bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial patterns and biodiversity in rock-paper-scissors models with regional unevenness
Authors: Menezes J , Tenorio M 
Published: May 2023

Abstract
Climate changes may affect ecosystems destabilising relationships among species. We investigate the spatial rock-paper-scissors models with a regional unevenness that reduces the selection capacity of organisms of one species. Our results show that the regionally weak species predominates in the local ecosystem, while spiral patterns appear far from the region, where individuals of every species play the rock-paper-scissors game with the same strength. Because the weak species controls all local territory, it is attractive for the other species to enter the local ecosystem to conquer the territory. However, our stochastic simulations show that the transitory waves formed when organisms of the strong species reach the region are quickly destroyed because of local strength unbalance in the selection game rules. Computing the effect of the topology on population dynamics, we find that the prevalence of the weak species becomes more significant if the transition of the selection capacity to the area of uneven rock-paper-scissors rules is smooth. Finally, our findings show that the biodiversity loss due to the arising of regional unevenness is minimised if the transition to the region where the cyclic game is unbalanced is abrupt. Our results may be helpful to biologists in comprehending the consequences of changes in the environmental conditions on species coexistence and spatial patterns in complex systems.
Total neoadjuvant therapy versus chemoradiotherapy for locally advanced rectal cancer: Bayesian network meta-analysis
Authors: Wu Qingbin , Zhou Jiahao , Huang Jun , Deng Xiangbing , Li Changtao , Meng Wenjian , He Yazhou , Wang Ziqiang 
Published: May 2023

Abstract

Background
Total neoadjuvant therapy is a promising treatment for locally advanced rectal cancer, utilizing either short-course radiotherapy or long-course chemoradiotherapy, but their relative efficacy remains unclear. The aim of this Bayesian network meta-analysis was to investigate clinical outcomes amongst patients receiving total neoadjuvant therapy with short-course radiotherapy or long-course chemoradiotherapy, and those receiving long-course chemoradiotherapy alone.

Methods
A systematic literature search was performed. All studies that compared at least two of these three treatments for locally advanced rectal cancer were included. The primary endpoint was the pathological complete response rate, and survival outcomes were adopted as secondary outcomes.

Results
Thirty cohorts were included. Compared with long-course chemoradiotherapy, both total neoadjuvant therapy with long-course chemoradiotherapy (OR 1.78, 95 per cent c.i. 1.43 to 2.26) and total neoadjuvant therapy with short-course radiotherapy (OR 1.75, 95 per cent c.i. 1.23 to 2.50) improved the pathological complete response rate. Similar benefits were observed in the sensitivity and subgroup analyses, except for short-course radiotherapy with one to two cycles of chemotherapy. No significant differences in survival outcomes were found amongst the three treatments. Long-course chemoradiotherapy with consolidation chemotherapy (HR 0.44, 95 per cent c.i. 0.20 to 0.99) exhibited higher disease-free survival than long-course chemoradiotherapy alone.

Conclusion
Compared with long-course chemoradiotherapy, both short-course radiotherapy with greater than or equal to three cycles of chemotherapy and total neoadjuvant therapy with long-course chemoradiotherapy can improve the pathological complete response rate, and long-course chemoradiotherapy with consolidation chemotherapy may lead to a marginal benefit in disease-free survival. The pathological complete response rate and survival outcomes are similar for total neoadjuvant therapy with short-course radiotherapy or long-course chemoradiotherapy.
Effect of selinexor on lipogenesis in virus-positive Merkel cell carcinoma cell lines
Authors: Landes Jennifer R , Bartley Brooke R , Moore Stephen A , He Qin , Simonette Rebecca , Rady Peter L , Doan Hung Q , Tyring Stephen K 
Published: May 2023

Abstract

Background
Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine cutaneous carcinoma aetiologically linked to the Merkel cell polyomavirus (MCPyV). Immune checkpoint inhibitors are currently the first-line therapy for metastatic MCC; however, the treatment is effective in only about half of patients, highlighting the need for alternative therapies. Selinexor (KPT-330) is a selective inhibitor of nuclear exportin 1 (XPO1) and has been shown to inhibit MCC cell growth in vitro, but the pathogenesis has not been established. Decades of research have established that cancer cells significantly upregulate lipogenesis to meet an increased demand for fatty acids and cholesterol. Treatments that inhibit lipogenic pathways may halt cancer cell proliferation.

Aim
To determine the effect of increasing doses of selinexor on fatty acid and cholesterol synthesis in MCPyV-positive MCC (MCCP) cell lines and aid in elucidating the mechanism by which selinexor prevents and reduces MCC growth.

Methods
MKL-1 and MS-1 cell lines were treated with increasing doses of selinexor for 72 h. Protein expression quantification was determined using chemiluminescent Western immunoblotting and densitometric analysis. Fatty acids and cholesterol were quantified using free fatty acid assay and cholesterol ester detection kits.

Results
Selinexor causes statistically significant reductions of the lipogenic transcription factors sterol regulatory element-binding proteins 1 and 2, and lipogenic enzymes acetyl-CoA carboxylase, fatty acid synthase, squalene synthase and 3β-hydroxysterol Δ-24-reductase in a dose-dependent manner in two MCCP cell lines. Although inhibiting the fatty acid synthesis pathway results in meaningful decreases in fatty acids, the cellular cholesterol levels did not demonstrate such reductions.

Conclusion
For patients with metastatic MCC refractory to immune checkpoint inhibitors, selinexor may provide clinical benefit through the inhibition of the lipogenesis pathway; however, further research and clinical trials are needed to evaluate these findings.
A UK-wide study to describe resource consumption and waste management practices in skin surgery including Mohs micrographic surgery
Authors: Shearman Harriet , Yap Soo Min , Zhao Andrew , Passby Lauren , Barrett Amy , Nikookam Yasmin  , Stoneham Sophie , Myint Nan Akari , Phillips Derrick , Dalal Fatima , Wylie Grant , Costley Matthew , Odedra Sunita , Phillips Mirain , Abbott Rachel A , Wernham Aaron  , Tso Simon ,   Dermatology Sustainability UK Group, Assad Adel , Aldiwani Mohanad , Bhat Aparna , Barkhadle Fatuma , Eghleilib Mohamed , Gnanappiragasam Dushyanth , Gamal Nahla , Haqiqi Ala , Hunt William , Nelson Toby , Kiana Adeela , Park Yoon Soo , Rahimi Mina , Shim Tang Ngee , Sillars Joanne , Tso Victoria , Woodcock Emma , Wilkinson Cairine , Aldiwani Mohanad , Gnanappiragasam Dushyanth 
Published: May 2023

Abstract

Background
There is a lack of national guidance specifying how skin surgery, including Mohs micrographic surgery (MMS), should be conducted, leading to a degree of heterogeneity in the set-up of skin surgery services and how skin surgeries are performed.

Objectives
To provide the first UK-wide cross-sectional study reporting real-world data on the set-up and waste management practices of skin surgery, including MMS.

Methods
A UK-wide service evaluation study was conducted between 1 March 2022 and 30 June 2022 using a standardized data collection pro forma. Twelve participating sites from England, Northern Ireland, Scotland and Wales provided data from 115 skin surgery lists involving 495 patients and 547 skin surgery procedures between 1 March 2022 and 30 June 2022.

Results
Mean total weight of nonsharps skin surgery waste was 0.52 kg per procedure (0.39 kg clinical waste, 0.05 kg general waste and 0.08 kg recycling waste). Data from a single site using disposable surgical instruments reported a mean of only 0.25 kg of sharps waste per procedure. The recycling rate ranged between 0% and 44% across the cohort with a mean recycling rate of 16%.

Conclusions
We advocate that staff transition to the British Society of Dermatological Surgery 2022 sustainability guidance, which made wide-ranging recommendations to facilitate staff to transition to sustainable practices in skin surgery.
Malassezia sympodialis Mala s 1 allergen is a potential KELCH protein that cross reacts with human skin
Authors: Corzo Leon Dora E , Scheynius Annika , MacCallum Donna M , Munro Carol A 
Published: May 2023

Abstract
Malassezia are the dominant commensal yeast species of the human skin microbiota and are associated with inflammatory skin diseases, such as atopic eczema (AE). The Mala s 1 allergen of Malassezia sympodialis is a β-propeller protein, inducing both IgE and T-cell reactivity in AE patients. We demonstrate by immuno-electron microscopy that Mala s 1 is mainly located in the M. sympodialis yeast cell wall. An anti-Mala s 1 antibody did not inhibit M. sympodialis growth suggesting Mala s 1 may not be an antifungal target. In silico analysis of the predicted Mala s 1 protein sequence identified a motif indicative of a KELCH protein, a subgroup of β-propeller proteins. To test the hypothesis that antibodies against Mala s 1 cross-react with human skin (KELCH) proteins we examined the binding of the anti-Mala s 1 antibody to human skin explants and visualized binding in the epidermal skin layer. Putative human targets recognized by the anti-Mala s 1 antibody were identified by immunoblotting and proteomics. We propose that Mala s 1 is a KELCH-like β-propeller protein with similarity to human skin proteins. Mala s 1 recognition may trigger cross-reactive responses that contribute to skin diseases associated with M. sympodialis.
Knowledge Production beyond West-Centrism in IR: Toward Global IR 2.0
Authors: Eun Yong-Soo 
Published: May 2023

Abstract
The primary purpose of this article is to advance the ongoing global international relations (Global IR) debate and to offer some possible paths toward Global IR 2.0. To this end, this article first analyzes how Global IR has emerged, what contributions it makes to giving new impetus to IR knowledge (production), and, more importantly, what charges are leveled against Global IR. Although Global IR has produced an important body of scholarship, contributing substantially to identifying West-centrism as a key point of contention in IR and nudging the discipline toward theoretical pluralism, Global IR in its current form still carries the risk of reinforcing the old hierarchical and essentialized structure of knowledge production in ways that are analytic, epistemological, and ontological. Following this critical mapping exercise, I argue that while Global IR can serve as a key signifier of challenge to West-centrism, this important signifier needs to be redefined in terms of what it indicates and means—thereby becoming Global IR 2.0. In onto-epistemological terms, Global IR 2.0 relates more directly to questioning and dissolving essentialized ways of knowing in the discipline. In the final section of this article, I elaborate on how to realize this idea and harness it in practice.
Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review
Authors: Sandoval María Macarena , Bardach Ariel , Rojas-Roque Carlos , Alconada Tomás , Gomez Jorge A , Pinto Thatiana , Palermo Carolina , Ciapponi Agustin 
Published: May 2023

Abstract

Background
Detailed information is needed on the dynamic pattern of antimicrobial resistance (AMR) in Neisseria gonorrhoeae in Latin America and the Caribbean (LAC).

Objectives
To conduct a systematic review of AMR in N. gonorrhoeae in LAC.

Methods
Electronic searches without language restrictions were conducted in PubMed, Embase, Cochrane Library, EconLIT, Cumulative Index of Nursing and Allied Health Literature, Centre for Reviews and Dissemination, and Latin American and Caribbean Literature in Health Sciences. Studies were eligible if published between 1 January 2011 and 13 February 2021, conducted in any LAC country (regardless of age, sex and population) and measured frequency and/or patterns of AMR to any antimicrobial in N. gonorrhoeae. The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO-GASP) for LAC countries and Latin American AMR Surveillance
Network databases were searched. AMR study quality was evaluated according to WHO recommendations.

Results
AMR data for 38, 417 isolates collected in 1990–2018 were included from 31 publications, reporting data from Argentina, Brazil, Colombia, Peru, Uruguay, Venezuela and WHO-GASP. Resistance to extended-spectrum cephalosporins was infrequent (0.09%–8.5%). Resistance to azithromycin was up to 32% in the published studies and up to 61% in WHO-GASP. Resistance to penicillin, tetracycline and ciprofloxacin was high (17.6%–98%, 20.7%–90% and 5.9%–89%, respectively). Resistance to gentamicin was not reported, and resistance to spectinomycin was reported in one study.

Conclusions
This review provides data on resistance to azithromycin, potentially important given its use as first-line empirical treatment, and indicates the need for improved surveillance of gonococcal AMR in LAC.
Trial registration: Registered in PROSPERO, CRD42021253342.
Wheat rhizosphere colonization by Bacillus amyloliquefaciens W10 and Pseudomonas protegens FD6 suppress soil and in planta abundance of the sharp eyespot pathogen Rhizoctonia cerealis
Authors: Zhang Qingxia , Liu Yinyin , Harvey Paul R , Stummer Belinda E , Yang Jinglong , Ji Zhaolin 
Published: May 2023

Abstract

Aims
Develop quantitative assays (qPCR) to determine the wheat rhizosphere competence of inoculant strains Bacillus amyloliquefaciens W10 and Pseudomonas protegens FD6, and their suppressive efficacies against the sharp eyespot pathogen Rhizoctonia cerealis.

Methods and results
Antimicrobial metabolites of strains W10 and FD6 decreased in vitro growth of R. cerealis. A qPCR assay for strain W10 was designed from a diagnostic AFLP fragment and the rhizosphere dynamics of both strains in wheat seedlings were compared by culture-dependent (CFU) and qPCR assays. The qPCR minimum detection limits for strains W10 and FD6 were log 3.04 and log 4.03 genome (cell) equivalents g−1 soil, respectively. Inoculant soil and rhizosphere abundance determined by CFU and qPCR were highly correlated (r &gt; 0.91). In wheat bioassays, rhizosphere abundance of strain FD6 was up to 80-fold greater (P &lt; 0.001) than strain W10 at 14 and 28 days postinoculation. Both inoculants reduced (P &lt; 0.05) rhizosphere soil and root abundance of R. cerealis by up to 3-fold.

Conclusions
Strain FD6 exhibited greater abundance in wheat roots and rhizosphere soil than strain W10 and both inoculants decreased the rhizosphere abundance of R. cerealis.
Unintended Intrauterine Death and Preterm Delivery: What Does Philosophy Have to Offer?
Authors: Colgrove Nicholas 
Published: May 2023

AbstractThis special issue of the Journal of Medicine and Philosophy focuses on unintended intrauterine death (UID) and preterm delivery (both phenomena that are commonly—and unhelpfully—referred to as “miscarriage,” “spontaneous abortion,” and “early pregnancy loss”). In this essay, I do two things. First, I outline contributors’ arguments. Most contributors directly respond to “inconsistency arguments,” which purport to show that abortion opponents are unjustified in their comparative treatment of abortion and UID. Contributors to this issue show that such arguments often rely on a grossly oversimplified picture of abortion opponents’ views. Furthermore, contributions in this issue weigh in on issues regarding UID with theoretical import and therapeutic implication beyond the inconsistency argument debate. These papers can be mined for principles that better inform us about anembryonic pregnancies (i.e., nonviable pregnancies in which a gestational sac exists but no embryonic pole can be seen via transvaginal ultrasound), UID-prevention research, the law concerning UID (especially post-Dobbs), policies for handling embryonic remains, and moral psychology as it relates to UID, emotion, and empathy. In each case, conceptual philosophical analysis might bring about therapeutic benefits for those affected by UID. Philosophers, therefore, are in position not only to provide clarity—careful analysis and discussion of UID and related phenomena—but are also in position to genuinely help people affected by UID.
Antitrust Economics of Cryptocurrency Mining
Authors: Deuflhard Florian , Heller C-Philipp 
Published: May 2023

Abstract
The development of blockchain-based applications, to date mostly virtual currencies, touches many areas of law and economics. The most well-known applications of public blockchains rely on Proof of Work as a consensus mechanism in which miners compete to solve a cryptographic puzzle. We argue that economic tools for market definition may be adapted to delineate relevant cryptocurrency mining markets. Antitrust law can help to prevent network attacks and exclusion of transactions with lower fees by large miners. When multiple blockchains are part of the same market, the role of network effects in securing the leading position of more established cryptocurrencies can potentially lead to exclusionary behaviour.
Pneumoperitoneum: always a surgical case?
Authors: Sandica Andreea , Baraksei Djawid , Hüsken Sabeth , Viebahn Richard , Snopok Iurii 
Published: May 2023

Abstract
Spontaneous idiopathic pneumoperitoneum (SIP) is a rare condition in the surgical practice. We introduce a case of an alcoholic male who presented with nausea, vomiting and diarrhea without clinical signs of peritonitis. A computed tomography of the abdomen showed free air distributed mainly along the ascending colon. We performed an emergency laparoscopy, which revealed no signs of perforation or bowl ischemia but showed air bubbles in the mesentery along the ascending colon. Subsequent endoscopy revealed unclassified inflammatory bowel disease manifesting in the rectum, erythematous mucosa and epithelialized erosions of the stomach. The patient discharged himself on Day 8 after the surgery. The causes of SIP are unknown, but some authors assume microperforation. SIP can be a challenge for the choice of therapy. Laparoscopy may be particularly beneficial in patients with generalized peritonitis, while patients with moderate symptoms may benefit from conservative treatment.
Sensitivity of Symptom-Based Screening for COVID-19 in Active Duty Basic Trainees
Authors: Matthews Zachary K , Cybulski Daniel J , Frankel Dianne N , Kieffer John W , Casey Theresa M , Osuna Angela B , Yun Heather C , Marcus Joseph E 
Published: May 2023

ABSTRACT

Introduction
Symptomatic Coronavirus Disease 2019 (COVID-19) screening has been a cornerstone of case identification during the pandemic. Despite the myriad of COVID-19 symptoms, symptom screens have primarily focused on symptoms of influenza-like illnesses such as fever, cough, and dyspnea. It is unknown how well these symptoms identify cases in a young, healthy military population. This study aims to evaluate the utility of symptom-based screening in identifying COVID-19 through three different COVID-19 waves.

Materials and Methods
A convenience sample of 600 military trainees who arrived at Joint Base San Antonio-Lackland in 2021 and 2022 were included. Two hundred trainees with symptomatic COVID-19 before the emergence of the Delta variant (February-April 2021), when Delta variant was predominant (June-August 2021), and when Omicron was the predominant variant (January 2022) had their presenting symptoms compared. At each time point, the sensitivity of a screen for influenza-like illness symptoms was calculated.

Results
Of the 600 symptomatic active duty service members who tested positive for COVID-19, the most common symptoms were sore throat (n = 385, 64%), headache (n = 334, 56%), and cough (n = 314, 52%). Although sore throat was the most prominent symptom during Delta (n = 140, 70%) and Omicron (n = 153, 77%), headache was the most common before Delta (n = 93, 47%). There were significant differences in symptoms by vaccination status; for example, ageusia was more common in patients who were not completely vaccinated (3% vs. 0%, P = .01). Overall, screening for fever, cough, or dyspnea had a 65% sensitivity with its lowest sensitivity in the pre-Delta cases (54%) and highest sensitivity in Omicron cases (78%).

Conclusions
In this descriptive cross-sectional study evaluating symptomatic military members with COVID-19, symptom prevalence varied based on predominant circulating COVID-19 variant as well as patients’ vaccination status. As screening strategies evolve with the pandemic, changing symptom prevalence should be considered.
Traumatic Transradial Forearm Amputation Temporized With Extracorporeal Membrane Oxygenation: A Brief Report
Authors: Hegeman Erik M , Fisher Miles W A , Cognetti Daniel J , Plucknette Benjamin F , Alderete Joseph F , Wilson David , Causey Marlin Wayne 
Published: May 2023

ABSTRACT

Introduction
Extracorporeal membrane oxygenation (ECMO) is typically used to provide mechanical perfusion and gas exchange to critically ill patients with cardiopulmonary failure. We present a case of a traumatic high transradial amputation in which the amputated limb was placed on ECMO to allow for limb perfusion during bony fixation and preparations and coordination of orthopedic and vascular soft tissue reconstructions.

Materials and Methods
This is a descriptive single case report which underwent managment at a level 1 trauma center. Instutional review board (IRB) approval was obtained.

Results
This case highlights many important factors of limb salvage. First, complex limb salvage requires a well-organized, pre-planned multi-disciplinary approach to optimize patient outcomes. Second, advancements in trauma resuscitation and reconstructive techniques over the past 20 years have drastically expanded the ability of treating surgeons to preserve limbs that would have otherwise been indicated for amputation. Lastly, which will be the focus of further discussion, ECMO and EP have a role in the limb salvage algorithm to extend current timing limitations for ischemia, allow for multidisciplinary planning, and prevent reperfusion injury with increasing literature to support its use.

Conclusions
ECMO is an emerging technology that may have clinical utility for traumatic amputations, limb salvage, and free flap cases. In particular, it may extend current limitations of ischemia time and reduce the incidence of ischemia reperfusion injury in proximal amputation, thus expanding the current indications for proximal limb replantation. It is clear that developing a multi-disciplinary limb salvage team with standardized treatment protocols is paramount to optimize patient outcomes and allows limb salvage to be pursued in increasingly complex cases.
Failure to Plan: The Disease That Cost an American Empire
Authors: Turner Matthew D , Sapp Jason 
Published: May 2023

Abstract
In 1802, the deadliest recorded epidemic of yellow fever struck a French expeditionary force, permanently destroying Napoleon Bonaparte’s ambition to re-conquer Haiti and secure a North American empire. Toussaint L’Ouverture, Haitian revolutionary, effectively used his medical experience to spread this disease among French troops.