bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of vault with two models of posterior chamber phakic intraocular lenses
Authors: Paredes Beatriz , Mora de Oñate Javier , Martín Sánchez Dolores , Piñero David P.
Published: August 2024

Purpose:

To evaluate and compare dynamic vault range (DVR) and asymmetry of the vault during a 3-month follow-up after the implantation of 2 posterior chamber phakic intraocular lenses (pIOLs).

Setting:

Aver Clinic, Madrid, Spain.

Design:

Prospective comparative study.

Methods:

119 eyes (65 patients) that underwent refractive surgical correction with implantation of 1 of 2 distinct pIOLs were enrolled: Eyecryl Phakic from Biotech Vision Care (Eyecryl group, 72 eyes) and Evo Visian Implantable Contact Lens from Staar Surgical (ICL group, 47 eyes). Besides evaluation of visual acuity, refraction, and ocular integrity, the pIOL vault centrally and at 2 mm nasally and temporally as well as the DVR from photopic (50 lux) to mesopic (10 lux) illumination conditions were measured.

Results:

No significant differences were found between the pIOL groups in visual and refractive outcomes (P ≥ .454). No significant differences between the groups were found in central (523.72 ± 168.4 vs 494.16 ± 156.7 μm, P = .248) and temporal (499.43 ± 155.8 vs 431.28 ± 150.5 μm, P = .067) vaults. However, nasal vault was significantly lower in the ICL group (465.6 ± 149.1 vs 375.4 ± 144.0 μm, P = .045). A trend of a larger DVR was observed in the ICL group, although differences between groups did not reach statistical significance (54.00 ± 36.39 vs 86.5 ± 57.9 μm, P = .070). The pIOL diameter only correlated significantly with vault measurements in the ICL group (r ≥ 0.650, P < .001).

Conclusions:

The Eyecryl pIOL showed more symmetric vaults and a trend of fewer light-induced changes in the central vault compared with the ICL pIOL. The clinical relevance of this finding should be investigated further.
Emergent epileptiform activity in spinal sensory circuits drives ectopic bursting in afferent axons and sensory dysfunction after cord injury
Authors: Bryson Matthew , Kloefkorn Heidi , Idlett-Ali Shaquia , Carrasco Dario I. , Noble Donald James , Martin Karmarcha , Sawchuk Michael A. , Au Yong Nicholas , Garraway Sandra M. , Hochman Shawn
Published: August 2024

Spinal cord injury leads to hyperexcitability and dysfunction in spinal sensory processing. As hyperexcitable circuits can become epileptiform, we explored whether such activity emerges in a thoracic spinal cord injury (SCI) contusion model of neuropathic pain. Recordings from spinal sensory axons in multiple below-lesion segmental dorsal roots demonstrated that SCI facilitated the emergence of spontaneous ectopic burst spiking in afferent axons, which were correlated across multiple adjacent dorsal roots. Burst frequency correlated with behavioral mechanosensitivity. The same bursting events were recruited by afferent stimulation, and timing interactions with ongoing spontaneous bursts revealed that recruitment was limited by a prolonged post-burst refractory period. Ectopic bursting in afferent axons was driven by GABAA receptor activation, presumably by conversion of subthreshold GABAergic interneuronal presynaptic axoaxonic inhibitory actions to suprathreshold spiking. Collectively, the emergence of stereotyped bursting circuitry with hypersynchrony, sensory input activation, post-burst refractory period, and reorganization of connectivity represent defining features of an epileptiform network. Indeed, these same features were reproduced in naive animals with the convulsant 4-aminopyridine (fampridine). We conclude that spinal cord injury promotes the emergence of epileptiform activity in spinal sensory networks that promote profound corruption of sensory signaling. This includes hyperexcitability and bursting by ectopic spiking in afferent axons that propagate bidirectionally by reentrant central and peripheral projections as well as sensory circuit hypoexcitability during the burst refractory period. More broadly, the work links circuit hyperexcitability to epileptiform circuit emergence, further strengthening it as a conceptual basis to understand features of sensory dysfunction and neuropathic pain.
“Where No One Has Gone Before”: Questions to Ensure the Ethical, Rigorous, and Thoughtful Application of Artificial Intelligence in the Analysis of HIV Research
Authors: Bergman Alanna J. , McNabb Katherine C. , Relf Michael V. , Dredze Mark H.
Published: August 2024

ChatGPT, an artificial intelligence (AI) system released by OpenAI on November 30th, 2022, has upended scientific and educational paradigms, reshaping the way that we think about teaching, writing, and now research. Since that time, qualitative data analytic software programs such as ATLAS.ti have quickly incorporated AI into their programs to assist with or even replace human coding. Qualitative research is key to understanding the complexity and nuance of HIV-related behaviors, through descriptive and historical textual research, as well as the lived experiences of people with HIV. This commentary weighs the pros and cons of the use of AI coding in HIV-related qualitative research. We pose guiding questions that may help researchers evaluate the application and scope of AI in qualitative research as determined by the research question, underlying epistemology, and goal(s). Qualitative data encompasses a variety of media, methodologies, and styles that exist on a spectrum underpinned by epistemology. The research question and the data sources are informed by the researcher's epistemological viewpoint. Given the heterogeneous applications of qualitative research in nursing, medicine, and public health there are circumstances where qualitative AI coding is appropriate, but this should be congruent with the aims and underlying epistemology of the research.
A rare case report: Brucellosis as an extreme cause of shoulder subluxation and rotator cuff tendinopathy
Authors: Tang Bo , Fan Cheng
Published: August 2024

Rationale:

Shoulder subluxation and rotator cuff tendinopathy is commonly associated with degeneration or trauma, and brucellosis has been reported to be correlated with shoulder subacromial bursitis, arthritis. However, brucellosis as a cause of shoulder subluxation and rotator cuff tendinopathy has never been reported in the English medical literature.

Patient concerns:

A 46-year-old man complained of left shoulder weakness and limited movement ongoing for 1 month. He was primarily diagnosed with shoulder subluxation and rotator cuff tear based on magnetic resonance imaging, and was advised to undergo arthroscopic rotator cuff surgical repair.

Diagnoses:

Although rotator cuff tear was diagnosed in another hospital, some doubts remained. First, a tendon profile with a relative high signal in T2-weighted magnetic resonance images in the supraspinatus tear area still existed. The findings were clearly different from the usual full-thickness rotator cuff tear, and no tendon profile could be found in the tear area. Second, degenerative rotator cuff tear mainly occurs in the aged population and this patient was relatively young, without a history of trauma. His left shoulder was painless but the weakness and the limited movement were extreme and all of these factors did not support the diagnosis of rotator cuff tear. Some infectious disease was suspected to be the cause and relevant laboratory tests were conducted. This patient was eventually diagnosed as having brucellosis-associated shoulder subluxation and rotator cuff tendinopathy based on positive serum standard tube agglutination test and buffer plate agglutination test for brucellosis.

Interventions:

Oral drug therapy with rifampicin and doxycycline was used for 8 weeks.

Outcomes:

A complete response with normal shoulder strength and movement was achieved at 8 weeks. At the one-year follow-up no signs of recurrence were detected.

Lessons:

Brucellosis-associated shoulder subluxation and rotator cuff tendinopathy may be misdiagnosed as a rotator cuff tear in magnetic resonance imaging and be further managed with indeterminate arthroscopic repair. A comprehensive understanding of the patient’s previous medical history, imaging and laboratory data and a careful physical examination are of great clinic value for the accurate diagnosis of the condition and the subsequent prognosis of the patient.
Towards a minimum data set for the female stress urinary incontinence surgical literature: a collaborative work
Authors: Rovner Eric S.
Published: August 2024

Purpose of review

There has been a need for an acceptable common minimum data set in the scientific literature as regards the surgical treatment of female stress urinary incontinence (SUI). Such a data set, if widely adopted, would improve the quality of the literature and allow objective comparisons between and across interventions.

Recent findings

The surgical treatment of female stress urinary incontinence has evolved considerably over the past few decades. The corresponding body of literature has grown exponentially describing the outcomes of hundreds of studies of these novel interventions. However, historically, the literature in this space has been of uneven quality. In order to improve the reporting of clinical studies, and ultimately patient outcomes, a standard minimum data set for trial design and publications was created by a collaborative group formed from leading scientific societies.

The consensus document created from this novel collaboration between members of SUFU (Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction), AUGS (American Urogynecologic Society), and ICS (International Continence Society) provides clear guidance for the structure of clinical studies and reporting of results in the peer-reviewed literature. This has substantial potential ramifications for scientific journals, journal editors, peer reviewers, investigators, regulatory agencies, industry, clinicians, and patients.
Mixed reality-supported near-infrared photoimmunotherapy for oropharyngeal cancer: a case report
Authors: Okada Ryuhei , Ito Taku , Kawabe Hiroaki , Tsutsumi Takeshi , Asakage Takahiro
Published: August 2024

Introduction and importance:

Near-infrared photoimmunotherapy (NIR-PIT, Alluminox) uses an antibody-photoabsorber conjugate and light excitation, requiring precise illumination. Mixed reality (MR) technology can enhance medical procedures through advanced visualization and planning.

Case presentation:

An 86-year-old man with recurrent oropharyngeal cancer and right cervical metastasis received NIR-PIT. Three-dimensional models from computed tomography (CT) and FDG-PET/CT images were used as holograms on a head-mounted display (HMD) for precise light targeting.

Clinical discussion:

HMD-MR technology was utilized for preoperative simulation and guided ideal light direction during surgery. This improved the effectiveness of NIR-PIT.

Conclusion:

Three months post-treatment, no residual lesion was observed, demonstrating the utility of HMD-MR technology in optimizing NIR-PIT outcomes.
A recent update on the connection between dietary phytochemicals and skin cancer: emerging understanding of the molecular mechanism
Authors: Singh Harpreet , Mishra Arun Kumar , Mohanto Sourav , Kumar Arvind , Mishra Amrita , Amin Ruhul , Darwin Chellappan Ronald , Emran Talha Bin
Published: August 2024

Constant exposure to harmful substances from both inside and outside the body can mess up the body’s natural ways of keeping itself in balance. This can cause severe skin damage, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. However, plant-derived compounds found in fruits and vegetables have been shown to protect against skin cancer-causing free radicals and other harmful substances. It has been determined that these dietary phytochemicals are effective in preventing skin cancer and are widely available, inexpensive, and well-tolerated. Studies have shown that these phytochemicals possess anti-inflammatory, antioxidant, and antiangiogenic properties that can aid in the prevention of skin cancers. In addition, they influence crucial cellular processes such as angiogenesis and cell cycle control, which can halt the progression of skin cancer. The present paper discusses the benefits of specific dietary phytochemicals found in fruits and vegetables, as well as the signaling pathways they regulate, the molecular mechanisms involved in the prevention of skin cancer, and their drawbacks.
Welcome to the Metaverse
Authors: Coughlin Vincenza , Bolanos Gabby , Moran Lauren , Jacob Arjuna , Stanislaus Manjula , Maydick-Youngberg Diane
Published: August 2024

Virtual reality (VR) is an innovative teaching strategy for professional development using computer-generated, three-dimensional images in an interactive virtual environment. Self-reported survey responses of nurses who used VR in orientation and the nurse residency program demonstrated improved knowledge, skills, and confidence. VR provides an innovative and engaging educational medium for learning that may have implications for future clinical practice and research.
Respiratory viral infections in children with cancer and febrile neutropenia and children undergoing hematopoietic stem cell transplantation
Authors: Torres Juan P. , Santolaya María E.
Published: August 2024

Purpose of review

The scope of this review is to understand the epidemiology and potential role of respiratory viral infections in children with cancer and febrile neutropenia, as well as in children, undergoing hematopoietic stem cell transplantation. Early detection of respiratory viral infections through molecular diagnostic techniques has allowed recent randomized clinical studies to advance the possibility of more rational use of antimicrobials in this susceptible population.

Recent findings

Progress has been made in the early detection of respiratory viruses in episodes of fever and neutropenia in children with cancer. In selected patients who meet specific clinical safety criteria and have negative bacterial cultures, it has been possible to safely and effectively discontinue antimicrobials. This has been validated in recent randomized clinical studies. However, more evidence is still needed for a similar indication in children, undergoing hematopoietic stem cell transplantation with viral respiratory infection episodes.

Understanding the role of respiratory viral infections in populations of immunocompromised children may contribute to a more rational use of antimicrobials and, in the near future, may help to decrease antimicrobial resistance in this susceptible population.
New antibiotics in clinical pipeline for treating infections caused by metallo-β-lactamases producing Gram-negative bacteria
Authors: Bassetti Matteo , Vena Antonio , Larosa Barbara , Giacobbe Daniele Roberto
Published: August 2024

Purpose of review

To discuss novel antibiotics under clinical development, focusing on agents showing in-vitro activity against metallo-β-lactamases (MBL)-producing carbapenem-resistant Gram-negative bacteria (CR-GNB).

Recent findings

Currently, only a few approved agents show activity, alone or in synergistic combinations, against MBL-producing CR-GNB. If approved by regulatory agencies in case of favorable results from ongoing (and, for some agents, already completed) phase-3 studies, some novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations could become available in the next few years as additional important options for treating MBL-producing CR-GNB infections. Additional interesting agents that belong both to BL/BLI combinations and to antibiotic classes other than BL and BL/BLI combinations have also shown activity against MBL-producing CR-GNB, with most of them being in early phases of clinical development.

Improving the use of these novel agents through virtuous antimicrobial stewardship frameworks able to guarantee both the efficacious treatment of infections requiring their use and the avoidance of their use whenever not necessary remains a challenge of utmost importance that should not be overlooked.
Dynamic landscape of a competing endogenous RNA network in early-onset preeclampsia under hypoxia conditions
Authors: Wei Chun-Yan , Hu Xiao-Lin
Published: August 2024

Objective:

Early-onset preeclampsia (EOPE) manifests as elevated blood pressure and indications of organ damage, predominantly in the kidneys, in women before 34 weeks of gestation. A growing body of evidence suggests that hypoxia triggers a series of maladaptive responses culminating in the progression of EOPE. However, the precise mechanisms underlying these processes remain largely undefined. This study aimed to map the dynamic interplay within the competing endogenous RNA (ceRNA) network in EOPE under hypoxic conditions to provide insights into its molecular etiology.

Methods:

To investigate the oxidative stress response in EOPE, RNA sequencing data (ID: GSE119265) were retrieved from the Gene Expression Omnibus database for exhaustive analysis. Oxygen-sensitive differentially expressed genes (DEGs) were identified by comparing EOPE samples to controls at 5% and 20% O2 concentrations, respectively. Furthermore, the STRING database facilitated the construction of a protein–protein interaction network, highlighting critical hub genes among the identified DEGs.

Results:

An intricate ceRNA network encompassing four representative DEGs (AOC1, DCN, TGFB1, and SYNE3) and seven differentially expressed long non-coding RNAs (HCG27, MEG3, XIST, LINC01119, LINC00964, LINC01118, and LINC01588) was established.

Conclusions:

Our analysis revealed a set of long non-coding RNA that respond to hypoxic stress, shedding light on their possible roles in the oxygen-dependent pathophysiology of EOPE. These insights offer new avenues for targeted EOPE diagnosis and treatment. Further studies are required to elucidate their precise functions.
Sinocutaneous Fistula: A Long-term Complication After Surgical Feminization of the Forehead
Authors: Ferrero Lauren , Atlan Michael , Cristofari Sarra
Published: August 2024

Facial feminization surgery is part of the process of treating patients with gender dysphoria. Forehead contouring, a common part of facial feminization surgery, modifies masculine facial features of the upper third, especially decreasing the thickness of their frontal sinuses and the orbital bossing. Forehead contouring is considered a safe procedure with minor complications and high patient satisfaction. However, rare cases of sinocutaneous fistula have been reported as long-term complications. The diagnosis and therapeutic management of this complication are challenging. Therefore, the authors report a case of frontal sinocutaneous fistula occurring 2 years and 10 months after forehead contouring with its clinical presentation and treatment modalities. Surgeons practicing forehead contouring and patients undergoing this procedure should be aware of the risk of sinocutaneous fistula, a rare but severe complication that requires multidisciplinary medico-surgical care.
Omitting the Escalating Dosage of Alpha-adrenergic Blockade Before Pheochromocytoma Resection
Authors: Holscher Isabelle , Engelsman Anton F. , Dreijerink Koen M.A. , Hollmann Markus W. , van den Berg Tijs J. , Nieveen van Dijkum Els J.M.
Published: August 2024

Objective:

This study describes the effects of introducing a protocol omitting preoperative α-blockade dose-escalation (de-escalation) in a prospective patient group.

Background:

The decline of mortality and morbidity associated with pheochromocytoma resection is frequently attributed to the introduction of preoperative α-blockade. Current protocols require preoperative α-blockade dose-escalation and multiple-day hospital admissions. However, correlating evidence is lacking. Moreover, recent data suggest equal perioperative safety regardless of preoperative α-blockade escalation.

Methods:

Single-institution evaluation of protocol implementation, including patients who underwent adrenalectomy for pheochromocytoma between 2015 and 2023. Intraoperative hemodynamic control was regulated by active adjustment of blood pressure using vasoactive agents. The primary outcome was intraoperative hypertension, defined as the time-weighted average of systolic blood pressure (TWA-SBP) above 200 mm Hg. Secondary outcomes included perioperative hypotension, postoperative blood pressure support requirement, hospital stay duration, and complications.

Results:

Of 102 pheochromocytoma patients, 82 were included; 44 in the de-escalated preoperative α-adrenergic protocol and 38 following the previous dose-escalation protocol. Median [IQR] TWA-SBP above 200 mm Hg was 0.01 [0.0–0.4] mm Hg in the de-escalated group versus 0.0 [0.0–0.1] mm Hg in the dose-escalated group (P=0.073). The median duration of postoperative continuous norepinephrine administration was 0.3 hours [0.0–5.5] versus 5.1 hours [0.0–14.3], respectively (P=0.003). Postoperative symptomatic hypotension occurred in 34.2% versus 9.1% of patients (P=0.005). Median hospital stay was 2.5 days [1.9–3.6] versus 7.1 days [6.0–11.9] (P<0.001). No significant differences in complication rates were observed.

Conclusion:

Our data suggest that adrenalectomy for pheochromocytoma employing a de-escalated preoperative α-blockade protocol is safe and results in a shorter hospital stay.
The Microscope and Beyond: Current Trends in the Characterization of Kidney Allograft Rejection From Tissue Samples
Authors: Chauveau Bertrand , Couzi Lionel , Merville Pierre
Published: August 2024

The Banff classification is regularly updated to integrate recent advances in the characterization of kidney allograft rejection, gathering novel diagnostic, prognostic, and theragnostic data into a diagnostic and pathogenesis-based framework. Despite ongoing research on noninvasive biomarkers of kidney rejection, the Banff classification remains, to date, biopsy-centered, primarily relying on a semiquantitative histological scoring system that overall lacks reproducibility and granularity. Besides, the ability of histopathological injuries and transcriptomics analyses from bulk tissue to accurately infer the pathogenesis of rejection is questioned. This review discusses findings from past, current, and emerging innovative tools that have the potential to enhance the characterization of allograft rejection from tissue samples. First, the digitalization of pathological workflows and the rise of deep learning should yield more reproducible and quantitative results from routine slides. Additionally, novel histomorphometric features of kidney rejection could be discovered with an overall genuine clinical implementation perspective. Second, multiplex immunohistochemistry enables in-depth in situ phenotyping of cells from formalin-fixed samples, which can decipher the heterogeneity of the immune infiltrate during kidney allograft rejection. Third, transcriptomics from bulk tissue is gradually integrated into the Banff classification, and its specific context of use is currently under extensive consideration. Finally, single-cell transcriptomics and spatial transcriptomics from formalin-fixed and paraffin-embedded samples are emerging techniques capable of producing up to genome-wide data with unprecedented precision levels. Combining all these approaches gives us hope for novel advances that will address the current blind spots of the Banff system.
More allogrooming is followed by higher physiological stress in wild female baboons
Authors: Christensen Charlotte , Bracken Anna M. , O'Riain M. Justin , Heistermann Michael , King Andrew J. , Fürtbauer Ines
Published: August 2024

Social bonds increase fitness in a range of mammals. One pathway by which social bonds may increase fitness is by reducing the exposure to physiological stress, i.e. glucocorticoid (GC) hormones, that can be detrimental to health and survival. This is achieved through downregulating hypothalamic–pituitary–adrenal (HPA)-axis activity. Indeed, long-term measures of social (grooming) bonds are often negatively correlated with HPA-axis activity. However, the proximate role of physical touch through allogrooming remains an open question in the sociality–health–fitness debate. Demonstrating the potential anxiolytic benefits of grooming in the wild is hindered by methodological limitations. Here, we match accelerometer-identified grooming in wild female chacma baboons (
Papio ursinus
) to non-invasive faecal GC metabolite concentrations (fGCs). Consistent with previous work, we found a negative (but statistically non-significant) overall relationship between individual averaged fGCs and grooming rates. However, when time-matching grooming to fGCs, we found that both more giving and receiving grooming were followed by higher fGCs. This upregulation of HPA-axis activity suggests that maintaining social bonds (and its ultimate fitness benefits) may come at a shorter-term physiological cost. This finding sheds new light on a ubiquitous social behaviour typically considered ‘relaxing’ and suggests that sociopositive contact can trigger physiological stress.
GIS-ODE: linking dynamic population models with GIS to predict pathogen vector abundance across a country under climate change scenarios
Authors: Worton A. J. , Norman R. A. , Gilbert L. , Porter R. B.
Published: August 2024

Mechanistic mathematical models such as ordinary differential equations (ODEs) have a long history for their use in describing population dynamics and determining estimates of key parameters that summarize the potential growth or decline of a population over time. More recently, geographic information systems (GIS) have become important tools to provide a visual representation of statistically determined parameters and environmental features over space. Here, we combine these tools to form a ‘GIS-ODE’ approach to generate spatiotemporal maps predicting how projected changes in thermal climate may affect population densities and, uniquely, population dynamics of
Ixodes ricinus
, an important tick vector of several human pathogens. Assuming habitat and host densities are not greatly affected by climate warming, the GIS-ODE model predicted that, even under the lowest projected temperature increase,
I. ricinus
nymph densities could increase by 26–99% in Scotland, depending on the habitat and climate of the location. Our GIS-ODE model provides the vector-borne disease research community with a framework option to produce predictive, spatially explicit risk maps based on a mechanistic understanding of vector and vector-borne disease transmission dynamics.
Near-field hydrodynamic interactions determine travelling wave directions of collectively beating cilia
Authors: Cheng Ziqi , Vilfan Andrej , Wang Yanting , Golestanian Ramin , Meng Fanlong
Published: August 2024

Cilia can beat collectively in the form of a metachronal wave, and we investigate how near-field hydrodynamic interactions between cilia can influence the collective response of the beating cilia. Based on the theoretical framework developed in the work of Meng
et al
. (Meng
et al
. 2021
Proc. Natl Acad. Sci. USA
118
, e2102828118), we find that the first harmonic mode in the driving force acting on each individual cilium can determine the direction of the metachronal wave after considering the finite size of the beating trajectories, which is confirmed by our agent-based numerical simulations. The stable wave patterns, e.g. the travelling direction, can be controlled by the driving forces acting on the cilia, based on which one can change the flow field generated by the cilia. This work can not only help to understand the role of the hydrodynamic interactions in the collective behaviours of cilia, but can also guide future designs of artificial cilia beating in the desired dynamic mode.
A knowledge curse: how knowledge can reduce human welfare
Authors: Basu Kaushik , Weibull Jörgen
Published: August 2024

Greater knowledge is always an advantage for a rational individual. However, this article shows that for a group of rational individuals greater knowledge can backfire, leading to a worse outcome for all. Surprisingly, this can happen even when new knowledge does not mean the discovery of a new action but simply provides a deeper understanding of the interaction at stake. More specifically, enhanced knowledge about the current state of nature may hinder cooperation among purely self-interested individuals. The paper describes this paradoxical possibility—a ‘knowledge curse’—and analyses the evolutionary process that occurs if, initially, only a few people have access to the greater knowledge. It concludes with a tentative comment on ways to avert this potential knowledge backlash.
High infectivity and waterborne transmission of seagrass wasting disease
Authors: Eisenlord Morgan E. , Agnew M. Victoria , Winningham Miranda , Lobo Olivia J. , Vompe Alex D. , Wippel Bryanda , Friedman Carolyn S. , Harvell C. Drew , Burge Colleen A.
Published: August 2024

Pathogen transmission pathways are fundamental to understanding the epidemiology of infectious diseases yet are challenging to estimate in nature, particularly in the ocean. Seagrass wasting disease (SWD), caused by
Labyrinthula zosterae
, impacts seagrass beds worldwide and is thought to be a contributing factor to declines; however, little is known about natural transmission of SWD. In this study, we used field and laboratory experiments to test SWD transmission pathways and temperature sensitivity. To test transmission modes in nature, we conducted three field experiments out-planting sentinel
Zostera marina
shoots within and adjacent to natural
Z. marina
beds (20 ± 5 and 110 ± 5 m from bed edge). Infection rates and severity did not differ among outplant locations, implicating waterborne transmission. The infectious dose of
L. zosterae
through waterborne exposure was assessed in a controlled laboratory experiment. The dose to 50% disease was 6 cells ml
−1
and did not differ with the temperatures tested (7.5°C and 15°C). Our results show
L. zosterae
is transmissible through water without direct contact with infected plants. Understanding the transmission dynamics of this disease in the context of changing ocean conditions will improve
Z. marina
protection and restoration in critical coastal habitats worldwide.
Lunar rhythms and their carry-over effects may shape environmental sex determination in a coral reef fish
Authors: Shima Jeffrey S. , Alonzo Suzanne H. , Osenberg Craig W. , Noonburg Erik G. , Swearer Stephen E.
Published: August 2024

Lunar rhythms shape spawning phenology and subsequent risks and rewards for early life-history stages in the sea. Here, we consider a perplexing spawning phenology of the sixbar wrasse (
Thalassoma hardwicke
), in which parents spawn disproportionately around the new moon, despite the low survival of these larvae. Because primary sex determination in this system is highly plastic and sensitive to social environments experienced early in development, we ask whether this puzzling pattern of spawning is explained by fitness trade-offs associated with primary sexual maturation. We used otoliths from 871 fish to explore how spawning on different phases of the moon shapes the environments and phenotypes of settling larvae. Offspring that were born at the new moon were more likely to settle (i) before other larvae, (ii) at a larger body size, (iii) at an older age, (iv) to the best quality sites, and (v) as part of a social group—all increasing the likelihood of primary maturation to male. Selection of birthdates across life stage transitions suggests that the perplexing spawning phenology of adults may reflect an evolutionarily stable strategy that includes new moon spawning for compensatory benefits later in life, including preferential production of primary males at certain times.
Qing-Luo-Yin eases angiogenesis in adjuvant-induced arthritis rats by activating PPARγ
Authors: Song Meng-Ke , Yin Qin , Gu Meng-Fan , Chen Wen-Gang , Olatunji Opeyemi Joshua , Li Yan , Zuo Jian
Published: August 2024

Objective

Qing-Luo-Yin (QLY) is an anti-rheumatic herbal formula with potentials activating PPARγ. This study investigated if its anti-angiogenesis effects are related to immune modulation.

Method

Adjuvant-induced arthritis (AIA) rats were orally treated by QLY or rosiglitazone (a PPARγ agonist) for 30 days. Their immune and metabolism statues were investigated afterward. Isolated monocytes and lymphocytes were co-cultured reciprocally, and treated by different serums. Healthy rats received blood transfusion from QLY-treated or AIA model rats. Two days ahead of sacrifice, a matrigel plug was planted. The plug and some blood immune indicators were examined. AIA rat serum-incubated THP-1 and Jurkat cells were treated by sinomenine, berberine and palmatine. The medium and T0070907 (a PPARγ inhibitor) were used to stimulate HUVEC cells.

Results

QLY showed similar therapeutic effects on AIA to rosiglitazone, alleviating joint injuries, synovial angiogenesis, and metabolic disorders. Although QLY impaired inflammatory phenotype of AIA monocytes in vivo, the effect was hardly achieved or sustained in vitro. T cells from QLY-treated AIA rats showed the weakened inflammatory phenotype, and were unable to induce monocytes inflammatory polarization. AIA rat lymphocytes induced angiogenesis in the matrigel plug in healthy recipients. In lymphocytes enrichment site, QLY reduced the secretion of IL-17A, IFNγ, and many angiogenesis-related cytokines. QLY-related components affected Jurkat but not THP-1 cells. Jurkat T cells induced angiogenesis of HUVEC cells when cultured by AIA rat serum. Inhibitory effects of the compounds on it were abolished by T0070907.

Conclusion

PPARγ activation in T cells is a foundation for the anti-angiogenesis property of QLY.
A foundational transformer leveraging full night, multichannel sleep study data accurately classifies sleep stages
Authors: Fox Benjamin , Jiang Joy , Wickramaratne Sajila , Kovatch Patricia , Suarez-Farinas Mayte , Shah Neomi A , Parekh Ankit , Nadkarni Girish N
Published: August 2024

Study Objectives

To investigate whether a foundational transformer model using 8-hour, multi-channel data from polysomnograms can outperform existing artificial intelligence (AI) methods for sleep stage classification.

Methods

We utilized the Sleep Heart Health Study (SHHS) visits 1 and 2 for training and validation and the Multi-Ethnic Study of Atherosclerosis (MESA) for testing of our model. We trained a self-supervised foundational transformer (called PFTSleep) that encodes 8-hour long sleep studies at 125 Hz with 7 signals including brain, movement, cardiac, oxygen, and respiratory channels. These encodings are used as input for training of an additional model to classify sleep stages, without adjusting the weights of the foundational transformer. We compared our results to existing AI methods that did not utilize 8-hour data or the full set of signals but did report evaluation metrics for the SHHS dataset.

Results

We trained and validated a model with 8,444 sleep studies with 7 signals including brain, movement, cardiac, oxygen, and respiratory channels and tested on an additional 2,055 studies. In total, we trained and tested 587,944 hours of sleep study signal data. Area under the precision recall curve (AUPRC) scores were 0.82, 0.40, 0.53, 0.75, and 0.82 and area under the receiving operating characteristics curve (AUROC) scores were 0.99, 0.95, 0.96, 0.98, and 0.99 for wake, N1, N2, N3, and REM, respectively, on the SHHS validation set. For MESA, the AUPRC scores were 0.56, 0.16, 0.40, 0.45, and 0.65 and AUROC scores were 0.94, 0.77, 0.87, 0.91, and 0.96, respectively. Our model was compared to the longest context window state-of-the-art model and showed increases in macro evaluation scores, notably sensitivity (3.7% increase) and multi-class REM (3.39% increase) and wake (0.97% increase) F1 scores.

Conclusions

Utilizing full night, multi-channel PSG data encodings derived from a foundational transformer improve sleep stage classification over existing methods.
The Relationship Between Self-Determination and Burnout: Mental Health Outcomes in Medical Residents
Authors: Mobarak Hassan , Haddad Chadia , Salameh Pascale , Towair Evelyne , El Khoury-Malhame Myriam , Chatila Rajaa
Published: August 2024

Background

Burnout is a pervasively increasing threat to personal and professional wellbeing and performance. It is yet understudied in relation to basic psychological needs (BPN), especially in at-risk population such as medical residents. This study intends to explore the differential relationship between various aspects of burnout including depersonalization (DP), emotional exhaustion (EE) and lack of personal achievement (PA) and subsets of BPN satisfaction or frustration namely autonomy, relatedness, and competence, with the framework of the Self-Determination Theory (SDT) in healthcare.

Materials

A total of 110 medical residents in various Lebanese hospitals were included. Demographics and standardized scales were used to measure basic psychological need satisfaction and frustration (BPNSFS), burnout (MBI), depression and anxiety (PHQ-4). Residents were also asked about subjective evaluation of academic training and level of impact by ongoing crises (COVID-19 pandemic, Beirut port explosion and financial breakdown).

Results

Result point to alarming prevalence of burnout and mental distress in our sample. It also indicates a differential correlation between gender, financial security and various subsets of burnout. It lastly points to association of DP with overall satisfaction scale (Beta=0.342,p=0.001) and PHQ-4 scores (Beta=-0.234,p=0.017), while feeling burdened to attend lectures and having been physically affected by the Beirut blast correlated with a sense of PA (Beta=0.332,p=0.010, Beta=0.187,p=0.041 respectively) and PHQ-4 (Beta=0.341,p=0.000), interacting with COVID-19 patients (Beta=0.168,p=0.020) and feeling protected in the working environment (Beta=-.231,p=0.002) showed a significant association with EE.

Discussion

Within the SDT framework, this study highlights the complex interplay between collective crises, subjective evaluations or work conditions and other demographics with aspects of burnout in medical residents. It mostly points to the need address this at an individual but also an institutional level to buffer distress in future healthcare providers.
Red blood cell-tumour cell interactions promote tumour cell progression
Authors: Pereira-Veiga Thais , Yáñez-Gómez Celso , Pekkarinen Aleksi , Abuín Carmen , Blechner Christine , González-Conde Miriam , Bauer Alexander T. , Vidal-y-Sy Sabine , Moustafa Ayham , Siebels Bente , Dávila-Ibáñez Ana B. , Cabezas-Sainz Pablo , Santos Maider , Sánchez Laura , Gorgulho Joao , Götze Julian , Meißner Kira , Cueva Juan , Palacios Patricia , Cortegoso Alexia , Curiel Teresa , Rodríguez Carmela , Carmona Marta , Peine Sven , Schmidt Milena , Heuer-Olewinski Nadine , Reck Martin , Abdo Mustafa , López-López Rafael , Windhorst Sabine , Pantel Klaus , Wikman Harriet , Costa Clotilde
Published: August 2024

One critical step in the metastatic cascade is the survival of circulating tumour cells (CTCs) within the bloodstream. While numerous interactions between CTCs and various hematopoietic cells have been described, the role of red blood cells (RBCs) in this process remains underexplored. This study investigates the interactions between tumour cells and RBCs from breast and lung cancer patients, revealing significant phenotypic and functional changes in the tumour cells, unlike when the contact is with RBCs from healthy donors. In vitroco-culture of cancer cell lines with RBCs from metastatic cancer patients resulted in increased tumour cell attachment accompanied by morphological changes. Additionally, RBCs-primed tumour cells showed increased adhesion and disruption of the endothelial barrierin vitroand increased invasiveness bothin vitroandin vivo. Transcriptomic analysis showed that RBCs from metastatic breast cancer patients induce significant gene expression changes, notably upregulatingPAK4, which enhances migration and epithelial-mesenchymal transition. PAK4 inhibition reduced these effects. Proteomic studies revealed substantial remodelling, including actin-related changes and the accumulation of VASP at cell edges, promoting directional migration. Clinically, higher RBC distribution width (RDW) in metastatic breast cancer patients is associated with increased CTC counts and worse outcome. This study highlights the previously unrecognized role of RBCs in promoting metastatic behaviours in cancer cells and suggests potential therapeutic targets, such as PAK4, to counteract these effects. Further exploration of RBCs-tumour cell interactions could provide new insights into metastatic mechanisms and improve cancer prognosis and treatment strategies.

Key Points

This study reveals the previously unknown role of RBCs in enhancing tumour cell invasiveness and metastatic potential.

Tumour cells undergo significant phenotypic and functional changes after contact with RBCs from cancer patients.
Trajectories of Cognitive Decline Before and After New-onset Hypertension
Authors: Chen Qingmei , Dong Jianye , Chen GC , Li Haibin , Shen Yueping , Hua Jianian
Published: August 2024

Background

Hypertension is a known factor for cognitive impairment, especially in midlife. However, whether the cognitive function declines before and shortly after new-onset hypertension remains largely unknown.

Objectives

We aimed to examine the cognitive trajectories before and after new-onset hypertension among community-dwelling midlife and older participants.

Methods

This study included 2,964 participants from the English Longitudinal Study of Ageing who were free of hypertension at baseline. Participants who had a stroke at baseline or during follow-up were excluded. Global cognition (a summary of semantic fluency, orientation, and memory) was assessed at baseline (wave 2, 2004) and at least once from wave 3 to wave 9 (2018). New-onset hypertension was defined by self-reported doctor diagnosis, use of antihypertensive medications, and blood measurements < 140/90 mmHg.

Results

Over a median follow-up of 13.6 years, 1,121 (37.8%) participants developed hypertension. The cognitive decline rate among those who later developed hypertension during the pre-hypertension period was similar to the rate among those who remained hypertension-free throughout the study. After the onset of hypertension, the rate of cognitive decline accelerated in global cognition (β, −0.015 SD/year; 95% CI, −0.026 to −0.003;p=0.011), semantic fluency (β, −0.015 SD/year; 95% CI, −0.027 to −0.003;p=0.017), and memory (β, −0.022 SD/year; 95% CI, −0.033 to −0.010;p<0.001), but not in orientation ability (β, −0.012 SD/year; 95% CI, −0.028 to 0.005;p=0.157). Participants who developed hypertension in older age did not experience a reduced impact of post-hypertension cognitive decline compared to those who developed hypertension in midlife.

Conclusions

Participants experienced accelerated cognitive decline upon developing new-onset hypertension. Older participants are equally susceptible to cognitive impairment due to hypertension. Early antihypertensive initiation is crucial in both midlife and later life to protect cognitive health.
Comparative Efficacy of Brush Cytology and Forceps Biopsy in the Diagnosis of Malignant Biliary Strictures: A Single-Center Study in Pakistan
Authors: Khalid Abdullah , Qureshi Sara , Syed Imran Ali , Nadeem Hassan , Malik Ahmad Karim , Aujla Usman Iqbal
Published: August 2024

Introduction

The accurate diagnosis of biliary strictures or narrowing of the bile duct is challenging in clinical practice. Differentiating malignant from benign strictures is critical, because these treatments differ considerably. Although noninvasive imaging techniques help identify these strictures, they do not provide definitive tissue diagnosis, making techniques such as brush cytology and forceps biopsy essential. This study aimed to address the dearth of comparative research on the diagnostic efficacy of brush cytology and forceps biopsy in Pakistan.

Methods

This single-center observational study was conducted at the Pakistan Kidney and Liver Institute & Research Center (PKLI&RC), Lahore, from March 2019 to January 2023. Patients with clinically and radiologically suspected biliary strictures were included in the study. Both brush cytology and forceps biopsy samples were subjected to cytopathological analysis by blinded pathologists. Sensitivity, specificity, and predictive values were among the key metrics analyzed.

Results

The study included 54 patients in the biopsy group and 89 in the brushing group. In terms of diagnostic metrics, the biopsy technique displayed a sensitivity of 65.8%, specificity of 92.3%, positive predictive value (PPV) of 96.4%, and accuracy rate of 72.2%. For the brushing technique, the sensitivity, specificity, PPV, and accuracy were 56.7 %, 93.3%, 83.1%, and 62.9%, respectively. Although both methods showed high specificity, the biopsy technique exhibited a slightly better sensitivity and overall accuracy.

Conclusion

Our findings underscore the importance of the biopsy method in the accurate diagnosis of malignant biliary strictures, showing marginally superior sensitivity and overall accuracy compared to brush cytology. This knowledge can guide clinicians in Pakistan and similar settings in making informed diagnostic choices to improve patient outcomes.
Assessing the effect of a massive open online course (MOOC) on school water, sanitation, and hygiene improvements in the Philippines
Authors: Rahaman Kh. Shafiur , Marquez Marvin , Bick Sarah , Galban Dexter , Benzian Habib , Monse Bella , Dreibelbis Robert
Published: August 2024

Improving the water, sanitation, and hygiene (WASH) services in low-resources setting is a challenge. The Department of Education (DepEd) of the Philippines, supported by GIZ and UNICEF, runs the national WASH in schools program which promotes a stepwise approach to reach national WinS Standards and foster the institutionalization of WASH in the education sector. This includes national-level annual monitoring on WASH service levels in schools, information which is used to set target and allocation resources. Since 2019, the programme has also included a Massive Open Online Course (MOOC) for school staff. This platform provides uniform implementation guidance of WinS in the schools across the country. In this analysis, we use annual WASH monitoring data from the 2017/2018 (baseline) and 2021/2022 (endline) and compare this against school-level information on MOOC enrolment and completion. For each school in our analysis, we calculated baseline and endline overall and domain specific star ranking, a standardized 3-point composite measure of school WASH services adopted by DepEd. Linear regression models assessed the relationship between school staff participation in the MOOC and average change in star ranking between baseline and endline and logistic regression models were used to calculate the odds of improvement in star ranking between baseline and endline. Baseline and endline data were available for 28,779 schools. Of those, 5,980 schools had at least 1 teacher enrolled in the MOOC. Overall, MOOC participation was associated with improvements in both overall and domain specific star ranking, with larger improvements seen for hygiene services. The MOOC is a promising key component of the national WASH stategy complementing the annual monitoring process and warrants further investigation in the school management sector.