bluuebunny/crossref_metadata_2025 huggingface dataset:
Impacts of brood parasitism by shiny cowbird Molothrus bonariensis on the breeding success of a small host, the black-backed water tyrant Fluvicola albiventer
Authors: Vanesa Sovrano Lorena , Jesica León Evelina , Ezequiel Lorenzón Rodrigo , Fernanda Olguín Pamela , Héctor Beltzer Adolfo , Raúl Giraudo Alejandro
Published: July 2023

The shiny cowbird Molothrus bonariensis parasitizes many species with different life-history traits and has a detrimental effect on the survival of the progeny of the hosts. In response, hosts have developed numerous antiparasitic defenses. Here, we examined the effects of brood parasitism by shiny cowbird on the clutch and brood sizes (83 nests) in a small host, the black-backed water tyrant Fluvicola albiventer. We also studied whether the death of parasite nestlings was related to the care of the foster parents and whether the host had any antiparasitic defense against the shiny cowbird. Our results indicate that brood parasitism significantly decreased the host hatching and fledging successes. The majority of nest failures (57%) were caused by brood parasitism. Shiny cowbird parasitism occurred in 52% of nests and the intensity of parasitism was 1.23 ± 0.53 eggs per parasitized nest. Of the total host eggs, 54% were damaged. During the incubation stage, 20 nests (47%) were abandoned because of egg punctures by shiny cowbirds females. Only two parasitic fledglings were recorded, while the remaining nestlings either died from starvation (n = 12) or predation (n = 3). Foster parents abandoned parasitic nestlings between 5 and 10 days old. Our findings demonstrate that the shiny cowbird has very low rates of fledging success when parasitizing black-backed water tyrant. Also, parasitism had a high reproductive cost in the black-backed water tyrant because a very low proportion (7%) of the parasitized nests (n = 43) were successful.
A case report of high-output heart failure due to arteriovenous shunt without bowel: how to address?
Authors: Habibi Zarina , Abma-Kramer Johanna , Brunner-La Rocca Hans-Peter
Published: July 2023

Background

High-output heart failure (HF) is a form of HF where patients present with a high-output state with low systemic vascular resistance. This report presents the case of high-output HF in a patient with an arteriovenous shunt and no options for oral-administered drugs.

Case summary

A 70-year-old male with a terminal jejunostomy fully depending on parenteral feeding through a vena saphena magna shunt presented with symptoms of shortness of breath. Echocardiography revealed eccentric hypertrophy with reduced left ventricular ejection fraction (LVEF) and atrial fibrillation with a heart rate of 70–100 b.p.m. Cardiac magnetic resonance imaging, endomyocardial biopsy, and cardiomyopathy lab revealed no cause of HF. High-output HF based on right heart catheterization due to the arteriovenous shunt or related to irregularity due to atrial fibrillation were potential causes. As a result of his malfunctioning gastrointestinal system, the pharmacological options were limited. He was treated with captopril sublingual, initially 6.25 mg three times daily (TID) and later 12.5 mg TID, which reduced blood pressure. Electrical cardioversion to sinus rhythm was successful but did not improve LVEF. Therefore, the patient was opted for surgically reducing the blood flow through the shunt, resulting in normalization of LVEF.

Discussion

High-output HF is an uncommon form of HF with an uncertain prevalence. The most common aetiologies reported in the literature are obesity, cirrhosis, and arteriovenous shunts. Sublingual administration of captopril can be an effective treatment option for HF patients unable to absorb oral-administered drugs.
Investigating Heterogeneity in the Relationship Between Marital Satisfaction and Cognitive Health by Gender and Across the Cognitive Function Distribution
Authors: Kim Jinho , Kwon Keun Young
Published: July 2023

Background and Objectives

Marital satisfaction has been established as an essential factor for promoting health and well-being in older adults. However, it is unclear whether marital satisfaction is also associated with cognitive health in this population. This study aimed to investigate the longitudinal association between marital satisfaction and cognitive function, while also exploring variations in this relationship by gender and across the cognitive function distribution.

Research Design and Methods

This study used 6 waves of the Korean Longitudinal Study of Ageing (KLoSA) and employed gender-stratified unconditional quantile regression (UQR) models with fixed effects (FE) to estimate the association between marital satisfaction and cognitive function across different quantiles of the cognitive function distribution. FE models controlled for unobserved individual-level confounders such as genetics, cognitive and noncognitive skills, and early childhood social and cultural background.

Results

The results of this study revealed that marital satisfaction was positively associated with cognitive function (b = 0.305), and this association was stronger in older men than in older women (b = 0.392 for older men vs b = 0.181 for older women). The UQR-FE models suggested that stronger association between marital satisfaction and cognitive function was observed among older men with lower cognitive function (b = 0.817 for 10th percentile vs b = 0.118 for 90th percentile). Among older women, no clear patterns of heterogeneity were found across the cognitive function distribution.

Discussion and Implications

The findings of this study highlight a significant degree of heterogeneity in the relationship between marital satisfaction and cognitive function among older men, with stronger associations observed in the lower percentiles of the cognitive function distribution. Interventions aimed at improving marital quality could be an effective strategy for promoting cognitive health in older adults, with an approach tailored to the individual’s characteristics.
Position Statement of the Max Planck Institute for Innovation and Competition of 2 May 2023 on the Implementation of the Digital Markets Act (DMA)
Authors: Drexl Josef , Conde Gallego Beatriz , González Otero Begoña , Herrmann Liza , Hoffmann Jörg , Johannsen Germán Oscar , Kestler Lukas , Matarazzi Giulio
Published: July 2023

The Max Planck Institute for Innovation and Competition is a research institute within the Max Planck Society for the Advancement of Science. The Institute is committed to fundamental legal and economic research on processes of innovation and competition and their regulation. Its research focus is on the incentives, determinants and implications of innovation. The Institute informs and guides legal and economic discourse on an impartial basis. It hereby provides its position on the implementation of Regulation (EU) 2022/1925 of the European Parliament and of the Council of 14 September 2022 on contestable and fair markets in the digital sector and amending Directives (EU) 2019/1937 and (EU) 2020/1828 (Digital Markets Act; DMA).
A novel antisense lncRNA, ARBAG harboring an RNA destabilizing GWAS variant for C-peptide dictates the transcript isoforms of GABRA6 in cerebellum
Authors: Bandesh Khushdeep , Pal Muneesh , Balakrishnan Abitha , Gautam Pradeep , Jha Punam , Tandon Nikhil , Pillai Beena , Bharadwaj Dwaipayan
Published: July 2023

Human disease-associated genetic variations often map to long non-coding RNA (lncRNA) genes; however, elucidation of their functional impact is challenging. We previously identified a new genetic variant rs4454083 (A/G) residing in exon of an uncharacterized lncRNA ARBAG that strongly associates with plasma levels of C-peptide, a hormone that regulates insulin bioavailability. On the opposite strand, rs4454083 also corresponds to an intron of a cerebellum-specific GABA receptor subunit gene GABRA6 that mediates strengthening of inhibitory synapses by insulin. Here, we show that alleles of rs4454083 modulate transcript levels of the antisense gene, ARBAG, which then controls the expression of the sense gene, GABRA6. Predisposing to low C-peptide, GG (a minor allele genotype across ethnicities) stabilizes ARBAG lncRNA causing higher transcript levels in cerebellum. ARBAG lncRNA abundance leads to cleavage of GABRA6 mRNA at the complementary region, resulting in a dysfunctional GABRA6 protein that would not be recruited for synapse strengthening. Together, our findings in human cerebellar cell-line and induced Pluripotent Stem Cells (iPSCs) demonstrate biological role of a novel lncRNA in determining the ratio of mRNA isoforms of a protein-coding gene and the ability of an embedded variant in modulating lncRNA stability leading to inter-individual differences in protein expression.
Detection of Human Papillomavirus DNA, E6/E7 Messenger RNA, and p16INK4a in Lung Cancer: A Systematic Review and Meta-analysis
Authors: Li Xiaoxuan , Ling Yihong , Hu Lina , Zhang Lihong , Lin Suxia , Zhang Xuanye , Zang Shengbing
Published: July 2023

Background

The etiologic link between human papillomavirus (HPV) and lung cancer is still controversial.

Methods

PubMed and Cochrane databases were searched from inception to December 2020 to identify studies on the infection of HPV in lung cancer. We calculated the attributable proportion of HPV in lung cancer by pooling the infection of cases positive for both HPV DNA and biomarkers of carcinogenesis that may be induced by HPV (E6/E7 messenger RNA or p16INK4a).

Results

A total of 117 studies, comprising data of 12 616 lung cancer cases from 22 countries across 5 continents, were included. The overall HPV DNA positivity in primary lung cancer cases worldwide was 16.4% (95% confidence interval, 12.7%–20.5%). HPV DNA positivity of lung cancer varied significantly by pathological type and geographic region. Notably, the expression rate of p16INK4a is significantly higher than the positivity of HPV DNA and of HPV E6/E7 mRNA (P < .05). The estimate of HPV attributable proportion defined by expression of E6/E7 mRNA was 0 and of p16INK4a was 7.3%.

Conclusions

The data in this systematic review is robust enough to contradict the possible participation of HPV in lung cancer carcinogenesis. Prophylactic vaccines targeting HPV cannot have the potential to prevent lung cancer.
Composition of soil bacterial communities associated with urban stormwater detention basins and their predicted functional roles in N cycle
Authors: Moghadam Sina V , Jafarzadeh Arash , Vadde Kiran Kumar , Matta Akanksha , Dessouky Samer , Hutchinson Jeffrey , Kapoor Vikram
Published: July 2023

Aims

Stormwater detention basins serve as vital components in mitigating the adverse effects of urban runoff, and investigating the microbial dynamics within these systems is crucial for enhancing their performance and pollutant removal capabilities. The aim of this study was to examine and compare the soil bacterial communities in two stormwater detention basins located on the Edwards Aquifer in Bexar County, Texas, USA, and evaluate how soil physiochemical properties may affect them.

Methods and Results

Each basin soil was sampled in two different seasons at varying depths and the structure of microbial communities was examined using paired end Illumina sequencing using V3 and V4 region of 16S rRNA gene. PICRUSt2 was used to predict functional genes in the nitrogen cycle. In addition, soil physicochemical properties such as pH, carbon, nitrogen, and phosphorus and particle size were examined. A beta diversity analysis revealed that basins had distinctive microbial communities. Additionally, soil particle size, phosphorus and ammonia significantly correlated with some of the dominant phyla in the basins. Proteobacteria and Acidobacteria showed a positive correlation with the relative abundances of nitrogen-cycling genes, while Actinobacteria showed a negative correlation.

Conclusions

This study evaluated the associations between soil physicochemical properties and microbial community dynamics in stormwater basins. The study also predicts the relative abundance of nitrogen cycling genes, suggesting shared functional traits within microbial communities. The findings have implications for understanding the potential role of microbial communities in nitrogen cycling processes and contribute to developing sustainable stormwater management strategies and protecting water quality in urban areas.
Evolutionary implications from lipids in membrane bilayers and photosynthetic complexes in cyanobacteria and chloroplasts
Authors: Kobayashi Koichi , Yoshihara Akiko , Kubota-Kawai Hisako
Published: July 2023

In biomembranes, lipids form bilayer structures that serve as the fluid matrix for membrane proteins and other hydrophobic compounds. Additionally, lipid molecules associate with membrane proteins and impact their structures and functions. In both cyanobacteria and the chloroplasts of plants and algae, the lipid bilayer of the thylakoid membrane consists of four distinct glycerolipid classes: monogalactosyldiacylglycerol, digalactosyldiacylglycerol, sulfoquinovosyldiacylglycerol, and phosphatidylglycerol. These lipids are also integral components of photosynthetic complexes such as photosystem II and photosystem I. The lipid-binding sites within the photosystems, as well as the lipid composition in the thylakoid membrane, are highly conserved between cyanobacteria and photosynthetic eukaryotes, and each lipid class has specific roles in oxygenic photosynthesis. This review aims to shed light on the potential evolutionary implications of lipid utilization in membrane lipid bilayers and photosynthetic complexes in oxygenic photosynthetic organisms.
Selection of aptamers using β-1,3-glucan recognition protein-tagged proteins and curdlan beads
Authors: Kumagai Kazuyuki , Okubo Hiroki , Amano Ryo , Kozu Tomoko , Ochiai Masanori , Horiuchi Masataka , Sakamoto Taiichi
Published: July 2023

RNA aptamersare nucleic acids that are obtained using the systematic evolution of ligands by exponential enrichment (SELEX) method. When using conventional selection methods to immobilize target proteins on matrix beads using protein tags, sequences are obtained that bind not only to the target proteins but also to the protein tags and matrix beads. In this study, we performed SELEX using β-1,3-glucan recognition protein (GRP)-tags and curdlan beads to immobilize the acute myeloid leukaemia 1 (AML1) Runt domain (RD) and analysed the enrichment of aptamers using high-throughput sequencing. Comparison of aptamer enrichment using the GRP-tag and His-tag suggested that aptamers were enriched using the GRP-tag as well as using the His-tag. Furthermore, surface plasmon resonance analysis revealed that the aptamer did not bind to the GRP-tag and that the conjugation of the GRP-tag to RD weakened the interaction between the aptamer and RD. The GRP-tag could have acted as a competitor to reduce weakly bound RNAs. Therefore, the affinity system of the GRP-tagged proteins and curdlan beads is suitable for obtaining specific aptamers using SELEX.
Increasing age predicts adverse pathology including intraductal carcinoma of the prostate and cribriform patterns in deferred radical prostatectomy after upfront active surveillance for Gleason grade group 1 prostate cancer: analysis of prospective observational study cohort
Authors: Tohi Yoichiro , Ishikawa Ryou , Kato Takuma , Miyakawa Jimpei , Matsumoto Ryuji , Mori Keiichiro , Mitsuzuka Koji , Inokuchi Junichi , Matsumura Masafumi , Shiga Kenichiro , Naito Hirohito , Kohjimoto Yasuo , Kawamura Norihiko , Inoue Masaharu , Akamatsu Shusuke , Terada Naoki , Miyazawa Yoshiyuki , Narita Shintaro , Haba Reiji , Sugimoto Mikio
Published: July 2023

Background

In men undergoing upfront active surveillance, predictors of adverse pathology in radical prostatectomy specimens, including intraductal carcinoma of the prostate and cribriform patterns, remain unknown. Therefore, we aimed to examine whether adverse pathology in radical prostatectomy specimens could be predicted using preoperative patient characteristics.

Methods

We re-reviewed available radical prostatectomy specimens from 1035 men prospectively enrolled in the PRIAS-JAPAN cohort between January 2010 and September 2020. We defined adverse pathology on radical prostatectomy specimens as Gleason grade group ≥3, pT stage ≥3, pN positivity or the presence of intraductal carcinoma of the prostate or cribriform patterns. We also examined the predictive factors associated with adverse pathology.

Results

All men analyzed had Gleason grade group 1 specimens at active surveillance enrolment. The incidence of adverse pathologies was 48.9% (with intraductal carcinoma of the prostate or cribriform patterns, 33.6%; without them, 15.3%). The addition of intraductal carcinoma of the prostate or cribriform patterns to the definition of adverse pathology increased the incidence by 10.9%. Patients showing adverse pathology with intraductal carcinoma of the prostate or cribriform patterns had lower biochemical recurrence-free survival (log-rank P = 0.0166). Increasing age at active surveillance enrolment and before radical prostatectomy was the only predictive factor for adverse pathology (odds ratio: 1.1, 95% confidence interval: 1.02–1.19, P = 0.0178; odds ratio: 1.12, 95% confidence interval: 1.02–1.22, P = 0.0126).

Conclusions

Increasing age could be a predictive factor for adverse pathology. Our findings suggest that older men could potentially derive advantages from adhering to the examination schedule in active surveillance.
Inflammatory macrophages exploited by oral streptococcus increase IL-1B release via NLRP6 inflammasome
Authors: Metcalfe Sarah , Panasiewicz Michelle , Kay Jason G
Published: July 2023

Chronic inflammatory periodontal disease develops in part from the infiltration of a large number of classically activated inflammatory macrophages that release inflammatory cytokines important for disease progression, including inflammasome-dependent interleukin (IL)-1β. Streptococcus gordonii is a normally commensal oral microorganism; while not causative, recent evidence indicates that commensal oral microbes are required for the full development of periodontal disease. We have recently reported that inflammatory macrophages counterintuitively allow for the increased survival of phagocytosed S. gordonii over nonactivated or alternatively activated macrophages. This survival is dependent on increased reactive oxygen species production within the phagosome of the inflammatory macrophages, and resistance by the bacterium and can result in S. gordonii damaging the phagolysosomes. Here, we show that activated macrophages infected with live S. gordonii release more IL-1β than non-activated macrophages infected with either live or dead S. gordonii, and that the survival of oral Streptococci are more dependent on macrophage activation than other Gram positive microbes, both classical pathogens and commensals. We also find that S. gordonii–dependent inflammatory macrophage inflammasome activation requires the cytoplasmic NLRP6. Overall, our results suggest S. gordonii is capable of evading immune destruction, increasing inflammatory mediators, and increasing inflammatory macrophage response, and that this ability is increased under conditions of inflammation. This work reveals additional mechanisms by which normally commensal oral streptococci-macrophage interactions can change, resulting in increased release of mature IL-1β, potentially contributing to an environment that perpetuates inflammation.
The transcription factor SPL13 mediates strigolactone suppression of shoot branching by inhibiting cytokinin synthesis in Solanum lycopersicum
Authors: Chen Shangyu , Song Xuewei , Zheng Qixiang , Liu Yuqi , Yu Jingquan , Zhou Yanhong , Xia Xiaojian
Published: July 2023

Plant architecture imposes a large impact on crop yield. IDEAL PLANT ARCHITECTURE 1 (IPA1), which encodes a SQUAMOSA PROMOTER BINDING PROTEIN-LIKE (SPL) transcription factor, is a target of molecular design for improving grain yield. However, the roles of SPL transcription factors in regulating tomato (Solanum lycopersicum) plant architecture are unclear. Here, we show that the expression of SPL13 is down-regulated in the lateral buds of strigolactone (SL)-deficient ccd mutants and is induced by GR24 (a synthetic analog of SL). Knockout of SPL13 by CRISPR/Cas9 resulted in higher levels of cytokinins (CKs) and transcripts of the CK synthesis gene ISOPENTENYL TRANSFERASES 1 (IPT1) in the stem nodes, and more growth of lateral buds. GR24 suppresses CK synthesis and lateral bud growth in ccd mutants, but is not effective in spl13 mutants. On the other hand, silencing of the IPT1 gene inhibited bud growth of spl13 mutants. Interestingly, SL levels in root extracts and exudates are significantly increased in spl13 mutants. Molecular studies indicated that SPL13 directly represses the transcription of IPT1 and the SL synthesis genes CAROTENOID CLEAVAGE DIOXYGENASE 7 (CCD7) and MORE AXILLARY GROWTH 1 (MAX1). The results demonstrate that SPL13 acts downstream of SL to suppress lateral bud growth by inhibiting CK synthesis in tomato. Tuning the expression of SPL13 is a potential approach for decreasing the number of lateral shoots in tomato.
Imipenem and meropenem influence the Las/Rhl quorum-sensing systems in clinical isolates of Pseudomonas aeruginosa
Authors: Deshamukhya Chandrayee , Das Bhaskar J , Paul Deepjyoti , Dhar (Chanda) Debadatta , Bhattacharjee Amitabha
Published: July 2023

The present study was conducted to study the influence of imipenem and meropenem at subinhibitory concentration on the transcriptional response of Las/Rhl quorum-sensing systems in isolates of Pseudomonas aeruginosa.

In the present study, six representative carbapenem nonsusceptible clinical isolates of P. aeruginosa were obtained. The agar dilution method was used to determine the minimum inhibitory concentration against imipenem and meropenem. The bacterial isolates were then cultured up to the early log phase in fresh Luria Bertani (LB) broths at 37°C with and without 2 µg mL−1 imipenem and meropenem, respectively. mRNA was then isolated from the bacterial isolates and was immediately reverse-transcribed to cDNA. The relative quantity of the expression of the lasI, lasR, rhlI, and rhlR genes was assessed by quantitative real-time Polymerase Chain Reaction (PCR) using the ΔΔCt method. The transcriptional response of the lasI and lasR genes was upregulated at subinhibitory concentration of meropenem. In contrast, the transcriptional response of the lasI, lasR, and rhlR genes was downregulated at subinhibitory concentration of imipenem as compared to the expression in untreated isolates. The data obtained in the current study showcased the ability of imipenem and meropenem to influence the response of the quorum-sensing genes at subinhibitory concentration.
Session 6: Identifying Anxiety, Depression, Trauma; Coping with Cravings
Authors: Epstein Elizabeth E. , McCrady Barbara S.
Published: July 2023

Session 6 provides psychoeducation on mood and anxiety symptoms and teaches skills to improve psychological health as well as to consider seeking additional help when indicated. Cognitive behavioral therapy (CBT) techniques such as cognitive restructuring, keeping a thought log, and identifying and understanding symptoms are taught and practiced in subsequent sessions. The relationship of alcohol and drugs with anxiety, depression, and other co-occurring disorders are discussed. Also, the concepts and underlying neuroscience of cravings for alcohol and drugs are discussed, and strategies for managing cravings are discussed and practiced. As in every session, abstinence plans and status are monitored and adjusted, daily drinking/craving/trigger logs are discussed, other routine interventions are delivered, and the skills learned in previous sessions are reinforced.
Session 9: Assertiveness Training and Drink/Drug refusal
Authors: Epstein Elizabeth E. , McCrady Barbara S.
Published: July 2023

In Session 9, , clients learn the difference between passive, passive-aggressive, aggressive, and assertive behaviors. The notion that assertive behavior promotes autonomy and well-being of women is discussed. Skills to practice assertive communication and communication in general are covered. Drink refusal as a special case of assertiveness training is also taught, with specific instructions for how and why to say “no.” These skills are practiced in session via role-play. As in every session, prior skills are carried forward, each client’s abstinence plan is monitored, routine interventions are delivered, and group support is encouraged.
Session 10: Anger Management; Relapse Prevention I: Seemingly Irrelevant Decisions
Authors: Epstein Elizabeth E. , McCrady Barbara S.
Published: July 2023

Session 10 teaches women anger management skills using a behavior chain to identify anger triggers, thoughts and feelings leading to aggressive behavior, and consequences.. The session also introduces a relapse prevention concept, “seemingly irrelevant decisions,” to help women identify and manage risky decisions that may seem unrelated to drinking or drug use, but that actually increase chances of using alcohol or drugs. As in every session, women-relevant vignettes and sample worksheets are provided. As in every session, prior skills are carried forward, each client’s abstinence plan is monitored, routine interventions are delivered, and group support is encouraged.
Session 2: Triggers and Behavior Chains
Authors: Epstein Elizabeth E. , McCrady Barbara S.
Published: July 2023

This session will help clients understand the factors supporting their drinking or drug use. They will learn about triggers, thoughts and feelings, behaviors (drinking or drug use), and consequences of use. Examples are provided and the skill is practiced during session, first by using a worksheet to list their own triggers for drinking/drug use and then by completing some behavior chains for particular triggers. Behavior chains set the stage for skills to “break the chain” and are a basic cognitive behavioral technique for behavior change. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs. The therapist also will review homework for the upcoming week.
Session 4: Enhancing Motivation to Change and Increasing Positive Consequences of Abstinence
Authors: Epstein Elizabeth E. , McCrady Barbara S.
Published: July 2023

The chapter introduces the decisional matrix to help clients evaluate the pros and cons of stopping or continuing drinking or drug use and to understand the natural ambivalence people have about stopping. Clients will learn how to pay attention to the positive consequences of abstinence and keep in mind the negative consequences of use. They also will identify and plan into their weekly schedule pleasant activities to take the place of the time they used to spend using alcohol or drugs in order to make abstinence more pleasant and rewarding. Clients also will identify the functions that alcohol or drugs may have served so they will be able to replace those with healthier ways to achieve similar results. At the end of the session clients will identify upcoming high-risk situations and develop plans to cope without using alcohol or drugs. The therapist also will review homework for the upcoming week.
The SimCard Trial
Authors: Bazua Lobato Rodrigo
Published: July 2023

In many rural areas and low- and middle-income countries (LMICs), the noncommunicable disease (NCD) burden, such as cardiovascular disease, is increasing but primary-care infrastructure and health services are limited. This study aimed to develop and evaluate a simplified cardiovascular management program (SimCard) delivered by community health workers (CHWs) with the aid of a smartphone-based decision support system. Compared with the control group, the intervention group had a 25.5% (p <0.001) higher net increase in the proportion of patient-reported antihypertensive medication use pre- and post-intervention. This study shows that properly trained CHWs can provide basic treatment at the doorstep of patients when supported by protocols to aid in the decision-making process.
Early Life Deprivation and Developmental Origins of Adult Metabolic Disease
Authors: Ghali Bassem
Published: July 2023

This study traces the social class and cause of death of a cohort of men born in the early 20th century in the United Kingdom over several decades to evaluate the effect of social determinants of health. The investigators traced a cohort of men who survived early childhood to ascertain cause of death. They looked at their birth weight, weight at 1 year, and feeding method and demonstrated that low birthweight and low weight at 1 year of age pose a 3-fold increased risk of death from ischemic heart disease later in life. This suggests that processes intrinsic to early growth and development impact future development of ischemic heart disease. It is possible that targeted social programs that alleviate poverty and food scarcity to address these social determinants of health of women and their infants will reduce deaths from ischemic heart disease in the future.
Can Household Contact Investigation Reduce Tuberculosis?
Authors: Seth Bhavna
Published: July 2023

There is a large burden of tuberculosis (TB) globally, and infection often spreads among household contacts of patients with TB. This large, cluster-randomized trial was the first to robustly demonstrate the benefits of active case finding in TB transmission. Districts in Vietnam were randomized into intervention and control arms. In the intervention districts, contacts of TB patients were actively screened for TB. The contacts of patients in the control districts were not screened, but were given educational materials. The authors found that the relative risk of screening positive for TB was 2.6 (95% CI 2.0 to 3.3) in intervention districts. The number of persons who would need to be screened to gain one additional registered case of TB was 74.6 (95% CI 64.2 to 89.2). This study demonstrates the effectiveness of active case finding for TB in high-burden countries.
Fluids in Pediatric Sepsis
Authors: Top Jessica
Published: July 2023

The current standard of care for treating hypovolemic shock and impaired circulation are fluid boluses. The Fluid Expansion as Supportive Therapy (FEAST) trial investigates the practice of early resuscitation with a saline bolus as compared with no bolus (control) and with an albumin bolus as compared with a saline bolus. They found that in children with febrile illness without severe hypotension, bolus resuscitation increased absolute risk of death at 48 hours by 3.3%. The results of the FEAST trial would seem to suggest that fluids should be given cautiously in children with early signs of sepsis, but should be interpreted with caution due to the limitations of the study. As a result of the FEAST trial, the WHO suggests cautious fluid administration in children with malnourishment, anemia, or malaria, and the 2012 Surviving Sepsis campaign restricts fluid resuscitation in pediatric patients to industrialized nations. Additionally, the FEAST trial is prompting investigation into how fluids are given to children in higher-resourced settings.
Does Prenatal Aspirin Prevent Preterm Preeclampsia?
Authors: Openshaw Maria
Published: July 2023

Hypertensive disorders of pregnancy contribute significantly to global maternal and neonatal morbidity and mortality, and an effective primary prevention strategy could save countless lives. Administration of low-dose aspirin starting in the late first trimester has shown promise in reducing the risk of preterm preeclampsia in high-risk clients. By using a combination of historical, demographic, and biometric screening factors, and randomizing high-risk women to receive low-dose aspirin or placebo, this study achieved a 62% reduction in preterm preeclampsia in high-risk women. However, the ultrasound and laboratory resources required by the screening algorithm make this approach most suitable for high-resource settings.
SPRINT Trial
Authors: Laux Timothy S.
Published: July 2023

Hypertension affects more than one billion worldwide. It is one of the leading risk factors for death and disability. The Systolic Blood Pressure Intervention Trial (SPRINT Trial) was done in the United States to assess the difference in cardiovascular outcomes between intensive blood pressure control (SBP <120) or a more lenient goal (SBP <140 mmHg) in patients with hypertension without diabetes. The trial was terminated early due to significantly lower rate of primary composite outcome in the intensive treatment group compared to the standard treatment group. The SPRINT Trial has been included in this anthology, to discuss how evidence generated in the Global North may not be translatable in resource-limited settings due to challenges at patient, clinician, and health system levels alike.
Task-Shifting for Caesarean Section
Authors: Kapira Sitalire , Openshaw Maria
Published: July 2023

In areas with physician shortages, nonphysician clinicians are often trained and employed to help cover this gap. Training nonphysician clinicians to perform tasks traditionally undertaken by physicians is termed “task-shifting.” This study evaluates health outcomes of patients who underwent cesarean sections by clinical officers compared with physicians and finds no increase in maternal or perinatal mortality by surgeon-type. However, clinical officers were found to have a significantly higher rate of wound infection and wound dehiscence when compared with physicians. As task-shifting is increasingly looked at as a way to help increase access to vital services, it is important not only to evaluate the health outcomes, but also to remember that task-shifting does not always occur in areas where a choice exists between nonphysician clinicians and physicians. Instead, it often occurs in areas where choices exist between nonphysician clinicians and no care at all. Importantly, this study does not evaluate the outcomes between no care, nonphysician clinicians, and physicians.
Observing the Problem
Authors: Weiner Saul J. , Schwartz Alan
Published: July 2023

Chapter 1, “Observing the Problem,” illustrates, through a series of case examples, what happens when clinicians overlook patient context and how care planning changes when they finally take it into account. The chapter also proposes hypotheses about why contextual errors in care planning occur—because of a tendency either to make unsupported assumptions about patients’ life circumstances and state of mind or not to consider them at all. Finally, the chapter considers how contextualizing care entails knowing what questions to ask patients and how to ask them. The authors describe how a contextualized care plan emerges out of an engaged interaction between two individuals working together to solve problems, one in the healing role and the other seeking health through health care. Interpersonal “engagement” is characterized as a particular kind of interaction between individuals, essential to contextualizing care in the clinical setting.
Better Teaching, Better Doctors
Authors: Weiner Saul J. , Schwartz Alan
Published: July 2023

Chapter 6, “Better Teaching, Better Doctors,” describes the development and testing of a curriculum to improve physician performance at contextualizing care. The chapter begins with an overview of American medical training, illustrating how it fosters an “efficient task completer” mindset, with a narrow biomedical focus that is often inattentive to contextual factors in patients’ lives that are essential to planning their care. A brief intensive curriculum designed to build skills at addressing contextual factors in care planning is then described. The last section provides an overview of two randomized trials of the curriculum, one comparing the performance of fourth-year medical students and another of residents to their respective control group. In the latter, subjects are also assessed in a “real-world” setting utilizing audio recordings of their clinical encounters. The findings illustrate how such a curriculum can improve skills but is not sufficient to change actual performance in practice.
A stacking survey of gamma-ray pulsars
Authors: Song Yuzhe , Paglione Timothy A D , Tan Joshua , Lee-Georgescu Charles , Herrera Danisbel
Published: July 2023

We report on a likelihood-stacking search for γ-ray pulsars at 362 high-latitude locations that coincide with known radio pulsar positions. We observe a stacked signal conservatively 2.5σ over the background. Stacking their likelihood profiles in spectral parameter space implies a pulsar-like spectral index and a characteristic flux a factor of 2 below the Fermi Large Area Telescope point-source sensitivity, assuming isotropic/unbeamed emission from all sample pulsars. The same procedures performed on empty control fields indicate that the pulsars as a population can be distinguished from the background with a Δ(TS) = 28, where TS refers to test statistic, at the peak location (or 4.8σ), and the stacked spectra of the control fields are distinctly softer than those of the pulsars. This study also probes a unique region of parameter space populated by low $\dot{E}$ pulsars, most of which have no γ-ray ephemeris available, and is sensitive to high duty cycles. We also discuss the possible γ-ray emission mechanism from such pulsars.
Exploring the short-term variability of H α and H β emissions in a sample of M dwarfs
Authors: Kumar Vipin , Rajpurohit A S , Srivastava Mudit K , Fernández-Trincado José G , Queiroz A B A
Published: July 2023

The time-scales of variability in active M dwarfs can be related to their various physical parameters. Thus, it is important to understand such variability to decipher the physics of these objects. In this study, we have performed the low resolution (∼5.7 Å) spectroscopic monitoring of 83 M dwarfs (M0–M6.5) to study the variability of H α/H β emissions; over the time-scales from ∼0.7 to 2.3 h with a cadence of ∼3–10 min. Data of a sample of another 43 late-type M dwarfs (M3.5–M8.5) from the literature are also included to explore the entire spectral sequence. 53 of the objects in our sample (∼64 per cent) show statistically significant short-term variability in H α. We show that this variability in 38 of them are most likely to be related to the flaring events. We find that the early M dwarfs are less variable despite showing higher activity strengths (LH α/Lbol and LH β/Lbol), which saturates around ∼10−3.8 for M0–M4 types. Using archival photometric light curves from TESS and Kepler/K2 missions, the derived chromospheric emission (H α and H β emission) variability is then explored for any plausible systematics with respect to their rotation phase. The variability indicators clearly show higher variability in late-type M dwarfs (M5–M8.5) with shorter rotation periods (<2 d). For 44 sources, their age has been estimated using StarHorse project and possible correlations with variability have been explored. The possible causes and implications for these behaviours are discussed.
Anticipating the XRISM search for the decay of resonantly produced sterile neutrino dark matter
Authors: Lovell Mark R
Published: July 2023

The sterile neutrino (N1) features in multiple extensions of the standard model and is a compelling dark matter candidate, especially as the decay of N1 with mass ms = 7.1 keV is a possible source for the unexplained 3.55 keV X-ray line reported in galaxy clusters. This particle will be accessible to the XRISM X-ray mission over the next 12 months. We revisit the physics behind N1 and the uncertainty in its parameters. We compare predictions for the ms = 7.1 keV N1 mixing angle, $\sin ^{2}(2\theta)\,$, and half-mode mass, Mhm, as described in the neutrino minimal standard model (νMSM) extension to existing X-ray observations and structure formation constraints. The strongest available constraints rule out N1 as a dark matter candidate, and a more optimistic reading of the data prefers $\sin ^{2}(2\theta)\,$ = 5 × 10−11 and Mhm = 3.5 × 108  ${\, \rm M_\odot }$. We highlight that the most promising upcoming opportunity for a detection is to find a line of velocity dispersion ∼500 $\, {\rm km}\, {\rm s}^{-1}$ in the Virgo cluster with XRISM, and then draw up a list of future objects of study to determine: (i) whether the line is from dark matter generally, and (ii) if from dark matter, whether that candidate is indeed N1.
CRISPR/Cas9-induced DNA breaks trigger crossover, chromosomal loss, and chromothripsis-like rearrangements
Authors: Samach Aviva , Mafessoni Fabrizio , Gross Or , Melamed-Bessudo Cathy , Filler-Hayut Shdema , Dahan-Meir Tal , Amsellem Ziva , Pawlowski Wojciech P , Levy Avraham A
Published: July 2023

DNA double-stranded breaks (DSBs) generated by the Cas9 nuclease are commonly repaired via nonhomologous end-joining (NHEJ) or homologous recombination (HR). However, little is known about unrepaired DSBs and the type of damage they trigger in plants. We designed an assay that detects loss of heterozygosity (LOH) in somatic cells, enabling the study of a broad range of DSB-induced genomic events. The system relies on a mapped phenotypic marker which produces a light purple color (betalain pigment) in all plant tissues. Plants with sectors lacking the Betalain marker upon DSB induction between the marker and the centromere were tested for LOH events. Using this assay, we detected a tomato (Solanum lycopersicum) flower with a twin yellow and dark purple sector, corresponding to a germinally transmitted somatic crossover event. We also identified instances of small deletions of genomic regions spanning the T-DNA and whole chromosome loss. In addition, we show that major chromosomal rearrangements including loss of large fragments, inversions, and translocations were clearly associated with the CRISPR-induced DSB. Detailed characterization of complex rearrangements by whole-genome sequencing and molecular and cytological analyses supports a model in which a breakage–fusion–bridge cycle followed by chromothripsis-like rearrangements had been induced. Our LOH assay provides a tool for precise breeding via targeted crossover detection. It also uncovers CRISPR-mediated chromothripsis-like events in plants.
Incidence of and risk factors for myelodysplastic syndrome in patients with rheumatologic diseases
Authors: Kim Young-Eun , Ahn Soo Min , Oh Ji Seon , Hong Seokchan , Lee Chang-Keun , Yoo Bin , Kim Yong-Gil
Published: July 2023

Objective

We investigated the incidence of and risk factors for myelodysplastic syndrome (MDS) in patients with rheumatologic disease.

Methods

We conducted a retrospective cohort study of patients who were diagnosed with rheumatologic diseases at a tertiary care hospital between May 2009 and July 2022 and identified the patients who were subsequently diagnosed with MDS. Each patient with MDS was matched with five age- and sex-matched controls chosen from the cohort of patients with each specific rheumatologic disease.

Results

During a total follow-up of 55 841 person-years (PY), MDS occurred in 64 patients, yielding an incidence rate of 1.15/1000 PY {median age 57.0 years [interquartile range (IQR) 41.0–69.0], median duration to MDS diagnosis 6.5 years (IQR 3.0–9.0)]. In an age-matched analysis, SLE was a significant risk factor for MDS [adjusted hazard ratio 2.61 (CI 1.19, 36.06), P = 0.01]. Refractory cytopenia with multilineage dysplasia was the most common phenotype of MDS (35.9%), and more than half of the patients had karyotypes with a favourable prognosis (54.7%). Compared with matched controls, RA, SLE and AS patients with MDS had lower levels of haemoglobin at the time of diagnosis of rheumatologic disease. Furthermore, the MDS patients with SLE and Behçet’s disease had higher levels of glucocorticoid use in terms of frequency of use and mean dose than control patients.

Conclusion

SLE is a significant risk factor for MDS among patients with rheumatologic diseases. A lower haemoglobin level at the time of diagnosis of rheumatologic disease was associated with the future development of MDS.
Periplasmic stress contributes to a trade-off between protein secretion and cell growth in Escherichia coli Nissle 1917
Authors: Emani Sivaram Subaya , Kan Anton , Storms Timothy , Bonanno Shanna , Law Jade , Ray Sanhita , Joshi Neel S
Published: July 2023

Maximizing protein secretion is an important target in the design of engineered living systems. In this paper, we characterize a trade-off between cell growth and per-cell protein secretion in the curli biofilm secretion system of Escherichia coli Nissle 1917. Initial characterization using 24-h continuous growth and protein production monitoring confirms decreased growth rates at high induction, leading to a local maximum in total protein production at intermediate induction. Propidium iodide (PI) staining at the endpoint indicates that cellular death is a dominant cause of growth reduction. Assaying variants with combinatorial constructs of inner and outer membrane secretion tags, we find that diminished growth at high production is specific to secretory variants associated with periplasmic stress mediated by outer membrane secretion and periplasmic accumulation of protein containing the outer membrane transport tag. RNA sequencing experiments indicate upregulation of known periplasmic stress response genes in the highly secreting variant, further implicating periplasmic stress in the growth–secretion trade-off. Overall, these results motivate additional strategies for optimizing total protein production and longevity of secretory engineered living systems

Graphical Abstract
Is Sharing Caring?
Authors: Kirton Carl A.
Published: July 2023

The benefits and consequences of patient access to health records
Fostering Race-Based Conversations in Nursing
Authors: Singh Chandra
Published: July 2023

Strategies for addressing racism and promoting cultural competence
Original Research: Exploring Frontline Nurses' Self-Perceived Levels of QI Engagement and QI Competence
Authors: Tschannen Dana , Alexander Catherine , Bidisha Ghosh , Zellefrow Cindy , Milner Kerry A.
Published: July 2023

Background and purpose:

Nurse engagement in quality improvement (QI) is critical in the delivery of safe high-quality care, yet few studies have evaluated frontline nurses in this area. The purpose of this study was to identify and compare levels of self-reported QI engagement and QI competence among frontline nurses and nurse leaders.

Methods:

This study used a cross-sectional descriptive design. A convenience sample of frontline nurses (bedside RNs and advanced practice nurses) and nurse leaders from acute and ambulatory care sites completed the Nursing Quality Improvement in Practice (NQuIP) tool, which measures engagement and competence (knowledge, skills, and attitudes) in QI.

Results:

Data from 6,351 surveys completed by frontline nurses and nurse leaders representing 66 sites nationwide were analyzed. Only 52.5% of all respondents reported participating in QI. Knowledge scores were relatively high, while skills scores—especially those related to using QI tools—were low. Overall attitudes toward QI were positive. Nurse leaders scored significantly higher in engagement and competence than the frontline nurses they supervise.

Conclusions:

The study findings indicate that nurse engagement in QI is limited. Although nurses' knowledge levels appear to be high, their limited competency in QI-related skills may contribute to low QI engagement. Leaders must make efforts to increase nurse engagement in order to attain high-quality outcomes. Using the NQuIP tool will allow leaders to evaluate nurses' self-perceived QI competence and engagement, which will aid in identifying target areas and developing effective strategies for improvement.