bluuebunny/crossref_metadata_2025 huggingface dataset:
The mechanical and clinical influences of prosthetic index structure in Morse taper implant-abutment connection: a scoping review
Authors: Shen Liheng , Dong Chengzhi , Chen Jianping , Bai Xiaolei , Yang Fan , Wang Linhong
Published: October 2023

Aim

The implant-abutment connection is a crucial factor in determining the long-term stability of dental implants. The use of a prosthetic index structure in the Morse taper implant-abutment connection has been proposed as a potential solution to improve the accuracy of this connection. This study aimed to provide a scoping review of the mechanical and clinical effects of the prosthetic index structure in the Morse taper implant-abutment connection.

Methods

A systematic scoping review of articles related to "dental implants," "Morse taper," and "index" was conducted using PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases, as well as a comprehensive literature search by two independent reviewers. Relevant articles were selected for analysis and discussion, with a specific focus on investigating the impact of prosthetic index structure on the mechanical and clinical aspects of Morse taper implant-abutment connections.

Results

Finally, a total of 16 articles that met the inclusion criteria were included for data extraction and review. In vitro studies have demonstrated that the use of a prosthetic index structure in the Morse taper implant-abutment connection can affect stress distribution, biomechanical stability, and reverse torque values, which may reduce stress within cancellous bone and help limit crestal bone resorption. However, retrospective clinical studies have shown that this structure is also associated with a higher risk of mechanical complications, such as abutment fracture and abutment screw loosening.

Conclusions

Therefore, the clinical trade-off between preventing crestal bone resorption and mechanical complications must be carefully considered when selecting appropriate abutments. The findings suggest that this structure can improve the accuracy and stability of the implant-abutment connection, but its use should be carefully evaluated in clinical practice.
Development of a multi-level family planning intervention for couples in rural Uganda: key findings & adaptations made from community engaged research methods
Authors: Muhumuza Christine , Sileo Katelyn M. , Wanyenze Rhoda K. , Kershaw Trace S. , Lule Haruna , Sekamatte Samuel , Kiene Susan M.
Published: October 2023

Background

Uganda has among the highest fertility rates in the world and multi-level barriers contribute to the low contraceptive use.

Objective

The objective of this study was to develop a culturally and socially relevant, community-based intervention to increase contraceptive use among couples in rural Uganda through community-engaged research methods. This study reports on the community-engaged research that informed the intervention’s content and structure and the final content of the intervention; the evaluation of the pilot intervention will be reported upon completion.

Methods

An intervention steering committee of community stakeholders reviewed the initially proposed intervention content and approach. Four (4) gender-segregated focus groups were conducted with twenty-six (26) men and women who had an unmet need for family planning. Fifteen key-informant interviews were conducted with community leaders and family planning stakeholders. Finally, the 4-session intervention was pilot tested with a cohort of couples (N = 7) similar in demographics to the target sample of the future pilot intervention trial. Qualitative data were analyzed thematically.

Results

Findings included the identification of community beliefs to reshape in order to increase family planning acceptance, as well as strategies to engage men, acceptable approaches for community leader involvement in the intervention to endorse family planning, and methods for managing gender dynamics and minimizing risk of unintended negative consequences of participation. The findings were used to inform the ideal structure and format of the intervention, including the distribution of contraceptives directly during group sessions, and identified the need to strengthen health worker capacity to provide Long-Acting Reversable Contraceptives (LARCs) as part of the intervention.

Conclusions

These findings were used to refine an intervention before a larger scale pilot test of its feasibility, acceptability, and potential efficacy. They can inform other multi-level family planning interventions in similar settings and the methods can be adopted by others to increase the feasibility, acceptability, and cultural relevance of interventions.
Applications of laser technology in the manipulation of human spermatozoa
Authors: Xue Yamei , Xiong Yuping , Cheng Xiaohong , Li Kun
Published: October 2023

The application of laser technology in the field of assisted reproductive technology (ART) has experienced rapid growth over the past decades owing to revolutionary techniques such as intracytoplasmic sperm injection (ICSI), preimplantation genetic testing (PGT), and in vitro manipulation of gametes and embryos. For male gametes, in vitro manipulation techniques include spermatozoa selection, sorting, immobilization, and quality assessment. A number of studies have been conducted to investigate the application of different laser technologies in the manipulation of human spermatozoa. However, there is a lack of a unified understanding of laser application in the in vitro manipulation of sperm and safety considerations in ART and, subsequently, the inability to make clear and accurate decisions on the clinical value of these laser technologies. This review summarizes the advancements and improvements of laser technologies in the manipulation of human spermatozoa, such as photobiomodulation therapy, laser trap systems for sperm analysis and sorting, laser-assisted selection of immotile sperm and laser-assisted immobilization of sperm prior to ICSI. The safety of those technologies used in ART is also discussed. This review will provide helpful and comprehensive insight into the applications of laser technology in the manipulation of human spermatozoa.
Clinical features of patients with previous spontaneous rupture of ovarian endometrioma operated electively: a case-control study
Authors: Gu Zhiyue , Li Xiaoyan , Dai Yi , Shi Jinghua , Wu Yushi , Zhang Chenyu , Li Qiutong , Yan Hailan , Leng Jinhua
Published: October 2023

Background

The aim of the study is to investigate the proportion and clinical features of previous spontaneously ruptured ovarian endometrioma among women who underwent elective surgery for endometrioma.

Methods

This retrospective study was based on a cohort of elective surgeries for endometrioma performed by the same gynecologic team at Peking Union Medical College Hospital from January 2017 to October 2022. Patients diagnosed with previous spontaneously ruptured endometrioma during elective surgery were enrolled in the ruptured group. In the same cohort, patients with unruptured endometrioma treated during the same period were selected as the unruptured group by 1:2 matching according to age. Demographic and clinical information were collected and compared between two groups.

Results

A total of 422 patients in the cohort were diagnosed with endometrioma. There were 38 patients (9.0%) in ruptured group and 76 patients in unruptured group. All enrolled participants were treated by laparoscopic surgery. In ruptured group, 86.8% patients had a history of acute abdominal pain, which was only 13.2% in unruptured group (P < 0.001). Compared to unruptured group, patients diagnosed with ruptured endometrioma had a lower BMI (P = 0.021), larger maximum diameter of endometrioma (P = 0.040), higher proportion of cul-de-sac partial obliteration rather than complete obliteration (P = 0.003).

Conclusions

Spontaneous rupture of endometrioma is not rare. The proportion of spontaneous rupture of endometrioma in our study was higher than that reported in the literatures. In women with endometrioma, the onset of acute abdominal pain should be considered a rupture of cyst, especially in patients with big cysts.
Identification of dual STRN-NTRK2 rearrangements in a high grade sarcoma, with good clinical response to first-line larotrectinib therapy
Authors: Lin Ruihe , Mallick Atrayee Basu , Wang Zi-Xuan , Brown Scot Andrew , Lu Bo , Jiang Wei
Published: October 2023

Background

Among the three NTRK genes, NTRK2 possesses a tremendous structural complexity and involves tumorigenesis of several types of tumors. To date, only STRN and RBPMS are identified in the fusion with NTRK2 in adult soft tissue tumors. More recently, the highly selective Trk tyrosine kinases inhibitors, including larotrectinib and entrectinib, have shown significant efficacy for treating tumors harboring NTRK fusions and were approved by FDA.

Case presentation

We report a case of sarcoma in a 35-year-old female harboring two STRN-NTRK2 gene fusions, with a good clinical response to first-line larotrectinib treatment. Core biopsy of the 16.5 cm gluteal mass showed a high-grade mesenchymal neoplasm with features reminiscent of a solitary fibrous tumor, but negative for STAT6. In-house next-generation sequencing gene fusion panel showed two in-frame STRN-NTRK2 fusions, which contain the same 5’ partner sequence (exon 1–3) of STRN, and the 3’ fusion partner starting from either the exon 15 or the exon 16 of NTRK2. Due to the large size and location of the tumor, first-line neoadjuvant therapy with larotrectinib was initiated. The patient has an excellent clinical response with an 83% tumor size reduction by imaging. The tumor was subsequently completely resected. After 130 days, larotrectinib was reinitiated for lung metastasis (up to 7 cm), and a complete resolution was achieved. When compared with NTRK1 and NTRK3, NTRK2 fusions are the least common. Of note, the only other report in the literature on NRTK2 fusion-positive sarcoma also showed solitary fibrous tumor (SFT)-like morphology, and the patient responded well to larotrectinib as the second line adjuvant therapy.

Conclusions

In conclusion, the identification of NTRK2 fusions in patients with soft tissue tumors could significantly improve the clinical outcome through selective NTRK inhibitor therapy, especially in the first-line setting. Prompt RNA-based NGS testing at initial diagnosis may benefit these patients. Our case is among the first few in the literature on NTRK2 fusion sarcoma with first-line larotrectinib therapy in the primary and metastatic setting, with good clinical response and minimal side effects.
E3 ligase TRIM28 promotes anti-PD-1 resistance in non-small cell lung cancer by enhancing the recruitment of myeloid-derived suppressor cells
Authors: Liang Manman , Sun Zhengui , Chen Xingwu , Wang Lijing , Wang Hanli , Qin Lilong , Zhao Wenying , Geng Biao
Published: October 2023

Background

Alterations in several tripartite motif-containing (TRIM) family proteins have been implicated in the pathogenesis of lung cancer. TRIM28, a member of the TRIM E3 ligase family, has been associated with tumorigenesis, cell proliferation, and inflammation. However, little is known about TRIM28 expression and its role in the immune microenvironment of non-small cell lung cancer (NSCLC).

Methods

We assessed the clinical significance of TRIM28 in tissue microarrays and TCGA cohorts. We investigated the function of TRIM28 in syngeneic mouse tumor models, theKrasLSL−G12D/+;Tp53fl/fl(KP) mouse model, and humanized mice. Immune cell composition was analyzed using flow cytometry and immunohistochemistry.

Results

Our findings revealed a positive correlation between TRIM28 expression and the infiltration of suppressive myeloid-derived suppressor cells (MDSCs) in NSCLC. Moreover, silencing TRIM28 enhanced the efficacy of anti-PD-1 immunotherapy by reshaping the inflamed tumor microenvironment. Mechanistically, we demonstrated that TRIM28 could physically interact with receptor-interacting protein kinase 1 (RIPK1) and promote K63-linked ubiquitination of RIPK1, which is crucial for sustaining activation of the NF-κB pathway. Mutagenesis of the E3 ligase domain corroborated the essential role of E3 ligase activity in TRIM28-mediated NF-κB activation. Further experiments revealed that TRIM28 could upregulate the expression of CXCL1 by activating NF-κB signaling. CXCL1 could bind to CXCR2 on MDSCs and promote their migration to the tumor microenvironment. TRIM28 knockdown increased responsiveness to anti-PD-1 therapy in immunocompetent mice, characterized by increased CD8+T tumor-infiltrating lymphocytes and decreased MDSCs.

Conclusion

The present study identified TRIM28 as a promoter of chemokine-driven recruitment of MDSCs through RIPK1-mediated NF-κB activation, leading to the suppression of infiltrating activated CD8+T cells and the development of anti-PD-1 resistance. Understanding the regulation of MDSC recruitment and function by TRIM28 provides crucial insights into the association between TRIM28 signaling and the development of an immunosuppressive tumor microenvironment. These insights may inform the development of combination therapies to enhance the effectiveness of immune checkpoint blockade therapy in NSCLC.
Creating the ICU of the future: patient-centred design to optimise recovery
Authors: Tronstad Oystein , Flaws Dylan , Patterson Sue , Holdsworth Robert , Fraser John F.
Published: October 2023

Background

Intensive Care survival continues to improve, and the number of ICU services is increasing globally. However, there is a growing awareness of the detrimental impact of the ICU environment on patients, families, and staff. Excessive noise and suboptimal lighting especially have been shown to adversely impact physical and mental recovery during and after an ICU admission. Current ICU designs have not kept up with advances in medical technology and models of care, and there is no current ‘gold-standard’ ICU design. Improvements in ICU designs are needed to optimise care delivery and patient outcomes.

Methods

This manuscript describes a mixed-methods, multi-staged participatory design project aimed at redesigning and implementing two innovative ICU bedspaces. Guided by the action effect method and the consolidated framework for implementation research, the manuscript describes the processes taken to ensure the patient-centred problems were properly understood, the steps taken to develop and integrate solutions to identified problems, and the process of implementation planning and rebuilding in a live ICU.

Results

Two innovative ICU bedspaces were rebuilt and implemented. They feature solutions to address all identified problems, including noise reduction, optimisation of lighting, access to nature via digital solutions, and patient connectivity and engagement, with solutions developed from various specialty fields, including IT improvements, technological innovations, and design and architectural solutions. Early evaluation demonstrates an improved lighting and acoustic environment.

Conclusions

Optimising the ICU bedspace environment and improving the lighting and acoustic environment is possible. The impact on patient outcomes needs to be evaluated.
Metabolic engineering of Thermoanaerobacterium aotearoense strain SCUT27 for biofuels production from sucrose and molasses
Authors: Dai Kaiqun , Qu Chunyun , Feng Jun , Lan Yang , Fu Hongxin , Wang Jufang
Published: October 2023

Background

Sucrose-rich sugarcane trash surpasses 28 million tons globally per year. Effective biorefinery systems could convert these biomasses to bioproducts, such as bioethanol from sugarcane sucrose in Brazil. Thermophilic microbes for biofuels have attracted great attention due to their higher fermentation temperature and wide substrate spectrum. However, few thermophiles using sucrose or molasses for biofuels production was reported. Thermoanaerobacterium aotearoense SCUT27 has been considered as an efficient ethanol producer, but it cannot directly utilize sucrose. In this study, various sucrose metabolic pathways were introduced and analyzed in Thermoanaerobaterium.

Results

The sucrose-6-phosphate hydrolase (scrB), which was from a screened strain Thermoanaerobacterium thermosaccharolyticum G3-1 was overexpressed in T. aotearoense SCUT27 and endowed this strain with the ability to utilize sucrose. In addition, overexpression of the sucrose-specific PTS system (scrA) from Clostridium acetobutylicum accelerated the sucrose transport. To strengthen the alcohols production and substrates metabolism, the redox-sensing transcriptional repressor (rex) in T. aotearoense was further knocked out. Moreover, with the gene arginine repressor (argR) deleted, the ethanologenic mutant P8S10 showed great inhibitors-tolerance and finally accumulated ~ 34 g/L ethanol (a yield of 0.39 g/g sugars) from pretreated cane molasses in 5 L tank by fed-batch fermentation. When introducing butanol synthetic pathway, 3.22 g/L butanol was produced by P8SB4 with a yield of 0.44 g alcohols/g sugars at 50℃. This study demonstrated the potential application of T. aotearoense SCUT27 for ethanol and butanol production from low cost cane molasses.

Conclusions

Our work provided strategies for sucrose utilization in thermophiles and improved biofuels production as well as stress tolerances of T. aotearoense SCUT27, demonstrating the potential application of the strain for cost-effective biofuels production from sucrose-based feedstocks.
N6-methyladenosine methylation in kidney injury
Authors: Wang Qimeng , Fan Xiaoting , Sheng Qinghao , Yang Meilin , Zhou Ping , Lu Shangwei , Gao Ying , Kong Zhijuan , Shen Ning , Lv Zhimei , Wang Rong
Published: October 2023

Multiple mechanisms are involved in kidney damage, among which the role of epigenetic modifications in the occurrence and development of kidney diseases is constantly being revealed. However, N6-methyladenosine (M6A), a well-known post-transcriptional modification, has been regarded as the most prevalent epigenetic modifications in higher eukaryotic, which is involved in various biological processes of cells such as maintaining the stability of mRNA. The role of M6A modification in the mechanism of kidney damage has attracted widespread attention. In this review, we mainly summarize the role of M6A modification in the progression of kidney diseases from the following aspects: the regulatory pattern of N6-methyladenosine, the critical roles of N6-methyladenosine in chronic kidney disease, acute kidney injury and renal cell carcinoma, and then reveal its potential significance in the diagnosis and treatment of various kidney diseases. A better understanding of this field will be helpful for future research and clinical treatment of kidney diseases.
Further refinement of the differentially methylated distant lung-specific FOXF1 enhancer in a neonate with alveolar capillary dysplasia
Authors: Szafranski Przemyslaw , Garimella Rijutha P. , Mani Haresh , Hartman Ryan , Deutsch Gail , Silk Alan , Benheim Alan , Stankiewicz Paweł
Published: October 2023

Heterozygous SNVs or CNV deletions involving the FOXF1 gene, or its distant enhancer, are causative for 80–90% of cases of alveolar capillary dysplasia with misalignment of pulmonary veins. Recently, we proposed bimodal structure and parental functional dimorphism of the lung-specific FOXF1 enhancer, with Unit 1 having higher activity on the paternal chr16 and Unit 2 on the maternal chr16. Here, we describe a novel unusually sized pathogenic de novo copy-number variant deletion involving a portion of the FOXF1 enhancer on maternal chr16 that implies narrowing Unit 2 to an essential ~ 9-kb segment. Using a restrictase-based assay, we found that this enhancer segment is weakly methylated at ApT adenine, with about twice the frequency of methylation on the maternal versus paternal chr16. Our data provide further insight into the FOXF1 enhancer structure and function.
Art driven by visual representations of chemical space
Authors: Gaytán-Hernández Daniela , Chávez-Hernández Ana L. , López-López Edgar , Miranda-Salas Jazmín , Saldívar-González Fernanda I. , Medina-Franco José L.
Published: October 2023

Science and art have been connected for centuries. With the development of new computational methods, new scientific disciplines have emerged, such as computational chemistry, and related fields, such as cheminformatics. Chemoinformatics is grounded on the chemical space concept: a multi-descriptor space in which chemical structures are described. In several practical applications, visual representations of the chemical space of compound datasets are low-dimensional plots helpful in identifying patterns. However, the authors propose that the plots can also be used as artistic expressions. This manuscript introduces an approach to merging art with chemoinformatics through visual and artistic representations of chemical space. As case studies, we portray the chemical space of food chemicals and other compounds to generate visually appealing graphs with twofold benefits: sharing chemical knowledge and developing pieces of art driven by chemoinformatics. The art driven by chemical space visualization will help increase the application of chemistry and art and contribute to general education and dissemination of chemoinformatics and chemistry through artistic expressions. All the code and data sets to reproduce the visual representation of the chemical space presented in the manuscript are freely available at https://github.com/DIFACQUIM/Art-Driven-by-Visual-Representations-of-Chemical-Space-.Scientific contribution: Chemical space as a concept to create digital art and as a tool to train and introduce students to cheminformatics.

Graphical Abstract
Effects of hTERT transfection on the telomere and telomerase of Periplaneta americana cells in vitro
Authors: Ma Chenjing , Li Xian , Ding Weifeng , Zhang Xin , Chen Hang , Feng Ying
Published: October 2023

Telomere and telomerase are crucial factors in cell division and chromosome stability. Telomerase activity in most cells depends on the transcription control by the telomerase reverse transcriptase (TERT). The introduction of an exogenous human TERT (hTERT) in cultured cells could enhance telomerase activity and elongate the lifespan of various cells. Telomere elongation mechanisms vary between insects and are complex and unusual. Whether the use of exogenous hTERT can immortalize primary insect cells remains to be investigated. In this study, we used a recombinant virus expressing hTERT to infect primary cultured cells of Periplaneta americana and evaluated its effects on insect cell immortalization. We found that hTERT was successfully expressed and promoted the growth of P. americana cells, shortening their doubling time. This was due to the ability of hTERT to increase the activity of telomerase in P. americana cells, thus prolonging the telomeres. Our study lays the foundation for understanding the mechanisms of telomere elongation in P. americana, and suggests that the introduction of hTERT into insect cells could be an efficient way to establish certain insect cell lines.
GHB: a life-threatening drug complications and outcome of GHB detoxification treatment—an observational clinical study
Authors: Neu Peter , Danker-Hopfe Heidi , Fisher Robert , Ehlen Felicitas
Published: October 2023

Background

GHB (gammahydroxybutyrate) and its precursors are popular recreational drugs due to their sedative, anxiolytic and sexually stimulating effects. Their use has been steadily increasing in recent years. The detoxification process is complex and prone to high rates of complications while little is known about the pathophysiology. This study aims to elucidate the characteristics of GHB-addicted patients and to evaluate the risks and complications of GHB withdrawal treatment.

Methods

This observational study describes prospectively the socioeconomic status, clinical history and course of inpatient detoxification treatment of a group of 39 patients suffering from GHB substance use disorder. Detoxification treatment took place in a highly specialized psychiatric inpatient unit for substance use disorders.

Results

GHB patients were characterised by being young, well-educated and by living alone. More than 50% of the patients had no regular income. The patients were male and female in equal numbers. Detoxification treatment was complicated, with high rates of delirium (30.8%) and high need for intensive care (20.5%).

Conclusions

In our sample, GHB users were young, well-educated people and male and female in equal number. Detoxification proved to be dangerous for GHB-addicted patients. The presence of delirium and the need for transfer to an intensive care unit during detoxification treatment was extraordinarily high, even with appropriate clinical treatment. The reasons for this remain unknown. Therefore an intensive care unit should be available for GHB detoxification treatment. Further studies are needed to evaluate the options for prophylactic treatment of delirium during detoxification.
A comprehensive analysis of gut and skin microbiota in canine atopic dermatitis in Shiba Inu dogs
Authors: Thomsen Mirja , Künstner Axel , Wohlers Inken , Olbrich Michael , Lenfers Tim , Osumi Takafumi , Shimazaki Yotaro , Nishifuji Koji , Ibrahim Saleh M. , Watson Adrian , Busch Hauke , Hirose Misa
Published: October 2023

Background

Like its human counterpart, canine atopic dermatitis (cAD) is a chronic relapsing condition; thus, most cAD-affected dogs will require lifelong treatment to maintain an acceptable quality of life. A potential intervention is modulation of the composition of gut microbiota, and in fact, probiotic treatment has been proposed and tried in human atopic dermatitis (AD) patients. Since dogs are currently receiving intensive medical care, this will be the same option for dogs, while evidence of gut dysbiosis in cAD is still missing, although skin microbial profiling in cAD has been conducted in several studies. Therefore, we conducted a comprehensive analysis of both gut and skin microbiota in cAD in one specific cAD-predisposed breed, Shiba Inu. Additionally, we evaluated the impact of commonly used medical management on cAD (Janus kinase; JAK inhibitor, oclacitinib) on the gut and skin microbiota. Furthermore, we genotyped the Shiba Inu dogs according to the mitochondrial DNA haplogroup and assessed its association with the composition of the gut microbiota.

Results

Staphylococcuswas the most predominant bacterial genus observed in the skin;Escherichia/ShigellaandClostridium sensu strictowere highly abundant in the gut of cAD-affected dogs. In the gut microbiota,FusobacteriaandMegamonaswere highly abundant in healthy dogs but significantly reduced in cAD-affected dogs. The abundance of these bacterial taxa was positively correlated with the effect of the treatment and state of the disease. Oclacitinib treatment on cAD-affected dogs shifted the composition of microbiota towards that in healthy dogs, and the latter brought it much closer to healthy microbiota, particularly in the gut. Additionally, even within the same dog breed, the mtDNA haplogroup varied, and there was an association between the mtDNA haplogroup and microbial composition in the gut and skin.

Conclusions

Dysbiosis of both the skin and the gut was observed in cAD in Shiba Inu dogs. Our findings provide a basis for the potential treatment of cAD by manipulating the gut microbiota as well as the skin microbiota.
Global diversity and biogeography of DNA viral communities in activated sludge systems
Authors: Fan Xiangyu , Ji Mengzhi , Mu Dashuai , Zeng Xianghe , Tian Zhen , Sun Kaili , Gao Rongfeng , Liu Yang , He Xinyuan , Wu Linwei , Li Qiang
Published: October 2023

Background

Activated sludge (AS) systems in wastewater treatment plants (WWTPs) harbor enormous viruses that regulate microbial metabolism and nutrient cycling, significantly influencing the stability of AS systems. However, our knowledge about the diversity of viral taxonomic groups and functional traits in global AS systems is still limited. To address this gap, we investigated the global diversity and biogeography of DNA viral communities in AS systems using 85,114 viral operational taxonomic units (vOTUs) recovered from 144 AS samples collected across 54 WWTPs from 13 different countries.

Results

AS viral communities and their functional traits exhibited distance-decay relationship (DDR) at the global scale and latitudinal diversity gradient (LDG) from equator to mid-latitude. Furthermore, it was observed that AS viral community and functional gene structures were largely driven by the geographic factors and wastewater types, of which the geographic factors were more important. Carrying and disseminating auxiliary metabolic genes (AMGs) associated with the degradation of polysaccharides, sulfate reduction, denitrification, and organic phosphoester hydrolysis, as well as the lysis of crucial functional microbes that govern biogeochemical cycles were two major ways by which viruses could regulate AS functions. It was worth noting that our study revealed a high abundance of antibiotic resistance genes (ARGs) in viral genomes, suggesting that viruses were key reservoirs of ARGs in AS systems.

Conclusions

Our results demonstrated the highly diverse taxonomic groups and functional traits of viruses in AS systems. Viral lysis of host microbes and virus-mediated HGT can regulate the biogeochemical and nutrient cycles, thus affecting the performance of AS systems. These findings provide important insights into the viral diversity, function, and ecology in AS systems on a global scale.
Secretory IgA impacts the microbiota density in the human nose
Authors: van Dalen Rob , Elsherbini Ahmed M. A. , Harms Mareike , Alber Svenja , Stemmler Regine , Peschel Andreas
Published: October 2023

Background

Respiratory mucosal host defense relies on the production of secretory IgA (sIgA) antibodies, but we currently lack a fundamental understanding of how sIgA is induced by contact with microbes and how such immune responses may vary between humans. Defense of the nasal mucosal barrier through sIgA is critical to protect from infection and to maintain homeostasis of the microbiome, which influences respiratory disorders and hosts opportunistic pathogens.

Methods

We applied IgA-seq analysis to nasal microbiota samples from male and female healthy volunteers, to identify which bacterial genera and species are targeted by sIgA on the level of the individual host. Furthermore, we used nasal sIgA from the same individuals in sIgA deposition experiments to validate the IgA-seq outcomes.

Conclusions

We observed that the amount of sIgA secreted into the nasal mucosa by the host varied substantially and was negatively correlated with the bacterial density, suggesting that nasal sIgA limits the overall bacterial capacity to colonize. The interaction between mucosal sIgA antibodies and the nasal microbiota was highly individual with no obvious differences between potentially invasive and non-invasive bacterial species. Importantly, we could show that for the clinically relevant opportunistic pathogen and frequent nasal resident Staphylococcus aureus, sIgA reactivity was in part the result of epitope-independent interaction of sIgA with the antibody-binding protein SpA through binding of sIgA Fab regions. This study thereby offers a first comprehensive insight into the targeting of the nasal microbiota by sIgA antibodies. It thereby helps to better understand the shaping and homeostasis of the nasal microbiome by the host and may guide the development of effective mucosal vaccines against bacterial pathogens.
Learning analytics to explore the motivational profiles of non-traditional practical nurse students: a mixed-methods approach
Authors: Kleimola Riina , López-Pernas Sonsoles , Väisänen Sanna , Saqr Mohammed , Sointu Erkko , Hirsto Laura
Published: October 2023

Learning analytics provides a novel means to examine various aspects of students’ learning and to support them in their individual endeavors. The purpose of this study was to explore the potential of learning analytics to provide insights into non-traditional, vocational practical nurse students’ (N = 132) motivational profiles for choosing their studies, using a mixed-methods approach. Non-traditional students were somewhat older learners than those following a more straightforward educational pathway and had diverse educational or professional backgrounds. Institutional admission data and analytics were used to identify their specific study motives and distinct motivational profiles, and to illustrate the connections between the motives emerging in the motivational profiles. Furthermore, the association between the motivational profiles and study performance was examined. The results of qualitative content analysis indicated that non-traditional practical nurse students pursued such specialized training for various reasons, and that pragmatic, professional rationales were emphasized over prosocial, altruistic factors. Through the adoption of person-centered latent class analysis, three motivational profiles were identified: self-aware goal-achievers, qualification attainers, and widely oriented humanitarians. Additionally, the analyses of epistemic networks for the profiles showed the complex interplay between the motives, confirming that some motive connections appear to be more prominent than others. Moreover, the findings indicated that study motives reported at admission did not seem to dictate students’ later study performance, as no statistically significant associations were found between the motivational profile and the students’ final grade point average or study dropout. This investigation paves the way for more-targeted motivational support and the use of learning analytics in the context of vocational education and training.
Intermittent fasting: consider the risks of disordered eating for your patient
Authors: Blumberg Jack , Hahn Samantha L. , Bakke Jesse
Published: October 2023

This is a commentary on “Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians” by Albosta et al. While this article adequately summarized the biochemical clinical advantages and limitations, we feel it failed to mention a few drawbacks, primarily the risk for disordered eating and eating disorders. Here we delve into the emerging data on intermittent fasting or time-restricted feeding in patient populations and urge clinicians to consider these risks prior to encouragement of intermittent fasting.
A bispectral index guided comparative evaluation of dexmedetomidine as an adjuvant to propofol-based total intravenous anaesthesia in spine surgeries done under motor-evoked potential monitoring
Authors: Anand Anshuman , Kumar Suraj , Kumar Virendra , Giri Manoj Kumar , Das Praveen Kumar , Sharma Deepti
Published: October 2023

Background

The anaesthetic agents can affect the quality of motor-evoked potential intraoperatively as they inhibit synaptic transmission. Intravenous anaesthetics suppress motor-evoked potential lesser than inhalational agents, so total intravenous anaesthesia or a combination of intravenous with minimal inhalational anaesthetic supplementation is used when motor-evoked potential is monitored. Motor-evoked potential can get depressed at high doses of propofol required to maintain surgical depth, hence, adjuvant agents like dexmedetomidine that maintain anaesthetic depth without affecting the motor-evoked potential are often required. This study was a prospective non-randomized and comparative study (quasi-experimental) assigned into two groups of 64 each, labelled as the propofol group (group P) and Propofol + dexmedetomidine group (group PD). The primary objective of our study was to compare the total dose reduction of propofol with the addition of dexmedetomidine and their interference with motor-evoked potential readings. The secondary objective was to assess the hemodynamic changes, changes in amplitude and latency of motor-evoked potential, and complications if any.

Results

The mean total dose of propofol consumed in our study was 502.81 ± 71.01 mg in group propofol( P) and 392.18 ± 59.00 mg in group propofol + dexmedetomidine (PD). Moreover, the mean total dose of propofol (mg) was significantly less used in group PD. Intraoperative hemodynamic stability, no difference in amplitude and latency for motor-evoked potential, and only significant bradycardia in group propofol + dexmedetomidine (PD).

Conclusions

Dexmedetomidine can be successfully used in propofol-based total intravenous anaesthesia for motor-evoked potential monitoring in spine surgeries, but it is better to maintain stable hemodynamics with a significant reduction of the mean dose of propofol.
A glance on Immunogenetics Laboratory: from the origins to the future
Authors: Madalese Donato , Casalino Rosaria , Auriemma Laura , Colucci Rosa , Di Maio Antonio , Tambaro Francesco Paolo , de Vera d’Aragona Roberta Penta
Published: October 2023

Histocompatibility and Immunogenetics (H&I) laboratories have currently a significant relevance in clinical and research medical fields. The purpose of this review is to investigate their role through an excursus between bioethics, histocompatibility history and laboratory organization. The histocompatibility laboratories play an essential role in the transplantation process, and, through their molecular techniques, they can affect clinical decisions in a remarkable way. Half a century has passed from the first paper, published in 1958, to the modern deep sequencing techniques; in these years through specific guidelines and international standards drafted by 2 specific bodies (ASHI and EFI), H&I laboratories are subjected to continuous controls by inspection authorities formed by professionals in the Immunogenetics field. For their functioning, H&I laboratories require: a structure and devices, a dedicated room and a clear path to samples workflow. In these laboratories, the personnel must be specialized even just in a single precise assignment, and every member is assigned to a role according to the experience matured over the years. In these laboratories, the role of Director/Co-Director or Technical Supervisor is usually assigned to a staff member with a minimum of 4 years of experience in Immunogenetics or transplantation fields, following the EFI/ASHI Standards. Bioethics is another important aspect because, in the last few years, there has been a major change in legal regulations on informed consent. The advent of digitization has pushed many laws on personal and genetic data treatment to be adapted to most modern guidelines, although they may differ according to the countries in Europe and USA. In the last years, the H&I laboratories turned as great resources with many clinical features and nowadays they may lead an important transformation in research and clinical fields.

Graphical abstract
Higher Maternal Body Mass Index Is Associated With Lower Placental Expression ofEPYC:A Genome-Wide Transcriptomic Study
Authors: Sordillo Joanne E , White Frédérique , Majid Sana , Aguet François , Ardlie Kristin G , Karumanchi S Ananth , Florez Jose C , Powe Camille E , Edlow Andrea G , Bouchard Luigi , Jacques Pierre-Etienne , Hivert Marie-France
Published: October 2023

Context

Elevated body mass index (BMI) in pregnancy is associated with adverse maternal and fetal outcomes. The placental transcriptome may elucidate molecular mechanisms underlying these associations.

Objective

We examined the association of first-trimester maternal BMI with the placental transcriptome in the Gen3G prospective cohort.

Methods

We enrolled participants at 5 to 16 weeks of gestation and measured height and weight. We collected placenta samples at delivery. We performed whole-genome RNA sequencing using Illumina HiSeq 4000 and aligned RNA sequences based on the GTEx v8 pipeline. We conducted differential gene expression analysis of over 15 000 genes from 450 placental samples and reported the change in normalized gene expression per 1-unit increase in log2 BMI (kg/m2) as a continuous variable using Limma Voom. We adjusted models for maternal age, fetal sex, gestational age at delivery, gravidity, and surrogate variables accounting for technical variability. We compared participants with BMI of 18.5 to 24.9 mg/kg2 (N = 257) vs those with obesity (BMI ≥30 kg/m2, N = 82) in secondary analyses.

Results

Participants’ mean ± SD age was 28.2 ± 4.4 years and BMI was 25.4 ± 5.5 kg/m2 in early pregnancy. Higher maternal BMI was associated with lower placental expression of EPYC (slope = −1.94, false discovery rate [FDR]-adjusted P = 7.3 × 10−6 for continuous BMI; log2 fold change = −1.35, FDR-adjusted P = 3.4 × 10−3 for BMI ≥30 vs BMI 18.5-24.9 kg/m2) and with higher placental expression of IGFBP6, CHRDL1, and CXCL13 after adjustment for covariates and accounting for multiple testing (FDR < 0.05).

Conclusion

Our genome-wide transcriptomic study revealed novel genes potentially implicated in placental biologic response to higher maternal BMI in early pregnancy.
Structural and Functional Brain Changes After Glucocorticoid Therapy in Thyroid-Associated Ophthalmopathy
Authors: Wu Qian , Zhou Jiang , Fang Wei , Jiang Wen-Hao , Pu Xiong-Ying , Chen Huan-Huan , Xu Xiao-Quan , Hu Hao , Wu Fei-Yun
Published: October 2023

Objective

To investigate the brain structural and functional alterations in patients with thyroid-associated ophthalmopathy (TAO) before and after glucocorticoid therapy, using voxel-based morphometry (VBM) as well as resting-state functional magnetic resonance imaging (MRI) with amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo).

Methods

Between 2019 and 2022, 32 patients with TAO and 23 healthy controls underwent pre-therapy MRI in Nanjing, China. Intravenous glucocorticoid therapy was administered to all patients. At 3 months after end of therapy, 26 patients were available for rescanned MRI. VBM, ALFF, and ReHo were used to evaluate the brain structural and functional differences.

Results

Before therapy, TAO patients showed significantly decreased gray matter volume (GMV) in the left orbital part of superior frontal gyrus (ORBsup) and medial superior frontal gyrus (SFGmed) than healthy controls. Patients had higher ALFF values in bilateral gyrus rectus and olfactory cortex and lower values in bilateral cuneus. Patients also showed decreased ReHo values in bilateral lingual gyrus. After therapy, increased GMV in the left anterior cingulate gyrus and SFGmed, increased ALFF values in bilateral cuneus and superior occipital gyrus, and increased ReHo values in bilateral SFGmed were found in TAO patients compared to the pre-therapy cohort. Compared to controls, decreased GMV in left ORBsup was observed in post-therapy TAO patients.

Conclusion

Our results indicated that TAO might cause functional and structural deficits in the visual and emotional regions of the brain, with recovery in the former and partial restoration in the latter after effective glucocorticoid therapy. These findings may lead to deeper understanding of the pathophysiological mechanism behind TAO.
Class A ventral spinal epidural hematoma as a rare complication of hypertensive crisis
Authors: Le Duc , Le Triet , Fredrickson Mark , Norbury John
Published: October 2023

Spinal epidural hematoma is a rare but severe medical condition that can cause neurological deficits and disability. In this case report, a 53-year-old man with poorly controlled hypertension and end-stage renal disease presented with hypertensive crisis and a one-week history of symptoms including back pain, abdominal pain, and pain radiating down his legs. Despite aggressive blood pressure control, the patient was found to have a 21mm ventral epidural hematoma at T10 causing thoracic cord compression and paraplegia. The patient underwent surgical hematoma evacuation but remained paraplegic with minimal motor and sensory recovery. Spinal epidural hematoma as a complication of hypertensive crisis is rare. Clinicians should be aware of the potential development of spinal epidural hematoma in patients with hypertensive crisis, even in cases with no obvious risk factors. Prompt diagnosis and treatment are crucial for preventing permanent neurological damage and improving patient outcomes. Further research is needed to better understand the underlying mechanisms and risk factors for spinal epidural hematoma in patients with hypertensive crisis.
The association of positive sepsis PCRs tests with patient mortality, length of stay, and antibiotic management in a medical intensive care unit
Authors: Solis Ximena , Batson Ben , Morataya Cristina , Iwuji Kenneth , Fairley Hannah , Chakkour Wadih , Nugent Kenneth , Islam Ebtesam
Published: October 2023

Background: Polymerase chain reaction (PCR) testing amplifies a specific DNA segment through heat cycling to identify pathogens for the diagnosis of infection.  This testing allows for rapid detection of pathogens, before conventional blood culture results become available. The high mortality associated with severe sepsis and septic shock stresses the importance of early diagnosis and initiation of early antibiotic therapy.  This study analyzed the association of the sepsis PCR results and antibiotic management, length of stay, and mortality outcomes in a medical intensive care unit (MICU).
Methods: This study is a retrospective, cross-sectional study on patients diagnosed with severe sepsis and septic shock based on ICD-10 codes, aged 18 years and older, admitted to the MICU at University Medical Center, Lubbock, Texas, between December 2016 to December 2020.
Results: Clinical information from 268 patients with the diagnosis of sepsis or septic shock was collected and analyzed. The mean age was 60.9 ± 15.6 years with a predominance of men (144, 53.7%) and Caucasian race (193,73.4%). A total of 101 patients (37.6%) had positive PCR results; overall, PCR test results had a diagnostic sensitivity of 91.2 %. The concordance between positive blood culture and positive PCR was 93.3 % (p <.0001). There was a significant correlation between PCR positivity and increased serum lactate levels (p=0.03), changes in antibiotics (P<0.00010), and increased mortality rate (p=0.04).  There was no significant correlation between PCR positivity and length of stay (p=0.84).
Conclusion: In this study, PCR testing was an accurate tool for early identification of bacterial pathogens. A positive PCR was associated with higher serum lactate levels, higher mortality rates, and an increased frequency of antibiotic changes but was not associated with shorter ICU length of stay.
 Key words: Sepsis, septic shock, PCR testing, outcomes
Trueperella bernardiae bacteremia in paraplegic patient with polymicrobial infection
Authors: Mazin Lauren , Peterson Christopher , Thomas Miles , Wang Yunan
Published: October 2023

Abstract: Trueperella bernardiae is an infrequently identified Gram-positive bacillus that has been isolated in various clinical infections. Here we report a case of T bernardiae infection in a paraplegic male and report antimicrobial susceptibilities.
Keywords: Trueperella bernardiae, polymicrobial infection, antibiotic resistance