bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular blood flow dynamics following sinus rhythm restoration through catheter ablation: laser speckle flowgraphy in patients with persistent atrial fibrillation
Authors: Yamamoto Nobuhiko , Nakano Makoto , Nochioka Kotaro , Yasuda Masayuki , Kunikata Hiroshi , Nakazawa Toru , Yasuda Satoshi 
Published: August 2024

Abstract

Aims
Laser speckle flowgraphy (LSFG) is a well-established tool renowned for its non-invasive and reproducible assessment of ocular blood flow. While rhythm control therapies, such as catheter ablation (CA), have shown promise in enhancing cognitive function in atrial fibrillation (AF) patients, the acute impact of CA on microcirculatory changes, particularly in ocular blood flow, remains a topic of limited understanding. The present study aims to delve into the potential of LSFG in detecting microcirculatory alterations following the restoration of sinus rhythm (SR) through CA in patients with AF.

Methods and results
We studied 8 paroxysmal AF (Paf) and 20 persistent AF (PeAF) patients (mean age 67 ± 6 years, 26% female) undergoing CA. Ocular blood flow was assessed using LSFG by measuring the mean blur rate (MBR) pre- and post-CA. Post-CA, all PeAF patients achieved SR restoration, resulting in a significant increase in tissue MBR (10.0 ± 2.2 to 10.8 ± 2.9, P = 0.021). In contrast, Paf patients showed no significant difference between pre- and post-MBR (12.0 ± 2.7 vs. 11.8 ± 2.6, P = 0.76).

Conclusion
LSFG analysis effectively identified microcirculatory changes in patients undergoing CA for PeAF, suggesting that therapeutic interventions targeting the heart may have broader implications for ocular and cerebral health, establishing a novel ‘cardio-oculo-cerebral relationship’.
Thoracic sarcopenia measured by Hounsfield unit average calculation predicts morbidity and mortality in coronary artery bypass grafting
Authors: Krombholz-Reindl Philipp , Winkler Andreas , Vötsch Andreas , Hitzl Wolfgang , Schernthaner Christiana , Hecht Stefan , Seitelberger Rainald , Gottardi Roman 
Published: August 2024

Abstract

OBJECTIVES
The aim of the study was to investigate the potential prognostic role of preoperative measurement of erector spinae myosteatosis with Hounsfield unit average calculation as a marker for sarcopenia and frailty in patients undergoing coronary bypass surgery.

METHODS
Preoperative computer tomography-derived measurements of 479 consecutive patients undergoing coronary bypass surgery between January 2017 and December 2019 were retrospectively performed. The erector spinae muscle at the level of the 12th vertebra was manually outlined bilaterally on the axial computer tomography slices and Hounsfield unit average calculation was performed. The lower quartile of muscle density values was defined as myosteatotic and thus sarcopenic. Sarcopenic (n = 121) versus non-sarcopenic patients (n = 358) were compared regarding postoperative morbidity and short- and long-term mortality. Results were adjusted for age, body mass index, atrial fibrillation and hypertension using inverse probability weighting.

RESULTS
Sarcopenia was associated with higher 30-day mortality (4.1% vs 0.8%; P = 0.012), mid-term mortality after 1 year (9.3% vs 3.1%; P = 0.047) and 2 years (10.8% vs 4.2%; P = 0.047). Long-term mortality (5 years) was 20.8% for sarcopenic and 13.0% for non-sarcopenic patients but was not found to be significantly different (P = 0.089). Sarcopenia was associated with higher rates of reintubation (7.5% vs 1.1%; P &lt; 0.001), sternal wound infections (7.5% vs 2.8%; P = 0.039) and acute kidney injury requiring haemodialysis (2.5% vs 0.4%; P = 0.021).

CONCLUSIONS
In patients undergoing coronary bypass surgery, sarcopenia was associated with increased short-term mortality, mid-term mortality and morbidity. The measurement of erector spinae myosteatosis could be an easy and useful parameter in preoperative risk assessment.
Revisiting Dominance in Population Genetics
Authors: Di Chenlu , Lohmueller Kirk E 
Published: August 2024

Abstract
Dominance refers to the effect of a heterozygous genotype relative to that of the two homozygous genotypes. The degree of dominance of mutations for fitness can have a profound impact on how deleterious and beneficial mutations change in frequency over time as well as on the patterns of linked neutral genetic variation surrounding such selected alleles. Since dominance is such a fundamental concept, it has received immense attention throughout the history of population genetics. Early work from Fisher, Wright, and Haldane focused on understanding the conceptual basis for why dominance exists. More recent work has attempted to test these theories and conceptual models by estimating dominance effects of mutations. However, estimating dominance coefficients has been notoriously challenging and has only been done in a few species in a limited number of studies. In this review, we first describe some of the early theoretical and conceptual models for understanding the mechanisms for the existence of dominance. Second, we discuss several approaches used to estimate dominance coefficients and summarize estimates of dominance coefficients. We note trends that have been observed across species, types of mutations, and functional categories of genes. By comparing estimates of dominance coefficients for different types of genes, we test several hypotheses for the existence of dominance. Lastly, we discuss how dominance influences the dynamics of beneficial and deleterious mutations in populations and how the degree of dominance of deleterious mutations influences the impact of inbreeding on fitness.
Advance Directives Revisited (2002 vs 2023): Are We Closer to Uniformity?
Authors: Luck George R , Bautista Adriana , Peters Darian , Attonito Jennifer , Fridman Sabina , Sohmer Joshua , Jacomino Mario 
Published: August 2024

Abstract

Background and Objectives
Advance directives (ADs) are based on state-specific statutes that vary in structure, terminology, and options. This variability leads to inconsistent end-of-life (EOL) care for patients who have executed an AD in 1 state but fall ill in another state. This study revisits a 2002 article that identified considerable differences in ADs to determine whether ADs have become more uniform.

Research Design and Methods
ADs from all 50 states and the District of Columbia were examined to determine the frequency of document types and seven key issues. The results were compared to the 2002 study using nonparametric approaches. Mean numbers of key issues were compared using t-tests and 1-way analysis of variance.

Results
Consistent with 2002, 3 states in 2023 provide statutes for a healthcare power of attorney (HCPOA). However, states offering a combined HCPOA, and living will (LW), deemed an advance directive for healthcare (ADHC), increased from 13 to 30. Between both studies, Long-Term Care increased significantly in LW and ADHC, whereas Artificial Sustenance significantly increased in LW. Despite the rising prevalence of Alzheimer’s in the United States, only 10% of states included this issue in 2023.

Discussion and Implications
Despite evolving healthcare trends, minimal revisions have been made to ADs since 2002. This lack of uniformity can cause confusion regarding the proper understanding of EOL wishes. The authors recommend that the Uniform Act for Advance Directives be revisited to promote greater uniformity in ADs and ensure that individuals’ preferences are understood and respected across different states.
Current status of global conservation and characterisation of wild and cultivated Brassicaceae genetic resources
Authors: Castillo-Lorenzo Elena , Breman Elinor , Gómez Barreiro Pablo , Viruel Juan 
Published: August 2024

Abstract

Background
The economic importance of the globally distributed Brassicaceae family resides in the large diversity of crops within the family and the substantial variety of agronomic and functional traits they possess. We reviewed the current classifications of crop wild relatives (CWRs) in the Brassicaceae family with the aim of identifying new potential cross-compatible species from a total of 1,242 species using phylogenetic approaches.

Results
In general, cross-compatibility data between wild species and crops, as well as phenotype and genotype characterisation data, were available for major crops but very limited for minor crops, restricting the identification of new potential CWRs. Around 70% of wild Brassicaceae did not have genetic sequence data available in public repositories, and only 40% had chromosome counts published. Using phylogenetic distances, we propose 103 new potential CWRs for this family, which we recommend as priorities for cross-compatibility tests with crops and for phenotypic characterisation, including 71 newly identified CWRs for 10 minor crops. From the total species used in this study, more than half had no records of being in ex situ conservation, and 80% were not assessed for their conservation status or were data deficient (IUCN Red List Assessments).

Conclusions
Great efforts are needed on ex situ conservation to have accessible material for characterising and evaluating the species for future breeding programmes. We identified the Mediterranean region as one key conservation area for wild Brassicaceae species, with great numbers of endemic and threatened species. Conservation assessments are urgently needed to evaluate most of these wild Brassicaceae.
Impact of reference design on estimating SARS-CoV-2 lineage abundances from wastewater sequencing data
Authors: Aßmann Eva , Agrawal Shelesh , Orschler Laura , Böttcher Sindy , Lackner Susanne , Hölzer Martin 
Published: August 2024

Abstract

Background
Sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA from wastewater samples has emerged as a valuable tool for detecting the presence and relative abundances of SARS-CoV-2 variants in a community. By analyzing the viral genetic material present in wastewater, researchers and public health authorities can gain early insights into the spread of virus lineages and emerging mutations. Constructing reference datasets from known SARS-CoV-2 lineages and their mutation profiles has become state-of-the-art for assigning viral lineages and their relative abundances from wastewater sequencing data. However, selecting reference sequences or mutations directly affects the predictive power.

Results
Here, we show the impact of a mutation- and sequence-based reference reconstruction for SARS-CoV-2 abundance estimation. We benchmark 3 datasets: (i) synthetic “spike-in”’ mixtures; (ii) German wastewater samples from early 2021, mainly comprising Alpha; and (iii) samples obtained from wastewater at an international airport in Germany from the end of 2021, including first signals of Omicron. The 2 approaches differ in sublineage detection, with the marker mutation-based method, in particular, being challenged by the increasing number of mutations and lineages. However, the estimations of both approaches depend on selecting representative references and optimized parameter settings. By performing parameter escalation experiments, we demonstrate the effects of reference size and alternative allele frequency cutoffs for abundance estimation. We show how different parameter settings can lead to different results for our test datasets and illustrate the effects of virus lineage composition of wastewater samples and references.

Conclusions
Our study highlights current computational challenges, focusing on the general reference design, which directly impacts abundance allocations. We illustrate advantages and disadvantages that may be relevant for further developments in the wastewater community and in the context of defining robust quality metrics.
Putting meat on the bone: how to fast-track innovative medicines to those who need them and generate data to justify continued use
Authors: Ollendorf Daniel , Henshall Christopher , Phillips Marie , Synnott Patricia , Sansom Lloyd , Tunis Sean 
Published: August 2024

Abstract
Regulatory agencies worldwide have taken significant steps to expedite approval and market authorization of medicines based on their potential to address areas of significant unmet medical need and severe disease burden. However, initial approval of such medicines is often accompanied by limited evidence of benefit, posing a conundrum for payers and health systems who may desire greater certainty of their value. This paper describes a system of “accelerated access” to manage these tensions and coordinate activities across stakeholders, based on discussions held at a multi-stakeholder convening in June 2023. We focus on 6 core, near-term actions that can be taken to improve the current system: clarifying criteria for expedited regulatory approval, enhancing stakeholder coordination, creating expedited pathways in payer and health technology assessment settings, developing joint regulatory/payer/health technology assessment guidance on study design and data needs, linking pricing policy to data uncertainty, and improving patient and public understanding of the processes involved as well as the risks and benefits of the relevant medicines. Many of these actions will require additional resources and personnel, and some will necessitate unprecedented levels of coordination. Nevertheless, each action is designed to work with minimal adjustments to the current system rather than demanding an entirely new approach.
Microbial communities living inside plant leaves or on the leaf surface are differently shaped by environmental cues
Authors: Mahmoudi Maryam , Almario Juliana , Lutap Katrina , Nieselt Kay , Kemen Eric 
Published: August 2024

Abstract
Leaf-associated microbial communities can promote plant health and resistance to biotic and abiotic stresses. However, the importance of environmental cues in the assembly of the leaf endo- and epi-microbiota remains elusive. Here, we aimed to investigate the impact of seasonal environmental variations, on the establishment of the leaf microbiome, focusing on long-term changes (five years) in bacterial, fungal, and nonfungal eukaryotic communities colonizing the surface and endosphere of six wild Arabidopsis thaliana populations. While leaf-microbial communities were found to be highly stochastic, the leaf niche had a predominant importance with endophytic microbial communities consistently exhibiting a lower diversity and variability. Among environmental factors, radiation- and humidity-related factors are the most important drivers of diversity patterns in the leaf, with stronger effects on epiphytic communities. Using linear models, we identified 30 important genera whose relative abundance in leaf compartments could be modeled from environmental variables, suggesting specific niche preferences for these taxa. With the hypothesis that environmental factors could impact interactions within microbial communities, we analyzed the seasonal patterns of microbial interaction networks across leaf compartments. We showed that epiphytic networks are more complex than endophytic and that the complexity and connectivity of these networks are partially correlated with the mentioned environmental cues. Our results indicate that humidity and solar radiation function as major environmental cues shaping the phyllosphere microbiome at both micro (leaf compartment) and macro (site) scales. These findings could have practical implications for predicting and developing field-adapted microbes in the face of global change.
The improbability of detecting trade-offs and some practical solutions
Authors: Johnson Marc T J , Nassrullah Zain 
Published: August 2024

Abstract
Trade-offs are a fundamental concept in evolutionary biology because they are thought to explain much of nature’s biological diversity, from variation in life-histories to differences in metabolism. Despite the predicted importance of trade-offs, they are notoriously difficult to detect. Here we contribute to the existing rich theoretical literature on trade-offs by examining how the shape of the distribution of resources or metabolites acquired in an allocation pathway influences the strength of trade-offs between traits. We further explore how variation in resource distribution interacts with two aspects of pathway complexity (i.e., the number of branches and hierarchical structure) affects tradeoffs. We simulate variation in the shape of the distribution of a resource by sampling 106 individuals from a beta distribution with varying parameters to alter the resource shape. In a simple “Y-model” allocation of resources to two traits, any variation in a resource leads to slopes less than −1, with left skewed and symmetrical distributions leading to negative relationships between traits, and highly right skewed distributions associated with positive relationships between traits. Adding more branches further weakens negative and positive relationships between traits, and the hierarchical structure of pathways typically weakens relationships between traits, although in some contexts hierarchical complexity can strengthen positive relationships between traits. Our results further illuminate how variation in the acquisition and allocation of resources, and particularly the shape of a resource distribution and how it interacts with pathway complexity, makes its challenging to detect trade-offs. We offer several practical suggestions on how to detect trade-offs given these challenges.
Ileocolic intussusception secondary to Peutz-Jeghers polyp: the need for oncological resection surgery
Authors: Ylli Kristali , Eljack Wala , Hayes Brian , Murphy Thomas 
Published: August 2024

Abstract
In this case report, we detail the management of a woman in her late 30s with ileocolic intussusception, emphasizing the high malignancy risk inherent in adult intussusception cases. Given the patient’s acute symptoms and significant family history of ovarian and breast cancers, radical oncological resection was pursued. The surgical intervention comprised a right hemicolectomy and right ovarian cystectomy, with histopathological findings revealing a Peutz-Jeghers polyp and benign thyroid tissue, but no malignancy. This case underscores the imperative for a surgical approach that anticipates the potential for malignancy in adult intussusception, advocating for radical resection as a fundamental strategy, even in the absence of confirmed malignant histopathology, to ensure comprehensive management and alignment with oncological best practices.
Autologous vascular proximal fibular graft in the treatment of giant cell tumor of the distal radius—a case report
Authors: Todorova Teodora , Gramatnikovski Nikola , Angelovska Tamara , Kostadinova-Kunovska Slavica , Manevska Nevena , Foteva Marta , Samardziski Milan 
Published: August 2024

Abstract
Giant cell tumor of bone (GCTB) represents an intermediate, locally aggressive tumor, with a peak of incidence in the third decade of life with female predominance (2:1). The distal radius is the third most common localization and especially challenging in the treatment is saving the wrist joint function. In this report, we present a case of a 32-year-old patient diagnosed with a giant cell tumor of the distal radius, primarily treated with curettage of the bone. Due to aggressive tumor recurrence, considering local control of the tumor, we decided to perform a resection of the distal radius and reconstruction with an autologous proximal vascular fibular graft. We performed a SPECT/CT scan to confirm the functionality of the graft. We find this procedure a safe technique for local control of tumor recurrence and an ideal substitute for a limb salvage procedure.
Delayed presentation of splenic laceration in a postpartum patient: a case of wandering spleen
Authors: Zayed Alaa , Samara Enas , Shubietah Abdalhakim , Awwad Ahmad , Zakaria Zaid , Daraghma Rawan , Hajhamad Mohammed 
Published: August 2024

Abstract
Wandering spleen (WS) is a rare condition where the spleen is abnormally mobile due to lax or poorly developed ligaments, leading to complications like torsion and laceration after trauma. We describe a case of a 31-year-old postpartum female who presented with severe abdominal pain following blunt trauma. Diagnostics showed an enlarged, ectopic spleen, and significant hematoma. Surgical exploration revealed a 10-cm splenic laceration, necessitating a splenectomy due to extensive blood loss and organ damage. This case highlights the challenges of diagnosing WS, particularly in postpartum patients with increased ligamentous laxity, emphasizing the need for vigilant monitoring and potentially preventive surgical measures to manage this complex condition effectively.
Type 2 diabetes: a sacrifice program handling energy surplus
Authors: Ye Jianping , Yin Jun 
Published: August 2024

Abstract
Type 2 diabetes mellitus (T2DM) is closely associated with obesity, while interactions between the two diseases remain to be fully elucidated. To this point, we offer this perspective to introduce a set of new insights into the interpretation of T2DM spanning the etiology, pathogenesis, and treatment approaches. These include a definition of T2DM as an energy surplus-induced diabetes characterized by the gradual decline of β cell insulin secretion function, which ultimately aims to prevent the onset of severe obesity through mechanisms of weight loss. The body employs three adaptive strategies in response to energy surplus: the first one is adipose tissue expansion to store the energy for weight gain under normal weight conditions; the second one is insulin resistance to slow down adipose tissue expansion and weight gain under overweight conditions; and the third one is the onset of T2DM following β cell failure to reverse the weight gain in obese conditions. The primary signaling molecules driving the compensatory responses are adenosine derivatives, such as adenosine triphosphate (ATP), acetyl coenzyme A (acetyl-CoA), and reduced nicotinamide adenine dinucleotide (NADH). These molecules exert their effects through allosteric, post-translational, and transcriptional regulation of metabolic pathways. The insights suggest that insulin resistance and T2DM are protective mechanisms in the defense against excessive adiposity to avert severe obesity. The perspective provides a unified framework explaining the interactions between the two diseases and opens new avenues in the study of T2DM.
Truth and Finite Conjunction
Authors: Luo Guanglong , Horsten Leon , Roberts Sam 
Published: August 2024

Abstract
This note is a critical response to Kentaro Fujimoto’s new conservativeness argument about truth, which centres on the notion of finite conjunction. We argue that Fujimoto’s arguments turn on a specific way of formalizing the notions of finite collection and finite conjunction in first-order logic. In particular, by instead formalizing these concepts in a natural way in set theory or in second-order logic, Fujimoto’s new conservativeness argument can be resisted.
Septic cardioembolic stroke secondary to infective endocarditis in a young patient with rheumatic heart disease: a case report
Authors: Buque Helena Agostingo , Namburete Evangelina , Vaz Deise Catamo , Sebasteão Frederico João , Baduro Yanina , Rosales Elder Lorenzo , Arroz Nachan , Bacallao Lazara , Pizzol Damiano , Smith Lee 
Published: August 2024

Abstract
The risk of stroke due to infective endocarditis is particularly high during the first week. Moreover, in low-resource settings where imaging access is limited, and diagnostic pathways are inaccurate the risk further increases. In addition to antibiotic therapy, treatment may include intravenous thrombolysis, with high risk of hemorrhagic complications in patients with infective endocarditis or mechanical thrombectomy. We report here a case of a 24-year-old male with rheumatic heart disease presenting a septic cardioembolic stroke secondary to infective endocarditis that was successfully treated in a low-resource setting.