bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical simulation of bonding performance between GFRP and lightweight aggregate concrete
Authors: Wang Yinmao , Wu Liwei , Guo Xueyuan , Chen Haibin , Ba Ying , Liu Zhang
Published: February 2025

This study investigates the bonding performance between Glass Fiber-Reinforced polymer (GFRP) bars and Lightweight Aggregate Concrete (LWAC). We established 81 central pull-out numerical simulation scenarios to analyze the influence of four factors—lightweight aggregate concrete strength grade, GFRP bar diameters, GFRP bar rib height, and GFRP bar bonding length—on the bonding performance between LWAC and GFRP bars. The results indicated that considering the surface characteristics of GFRP and the intrinsic model of LWAC, the bonding damage pattern between GFRP and LWAC can be accurately reflected. The damage patterns observed in the simulations were generally consistent with experimental findings. The ultimate bond strength between GFRP and concrete increased with the increase in LWAC strength. However, beyond a concrete strength of 50 MPa, the enhancement in ultimate bond strength becomes marginal. Within a certain range, the ultimate bond strength decreases with increasing GFRP diameter and bond length, while it increases with increasing GFRP rib height. The predictions from our GFRP and LWAC bonding strength model closely matched the experimental values, with prediction errors within 15%. The numerical simulation method and the ultimate bond strength prediction model established in this paper provide scientific reference and theoretical support for the evaluation of the bonding performance between lightweight aggregate concrete and GFRP bars.
Future CH4 as modelled by a fully coupled Earth system model: prescribed GHG concentrations vs. interactive CH4 sources and sinks
Authors: Im Ulas , Tsigaridis Kostas , Bauer Susanne , Shindell Drew , Olivié Dirk , Wilson Simon , Sørensen Lise Lotte , Langen Peter , Eckhardt Sabine
Published: February 2025

We have used the NASA Goddard Institute for Space Studies (GISS) Earth system model GISS-E2.1 to study the future budgets and trends of global and regional CH4 under different emission scenarios, using both the prescribed GHG concentrations as well as the interactive CH4 sources and sinks setup of the model, to quantify the model performance and its sensitivity to CH4 sources and sinks. We have used the Current Legislation (CLE) and the maximum feasible reduction (MFR) emission scenarios from the ECLIPSE V6b emission database to simulate the future evolution of CH4 sources, sinks, and levels from 2015 to 2050. Results show that the prescribed GHG version underestimates the observed surface CH4 concentrations during the period between 1995 and 2023 by 1%, with the largest underestimations over the continental emission regions, while the interactive simulation underestimates the observations by 2%, with the biases largest over oceans and smaller over the continents. For the future, the MFR scenario simulates lower global surface CH4 concentrations and burdens compared to the CLE scenario, however in both cases, global surface CH4 and burden continue to increase through 2050 compared to present day. In addition, the interactive simulation calculates slightly larger O3 and OH mixing ratios, in particular over the northern hemisphere, leading to slightly decreased CH4 lifetime in the present day. The CH4 forcing is projected to increase in both scenarios, in particular in the CLE scenario, from 0.53 W m−2 in the present day to 0.73 W m−2 in 2050. In addition, the interactive simulations estimate slightly higher tropospheric O3 forcing compared to prescribed simulations, due to slightly higher O3 mixing ratios simulated by the interactive models. While in the CLE, tropospheric O3 forcing continues to increase, the MFR scenario leads to a decrease in tropospheric O3 forcing, leading to a climate benefit. Our results highlight that in the interactive models, the response of concentrations are not necessarily linear with the changes in emissions as the chemistry is non-linear, and dependent on the oxidative capacity of the atmosphere. Therefore, it is important to have the CH4 sources and chemical sinks to be represented comprehensively in climate models.
Quantum-symmetric equivalence is a graded Morita invariant
Authors: Huang Hongdi , Nguyen Van , Vashaw Kent , Veerapen Padmini , Wang Xingting
Published: February 2025

We show that if two

m
m

-homogeneous algebras have equivalent graded module categories, then they are quantum-symmetrically equivalent, that is, there is a monoidal equivalence between the categories of comodules for their associated universal quantum groups (in the sense of Manin) which sends one algebra to the other. As a consequence, any Zhang twist of an

m
m

-homogeneous algebra is a 2-cocycle twist by some 2-cocycle from its Manin’s universal quantum group.
Clinical utility of non-gated 4-min delayed dual-energy CT for myocardial extracellular volume quantification
Authors: Kojima Tsukasa , Yamasaki Yuzo , Nishigake Daisuke , Shirasaka Takashi , Kondo Masatoshi , Hioki Kazuhito , Kamitani Takeshi , Kato Toyoyuki , Ishigami Kousei
Published: February 2025

Objectives

To develop and validate the myocardial extracellular volume (ECV) obtained from non-electrocardiography (ECG)-gated delayed CT images acquired 4 min post-contrast infusion (4-min-non-ECG-ECV) compared with the ECV obtained from ECG-gated delayed CT images acquired 10 min post-contrast infusion (Conv-ECV).

Methods

We retrospectively analysed 29 patients (males: 21) after a comprehensive CT protocol of both 4-min-non-ECG-ECV and Conv-ECV on a dual-layer CT scanner. The mean volume of contrast medium administered was 90 ± 11.8 mL, and the average heart rate during the CT examinations was 74.2 ± 18.2 bpm. Two independent observers calculated the respective 4-min-non-ECG-ECV and Conv-ECV. We determined the correlation between the ECV obtained by the 2 methods and conducted a Bland-Altman analysis to identify systematic errors and determine the limits of agreement (LOA) between the 4-min-non-ECG-ECV and Conv-ECV values.

Results

The respective median ECV values for observer 1 were 27.3 for 4-min-non-ECG-ECV and 26.5 for Conv-ECV; for observer 2, they were 27.8 and 27.1. The correlation between the methods was 0.97 for both observers (P < .01). The Bland-Altman plots for observers 1 and 2 demonstrated a minor bias (−0.2% and −0.5%, respectively), with the 95% LOA ranges at −4.4% to 4.0% and −5.0% to 4.0%, respectively.

Conclusion

The 4-min-non-ECG-ECV provided ECV values comparable to those obtained by Conv-ECV.

Advances in knowledge

Myocardial ECV quantification is feasible using a non-gated, 4-min delayed dual-energy CT scan with an already established CT acquisition method. This approach achieves ECV accuracy comparable to that of the conventional CT-ECV calculation method (gated 10-min delayed imaging) while enhancing clinical efficacy and diagnostic throughput.
Application of Whole-Exome Sequencing to Predict Inborn Errors of Immunity in Pediatric Severe Infections and Sepsis
Authors: Moundir Abderrahmane , Aissaoui Ouissal , Akhrichi Nassima , Allaoui Abire , Benhsaien Ibtihal , Jouanguy Emmanuelle , Casanova Jean-Laurent , El Bakkouri Jalila , Ailal Fatima , Bousfiha Ahmed Aziz
Published: February 2025

Introduction

Increasing evidence supports the involvement of inborn errors of immunity (IEI) in severe infections, but little is known about the prevalence of these genetic defects in children with sepsis. Due to the limited understanding of the molecular and immunological mechanisms driving sepsis, genetic testing is rarely used in routine diagnostics to identify genetic susceptibility to the condition.

Methods

We performed a prospective observational study on previously healthy children hospitalized for severe infections, including sepsis. Patients underwent immunophenotyping and whole-exome sequencing (WES), followed by in silico analysis to identify potentially causal variants. We assembled a cohort of 194 previously healthy children, including 149 (77%) patients with severe infection and 45 (23%) with sepsis. Our cohort was marked by a high frequency of respiratory tract infections (35%), bloodstream infections (20%), and central nervous system infections (16%).

Results

The genetic investigation identified 28 potentially causal variants, 18 (64%) are classified as variants with uncertain significance, and 10 (36%) are likely pathogenic variants. Of 45 patients with sepsis, 6 (13%) had potentially causal genetic variants. Similarly, 22/149 (15%) patients with severe infection presented potentially causal genetic variants. WES predicted the impairment of various immune mechanistic pathways such as immune dysregulation defects, antibody deficiencies, and combined immunodeficiencies (18% each).

Conclusion

We found no clear association between genetic variants and the studied parameters: organ failure, microbe identification, immunoglobulin levels, and lymphocyte subset numbers. Although WES is a valuable tool for detecting IEI underlying sepsis and unexplained severe infections, it could be selectively recommended for patients with a strong clinical suspicion of genetic abnormalities, balancing its diagnostic value with its cost and complexity.
Could a focus on care process put care back into the US health system?
Authors: Shah Arnav , Williams Reginald (Reggie) D
Published: February 2025

The US health care system continues to underperform compared with other high-income countries, despite excelling on measures of care delivery and quality, also referred to as indicators of “care process.” This commentary explores how the United States managed to perform well on measures of care process and how learning from this lone area of positive cross-country comparison can provide valuable lessons for improving overall health care system performance. By applying these lessons, the United States can create a more effective, efficient, and equitable health care system, ensuring better access, streamlined administration, and improved health outcomes for more Americans.
“We Are Always Each Other's Keeper”: Transformative Dimensions of Women's Local Peacebuilding in Africa
Authors: Mari Tripp Aili , Maiga Awa , Yahi Maina
Published: February 2025

Many women have continued to engage in local peacebuilding activities in the face of massive failures of formal peacekeeping missions in the Sahel region of Africa, where the world's fastest-growing and most deadly insurgent groups are found. Women are largely excluded from these missions. Instead, they are most active in grassroots peacebuilding initiatives, where their impact is significant, yet often overlooked. Women's localized peacebuilding activities can have transformative impacts on gender relations and roles and on society more broadly. We examine women's efforts specifically in the context of significant failures and setbacks of formal peace efforts. Using in-depth interviews with women engaged in grassroots peacebuilding in Mali and Nigeria, where ongoing regional jihadist insurgencies and political instability persist, we identify three important mechanisms through which women are responding to these massive setbacks: (1) Women build ties across religious, ethnic, pastoralist-nomad, and other divisions central to the conflict, addressing the very divides that formal peace processes have struggled to overcome; (2) Women engage in income-generating activities and community and peacebuilding initiatives that challenge traditional gender roles and increase women's empowerment; and (3) Women's daily peacebuilding activities have multiplier effects, improving not only their own welfare but that of their households and communities. This article contributes to our understanding of how women's peacebuilding activities can have transformative effects in the face of setbacks. It draws on in-depth interviews with women peacebuilders from Mali and Nigeria.
Classification and spatiotemporal correlation of dominant fluctuations in complex dynamical systems
Authors: Caruso Cristina , Crippa Martina , Cardellini Annalisa , Cioni Matteo , Perrone Mattia , Delle Piane Massimo , Pavan Giovanni M
Published: February 2025

The behaviors of many complex systems, from nanostructured materials to animal colonies, are governed by local events/rearrangements that, while involving a restricted number of interacting units, may generate collective cascade phenomena. Tracking such local events and understanding their emergence and propagation in the system is often challenging. Common strategies consist, for example, in monitoring over time parameters (descriptors) that are designed ad hoc to analyze certain systems. However, such approaches typically require prior knowledge of the system’s physics and are poorly transferable. Here, we present a general, transferable, and agnostic analysis approach that can reveal precious information on the physics of a variety of complex dynamical systems starting solely from the trajectories of their constitutive units. Built on a bivariate combination of two abstract descriptors, Local Environments and Neighbors Shuffling and TimeSmooth Overlap of Atomic Position, such approach allows to (i) detect the emergence of local fluctuations in simulation or experimentally acquired trajectories of multibody dynamical systems, (ii) classify fluctuations into categories, and (iii) correlate them in space and time. We demonstrate how this method, based on the abstract concepts of local fluctuations and their spatiotemporal correlations, may reveal precious insights on the emergence and propagation of local and collective phenomena in a variety of complex systems ranging from the atomic- to the macroscopic-scale. This provides a general data-driven approach that we expect will be particularly helpful to study and understand the behavior of systems whose physics is unknown a priori, as well as to revisit a variety of physical phenomena under a new perspective.
Building Consensus on the Essential Quantitative Competencies, Skills, and Practices for Entry-Level Nurses
Authors: Ozimek Daniel , Bowers Heather , Good Lindsay , Kelch Beth , Valcourt Maryann
Published: February 2025

AIM

Nursing and mathematics educators sought to establish consensus on the essential quantitative competencies, skills, and practices for entry-level nurses.

BACKGROUND

National recommendations have called for the identification of quantitative skills and competencies necessary for safe nursing practice.

METHOD

A descriptive survey design was utilized to gather input from educators across the United States. Individuals were asked to classify 64 quantitative-related items as essential, not essential but nice to have, or not necessary for safe practice. Responses were analyzed using a three-item Likert scale. Fisher’s exact test was used to explore differences between associate and bachelor’s levels.

RESULTS

Individuals across 31 states (n = 76) completed the survey. Items within five content domains were identified as essential. Significant differences were identified within probability and statistics.

CONCLUSION

The findings offer a basis for further collaborative efforts to identify the most appropriate educational offerings and practices to support nursing students’ quantitative education.
Impact of Low Ligation on Bowel Perfusion and Anastomotic Leakage in Minimally Invasive Rectal Cancer Surgery: A Post Hoc Analysis of a Randomized Controlled Trial
Authors: Kimura Kei , Watanabe Jun , Suwa Yusuke , Kotake Masanori , Noura Shingo , Suwa Hirokazu , Tei Mitsuyoshi , Takano Yoshinao , Munakata Koji , Matoba Shuichiro , Yamagishi Shigeru , Yasui Masayoshi , Kato Takeshi , Ozawa Mayumi , Shiozawa Manabu , Ishii Yoshiyuki , Yabuno Taichi , Nitta Toshikatsu , Saito Shuji , Nagata Naoki , Ichikawa Daisuke , Hasegawa Suguru , Katsuno Goutaro , Takahashi Hiroki , Kawai Kenji , Furuhata Tomohisa , Tonooka Toru , Kanazawa Akiyoshi , Kuriu Yoshiaki , Sakamoto Kazuhiro , Kinjo Tatsuya , Otsuka Hideo , Uemura Mamoru , Watanabe Toshifumi , Ueda Kazuki , Ikeda Masataka , Takemasa Ichiro ,   EssentiAL Trial Group
Published: February 2025

BACKGROUND:

Whether the level of the inferior mesenteric artery ligation affects the incidence of anastomotic leakage remains unclear.

OBJECTIVE:

To assess the impact of the level of inferior mesenteric artery ligation on the blood flow to the anastomotic site and the incidence of anastomotic leakage using indocyanine green fluorescence imaging.

DESIGN:

A post hoc analysis of EssentiAL trial.

SETTINGS:

This study was conducted at 41 tertiary referral centers in Japan.

PATIENTS:

839 rectal cancer patients (<12 cm from the anal verge).

MAIN OUTCOME MEASURES:

The incidence of anastomotic leakage and perfusion status were compared between the high and low ligation groups.

RESULTS:

The median fluorescence time was similar at 25 seconds in both groups (p= 0.74). Although no statistical difference was noted, the high ligation group was more likely to have greater outliers in fluorescence time compared to the low ligation group. The high ligation group demonstrated higher poor perfusion rates than the low ligation group (2.8% vs 1.5%). In the high ligation group, anastomotic leakage occurred in one case of poor perfusion where additional resection was not performed by the surgeon’s intraoperative judgment. Additionally, the additional resection rate nearly doubled with the use of indocyanine green fluorescence imaging. After propensity score matching (129 patients per group), the overall anastomotic leakage rate was 13.2% in the high ligation group and 10.9% in the low ligation group (p = 0.57).

LIMITATIONS:

This study was a post hoc analysis, the sample size was small, and the anastomosis methods varied.

CONCLUSIONS:

The level of inferior mesenteric artery ligation did not affect blood flow at the anastomotic site or the incidence of anastomotic leakage statistically, but assessing bowel perfusion using indocyanine green fluorescence imaging can offer clinical benefits, optimizing patient outcomes. See Video Abstract.

TRIAL REGISTRATION:

The Japan Registry of Clinical Trials (jRCTs-CRB3180007), the Japanese Clinical Trials Registry (UMIN-CTR000030240). See Video.
A Multi-institutional Study From the United States Resident Operative Experience Consortium Examining Factors Associated With Exposure and Pursuit of Colorectal Fellowship Following General Surgery Residency
Authors: Price Adam D. , Nasim Bilal W , Montgomery Kelsey B. , Layne Desmond , Cortez Alexander R. , Abelson Jonathan , Patel Jitesh A. ,   US Resident OPerative Experience (ROPE) Consortium
Published: February 2025

BACKGROUND:

Colon and rectal surgery is a popular fellowship following general surgery residency. The impact of a resident’s colon and rectal surgery experience during residency may impact their career trajectory and pursuit of colon and rectal surgery.

OBJECTIVE:

This study aims to identify individual and program factors associated with matriculation into colon and rectal surgery fellowship compared to other career trajectories.

DESIGN:

An analysis of case logs and demographic data from graduates of 19 accredited general surgery residency programs from the Accreditation Council for Graduate Medical Education between 2010-2020 was completed utilizing the United States Resident Operative Experience Consortium. The demographics and operative experience of residents who pursued colon and rectal surgery fellowship were compared to those who did not.

SETTINGS:

This study is a retrospective review of resident specialty selection, demographic information, and operative case logs.

PARTICIPANTS:

Graduates of 19 accredited general surgery residency programs from the Accreditation Council for Graduate Medical Education between 2010-2020 participated in the study.

MAIN OUTCOMES MEASURES:

Resident demographics, general and colon and rectal surgery-related program-specific characteristics, and resident operative case logs associated with entrance into colon and rectal surgery fellowship served as the primary outcome measures.

RESULTS:

Those in the colon and rectal surgery cohort were more likely to be female sex and have completed a dedicated research experience. No association was noted with co-location of a colon and rectal surgery fellowship and general surgery residency. Multivariable analysis demonstrated a higher likelihood of colon and rectal surgery fellowship matriculation for female sex residents and residents who completed a clinical fourth-year colon and rectal surgery rotation. Higher logged colon and rectal surgery-specific case volume was associated with those matriculating into colon and rectal surgery.

LIMITATIONS:

Self-reported case log data, differences in residency structures in offering colon and rectal surgery rotations to clinical fourth-year residents, academic bias of participating residency programs.

CONCLUSIONS:

This study identified individual and program-specific factors associated with matriculating into colon and rectal surgery fellowship, such factors include female sex, colon and rectal surgery-specific rotation in the fourth clinical year, and higher volume of colon and rectal surgery-specific cases. These data may optimize resident colon and rectal surgery experience and strengthen the colon and rectal surgery fellowship pipeline. See Video Abstract.
Neisseria weaveri: Atypical Infection in Breast Implant–Based Reconstruction
Authors: Maxey Julia , Harvey Donald
Published: February 2025

Surgical site infection (SSI) following breast implant surgery can have devastating complications. Infection is most commonly from coagulase-negative Staphylococcus bacteria. Neisseria weaveri is a gram-negative bacterium that is associated with animal bites. We present the first known case of N. weaveri causing SSI following breast implant reconstruction. We report the case of a 61-year-old woman with invasive ductal carcinoma who underwent bilateral skin–sparing mastectomy with immediate implant-based reconstruction. She presented on postoperative day 24 with malodorous drainage from her Jackson-Pratt drain. The patient explained that she has a shih tzu at home that frequently licked her. Cultures from the drain grew N. weaveri. The patient’s antibiotic regimen was transitioned, and she completed her course without complications. Practitioners should counsel their patients on adequate postsurgery hygiene and take into consideration rare causes of SSI and how this may affect patient care.
Skin Necrosis After Methylene Blue Dye Use in Immediate Breast Reconstruction
Authors: Panopoulou Georgina , Fotiou Antonia
Published: February 2025

Skin-sparing mastectomy or nipple-sparing mastectomy is usually combined with sentinel lymph node biopsy and often followed by immediate breast reconstruction. Currently, methylene blue dye (MBD) is being used for the localization of the sentinel lymph node during mastectomy in patients with early breast cancer. However, MBD has been associated with skin complications. Two patients underwent a nipple-sparing mastectomy followed by immediate reconstruction with silicone implants. MBD was injected into the subareolar area to identify the sentinel lymph node. The 2 cases were complicated by MBD. The first case developed 2 gangrenous areas on the site of the MBD injection. The second one developed skin necrosis as well. The use of MBD is responsible for skin complications, such as skin necrosis. In detail, discussion before surgery must be done when organizing immediate breast reconstruction using silicone implants.
Reciprocal Causation Among Pain, Physical Health, and Mental Health 1 Year Post-Traumatic Brain Injury: A Cross-Lagged Panel Model From the TRACK-TBI Study
Authors: Wender Carly , Perrin Paul B. , Krch Denise
Published: February 2025

Objective:

To estimate the relative causal influence of physical and mental health on pain in persons with traumatic brain injury (TBI) within the year following injury.

Setting:

Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) was a multicenter study that collected data from 18 level 1 trauma centers around the United States.

Participants:

TRACK-TBI recruited adults who experienced an acute TBI. For this secondary analysis, participants were included if they endorsed pain during at least 1 follow-up within 1 year post-TBI.

Design:

Secondary analysis using structural equation modeling of the longitudinal TRACK-TBI dataset of an inception cohort.

Interventions:

None.

Main Outcomes and Measures:

The primary outcomes are pain, physical health, and mental health. Pain was measured by averaging the T-scores of the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity and Pain Interference scales. Physical and mental health were measured with the raw component scores (physical component score and mental component score, respectively) on the Short Form Health Survey.

Results:

Eighty-nine percent of the TRACK-TBI cohort (n = 2022) reported pain throughout 1 year postinjury. This sample (n = 1796) was primarily white (77%) men (67%) in their early forties with mild (87%) closed head injuries (99%) related to motor or road vehicle accidents (57%). Based on the final trimmed model, there was a stronger dominance of pain on physical and mental health than physical and mental health on pain. Thus, pain is a bigger driver of physical and mental health than vice versa.

Conclusions:

Persistent pain is highly prevalent post-TBI and is a bigger driver of physical and mental health 1 year post-TBI than the other way round. Future research should aim to better understand the causes of pain post-TBI to inform what treatments are most effective at reducing pain intensity and interference post-TBI.
The impact of environmental changes on infectious diseases among children in North America
Authors: Bastug Kristen A. , Schwartz Elizabeth L. , Sam-Agudu Nadia A.
Published: February 2025

Purpose of review

Climate change is no longer a distant threat but a present and accelerating force reshaping the epidemiology of infectious diseases in North America and elsewhere. Rising temperatures, shifting precipitation patterns, and extreme weather events are impacting the geographic distribution of pathogens and their vectors. Understanding these environmental influences on infectious diseases in children is essential for equipping healthcare providers to deliver competent care in the era of climate change.

Recent findings

The northward spread of vector-borne diseases, warming waters and soils, and disease outbreaks following extreme weather events highlight the complex and multifactorial ways through which the environment influences the spread of infectious diseases.

Continuing medical education and training on the evolving epidemiology of climate-sensitive diseases is critical for clinicians to address emerging health threats effectively. We advocate for more equitable funding and resource allocation to support innovative pediatric research on climate change and infectious diseases in the United States and other countries in North America.
Changes in Care in Spanish Pediatric Emergency Departments After the First Immunization With Nirsevimab
Authors: Vazquez-Lopez Paula , Rivas-Garcia Aristides , Luaces-Cubells Carles , Perez-Gonzalez Elena , Ales-Palmer María Luisa , Cahis-Vela Nuria , Lera-Carballo Esther , Solano-Navarro Carmen , Romero-Castillo Estefanía , Torres-Begara Eva Patricia , Sanchez-Alvarez Maria Jesus , Benito-Fernandez Javier , Sanz-Rueda Laura , Garcia-Herrero María Angeles , Henares-Rodriguez Alba , Yañez-Mesia Sandra , de Francisco-Profumo Antonio , Martinez-Mejias Abel , May-Llanas Maria Elena , Mesa-Garcia Sofia , Aranda-Mora Alejandro , Baquero-Gomez Concepcion , de la Rosa-Sanchez Daniel , de Ceano–Vivas Maria , de la Torre Espí Mercedes , Oliva-Rodriguez-Pastor Silvia , Guerra-Diez Jo﻿se Lorenzo , Pons-Morales Sara , Gomez-Carabaza Arantxa , Campos-Calleja Carmen , Torres-Torres Antonio Ramon
Published: February 2025

Objectives:

The aim of the study is to assess the changes in the pediatric care of patients seen in the Pediatric Emergency Departments (PED) during the bronchiolitis season following the introduction of immunization with a monoclonal antibody against RSV (nirsevimab).

Methods:

An observational, retrospective, multicenter study was conducted, analyzing the Bronchiolitis Registry of the Spanish Society of Pediatric Emergency Medicine. This registry, containing data on bronchiolitis cases, was initiated in December 2022. A total of 30 hospitals participated, all of which are members of the Spanish Society of Pediatric Emergency Medicine. Data from a 26-day period in 2 bronchiolitis seasons (2022: preimmunization and 2023: postimmunization) were included. Variables regarding health care burden were recorded for both periods. Quantitative variables were described using mean and SD, and the Student t test was used for comparisons between the 2 periods.

Results:

Twenty-five hospitals from 11 autonomous communities were included with a mean of 47,811 PED visits/year (SD: 26,675). The number of bronchiolitis cases presenting to the PED and bronchiolitis-related admissions decreased by 41.6%(95% CI: 34.9%-48.2%) and 55.4% (95% CI: 46.6%-64.2%), respectively, while admissions for RSV bronchiolitis decreased by 60.3% (95% CI: 51.9%-68.7%). Admissions to pediatric intensive care units decreased by 81.3% (95% CI: 57.9%-100%). Furthermore, the occupancy rate in the pediatric intensive care units decreased by 30% (95% CI: 22.8%-37.3%), while a reduction of 22.4% (95% CI: 13.2%-31.5%) was observed in the occupancy rate of observation units. The number of bronchiolitis cases transferred to other hospitals decreased by 73.4% (95% CI: 29.0%-100%). Finally, there was a 60.9% (95% CI: 26.5%-95.3%) reduction in the need for high-flow oxygen therapy among bronchiolitis patients.

Conclusions:

After the introduction of nirsevimab, a large portion of indicators related to the burden of care associated with bronchiolitis during its epidemic season decreased significantly.
The Aberrantly Expressed Nuclear Factor (Erythroid-derived 2)-Like 2 Participates in aGVHD by Modulating the Activation and Differentiation of CD4+ T Lymphocytes
Authors: Chen Xu , Zhang Yue , Chen Yan , Qin Wei , Cheng Tingting , Wang Shiyu , Xu Yajing
Published: February 2025

Background.

Current investigation indicates that nuclear factor (erythroid-derived 2)-like 2 (NRF2) possesses both proinflammatory and anti-inflammatory capabilities in T cells, yet its exact function in acute graft-versus-host disease (aGVHD) CD4+ T cells remains unexplored.

Methods.

This study aims to determine NRF2 levels within CD4+ T cells of patients with or without aGVHD and analyze the correlation between T-cell receptor activation and NRF2 expression. RNA sequencing was used to detect changes in the expression profile of CD4+ T cells after overexpression of NRF2, and functional enrichment analysis was performed on the sequencing results. Finally, after treating aGVHD CD4+ T cells with NRF2 inhibitor, the expression of related pathway molecules was detected.

Results.

Our findings demonstrated a significant upregulation of NRF2 expression in CD4+ T cells from patients in the aGVHD group compared with patients in the non-aGVHD group, and its expression level is correlated with the severity of aGVHD. Additionally, T-cell receptor activation in CD4+ T cells elevates NRF2 expression. Postactivation of NRF2-inhibited CD4+ T cells, the expression levels of T-cell activation markers were notably lower than those in non-NRF2-inhibited CD4+ T cells. Sequencing analysis identified 904 genes that changed after NRF2 overexpression. These genes were categorized into 288 gene subsets, encompassing pathways such as T-cell receptor signaling transduction, Janus kinase 1/signal transducer and activator of transcription 1 (JAK1-STAT1) signaling, T helper cell 17 (Th17) cell differentiation, etc. Ultimately, treating CD4+ T cells of aGVHD patients with an NRF2 inhibitor led to a significant downregulation of JAK1-STAT1 signaling and Th17 cells.

Conclusions.

Elevated NRF2 expression in CD4+ T cells of patients with aGVHD initiates and exacerbates aGVHD by potentiating T-cell activation, amplifying JAK1/STAT1 signaling, and instigating Th17/regulatory T-cell ratio imbalance.
Management of Kidney Disease in Heart Transplant Patients: A National Delphi Survey-based Consensus Expert Paper
Authors: García-Cosío Carmena María Dolores , Farrero Marta , Blasco Peiró María Teresa , Crespo Marta , Delgado Jiménez Juan , Díaz Molina Beatriz , Fernández Rivera Constantino , Garrido Bravo Iris Paula , López Jiménez Verónica , Melilli Edoardo , Mirabet Pérez Sonia , Pérez Tamajón María Lourdes , Rangel Sousa Diego , Rodrigo Emilio , Cruzado Josep María , Hernández Marrero Domingo ,   On behalf of the Spanish Society of Transplantation,   the Spanish Society of Nephrology, and the Spanish Society of Cardiology (SET-SEC-SEN)
Published: February 2025

Kidney disease is a common complication in heart transplant recipients and requires a comprehensive and personalized approach. The interplay between preexisting kidney disease, perioperative factors, immunosuppression, and cardiovascular complications makes the management of kidney dysfunction challenging in these patients. The objective of this expert consensus was to look for agreements for the management of chronic kidney disease in heart transplant recipients. A panel of Spanish cardiologists and nephrologists with expertise in heart and kidney transplantation reviewed the evidence related to the current management of chronic kidney disease in heart transplant recipients and consensus statements were developed using a 2-round Delphi methodology. Consensus statements were proposed covering key topics, including the identification and management of kidney disease in heart transplant recipients and the indications for kidney transplantation. These statements provide additional expert guidance for the management of kidney disease in patients undergoing heart transplantation where published clinical evidence is scarce.
Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video
Authors: Khanna Abhinav , Wolf Tamir , Frank Igor , Krueger Alexander , Shah Paras , Sharma Vidit , Gettman Matthew T , Boorjian Stephen A , Asselmann Dotan , Tollefson Matthew K
Published: February 2025

Background:

The creation of operative reports is a tedious documentation task that increases administrative burden, which is a potential driver of burnout. Additionally, operative reports are inherently subjective and may contain inaccuracies and incomplete information. Recent advances in artificial intelligence (AI) technology have enabled computer-vision systems to accurately detect operative steps on surgical video. We aim to develop a platform for automated creation of video-based AI surgical operative reports in robotic-assisted radical prostatectomy (RARP).

Study Design:

An AI computer-vision algorithm was employed to automatically detect surgical steps. Each step detected on video was mapped to pre-specified text, which was then compiled into a narrative AI operative report. Accuracy of the AI operative reports was compared to operative reports written by surgeons, using expert review of raw surgical video footage as the ground-truth.

Results:

158 cases from a tertiary referral center were included. In surgeon operative reports, 84(53.2%) cases had at least one discrepancy between the operative report and surgical video. Of these, 43(27.2%) cases had a clinically significant discrepancy based on expert video review. In AI operative reports, 46(29.1%) cases had at least one discrepancy between the operative report and surgical video. Of these, 20(12.7%) cases had a clinically significant discrepancy. Overall accuracy was higher for AI operative reports as compared to surgeon operative reports (87.3% versus 72.8%,p=0.001).

Conclusion:

Operative reports created by AI achieved higher accuracy than those written by surgeons. To our knowledge, this is the first report of automated video-based AI surgical documentation. Future studies are warranted to explore the potential for this novel tool to reduce documentation burden, improve operative report accuracy, promote surgical transparency, and decrease subjectivity in surgical documentation.
Fast traveling waves for an epidemic model
Authors: Dormy E. , Soward A. M.
Published: February 2025

Asymptotic solutions are investigated for the travelling wave consisting of infectives

I
(
x
−
c
t
)

propagating at speed
c
into a region of uninfected susceptibles

S
=

S

+

, on the basis that

S
+

is large. In the moving frame, three domains are identified. In the narrow leading frontal region, the infectives terminate relatively abruptly. Conditions ahead (increasing

x

) of the front control the speed
c
of the front advance. In the trailing region (decreasing

x

), the number of infectives decay relatively slowly. Our asymptotic development focuses on the dependence of

I

on

S

in the central region. Then, the apparently simple problem is complicated by the presence of both algebraic and logarithmic dependencies. Still, we can construct an asymptotic expansion to a high order of accuracy that embeds the trailing region solution. A proper solution in the frontal region is numerical, but here the central region solution works well too. We also investigated numerically the evolution from an initial state to a travelling wave. Following the decay of transients, the speed adopted by the wave is fast, though the slowest of those admissible. The asymptotic solutions are compared with the numerical solutions and display excellent agreement.
Lacrimispora sinapis sp. nov., isolated from pickled potherb mustard (Brassica juncea Coss.)
Authors: Ren Quanlu , Wang Danqi , Han Jin , Liu Zhenmin , Wu Zhengjun
Published: February 2025

Strain JR3T was isolated from Chinese pickled potherb mustard (Brassica juncea Coss.) purchased from a local market in Shanghai, China. A polyphasic approach including 16S rRNA gene sequence analysis, average nucleotide identity (ANI) analysis, digital DNA–DNA hybridization (dDDH), determination of G+C content and various phenotypic analyses was employed to characterize strain JR3T. The bacterium was rod-shaped, Gram-stain-positive, terminal round endospore-forming and catalase-positive. The strain could grow at a wide range of temperatures (20–45 °C) and pH values (6.0–8.0). Optimal growth of strain JR3T occurred at 35–40 °C and a pH value of 7.0. The strain exhibited growth at salt (NaCl) concentrations of up to 3% (w/v). The G+C content of the genomic DNA was 44.0 mol%. The major fatty acids were C16 : 0, C19 : 0 c9, 10, summed feature 10 (C18 : 1 c11/t9/t6) and C18 : 1 c9. 16S rRNA gene sequencing revealed that strain JR3T represents a member of the genus Lacrimispora, and it has higher sequence similarity with Lacrimispora amygdalina BR-10T (=DSM 12857T) (98.72%), Lacrimispora saccharolyticum WM1T (98.29%) and Lacrimispora xylanolytica sy1 (98.22%). The dDDH value for strain JR3T and phylogenetically related species within the genus Lacrimispora ranged from 17.7% to 29.9%. The ANI of strain JR3T with its closely related taxa was far lower than the threshold (95%−96%) used for species differentiation. Results of phylogenetic, physiological and phenotypic characterization confirmed that strain JR3T represented a novel species within the genus Lacrimispora, for which the name Lacrimispora sinapis sp. nov. is proposed. The type strain is JR3T=CCTCC AB 2024044T=LMG 33655T.
Crosstalk between cyclic-di-guanosine monophosphate and the sensor kinase MtrB regulates MtrA-dependent genes, bacterial growth, biofilm formation and lysosomal trafficking of Mycobacterium tuberculosis
Authors: Bagchi Shreya , Sharma Arun Kumar , Mal Soumya , Kundu Manikuntala , Basu Joyoti
Published: February 2025

Cyclic-di-guanosine monophosphate (c-di-GMP) plays an important role in bacterial signalling networks. C-di-GMP exerts a regulatory function through binding to diverse molecules that include transcription factors, riboswitches and sensor kinases (SKs), thereby regulating diverse processes. Here, we demonstrate the crosstalk between c-di-GMP and the SK MtrB of Mycobacterium tuberculosis. MtrB phosphorylates and regulates its cognate response regulator MtrA. C-di-GMP binds directly to the cytosolic domain of MtrB to inhibit its autophosphorylation. C-di-GMP levels in M. tuberculosis were manipulated by overexpressing a c-di-GMP synthesizing enzyme ydeH and a degrading enzyme rv1357c. We demonstrate that overexpression of ydeH lowers growth of the bacterium both in vitro and in M. tuberculosis grown in macrophages. This is in conformity with lowered expression of mtrA and selected genes of the mtrA regulon involved in cell wall turnover in the ydeH-overexpressing strain compared to the parent strain. We also demonstrate that overexpression of ydeH in M. tuberculosis hinders biofilm formation, whereas overexpression of rv1357c has the opposite effect. Neither of the two genes could rescue the biofilm defective phenotype of the MtrB knock out mutant (ΔmtrB), suggesting that c-di-GMP exerts its role on biofilm formation through MtrB. Finally, we show by fluorescence microscopy that the trafficking of M. tuberculosis overexpressing ydeH is significantly higher than that of the parent strain and that this is linked to reduced expression of the MtrB-dependent genes esxG and esxH, which play a role in subversion of lysosomal trafficking of M. tuberculosis. These results provide important new insight into the crosstalk between c-di-GMP and MtrB in M. tuberculosis.
The association between sleep trajectories throughout pregnancy and postpartum pain in individuals with overweight or obesity: a prospective cohort study
Authors: Hawkins Marquis S. , Chapa Danielle A. N. , Lim Grace , Goldschmidt Andrea B. , Meyer Michelle L. , Avorgbedor Forgive , Levine Michele D.
Published: February 2025

Background

Pain after childbirth affects maternal and infant outcomes. Although sleep influences pain in general adult populations, research on this during the perinatal period is limited. This study examines the association between sleep quality and duration changes from mid to late pregnancy and pain during postpartum hospitalization.

Methods

This secondary data analysis included 118 pregnant individuals (12-20 weeks gestation at enrollment) with a pre-pregnancy BMI ≥ 25 kg/m². The Pittsburgh Sleep Quality Index estimated sleep quality and duration at six prenatal visits. Group-based trajectory models identified distinct sleep patterns. Pain was assessed every 8 hours during the three-day postpartum hospitalization using a 0-10 numeric rating scale and was then calculated as the pain Area Under the Curve (AUC). Multivariable-adjusted linear regression analyzed the relationship between sleep trajectories and postpartum pain.

Results

Two trajectories for sleep quality and two for sleep duration were identified. The "Consistently poor" group showed increasing PSQI scores from 9 to 11, while the "Late worsening" group’s scores increased from 4 to 6. The "Late decreasing" duration group consistently slept 6-7 hours, while the "Consistently short" group maintained 5-6 hours nightly. No significant associations were found between sleep quality (expβ = 0.77, 95% CI: 0.51 to 1.17, p = 0.22) or duration (expβ = 0.75, 95% CI: 0.46 to 1.21, p = 0.24) and postpartum pain.

Conclusions

Sleep quality and duration changes during pregnancy were not associated with postpartum pain in this cohort. Future research should explore sleep’s impact on pain later in the postpartum period when chronic pain may develop.
Dual inhibition of lactate transporters MCT1 and MCT4 in pancreatic neuroendocrine tumors targets metabolic heterogeneity and functional redundancy
Authors: Bräutigam Konstantin , Straub Janine , Bihi Abdulloh K , Maire Renaud , Avanthay Simona , Filipova Kristyna , Andreasi Valentina , Battistella Anna , Kirchner Philipp P , Dettmer Matthias S , Schrader Jörg , Schiavo Lena Marco , Partelli Stefano , Falconi Massimo , Marinoni Ilaria , Sadowski Martin C , Perren Aurel
Published: February 2025

Our current understanding of the metabolic landscape of pancreatic neuroendocrine tumors (PanNETs) is very limited. Such knowledge could lead the development of novel therapeutic strategies for subgroups of PanNET patients based on the metabolic profile of their tumor. Here, we investigated the expression of lactate transporters MCT1 and MCT4 in two independent PanNET cohorts (n=93; n=70) and analyzed their association with tumor aggressiveness and therapeutic vulnerability in cell lines, spheroids and patient-derived tumoroids of PanNET. Immunohistochemistry revealed four expressor types: MCT1/4-negative, MCT1-positive, MCT4-positive, and MCT1/4-double positive with frequent regional co-expression. Both homogenous and heterogenous expression patterns were observed, indicating metabolic heterogeneity within the latter subset of PanNETs. MCT4 expression correlated with the hypoxia marker CA9, suggesting a hypoxic and acidic tumor microenvironment. Mechanistic studies revealed that MCT1 and MCT4 operate both as lactate efflux systems in PanNET cell lines, providing functional redundancy to their glycolytic roles. Inhibition of lactate efflux in normoxia and hypoxia using the dual MCT1/4 inhibitor syrosingopine significantly impaired lactate secretion, glycolysis, and proliferation across PanNET cell lines and 3D spheroid and patient-derived tumoroid models. In contrast, selective MCT1 or MCT4 inhibitors showed limited efficacy, underscoring the therapeutic need for co-targeting MCT1 and MCT4 due to functional redundancy and heterogenous expression. This work demonstrates MCT1 and MCT4 as metabolic markers and promising therapeutic targets of a subset of PanNETs with clinical features of aggressiveness.