bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of epileptiform electroencephalographic abnormalities in people without a history of seizures: A systematic review and meta‐analysis
Authors: Aschner Amir , Kowal Christine , Arski Olivia , Crispo James A. G. , Farhat Nawal , Donner Elizabeth
Published: December 2023

Abnormal patterns identified on electroencephalogram (EEG) are one of the primary diagnostic tests for epilepsy. However, epidemiological studies have established that both benign and epileptiform abnormalities (EAs) occur on the EEG of nonepileptic, seizure‐free people as well. The reported rates of EAs in nonepileptic, seizure‐free populations vary, and the true prevalence is unknown. The primary objective of this systematic review and meta‐analysis was to estimate the overall prevalence of EAs in the EEG of people without a history of seizures. Secondary aims were to characterize (1) the cortical localization of focal abnormalities, (2) the proportion of findings that occurred during standard EEG stimulation protocols, and (3) the persistence and implications of abnormalities at follow‐up. A comprehensive electronic search of six bibliographic databases was completed: Embase, MEDLINE, PsycInfo, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register for Controlled Trials, and Web of Science. No search date restrictions were applied. Overall effect size was calculated using a generalized linear mixed‐effects model. Fifty‐three studies, totaling 73 990 individuals, met our inclusion criteria. The overall point prevalence of EAs was 1.74% (95% confidence interval [CI] = 1.13–2.67). Due to the risk of bias in the literature, especially from participant selection, we believe this to be an overestimate of the true prevalence. Prevalence of EAs was greater in children (2.45%, 95% CI = 1.41–4.21) and the elderly (5.96%, 95% CI = 1.39–22.13) compared with adults (.93%, 95% CI = .48–1.80). Reports of developing epilepsy after an EA‐positive EEG were rare. The likelihood of subsequent positive findings on follow‐up EEG may be as high as 50%. Our study has limitations in that males were overrepresented in the study samples, there is substantial heterogeneity among studies, and many studies provided insufficient detail about their exclusion criteria. Nonetheless, our estimates provide benchmark data for future studies examining EAs in clinical populations, particularly behavioral and psychiatric populations.
Clinical dermatologic applications of ginger: a focused review
Authors: Alhanshali Lina , Khachemoune Amor
Published: December 2023

Ginger is a traditional herb with medicinal properties. Although most commonly utilized as a spice, it has been used for various medicinal ailments for thousands of years. Over the past century, the anti‐inflammatory, antioxidative, and antimicrobial properties of ginger have been increasingly studied. Ginger has been demonstrated to be beneficial for many conditions including dermatologic, gastrointestinal, neoplastic, and respiratory diseases. Herein, we examine the existing literature regarding the clinical uses of ginger with a focus on its dermatologic applications.
Acne excoriée: Diagnostic overview and management
Authors: Johnsen Nicole , Poppens McKayla , Cheng Kyle
Published: December 2023

Acne excoriée (AE) is a skin picking disorder (SPD) within the group of obsessive compulsive (OCD) and related disorders characterized by the compulsive manipulation of acne lesions. AE typically appears in females during adolescence or young adulthood and can cause significant disfigurement and psychosocial impairment. This disorder is under‐recognized due to patient discomfort to disclose excoriation habits or lack of behavior awareness. It is imperative that dermatologists accurately diagnose and treat this disorder to minimize long‐term damage to the skin. This review aims to provide an overview of the diagnosis and treatment options for AE.
Consumer acceptability, metabolite profile analysis and storage stability of sorghum‐Bambara groundnut mahewu
Authors: Akanni Gabriel Bidemi , Qaku Xolisile W. , Adetunji Adeoluwa , Dlamini Bhekisisa C.
Published: December 2023

Cereal‐based diets supplemented with legumes have proven to be an effective approach to enhancing nutritional value. This study evaluated the consumer acceptability and metabolite profile of fermented sorghum mahewu improved with different proportions (20% and 30%) of Bambara groundnut (BGN). Consumer acceptability, metabolite profile analysis using gas chromatography high‐resolution time‐of‐flight mass spectrometry (GC‐HRTOF‐MS), storage stability and microbial quality of mahewu were determined. Sorghum (100SORG) mahewu without BGN was the most preferred by the consumer panellists followed by 80SORG:20BGN. Metabolites identified in all three mahewu products included esters (21%), alcohols (17%), alkanes (12%), acids and derivatives (9%). Overall, 70SORG:30BGN had an improved metabolite profile but least preferred by consumer. The sorghum‐BGN mahewu maintained their pH, while increases in consistency and TTA were observed with storage time and BGN supplementation. Inclusion of BGN in sorghum mahewu did not alter microbial quality; however, more awareness is required to increase its acceptance among consumers.
Idiotopes of antibodies against HIV‐1 CD4‐induced epitope shared with those against microorganisms
Authors: Biswas Shashwata , Kuwata Takeo , Yamauchi Soichiro , Okazaki Kyo , Kaku Yu , Hasan Md Zahid , Morioka Hiroshi , Matsushita Shuzo
Published: December 2023

Induction of antibodies (Abs) against the conformational CD4‐induced (CD4i) epitope is frequent in HIV‐1 infection. However, the mechanism of development of anti‐CD4i Abs is unclear. We used anti‐idiotypic (aID) monoclonal Abs (mAbs) of anti‐CD4i mAbs to isolate anti‐CD4i mAbs from infected subjects and track the causative antigens. One anti‐aID mAb sorted from infected subjects by aID mAbs had the characteristics of anti‐CD4i Abs, including IGHV1‐69 usage and ability to bind to HIV‐1 Env enhanced by sCD4. Critical amino acid sequences for the binding of six anti‐aID mAbs, with shared idiotope to anti‐CD4i mAbs, were analysed by phage display. The identified amino acid sequences showed similarity to proteins from human microbiota and infectious agents. Peptides synthesized from Caudoviricetes sp and Vibrio vulnificus based on the identified sequences were reactive to most anti‐aID and some anti‐CD4i mAbs. These results suggest that anti‐CD4i Abs may evolve from B cells primed by microorganisms.
Dispersal movements of non‐native and native terrestrial slugs in an urban environment
Authors: Nyqvist Daniel , Ritchey Gabriella , Watz Johan
Published: December 2023

Animal movement varies from undirected dispersal to directed migration. Movement rates may have implications for conservation and resource management, as well as pest control, and they play a key role in invasion success. In slugs, long‐distance dispersal is typically passive, whereas active movement is critical for local dispersal and determines access to resources such as food and shelter. Telemetry has recently been used to study individual slug movements in the wild, whereas movement in arena tests has explored mechanisms of interspecific competition and invasiveness in slugs. Studies that relate the performance of individual slugs in arena tests to their post‐release behavior in nature are lacking. We measured individual short‐term movement speed of commonly occurring native and non‐native slugs of the genera Arion and Limax in arena tests and tracked their post‐release dispersal movements in a garden by PIT telemetry. We demonstrate clear differences in movement behavior among the species, but non‐native slugs did not display higher movement rates than their native congeners. In the arena test, slugs of the genus Limax displayed a higher short‐term speed than slugs of the genus Arion, whereas in the field, individuals of Limax maximus showed lower dispersal rates compared to the other slug species. Moreover, there was a positive correlation between short‐term speed in the arena test and movement in the field among individuals of L. cinereoniger, indicating the possible existence of behavioral syndromes in slugs, which may link movement ecology, animal personality, and the invasion ecology of pest species.
Risk factors associated with surgical site infections in patients undergoing cardiothoracic surgery: A systematic review and meta‐analysis
Authors: Zhang Yanfei , Tan Songtao , Chen Suning , Fan Xiaoping
Published: December 2023

Surgical site infections (SSIs) following cardiothoracic surgery can pose significant challenges to patient recovery and outcome. This systematic review and meta‐analysis aim to identify and quantify the risk factors associated with SSIs in patients undergoing cardiothoracic surgery. A comprehensive literature search adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines and based on the PICO paradigm was conducted across four databases: PubMed, Embase, Web of Science and the Cochrane Library, without any temporal restrictions. The meta‐analysis incorporated studies detailing the risk factors for post‐operative sternal infections, especially those reporting odds ratios (OR) or relative risks with 95% confidence intervals (CI). Quality assessment of the studies was done using the Newcastle‐Ottawa Scale. Statistical analysis was executed using the chi‐square tests for inter‐study heterogeneity, with further analyses depending on I2 values. Sensitivity analyses were performed, and potential publication bias was also assessed. An initial dataset of 2442 articles was refined to 21 articles after thorough evaluations based on inclusion and exclusion criteria. Patients with diabetes mellitus have an OR of 1.80 (95% CI: 1.40–2.20) for the incidence of SSIs, while obese patients demonstrate an OR of 1.63 (95% CI: 1.40–1.87). Individuals who undergo intraoperative blood transfusion present an OR of 1.13 (95% CI: 1.07–1.18), and smokers manifest an OR of 1.32 (95% CI: 1.03–1.60). These findings unequivocally indicate a pronounced association between these factors and an elevated risk of SSIs post‐operatively. This meta‐analysis confirms that diabetes, obesity, intraoperative transfusion and smoking heighten the risk of SSIs post‐cardiac surgery. Clinicians should be alert to these factors to optimise patient outcomes.
Reflections of the COVID‐19 pandemic on health problems of children with special needs
Authors: Dost Ayse , Kaya Sura , Kurucay Ramazan , Sezen Berkan , Akinci Mehmet , Sunal Nihal
Published: December 2023

Objective

This research aimed to examine changes caused by the COVID‐19 pandemic in activities of daily living and health status of children with special needs.

Method

The current descriptive and comparative study was carried out with 82 students studying at a special education practice school that provided daytime education to children with special needs before and during the COVID‐19 pandemic. The Personal Information Form, the Katz Index of Independence in Activities of Daily Living, and the Omaha System Problem Classification Scheme were employed as data collection tools in the research.

Results

The 10 most common problems during the COVID‐19 pandemic were stated as cognition (86.6%), mental health (75.6%), speech and language (85.4%), interpersonal relationships (79.3%), personal care (79.3%), social contact (64.6%), growth and development (63.4%), neighborhood/workplace safety (58.5%), communication with community resources (57.3%), and caretaking/parenting (n = 47, 57.3%). The incidence of “cognition,” “speech and language,” “neighborhood/workplace safety,” “communication with community resources,” and “caretaking/parenting” problems of children with special needs was significantly higher during the pandemic than before the pandemic (p < 0.05; p < 0.001).

Conclusion

The current research emphasized the significant impacts on the health of children with physical and mental disabilities and loss of opportunity, as their education was considerably interrupted during the quarantine. During a pandemic, the regular evaluation of health benefits/risks is essential to ensure the continuity of medical follow‐up, rehabilitation, education, and support mechanisms for children with disabilities.
Efficacy and safety of pharmacological intervention for smoking cessation in smokers with diseases: A systematic review and network meta‐analysis
Authors: Xing Xin , Shang Xue , Deng Xinxin , Guo Kangle , Fenfen E , Zhou Liying , Wang Yongsheng , Yang Chaoqun , Yang Kehu , Li Xiuxia
Published: December 2023

Objective

To investigate the most effective and best‐tolerated drugs for treating diseased smokers.

Methods

Eight databases were searched for randomized controlled trials (RCTs) involving different pharmacological interventions for smoking cessation in disease patients (January 2023). Network meta‐analysis was performed using STATA 15.1 software. The Cochrane Risk of Bias Tool assessed the risk of bias, and confidence in evidence was assessed using CINeMA.

Results

A total of 60 RCTs involving 13,009 patients of 12 disease categories were included. All trials reported 13 interventions, resulting in 78 comparisons. Network meta‐analysis showed that varenicline (OR = 2.30, 95% CI (1.77, 3.00)) and bupropion (OR = 1.65, 95% CI (1.29, 2.11)) showed favorable abstinence effects compared to placebo in the cardiovascular disease population. Nicotine replacement therapy (NRT) had better withdrawal advantages than placebo (OR = 11.18, 95% CI (2.25, 55.54)) in the chronic obstructive pulmonary disease (COPD) population. Some combination treatments showed better results than monotherapy, such as bupropion + NRT was superior to bupropion (OR = 8.45, 95% CI (1.84, 38.89)) and NRT (OR = 4.98, 95% CI (1.25, 19.78)) in mental illness population. The final surface under the cumulative ranking curve indicated that bupropion + NRT achieved the best smoking cessation effect. Overall confidence in the evidence was low. In a comparison of drugs, the results showed that bupropion + NRT had the best safety.

Conclusions

Most interventions show the benefit of quitting smoking compared with placebo, including monotherapy and combination therapy. Moreover, varenicline or bupropion combined with NRT is superior to some monotherapies.
Mechanisms of aquaporin‐4 vesicular trafficking in mammalian cells
Authors: Markou Andrea , Kitchen Philip , Aldabbagh Ahmed , Repici Mariaelena , Salman Mootaz M. , Bill Roslyn M. , Balklava Zita
Published: December 2023

The aquaporin‐4 (AQP4) water channel is abundantly expressed in the glial cells of the central nervous system and facilitates brain swelling following diverse insults, such as traumatic injury or stroke. Lack of specific and therapeutic AQP4 inhibitors highlights the need to explore alternative routes to control the water permeability of glial cell membranes. The cell surface abundance of AQP4 in mammalian cells fluctuates rapidly in response to changes in oxygen levels and tonicity, suggesting a role for vesicular trafficking in its translocation to and from the cell surface. However, the molecular mechanisms of AQP4 trafficking are not fully elucidated. In this work, early and recycling endosomes were investigated as likely candidates of rapid AQP4 translocation together with changes in cytoskeletal dynamics. In transiently transfected HEK293 cells a significant amount of AQP‐eGFP colocalised with mCherry‐Rab5‐positive early endosomes and mCherry‐Rab11‐positive recycling endosomes. When exposed to hypotonic conditions, AQP4‐eGFP rapidly translocated from intracellular vesicles to the cell surface. Co‐expression of dominant negative forms of the mCherry‐Rab5 and ‐Rab11 with AQP4‐eGFP prevented hypotonicity‐induced AQP4‐eGFP trafficking and led to concentration at the cell surface or intracellular vesicles respectively. Use of endocytosis inhibiting drugs indicated that AQP4 internalisation was dynamin‐dependent. Cytoskeleton dynamics‐modifying drugs also affected AQP4 translocation to and from the cell surface. AQP4 trafficking mechanisms were validated in primary human astrocytes, which express high levels of endogenous AQP4. The results highlight the role of early and recycling endosomes and cytoskeletal dynamics in AQP4 translocation in response to hypotonic and hypoxic stress and suggest continuous cycling of AQP4 between intracellular vesicles and the cell surface under physiological conditions.
Host‐switching events are not always the driver of speciation in social parasites: a case study in Temnothorax (Myrmoxenus) ants (Hymenoptera, Formicidae)
Authors: Báthori F. , Heinze J. , Trindl A. , Seifert B. , Herczeg G. , Csősz S.
Published: December 2023

Host–parasite systems, including social parasites that exploit resources of the host colonies, are fascinating objects for evolutionary biologists mainly due to the dynamic and often rapid host–parasite coevolution. Host‐switching events are believed to induce rapid speciation of parasitic species. The socially parasitic ant lineage Myrmoxenus, which corresponds to the monophyletic Temnothorax corsicus group, counts in total a dozen species. Most Myrmoxenus species utilize a single host species, but a few others, like Myrmoxenus ravouxi (André, 1896) and M. gordiagini Ruzsky, 1902, are known to use multiple host taxa. Myrmoxenus zaleskyi (Sadil, 1953) was described as a putative congener of M. ravouxi based on its distinct host selection. In this paper, we investigate the diversity of the widely distributed European lineages M. ravouxi and M. zaleskyi from multiple and complementary perspectives to understand whether the host preference exhibited by these two forms implies speciation. We integrated evidence from molecular genetics using mitochondrial CO I/CO II genes, including the tLeu‐region, and multivariate analyses of morphometric data collected from workers and female sexuals (gynes). Although there is substantial regional host species specificity, results suggest that host switching did not result in phylogenetic or morphological divergence and that the central European M. zaleskyi can be considered the junior synonym of M. ravouxi. As the lineage Myrmoxenus has been the subject of considerable evolutionary research, these results are essential to achieve a more accurate picture of host–parasite systems in the future and further strengthen the justification of an integrative approach in studying similarly complex systems. We advise against describing new parasitic species based on host preference unless coupled with marked heritable phenotypic adaptations.
Trade Liberalization, IMF Conditionality, and Policy Substitution in Developing Countries
Authors: Busse Matthias , Vogel Tim
Published: December 2023

Substantial tariff reductions and increased usage of non‐tariff measures (NTMs) have been key dynamics of global trade policy in recent decades. We use highly disaggregated data on applied most favored nation tariffs, NTMs, and trade to investigate how International Monetary Fund (IMF) conditionality as a form of external pressure to reduce tariffs contributed to this dynamic in developing countries. Our results show that structural adjustment programs (SAPs) effectively lowered tariffs without increasing the usage of NTMs. A typical three‐year program containing tariff conditionality decreased tariff rates in the range of 2.0 to 3.8 percentage points in total. Furthermore, IMF programs reduced NTM initializations significantly. We also show that tariff conditionality was more effective in initiating tariff cuts for countries without previous greater globalization efforts than being a “catalyst” for ongoing liberalization efforts.
Peripheral magnetic stimulation for chronic peripheral neuropathic pain: A systematic review and meta‐analysis
Authors: Dana Elad , Tran Cody , Osokin Evgeny , Westwood Duncan , Moayedi Massieh , Sabhaya Priyancee , Khan James S.
Published: December 2023

Objectives

To provide a systematic review of the literature on the effects of peripheral magnetic stimulation (PMS) in the treatment of chronic peripheral neuropathic pain.

Methods

A systematic search of MEDLINE, EMBASE, CENTRAL, CINHAL, Web of Science, and ProQuest was conducted from inception to July 2023 to identify studies of any design published in English language that enrolled adult patients (≥18 years) that received PMS for treatment of a chronic peripheral neuropathic pain disorder (pain > 3 months).

Results

Twenty‐three studies were identified which included 15 randomized controlled trials (RCTs), five case series, two case reports, and one non‐randomized trial. PMS regimens varied across studies and ranged from 5 to 240 min per session over 1 day to 1 year of treatment. Results across included studies were mixed, with some studies suggesting benefits while others showing no significant differences. Of nine placebo‐controlled RCTs, four reported statistically significant findings in favor of PMS use. In the meta‐analysis, PMS significantly reduced pain scores compared to control within 0–1 month of use (mean difference −1.64 on a 0–10 numeric rating scale, 95% confidence interval −2.73 to −0.56, p = 0.003, I2 = 94%, 7 studies [264 participants], very low quality of evidence), but not at the 1–3 months and >3 months of PMS use (very low and low quality of evidence, respectively). Minimal to no adverse effects were reported with PMS use.

Discussion

There is limited and low‐quality evidence to make definitive recommendations on PMS usage, however, the available data is encouraging, especially for short‐term applications of this novel modality. Large high‐quality randomized controlled trials are required to establish definitive efficacy and safety effects of PMS.
Case report: Dorsal root ganglion stimulator lead fracture
Authors: Kochat Suhas , Byers Jacob , Yi Peter K.
Published: December 2023

Background

One of the unique advances in neuromodulation for chronic pain has been spinal cord stimulators (SCS) and dorsal root ganglion stimulators (DRG‐S). These devices have aided in conditions such as neuropathic pain, complex regional pain syndromes, failed back surgery, and peripheral neuropathies. With these benefits, however, complications from implantable stimulators have included lead fractures and migration. The authors reviewed a lead migration, kinking, and subsequent fracture event involving a patient with complex regional pain syndrome (CRPS) II, who was treated with a DRG‐S.

Case Presentation

The case report follows this patient, from their past medical history to assessment of appropriate qualifications for neuromodulation, to successful surgical placement, to follow‐up care. The authors further monitored assessment of inefficacy of pain relief, and identification of lead migration and kinking through imaging. In the process of removal, due to lead stress, lead fracturing occurred. After lead removal, the leads were fully replaced, and the patient was followed up and experienced improved pain relief.

Conclusion

The case report assesses probable mechanisms of lead fracture and considerations for physicians for future assessment and triage of neuromodulation efficacy.
Live two‐way video versus face‐to‐face treatment for depression, anxiety, and obsessive‐compulsive disorder: A 24‐week randomized controlled trial
Authors: Kishimoto Taishiro , Kinoshita Shotaro , Kitazawa Momoko , Hishimoto Akitoyo , Asami Takeshi , Suda Akira , Bun Shogyoku , Kikuchi Toshiaki , Sado Mitsuhiro , Takamiya Akihiro , Mimura Masaru , Sato Yasunori , Takemura Ryo , Nagashima Kengo , Nakamae Takashi , Abe Yoshinari , Kanazawa Tetsufumi , Kawabata Yasuo , Tomita Hiroaki , Abe Koichi , Hongo Seiji , Kimura Hiroshi , Sato Aiko , Kida Hisashi , Sakuma Kei , Funayama Michitaka , Sugiyama Naoya , Hino Kousuke , Amagai Toru , Takamiya Maki , Kodama Hideyuki , Goto Kenichi , Fujiwara Shuichiro , Kaiya Hisanobu , Nagao Kiichiro ,   the J‐PROTECT collaborators
Published: December 2023

Aim

Live two‐way video, easily accessible from home via smartphones and other devices, is becoming a new way of providing psychiatric treatment. However, lack of evidence for real‐world clinical setting effectiveness hampers its approval by medical insurance in some countries. Here, we conducted the first large‐scale pragmatic, randomized controlled trial to determine the effectiveness of long‐term treatment for multiple psychiatric disorders via two‐way video using smartphones and other devices, which are currently the primary means of telecommunication.

Methods

This randomized controlled trial compared two‐way video versus face‐to‐face treatment for depressive disorder, anxiety disorder, and obsessive‐compulsive disorder in the subacute/maintenance phase during a 24‐week period. Adult patients with the above‐mentioned disorders were allocated to either a two‐way video group (≥50% video sessions) or a face‐to‐face group (100% in‐person sessions) and received standard treatment covered by public medical insurance. The primary outcome was the 36‐Item Short‐Form Health Survey Mental Component Summary (SF‐36 MCS) score. Secondary outcomes included all‐cause discontinuation, working alliance, adverse events, and the severity rating scales for each disorder.

Results

A total of 199 patients participated in this study. After 24 weeks of treatment, two‐way video treatment was found to be noninferior to face‐to‐face treatment regarding SF‐36 MCS score (48.50 vs 46.68, respectively; p < 0.001). There were no significant differences between the groups regarding most secondary end points, including all‐cause discontinuation, treatment efficacy, and satisfaction.

Conclusion

Two‐way video treatment using smartphones and other devices, was noninferior to face‐to‐face treatment in real‐world clinical settings. Modern telemedicine, easily accessible from home, can be used as a form of health care.
Athletic competition between the states: The rapid spread of Name, Image, Likeness laws and why it matters for understanding policy diffusion
Authors: Colvin Roshaun , Jansa Joshua M.
Published: December 2023

In the study of the policy diffusion process, scholars have found that states adopt policies to remain competitive with one another over economic resources. But the rapid spread of Name, Image, and Likeness (NIL) policies, which treat college athletes as professionals, is not readily explained by economic competition nor other diffusion mechanisms. The NIL phenomenon points to a new dimension of competition between the states, which is more closely tied to states protecting or enhancing their reputations than it is to directly accruing economic resources. To test if NIL spread as the result of athletic reputation competition, we model the adoption of NIL legislation as a function of internal characteristics (i.e. number, value, and ranking of college football programs) and interstate dynamics (i.e. actions of football, conference, and Power 5 competitors). We test the effect of these measures alongside traditional diffusion indicators, finding that both internal and interstate indicators of athletic competition drive states to adopt and implement NIL. NIL is important to study as it has changed the landscape of amateur sports, as well as our scholarly understanding of policy diffusion in the American federal system, specifically broadening our conceptualization of the competition mechanism and developing customized measures of it.
NnSnRK1‐NnATG1‐mediated autophagic cell death governs flower bud abortion in shaded lotus
Authors: Li Xiehongsheng , Xu Yingchun , Wei Zongyao , Kuang Jiaying , She Mingzhao , Wang Yanjie , Jin Qijiang
Published: December 2023

Many plants can terminate their flowering process in response to unfavourable environments, but the mechanisms underlying this response are poorly understood. In this study, we observed that the lotus flower buds were susceptible to abortion under shaded conditions. The primary cause of abortion was excessive autophagic cell death (ACD) in flower buds. Blockade of autophagic flux in lotus flower buds consistently resulted in low levels of ACD and improved flowering ability under shaded conditions. Further evidence highlights the importance of the NnSnRK1‐NnATG1 signalling axis in inducing ACD in lotus flower buds and culminating in their timely abortion. Under shaded conditions, elevated levels of NnSnRK1 activated NnATG1, which subsequently led to the formation of numerous autophagosome structures in lotus flower bud cells. Excessive autophagy levels led to the bulk degradation of cellular material, which triggered ACD and the abortion of flower buds. NnSnRK1 does not act directly on NnATG1. Other components, including TOR (target of rapamycin), PI3K (phosphatidylinositol 3‐kinase) and three previously unidentified genes, appeared to be pivotal for the interaction between NnSnRK1 and NnATG1. This study reveals the role of autophagy in regulating the abortion of lotus flower buds, which could improve reproductive success and act as an energy‐efficient measure in plants.
Statistical Approaches for the Reduction of Measurement Errors in Metrology
Authors: Gille Marc , Beaurepaire Pierre , Gayton Nicolas , Dumas Antoine , Yalamas Thierry
Published: December 2023

Metrology is extensively used in the manufacturing industry to determine whether the dimensions of parts are within their tolerance interval. However, measurement errors cannot be avoided. Metrology experts are of course aware of it and they are able to identify the different sources that contribute to making errors. In this paper, the probability density function of the measurement error is considered as a given input. As it is rare to have access to this distribution, there are very few methods in the literature that aim to use this knowledge directly to improve the measurements obtained in metrology. A first method is proposed to correct the effects of the measurement errors on the distribution that characterizes a set of measurements. Then a second method is proposed to estimate the true value that is hidden behind each single measurement, by removing the measurement error statistically. The second method is based on the output knowledge of the first, which is integrated with Bayesian statistics. The relevance of these two methods is shown through two examples applied on simulated data.
Emergency hysterectomy following iatrogenic injury to the descending branch of the uterine artery during colposcopy
Authors: Soleymani majd Hooman , Yancheva Slaveya , Abdul Beena , Hellner Karin
Published: December 2023

Large loop excision of the transformation zone is an extremely common procedure routinely carried out in a gynaecology or colposcopy outpatient setting under local anaesthetic. Here, we present a rare case resulting in emergency hysterectomy. A healthy para 3, who had been diagnosed with microscopic cancer of the cervix, attended colposcopy for repeat excision. The colposcopy revealed a normal cervix, and diathermy loop excision was performed. During the procedure, heavy bleeding from the anterior cutting edge was noted. Despite the best attempts to manage the haemorrhage conservatively in outpatients, the bleeding persisted, and the patient was transferred to theatres. Examination under anaesthesia revealed an injury to the descending branch of the uterine artery, and emergency hysterectomy was performed. Immediate recognition of an extremely rare complication, fast decision-making and a cross-disciplinary approach led to a satisfactory outcome.
PulmonaryMycobacterium abscessusinfection treated in combination with inhaled tigecycline
Authors: Pedersen Andreas Arnholdt , Fløe Andreas , Løkke Anders , Hilberg Ole
Published: December 2023

Pulmonary disease caused byMycobacterium abscessusis difficult to treat, as there is currently no reliable evidence-based treatment. Treatment is long, complex and has many side effects. In this case, we report a patient with treatment-refractory pulmonaryM.abscessusdisease, treated with inhaled tigecycline. Treatment with inhaled tigecycline lasted 15 months with comparably limited side effects. There were no positive mycobacterial cultures in the follow-up period of 2 years. Inhaled tigecycline is an option in the treatment of pulmonaryM. abscessuswhen first-line treatment fails. Additional research should investigate this further.
Acute myositis secondary to Epstein-Barr virus in the absence of infectious mononucleosis with severe rhabdomyolysis
Authors: Tuchinsky Adam , Montalvo Angela , Lent Dale , Goldman John
Published: December 2023

Rhabdomyolysis is characterised by muscle breakdown which causes myoglobin light chain release and can result in renal injury. While some of the most common causes of rhabdomyolysis are trauma related, others include toxins, autoimmune processes or viral aetiologies. We present the case of a 20s-year-old man, with no significant medical history, who presented to the emergency department with a 1-week history of weakness, myalgias, nausea, vomiting and subjective fevers. A review of systems and physical exam were otherwise unremarkable, including being negative for sore throat, dysphagia and lymphadenopathy. On presentation, the patient was noted to have dark urine with a creatine kinase value of 452 458 U/L and an elevated creatinine at 7.23 mg/dL. The patient denied any trauma or increased physical activity. His toxin screen and autoimmune workup were negative. The patient’s serological workup was significant for acute Epstein-Barr virus (EBV) infection, without additional viral coinfection or mononucleosis. During his hospitalisation course, the patient was managed with supportive care including haemodialysis. The patient made a full renal recovery and was discharged with scheduled outpatient follow-up. This case highlights the recognition of an acute EBV infection causing rhabdomyolysis in the absence of mononucleosis or concomitant infection.
Type A acute aortic dissection presenting as a stroke in a young male patient
Authors: Gonzalez Reyes Laura , Perez Del Nogal Genesis , Sierra David Juan , Bastidas Palacios Alexander
Published: December 2023

A male patient in his 40s with a history of nephrolithiasis and found in the desert after 10 days without oral intake was admitted to the hospital for severe dehydration, acute kidney injury and rhabdomyolysis. He had acute-onset loss of consciousness during hospitalisation with new left-sided hemiparesis and hemineglect. After haemorrhage was excluded, prompt thrombolysis was given. He later had chest pain and became hypotensive. An echocardiogram revealed pericardial effusion and dilation of the ascending aorta with suspected dissection. Magnetic resonance angiography of the brain and neck reported bilateral parieto-occipital areas of stroke in a watershed distribution and dissection of the right internal carotid artery. CT angiography showed type A aortic dissection from the ascending aorta extending into the bilateral common iliac arteries. Thrombolysis was reversed and the patient underwent ascending aorta replacement, resuspension of the aortic valve and aortic arch debranching at outside facility with complete recovery.
Dermatomyositis presenting with diffuse calcinosis
Authors: Walsh Madalyn , Bettendorf Brittany , Zahn Carleigh
Published: December 2023

We present the case of a woman in her early 50s who initially presented to an orthopedist for nodules located near the posterior knee. Imaging revealed diffuse subcutaneous calcifications and she was subsequently referred to rheumatology. Additional testing included myositis panel, electromyography (EMG) and muscle biopsy which indicated the presence of an inflammatory myopathy. It was determined that this patient had an uncommon presentation of dermatomyositis in which her primary complaint was calcinosis cutis. While rash and muscle weakness are often the symptoms most commonly associated with dermatomyositis, it is essential to have a wide differential for patients presenting with calcium deposition in soft tissues. This is particularly important in patients with certain antibodies, including the NXP-2 antibody, which can be associated with malignancy and should prompt an appropriate malignancy workup.
Eosinophilic enteritis in a case of cystic fibrosis: an elusive diagnosis with an elementary cure
Authors: Nageswaran Gomathy Aarthy , Chandrasekar Viveksandeep Thoguluva , Ghleilib Intisar , Yap John Erikson
Published: December 2023

A late adolescent man diagnosed with cystic fibrosis and presenting with predominantly gastrointestinal symptoms, including chronic constipation, exocrine pancreatic insufficiency and gastro-oesophageal reflux disease, experienced recurrent episodes of nausea, vomiting and abdominal pain. CT of the abdomen unveiled the presence of chronic appendicitis, alongside constipation without evidence of distal intestinal obstruction syndrome. Endoscopic biopsies revealed small bowel eosinophilic infiltrates. Subsequently, the patient underwent an appendectomy, and a tailored regimen was established to address constipation, resulting in an initial alleviation of his symptoms. Three months later, a resurgence of symptoms occurred, coinciding with persistent intestinal eosinophilic infiltrates. A diagnosis of eosinophilic enteritis was rendered, and treatment commenced with an oral dosage of 40 mg of prednisone. Two weeks later, the patient experienced symptom resolution, corroborated by the findings of an endoscopic biopsy conducted 8 weeks later. During a follow-up examination 6 months later, the patient remained asymptomatic.
Unusual approach to popliteal vein bypass graft stenosis following failed angioplasty in popliteal entrapment syndrome
Authors: Worrall Alice , Corrigan Amber Elyse , Slim Hani
Published: December 2023

Popliteal artery entrapment syndrome (PAES) is where the popliteal artery is compressed—typically by the medial head of the gastrocnemius muscle. PAES is typically treated surgically with popliteal artery release with or without bypass. Graft stenosis is a recognised complication of vein grafts. These are normally treated endovascularly. Endarterectomy of venous graft stenosis may be a useful tool in selected cases, where an endovascular approach was unsuccessful. Long-term follow-up of graft stenosis endarterectomy will allow us to determine effectiveness of this method of treatment where other options have failed.
Recurrent bilateral idiopathic chylothorax: a therapeutic challenge
Authors: Ng Boon Hau , Ban Andrea Yu-Lin , Nik Abeed Nik Nuratiqah , Abdul Hamid Mohamed Faisal
Published: December 2023

Chylothorax is a rare condition caused by pleural effusion resulting from thoracic duct injury. Recurrent chylothorax is often resistant to conservative treatment and presents a clinical conundrum in its management. Here, we report a compelling case of recurrent chylothorax that persisted despite the administration of total parenteral nutrition, octreotide and thoracic duct embolisation. The patient eventually required thoracic duct ligation and talc pleurodesis, which resulted in the resolution of the effusion. Our case is an illustrative example of the effective multidisciplinary management of recurrent bilateral idiopathic chylothorax.
Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial
Authors: Tiebie E G , Baerends E P , Boeije T , Frankenmolen P G , Lameijer H , van den Berg W , van Stralen K J , Ridderikhof M L , Bredenoord A J
Published: December 2023

Objective

To determine the efficacy and safety of cola in resolving complete oesophageal food bolus impaction.

Design

Open label, multicentre, randomised controlled trial.

Setting

Emergency departments of five Dutch hospitals at the secondary and tertiary level, between 22 December 2019 and 16 June 2022.

Participants

51 adults presenting with complete oesophageal food bolus impaction, defined as a sudden inability to pass saliva after consumption of foods. Patients who ingested meat that contained bones, and patients with an American Society of Anesthesiologists (ASA) physical status classification of IV or higher were excluded.

Interventions

28 patients in the intervention group were instructed to consume 25 mL cups of cola at intervals up to a maximum total volume of 200 mL. 23 patients in the control group awaited spontaneous passage. In either group, if complete resolution of symptoms did not occur, endoscopic removal was performed following current guidelines: within 6 hours for patients with complete obstruction, and within 24 hours for partial obstruction. In case of complete resolution of symptoms, elective diagnostic endoscopy was required.

Main outcome measures

Improvement of oesophageal food bolus obstruction as reported by patients (ie, aggregate of complete and partial passage), and evaluation of complete passage. The secondary outcome was any intervention related adverse event.

Results

Cola did not have a meaningful effect on the improvement of food bolus obstruction (17/28 (61%) interventionv14/23 (61%) control; odds ratio 1.00, 95% confidence interval 0.33 to 3.1; relative risk reduction 0.0, 95% confidence interval −0.55 to 0.36; P>0.99). Complete passage was reported more often in the intervention group but this difference was not significant (12/28 (43%) interventionv8/23 (35%) control; odds ratio 1.4 (0.45 to 4.4); relative risk reduction −0.23 (−1.5 to 0.39); P=0.58). No severe adverse events occurred. However, six (21%) patients in the intervention group experienced temporary discomfort after drinking cola.

Conclusions

In this study, cola consumption did not lead to a higher rate of improvement of complete oesophageal food bolus impaction. Given the lack of adverse events in the treatment group and some events of resolution after treatment, cola might be considered as a first line treatment, but should not delay any planning of endoscopic management.

Trial registration

Netherlands Trial Register (currently International Clinical Trial Registry Platform) NL8312.
Social determinants of health among people working on informal gold mines in French Guiana: a multicentre cross-sectional survey
Authors: Douine Maylis , Lambert Yann , Plessis Lorraine , Jimeno Irène , Galindo Muriel , Bardon Teddy , Le Tourneau François-Michel , Molinié Perrine , Vié Alexandre , Adenis Antoine , Nacher Mathieu , Figueira da Silva Amanda , Vreden Stephen , Suarez-Mutis Martha Cécilia , Sanna Alice
Published: December 2023

Introduction

Social determinants of health, such as living and working conditions, economical and environmental context and access to care, combine to impact the health of individuals and communities. In French Guiana (FG), the persons working in informal artisanal and small-scale gold mining in the rainforest are a particularly vulnerable population which lives in precarious conditions and far from the health system. Previous studies have demonstrated their high morbidity due to infectious diseases. This study aims to describe the social determinants of health in this specific population.

Methods

This international multicentre cross-sectional survey included people working on the informal FG gold mines at the crossing points located at both borders with Suriname and Brazil. After collecting written informed consent, a structured questionnaire was administered.

Results

From September to December 2022, 539 gold miners were included. These poorly educated migrants, mainly from Brazil (99.1%) did not have access to drinkable water (95.4%), lived in close contact with wild fauna by hunting, eating bushmeat or being bitten and were exposed to mercury by inhalation (58.8%) or ingestion (80.5%). They report frequent accidents (13.5%) and chronic treatment interruptions (26.6% of the 11.9% reporting chronic treatment). Half of them considered themselves in good health (56.4%).

Conclusion

This study shows a singular combination of adverse exposures of gold miners working in FG such as zoonoses, heavy metal poisoning, aggression of wild fauna. For ethical as well as public health reasons, actions towards health equity must be considered at different levels: individual, community, environmental, systemic and global level. As end users of minerals, we must assume our responsibilities for the well-being of the extractors by including health in political decisions to engage together in global health.

Trial registration number

NCT05540470.
Lifting all boats: strategies to promote equitable bidirectional research training opportunities to enhance global health reciprocal innovation
Authors: Muddu Martin , Jaffari Adiya , Brant Luisa C C , Kiplagat Jepchirchir , Okello Emmy , Masyuko Sarah , Su Yanfang , Longenecker Chris Todd
Published: December 2023

Inequities in global health research are well documented. For example, training opportunities for US investigators to conduct research in low-income and middle-income countries (LMIC) have exceeded opportunities for LMIC investigators to train and conduct research in high-income countries. Reciprocal innovation addresses these inequities through collaborative research across diverse global settings.

The Fogarty International Center of the US National Institutes of Health (NIH) promotes research capacity building in LMICs. Fogarty K-grants for mentored career development in global health are available for both US and LMIC investigators, whereas the D43 is the standard grant to support institutional training programmes in LMIC. Other NIH institutes fund T32 training grants to support biomedical research training in the USA, but very few have any global health component. Most global health training partnerships have historically focused on research conducted solely in LMIC, with few examples of bidirectional training partnerships. Opportunities may exist to promote global health reciprocal innovation (GHRI) research by twinning K-awardees in the USA with those from LMIC or by intentionally creating partnerships between T32 and D43 training programmes.

To sustain independent careers in GHRI research, trainees must be supported through the path to independence known as the K (mentored grantee)-to-R (independent grantee) transition. Opportunities to support this transition include comentorship, research training at both LMIC and US institutions and protected time and resources for research. Other opportunities for sustainability include postdoctoral training before and after the K-award period, absorption of trained researchers into home institutions, South-South training initiatives and innovations to mitigate brain drain.