registries but with National Accounts. Since no single method to correct for underreporting at the top is fully convincing at present, we are left with (often wide) ranges, or bands, of inequality as our best summaries of inequality levels. Reassuringly, however, the dynamic patterns are generally robust across the bands. Although the evidence roughly until the 1970s is too fragmentary and difficult to compare, clearer patterns emerge for the last fifty years. The main feature is a broad inverted U curve, with inequality rising in most countries prior to and often during the 1990s, and falling during the early 21st century, at least until around 2015, when trends appear to diverge across countries. This pattern is broadly robust but features considerable variation in timing and magnitude depending on the country.
Ribosome stalling during c-myc translation presents actionable cancer cell vulnerability
Authors: Khaket Tejinder Pal , Rimal Suman , Wang Xingjun , Bhurtel Sunil , Wu Yen-Chi , Lu Bingwei
Published: August 2024

Myc is a major driver of tumor initiation, progression, and maintenance. Up-regulation of Myc protein level rather than acquisition of neomorphic properties appears to underlie most Myc-driven cancers. Cellular mechanisms governing Myc expression remain incompletely defined. In this study, we show that ribosome-associated quality control (RQC) plays a critical role in maintaining Myc protein level. Ribosomes stall during the synthesis of the N-terminal portion of cMyc, generating aberrant cMyc species and necessitating deployment of the early RQC factor ZNF598 to handle translational stress and restore cMyc translation. ZNF598 expression is up-regulated in human glioblastoma (GBM), and its expression positively correlates with that of cMyc. ZNF598 knockdown inhibits human GBM neurosphere formation in cell culture and Myc-dependent tumor growth in vivo in Drosophila. Intriguingly, the SARS-COV-2-encoded translational regulator Nsp1 impinges on ZNF598 to restrain cMyc translation and consequently cMyc-dependent cancer growth. Remarkably, Nsp1 exhibits synthetic toxicity with the translation and RQC-related factor ATP-binding cassette subfamily E member 1, which, despite its normally positive correlation with cMyc in cancer cells, is co-opted by Nsp1 to down-regulate cMyc and inhibit tumor growth. Ribosome stalling during c-myc translation thus offers actionable cancer cell vulnerability.
The Third Family Quark Mass Hierarchy and FCNC in the Universal Seesaw Model
Authors: Morozumi Takuya , Panuluh Albertus Hariwangsa
Published: August 2024

We present the study of the quark sector of the universal seesaw model with $\mathrm{SU(2)_L \times SU(2)_R \times U(1)_{Y^{\prime }}}$ gauge symmetry in the massless case of the two lightest quark families. This model aims to explain the mass hierarchy of the third family quark by introducing a vector-like quark (VLQ) partner for each quark. In this model, we introduce $\mathrm{SU(2)_L}$ and $\mathrm{SU(2)_R}$ Higgs doublets. We derive explicitly the Lagrangian for the quark sector, Higgs sector, and kinetic terms of the gauge fields, starting from the Lagrangian, which is invariant under $\mathrm{SU(2)_L \times SU(2)_R \times U(1)_{Y^{\prime }}}$ gauge symmetry. At each stage of the symmetry breaking, we present the Lagrangian with the remaining gauge symmetry. Additionally, we investigate the flavor-changing neutral currents (FCNCs) of the Higgs (h) and Z-bosons in the interaction with the top, heavy top, bottom, and heavy bottom quarks.
The role of collagen and crystallinity in the physicochemical properties of naturally derived bone grafts
Authors: Øvrebø Øystein , Orlando Luca , Rubenis Kristaps , Ciriello Luca , Ma Qianli , Giorgi Zoe , Tognoni Stefano , Loca Dagnija , Villa Tomaso , Nogueira Liebert P , Rossi Filippo , Haugen Håvard J , Perale Giuseppe
Published: August 2024

Xenografts are commonly used for bone regeneration in dental and orthopaedic domains to repair bone voids and other defects. The first-generation xenografts were made through sintering, which deproteinizes them and alters their crystallinity, while later xenografts are produced using cold-temperature chemical treatments to maintain the structural collagen phase. However, the impact of collagen and the crystalline phase on physicochemical properties have not been elucidated. We hypothesized that understanding these factors could explain why the latter provides improved bone regeneration clinically. In this study, we compared two types of xenografts, one prepared through a low-temperature chemical process (Treated) and another subsequently sintered at 1100°C (Sintered) using advanced microscopy, spectroscopy, X-ray analysis and compressive testing. Our investigation showed that the Treated bone graft was free of residual blood, lipids or cell debris, mitigating the risk of pathogen transmission. Meanwhile, the sintering process removed collagen and the carbonate phase of the Sintered graft, leaving only calcium phosphate and increased mineral crystallinity. Microcomputed tomography revealed that the Treated graft exhibited an increased high porosity (81%) and pore size compared to untreated bone, whereas the Sintered graft exhibited shrinkage, which reduced the porosity (72%), pore size and strut size. Additionally, scanning electron microscopy displayed crack formation around the pores of the Sintered graft. The Treated graft displayed median mechanical properties comparable to native cancellous bone and clinically available solutions, with an apparent modulus of 166 MPa, yield stress of 5.5 MPa and yield strain of 4.9%. In contrast, the Sintered graft exhibited a lower median apparent modulus of 57 MPa. It failed in a brittle manner at a median stress of 1.7 MPa and strain level of 2.9%, demonstrating the structural importance of the collagen phase. This indicates why bone grafts prepared through cold-temperature processes are clinically favourable.
N-acetylcysteine attenuates sodium arsenite-induced oxidative stress and apoptosis in embryonic fibroblast cells
Authors: Tasci Tunahan , Orta-Yilmaz Banu , Aydin Yasemin , Caliskan Mahmut
Published: August 2024

In recent years, the increase in environmental pollutants has been one of the most important factors threatening human and environmental health. Arsenic, a naturally occurring element found in soil, water, and air, easily enters the human body and leads to many metabolic disorders. In this study, we focused on the possible protective effects of N-acetylcysteine (NAC) against sodium arsenite (As)-induced toxic effects on embryonic fibroblast cells. The effects of As and NAC treatment on cells were evaluated, including cytotoxicity, oxidative stress, and apoptosis. Embryonic fibroblast cells were exposed to As (ranging from 0.01 μM to 10 μM) and NAC (at a concentration of 2 mM) for 24 h. The assessment of cytotoxicity markers, such as cell viability and lactate dehydrogenase (LDH), showed that As significantly reduced cell viability and increased LDH levels. Furthermore, we observed that As increased the amount of reactive oxygen species (ROS) in the cell, decreased the activity of antioxidant enzymes, and triggered apoptosis in cells. Additionally, our research revealed that the administration of NAC mitigates the detrimental effects of As. The results showed that As exerted hazardous effects on embryonic fibroblast cells through the induction of oxidative stress and apoptosis. In this context, our study provides evidence that NAC may have a protective effect against the toxicity of As in embryonic fibroblast cells.
Inhibition of TFEB deacetylation in proximal tubular epithelial cells (TECs) promotes TFEB activation and alleviates TEC damage in diabetic kidney disease
Authors: Li Xiaoyu , Zhang Yaozhi , Chen Huixia , Wu Yang , Chen Yongming , Gong Siqiao , Liu Yonghan , Liu Huafeng
Published: August 2024

The inhibition of the autophagolysosomal pathway mediated by transcription factor EB (TFEB) inactivation in proximal tubular epithelial cells (TECs) is a key mechanism of TEC injury in diabetic kidney disease (DKD). Acetylation is a novel mechanism that regulates TFEB activity. However, there are currently no studies on whether the adjustment of the acetylation level of TFEB can reduce the damage of diabetic TECs. In this study, we investigated the effect of Trichostatin A (TSA), a typical deacetylase inhibitor, on TFEB activity and damage to TECs in both in vivo and in vitro models of DKD. Here, we show that TSA treatment can alleviate the pathological damage of glomeruli and renal tubules and delay the DKD progression in db/db mice, which is associated with the increased expression of TFEB and its downstream genes. In vitro studies further confirmed that TSA treatment can upregulate the acetylation level of TFEB, promote its nuclear translocation, and activate the expression of its downstream genes, thereby reducing the apoptosis level of TECs. TFEB deletion or HDAC6 knockdown in TECs can counteract the activation effect of TSA on autophagolysosomal pathway. We also found that TFEB enhances the transcription of Tfeb through binding to its promoter and promotes its own expression. Our results, thus, provide a novel therapeutic mechanism for DKD that the alleviation of TEC damage by activating the autophagic lysosomal pathway through upregulating TFEB acetylation can, thus, delay DKD progression.
Integrative therapeutics for ocular surface disorders
Authors: Kourosh Atoosa , Nanda Anil , Sheth Dipa K. , Parmer Fariba Eshraghi
Published: August 2024

Purpose of review

Integrative medicine techniques are increasingly accepted into the treatment paradigm for many chronic disorders including eye disease. Over 71% of patients, including 67% of those with eye disorders, use some form of Integrative therapy. Physicians should be well versed in evidence-based therapies to know how to refer patients for the best complimentary care. We highlight the most effective integrative therapeutics from different complementary treatment paradigms to offer a framework for approaching therapy in patients with ocular surface disorders (OSDs).

Recent findings

Lifestyle and behavioral modifications help a proportion of people with OSDs like dry eye disease and allergic conjunctivitis, which are interrelated disorders. Nutrition and supplementation can also play a role in addressing underlying inflammation and improving OSD symptoms. Acupuncture and traditional herbal medicine may also benefit some patients. New technologies offer innovative treatment pathways in the treatment of OSD but require referral to Ocular Surface Treatment Centers.

Integrative treatment approach for OSD incorporates allopathic medicine, traditional remedies and lifestyle behavioral interventions, Ayurveda and herbal medicine, Nutritional Supplements, Homeopathy, Acupuncture and Chinese Medicine. New cutting-edge technologies offer breakthroughs in difficult to treat ocular surface cases. Collaboration between allergy or otolaryngology offices, complementary practitioners, as well as optometrists and ophthalmologists in Ocular Surface Treatment Centers can offer patients new avenues of treatment.
Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment
Authors: Lepping Rebecca J. , Hoffart Cara M. , Bruce Amanda S. , Taylor Jasmine M. , Mardis Neil J. , Lim Seung-Lark , Wallace Dustin P.
Published: August 2024

Objective:

Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth.

Methods:

This study examined changes in brain activation associated with experiencing physical pain and observing physical and emotional pain in others by using functional magnetic resonance imaging (fMRI) before and after intensive interdisciplinary pain treatment (IIPT). Eighteen youths (age 14 to 18) with widespread chronic pain completed fMRI testing before and after IIPT to assess changes in brain activation in response to physical and emotional pain.

Results:

Broadly, brain activation changes were observed in frontal, somatosensory, and limbic regions. These changes may suggest improvements in descending pain modulation via thalamus and caudate, and the different pattern of brain activation after treatment suggests potentially better discrimination between physical and emotional pain. Brain activation changes were also correlated with improvements in clinical outcomes of catastrophizing (reduced activation in right caudate, right mid-cingulate, and postcentral gyrus) and pain-related disability (increased activation in precentral gyrus, left hippocampus, right middle occipital cortex, and left superior frontal gyrus).

Discussion:

These changes could indicate that reduced brain protective responses to pain were associated with treatment-related improvements. This pilot study highlights the need for larger trials designed to better understand the brain mechanisms involved in pediatric widespread pain treatment.
The Different Surgical Approaches to Maxillofacial Reconstruction after Ballistic Trauma
Authors: Zeidan Toufic , Kassouf Elia , Ahmadieh Nizar , Nassar Aref , Jabbour Georges , Sleilati Fadi
Published: August 2024

Background:

Ballistic trauma to the face is a challenge, combining complex bone injury with severe soft tissue loss. The various surgical methods available are influenced by the extent of injuries. This study compares different operative modalities and their outcomes with different variables, aiming to define the ideal therapeutic approach.

Methods:

We retrospectively compared reconstructive modalities used to treat facial ballistic trauma cases at Hôtel-Dieu de France Hospital, Beirut, Lebanon, for a 12-year span. Statistical analysis was used to determine correlation between several factors and satisfactory results.

Results:

Eighteen patients were included, with varying degrees of bone and soft tissue loss. After conservative debridement, fractures were treated by different modalities: open reduction and internal fixation, maxillomandibular fixation, and osteosynthesis with a reconstruction plate. Although primary closure was sufficient in 10 cases, severe loss of tissues was reconstructed with a fibular free flap in five cases, radial free forearm flap in two cases, and free parascapular flap in one case. Two others received an iliac bone graft as secondary reconstruction. The average follow-up was 2.45 years. Most cases achieved good aesthetic and functional results after several secondary operations, with few late complications. Early reconstruction and younger patients were associated with better outcomes.

Conclusions:

We favor early debridement and reconstruction. Free flaps were ideal for extensive tissue loss. Bone grafting was needed secondarily. A single surgical procedure seldom led to satisfactory functional and aesthetic outcomes, and secondary operations were inevitable.
IgG4-Related Dacryoadenitis With Fibrous Mass in a 19-Month-Old Child: Case Report and Literature Review
Authors: Yazici Bulent , Onaran Zisan , Yalcinkaya Ulviye
Published: August 2024

A 19-month-old boy presented with eyelid swelling, proptosis, and upgaze limitation in the OD. The radiological study showed a homogeneous mass enclosing the lacrimal gland. Near-total tumor excision revealed IgG4-related orbital disease. Eosinophilia, serum IgG4, and IgE elevations were detected without extraorbital involvement. The patient received oral prednisolone for 4 months postoperatively and remained relapse-free for 27 months. Among the 17 well-documented pediatric cases of IgG4-related orbital disease in the literature (including this case), 59% were female, and the median age was 10 years; 2 patients were under 2 years old. The disease was unilateral in 82% of the patients and caused a soft tissue mass in 88%, involving the lacrimal gland in 53%. Nine patients received immunosuppression only, 4 surgery and immunosuppression, and 2 only surgical excision. Treatment results were reported in 13 patients, and all were favorable. IgG4-related dacryoadenitis with a fibrous mass may occur in very young children, responding well to surgical excision and steroids. Although pediatric IgG4-related orbital disease is not well-characterized yet, it may manifest differently from its adult variant.
Orbital Richter Transformation With Subsequent Orbital MALT-type Lymphoma in a Patient With Chronic Lymphocytic Leukemia
Authors: Hunt Patrick J. , Mehta Jeel , Ehrenburg Matthew R. , Reyes-Capó Daniela P. , Chen Chen , Zieske Arthur , Zu Yuli , Chévez-Barrios Patricia , Yen Michael T. , Pflugfelder Stephen C.
Published: August 2024

A 74-year-old man with a history of chronic lymphocytic leukemia (CLL) presented with large salmon-colored patch lesions along the inferior fornix and superotemporal conjunctiva of the OS. The patient underwent an incisional biopsy of the lesions, which showed a CLL with areas of large B-cell lymphoma, consistent with Richter transformation. Following medical and radiation-based therapy of these lesions, the patient returned 3 months later with inferomedial preseptal swelling in the contralateral eye, which biopsy proved to be recurrent/resistant low-grade CLL with a posttreatment extranodal marginal zone B-cell lymphoma pattern. This case exemplifies a rare presentation of CLL with Richter transformation and a recurrent/resistant posttreatment orbital CLL with a marginal zone B-cell lymphoma-like pattern.
Whole-Eye Transplantation: How Far Are We From a Breakthrough?
Authors: Bekono-Nessah Ingrid , Duah-Asante Kwaku A. , Poku Daryl , Kankam Hadyn K. N. , Kannan Ruben Y.
Published: August 2024

Purpose:

Traumatic facial injuries and resultant eye enucleation remain a devastating life-changing event for many. However, whole-eye transplantation (WET) has remained a distant goal until recently. This narrative review explores the existing literature on WET, assesses current hurdles to its success, and considers the ethical challenges to the expansion of WET programs globally.

Method:

The authors identified pertinent keywords by conducting an initial literature exploration which were subsequently used to search scientific databases. In line with the narrative methodology employed in this article, specific inclusion and exclusion criteria were not explicitly defined. Nevertheless, the review focused exclusively on articles relating to ocular restoration and reconstructive surgery.

Results:

Though vision restoration remains elusive, burgeoning surgical techniques such as vascularized composite allotransplantation have opened the scope for surgeons to consider WET when planning facial transplants. Dr. Rodriguez and the New York University Langone team’s success supports the recent advancements made in surgical innovation and the potential of CD34-positive stem cells as neuroprotective agents when injected at the optic nerve connection of the recipient. For WET to succeed, vascular and neural structures and the transplanted eye must be considered. Such requirements have been strengthened by the development of microsurgical techniques. In addition to addressing the technical feasibility of WET, it is crucial to deliberate on ethical considerations such as the lifelong implications associated with immunosuppression and, challenges related to the fair division of ocular tissue for WET versus keratoplasty.

Conclusion:

WET amid significant facial trauma has great potential to restore the quality of life in patients, however, more research is required to demonstrate its long-term viability.
A Case of Malignant Transformation of an Orbital Epidermoid Cyst to Cystic Squamous Cell Carcinoma
Authors: Sterner Robert C. , Downie Elaine M. , Duncan Nicole B. , Wang Qiancheng , Vander Zee Brandon , Potter Heather A. , Lucarelli Mark J.
Published: August 2024

Squamous cell carcinoma of the orbit is uncommon as there is no squamous epithelium in the orbit. Thus, mechanistically squamous cell carcinoma of the orbit most commonly arises from a cutaneous lesion. Although orbital epidermoid cysts are thought to have very low malignant potential, these lesions possess squamous epithelium and theoretically can undergo malignant transformation. Here, the authors present the case of a 63-year-old woman who presented with a 3-month history of diplopia and forehead tenderness with an orbital extraconal lesion on MRI consistent with a ruptured epidermoid cyst. Six months following resection, she suddenly experienced new-onset left upper eyelid ptosis, recurrent diplopia, and left orbital pain. MRI revealed a recurrence of the left orbital mass. Left anterior orbitotomy and biopsy revealed cystic squamous cell carcinoma. This case appears to demonstrate a very rare malignant transformation of an epidermoid cyst to cystic squamous cell carcinoma.
Clinical Characteristics and Outcome of Disseminated Nontuberculous Mycobacteria Infections in Patients With Solid Organ Transplant
Authors: Ong Leong Tung
Published: August 2024

Introduction

Solid organ transplant recipients are predisposed to nontuberculous mycobacteria (NTM) infections due to the use of immunosuppressant drugs. This metasummary aims to characterize the clinical characteristics and outcomes of disseminated NTM infection in solid organ transplant recipients.

Methods

A systematic literature search was conducted using different electronic databases (PubMed, Scopus, and Ovid SP) to identify relevant case reports. Case reports involved patients with diagnosis of disseminated NTM infection after solid organ transplant. Statistical analyses were performed using JMP software (version 15; SAS Institute, Cary, NC).

Results

A total of 34 case reports with 36 patients were included in this study. The mean age of the patients was 49.6 ± 13.0 years, and 44.4% of the patients were male. The majority of the patients had kidney transplant (61.1%). Fever (58.3%) was the most common presenting symptoms of disseminated NTM disease, followed by skin manifestations (44.0%), gastrointestinal symptoms (38.9%), and constitutional symptoms (30.6%). The most frequent organs involved were skin (44.4%), blood (36.1%), and lungs (36.1%). The most common cause of disseminated NTM infection was Mycobacterium avium complex (30.6%). The overall mortality rate was 22.2%. Univariate regression analysis demonstrated that infection of bone marrow (odds ratio, 6.00; 95% confidence interval, 1.05–34.32) and infection of the gastrointestinal tracts (odds ratio, 8.33; 95% confidence interval, 1.33–52.03) were independent predictors of mortality.

Conclusion

Disseminated NTM infection in solid organ recipients may present with different clinical features and involve a wide spectrum of different organs.
Posterior capsule opacification with two similar-design hydrophobic acrylic intraocular lenses: 3-year results of a randomized controlled trial
Authors: Leydolt Christina , Schartmüller Daniel , Schwarzenbacher Luca , Prenner Veronika , Danzinger Victor , Lisy Marcus , Abela-Formanek Claudette , Menapace Rupert
Published: August 2024

Purpose:

To compare intraindividually the incidence and intensity of posterior capsule opacification (PCO) and Nd:YAG capsulotomy rates between 2 similar open-loop single-piece hydrophobic acrylic intraocular lenses (IOLs) differing slightly in their particular material, optic surface, and sharp posterior edge design over a period of 3 years.

Setting:

Department of Ophthalmology, Medical University Vienna, Vienna, Austria.

Design:

Randomized, prospective, patient-masked and examiner-masked clinical trial with intraindividual comparison.

Methods:

100 patients randomly received a Vivinex XY1 IOL in 1 eye and a Clareon CNA0T0 IOL in the fellow eye. The amount of PCO (score 0 to 10) was assessed subjectively and objectively with digital retroillumination pictures using automated image analysis software (Automated Quantification of After-Cataract). Corrected distance visual acuity and the presence of glistenings, subjective visual symptoms, and Nd:YAG laser capsulotomy rate were noted.

Results:

67 of 100 patients were available for the 3-year follow-up examination. The objective PCO score of the Vivinex XY1 IOLs was 1.0 ± 1.0 compared with the PCO score of 1.5 ± 1.2 for the Clareon CNA0T0 IOLs (P < .001). 7.5% of patients had a Nd:YAG capsulotomy in the Vivinex XY1 eye, and 9.0% had a capsulotomy in the Clareon CNA0T0 eye (P = 1.0).

Conclusions:

Both hydrophobic acrylic IOLs showed low PCO and YAG rates with a small but significant favor of the Vivinex XY1 IOL compared with the Clareon CNA0T0 IOL. The interaction of various factors such as hydrophobic material, smooth optic surface, and sharp posterior optic edge is the major key for PCO prevention.

Clinical Trial Number:

NCT 04369482.
The Unique Challenges of Older Informal Caregivers Living With HIV in the U.S. Deep South: A Qualitative Study
Authors: Lee Yookyong , Vance David E. , Batey D. Scott
Published: August 2024

As people with HIV live longer and healthier, it has become more likely that they will assume a caregiver role for their families and/or friends. Yet, there is a significant gap in the literature that older caregivers with HIV (OCWH) have not received attention from practitioners and researchers. To fill the gap, our qualitative study was conducted with OCWH (N = 19) to explore various themes such as adjustment to caregiving, caregiving responsibilities, HIV and other health issues, support systems, caregiving outcomes, needs assessment, cognitive health, and the impact of COVID-19. Results indicated that each OCWH faced their own unique challenges (e.g., severity of health conditions, intense caregiving responsibilities, caregiving situation, lack of social support/transportation/financial means), but they expressed positive and fulfilling caregiving outcomes. Understanding the lived experiences of OCWH is requisite to develop holistic service programs to meet their caregiving needs while supporting their HIV health and co-occurring health conditions.
Provider Factors Likely to Impact Access and Uptake of Long-Acting Injectable Cabotegravir for Transgender Women in the United States: Results of a Qualitative Study
Authors: Rael Christine Tagliaferri , Das Doyel , Porter Jonathan , Lopez-Ríos Javier , Abascal Elena , Dolezal Curtis , Vaughn Michael P. , Giffenig Pilar , Lopez Jasmine M. , Stonbraker Samantha , Sun Christina , Velasco Roque Anthony , Bitterfeld Leandra , Bockting Walter O. , Bauermeister Jose
Published: August 2024

Long-acting injectable cabotegravir (CAB-LA) was US Food and Drug Administration–approved in 2021. However, little is known about providers' CAB-LA knowledge, attitudes, challenges, and prescribing preferences for transgender women patients. Understanding this is critical to developing new pre-exposure prophylaxis (PrEP) interventions tailored to transgender women. We conducted 45-min, in-depth Zoom interviews (IDIs) with United States–based health care providers who prescribe PrEP to transgender women. IDIs focused on providers' CAB-LA knowledge/acceptability, willingness to prescribe CAB-LA to transgender women, potential challenges, and solutions to mitigate challenges. Providers (N = 17) had a mean age of 43 years, and 35.4% (n = 6) identified as people of color. Most (n = 12) had basic knowledge of CAB-LA but wanted additional training. All participants found CAB-LA acceptable and were willing to prescribe. Most (n = 11) anticipated minimal challenges to implementation. Others (n = 4) reported potential issues, including logistical/scheduling concerns that impede CAB-LA integration and staffing concerns. Many providers expressed support for self-injection (n = 13) and injections at “drop-in” clinics (n = 8) to overcome challenges.
Ethics of abortion in transplantation
Authors: Ramos Hector C. , Hill Allison
Published: August 2024

Purpose of review

The controversial medical procedure of abortion is the subject of this article. It argues that for transplant patients, including recipients, abortion is ethical.

Recent findings

In June 2022, the United States Supreme Court overturned the long-standing decision of Roe v. Wade. This decision has led to a socio-legal environment where obtaining an abortion is impossible for some patients. However, the moral position relating to patients who have undergone transplants or are on a waiting list has been largely overlooked. End-stage renal, liver, and heart disease presents a hazardous situation for pregnancy, posing risks to both the fetus and the pregnant person. The abortion procedure is medically safer and allows a patient to proceed with a transplant. Limiting access to abortion or preventing it altogether will have a significant negative impact on transplant patients. The ethical analysis of abortion can be likened to compelling a relative or loved one of a transplant recipient to donate an organ to their family member or loved one.

This article emphasizes the importance of maintaining the legal availability of abortion for transplant patients. Allowing abortions in transplant patients upholds ethical parity, as seen in the analogous situation of live organ donation.
Assessment of the occurrence of apical periodontitis and endodontically treated/non-treated teeth in a Lower Austrian patient population treated for osteoporosis: a cohort study
Authors: Grün Pascal , Meier Marius , Dittrich Johannes , Gjergjindreaj Arb , Ströbele Dragan , Pfaffeneder-Mantai Florian , Hatamikia Sepideh , Geibel Margrit-Ann , Turhani Dritan
Published: August 2024

Introduction:

Osteoporosis (OP) is a bone disease linked to low bone mass and heightened fracture risk. Apical periodontitis (AP) is an inflammation of the apical periodontium, visible on radiographs, often associated with infection or necrosis of the root canal system. Both conditions, AP and OP, share inflammation and ageing as common factors, warranting exploration of their potential interactions. This study examined the association between AP and endodontically treated/non-treated teeth in patients with OP in Lower Austria.

Methods:

The authors included 425 patients (7924 examined teeth) aged over 60 years (average age 68±10 years) with 208 patients (3537 examined teeth) [179 women (3027 teeth) and 29 men (510 teeth)] initially diagnosed and treated for OP and a corresponding control group with 217 patients (4387 examined teeth) [187 women (3781 teeth) and 30 men (606 teeth)] without an OP diagnosis. For the diagnosis of AP, the panoramic radiographs and medical history taken at the initial presentation were analysed.

Results:

In patients treated for OP, AP was diagnosed as follows: in 134 (26%) treated and 234 (9%) non-treated teeth among women (511 treated/2516 non-treated teeth) and in 23 (27%) treated and 50 (11%) non-treated teeth among men (83 treated/427 non-treated teeth). The control group without OP consisted of: women (569 treated/ 3212 non-treated teeth) in 147 (25%) treated and 403 (12%) non-treated teeth; men (77 treated/ 529 non-treated teeth) 17 (22%) treated and 29 (6%) non-treated teeth.

When comparing AP in endodontically treated teeth according to sex, no statistically significant differences were observed between patients with and without OP (P>0.05). The same result was observed in endodontically non-treated teeth (P>0.05).

Conclusion:

The authors’ results indicate that there is no association between the occurrence of AP and endodontically or non-endodontically treated teeth in female and male patients treated for OP.
Combined ethanol and radiofrequency ablation for the elimination of focal atrial tachycardia originating from the Marshall bundle
Authors: Volkov Dmytro , Karpenko Yurii , Sidhu Alamjeet Kaur , Skoryi Dmytro , Batsak Bogdan , Akobirov Yevhen Sadatshovych , Shustytsky Roman Volodymyrovych , Kravchenko Tetiana
Published: August 2024

Introduction and importance:

Atrial tachycardias (AT) originating from the Marshall bundle (MB) are rare and present significant challenges in diagnosis and management. The authors present the case of a 29-year-old male with recurrent AT successfully treated with a combined ethanol and radiofrequency ablation approach. This case highlights the effectiveness of this dual ablation strategy in resolving AT originating from the MB, contributing valuable insights into managing complex AT cases.

Case presentation:

A 29-year-old male with recurrent, symptomatic palpitations was initially suspected of orthodromic atrioventricular reentrant tachycardia, but an initial electrophysiological study (EPS) failed to induce arrhythmia. Subsequent spontaneous episodes led to a detailed EPS, revealing automatic AT originating presumably from an epicardial focus on the posterior wall of the left atrium (LA). Detailed mapping identified the earliest activation at the vein of Marshall (VoM) ostium within the coronary sinus (CS). Suspecting the involvement of MB structures, VoM ethanol ablation was performed. Complete arrhythmia elimination was achieved with radiofrequency ablation (RFA) at the VoM ostium within the CS, with no recurrence.

Discussion:

Most cases in the literature are associated with atrial fibrillation (AF) or AT within AF, typically involving re-entry mechanisms. The given case is unique as it presents a highly probable VoM origin of automatic AT with no concomitant AF. The VoM’s anatomical and electrophysiological properties make it a potential source of refractory AT. In this case, ethanol ablation supplemented by targeted, limited RFA emerged as an effective strategy, highlighting the importance of comprehensive mapping and tailored ablation approaches in managing complex atrial arrhythmias.

Conclusion:

The potential implications for clinical practice include recognizing the VoM as a critical target in refractory AT cases and adopting a combined ablation strategy to improve patient outcomes in similarly challenging scenarios.
From confusion to clarity: a case report of hypertensive and autoimmune encephalopathy in an elderly woman
Authors: Adhikari Pratik
Published: August 2024

Introduction and importance:

Hypertensive encephalopathy is a critical condition characterized by acute hypertension-induced cerebral dysfunction, while autoimmune encephalitis involves immune-mediated neuronal damage. Distinguishing between these entities is crucial due to overlapping clinical features and distinct management approaches.

Case presentation:

The authors present a case of a 70-year-old woman with poorly controlled hypertension who initially presented with confusion and severe headache. Despite treatment for a hypertensive emergency, including intravenous labetalol, her neurological status deteriorated. She developed seizures and fever, prompting further investigations. Initial imaging and cerebrospinal fluid (CSF) analysis suggested hypertensive encephalopathy, but negative microbiological findings and persistent symptoms necessitated consideration of autoimmune causes.

Clinical discussion:

Clinical evaluation, EEG findings, and autoimmune panels were pivotal in diagnosing autoimmune encephalitis, supported by positive anti-NMDA receptor antibodies. Prompt initiation of high-dose intravenous immunoglobulin (IVIG) led to clinical improvement, underscoring the role of targeted immunotherapy.

Conclusion:

This case highlights the diagnostic complexities and therapeutic challenges of hypertensive and autoimmune encephalopathy overlap in elderly patients. Early recognition and tailored immunotherapy were instrumental in achieving favorable outcomes, advocating for a multidisciplinary approach to managing such complex neurological conditions.