bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of a syngas-fed solid oxide fuel cell power generation module
Authors: Wang Yanchao , Yang Xia , Yao Jinsong , Li Wenxiao , Hao Guozheng , Li Chufu
Published: January 2025

Solid oxide fuel cells are efficient and environmentally friendly energy-generating devices, where chemical energy is directly converted into electrical energy through the electrochemical reaction of the gases within the fuel cell. In this study, an electrochemical model was implemented in Aspen Plus to analyze the power generation performance of a 1-kW stack under various temperature and gas conditions. The design parameters for the 20-kW power generation module were determined, and the power generation performance of this module was examined. The results indicate that, when using hydrogen (H2), the current density of each tower was 3625 A·m−2, corresponding to a fuel utilization rate of 80%, with the total power output of the module reaching 20.40 kW. In contrast, when using syngas, the voltage and power output of the module decreased. Furthermore, with a current density of 3500 A·m−2 per tower, the total power output was 19.73 kW. Finally, varying the mole ratio of hydrogen to carbon monoxide (H2:CO) from 2.6 to 3.4 had a negligible effect on the voltage output when the mole ratio of steam to carbon monoxide (H2O:CO) was maintained at 1:1 and the current density was 3375 A·m−2.
A rapidly enlarging axillary nodule
Authors: Herlihy Maeve , Brennan Shane , Field Sinead
Published: January 2025

We report the case of an otherwise healthy 40-year-old man who presented to dermatology with a short history of an unusual, rapidly enlarging, calcified cutaneous nodule.
DNA Sequencing in Newborn Screening: Opportunities, Challenges, and Future Directions
Authors: Jeanne Médéric , Chung Wendy K
Published: January 2025

Background

Newborn screening is a public health system designed to identify infants at risk for conditions early in life to facilitate timely intervention and treatment to prevent or mitigate adverse health outcomes. Newborn screening programs use tandem mass spectrometry as a platform to detect several treatable inborn errors of metabolism, and the T-cell receptor excision circle assay to detect some inborn errors of the immune system. Recent advancements in DNA sequencing have decreased the cost of sequencing and allow us to consider DNA sequencing as an additional platform to complement other newborn screening methods.

Content

This review provides an overview of DNA-based newborn screening, including its applications, opportunities, challenges, and future directions. We discuss the potential benefits of expanded DNA sequencing in newborn screening, such as expanding conditions screened and improved specificity and sensitivity of currently screened conditions. Additionally, we examine the ethical, legal, and social implications of implementing genomic sequencing in newborn screening programs, including issues related to consent, privacy, equity, data interpretation, scalability, and psychosocial impact on families. Additionally, we explore emerging strategies for addressing current limitations and advancing the field of newborn screening.

DNA sequencing in newborn screening has the potential to improve the diagnosis and management of rare diseases but also presents significant challenges that need to be addressed before implementation at the population level.
Structural Variation Interpretation in the Genome Sequencing Era: Lessons from Cytogenetics
Authors: Pizzo Lucilla , Rudd M Katharine
Published: January 2025

Background

Structural variation (SV), defined as balanced and unbalanced chromosomal rearrangements >1 kb, is a major contributor to germline and neoplastic disease. Large variants have historically been evaluated by chromosome analysis and now are commonly recognized by chromosomal microarray analysis (CMA). The increasing application of genome sequencing (GS) in the clinic and the relatively high incidence of chromosomal abnormalities in sick newborns and children highlights the need for accurate SV interpretation and reporting. In this review, we describe SV patterns of common cytogenetic abnormalities for laboratorians who review GS data.

Content

GS has the potential to detect diverse chromosomal abnormalities and sequence breakpoint junctions to clarify variant structure. No single GS analysis pipeline can detect all SV, and visualization of sequence data is crucial to recognize specific patterns. Here we describe genomic signatures of translocations, inverted duplications adjacent to terminal deletions, recombinant chromosomes, marker chromosomes, ring chromosomes, isodicentric and isochromosomes, and mosaic aneuploidy. Distinguishing these more complex abnormalities from simple deletions and duplications is critical for phenotypic interpretation and recurrence risk recommendations.

Unlike single-nucleotide variant calling, identification of chromosome rearrangements by GS requires further processing and multiple callers. SV databases have caveats and limitations depending on the platform (CMA vs sequencing) and resolution (exome vs genome). In the rapidly evolving era of clinical genomics, where a single test can identify both sequence and structural variants, optimal patient care stems from the integration of molecular and cytogenetic expertise.
Standardization of Genomic Nomenclature across a Diverse Ecosystem of Stakeholders: Evolution and Challenges
Authors: Conlin Laura K , Landrum Melissa J , Freimuth Robert R , Funke Birgit
Published: January 2025

Background

Genetic testing has traditionally been divided into molecular genetics and cytogenetics, originally driven by the use of different assays and their associated limitations. Cytogenetic technologies such as karyotyping, fluorescent in situ hybridization or chromosomal microarrays are used to detect large “megabase level” copy number variants and other structural variants such as inversions or translocations. In contrast, molecular methodologies are heavily biased toward subgenic “small variants” such as single nucleotide variants, insertions/deletions, and targeted detection of intragenic, exon level deletions or duplications. The boundaries between these approaches are now increasingly blurred as next-generation sequencing technologies and their use for genome-wide analysis are used by both disciplines, therefore eliminating the historic and somewhat artificial separation driven by variant type.

Content

This review discusses the history of genomic nomenclature across both fields, summarizes implementation challenges for the clinical genetics community, and identifies key considerations for enabling a seamless connection of the stakeholders that consume variant descriptions.

Standardization is naturally a lengthy and complex process that requires consensus building between different stakeholders. Developing a standard that not only fits the multitude of needs across the entities that consume genetic variant information but also works equally well for all genetic variant types is an ambitious goal that calls for revisiting this vision.
Friendshoring in global food supply chains
Authors: Khadka Savin , Gopinath Munisamy , Batarseh Feras A
Published: January 2025

In the last decade, climate change, Covid-19, and several international conflicts have created significant disruptions to global and regional supply chains, leading to a re-evaluation of the benefits of globalisation. Modelling food trade as network graphs, this study spotlights the effects of these shocks, on the structure, flow and evolution of food supply chains. Network centrality measures show substantial changes in the influence exerted by China, Russia, and the United States, among others. Using machine learning, community detection and global metrics such as clustering further detail the structural changes in the trade network. Differences between systemic and idiosyncratic shocks are also discussed.
Physical activity partially mediates the association between health literacy and mild cognitive impairment in older adults: cross-sectional evidence from Switzerland
Authors: Meier Clément , Wieczorek Maud , Aschwanden Damaris , Ihle Andreas , Kliegel Matthias , Maurer Jürgen
Published: January 2025

Individuals’ health literacy (HL) is positively associated with healthy behaviors and global cognitive functioning. Current evidence also suggests that physical activity may prevent or delay cognitive decline and dementia. This study examines the potential mediating role of physical activity in the association between HL and cognition in a population-based sample of adults aged 58+ in Switzerland. We used data from 1645 respondents to Wave 8 (2019/2020) of the Survey on Health, Ageing, and Retirement in Europe in Switzerland. HL was assessed using the HLS-EU-Q16 questionnaire. Mild cognitive impairment (MCI) was defined as a 1.5 SD below the mean of age- and education-specific global cognition score. The frequency of moderate and vigorous physical activity was self-reported. The associations were assessed using probit regression models, controlling for social, health, and regional characteristics. Structural equation modeling was used to test the mediation hypothesis. Higher HL was associated with a higher likelihood of being engaged in moderate (P < .001) and vigorous (P < .01) physical activity and with a lower likelihood of having MCI (P < .05). In addition, both moderate (P < .05) and vigorous (P < .01) physical activity were associated with a lower probability of having MCI. Mediation analysis indicated that the association between HL and MCI was partially mediated by both moderate (12.9%) and vigorous (6.7%) physical activity. Given that physical activity may partially mediate the association between HL and MCI, improving HL in older adults could potentially foster engagement in physical activity, which could, in turn, act as a protective factor against MCI.
Human ovarian tissue xenotransplantation: advancements, challenges, and future perspectives
Authors: Thuwanut Paweena , Leonel Ellen C R , Rocha Ruiz Thalles Fernando , Sirayapiwat Porntip , Kristensen Stine Gry , Amorim Christiani A
Published: January 2025

Ovarian tissue cryopreservation and transplantation has emerged as a promising fertility preservation technique for individuals facing premature ovarian insufficiency due to various medical conditions or treatments. Xenotransplantation, involving the transplantation of ovarian tissue into animal hosts, has played a pivotal role in refining ovarian tissue cryopreservation and transplantation techniques and addressing key challenges. This review provides a comprehensive overview of the current landscape of ovarian tissue xenotransplantation research, focusing on its applications in investigating ovarian biology, optimizing ovarian tissue cryopreservation and transplantation protocols, and assessing safety concerns. It also explores the utilization of xenografting of human ovarian tissue in mouse models in the last 10 years. Key findings from preclinical studies investigating grafting site optimization, cryopreservation protocol refinement, the development of strategies to mitigate chemotherapy-induced damage, follicle development, tissue revascularization, and the risk of malignant cell reintroduction are summarized. Moreover, the review examines the ethical considerations surrounding the use of animals in ovarian tissue xenotransplantation research and suggests emerging alternative models that aim to minimize animal use while maximizing clinical relevance.
Aspirational “Total Peace”: Feminism in the Face of Resurging Violence in Chocó, Colombia
Authors: Gindele Rebecca , Cabanzo Miyerlandy , Zulver Julia Margaret
Published: January 2025

Following a historic election result in Colombia, the left-wing government has proposed a policy of “Total Peace” for the country. President Petro and Vice President Márquez have promised to put human rights—including women’s rights—at the center of plans for peace and development, with a particular emphasis on the rights of communities historically marginalized from political power. However, the country continues to face mounting and escalating violence at the hands of armed groups. This article analyzes the situation faced by women in the department of Chocó, on the Pacific coast of Colombia, in their peacebuilding efforts amid conditions of adverse security. Despite what might be considered a failure of the peace dividends they were promised, women leaders have continued their resistance. They (i) take advantage of small political empowerment opportunities to sow the seeds for transformative growth and (ii) model a forward-looking and aspirational version of what Total Peace could look like rather than solely reacting to new sites of violence. Indeed, drawing on a situated anti-violence, anti-misogyny, and anti-racist vision of peace, women in Chocó use the peace accord as a platform to make advances in their historical agenda of gender, ethnic, racial, and environmental rights, even though the document itself has not delivered as promised.
Surveillance of Clostridioides difficile on hospital admission and outpatient antibiotic use in Germany—a 9 year ecological analysis
Authors: Saydan Selin , Schwab Frank , Holstiege Jakob , Bätzing Jörg , Behnke Michael , Schneider Sandra , Clausmeyer Jörg , Gastmeier Petra , Geffers Christine , Maechler Friederike
Published: January 2025

Background

Antibiotic consumption is considered an important risk factor for Clostridioides difficile infection (CDI). This ecological analysis investigates the influence of outpatient antibiotic prescriptions in statutory health insurance (SHI) on the admission prevalence of CDI in German hospitals participating in voluntary CDI surveillance through the hospital infection surveillance system (Krankenhaus-Infektions-Surveillance-System; KISS).

Methods

The annual CDI admission prevalence of a hospital at the federal state level was associated with the outpatient antibiotic consumption of the corresponding federal state. The quantification of outpatient antibiotic prescriptions was determined as the average DDD per 1000 insured persons per day. The risk factors for CDI on hospital admission included the annual consumption of the eight substance groups aminopenicillin combinations/staphylococcal penicillins, basic penicillins, cephalosporins, quinolones, lincosamides/macrolides, nitrofurantoin/fosfomycin/nitroxoline, sulphonamides/trimethoprim and tetracyclines, the type of care provided by the hospital, and the calendar year, and were examined using multivariable regression analyses (generalized estimating equations models).

Results

Between 2011 and 2019, the number of outpatient antibiotic prescriptions decreased from 13.9 to 10.4 DDD per 1000 insured persons per day (−25%), and the CDI admission prevalence decreased from 0.22 to 0.12 per 100 patients (−45%). Basic penicillins and cephalosporins were identified as risk factors for increased CDI admission prevalence, while nitrofurantoin/fosfomycin/nitroxoline and sulphonamides/trimethoprim were associated with decreased CDI admission prevalence.

Conclusions

A decrease in outpatient antibiotic prescriptions with known risk of developing CDI was associated with a decrease in hospital CDI admission prevalence. Our ecological analysis indicates that rational and restrained antibiotic use in the outpatient setting may reduce the incidence of CDI in the population requiring inpatient treatment.
Automated abdominal aortic calcification and major adverse cardiovascular events in people undergoing osteoporosis screening: the Manitoba Bone Mineral Density Registry
Authors: Smith Cassandra , Sim Marc , Ilyas Zaid , Gilani Syed Zulqarnain , Suter David , Reid Siobhan , Monchka Barret A , Jozani Mohammed Jafari , Figtree Gemma , Schousboe John T , Lewis Joshua R , Leslie William D
Published: January 2025

Vertebral fracture assessment (VFA) images from bone density machines enable the automated machine learning assessment of abdominal aortic calcification (ML-AAC), a marker of cardiovascular disease (CVD) risk. The objective of this study was to describe the risk of a major adverse cardiovascular event (MACE, from linked health records) in patients attending routine bone mineral density (BMD) testing and meeting specific criteria based on age, BMD, height loss, or glucocorticoid use have a VFA in the Manitoba BMD Registry. The cohort included 10 250 individuals (mean age 75.5 yr, 94% women without CVD) with VFA (February 2010 to March 2017). ML-AAC24 scores were categorized (low <2; moderate 2–<6; high ≥6). Over follow-up (mean 3.9 yr), 1265 people (12.3%) experienced a MACE. Among those with low, moderate, and high ML-AAC24, MACE rates per 1000 person-years were 18.4 (95% CI 16.4-20.5), 34.1 (95% CI 30.9-37.4), and 55.6 (95% CI 50.8-60.1), respectively. A similar gradient was observed after stratifying by age and sex. Incidence rate ratios (IRRs) for low vs moderate and high groups were 1.9 (95% CI 1.6-2.2) and 3.0 (95% CI 2.6-3.5), respectively. In those most likely to benefit from pharmaceutical intervention (<80 yr, not on statins), MACE rates among those with low, moderate, and high ML-AAC24 were 13.5 (95% CI 11.5-15.8), 26.0 (95% CI 22.1-30.3) and 44.1 (95% CI 37.0-52.0). Corresponding IRRs for low vs moderate 1.9 (95% CI 1.5-2.4) and high ML-AAC24 was 3.3 (95% CI 2.6-4.1]), respectively. In routine osteoporosis screening, individuals with moderate and high ML-AAC24 had substantially greater MACE rates compared to those with low ML-AAC24. Consequently, AAC detection during osteoporosis screening (especially in women) may guide intensification of preventative cardiovascular strategies.
X-ray timing and spectral characteristics of compact symmetric objects
Authors: Swain Subhashree , Stalin C S , Paliya Vaidehi S , Saikia D J
Published: January 2025

Compact Symmetric Objects (CSOs) are a distinct category of jetted active galactic nuclei whose high-energy emission is not well understood. We examined the X-ray characteristics of 17 bona fide CSOs using observations from Chandra, XMM–Newton, and NuSTAR. Among the sources with XMM–Newton observations, we found two sources, J0713+4349 and J1326+3154 to show clear evidence of variations in the soft (0.3–2 keV), the hard (2–10 keV), and the total energy (0.3–10 keV) bands with the normalized excess variance (F$_{\mathrm{ var}}$) as large as 1.17$\pm$0.27. Also, the F$_{\mathrm{ var}}$ is found to be larger in the hard band relative to the soft band for J1326+3154. From the analysis of the hardness ratio (HR) with count rate, we found both sources to show a harder when brighter (HWB) trend. Similarly, in the Chandra observations, we found one source, J0131+5545, to show flux variations in the total energy band (0.5–7 keV). We discuss possible reasons for about 82 per cent of the CSOs being non-variable. From spectral analysis, carried out in a homogeneous manner, we found the existence of obscured as well as unobscured CSOs. Three CSOs, J0111+3906, J1407+2827, and J2022+6136, were found to have the intrinsic neutral hydrogen column density N$_{\rm H,z} \gt 10^{23}$ cm$^{-2}$, consistent with earlier analyses. For the majority of the CSOs, the observed hard X-ray emission is expected to be dominated by their mildly relativistic jet emission. For the sources, J0713+4349, J1347+1217, J1407+2827, J1511+0518, and J2022+6136, the confirmed detection of Fe K $\alpha$ emission line suggests a significant contribution from the disc/corona. Our results point to diverse X-ray characteristics of CSOs.
Considerations with stacking absorption spectra: cold H i gas in cirrus region of the Milky Way
Authors: Lynn Callum , Marchal Antoine , McClure-Griffiths N M , Miville-Deschênes Marc-Antoine , Murray Claire E , Nguyen Hiep , Dempsey James , Teodoro Enrico Di , van Loon Jacco Th , Dickey John M , Lee Min-Young , Joncas Gilles , Ma Yik Ki , Pingel Nickolas M , Stanimirović Snežana , Kemp Ian , Gibson Steven , Dénes Helga
Published: January 2025

We use the Milky Way neutral hydrogen (H i) absorption and emission spectra from the Galactic Australian Square Kilometre Array Pathfinder (GASKAP) Phase II Pilot survey along with toy models to investigate the effects of stacking multicomponent spectra on measurements of peak optical depth and spin temperature. Shifting spectra by the peak in emission, ‘primary’ components shifted to 0 km s$^{-1}$ are correctly averaged. Additional components on individual sightlines are averaged with non-centred velocities, producing a broader and shallower ‘secondary’ component in the resulting stack. Peak optical depths and brightness temperatures of the secondary components from stacks are lower limits of their true average values due to the velocity offset of each component. The spin temperature however is well correlated with the truth since the velocity offset of components affects the emission and absorption spectra equally. Stacking 462 GASKAP absorption-emission spectral pairs, we detect a component with a spin temperature of $1320 \pm 263$ K, consistent with gas from the unstable neutral medium and higher than any previous GASKAP detection in this region. We also stack 2240 pilot survey spectra containing no Milky Way absorption, revealing a primary narrow and secondary broad component, with spin temperatures belonging to the cold neutral medium (CNM). Spatially binning and stacking the non-detections across the plane-of-sky by their distance from CNM absorption detections, the primary component’s optical depth decreases with distance from known locations of cold gas. The spin temperature however remains stable in both components, over an approximate physical plane-of-sky distance of $\sim 100$ pc.
Optical spectral transmission to monitor disease activity in arthritis patients: longitudinal follow-up comparison with clinical parameters
Authors: Triantafyllias Konstantinos , Alhaddad Mohammed , Baraliakos Xenofon , Muthuraman Muthuraman , Schwarting Andreas
Published: January 2025

Objective

To examine the longitudinal associations of optical spectral transmission (OST) with clinical inflammatory arthritis activity markers in order to investigate its potential in monitoring disease activity.

Methods

OST measurements were performed in 1312 wrist and finger joints of 60 patients with clinical suspicion of inflammatory activity, within the context of known rheumatic inflammatory diseases at two separate time intervals. In each time point, patients underwent additional clinical and laboratory examinations. The change of OST values was statistically compared with changes in clinical activity parameters like DAS28 and swollen joint counts (SJC). Additionally, the diagnostic performance of OST was assessed in comparison to a historic control group (2508 joints of 114 healthy subjects) using receiver operating characteristics (ROC). The relationships between OST values, clinical and laboratory parameters, as well as patient characteristics, were evaluated through correlation analyses.

Results

Mean OST scores were significantly higher in the inflammatory arthritis group compared with the control group (P < 0.001). OST correlated significantly with clinical activity markers like DAS28, SJC and TJC in both time points (all; P < 0.05). Longitudinal changes of OST values (ΔOST) were significantly associated with changes in DAS28 (ΔDAS28) (r = 0.377; P = 0.004) and ΔSJC (r = 0.488; P < 0.001) over the same time period. The area under the curve of the baseline receiver operating characteristic curve was 0.781 (95%CI 0.82–0.94).

Conclusion

OST was able to reliably assess disease activity and correlated longitudinally with arthritis activity markers, showing promising potential during monitoring of inflammatory arthritis.
Chikungunya infection in children: clinical profile and outcome
Authors: Naik Korra Dhanunjaya , Delhi Kumar C G , Abimannane Anitha , Dhodapkar Rahul , Biswal Niranjan
Published: January 2025

The clinical profile and outcomes of children with chikungunya infection differ from those observed in adults. As there is a paucity of data on chikungunya infection in children, this study aimed to find the clinical course, complications, and mortality rates of chikungunya infection in children. This was a combined retrospective and prospective observational study. Children aged 1 month to 15 years who tested positive for chikungunya infection by IgM enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction in serum or body fluids were included. The demographic details, clinical presentation, laboratory parameters, treatment given, and outcomes were recorded in a structured proforma. Fifty-eight cases (41 retrospective and 17 prospective) were recruited, out of which 30 (52%) were males. The median age was 8 (3–11) years. The most common clinical feature at admission was fever observed in 55 patients (94.8%), followed by vomiting [25 (43.1%)] and myalgia [23 (39.7%)]. Commonly observed clinical signs were skin rash [32 (55.2%)], hepatomegaly [25 (43.1%)], and anemia [22 (37.9%)]. Frequently observed acute complications were lymphopenia [46 (79.3%)], hyponatremia [32 (55.2%)], capillary leak [27 (46.6%)], and thrombocytopenia [26 (44.8%)]. Of 58 cases, 8 (13.8%) children had co-infection with other microbes. Overall, 55 (94.8%) children had complete recovery, 2 (3.4%) children died of complications (one with acute encephalitis and one child with acute respiratory distress syndrome), and 5 children had prolonged arthralgia. Children with chikungunya had more skin manifestations and neurological manifestations than arthralgia. Also, a significant proportion of children developed serious complications like a capillary leak.
Envenomation by ‘dead’ snakes: a review
Authors: Naik B Sadananda
Published: January 2025

Venomous snakes are a potential hazard even after their death. Dead snakes or their severed heads can inflict bites under various bizarre circumstances and may result in envenomation. In this review, an effort has been made to discuss the circumstances under which envenomation from dead snakes can occur, the incidence and pathomechanics of such envenomation, clinical manifestations and management and preventive measures, as well as a review of the literature on this unique mode of snake envenomation.
Evaluation of a nanostructured CpG-ODN/ascorbyl palmitate as a safe and effective adjuvant for anticrotalic PLA2 serum
Authors: Fusco Luciano S , Lopez Gisela L , Maslovski Franco , Brignone Sofía , Chaves María G , Calvete Juan J , Franco Yanet G , Hernandez David , Van de Velde Andrea , Marin Constanza , Palma Santiago , Maletto Belkys , Moron Gabriel , Leiva Laura C
Published: January 2025

Background

The WHO states that antivenom is the only safe and effective treatment to neutralize snake venom. Snakebite antivenom typically involves horse hyperimmunization with crude venom and Freund's adjuvant.

Methods

In the current work, we analyzed the ascorbyl palmitate liquid crystal structure with snake protein or PLA2, the carrier charge capacity, and we evaluated the immune response induced by the enzyme P9a(Cdt-PLA2) formulated in a nanostructure using CpG-ODN, determining the titer of IgG antibodies. BALB/c mice were subcutaneously immunized on days 0, 15 and 30 with P9a(Cdt-PLA2)/CpG-ODN/Coa-ASC16 or P9a(Cdt-PLA2)/Freund's adjuvant (complete first and incomplete-booster). On day 48 the mice were sacrificed. The neutralization ability of antibodies from animals immunized with P9a(Cdt-PLA2)/CpG-ODN/Coa-ASC16 or P9a(Cdt-PLA2)/Freund's adjuvant was tested against PLA2 activity and venom lethality.

Results

In both groups of immunized mice, the antibody titers in blood samples at the assayed time were high (approximately 1×105). The antibodies were able to neutralize P9a(Cdt-PLA2) activity in vitro and lethality in vivo. Microscopic analysis showed that P9a(Cdt-PLA2)/CpG-ODN/Coa-ASC16 produces minimal damage at injection sites compared with Freund's adjuvant.

Conclusion

The Coa-ASC16/CpG-ODN formulation shows promise as a safe and effective adjuvant against crotalic PLA2, inducing a strong humoral response and reducing local tissue damage compared with Freund's adjuvant.
Genome Sequence Resource of Four Botrytis cinerea Isolates from North Carolina
Authors: Adhikari Tika B. , Muzhinji Norman , Philbrick Ashley N. , Schnabel Guido , Louws Frank J.
Published: January 2025

Botrytis cinerea is a fungal pathogen that affects over 1,400 plant species and causes significant damage to crops. It is also responsible for causing gray mold in small fruits, such as blueberries and strawberries. In this study, four isolates of B. cinerea were collected (two from blueberry andblueberry and two from strawberry) in North Carolina. Their genomes were sequenced using Illumina paired-end sequencing. The core genome of the isolates was analyzed for their carbohydrate-active enzymes, secretomes, effectors, and secondary metabolite repertoires. The genome assembly of the four isolates ranged from 41.9 Mb for NC5 to 44.9 Mb for KC33. Based on BUSCO analysis, all the genomes had high levels of completeness, ranging from 98.2% to 99.1%. The annotation revealed the presence of 500 to 565 carbohydrate-active enzymes, 649 to 688 secreted proteins, and 162 to 181 potential fungal effectors. This study not only provides valuable genomic resources for B. cinerea, but also significantly contributes to the existing resources available for understanding host-pathogen interactions and the factors that affect disease development in the host.
Therapeutic potential of mesenchymal stem cells on cholesterol homeostasis‐associated genes in AD‐like rats
Authors: Karimi Darabi Mehrnaz , Rafeeinia Arash , Pezeshki Seyedeh Pardis , Nazeri Zahra , Kheirollah Alireza , Cheraghzadeh Maryam
Published: January 2025

Cholesterol is vital for nerve processes. Changes in cholesterol homeostasis lead to neurodegeneration and Alzheimer's disease (AD). In recent years, extensive research has confirmed the influential role of adipose tissue mesenchymal stem cells (MSCs) in managing AD. The present study aims is to investigate a new approach concerning AD by MSCs with particular reference to the cholesterol homeostasis pathway and its regulatory miRNAs in an AD‐like rat model. Three groups of 24 male Wistar rats have been divided: healthy rats (control), Alzheimer's rats (AD), and Alzheimer's rats that received MSCs (AD + MSC). Cholesterol level was measured using the GC‐mass technique. The mRNA and expression levels of 3‐hydroxy‐3‐methylglutaryl‐CoA reductase (HMGCR), apolipoprotein E (APOE), ATP‐binding cassette transporter A1 (ABCA1), and CYP46A1 genes, as well as their regulating miRNAs, were assessed using real‐time polymerase chain reaction (RT‐PCR) and western blotting techniques, respectively. Intraventricular transplantation of MSCs improved behavioral disorders and decreased the count of Aβ plaques in brain tissue. Transplantation of these cells also led to a significant decrease in cholesterol levels and HMGCR, ApoE, and ABCA1 and a remarkable increase in CYP46A1 mRNAs and protein expression. These cells considerably changed the expression of microRNAs regulating these genes. These results indicated that the examined miRNAs could be used as promising biomarkers for AD management. Additionally, the potential therapeutic role of MSCs in improving cholesterol levels the expression levels of the targeted miRNAs and their related genes in the cholesterol homeostasis pathway was established.
Updated Geriatrics Competencies for Graduating Medical Students: Training Physicians to Provide Age-Friendly Care
Authors: Schwartz Andrea Wershof , Sehgal Mandi , Dawson Catherine M.P. , Granville Lisa J. , Powers Becky B. , Shah Amit A. , Sullivan Amy M. , Leipzig Rosanne M.
Published: January 2025

Purpose

Medical student education in geriatrics is a critical need for every doctor-in-training as the population ages, with fewer than 7,000 geriatricians, and older patients, who now approach 20% of the U.S. population, having unique health care needs. This study presents the updated competencies in geriatrics for graduating medical students, framed by the Geriatrics 5Ms (Mind, Mobility, Medications, Multicomplexity, and What Matters Most).

Method

From 2019-2022, a working group of the American Geriatrics Society (AGS) drafted the updated medical student geriatrics education competencies, using a modified Delphi approach.

The working group reviewed the literature, conducted an initial survey of working group members, and drafted and refined proposed updates to the competencies. The 27 resulting competencies were disseminated as a national survey to geriatrics experts and medical school education deans. Following the national survey, the competencies were updated and presented at the 2021 AGS Annual Scientific Meeting and open to public comment before they were finalized.

Results

The 27 updated geriatrics competencies for medical students included several new competencies, such as a focus on health equity, frailty, deprescribing, and patient priorities. A total of 211 respondents completed the national survey, including geriatrics experts (187/398, response rate: 47.0%) and education deans (24/191, response rate: 12.6%). All 27 proposed competencies met the predetermined threshold of 70% cumulative agreement, with a range of 93.0% (174/187) to 100% (187/187) among geriatrics experts and 87.5% (21/24) to 100% (24/24) among education deans.

Conclusions

The updated Geriatrics Competencies for Graduating Medical Students met with broad agreement among the geriatrics experts and medical school education deans who responded to the national survey. By focusing on the Geriatrics 5Ms, the competencies highlight key knowledge and skills graduating medical students need for the first day of internship to be prepared to deliver age-friendly care to older adults under their care.
THC Ingestions and Child Protective Services: Guidelines for Practitioners
Authors: Raz Mical , Gupta-Kagan Josh , Asnes Andrea G.
Published: January 2025

The decriminalization of tetrahydrocannabinol (THC)-containing products has resulted in an increased presence of these products in households. This increased presence, along with frequent use of product packaging that mimics recognizable and appealing treats, has led to a rise in accidental ingestions of THC-containing substances by children. Some clinicians and child protective services (CPS) professionals have recommended that every accidental THC ingestion by a child, irrespective of the circumstances, should be reported for investigation by CPS. We argue that this recommendation has the potential to waste scarce resources, harm families, and worsen current inequities in CPS reporting. We offer an alternative framework to this blanket recommendation that clinicians can employ when providing care to a child who has ingested THC.
Effects of Sympathetic Denervation in Metabolism Regulation: A Novel Approach for the Treatment of MASLD?
Authors: Dimitriadis Kyriakos , Iliakis Panagiotis , Vakka Angeliki , Pyrpyris Nikolaos , Pitsillidi Anna , Tsioufis Panagiotis , Fragkoulis Christos , Hering Dagmara , Weil Joachim , Kollias Anastasios , Konstantinidis Dimitris , Tsioufis Konstantinos
Published: January 2025

Although metabolic dysfunction–associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease, has become the most common chronic liver disorder, its complex pathophysiology has not been fully elucidated up to date. A correlation between elevated sympathetic activation and MASLD has been highlighted in recent preclinical and clinical studies. Furthermore, increased sympathetic activity has been associated with the main mechanisms involved in MASLD, such as lipid accumulation in the liver, insulin resistance, and metabolic dysregulation, while it has been also correlated with the progression of MASLD, leading to liver fibrosis. Preclinical studies demonstrated that therapies which ameliorate the activation of the sympathetic nervous system, such as renal and liver sympathetic denervation, reduce hepatic insulin resistance, decrease hepatic glucose production, and reverse hepatic steatosis in high-fat-diet models. However, data from clinical trials regarding the effect of renal denervation on metabolic parameters are conflicting, since several trials reported a favorable effect, while other trials stated no significant difference, with the profound limitation of the lack of originally designed denervation trials in this setting. Thus, a thorough review of the role of the sympathetic nervous system in the pathophysiology of MASLD, as well as the results of recent sympathetic denervation studies and trials regarding metabolic regulation and MASLD treatment would be of great importance.
Geographic Variation in Inpatient Rehabilitation Outcomes After Traumatic Brain Injury
Authors: Darji Nathan , Zhang Bei , Goldstein Richard , Shih Shirley L. , Iaccarino Mary Alexis , Schneider Jeffrey C. , Zafonte Ross
Published: January 2025

Objective:

To determine whether regional variations exist in functional outcomes of patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation facilities (IRFs) across the United States, while controlling for demographic and clinical variables.

Setting:

Inpatient rehabilitation facilities (IRFs) across 4 U.S. regions: West, Midwest, South, and East.

Participants:

Adult patients with open or closed TBI (Rehabilitation Impairment Codes 2.21 or 2.22) discharged from an IRF between 2016 and 2019.

Design:

This is a retrospective analysis de-identified data from the Uniform Data System for Medical Rehabilitation. The study compared total functional independence measure (FIM) scores and discharge dispositions across the 4 regions.

Main Measures:

Primary outcomes were FIM scores at discharge, changes in FIM scores between admission and discharge, and community discharge rates, adjusted for demographic and clinical factors. Cohen’s d effect sizes were calculated to assess the clinical significance of regional differences on FIM scores. Prevalence ratios were used for discharge disposition outcomes.

Results:

Regional differences were identified in functional outcomes for patients with TBI. The West had the highest community discharge rate (80.9%) compared to the East (70.5%). Discharge FIM scores were significantly lower in the Midwest and East compared to the South (−1.98 and − 2.31, respectively, P < .01), while the West showed no significant difference from the South (−0.78, P = .11). Effect sizes for FIM total scores were small across regions, with Cohen’s d for West versus South at 0.017, Midwest versus South at 0.047, and East versus South at 0.047. Prevalence ratios for community discharge showed minor differences: West versus South at 1.010, Midwest versus South at 0.937, and East versus South at 0.918; all without statistical significance.

Conclusions:

Regional disparities in functional outcomes following inpatient rehabilitation for TBI were observed, particularly in community discharge rates and total FIM scores. However, based on the effect sizes and prevalence ratios, these differences may not be clinically meaningful and could not be fully explained by demographic and clinical factors. Further studies are needed to explore region-specific factors influencing rehabilitation efficacy to improve outcomes for patients with TBI nationwide.
Risk Factors for Proliferative Vitreoretinopathy in a Large Clinical Database
Authors: Oncel Damla , Minaker Samuel , Shepherd E Annie , Rezaei Sam , Boucher Nick , Aggarwal Nitika , MacCumber Mathew
Published: January 2025

Purpose:

Proliferative vitreoretinopathy (PVR) is the leading cause of surgical failure following rhegmatogenous retinal detachment (RRD). In this study, we aimed to explore ocular and systemic risk factors for PVR due to RRD in a large patient database.

Methods:

Patients who have a diagnosis of RRD and PVR, and who have been seen in the last seven years prior to analysis (January 2015-February 2023) were identified in the Vestrum Health database. The variables selected for univariate and multivariate analysis in this study included age, gender, history of smoking, diabetes, hypertension, dyslipidemia, anemia, Wagner syndrome, Stickler syndrome, vitreous hemorrhage, high myopia, ocular trauma, choroidal detachment, uveitis, giant retinal tear, aphakia and endophthalmitis. Eyes with proliferative diabetic retinopathy and those that had a history of PVR before the RRD diagnosis date were excluded from the study. The incidence of PVR was determined within each subset of the patient population.

Results:

There were 57,264 eyes that underwent a post-operative examination within 1 month following RRD diagnosis. Systemic factors younger age, female gender, smoking history, and hypertension, and ocular factors poor baseline visual acuity, history of ocular trauma, choroidal detachment, history of uveitis, giant retinal tear, pseudophakia, aphakia, and endophthalmitis were significantly and independently associated with increased odds of PVR development.

Conclusion:

The findings of this study indicate that there are several systemic and ocular risk factors that increase PVR development. Ophthalmologists should keep these in mind when planning surgical and therapeutic interventions for PVR prevention and treatment in patients with RRD.
Optical Coherence Tomography Angiography findings in Syphilitic Outer Retinitis
Authors: Zeman Luis , Cartier Mauricio Martínez , Couto Cristóbal , Schlaen Ariel
Published: January 2025

Purpose:

to report optical coherence tomography angiography findings in syphilitic outer retinopathy, a singular clinical manifestation of ocular syphilis.

Methods:

case report

Results:

Multimodal imaging including optical coherence tomography angiography was performed in a patient presenting syphilitic outer retinopathy. Optical coherence tomography angiography showed multifocal areas of flow deficit at the choriocapillaris level at presentation, whereas no vascular abnormalities were observed at deep and superficial capillary plexuses. After a one-year follow-up period, choriocapillaris flow showed an almost complete recovery.

Conclusion:

Syphilitic outer retinopathy represents a singular clinical manifestation of ocular syphilis. The almost complete recovery of initial ischemic changes at one year of follow-up suggests that this entity may have a good prognosis with timely and proper antibiotic treatment.
Correlation of Mindfulness Practices, Resilience, and Compassion Satisfaction in Hospital-Based Healthcare Workers: A Randomized Controlled Trial
Authors: Liska Heather , Bentzoni Megan , Donovan Courtney , Gaibel Ben , Hueth Alison , Johnson Adrienne , Shepler Mary , Roybal Deb , Mealer Meredith
Published: January 2025

Goal:

A lack of healthcare worker well-being is a serious threat to patient care quality and safety, as well as to the overall operational performance of hospitals in the US healthcare delivery system. Extreme resilience depletion and compassion fatigue are known to negatively influence individual well-being and have contributed to the rise in turnover in the healthcare workforce. The primary aim of this research was to identify interventions that health system leaders can use to combat resilience depletion and exhaustion among healthcare workers.

Methods:

Researchers deployed a randomized controlled trial methodology to study the association between the use of regular mindfulness practices, resilience, and compassion satisfaction. After completing an initial screening questionnaire and preassessments, participants were randomized into one of two groups: (1) an experimental group with mindfulness practices as the intervention and (2) a control group. The experimental group participated in structured mindfulness practices during their regular workday on three different days per week for a minimum of 10 minutes per day. At the end of the six-week study period, both groups completed postassessment questionnaires. Results from the pre- and postassessments were analyzed to determine the correlation between mindfulness practices, resilience, and compassion satisfaction.

Principal Findings:

Data analysis revealed that baseline resilience scores in the experimental group increased by 4 points, with a progressive 92% power. In addition, the experimental group demonstrated a statistically significant improvement in resilience (p mean difference pre-post = .147/.002) and compassion satisfaction (p mean difference pre-post = 3.99/.019).

Practical Applications:

Readily available, low-cost mindfulness practices may be introduced to hospital staff to build resilience and improve compassion satisfaction. In turn, this may help support hospital efforts to reduce turnover in the healthcare workforce.
Advance Care Planning Billing Codes Associated With Decreased Healthcare Utilization in Neurological Disease
Authors: Brown Gregory , Jesus Sol De , Leboffe Emily , Esch Andy , Newport Kristina
Published: January 2025

Goals:

Advance care planning (ACP) procedure codes have been established to reimburse meaningful care goal discussions; however, the utilization frequency of these codes in neurological disease is unknown. The objective of this study is to identify the association between ACP codes and healthcare utilization in chronic neurodegenerative diseases.

Methods:

This is a multicenter cohort study using real-world electronic health data. Using the TriNetX database, we collected electronic health data from 92 institutions in the United States. We included patients aged 65 and older who had been diagnosed with one of four neurological diseases: Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or amyotrophic lateral sclerosis (ALS). Patients with congestive heart failure were included as a reference. From the 64,683,009 total patients in the database, 877,138 had Alzheimer’s disease, 544,610 had Parkinson’s disease, 208,341 had multiple sclerosis, 9,944 had amyotrophic lateral sclerosis, and 1,500,186 had congestive heart failure. For each disease, we compared hospitalizations and emergency department (ED) visits over a two-year period between patients with and without ACP codes documented. Then, in patients with ACP, we investigated the rates of hospitalizations and ED visits over the two years before ACP and two years after ACP to understand the impact of ACP on the healthcare utilization trend. All patients had records for at least two years after index.

Principal Findings:

The rate of ACP code documentation ranged from 1.8% of multiple sclerosis patients to 3.6% of Alzheimer’s disease patients. After matching for demographic and health variables, usage of ACP codes was associated with significantly fewer hospitalizations for Alzheimer’s disease patients. Across all diseases, there was a 20% to 30% decrease in ED visits, which was significant. Furthermore, there was a significant change in the trend of hospitalizations and ED visits for patients after ACP documentation. Patients went from increasing utilization before ACP documentation to decreasing utilization after documentation.

Practical Applications:

ACP billing codes are used infrequently in neurological disease, which may indicate that reimbursement alone is not sufficient to drive code usage. Usage of ACP billing codes was associated with decreased healthcare utilization, particularly in terms of ED visits. Beyond the primary objective of providing goal-concordant care, ACP may impact the economic burden of chronic neurodegenerative disease, which has high costs of care in our aging society. There may be particular benefits with Alzheimer’s disease, which had an impact on both hospitalizations and ED visits and is the most prevalent neurodegenerative disease. Future work is needed to better understand the best implementation strategy for ACP in a multifaceted approach that emphasizes patient care preferences for their illness.