bluuebunny/crossref_metadata_2025 huggingface dataset:
Transitions
Authors: Barton Jill
Published: August 2024

Transitions, in legal writing, seamlessly link facts to precedent, ideas to arguments, and rationales to conclusions. These shifts help show the reader exactly how each statement helps shape our system of laws. All the justices use a variety of transitions to tie together what can amount to dozens of points on a 50-page opinion. The common features: each transition has meaning, orients readers, and impels readers forward. With these connecting words, the justices avoid choppy writing. Many transitions signal that there is an additional point on the same issue. Other purposes for transitions are introducing, comparing, contrasting, preempting, emphasizing, showing time or place, and concluding. The examples in this chapter show how the justices transition between points with these various purposes—with a single word, a phrase, or statement.
Expanding Literary Domains
Authors: Loewy Shacham Ilanit
Published: August 2024

Analyzing the poetics of the Āmuktamālyada through its narrative structure, descriptive sections, and figuration, this chapter questions the classification of the Āmuktamālyada as a court poem that narrates the story of the poet-saint (Āḻvār) Āṇṭāḷ—a classification that ignores more than three-quarters of the text. The chapter demonstrates that the text uses different hagiographies to tell the story of the Śrīvaiṣṇava community, and it is the community that binds the seemingly disjointed parts of text. The chapter argues that the poem ignores the Sanskritic principle of a dominant mood (rasa), clearing the way for an aesthetic experience derived from eclectic mundane and personal experiences. Additionally, while most court poems emphasize the power of ornamented speech as the means to transcend everyday reality, the Āmuktamālyada celebrates a different worldview, in which devoted service to god subordinates everything else, allowing for everyday life to play a greater role in the poetic experience.
Political Parties and Democracy
Authors: Shapira Assaf
Published: August 2024

Israel has a competitive multi-party system that is an expression of not only the proportional electoral system but also the ideological, ethnic, and religious cleavages in Israel’s highly fragmented society. Once described as a ‘parties state’, Israel has experienced a (comparatively) radical decline of political parties in recent decades. In terms of electoral achievements, political participation, public trust, and economic conduct, the parties—especially veteran, large, aggregative, democratic parties such as the right-wing Likud and left-wing Labour—are much weaker today, although Likud is still the most successful party in Israel, and even Labour has managed to survive as a small party. This is part of a universal phenomenon, but it is also affected by specific factors such as demographic changes, extreme political personalization, internal splits within Likud and Labour, and the pathologies of the primaries (which were adopted by these parties in the 1990s). The process of decline has been accompanied by the strengthening of smaller, sectoral parties, as well as the success (albeit often temporary) of new, personal parties such as the centrist Yesh Atid. In addition to offering a general analysis of the state of parties in Israel today and their decline in recent decades, together with a more in-depth review of Likud, Labour, and Yesh Atid, this chapter also suggests that the crisis that the large parties are undergoing might accelerate recent political developments jeopardizing liberal democracy in Israel.
The airway mycobiome and interactions with immunity in health and chronic lung disease
Authors: Katsoulis Orestis , Pitts Oliver R , Singanayagam Aran
Published: August 2024

The existence of commensal fungi that reside within the respiratory tract, termed the airway mycobiome, has only recently been discovered. Studies are beginning to characterize the spectrum of fungi that inhabit the human upper and lower respiratory tract but heterogeneous sampling and analysis techniques have limited the generalizability of findings to date. In this review, we discuss existing studies that have examined the respiratory mycobiota in healthy individuals and in those with inflammatory lung conditions such as asthma, chronic obstructive pulmonary disease and cystic fibrosis. Associations between specific fungi and features of disease pathogenesis are emerging but the precise functional consequences imparted by mycobiota upon the immune system remain poorly understood. It is imperative that further research is conducted in this important area as a more detailed understanding could facilitate the development of novel approaches to manipulating the mycobiome for therapeutic benefit.
Engineering Services
Authors: Castro Rafael , Álvaro-Moya Adoración
Published: August 2024

This chapter explores the evolution and impact of the engineering services industry, shedding light on its often overlooked yet pivotal role in driving industrial and infrastructure development. After summarizing the characteristics of engineering as a profession and of engineering services as an industry, the chapter traces the rise of engineering as a profession in the 19th century and its evolution into a service industry thereafter. It discusses the industry’s role in state and empire building in the 19th and early 20th centuries, and then explores emergence of modern engineering consulting in the post-World War II era within the context of American hegemony, before providing a snapshot of its contemporary landscape, where shifts in global markets for engineering services are linked to geopolitical changes, especially the rise of China—confirming once again the importance of geopolitics in understanding the dynamics of this particular industry.
Free, Prior and Informed Consent and Indigenous Peoples
Authors: Lenzerini Federico
Published: August 2024

Free, prior, and informed consent (FPIC) constitutes an essential prerequisite for guaranteeing effective enjoyment by Indigenous peoples and their members of their internationally recognized human rights. It is a multifaceted, complex, concept that is, simultaneously a procedural condition for the realization of Indigenous peoples’ rights, a legal principle—as it informs the conduct of state authorities vis-à-vis Indigenous peoples—and an autonomous substantive right of collective character. In fact, even though FPIC is embedded in the right to self-determination, and is strictly interconnected with other Indigenous peoples’ rights, its status of ‘right’ is beyond any doubt. While it cannot be held that FPIC entitles Indigenous peoples to exercise a right to veto with respect to every kind of measures or activities potentially affecting their interests, it may be convincingly asserted that such a right to veto actually exists when it comes to activities that are likely to seriously impact their fundamental rights, cultural integrity and/or physical existence.
Raising Temple Family Members
Authors: Starling Jessica
Published: August 2024

All the Buddhist sects in Japan now permit clerical marriage, and the position of resident priest of parish temples is normally passed down from father to son. In one sect, the Jōdo Shinshū, this practice of married clergy and family inheritance has been the norm for centuries. While seminaries and administrative temples offer official training and ordination for priests in preparation for this role, in fact much religious learning also takes place at home, within the temple family. This chapter focuses on the unofficial, affective, and often gendered ways in which various forms of religious expertise are transmitted within Jōdo Shinshū temple families—and between temple families and parishioners—thus ensuring intergenerational continuity of Buddhist practices, institutions, and doctrine in contemporary Japan. The research includes a case study drawn from the author’s interview with a woman cleric in Kanazawa.
Charity in a Working-Class Taiwanese Buddhist Community
Authors: Ritzinger Justin R.
Published: August 2024

The contemporary Taiwanese Buddhist scene is dominated by a handful of large organizations founded on Human Realm Buddhism: Tzu Chi, Foguang shan, and Dharma Drum Mountain. One of their most impressive features is extensive and sophisticated charitable work that has been characterized as “industrialized philanthropy.” While these organizations are undeniably important, Buddhist charity in Taiwan is not limited to their efforts. This chapter considers the opposite end of the spectrum by examining a small working-class group and its grassroots engagement with its immediate community, a poor neighborhood of Taoyuan. At first glance, the Lodge’s signature program, distributing homemade vegetarian snacks to schoolchildren, might appear idiosyncratic or even irrational. However, it is well-adapted to the community’s capacities and opportunities, and it facilitates the formation of connections practical and karmic that allow it to contribute in its small way to the goal of creating a pure land on earth.
Assemblies and Technologies of Surveillance
Authors: Aston Val
Published: August 2024

Surveillance systems designed to monitor public space are frequently used for the monitoring of public assemblies. While the privacy impact of public space surveillance is often dismissed as nothing more than what any individual might expect when they go out in public, a growing body of research suggests that surveillance—including the visible monitoring of the public domain—may result in complex harms not just to individual privacy, but also to the very act of assembly and the process of mobilization. Unfortunately, there has been limited recognition of these harms by courts and other oversight bodies: privacy is conceptualized narrowly in ways that prevent its application to protect collective acts carried out in public spaces, and courts have been slow to accept that surveillance can constitute a constraint on the right of peaceful assembly. As a result, states have enjoyed considerable discretion in their use of (so-called) ‘overt’ surveillance systems. The potential for such discretion to have a ‘chilling effect’ on the exercise of freedom of assembly has been inadequately acknowledged by judges and legislators alike.
Social Cognition of Moral Judgment
Authors: Conway Paul
Published: August 2024

Moral judgment often examines sacrificial dilemmas where causing limited harm will prevent greater harm. Such dilemmas entail a trade-off between moral concerns about avoiding harming others and concerns about maximizing overall well-being. Such dilemmas originated in philosophy, but research examines the psychological mechanisms that drive judgments. Yet, theorists often conflate philosophical theory with dilemma decisions and decisions with underlying mechanisms. This chapter discusses the origins of dilemma research and distinguishes between philosophical, judgment, and process levels of analysis. It considers the original “hard” dual-process model and a “softer” version that better meshes with evidence, as well as single-process models and social perception models. The chapter tours evidence obtained by examining judgments and via the process dissociation and consequences norms inaction modeling approaches. Finally, it considers the dangers of mixing levels of analysis and the utility of clarity for the goals of dilemma research.
Sexuality, gender, and the law
Authors: Holzleithner Elisabeth
Published: August 2024

This chapter explores the complex relation of sexuality, gender, and the law from the perspectives of legal philosophy, legal gender studies, and queer legal theory. Its point of departure is modern law’s promise of equal freedom, which is enshrined in human rights and in the constitutions of liberal democracies. The chapter starts out by introducing two approaches to sexuality, gender, and the law: the paradigm of conventional morality and that of equal freedom (autonomy). Having established autonomy as the central reference point, that principle is illuminated by spelling out the conditions necessary for its realization. Autonomy provides the basis for developing a concept of emancipatory law, including an outline of three paths to achieving it: legislation, popular referenda, and litigation. The chapter continues by delineating the specifics of the LGBTIQ+ equal rights approach, followed by the critiques brought forth in queer legal theory. Both approaches are analysed in terms of their strengths and weaknesses. In concluding the chapter provides suggestions for furthering autonomy in the realm of gender and sexuality as part of an encompassing conception of social justice.
Subnational Authoritarianism in Comparative Politics
Authors: Gibson Edward L.
Published: August 2024

Regime dynamics are multitiered territorial affairs, and our fixations on national politics have until recently blinded us to their territorial complexities. After a national government is democratized, subnational authoritarian or “hybrid” regimes often continue to deny rights guaranteed by national laws and constitutions. In these situations of “regime juxtaposition,” subnational authoritarianism is maintained by cross-tier institutional arrangements and strategic coordination between local autocrats and leaders of national democratic regimes. Subnational democratization struggles are also multilevel affairs, with local oppositions and autocrats employing distinctive local and national strategies to promote or prevent national involvement in the local conflict. These “boundary control” struggles are the basic conflict pattern in situations of subnational authoritarianism in national democratic regimes. New research agendas are advancing our understanding of the causes and consequences of subnational regime variations and on the subnational dimensions of national democratic “backsliding.”
From Mere Life to a Good Life: Shifting Refugee Integration Policy from Outcomes to Capabilities
Authors: Phillimore Jenny
Published: August 2024

Despite extensive criticism, integration policy has seen increasing resonance in many Western countries. Refugees are particularly susceptible to the effects of integration policy as, unlike other migrants, they do not have the option to return. Further, the nature of integration experiences has been shown to impact health and well-being, with positive experiences capable of moderating prior trauma. The primary focus of integration policy has been on self-sufficiency, with little attention paid to the ways in which refugees could be supported to live a good life. This article outlines a new framework, consisting of nine integration capabilities, which expand the focus on integration policy beyond the functional to cover a wide range of factors that enable or prevent refugees from flourishing in refuge. Applying the framework to two vignettes outlining the experiences of refugee survivors of sexual and gender-based violence, this article demonstrates how different forms of policy, both pre- and post-migration, shape individuals’ potential to flourish in refuge. This article ends by arguing that a capabilities approach has the potential to reframe integration policy, as the provision of freedoms and resources to develop capabilities and enable refugees’ functioning to flourish.
Mitigation of supply chain challenges in cell therapy manufacturing: perspectives from the cord blood alliance
Authors: Killela Patrick , Herrity Kieran , Frontier Ludwig , Horton Roger , Kurtzberg Joanne , Van’t Hof Wouter
Published: August 2024

Cellular therapies rely on highly specialized supply chains that often depend on single source providers. Public cord blood banks (CBB) manufacturing the first cell therapy to be highly regulated by the FDA and related international agencies are a prime example of being subject to this phenomenon. In addition to banking unrelated donor cord blood units for transplantation, CBBs also source and characterize starting materials for supply to allogeneic cell therapy developers that often employ customized technologies offered by just a small number of manufacturers. As such, these supply chains are especially sensitive to even minor changes which often result in potential major impacts. Regulations can shape supply chain efficiencies, both directly via the definition of restricted technology and process requirements and indirectly by steering strategic business decisions of critical supply or service providers.

We present 3 current supply chain issues with different root causes that are swaying efficiencies in cord blood banking and beyond. Specifically, the shortage of Hespan, a common supplement used in cord blood processing, the decision by the provider to stop supporting medical device marking of the Sepax system broadly used in cord blood banking, and a new European ruling on phasing out plasticizers that are critical for providing flexibility to cord blood collection bags, are all threatening downstream supply chain issues for the biologics field. We discuss overcoming these hurdles through the prism of unified mitigation strategies, defined, and implemented by multi-factorial teams and stakeholders, to negotiate resolutions with providers and regulators alike.
In vivo optical assessment of cerebral and skeletal muscle microvascular response to phenylephrine
Authors: Mawdsley Laura , Eskandari Rasa , Kamar Farah , Rajaram Ajay , Yip Lawrence C. M. , Abayomi Naomi , Milkovich Stephanie , Carson Jeffrey J. L. , St. Lawrence Keith , Ellis Christopher G. , Diop Mamadou
Published: August 2024

This study aimed to investigate the simultaneous response of the cerebral and skeletal muscle microvasculature to the same phenylephrine (PE) boluses. A hybrid optical system that combines hyperspectral near‐infrared spectroscopy (hs‐NIRS) and diffuse correlation spectroscopy (DCS) was used to monitor changes in tissue oxygenation and perfusion. Data were collected from the head and hind limb of seven male Sprague–Dawley rats while administering intravenous (IV) injections of PE or saline to all animals. The response to saline was used as a control. Skeletal muscle oxygenation decreased significantly after PE injection, while a statistically underpowered decrease in perfusion was observed, followed by an increase beyond baseline. Vascular conductance also decreased in the muscle reflecting the drug's vasoconstrictive effects. Tissue oxygenation and perfusion increased in the brain in response to PE. Initially, there was a sharp increase in cerebral perfusion but no changes in cerebral vascular conductance. Subsequently, cerebral flow and vascular conductance decreased significantly below baseline, likely reflecting autoregulatory mechanisms to manage the excess flow. Further, fitting an exponential function to the secondary decrease in cerebral perfusion and increase in muscular blood flow revealed a quicker kinetic response in the brain to adjust blood flow. In the skeletal muscle, PE caused a transient decrease in blood volume due to vasoconstriction, which resulted in an overall decrease in hemoglobin content and tissue oxygen saturation. Since PE does not directly affect cerebral vessels, this peripheral vasoconstriction shunted blood into the brain, resulting in an initial increase in oxygenated hemoglobin and oxygen saturation.
The role of EUS in the diagnosis of early chronic pancreatitis
Authors: Bai Yaya , Qin Xianzheng , Ao Xiang , Ran Taojing , Zhou Chunhua , Zou Duowu
Published: August 2024

The diagnosis of early chronic pancreatitis (ECP) is challenging due to the lack of standardized diagnostic criteria. EUS has been considered a sensitive diagnostic modality for chronic pancreatitis (CP), with advancements in technique such as EUS-guided fine needle aspiration and biopsy (EUS-FNA/FNB) being developed. However, their role in the diagnosis of ECP remains unelucidated. This review thereby aimed to provide an overview of the clinical landscape of EUS in the field of ECP.
GATA4 downregulation enhances CCL20-mediated immunosuppression in hepatocellular carcinoma
Authors: Nasir N. Jannah M. , Chuah Samuel , Shuen Timothy , Prawira Aldo , Ba Rebecca , Lim Mei Chee , Chua Joelle , Nguyen Phuong H. D. , Lim Chun J. , Wasser Martin , Hazirah Sharifah N. , Lim Tony K. H. , Leow Wei Qiang , Loh Tracy Jiezhen , Wan Wei Keat , Pang Yin Huei , Soon Gwyneth , Cheow Peng Chung , Kam Juinn Huar , Iyer Shridhar , Kow Alfred , Dan Yock Young , Bonney Glenn K. , Chung Alexander , Goh Brian K. P. , Chow Pierce K. H. , Albani Salvatore , Zhai Weiwei , Ouyang John F. , Toh Han Chong , Chew Valerie
Published: August 2024

Background:

Hepatocellular carcinoma (HCC) is a deadly cancer with a high global mortality rate, and the downregulation of GATA binding protein 4 (GATA4) has been implicated in HCC progression. In this study, we investigated the role of GATA4 in shaping the immune landscape of HCC.

Methods:

HCC tumor samples were classified into “low” or “normal/high” based on GATA4 RNA expression relative to adjacent non-tumor liver tissues. The immune landscapes of GATA4-low and GATA4-normal/high tumors were analyzed using cytometry by time-of-flight, bulk/spatial transcriptomic analyses and validated by multiplex immunofluorescence.

Results:

GATA4-low tumors displayed enrichment in exhausted programmed cell death protein 1+ T cells, immunosuppressive regulatory T cells, myeloid-derived suppressor cells, and macrophages, highlighting the impact of GATA4 downregulation on immunosuppression. Spatial and bulk transcriptomic analyses revealed a negative correlation between GATA4 and C-C Motif Chemokine Ligand 20 (CCL20) expression in HCC. Overexpressing GATA4 confirmed CCL20 as a downstream target, contributing to an immunosuppressive tumor microenvironment, as evidenced by increased regulatory T cells and myeloid-derived suppressor cells in CCL20-high tumors. Lastly, the reduced expression of GATA4 and higher expression of CCL20 were associated with poorer overall survival in patients with HCC, implicating their roles in tumor progression.

Conclusions:

Our study reveals that GATA4 downregulation contributes to an immunosuppressive microenvironment, driven by CCL20-mediated enrichment of regulatory T cells and myeloid-derived suppressor cells in HCC. These findings underscore the critical role of GATA4 reduction in promoting immunosuppression and HCC progression.
Evaluation of Retinal Arterial Occlusion and its Visual and Systemic Prognosis after Hyperbaric Oxygen Therapy
Authors: Kalaw Fritz Gerald P. , Chartrand Nicholas , Wedekind Lauren , Chen Jimmy S. , Lin Andrew C. , Koretz Zachary , Meller Leo , Oca Michael , Jagadeesh Vasan , Wilson Katherine , Walker Evan , Freeman William R. , Toomey Christopher B.
Published: August 2024

Purpose:

To evaluate the systemic and ocular outcomes of patients with branch retinal artery occlusion (BRAO) and central retinal artery occlusion (CRAO) after hyperbaric oxygen therapy (HBOT).

Methods:

This is a single-institution study of 75 subjects diagnosed with BRAO (28, 37.3%) and CRAO (47, 62.7%) who visited the emergency department or stroke clinic. Twenty-seven (36%) subjects received HBOT on initial presentation (BRAO–14.3%, CRAO–48.9%). The primary outcome was the best corrective visual acuity (BCVA) change in non-HBOT and HBOT subjects. Secondary outcomes included subsequent development of an acute cerebrovascular accident (CVA)/stroke or neovascular glaucoma (NVG).

Results:

Overall BCVA did not change from the initial presentation to the final timepoint (logMAR 1.5) in either the conservative management or HBOT cohorts for either BRAO subjects (non-HBOT–logMAR 0.4 vs. 0.6, p=0.658; HBOT–logMAR 0.1 vs. 0.4, p=0.207) or CRAO subjects (non-HBOT–logMAR 2.1 vs. 2.2, p=0.755; HBOT–logMAR 2.1 vs. 2.0, p=0.631). Seven (9.3%) subjects developed CVA (BRAO: non-HBOT–4.2% and HBOT–25.0%, p=0.207; CRAO: non-HBOT–16.7% and HBOT–4.3%, p=0.348) and five subjects (6.7%) developed NVG (BRAO: non-HBOT–4.2% and HBOT–0%, p=1.00; CRAO: non-HBOT–16.7% and HBOT–0%, p=0.109).

Conclusions:

Our findings suggest that HBOT does not significantly improve BCVA or mitigate the subsequent development of stroke and NVG in patients with RAOs.
Exploring the diagnostic and prognostic significance of circulating tumor cells in stage II-IV colorectal cancer using a nano-based detection method
Authors: Liu Gang , Zhu Jinfeng , Zhang Pengbo , Zhang Tingting , Cui Zheng , Jiao Fanglei , Le Wenjun , Li Xiaofeng , Chen Bingdi
Published: August 2024

Background:

Colorectal cancer (CRC) is a leading cause of cancer mortality globally, underscoring the urgency for a noninvasive and effective biomarker to enhance patient prognosis. Circulating tumor cells (CTCs), a potential marker for real-time tumor monitoring, are limited in clinical utility due to the low sensitivity of existing detection methods. Previously, we introduced a novel nano-based CTCs detection method that relies on the electrical properties of cell surfaces, thus eliminating the need for specific molecular biomarkers. In this study, we used this technique to evaluate the diagnostic and prognostic value of CTCs in stage II-IV CRC.

Methods:

A total of 194 participants were included, consisting of 136 CRC patients and 58 healthy individuals. The peripheral blood of the participants was collected, and CTC enumeration was performed utilizing the nano-based detection method that we newly developed. The receiver operating characteristic (ROC) curve and multivariate Cox proportional-hazards analysis were used to assess the effectiveness of CTCs for diagnosing CRC and predicting patient prognosis.

Results:

The nano-based method demonstrated an ability to differentiate CRC patients from healthy individuals with a sensitivity of 84.6% and a specificity of 94.8%. Furthermore, baseline CTC levels were predictive of progression-free survival (PFS) in CRC patients, with lower levels associated with longer PFS compared to higher levels (4.5 vs 8.0 months at 15 CTCs/mL, p = 0.016; 4.4 vs 8.0 months at 20 CTCs/mL, p = 0.028). We also explored the dynamic changes in the number of CTCs after 1 to 5 cycles of chemotherapy. Patients with increasing CTC levels typically experienced disease progression (PD), while those with decreasing levels often achieved a partial response (PR) or maintained stable disease (SD). These findings suggest that the dynamic fluctuations in CTC counts are closely tied to the clinical course of the disease.

Conclusion:

Our study indicates the potential of nano-based CTCs detection in diagnosing and predicting outcomes for patients with stage II-IV CRC.
Implications for Socioenvironmental Determinants of Health-Informed Health Worker Wellness Programs
Authors: Kim Linda Y. , Martinez-Hollingsworth Adrienne , Coleman Bernice , Aronow Harriet U.
Published: August 2024

Purpose

The aim of the study is to explore how socioenvironmental factors may potentially impact health outcomes across different groups of health workers (HWs).

Method

Data from the California Healthy Places Index (HPI) and administrative dataset including 12,715 HWs were analyzed using analysis of variance and two-step cluster analysis to evaluate variations in socioenvironmental factors across 11 HW job categories.

Results

While physicians had the highest average HPI percentiles (69th percentile) across almost all HPI components, the lower-wage HWs consistently ranked below the state average (50th percentile). Overall, the HPI percentile was lowest for environmental living conditions and pollution for all HCWs (30th percentile). The education (52nd percentile) and economic components (59th percentile) were higher than the state average.

Conclusions

The findings from this highlight the importance of socioenvironmental determinants of health-informed employee wellness programs and research studies.
Proceedings From a National Summit on Workplace Mental Health and Well-being
Authors: Roemer Enid Chung , Goetzel Ron Z. , Davis Meghan F. , Zhang Ying , Kent Karen B. , Harter Jim , McGee Ebony O. , Troester Joan M. , Hilton Lara , Stratton Kelcey J. , Vietas Jay , MacKenzie Ellen J.
Published: August 2024

Objective

The aim of the study is to spotlight the challenges, gaps, and opportunities to improve workforce mental health and well-being in higher education institutions.

Methods

We convened a full-day summit of subject matter experts from academia, business, government, and practice to share research and best practices on workplace mental health.

Results

Highlights from the summit are presented in this paper covering the importance of leadership and culture; the mental health costs associated with being a Black STEM scholar; the role of the environment; case studies of three university mental health and well-being programs; and the future of work.

Conclusions

Establishing a culture of caring requires leadership commitment, strategic planning, accountability and shared responsibility, and measurement and evaluation. Higher education institution leaders are called to lead by example; foster community partnerships; adopt a Total Worker Health framework; and regularly evaluate progress.
The microbiota comparative analysis of the characteristics between colorectal adenomatous polyps and normal mucosal intestinal
Authors: Liu Ya , Lin Xiao-xiao , Hu Si-si , Zheng En-dian , Ye Yi , Xu Bei-bei , Wu Le-can
Published: August 2024

Objective

The aim of this study is to systematically examine and compare the characteristics distinguishing colorectal adenomatous polyps from normal mucosal intestinal microbiota.

Methods

A total of 30 specimens were obtained from patients diagnosed with colorectal adenomatous polyps (adenoma group) who underwent endoscopic removal at Wenzhou People’s Hospital between September 2021 and November 2021. Concurrently, 30 normal mucosal specimens were collected from patients without adenomatous polyps (control group). Subsequently, microbiome total DNA extraction was carried out, followed by PCR amplification targeting the V3–V4 region of the 16S rDNA. High-throughput sequencing was conducted using the Illumina MiSeq platform. Subsequent to sequencing, bioinformatics analysis was used to assess the diversity, composition, and functional aspects of the intestinal microbiota in both study groups.

Results

A notable dissimilarity in the microbiota structure was identified, specifically within the transverse colon, between these two groups (P < 0.05). Species composition analysis revealed that Escherichia, Fusobacterium, and Bacteroides were predominant bacteria in both groups, with Escherichia and Enterobacter displaying significant differences at the genera level between the control group and the adenoma group (P < 0.05). Correlation analysis and functional prediction demonstrated substantial disparities in interactions among dominant intestinal microbial genera within patients from both groups. Additionally, it was discovered that the intestinal microbiomes in patients in the adenoma group exhibited a significantly higher pathogenic potential.

Conclusion

Upon conducting a comprehensive analysis, it was discerned that the microbiota present in the transverse colon of the control group exhibited distinctive characteristics that may contribute to the maintenance of intestinal health.
High-flow nasal cannula oxygen therapy versus noninvasive ventilation in acute respiratory failure related to suspected or confirmed acute heart failure: a systematic review with meta-analysis
Authors: Marjanovic Nicolas , Couvreur Raphael , Lamarre Jennifer , Piton Melyne , Guenezan Jérémy , Mimoz Olivier
Published: August 2024

The objective of this review is to compare high-flow nasal cannula (HFNC) oxygen (High flow oxygen) and noninvasive ventilation (NIV) for the management of acute respiratory failure secondary to suspected or confirmed acute heart failure (AHF). A comprehensive and relevant literature search of MEDLINE, Web of Science, and the Cochrane Library was conducted using Medical Subject Heading and Free text terms from January 2010 to March 2024. All randomized clinical trials and observational retrospective and prospective studies reporting adult patients with acute respiratory failure due to suspected or confirmed AHF and comparing HFNC to NIV were included. Primary outcome included treatment failure, as a composite outcome including early termination to the allocated treatment, need for in-hospital intubation or mortality, or the definition used in the study for treatment failure if adequate. Secondary outcomes included change in respiratory rate and dyspnea intensity after treatment initiation, patient comfort, invasive mechanical ventilation requirement, and day-30 mortality. Six of the 802 identified studies were selected for final analysis, including 572 patients (221 assigned to high flow and 351 to NIV). Treatment failure rate was 20% and 13% in the high flow oxygen and NIV groups, respectively [estimated odds ratio (OR): 1.7, 95% confidence interval (95% CI): 0.9–3.1] in randomized studies and 34% and 16% in the high flow oxygen and NIV groups, respectively (OR: 3.1, 95% CI: 0.7–13.5), in observational studies. Tracheal intubation requirement was 7% and 5% of patients in the HFNC and NIV groups, respectively (OR: 1.4, 95% CI: 0.5–3.5) in randomized studies, and 20% and 9% in the high flow oxygen and NIV group, respectively (OR: 2.1, 95% CI: 0.5–9.4) in observational studies. Mortality was 13% and 8% in the high flow oxygen and the NIV groups, respectively (OR: 1.8, 95% CI: 0.8–1.1) in randomized studies and 14% and 9% in the high flow oxygen and the NIV groups, respectively (OR: 1.4, 95% CI: 0.5–3.7) in observational studies. Compared with NIV, high flow oxygen was not associated with a higher risk of treatment failure during initial management of patients with acute respiratory failure related to suspected or confirmed AHF.
Incidence and Risk Factors for Genitourinary Tract Injury Within 1 Year After Surgery for Pelvic Organ Prolapse
Authors: Sheyn David , Gupta Ankita , Boyd Sara , Wu Xian , Shoag Jonathan , Bretschneider C. Emi
Published: August 2024

Importance

The rate of genitourinary tract injury (GUTI) following pelvic organ prolapse (POP) surgery is presently ill-defined and based on relatively small trials with short follow-up time. Given the potential for higher risk of injury with POP, a better understanding of this type of injury is important for patient counseling.

Objectives

The objective of this study was to identify the incidence and risk factors of GUTI related to POP surgery.

Study Design

Women undergoing POP surgery between 2010 and 2019 were identified using Current Procedural Terminology codes in the Premier Healthcare Database. The primary outcome was GUTI, defined as bladder or ureteral injury, and vesicovaginal or ureterovaginal fistula within 1 year of surgery. Genitourinary tract injury was identified using International Classification of Diseases and Current Procedural Terminology codes. Patients were divided into those with and without GUTI. Differences between groups were evaluated using the Student t test, Wilcoxon rank-sum test, and Fisher exact test as appropriate. Multivariable logistic regression was used to evaluate the independent predictors of GUTI.

Results

One hundred thirty-nine thousand one hundred fifty-eight surgical procedures for POP were captured between 2010 and 2019. The rate of GUTI was 1.10%: 0.48% bladder, 0.64% ureteral injuries, and 0.01% fistulas. The most significant variables associated with any GUTI were as follows: adhesiolysis (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.07–6.51), blood transfusion (aOR, 3.67; 95% CI, 1.34–10.04), and low-volume surgeons (<12 cases per year) (aOR, 1.68; 95% CI, 1.60–1.77), nonurologic or gynecologic surgeon specialty (aOR, 1.62; 95% CI, 1.49–2.00), and uterosacral suspension (aOR, 1.30; 95% CI, 1.13–1.49).

Conclusions

The rate of GUTI following POP surgery is lower than has previously been reported. Surgeon experience and specialty and surgical approach may affect GUTI incidence.
AUGS-PERFORM: A New Patient-Reported Outcome Measure to Assess Quality of Prolapse Care
Authors: O’Shea Michele , Boyles Sarah , Bradley Catherine S. , Jacobs Kristin , McFatrich Molly , Sung Vivian , Weinfurt Kevin , Siddiqui Nazema Y.
Published: August 2024

Objective

Patient-reported outcomes (PRO) are important for measuring quality of care, particularly for interventions aimed at improving symptom bother such as procedures for pelvic organ prolapse. We aimed to create a concise yet comprehensive PRO measurement tool to assess pelvic organ prolapse care in high-volume clinical environments.

Methods

The relevant concepts to measure prolapse treatment quality were first established through literature review, qualitative interviews, and a patient and provider-driven consensus-building process. Extant items mapping to these concepts, or domains, were identified from an existing pool of patient-reported symptoms and condition-specific and generic health-related quality of life measures. Item classification was performed to group items assessing similar concepts while eliminating items that were redundant, inconsistent with domains, or overly complex. A consensus meeting was held in March 2020 where patient and provider working groups ranked the remaining candidate items in order of relevance to measure prolapse treatment quality. After subsequent expert review, the revised candidate items underwent cognitive interview testing and were further refined.

Results

Fifteen relevant PRO instruments were initially identified, and 358 items were considered for inclusion. After 2 iterative consensus reviews and 4 rounds of cognitive interviewing with 19 patients, 11 final candidate items were identified. These items map 5 consensus-based domains that include awareness and bother from prolapse, physical function, physical discomfort during sexual activity, pain, and urinary/defecatory symptoms.

Conclusions

We present a concise set of candidate items that were developed using rigorous patient-centered methodology and a national consensus process, including urogynecologic patients and providers.
Impact of obesity on the perinatal vaginal environment and bacterial microbiome: effects on birth outcomes
Authors: Ingram Kelly , Ngalame Eko Embelle , Nunziato Jaclyn , Ahrens Monica , Howell Brittany
Published: August 2024

Introduction.
Lactobacillus species predominate the human vagina and are associated with positive vaginal health, including an acidic pH (<4.5). The prevalence of vaginal Lactobacilli increases with increased oestrogen due to increased glycogen production within the vagina. Lactobacilli produce lactic acid, thereby lowering vaginal pH, preventing growth of other bacteria, and lowering microbial diversity. Lower placental oestrogen levels in obese pregnant women could dampen the mechanism to initiate this process, which may be associated with vaginal dysbiosis and unfavourable pregnancy outcomes.

Hypothesis. We hypothesize that oestrogen and glycogen levels will be lower, vaginal pH will be higher, and vaginal microbiome diversity will be greater during pregnancy in obese and overweight women compared to healthy weight women.

Aim. Pregnancy complications (e.g. preterm birth) are more common in overweight and obese women. If vaginal dysbiosis plays a role, and quantifiable predictors of this increased risk can be determined, these measures could be used to prospectively identify women at risk for pregnancy complications early in pregnancy.

Methodology. Vaginal samples were collected at 10–14, 18–24, 26–30, and 34–37 weeks gestation and at delivery from 67 pregnant participants (23 healthy weight, 22 overweight, 22 obese). A blood sample to quantify serum oestrogen was collected at 10–14 weeks. Vaginal samples were collected to test vaginal pH using pH paper, glycogen abundance using fluorometry, and the vaginal microbiome using 16S rRNA amplicon sequencing.

Results. Vaginal pH was higher in obese participants compared to healthy weight participants (P=<0.001). Vaginal glycogen levels increased over time in obese participants (P=0.033). The vaginal bacterial alpha diversity was higher in obese participants compared to healthy weight participants (P=0.033). The relative abundances of Peptoniphilus and Anaerococcus were increased in overweight and obese participants, as well as in complicated pregnancies, at 10–14 weeks gestation.

Conclusion. The relative abundance of specific vaginal bacteria, like Peptoniphilus and Anaerococcus, in early pregnancy could predict pregnancy outcomes. Our goal is to use the information gathered in this pilot study to further determine the feasibility of assessing the vaginal environment during pregnancy to identify women at risk for negative pregnancy and birth outcomes in the context of a larger study.
MagnoliidsGDB: An integrated functional genomics database for Magnoliids
Authors: Chen Yayu , Yang Zhuang , Chen Jiajie , Li Ping , Zhao Xinglong , Huang Sihui , Li Zhumao , Huang Sishu , Luo Jie , Hu Haiyan , Ding Yuanhao
Published: August 2024

In this study, we present MagnoliidsGDB, an integrated functional genomics database specifically developed for magnoliids, a group of plants known for their unique characteristics and medicinal properties. As of March 2024, MagnoliidsGDB has collected 31 genome sequences from 24 species, 149 resequencing datastes from 4 species, 842 transcriptomic datasets from 20 species, and metabolomic data from 15 species. This comprehensive resource allows researchers to explore the genomic, transcriptomic, and metabolomic variations of magnoliids. The user-friendly search and analysis functionalities of MagnoliidsGDB facilitate the study of genomic variations, gene functions, plant evolution and key metabolites of magnoliids. We hope this database will contribute to the study of magnoliids and increase our understanding of the origin, variation, and molecular basis of the unique biological features of magnoliids.
Effect of a novel food rich in miraculin on the intestinal microbiome of malnourished patients with cancer and dysgeusia
Authors: Plaza-Diaz Julio , Brandimonte-Hernández Marco , López-Plaza Bricia , Ruiz-Ojeda Francisco Javier , Álvarez-Mercado Ana Isabel , Arcos-Castellanos Lucía , Feliú-Batlle Jaime , Hummel Thomas , Palma Milla Samara , Gil Angel
Published: August 2024

Dysgeusia contributes to nutritional derangement and worsens the quality of life of patients with cancer. Despite the different strategies, there is no effective treatment for patients suffering from taste disorders provided by the pharmaceutical industry. We developed a novel strategy for reducing side effects in cancer patients by providing a novel food supplement with the tastemodifying glycoprotein miraculin, which is approved by the European Union, as an adjuvant to medical-nutritional therapy. A pilot randomized, parallel, triple-blind, and placebo-controlled intervention clinical trial was carried out in which 31 malnourished patients with cancer and dysgeusia receiving antineoplastic treatment, and were randomized into three arms: standard dose of DMB (150 mg DMB/tablet), high dose of DMB (300 mg DMB/tablet) or placebo (300 mg freeze-dried strawberry) for three months. Patients consumed a DMB or placebo tablet before each main meal (breakfast, lunch and dinner). Using stool samples from patients with cancer, we analyzed the intestinal microbiome via nanopore methodology. We detected differences in the relative abundances of generaPhocaeicolaandEscherichiadepending on the treatment. Nevertheless, only theSolibaculumgenus was more abundant in the standard-dose DMB group after 3 months. At the species level,Bacteroidessp. PHL 2737 presented a relatively low abundance in both DMB groups, andVescimonas coprocolapresented a relatively high abundance in both treatment groups after 3 months. Furthermore, a standard dose of DMB was positively associated with TNF-α levels andLachnoclostridiumandMediterraneibacterabundances, whereas a high dose of DMB was negatively associated with TNF-α levels and the relative abundance ofPhocaeicola. After a high dose of DMB, erythrocyte polyunsaturated fatty acids were positively correlated withLachnoclostridiumandRoseburia, and there was a positive association betweenPhocaeicolaand the acetic acid concentration of feces. The intake of DMB together with nutritional treatment and individualized dietary advice results in positive changes in the intestinal microbiome of patients with cancer and dysgeusia There was a negative association between the relative abundance ofPhocaeicolaand taste perception in the DMB high dose group. Changes observed in the intestinal microbiota might contribute to maintaining an appropriate immune response of cancer patients. Since the present pilot study involved only a few participants, further research is needed to draw robust conclusions.
Evoked resonant neural activity outperforms spectral markers in decoding sleep from the subthalamic nucleus
Authors: Wiest Christoph , Simpson Thomas G. , Pogosyan Alek , Hasegawa Harutomo , He Shenghong , Plazas Fernando Rodriguez , Wehmeyer Laura , Yassine Sahar , Guo Xuanjun , Shah Rahul , Merla Anca , Perera Andrea , Raslan Ahmed , O’Keeffe Andrew , Hart Michael G. , Morgante Francesca , Pereira Erlick A. , Ashkan Keyoumars , Tan Huiling
Published: August 2024

Background

Deep brain stimulation is a treatment for advanced Parkinson’s disease and currently tuned to target motor symptoms during daytime. Parkinson’s disease is associated with multiple nocturnal symptoms such as akinesia, insomnia and sleep fragmentation which may require adjustments of stimulation during sleep for best treatment outcome.

Objectives

There is a need for a robust biomarker to guide stimulation titration across sleep stages. This study aimed to investigate whether evoked resonant neural activity (ERNA) is modulated during sleep.

Methods

We recorded local field potentials from the subthalamic nucleus of four Parkinson’s patients with externalised electrodes while applying single stimulation pulses to investigate the effect of sleep on ERNA.

Results

We found that ERNA features change with wakefulness and sleep stages, and are correlated with canonical frequency bands and heart rate. We further evaluated the performance of machine learning models in classifying non-REM sleep versus wakefulness and found that ERNA amplitude outperforms all spectral markers.

Conclusions

Given the heterogeneity of spectral features during sleep, their susceptibility to movement artefacts and superior classification accuracy of models using ERNA features, this study paves the way for ERNA as a marker for automatic stimulation titration during sleep and improved patient care.
Unified Mass Imaging Maps the Lipidome of Vertebrate Development
Authors: Schede Halima Hannah , Haj Abdullah Alieh Leila , Rohde Laurel Ann , Herrera Antonio , Schlaeppi Anjalie , Valentin Guillaume , Motlagh Alireza Gargoori , Dominguez Mantes Albert , Jollivet Chloe , Paz-Montoya Jonathan , Capolupo Laura , Khven Irina , Oates Andrew C. , D’Angelo Giovanni , La Manno Gioele
Published: August 2024

Embryo development entails the formation of anatomical structures with distinct biochemical compositions. Compared with the wealth of knowledge on gene regulation, our understanding of metabolic programs operating during embryogenesis is limited. Mass spectrometry imaging (MSI) has the potential to map the distribution of metabolites across embryo development. Here, we established an analytical framework for the joint analysis of large MSI datasets that allows for the construction of multi-dimensional metabolomic atlases. Employing this framework, we mapped the 4D distribution of over a hundred lipids at quasi-single-cell resolution inDanio rerioembryos. We discovered metabolic trajectories that unfold in concert with morphogenesis and revealed spatially organized biochemical coordination overlooked by bulk measurements. Interestingly, lipid mapping revealed unexpected distributions of sphingolipid and triglyceride species, suggesting their involvement in pattern establishment and organ development. Our approach empowers a new generation of whole-organism metabolomic atlases and enables the discovery of spatially organized metabolic circuits.