bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between carcase traits of Bos taurus genotypes and ultrasound measurements across six stages of growth from weaning through to long-feedlot finishing
Authors: Alvarenga Tharcilla I. R. C. , Almeida Amelia K. , McPhee Malcolm , Siddell Jason P. , Walmsley Brad , Greenwood Paul L. , Wolcott Matt L.
Published: July 2023

Context Identification earlier in life of beef cattle with capacity for increased marbling, improved carcase yield and/or reduced subcutaneous fatness can facilitate more rapid genetic improvement and identification of cattle more appropriate for feedlot or pasture finishing. Earlier in life, ultrasound predictions have potential for significant improvements in compliance with market specifications and overall efficiency of beef production systems. Aims To assess the relationships just prior to slaughter and earlier in life between measurements of intramuscular fat, subcutaneous fat and eye-muscle (Longissimus thoracis et lumborum) cross-sectional area made using ultrasound, and carcase fatness, muscling and yield measurements following slaughter of Bos taurus steers that differed genetically in potential for subcutaneous fatness and marbling. Methods Ultrasound measurements of intramuscular fat (IMF), rib fat (RFT), P8 rump fat (P8FAT), eye-muscle area (EMA) and retail beef yield (RBY) of cattle heterogeneous for marbling and fat distribution were made at six stages of growth from weaning to long-feedlotting. Carcase measurements of the same traits were made at five stages of growth from weaning through to long-feedlotting. Key results IMF ultrasound scans 168 days post-weaning were more strongly correlated (r ≤ 0.79) with marbling in the carcase following long-feedlotting than were IMF ultrasound scans at the end of backgrounding (r ≤ 0.71, 326 days post-weaning), short-feedlotting (r ≤ 0.69, 431 days) and during (r ≤ 0.59, 521 days) and at the end of long-feedlotting (r ≤ 0.53, 585 days). P8FAT was the trait with the highest and most consistent accuracy across all stages of life (r = 0.80) between ultrasound and carcase measurements of P8FAT. Conclusions The results of the present study showed that ultrasound-scanned measures of carcase IMF, subcutaneous fat and EMA can be used to predict carcase characteristics with good accuracy earlier in life. Implications The finding that prediction of marbling in the carcase of long-feedlot-fed cattle was stronger by using ultrasound measurement of IMF in younger post-weaned cattle than in older post-weaned cattle warrants further investigation for genetic improvement and management applications, including using newer scanning technologies.
HSV-1 exploits host heterochromatin for nuclear egress
Authors: Lewis Hannah C. , Kelnhofer-Millevolte Laurel E. , Brinkley Mia R. , Arbach Hannah E. , Arnold Edward A. , Sanders Saskia , Bosse Jens B. , Ramachandran Srinivas , Avgousti Daphne C.
Published: July 2023

Herpes simplex virus (HSV-1) progeny form in the nucleus and exit to successfully infect other cells. Newly formed capsids navigate complex chromatin architecture to reach the inner nuclear membrane (INM) and egress. Here, we demonstrate by transmission electron microscopy (TEM) that HSV-1 capsids traverse heterochromatin associated with trimethylation on histone H3 lysine 27 (H3K27me3) and the histone variant macroH2A1. Through chromatin profiling during infection, we revealed global redistribution of these marks whereby massive host genomic regions bound by macroH2A1 and H3K27me3 correlate with decreased host transcription in active compartments. We found that the loss of these markers resulted in significantly lower viral titers but did not impact viral genome or protein accumulation. Strikingly, we discovered that loss of macroH2A1 or H3K27me3 resulted in nuclear trapping of capsids. Finally, by live-capsid tracking, we quantified this decreased capsid movement. Thus, our work demonstrates that HSV-1 takes advantage of the dynamic nature of host heterochromatin formation during infection for efficient nuclear egress.
Skin mesenchymal niches maintain and protect AML-initiating stem cells
Authors: Sandhow Lakshmi , Cai Huan , Leonard Elory , Xiao Pingnan , Tomaipitinca Luana , Månsson Alma , Kondo Makoto , Sun Xiaoyan , Johansson Anne-Sofie , Tryggvason Karl , Kasper Maria , Järås Marcus , Qian Hong
Published: July 2023

Leukemia cutis or leukemic cell infiltration in skin is one of the common extramedullary manifestations of acute myeloid leukemia (AML) and signifies a poorer prognosis. However, its pathogenesis and maintenance remain understudied. Here, we report massive AML cell infiltration in the skin in a transplantation-induced MLL-AF9 AML mouse model. These AML cells could regenerate AML after transplantation. Prospective niche characterization revealed that skin harbored mesenchymal progenitor cells (MPCs) with a similar phenotype as BM mesenchymal stem cells. These skin MPCs protected AML-initiating stem cells (LSCs) from chemotherapy in vitro partially via mitochondrial transfer. Furthermore, Lama4 deletion in skin MPCs promoted AML LSC proliferation and chemoresistance. Importantly, more chemoresistant AML LSCs appeared to be retained in Lama4−/− mouse skin after cytarabine treatment. Our study reveals the characteristics and previously unrecognized roles of skin mesenchymal niches in maintaining and protecting AML LSCs during chemotherapy, meriting future exploration of their impact on AML relapse.
Kv12-encoded K+ channels drive the day–night switch in the repetitive firing rates of SCN neurons
Authors: Hermanstyne Tracey O. , Yang Nien-Du , Granados-Fuentes Daniel , Li Xiaofan , Mellor Rebecca L. , Jegla Timothy , Herzog Erik D. , Nerbonne Jeanne M.
Published: July 2023

Considerable evidence suggests that day–night rhythms in the functional expression of subthreshold potassium (K+) channels regulate daily oscillations in the spontaneous firing rates of neurons in the suprachiasmatic nucleus (SCN), the master circadian pacemaker in mammals. The K+ conductance(s) driving these daily rhythms in the repetitive firing rates of SCN neurons, however, have not been identified. To test the hypothesis that subthreshold Kv12.1/Kv12.2-encoded K+ channels play a role, we obtained current-clamp recordings from SCN neurons in slices prepared from adult mice harboring targeted disruptions in the Kcnh8 (Kv12.1−/−) or Kcnh3 (Kv12.2−/−) locus. We found that mean nighttime repetitive firing rates were higher in Kv12.1−/− and Kv12.2−/− than in wild type (WT), SCN neurons. In marked contrast, mean daytime repetitive firing rates were similar in Kv12.1−/−, Kv12.2−/−, and WT SCN neurons, and the day–night difference in mean repetitive firing rates, a hallmark feature of WT SCN neurons, was eliminated in Kv12.1−/− and Kv12.2−/− SCN neurons. Similar results were obtained with in vivo shRNA-mediated acute knockdown of Kv12.1 or Kv12.2 in adult SCN neurons. Voltage-clamp experiments revealed that Kv12-encoded current densities in WT SCN neurons are higher at night than during the day. In addition, the pharmacological block of Kv12-encoded currents increased the mean repetitive firing rate of nighttime, but not daytime, in WT SCN neurons. Dynamic clamp-mediated subtraction of modeled Kv12-encoded currents also selectively increased the mean repetitive firing rates of nighttime WT SCN neurons. Despite the elimination of the nighttime decrease in the mean repetitive firing rates of SCN neurons, however, locomotor (wheel-running) activity remained rhythmic in Kv12.1−/−, Kv12.2−/−, and Kv12.1-targeted shRNA-expressing, and Kv12.2-targeted shRNA-expressing animals.
A framework based on the information domain to measure coupling changes in electrophysiological signals
Authors: Singh Kirti , Saini Indu , Sood Neetu
Published: August 2023

Objectives. In this paper, the features of physiological signals of healthy dataset are extracted using the linear and non-linear techniques, and a comparison has been made on healthy young and old subjects to study the aging and gender-related changes in the contribution of Heart Rate (HR), Blood Pressure (BP), and Respiration (RESP). Methods. To quantify the coupling changes in cardiovascular, cardiorespiratory, and vasculorespiratory complexity, an information domain approach based on compensated transfer entropy (cTE) is proposed. Result. The results show that there is a substantial decrease in the flow of information from BP tro the time interval between successive R-peaks (RR) and from RR to BP. There is also a significant decrease in the flow of information from RESP to BP and RESP to RR but there is no significant change in the information flow from BP to RESP and RR to RESP. Conclusion. We have done linear and non-linear analysis on the healthy datasets of young and old subjects. As already existed techniques lacks in studying complex behaviours of electrophysiological signals so to overcome these limitations, we have proposed compensated transfer entropy (cTE). We conducted an investigation to determine the degree to which recordings of RESP, BP, and HR can be utilized to predict changes in the other parameters. Specifically, the proposed analysis examined the relationship between these variables and assessed their consistency across different age groups and genders. By analyzing the data, we aimed to gain insights into the interdependencies and predictive potential of these physiological measures in relation to each other.
Investigating the human and nonobese diabetic mouse MHC class II immunopeptidome using protein language modeling
Authors: Hartout Philip , Počuča Bojana , Méndez-García Celia , Schleberger Christian
Published: August 2023

Motivation

Identifying peptides associated with the major histocompability complex class II (MHCII) is a central task in the evaluation of the immunoregulatory function of therapeutics and drug prototypes. MHCII-peptide presentation prediction has multiple biopharmaceutical applications, including the safety assessment of biologics and engineered derivatives in silico, or the fast progression of antigen-specific immunomodulatory drug discovery programs in immune disease and cancer. This has resulted in the collection of large-scale datasets on adaptive immune receptor antigenic responses and MHC-associated peptide proteomics. In parallel, recent deep learning algorithmic advances in protein language modeling have shown potential in leveraging large collections of sequence data and improve MHC presentation prediction.

Results

Here, we train a compact transformer model (AEGIS) on human and mouse MHCII immunopeptidome data, including a preclinical murine model, and evaluate its performance on the peptide presentation prediction task. We show that the transformer performs on par with existing deep learning algorithms and that combining datasets from multiple organisms increases model performance. We trained variants of the model with and without MHCII information. In both alternatives, the inclusion of peptides presented by the I-Ag7 MHC class II molecule expressed by nonobese diabetic mice enabled for the first time the accurate in silico prediction of presented peptides in a preclinical type 1 diabetes model organism, which has promising therapeutic applications.

Availability and implementation

The source code is available at https://github.com/Novartis/AEGIS.
Normal reference values for mitral annular plane systolic excursion by motion-mode and speckle tracking echocardiography: a prospective, multicentre, population-based study
Authors: Wang Yong-Huai , Sun Lu , Li Shi-Wen , Wang Chun-Feng , Pan Xiao-Fang , Liu Ying , Wu Jun , Guan Xiang-Ping , Zhang Su-Li , Dun Guo-Liang , Liu Yi-Lin , Wang Li-Yan , Cui Lei , Liu Yan , Lai Yu-Qiong , Ding Ming-Yan , Lu Gui-Lin , Tan Jing , Yang Xin-Jian , Li Yi-Hong , Zhang Xin-Tong , Fan Miao , Yu Jia-Hui , Zheng Qiao-Jin , Ma Chun-Yan , Ren Wei-Dong
Published: August 2023

Aims

Mitral annular plane systolic excursion (MAPSE) is a simple and reliable index for evaluating left ventricular (LV) systolic function, particularly in patients with poor image quality; however, the lack of reference values limits its widespread use. This study aimed to establish the normal ranges for MAPSE measured using motion-mode (M-mode) and two-dimensional speckle tracking echocardiography (2D-STE) and to explore its principal determinants.

Methods and results

This multicentre, prospective, cross-sectional study included 1952 healthy participants [840 men (43%); age range, 18–80 years] from 55 centres. MAPSE was measured using M-mode echocardiography and 2D-STE. The results showed that women had a higher MAPSE than men and MAPSE decreased with age. The age- and sex-specific reference values for MAPSE were established for these two methods. Multiple linear regression analyses revealed that MAPSE on M-mode echocardiography correlated with age and MAPSE on 2D-STE with age, blood pressure (BP), heart rate, and LV volume. Moreover, MAPSE measured by 2D-STE correlated more strongly with global longitudinal strain compared with that measured using M-mode echocardiography.

Conclusion

Normal MAPSE reference values were established based on age and sex. BP, heart rate, and LV volume are potential factors that influence MAPSE and should be considered in clinical practice. Normal values are useful for evaluating LV longitudinal systolic function, especially in patients with poor image quality, and may further facilitate the use of MAPSE in routine assessments.
Simultaneous transcatheter dual valve replacement (mitral and tricuspid valves): a case report
Authors: Garg Piyush , Chouhan Nagendra , Wander Gagandeep S , Chandra Praveen , Kashyap Rahul
Published: August 2023

Background

Structural valve dysfunction in bioprosthetic heart valves necessitates redo replacement procedure that are associated with high mortality and morbidity. The transcatheter valve-in-valve (VIV) approach has emerged as a preferred option for patients requiring redo procedures due to structural valve degeneration. We report from India the first case of the simultaneous transcatheter dual VIV implantation (mitral valve and tricuspid valves) in a high-surgical-risk patient.

Case summary

A 57-year-old female was presented with a history of rheumatic heart disease, post-mitral valve as well as tricuspid valve replacement (perimount 33 mm) 11 years back. Bioprosthetic heart valve was chosen probably due to limited life expectancy and compliance issues with monitoring of international normalised ratio (INR). She now presented with progressive dyspnoea, oedema, and palpitations (New York Heart Association Class III) for the last 6 months. The patient was scheduled for transcatheter dual valve replacement simultaneously. The procedure was successful with a favourable outcome, short hospital stays, and early recovery.

Discussion

This is the first case of simultaneous transcatheter dual valve replacement reported from India, which is fluoroscopically guided and supported by TEE. It is a valuable and considerable option for patients with failing bioprosthesis valves who are at increased peri-operative risk.
A case series: patients with complicated popliteal artery entrapment syndrome successfully treated with a hybrid surgical and interventional treatment
Authors: Park Min Jung , Kim Hyeongsoo , Kim Do-Kyun , Jang Ji-Yong
Published: August 2023

Background

Popliteal artery entrapment syndrome (PAES) is an underreported and underdiagnosed condition that affects the lower extremities. Previous case reports mainly presented young and uncomplicated PAES. Here, we report the cases of complicated PAES in middle-aged patients. Furthermore, we discuss the importance of a multidisciplinary team approach from diagnosis to treatment to obtain favourable clinical outcomes against this rare disease.

Case summary

Two middle-aged patients presented with recent claudication and were diagnosed with popliteal artery obstruction due to a complicated PAES. At the multidisciplinary meeting, the decided treatment plan was to prioritize the gastrocnemius tendon accessory transfer and surgical thromboendarterectomy. In case the popliteal artery patency was unsatisfactory, an additional on-site percutaneous intervention was planned. Follow-up lower extremity computed tomographic angiography showed a patent popliteal artery without any claudication in both two cases.

Discussion

Popliteal artery entrapment syndrome is a rare vascular disorder. Clinical suspicion and advanced imaging modalities can lead to an accurate diagnosis. A multidisciplinary team approach helps in obtaining favourable clinical results using minimally invasive hybrid surgical and interventional treatments.
Do Conditional Cash Transfers Improve Economic Outcomes in the Next Generation? Evidence from Mexico
Authors: Parker Susan W , Vogl Tom
Published: August 2023

Conditional cash transfer programmes have spread to over 60 countries in the past two decades, but little is known about their long-term effects. We estimate the lasting impact of childhood exposure to the Mexico’s flagship programme Progresa by leveraging the age structure of benefits and geographic variation in early programme penetration nationwide. Childhood exposure improves women’s outcomes in early adulthood with increases in educational attainment, geographic mobility, labour market performance and household living standards. For men, effects are smaller and more difficult to distinguish from spatial convergence.
Echocardiographic heart ageing patterns predict cardiovascular and non-cardiovascular events and reflect biological age: the SardiNIA study
Authors: Ganau Antonello , Orrù Marco , Floris Matteo , Saba Pier Sergio , Loi Federica , Sanna Giuseppe D , Marongiu Michele , Balaci Lenuta , Curreli Niccolò , Ferreli Liana A P , Loi Francesco , Masala Marco , Parodi Guido , Delitala Alessandro P , Schlessinger David , Lakatta Edward , Fiorillo Edoardo , Cucca Francesco
Published: August 2023

Aims

Age is a crucial risk factor for cardiovascular (CV) and non-CV diseases. As people age at different rates, the concept of biological age has been introduced as a personalized measure of functional deterioration. Associations of age with echocardiographic quantitative traits were analysed to assess different heart ageing rates and their ability to predict outcomes and reflect biological age.

Methods and results

Associations of age with left ventricular mass, geometry, diastolic function, left atrial volume, and aortic root size were measured in 2614 healthy subjects. Based on the 95% two-sided tolerance intervals of each correlation, three discrete ageing trajectories were identified and categorized as ‘slow’, ‘normal’, and ‘accelerated’ heart ageing patterns. The primary endpoint included fatal and non-fatal CV events, and the secondary endpoint was a composite of CV and non-CV events and all-cause death. The phenotypic age of the heart (HeartPhAge) was estimated as a proxy of biological age. The slow ageing pattern was found in 8.7% of healthy participants, the normal pattern in 76.9%, and the accelerated pattern in 14.4%. Kaplan–Meier curves of the heart ageing patterns diverged significantly (P = 0.0001) for both primary and secondary endpoints, with the event rate being lowest in the slow, intermediate in the normal, and highest in the accelerated pattern. In the Cox proportional hazards model, heart ageing patterns predicted both primary (P = 0.01) and secondary (P = 0.03 to <0.0001) endpoints, independent of chronological age and risk factors. Compared with chronological age, HeartPhAge was 9 years younger in slow, 4 years older in accelerated (both P < 0.0001), and overlapping in normal ageing patterns.

Conclusion

Standard Doppler echocardiography detects slow, normal, and accelerated heart ageing patterns. They predict CV and non-CV events, reflect biological age, and provide a new tool to calibrate prevention timing and intensity.
Impact of pregnancy on the natural history of women with hypertrophic cardiomyopathy
Authors: Fumagalli Carlo , Zocchi Chiara , Cappelli Francesco , Celata Anastasia , Tassetti Luigi , Sasso Laura , Zampieri Mattia , Argirò Alessia , Marchi Alberto , Targetti Mattia , Berteotti Martina , Maurizi Niccolò , Mori Fabio , Livi Paola , Baldini Katia , Tomberli Alessia , Girolami Francesca , Favilli Silvia , Mecacci Federico , Olivotto Iacopo
Published: August 2023

Aims

Whether pregnancy is a modifier of the long-term course and outcome of women with hypertrophic cardiomyopathy (HCM) is unknown. We assessed the association of pregnancy with long-term outcomes in HCM women.

Methods and results

Retrospective evaluation of women with HCM from 1970 to 2021. Only women with pregnancy-related information (pregnancy present or absent) and a follow-up period lasting ≥1 year were included. The peri-partum period was defined as −1 to 6 months after delivery. The primary endpoint was a composite for major adverse cardiovascular events [MACE: cardiovascular death, sudden cardiac death, appropriate defibrillator shock and heart failure (HF) progression]. Overall, 379 (58%) women were included. There were 432 pregnancies in 242 (63%) patients. In 29 (7.6%) cases, pregnancies (n = 39) occurred after HCM diagnosis. Among these, three carrying likely pathogenic sarcomeric variants suffered MACEs in the peri-partum period. At 10 ± 9 years of follow-up, age at diagnosis [hazard ratio (HR) 1.034, 95% confidence interval (CI) 1.018–1.050, P < 0.001] and New York Heart Association (NYHA) class (II vs. I: HR 1.944, 95% CI 0.896–4.218; III vs. I: HR 5.291, 95% CI 2.392–11.705, P < 0.001) were associated with MACE. Conversely, pregnancy was associated with reduced risk (HR 0.605; 95% CI 0.380–0.963, P = 0.034). Among women with pregnancy, multiple occurrences did not modify risk.

Conclusions

Pregnancy is not a modifier of long-term outcome in women with HCM and mostly occurs before a cardiac diagnosis. Most patients tolerate pregnancy well and do not show a survival disadvantage compared to women without. Pregnancy should not be discouraged, except in the presence of severe HF symptoms or high-risk features.
Causal Associations Between Lifestyle Habits and Risk of Benign Prostatic Hyperplasia: A Two-Sample Mendelian Randomization Study
Authors: Jia Fan , Wei Zhitao , Kong Xiangrui , Mao Yinhui , Yang Yong
Published: August 2023

Background

Benign prostatic hyperplasia (BPH) most often occurs in older men; previous studies and clinical experience suggest a potential link between lifestyle habits such as sleep habits, sedentary behavior, exercise levels, and BPH, but whether they have a clear causal relationship and the direction of that causality is unclear. We aimed to investigate the causal relationship between lifestyle habits and BPH using 2-sample Mendelian randomization (MR) analysis.

Methods

Instrumental genetic independent variables strongly associated with the selected exposure factors were filtered from published genome-wide association studies (GWAS) consisting primarily of European ancestry samples. GWAS from BPH was analyzed as an MR outcome with the inverse-variance weighted method, maximum likelihood, weighted median method, MR–Egger regression, and several sensitivity analyses, including Cochran’s Q test, intercept of MR–Egger, and MR pleiotropy residual sum and outlier test.

Results

MR analysis showed a significant causal risk relationship between sleep duration and BPH, with an odds ratio of 0.42 (95% confidence interval, 0.25–0.69, p = .001) for BPH when sleep duration was increased by 1 standard deviation, but we did not find a causal relationship between the 2 when we performed a reverse analysis. However, sedentary behavior and different levels of exercise did not significantly affect the risk of BPH.

Conclusions

This study showed a strong causal relationship between sleep levels and BPH, with adequate sleep duration being a protective factor for BPH.
Sequencing of Births by Wantedness: Implications for Changes in Mid-Life Health Among Aging NLSY79 Women
Authors: Thomeer Mieke Beth , Reczek Rin , Ross Clifford , Bijou Christina
Published: August 2023

Objectives

As life course frameworks highlight and gerontological studies confirm, the health implications of early birth timing (e.g., adolescent births) and unplanned births (e.g., unwanted or mistimed births) extend years after those births into mid and later life. Yet past research often overlooks the considerable diversity in sequencing and timing of unplanned births even within the same individual (e.g., having both wanted and unwanted births), which are likely fundamental for women’s long-term health trajectories. We develop a holistic understanding of birth timing and wantedness to provide insight into when and how childbearing histories matter for aging women’s health.

Methods

We use sequence analysis with hierarchical cluster method and estimate regression models using the 1979 National Longitudinal Survey of Youth (N = 3,231) to examine how timing and patterning of births by wantedness are associated with changes in physical and mental health from ages 40 to 50.

Results

We identify 7 clusters of childbearing sequences. Of those 7 clusters, respondents with sequences characterized by wanted births in their 20s and 30s had the smallest declines in health in mid-life, whereas respondents with sequences with mainly unwanted births at any age or with mainly mistimed births beginning in adolescence had the greatest health declines. Adjusting for social and economic variables accounted for some, but not all, health differences across childbearing clusters.

Discussion

This project demonstrates the need for comprehensive life course perspectives on long-term health implications of birth wantedness and timing, recognizing diversity within and between individuals.
Virtual surgery to predict optimized conduit size for adult Fontan patients with 16-mm conduits
Authors: Hut Tjerry , Roest Arno , Gaillard Duco , Hazekamp Mark , van den Boogaard Pieter , Lamb Hildo , Kroft Lucia , Jongbloed Monique , Westenberg Jos , Wentzel Jolanda , Rijnberg Friso , Kenjeres Sasa
Published: July 2023

OBJECTIVES

Recent evidence suggests that conduits implanted in Fontan patients at the age of 2–4 years become undersized for adulthood. The objective of this study is to use computational fluid dynamic models to evaluate the effect of virtual expansion of the Fontan conduit on haemodynamics and energetics of the total cavopulmonary connection (TCPC) under resting conditions and increased flow conditions.

METHODS

Patient-specific, magnetic resonance imaging-based simulation models of the TCPC were performed during resting and increased flow conditions. The original 16-mm conduits were virtually enlarged to 3 new sizes. The proposed conduit sizes were defined based on magnetic resonance imaging-derived conduit flow in each patient. Flow efficiency was evaluated based on power loss, pressure drop and resistance and thrombosis risk was based on flow stagnation volume and relative residence time (RRT).

RESULTS

Models of 5 adult patients with a 16-mm extracardiac Fontan connection were simulated and subsequently virtually expanded to 24–32 mm depending on patient-specific conduit flow. Virtual expansion led to a 40–65% decrease in pressure gradient across the TCPC depending on virtual conduit size. Despite improved energetics of the entire TCPC, the pulmonary arteries remained a significant contributor to energy loss (60–73% of total loss) even after virtual surgery. Flow stagnation volume inside the virtual conduit and surface area in case of elevated RRT (>20/Pa) increased after conduit enlargement but remained negligible (flow stagnation <2% of conduit volume in rest, <0.5% with exercise and elevated RRT <3% in rest, <1% with exercise).

CONCLUSIONS

Virtual expansion of 16-mm conduits to 24–32 mm, depending on patient-specific conduit flow, in Fontan patients significantly improves TCPC efficiency while thrombosis risk presumably remains low.
Fixed versus individualized treatment for five common bacterial infectious syndromes: a survey of the perspectives and practices of clinicians
Authors: Mponponsuo Kwadwo , Pinto Ruxandra , Fowler Robert , Rogers Ben , Daneman Nick
Published: August 2023

Background

Traditionally, bacterial infections have been treated with fixed-duration antibiotic courses; however, some have advocated for individualized durations. It is not known which approach currently predominates.

Methods

We conducted a multinational clinical practice survey asking prescribers their approach to treating skin and soft tissue infection (SSTI), community-acquired pneumonia (CAP), pyelonephritis, cholangitis and bloodstream infection (BSI) of an unknown source. The primary outcome was self-reported treatment approach as being fully fixed duration, fixed minimum, fixed maximum, fixed minimum and maximum, or fully individualized durations. Secondary questions explored factors influencing duration of therapy. Multivariable logistic regression with generalized estimating equations was used to examine predictors of use of fully fixed durations.

Results

Among 221 respondents, 170 (76.9%) completed the full survey; infectious diseases physicians accounted for 60.6%. Use of a fully fixed duration was least common for SSTI (8.5%) and more common for CAP (28.3%), BSI (29.9%), cholangitis (35.7%) and pyelonephritis (36.3%). Fully individualized therapy, with no fixed minimum or maximum, was used by only a minority: CAP (4.9%), pyelonephritis (5.0%), cholangitis (9.9%), BSI (13.6%) and SSTI (19.5%). In multivariable analyses, a fully fixed duration approach was more common among Canadian respondents [adjusted OR (aOR) 1.76 (95% CI 1.12–2.76)] and for CAP (aOR 4.25, 95% CI 2.53–7.13), cholangitis (aOR 6.01, 95% CI 3.49–10.36), pyelonephritis (aOR 6.08, 95% CI 3.56–10.39) and BSI (aOR 4.49, 95% CI 2.50–8.09) compared with SSTI.

Conclusions

There is extensive practice heterogeneity in fixed versus individualized treatment; clinical trials would be helpful to compare these approaches.
‘You Should Vote because I Say So!’ Influence towards Voting within Mozambican Households
Authors: Vaz Ana
Published: July 2023

How are the effects of voter education campaigns transmitted within the household? During the 2009 Mozambican elections, a field experiment implemented three voter education interventions: the distribution of a free newspaper, the creation of an SMS hotline to report electoral problems and a civic education campaign. Based on a relatively small sample of untreated individuals living with experimental subjects, this paper examines the diffusion of the interventions' effects within the household. The study finds evidence of spillover effects on interest in elections and turnout. But it finds no evidence of spillover effects on information about elections, nor evidence of spillover effects triggered by the delivery of the newspaper, the treatment most focused on the dissemination of information. On one hand, these findings show that voter education campaigns reach other individuals beyond the targeted subjects. On the other hand, they suggest that some voter education campaigns might boost turnout by increasing social pressure to vote rather than raising the level of information among voters. This paper highlights the need for additional research to probe unintended side effects of voter education campaigns.
Do pre-burn center management algorithms work? Evaluation of pre-admission diagnosis and treatment adequacy of burn patients referred to a burn center
Authors: Tuncer Huriye Bilge , Akın Merve , Çakırca Müge , Erkılıç Ezgi , Yıldız Hanifi Furkan , Yastı Ahmet Çınar
Published: August 2023

Interventions for burn management until the patient is transferred to a burn center affect mortality and morbidity. Therefore, adherence to the developed algorithms is an important issue. This study aimed to determine deficiencies in different aspects of the implementation of these algorithms during the pre-admission diagnosis and treatment processes of patients referred to our burn center. This study involved a 4-year review of patients referred to our burn center. One hundred and seventy burn cases admitted by referral were enrolled in the study. Adequacy of resuscitation within the first 24 hours, adherence to guidelines, and mortality were investigated. Resuscitation performed within the first 24 hours was found to be inadequate in 88 patients (51.8%). When the burned surface area percentages were evaluated all percentages were calculated higher before arrival. There were 78 major burn cases (45.9%), and the frequency of inhalation burns, intubation requirements and renal failure were more common in this group compared to the minor burn group (P < .001). The frequency of intubation without accurate indications was found to be 70.58%. Inadequate escharotomy was detected at a rate of 52.9%, and inadequate fasciotomy at a rate of 66.6%. The mortality rate was 22.4% among all patients. Interventions undertaken during the period until the patients’ referral to these centers affect mortality and morbidity. In this study, it was found that the pre-hospital applications generated were insufficient, and it was proposed that burn patient care algorithms be developed with in-service training throughout the country.
Giant gastric GIST with fast-growing mass after intra-tumoral bleeding
Authors: Duguma Yeabsera M , Seid Tesfahun A , Shumiye Yonas G , Dinagde Tesfaye A , Kejela Segni
Published: July 2023

Only a few instances of giant gastrointestinal stromal tumors and even fewer cases of such tumors with intra-tumoral bleeding have ever been reported. This report represents a case with both giant size and intra-tumoral spontaneous hemorrhage. Here a 42-year-old male patient presented with abdominal pain and abdominal distention of 5-month duration. The distention had fast growth over 1 month before the hospital presentation. Physical examination showed a conjunctival pallor and an ill-defined abdominal mass. A contrast-enhanced computed tomography (CT) scan showed a huge intra-abdominal mass with variable enhancements. Surgical exploration was done and a huge mass measuring 10.5 kg with dimensions of 32 × 30 × 15 cm was excised en-bloc with distal gastrectomy.
Venous ectasia preceding intra-tumoral hemorrhage in a case of gliosarcoma with transverse sinus involvement
Authors: Lee Chaejin , Kim Mee-Seon , Hwang Jeong-Hyun , Park Seong-Hyun , Park Ki-Su , Yoon Sang-Youl
Published: July 2023

Although intratumoral hemorrhage is common in patients with malignant brain tumors, reports on its clinical course are scarce. This report presents a rare case of a patient with intratumoral hemorrhage with gliosarcoma invading the venus sinus. This invasion and a small draining vein were observed at diagnosis. Magnetic resonance imaging performed 1 week later showed new-onset venous ectasia, which caused intratumoral hemorrhage. This case provides insight into the mechanisms underlying intratumoral hemorrhage and highlights the emergence of new intratumoral vasculature as a potential warning sign for hemorrhage.
A case of skin necrosis following pethidine intravenous injection
Authors: AlQhtani Abdullh
Published: July 2023

Pethidine is an opioid derivative typically used to treat moderate-to-severe pain. It has a good analgesic effect and is considered safe, although with adverse effects such as nausea, depression, vomiting, respiratory depression, and toxicity. We discuss the case of a 43-year-old female patient who received intravenous pethidine and developed skin necrosis in multiple areas of the body as a complication and how it was managed. This is the first report in the literature discussing skin necrosis after intravenous pethidine.
Simultaneous total robotic right hemicolectomy and right partial nephrectomy
Authors: Sanmoto Yohei , Hosoi Takayuki , Kinuta Shunji
Published: July 2023

The incidence of synchronous colorectal and renal cancers is reportedly as low as 0.33%. Simultaneous surgery for multi-organ cancers has been reported to have several advantages if tolerated by the patient. In addition, robotic surgery has gained wide application in various fields, but few reports exist on total robotic surgery involving multiple organ resections. We performed simultaneous total robotic surgery on a patient with combined colorectal and renal cancers. Before surgery, we examined the procedure with the surgical team, shared a portion of the trocar site without impairing the operability of the robotic surgery and performed the surgery safely. Further examinations are required to standardize the procedure for simultaneous robotic surgery for multi-organ cancers.
Physical forces guide curvature sensing and cell migration mode bifurcating
Authors: Feng Luyi , Zhao Tiankai , Xu Hongmei , Shi Xuechen , Li Changhao , Hsia K Jimmy , Zhang Sulin
Published: August 2023

The ability of cells to sense and adapt to curvy topographical features has been implicated in organ morphogenesis, tissue repair, and tumor metastasis. However, how individual cells or multicellular assemblies sense and differentiate curvatures remains elusive. Here, we reveal a curvature sensing mechanism in which surface tension can selectively activate either actin or integrin flows, leading to bifurcating cell migration modes: focal adhesion formation that enables cell crawling at convex front edges and actin cable assembly that pulls cells forward at concave front edges. The molecular flows and curved front morphogenesis are sustained by coordinated cellular tension generation and transmission. We track the molecular flows and mechanical force transduction pathways by a phase-field model, which predicts that multicellular curvature sensing is more efficient than individual cells, suggesting collective intelligence of cells. The unique ability of cells in curvature sensing and migration mode bifurcating may offer insights into emergent collective patterns and functions of living active systems at different length scales.
Single-molecule FRET and molecular diffusion analysis characterize stable oligomers of amyloid-β 42 of extremely low population
Authors: Meng Fanjie , Kim Jae-Yeol , Gopich Irina V , Chung Hoi Sung
Published: August 2023

Soluble oligomers produced during protein aggregation have been thought to be toxic species causing various diseases. Characterization of these oligomers is difficult because oligomers are a heterogeneous mixture, which is not readily separable, and may appear transiently during aggregation. Single-molecule spectroscopy can provide valuable information by detecting individual oligomers, but there have been various problems in determining the size and concentration of oligomers. In this work, we develop and use a method that analyzes single-molecule fluorescence burst data of freely diffusing molecules in solution based on molecular diffusion theory and maximum likelihood method. We demonstrate that the photon count rate, diffusion time, population, and Förster resonance energy transfer (FRET) efficiency can be accurately determined from simulated data and the experimental data of a known oligomerization system, the tetramerization domain of p53. We used this method to characterize the oligomers of the 42-residue amyloid-β (Aβ42) peptide. Combining peptide incubation in a plate reader and single-molecule free-diffusion experiments allows for the detection of stable oligomers appearing at various stages of aggregation. We find that the average size of these oligomers is 70-mer and their overall population is very low, less than 1 nM, in the early and middle stages of aggregation of 1 µM Aβ42 peptide. Based on their average size and long diffusion time, we predict the oligomers have a highly elongated rod-like shape.
Development and validation of a predictive model for pulmonary hemorrhage in computed tomography–guided percutaneous lung biopsy
Authors: Yang Song , Li Jie , Wang Wangjia , Lou Lejing , Jin Xiao , Wang Shijia , Cai Jihao , Cai Chang
Published: July 2023

Purpose

This study aimed to identify risk factors for pulmonary hemorrhage (PH) and higher-grade PH that complicate computed tomography (CT)-guided percutaneous lung biopsy (CT-PNLB) and establish predictive models to quantify the risk.

Methods

A total of 2653 cases of CT-PNLB were enrolled. Multivariate logistic regression was used to identify independent risk factors to develop a nomogram prediction model. The model was assessed using the area under the curve (AUC) of the receiver operator characteristic (ROC) and calibration curves and validated in the validation group.

Results

PH occurred in 23.52% (624/2653) of cases, and higher-grade PH occurred in 7.09% (188/2653) of cases. The parameters of lesion size, puncture depth, and contact to pleura were identified as risk factors of PH and higher-grade PH in the logistic regression model, besides the position as a risk factor for PH. The AUC of the PH prediction model was 0.776 [95% confidence interval (CI): 0.752–0.800], whereas that of the validation group was 0.743 (95% CI: 0.706–0.780). The AUC of the higher-grade PH prediction model was 0.782 (95% CI: 0.742–0.832), whereas that of the validation group was 0.769 (95% CI: 0.716–0.822). The calibration curves of the model showed good agreement between the predicted and actual probability in the development and validation groups.

Conclusion

We identified risk factors associated with PH and higher-grade PH after PNLBs. Furthermore, we developed and validated two risk prediction models for PNLB-related PH and higher-grade PH risk prediction and clinical decision support.

Key messages What is already known on this topic Pulmonary hemorrhage (PH) and other hemorrhagic complications are the most common complication in CT-guided percutaneous lung biopsy (CT-PNLB), except pneumothorax. However, the risk factors associated with PH remain controversial, and research on models of PH and higher-grade PH is also limited. What this study adds The parameters of lesion size, puncture depth, and contact to pleura were identified as risk factors of PH and higher-grade PH in the logistic regression model, besides the position as a risk factor for PH. In addition, we developed and validated two risk prediction models for PNLB-related PH and higher-grade PH risk prediction and clinical decision support. How this study might affect research, practice, or policy Of all the predictors, the position is the key factor to be considered by the operator. Moreover, two risk prediction models show good discrimination and calibration characteristics to identify patients at high risk of hemorrhage and higher-grade PH after PNLB, so these could assist clinicians in avoiding risk factors in advance.
Long-Term Safety of Bone Regeneration Using Autologous Stromal Vascular Fraction and Calcium Phosphate Ceramics: A 10-Year Prospective Cohort Study
Authors: Wu Vivian , Klein-Nulend Jenneke , Bravenboer Nathalie , ten Bruggenkate Christiaan M , Helder Marco N , Schulten Engelbert A J M
Published: August 2023

This prospective cohort study aimed to assess long-term safety, dental implant survival, and clinical and radiological outcomes after maxillary sinus floor elevation (MSFE; lateral window technique) using freshly isolated autologous stromal vascular fraction (SVF) combined with calcium phosphate ceramics. All 10 patients previously participating in a phase I trial were included in a 10-year follow-up. They received either β-tricalcium phosphate (β-TCP; n = 5) or biphasic calcium phosphate (BCP; n = 5) with SVF-supplementation on one side (study). Bilaterally treated patients (6 of 10; 3 β-TCP, 3 BCP) received only calcium phosphate on the opposite side (control). Clinical and radiological assessments were performed on 44 dental implants at 1-month pre-MSFE, and 0.5- to 10-year post-MSFE. Implants were placed 6 months post-MSFE. No adverse events or pathology was reported during a 10-year follow-up. Forty-three dental implants (98%) remained functional. Control and study sides showed similar peri-implant soft-tissue quality, sulcus bleeding index, probing depth, plaque index, keratinized mucosa width, as well as marginal bone loss (0-6 mm), graft height loss (0-6 mm), and graft volume reduction. Peri-implantitis was observed around 6 implants (control: 4; study: 2) in 3 patients. This study is the first to demonstrate the 10-year safety of SVF-supplementation in MSFE for jawbone reconstruction. SVF-supplementation showed enhanced bone regeneration in the short term (previous study) and led to no abnormalities clinically and radiologically in the long term.
Beef color and tenderness response to production systems utilizing additive combinations of growth-promotant technologies
Authors: Webb Megan J , Block Janna J , Jaeger John R , Funston Rick N , Gonda Michael G , Underwood Keith R , Grubbs Judson K , Olson Kenneth C , Blair Amanda D
Published: August 2023

The objective of this study was to compare the influence of beef production systems using additive combinations of growth-promotant technologies on meat quality. Steer calves (n = 120) were assigned to 1 of 4 treatments: 1) no technology (NT; control), 2) antibiotic treated (ANT; NT plus therapeutic antibiotics, monensin, and tylosin), 3) implant treated (IMP; ANT plus a series of three implants), and 4) beta-agonist treated (BA; IMP plus ractopamine-HCl). Muscle biopsy samples from the longissimus lumborum were extracted from a subset (n = 4 per treatment) of steers to evaluate expression of calpain-1, calpain-2, and calpastatin using real-time RT-PCR. Following carcass chilling, objective color (L*, a*, and b*) was evaluated. The right strip loin was removed from each carcass, portioned into 2.54-cm steaks, and designated to 7, 14, or 21 d postmortem aging periods for analysis of cook loss and Warner–Bratzler shear force (WBSF). The anterior face of each strip loin was used for analysis of crude fat and moisture. Treatment influenced (P < 0.001) L*, a*, and b*. The NT and IMP treatments had greater (P < 0.01) L* values, ANT was intermediate, and BA had the lowest (P < 0.01) L* values. The NT and IMP treatments had higher (P < 0.01) a* and b* values compared with ANT, which were higher (P < 0.01) than BA. Steaks from implanted steers (IMP and BA) tended (P ≤ 0.067) to exhibit higher a* and b* than steaks from nonimplanted steers. Cattle in the NT and ANT treatments produced steaks with increased (P < 0.01) crude fat percentage compared with the IMP and BA treatments, which were similar (P > 0.05). Percent moisture of NT steaks was lower (P < 0.01) than all other treatments, ANT was intermediate, and IMP and BA were similar (P > 0.05) and had the highest (P < 0.01) moisture content. Cook loss tended to be greater (P = 0.088) for implanted steers (IMP and BA) compared to nonimplanted steers (NT and ANT). Steaks from NT and ANT treatments were more tender (P < 0.05) than IMP and BA, which were similar (P > 0.05). Thus, WBSF was lower (P < 0.001) in nonimplanted than implanted steaks. Expression of calpastatin was increased (P ≤ 0.025) in ANT and BA treatments, and there was a tendency for expression of calpain-2 to be increased (P = 0.081) in ANT compared to NT. These results suggest that production systems with limited use of growth promoting technology produced strip loins with more crude fat, less moisture and cook loss, and improved tenderness.