bluuebunny/crossref_metadata_2025_split huggingface dataset:
Divine Counsel
Authors: Ballesteros Bernardo 
Published: November 2024

AbstractThe final chapter seeks to connect concepts about the gods to socio-political discourses concerning the human realm. It argues that Zeus’ rule is construed in ideal opposition to the political instability permeating the heroic world of Greek epos. This contrasts with Mesopotamian conceptions, where the mythological weakness of the divine ruler corresponds to a strongly centralized kingship institution in the historical record (§1). To explain these refractions, the chapter explores Mesopotamian intellectual discourses on power in connection to mythological poetry. It discusses limits encountered in historicizing Babylonian narrative poetry (§2); theologies of Enki/Ea, the god of wisdom and craft, and the divine adviser, who represents the linchpin between intellectual discourse and mythological poetry (§3); Ea in relation to intellectuals, poets and human advisers throughout Mesopotamian history (§4). The chapter concludes with a recapitulation of significant similarities and differences in the two corpora regarding divine power and poetics (§5).
Thediscidium-cycle
Authors: Franklinos T E 
Published: November 2024

AbstractThis chapter treats what one might call the discidium-cycle (3.15–25). Here Propertius, as poeta–amator, elaborates on the seafaring metaphor seen earlier in the book with a view to breaking free from his relationship with his beloved Cynthia and from the confines of amatory elegy (notably in 3.21), but he remains bound up in the amorous discourse and repetitive poetics that he has fashioned for himself in his poems; indeed, the elegist seems trapped by the language and themes that constitute the sphere from which he repeatedly fails to escape. In 3.24–5, Propertius acknowledges that his beloved is a construct and that he wishes to escape from their relationship and thus from the amatory elegy that she has embodied. His attempts at beginning a new relationship (3.20) and of undermining the premises of his and Cynthia’s one (3.15, 3.23) are unable to succeed until the book’s end.
Crowdsourced Assessment of Aesthetic Outcomes of Dorsal Preservation Rhinoplasty
Authors: Alford Jake A , McCleary Sean , Roostaeian Jason 
Published: November 2024

Abstract

Background
The inherent subjectivity in aesthetic outcomes presents a unique challenge in assessing rhinoplasty. Crowdsourcing has provided a new metric for objective analysis. The authors designed a retrospective study to compare the aesthetic outcomes of dorsal preservation rhinoplasty vs structural rhinoplasty.

Objectives
We aimed to objectively quantify the relative aesthetic advantages of performing a dorsal preservation technique. Additionally, we aimed to demonstrate the efficacy of crowdsourcing as an efficient and reliable method for evaluating any plastic surgery aesthetic outcome.

Methods
Patients’ preoperative and postoperative photographs were divided into 2 cohorts. Photographs were evaluated by crowdworkers on a secure online rating platform based on the overall nasal appearance, dorsal profile, dorsal aesthetic line symmetry, and dorsal contour, and rated their confidence about whether a patient had undergone surgery. A delta was calculated by comparing preoperative to postoperative states to represent an absolute value of improvement after surgery. Each cohort was compared with non-paired t tests.

Results
The structural rhinoplasty cohort included 34 patients. The dorsal preservation cohort included 30 patients. Both cohorts demonstrated improved aesthetic outcomes (dorsal preservation 0.300, 95% CI 0.047; structural 0.377, 95% CI 0.055). When raters were asked to predict whether a patient had surgery, the correlation coefficient of the structural cohort (0.74) suggested that a crowdworker was better able to identify whether a patient had surgery in those patients. The correlation coefficient in the dorsal preservation cohort (−0.0554) suggested that the raters were unable to identify which patients had surgery.

Conclusions
We found significant improvements in overall aesthetic outcomes with both techniques, although a more natural “unoperated” outcome was achieved when performing a dorsal preservation technique. We also provide evidence of the efficacy of crowdsourcing as an efficient and reliable method for evaluating aesthetic outcomes.

Level of Evidence: 4 (Therapeutic)
Insight into the post-translational modifications in pregnancy and related complications
Authors: Yin Yangxue , Liao Lingyun , Xu Qin , Xie Shuangshuang , Yuan Liming , Zhou Rong 
Published: November 2024

Abstract
Successful pregnancy is dependent on a number of essential events, including embryo implantation, decidualization, and placentation. Failure of the above process may lead to pregnancy-related complications, including preeclampsia, gestational diabetes mellitus, preterm birth, and fetal growth restriction, may affect 15% of pregnancies, and lead to increased mortality and morbidity of pregnant women and perinatal infants, as well as the occurrence of short-term and long-term diseases. These complications have distinct etiology and pathogenesis, and the present comprehension is still lacking. Post-translational modifications are important events in epigenetics, altering the properties of proteins through protein hydrolysis or the addition of modification groups to one or more amino acids, with different modification states regulating subcellular localization, protein degradation, protein–protein interaction, signal transduction, and gene transcription. In this review, we focus on the impact of various post-translational modifications on the progress of embryo and placenta development and pregnancy-related complications, which will provide important experimental bases for exploring new insights into the physiology of pregnancy and pathogenesis associated with pregnancy complications.
Human FCHO1 deficiency: review of the literature and additional two cases
Authors: Özdemiral Cansu , Yaz Ismail , Esenboga Saliha , Nabiyeva Cevik Nadira , Bildik Hacer Neslihan , Kilic Mehmet , Tezcan Ilhan , Cagdas Deniz 
Published: November 2024

Abstract
F-BAR domain only protein 1 (FCHO1) contributes as a critical component to an essential cellular process, clathrin-mediated endocytosis. Clathrin-mediated endocytosis involves cellular membrane invagination followed by cargo protein recruitment and adaptor protein assembly to form endocytic vesicles and maintains several cellular functions, such as signaling, differentiation, nutrition, absorption, and secretion. We aimed to determine the clinical/immunological findings of FCHO1 deficiency to generate an appropriate medical approach. We present clinical/immunological/genetic findings of two FCHO1 deficiency patients together with recently reported 17 patients. We found two different variants in the patients, one previously defined and one novel homozygous mutation [c.306C &gt; A (p.Tyr102Ter)]. Recurrent sinopulmonary infections occurred in all patients, with viral (63.1%) and fungal (52.6%) infections frequently reported. Lymphopenia and CD4 + T cell lymphopenia are present in 77.7% (14/18) and 100% of patients, respectively. CD8+ T cell number is low in half. Hypogammaglobulinemia and low IgM are present in 83.3% (15/18) and 61.1% (11/18) of patients, respectively. Neurological disorders (Guillian–Barre Syndrome, Moya-Moya disease, encephalitis, and cranial infarction) are common [n = 6 (31.5%)]. Malignancy is present in four (21%) patients, three suffered from diffuse large B cell lymphoma, and one developed Hodgkin lymphoma. Additional clinical and laboratory results from more patients helped to define the characteristics of FCHO1 deficiency. The early application of molecular genetic analysis in CID patients is crucial. Since all transplanted patients were alive, allogeneic hematopoietic stem cell transplantation emerged as a potential curative therapy.
The B-cells paradigm in systemic sclerosis: an update on pathophysiology and B-cell-targeted therapies
Authors: Scaletti Cristina , Pratesi Sara , Bellando Randone Silvia , Di Pietro Linda , Campochiaro Corrado , Annunziato Francesco , Matucci Cerinic Marco 
Published: November 2024

Abstract
Systemic sclerosis (SSc) is considered a rare autoimmune disease in which there are alterations of both the innate and adaptive immune response resulting in the production of autoantibodies. Abnormalities of the immune system compromise the normal function of blood vessels leading to a vasculopathy manifested by Raynaud’s phenomenon, an early sign of SSc . As a consequence of this reactive picture, the disease can evolve leading to tissue fibrosis. Several SSc-specific autoantibodies are currently known and are associated with specific clinical manifestations and prognosis. Although the pathogenetic role of these autoantibodies is still unclear, their production by B cells and plasma cells suggests the importance of these cells in the development of SSc. This review narratively examines B-cell dysfunctions and their role in the pathogenesis of SSc and discusses B-cell-targeted therapies currently used or potentially useful for the management of end-organ complications.
New workflow for the structure elucidation of trace amount natural products with microgram-scale crystalline sponge method: a scaled-down genome-mining study
Authors: Park Chieon , Mitsuhashi Takaaki , Wada Naoki , Kikuchi Takashi , Fujita Makoto 
Published: November 2024

Abstract
Genome mining, an effective approach to natural product discovery, often requires large-scale cultivation (several to dozens of liters). Here, we demonstrate that the crystalline sponge method significantly reduces the cultivation scale as the method requires only a microgram quantity of an analyte. Prior to the NMR study, we directly addressed the X-ray structure of a natural product from a terpene synthase, which was heterologously expressed by only a 25-mL scale cultivation.
Pre-emptive use of glucose 5% as the standard drug solvent reduces hypernatremia in critically ill patients
Authors: Hardenberg Jan-Hendrik B , Kunz Julius Valentin , Rubarth Kerstin , Mittermaier Mirja , Pigorsch Mareen , Balzer Felix , Witzenrath Martin , Hinz Ricarda Merle , Körner Roland , Eckardt Kai-Uwe , Knauf Felix , Hinrichs Carl , Enghard Philipp 
Published: November 2024

ABSTRACT

Background
Hypernatremia presents a common complication in intensive care unit (ICU) patients, associated with increased mortality and length of stay. This study investigates the effect of sodium chloride 0.9% compared with glucose 5% solution as the standard intravenous drug diluent on the prevalence of hypernatremia in a medical ICU.

Methods
This is a retrospective before-and-after study comparing two consecutive patient groups before and after the standard drug solvent was changed from sodium chloride 0.9% to glucose 5% solution for compatible medications. A total of 265 adult COVID-19 patients admitted between October 2020 and March 2021 to the study ICU were included, with 161 patients in the timeframe when sodium chloride 0.9% was employed as the standard drug solvent and 104 patients when glucose 5% was used. Routine sodium measurements from arterial and venous blood gases, along with heparinized lithium plasma, were analyzed. The daily sodium concentrations and the prevalence of severe hypernatremia (&gt;150 mmol/l) were assessed during the first 8 days after ICU admission.

Results
Baseline characteristics were similar between the two groups. The cumulative volume of intravenous drug diluents was comparable. In the glucose 5% group, about half of the total drug diluent volume was glucose 5% [mean (SD): 2251.6 (2355.4) ml], compared to 135.0 (746.9) ml (P &lt; .001) in the control group. Average sodium concentrations diverged after day two, with the glucose 5% group consistently showing lower sodium levels (mean difference of ∼2.5 mmol/l). Severe hypernatremia occurred less frequently in the glucose 5% group (6.6% vs. 20%).

Conclusion
Glucose 5% solution as the standard intravenous drug solvent significantly reduced sodium concentrations and the occurrence of severe hypernatremia. This simple modification in solvent choice may serve as a preventive strategy against hypernatremia in the ICU. Further prospective research is necessary to determine associated clinical outcomes.

Trial registration
The trial was registered in the German Clinical Trials Register (DRKS00031877).
Neuroimmune cross-talk in heart failure
Authors: Montuoro Sabrina , Gentile Francesco , Giannoni Alberto 
Published: November 2024

Abstract
Heart failure (HF) is characterized by autonomic nervous system (ANS) imbalance and low-grade chronic inflammation. The bidirectional relationship between the ANS and immune system (IS) is named ‘neuroimmune cross-talk’ (NICT) and is based on common signaling molecules, receptors, and pathways. NICT may be altered in HF, and neuroinflammation seems to be a main driver of HF progression.
In HF, heightened sympathetic nerve activity triggers inflammatory cascades that lead to cardiomyocyte death and myocardial interstitial fibrosis. Concurrently, parasympathetic withdrawal may impair the cholinergic anti-inflammatory pathway, with a less effective immune response to infections or inflammatory events. Additionally, microglial activation and inflammatory molecules contribute to autonomic imbalance by acting on central nuclei and peripheral visceral feedbacks, which in turn promote adverse cardiac remodeling, HF decompensation, and potentially life-threatening arrhythmias. Therefore, neuroinflammation has been identified as a potential target for treatment.
Pharmacological antagonism of the neurohormonal system remains the cornerstone of chronic HF therapy. While some drugs used in HF management may have additional benefits due to their anti-inflammatory properties, clinical trials targeting inflammation in patients with HF have so far produced inconclusive results. Nevertheless, considering the pathophysiological relevance of NICT, its modulation seems an appealing strategy to optimize HF management. Current research is therefore investigating novel pharmacological targets for anti-inflammatory drugs, and the immunomodulatory properties of denervation approaches and bioelectronic medicine devices targeting NICT and neuroinflammation in HF.
A deeper understanding of the complex relationship between the ANS and IS, as outlined in this review, could therefore facilitate the design of future studies aimed at improving outcomes by targeting NICT in patients with HF.
Factors influencing the cost-effectiveness of radiofrequency ablation for Barrett’s esophagus with low-grade dysplasia in Australia
Authors: Caush Lauren , Church Jody , Goodall Stephen , Lord Reginald V 
Published: November 2024

Abstract
Endoscopic eradication therapy using radiofrequency ablation (RFA) is considered an acceptable alternative to surveillance monitoring for Barrett’s esophagus with low-grade dysplasia (LGD). This study aimed to estimate whether RFA for LGD is cost-effective and to determine which factors influence cost-effectiveness. A Markov model was developed to estimate the incremental cost per quality-adjusted life year (QALY) gained for RFA compared with endoscopic surveillance. An Australian longitudinal cohort study (PROBE-NET) provides the basis of the model. Replacing surveillance with RFA yields 10 fewer cases of HGD and 9 fewer esophageal adenocarcinoma (EAC)-related deaths per 1000 patients’ treatment, given on average 0.192 QALYs at an additional cost of AU$9211 (€5689; US$6262) per patient (incremental cost-effectiveness ratio AU$47,815 per QALY). The model is sensitive to the rate of EAC from LGD health state, the utility values, and the number of RFA sessions. Hence, the incremental benefit ranges from 0.080 QALYs to 0.198 QALYs leading to uncertainty in the cost-effectiveness estimates. When the cancerous progression rate of LGD falls &lt;0.47% per annum, the cost-effectiveness of RFA becomes questionable. RFA treatment of LGD provides significantly better clinical outcomes than surveillance. The additional cost of RFA is acceptable if the LGD to EAC rate is &gt;0.47% per annum and no more than three RFA treatment sessions are provided. Accurate estimates of the risk of developing EAC in patients with LGD are needed to validate the analyses.
Labor Market Participation and Income in Patients With Inflammatory Bowel Disease Onset Before Young Adulthood—The Role of Disease Severity and Mental Health
Authors: Rasmussen Julie , Nørgård Bente Mertz , Bøggild Henrik , Qvist Niels , Everhov Åsa H , Malmborg Petter , Nielsen Rasmus Gaardskær , Brund René Børge Korsgaard , Fonager Kirsten 
Published: November 2024

Abstract

Background and Aims
Only few studies have examined the socioeconomic consequences of being diagnosed with inflammatory bowel disease (IBD) in childhood or youth. Disease severity has been linked to lower earnings, but little attention has been paid to comorbid mental health conditions. The aim is to examine labor market participation (LMP) and income in patients with IBD onset in childhood or youth and examine how disease severity and mental health conditions affect LMP.

Methods
In this register-based cohort study, we included patients with IBD onset before 25 years of age and matched comparators. We estimated the relative risk (RR) of having low LMP and the median yearly income from ages 26 to 30. RR of low LMP was also assessed in subgroups of patients based on disease severity (severe/nonsevere) and mental health conditions (yes/no).

Results
A total of 3398 patients with IBD and 28 207 comparators were included. Overall, patients with IBD more often had low LMP (16.4% vs 14.4% in comparators), but slightly higher income (median yearly income difference at age 30: 1141 Euro [95% CI, 483-1798]). In subgroup analyses, only patients with severe IBD had a higher risk of low LMP (RR: 1.46 [95% CI, 1.23-1.72]), whereas patients with nonsevere IBD did not. Among patients with severe disease and mental health conditions, 46% had low LMP (RR: 5.03 [95% CI, 4.38-5.78]).

Conclusions
Patients with IBD more often had low LMP, but their income was not affected. The subgroup of patients with severe disease and mental health conditions had the highest risk of low LMP.
Takotsubo syndrome induced by de novo left bundle branch area pacing: a case report
Authors: Thaitirarot Chokanan , Sze Shirley , Hafez Ahmed , Rajendra Raj , Ibrahim Mokhtar 
Published: November 2024

Abstract

Background
Takotsubo syndrome (TS), traditionally associated with emotional or physical stressors, manifests as transient left ventricular (LV) abnormalities mimicking acute coronary syndrome. Surgical procedures, such as pacemaker implantation, have emerged as potential TS triggers. Conduction system pacing (CSP), including His bundle pacing and left bundle branch area pacing (LBBAP), is a novel technique utilizing the heart's intrinsic conduction system. Despite documented cases of TS post-pacemaker implantation, the literature exploring the association between CSP and TS remains sparse.

Case summary
In a case involving a 62-year-old woman with 2:1 atrioventricular block, an uncomplicated de novo LBBAP procedure was followed by post-procedural dizziness and dyspnoea. An initial transthoracic echocardiography revealed moderate–severe LV dysfunction, accompanied by elevated troponin levels. Coronary angiography showed unobstructed coronary arteries, while left ventriculography exhibited a classic apical ballooning. The patient had a favourable recovery, with LV function improvement noted before discharge.

Discussion
Takotsubo syndrome may be triggered by other non-traditional physical stressors including traditional RV pacing and LBBAP. Clinicians should be aware of this potential, albeit rare, complication of LBBAP to ensure timely recognition and management. Increased awareness is vital for optimizing patient care during CSP procedures.
Subaortic pannus causing complete outlet obstruction after bioprosthetic aortic valve replacement in a patient with left ventricular assist device: a case report
Authors: Krishnaswamy Rohan Joshua , Sivasubramaniam Vanathi , Robson Desiree , Hayward Christopher Simon , Muthiah Kavitha 
Published: November 2024

Abstract

Background
Subaortic pannus formation complicates bioprosthetic aortic valve (AV) replacement. We report an extreme case in a continuous-flow left ventricular assist device (LVAD) patient.

Case summary
A 49-year-old Caucasian female with dilated cardiomyopathy was bridged to transplant with a HeartWare Ventricular Assist Device (Medtronic). Duration of support was prolonged, 6 years & 7 months, due to allosensitization requiring desensitization. Pump thrombosis occurred 2 years & 4 months post-LVAD requiring alteplase thrombolysis. The patient underwent bioprosthetic AV replacement 3 years & 10 months post-LVAD for symptomatic aortic incompetence. Transthoracic echocardiography (TTE) performed 1 year and 2 years post-bioprosthetic AV replacement repeatedly demonstrated an AV closed during all cardiac cycles without incompetence and nil flow through the left ventricular outflow tract (LVOT). Following transplant, analysis of explanted heart revealed a fused AV. A pannus adherent to the underside of the AV had formed across the entire AV outlet, with complete obliteration of LVOT. This subaortic pannus was not visualized on previous TTE. Histologically, the pannus consisted of hypocellular fibrous tissue with chronic inflammatory cells, spindle histiocytes, and myofibroblasts scattered throughout the loose fibromyxoid stroma, the latter highlighted on CD68 immunohistochemical stain (IHC). Partial endothelialization on the pannus surface was highlighted on ERG and CD31 IHC. Neither calcification nor signs of acute inflammation were noted. In contrast to previous cases, there was no evidence of associated thrombus macroscopically or microscopically.

Discussion
Prolonged LVAD support may facilitate subaortic pannus following bioprosthetic AV replacement due to AV closure and altered transvalvular flow. Due to the parallel LVAD circulation, subaortic pannus may develop asymptomatically, without haemodynamic compromise, allowing progression to total LVOT obstruction. This requires consideration prior to LVAD explantation in bridge-to-recovery patients.
Constraint on the background stress in the source region of the 2016 Kumamoto earthquake sequence based on temporal changes in elastic strain energies and coseismic stress rotation
Authors: Terakawa Toshiko , Asano Kimiyuki , Urata Yumi 
Published: November 2024

SUMMARY
We investigated the deviatoric stress magnitude of the background stress fields before the 2016 Kumamoto earthquake sequence in Japan based on temporal changes in elastic strain energies caused by the mainshock and coseismic stress rotation. We modelled the six components of background stress fields from stress orientations together with the parameter of effective friction coefficients (μ’ = 0.3, 0.15, 0.1, 0.05 and 0.03) using the 3-D Mohr diagram. We computed the absolute stress fields immediately following the primary events (the largest foreshock and mainshock) of the earthquake sequence by combining coseismic stress change fields with background stress fields. The total amount of elastic strain energy released by the mainshock increased with the effective friction coefficient. Considering the energy balance in which some part of the released energy must be consumed as radiated energy, we understood that the model with μ’ = 0.03 was unrealistic. We also examined the dependence of coseismic stress rotation on the effective friction coefficient. Furthermore, we applied a stress inversion method to moment tensor data of earthquakes to directly estimate coseismic stress rotation. Comparing the theoretical and estimated coseismic stress rotations, we concluded that the models with μ’ = 0.3 and 0.15 were more consistent with the observations than those with μ’ &lt; 0.1. In the reasonable models, the deviatoric stress magnitudes were 37–65 and 39−70 MPa at a depth of 10 km on the northern and southern source faults, respectively.